There is a sustained increase in demand for emergency and urgent care services in England. The NHS Long Term Plan aims to reduce the burden on emergency hospital services through changing how pre‐hospital care operates, including increased delivery of urgent care. Given the recognised potential of social prescribing to address wider determinants of health and reduce costs in other settings, this study aimed to understand the role that social prescribing can play in pre‐hospital emergency and urgent care from the perspectives of staff. Semi‐structured interviews (n = 15) and a focus group (n = 3) were conducted with clinical staff (n = 14) and non‐clinical health advisors (n = 4) from an English Ambulance Service covering emergency (999) and non‐emergency (111) calls. Data were analysed using a pre‐defined framework: awareness of social prescribing; potential cohorts suitable for social prescribing; and determinants of social prescribing. Awareness and knowledge of social prescribing was limited, though when social prescribing was explained to participants they almost universally recognised its benefits for their role. Social prescribing was considered to be most beneficial to those calling for reasons relating to mental health, loneliness or social isolation, in particular older people and frequent users of 999 and 111 services. Determinants of social prescribing were identified across the micro (patient and staff acceptability of social prescribing), meso (triage and referral pathways) and macro (commissioning and funding) levels of analysis. This is the first empirical study to explore social prescribing in pre‐hospital emergency and urgent care services, which suggests that it has potential to improve quality of care at the point of people accessing these services. There is a pressing need to address the micro, macro and meso level determinants identified within this study, in order to support staff within pre‐hospital emergency and urgent care services to socially prescribe.

中文翻译：

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探索院前急救和紧急护理中社会处方的潜力：一项定性研究

英格兰对急诊和紧急护理服务的需求持续增长。NHS 长期计划旨在通过改变院前护理的运作方式（包括增加紧急护理的提供）来减轻医院急诊服务的负担。鉴于社会处方在解决更广泛的健康决定因素和降低其他环境中的成本方面的公认潜力，本研究旨在从工作人员的角度了解社会处方在院前急救和紧急护理中可以发挥的作用。半结构式访谈 ( n  = 15) 和焦点小组 ( n  = 3) 与临床工作人员 ( n  = 14) 和非临床健康顾问 ( n = 4) 来自英国救护车服务，涵盖紧急 (999) 和非紧急 (111) 呼叫。使用预先定义的框架分析数据：社会处方意识；适合社会处方的潜在人群；和社会处方的决定因素。社会处方的意识和知识是有限的，尽管当向参与者解释社会处方时，他们几乎普遍承认其对他们的作用的好处。社会处方被认为最有利于那些因心理健康、孤独或社会孤立而打电话的人，尤其是老年人和 999 和 111 服务的频繁使用者。社会处方的决定因素在微观（患者和工作人员对社会处方的可接受性）中被确定，中观（分类和转诊途径）和宏观（委托和资助）水平的分析。这是第一项探索院前急诊和紧急护理服务中的社会处方的实证研究，这表明它有可能提高人们获得这些服务时的护理质量。迫切需要解决本研究中确定的微观、宏观和中观层面的决定因素，以支持院前急诊和紧急护理服务的工作人员进行社会处方。