A qualitative exploration of variations in social prescribing in primary care for people living with dementia in England: Barriers and enablers to positive service experiences

The number of people living with dementia and related costs continue to grow worldwide. Although generally associated with memory difficulties, non-cognitive symptoms of dementia are common and usually stem from unmet needs. Evidence emerging suggests that social prescribing improves the wellbeing of people living with dementia. This study explored adaptations to key elements of social prescribing for people living with dementia, as well as barriers to and enablers of positive experiences among people living with dementia and service providers. The qualitative study engaged people living with dementia (n = 8), carers (n = 9) and service providers (n = 17) involved in social prescribing through primary care. Data were collected through semi-structured interviews, and the essential ingredients of social prescribing schemes comprised the initial organising categories for template analysis. The final template included four integrative themes: unique challenges of dementia; interpretations of the social prescribing role; integration of social prescribing into dementia care; and evaluation, improvement and sustainability. Positive workplace cultures and skills in dementia care and support enabled multidisciplinary collaborations and the successful adaptations of the generic social prescribing model to improve the experiences among people living with dementia and service providers. Resistance to and confusion about the social prescribing link workers’ role, and inappropriate referrals were barriers to positive experiences and bottom-up feedback. Primary care networks’ agreements on core outcomes within proactive systems of dementia care and support may promote meaningful bottom-up feedback on the effectiveness of social prescribing for people living with dementia, guiding service improvements.