Dr Simon Newstead | Professor Carolyn Wallace – The Splossary: Making Social Prescribing Understandable for Everyone

Health and wellbeing is not only determined by the level of medical care received but can be affected by a range of environmental, economic, and social factors. Social prescribing aims to address these needs, using a holistic approach that helps empower individuals to be in control of their own health and wellbeing. Professor Carolyn Wallace and Dr Simon Newstead from the Wales School for Social Prescribing Research (WSSPR) at the University of South Wales, partnered with Public Health Wales (PHW) to develop a glossary of terms for social prescribing to clarify and standardise the associated terminology.

The Problem with Social Prescribing

Social prescribing, often called ‘community connection’ or ‘community referral’, describes a person-centred approach to connecting people to local community assets. It can help empower individuals to recognise their own needs, strengths, and personal assets and to connect with their own communities for support with their personal health and wellbeing.

Generally, there is a social prescribing practitioner, such as a ‘link worker’ or ’community navigator’ who helps people access various groups, services and interventions, which are usually provided by community and voluntary sector organisations. Examples include welfare support, exercise and sport, gardening, creative activities, and befriending groups.

Social prescribing may provide a continuum of support, play a preventative role, or form part of a ‘step-down’ model of support. Despite using the term ‘prescribing’, the Welsh model of social prescribing moves away from a medicalised approach, instead adopting a ‘no wrong door’ approach where the sources of referral are cross-sectoral.

Social prescribing and support in the community form part of the National Health Service Long Term Plan to personalise care for the UK population and reduce health inequalities in communities. Social prescribing has grown and developed in recent years, leading to a diverse and confusing terminology that impairs effective communication and creates barriers to engagement. To help address these issues, Professor Carolyn Wallace and Dr Simon Newstead from the Wales School for Social Prescribing Research (WSSPR), based at the University of South Wales, began research to develop a glossary of terms relating to social prescribing to clarify and standardise the terminology, later partnering with Public Health Wales to complete the development of the glossary.

The Wales School for Social Prescribing Research (WSSPR)

WSSPR is led by a team of researchers at the University of South Wales in partnership with the Wales Council for Voluntary Action, which is the membership body for voluntary organisations in Wales. WSSPR aims to improve the health and wellbeing of society through meaningful and robust social prescribing research and evaluation. Research is conducted across multiple sectors and disciplines, linking with the United Nations Sustainable Development Goals, which are global aims to end poverty, protect the planet, and ensure peace and prosperity for all. Through its work, WSSPR increases the pool of robust evidence for social prescribing not only in Wales but internationally.

WSSPR utilises a translational research model, which uses knowledge gained from research in practical applications to boost health and wellbeing. It also ensures their work has a high impact in the real world, in practice, policies, and education. WSSPR has five main objectives: to cultivate a high-quality, multi-phase programme of research to develop an evaluation methodology for social prescribing, to increase research awareness and capacity for social prescribing across sectors, to translate research findings into practice, policy and education, to build research capacity within WSSPR, and lastly, to link researchers, social prescribing practitioners and services, and policymakers on research subjects of mutual benefit.

Identifying the Terminology

WSSPR is committed to standardising and clarifying social prescribing terminology to remove barriers to engagement and communication between professionals and with the public. To this end, Dr Newstead and Professor Wallace have worked to develop a glossary of terms for social prescribing.

The first step of their process was to carry out a scoping review in order to identify all the social prescribing-related terminology used in peer-reviewed literature and studies in the UK and also grey literature in Wales. Grey literature includes research, papers, and reports produced by organisations which sit outside of the traditional academic channels. In this study, Welsh social prescribing literature from the Welsh Government, Welsh Local Authorities, and third sector and university websites were identified using Google and recommendations from the WSSPR network and social prescribing professionals. The peer-reviewed literature was found using a thorough search of 11 electronic databases using a list of 49 search terms that had been identified as relevant to social prescribing.

Dr Newstead and Professor Wallace found thousands of documents, and they screened the titles and abstracts (the short summary of a study) of 46,182 papers and the full text of 738 documents. After multiple steps in the scoping process were completed to determine the eligibility of the documents, the team eventually was able to chart data from a total of 205 documents (163 peer-reviewed and 42 grey literature documents).

Speaking the Same Language?

Professor Wallace and Dr Newstead identified 373 terms in their scoping review, highlighting the breadth and diversity of the terminology linked to social prescribing. They found that there were shared commonalities and clear distinctions between the terminology found in the peer-reviewed literature and grey literature. Their report also noted that most of the terms came from articles that examined research and interventions in England, which were written from a health or health and social care perspective. They concluded that nation- and sector-specific terms might not be suitably represented generally in the literature.

Moving forward, the team highlights the importance of ensuring that the social prescribing terminology used in the UK literature is culturally relevant and offers an accurate reflection of the terms used by the workforce who deliver social prescribing.

S Newstead, et al., A Glossary of terms for Social Prescribing in Wales. Public Health Wales, Wales School for Social
Prescribing Research (WSSPR), 2023.

Group Concept Mapping and Consultation

To ensure that the research captured terminology used by the social prescribing workforce in Wales, in addition to their scoping review, the team conducted a group concept mapping (GCM) study, recruiting social prescribing professionals in Wales to help complete the GCM tasks. This mixed-methods approach combines qualitative data collection with quantitative analysis processes. The first task was a brainstorming activity to create a list of social prescribing terms, in which 49 terms were identified. The latter tasks, conducted during an online follow-up workshop, involved the core social prescribing terms (see below) being rated and sorted into groups, which provided information on the relationship between terms and an understanding of the relative importance of terms.

Following the brainstorming task, the team collated the terms from the scoping review and brainstorming task, removed duplicate terms and submitted the list for consultation to members of the WSSPR Steering Group, Social Prescribing Coordinating Group, and social prescribing professionals in Wales. This process identified additional terms, providing a final list of 426 terms, which were then divided into core (192) and non-core terms (234). Dr Newstead and Professor Wallace explain that ‘core terms’ refer to those that specifically relate to and/or describe an essential part of the social prescribing process. ‘Non-core terms’ are those associated with social prescribing but do not relate to or describe an essential part of the process.

The Glossary

Focusing on the 192 core terms, the team (with numerous rounds of consultation) developed the glossary. They were able to refine the 192 core terms into a usable list of 36 terms. This was because many of the core terms described the same few aspects of social prescribing or were most effectively situated within the description of one of these 36 terms. Within the user-friendly document, the terms are easily navigated through various sections, such as the social prescribing pathway flowchart or navigation table. The original professional-facing version of the glossary also contains an A–Z list of all terms. The terms are clearly highlighted using bold black text, and alternative and connected terms are linked below the descriptions for each term.

In addition to the professional-facing version of the glossary, they have an easy-to-read version, created in conjunction with Learning Disabilities Wales. This shorter version contains the 22 terms most likely to be encountered by the people who access and deliver social prescribing. It features shorter descriptions and more accessible language. Both versions are available in Welsh and English.

An example term from the glossary on www.splossary.wales

The Website: www.splossary.wales

To maximise the usability and accessibility of the glossary, Professor Wallace and Dr Newstead (in conjunction with the Wales Institute for Digital Innovation – WIDI) have created a bilingual (Welsh and English) interactive website which houses both versions of the glossary and can be used by professionals and members of the public. In addition to the information contained within the hard copies of the glossary, the website also has a video about social prescribing and using the splossary, as well as visual depictions of how the terms relate to one another via interactive mind maps.

Upcoming Launch

Professor Wallace and Dr Newstead plan to launch www.splossary.wales in December 2023, in line with the publication of the glossary of terms and the Welsh Government’s National Framework for Social Prescribing. The interactive PDF versions of the original professional-facing glossary and the easy-read glossary will be available for download from here and also via Public Health Wales and the WSSPR website (www.wsspr.wales). The team emphasises that the splossary website is completely free to use, but to help ensure their glossary is kept up to date and relevant and to allow the dissemination of updates and gathering of feedback, they ask users to register in order to gain access. They explain that this will also help them improve the accuracy of the glossary as well as the functions of the website and offer insights into the types of users accessing the information.

WSSPR’s work on the splossary will be an ongoing process, but the team have taken a huge leap in helping social prescribing become more understandable and accessible for a variety of professionals who deliver or encounter social prescribing, and the individuals requiring these vital services for their health and wellbeing.