Using the candidacy model to understand service users' experiences of access to social prescribing

Social prescribing is an increasingly well-known international model of healthcare, yet there is little agreement about its role and efficacy. This paper comprises a secondary analysis of findings from service users in a small-scale (n.8) qualitative study in the English Midlands using the approach of candidacy, a comprehensive framework with the potential for achieving a deeper understanding of social prescribing. Participants were accessed through local social prescribing link workers, who were located within general practitioner services. A candidacy approach recognises that the ways in which individuals perceive their health needs are key to understanding how or why they assert a claim to be a candidate for services. The aim of the paper is to add to the voices of lived experience within social prescribing and to explore whether the application of a candidacy framework brings about new insights. The original study on which this paper is based employed a mixed-methods approach in one clinical commissioning group area with a significant rural population. The secondary analysis brought forth three new themes not originally illuminated—accessibility of the service (permeability), financial constraints (appearances) and relationships with social prescribing link workers (adjudications). Recommendations are that communities, and especially rural ones, need to be made more aware of their local social prescribing offers, that social prescribing staff take fuller account of individuals’ contexts and that healthcare staff need to be clear about how services are explained. Further larger-scale research is needed to demonstrate the ways in which candidacy theory can remain relevant within increasingly digitalised and complex health services where the opportunities for face-to-face negotiation are limited.