An evaluation of link workers in pain clinics

Background

The Southwest London (SWL) Pain Clinical Network commissioned the Health Innovation Network south London (HIN), to complete an evaluation of the link workers in pain clinics pilot. This report outlines the findings of that evaluation which ran from May 2022 – August 2023. The Personalised Care Team in SWL Integrated Care Board (ICB) funded a link worker to be embedded in the pain teams at St George’s and Epsom and St Helier hospitals, as part of a 12-month pilot. Specifically, these link worker roles were a health and wellbeing coach at St George’s and a social prescriber at Epsom and St Helier.  Both roles were patient-facing and based at the Trusts.

The purpose of the evaluation was to understand the benefits of and ways to improve the link worker role within pain clinics with the view to scaling up across Southwest London. The service evaluation took a mixed methods approach using:

• Service and clinical data collected by staff at the pain clinics,
• Data collected from staff via focus groups and interviews,
• Data was collected from patients via a survey and interviews.

Programme impact on patients

• Across the two sites, a total of 74 patients accepted a referral to a link worker.
• High level of satisfaction was reported by patients who engaged with a link worker.
• Data suggests patients experience a decrease in levels of concern relating to mental, emotional, and physical health, following engagement with a link worker.
• Patients interviewed also reported benefits, such as increased feelings of self-efficacy, positive changes in behaviour, and outlook on life.

Programme impact on staff

• The link worker model of care was regarded as acceptable and feasible amongst staff, who appreciated this additional role in their team.
• However, staff emphasised that the link worker role was an adjunct that provided valuable additional support but did not replace the support offer by existing clinical role, such as psychologists, and physiotherapists.

Recommendations and areas for improvement

• The link worker should be supported to fulfil their role e.g., by providing confidential space to complete sessions with patients and embedding in specialist teams to support supervision and development opportunities.
• Future work should focus on increasing referral rates to link workers.
• The link worker role could be extended to encompass skills associated with both social prescribers and health and wellbeing coaches. The offering could also extend to other conditions.
• Future commissioning should consider embedding the link worker in the Trust rather than funded by ICBs.