Co-designing implementation strategies for social prescribing in Lancashire and South Cumbria : a qualitative study with a participatory approach

Rafiei, Sima and Honary, Mahsa and Mezes, Barbara and Flowers, Susan (2025) Co-designing implementation strategies for social prescribing in Lancashire and South Cumbria : a qualitative study with a participatory approach. BMJ Open, 15 (4): e094522. ISSN 2044-6055

Abstract

Objectives: Social Prescribing (SP) programmes hold significant promise, yet there is a critical need to identify the underlying causes of their challenges and develop evidence-based, co-designed solution ideas through a collaborative approach. Design: This study applied a multimethod participatory design using co-design workshops to generate solutions to root problems and a 2-day Citizen Jury (CJ) event to validate these solutions from different perspectives. Participants: Four co-design workshops were conducted with different stakeholders, including experts-by-experience, community providers, SP link workers and other health and social care professionals who were responsible in SP coordination and leadership. Data analysis: Data were analysed using thematic analysis, identifying the root causes across several domains: human resources issues, social determinants of health), intrasectoral and intersectoral collaboration in health planning and service delivery, knowledge and awareness, financing, assessment systems for evaluating SP programme effectiveness, information systems and supportive policies/mechanisms. Results: 11 solutions were proposed, including prioritising a human-centric approach, establishing sustainable funding mechanisms, providing sufficient training and knowledge for staff, fostering co-production and shared vision across sectors, adopting a preventive approach to healthcare, enhancing information system support and encouraging self-referrals. These strategies were proposed and refined during the 2-day CJ event. Conclusions: Using a participatory method enabled a comprehensive understanding of different stakeholders’ perspectives and facilitated the development of co-produced solutions based on the identified challenges. This approach has the potential to assist policymakers in developing realistic policies to enhance social care within integrated care systems.