Hospital in-reach family-centred social prescribing pilot for children with neurodisability: mixed methods evaluation with social return on investment analysis

Background Social prescribing (SP) link workers (LWs) support individuals to engage with community resources, co-creating achievable goals. Most schemes are community-based, targetting adults. Vulnerable populations including hospitalized children with neurodisability and their families, could also benefit from SP. Aims To pilot a hospital-initiated SP service for children with neurodisability and their families; to explore its feasibility, acceptability and undertake social return on investment (SROI) analysis. Methods Mixed-methods cohort study with SROI analysis. We recruited children aged < 16y with neurodisability, identified during inpatient stays, their parents/carers and siblings. Participants received LW support for 6 months, extending beyond hospital discharge. Pre- and post-intervention pilot data covered profile of needs (Support Star), quality of life (EQ5D/CHU-9D), wellbeing (WEMWBS/CORS) and financial strain. We undertook 22 qualitative observations of family/LW interactions and 39 in-depth interviews with families, LWs, and healthcare professionals (HCPs). Together these data were analysed within a SROI to establish the costs and social value generated. Results Of 48 families supported by the service, 25 were recruited to the evaluation (26 children, aged 10m-15y; 4 siblings; 36 parents). Baseline quality of life and wellbeing indices averaged below population norms. LWs were highly effective at supporting families (only 6/151 goals unmet). Unmet need decreased by 6 months (Support Star, p < 0.001). Trial registration ISRCTN 42100