Social Prescribing in Specialist Weight Management Clinics for Children and Young People

Complications of Excess Weight (CEW) clinics are Tier 3, specialist weight management services for children and young people living with severe obesity and related health complications. Social prescribing involves connecting individuals to community services for additional, non-medical support. Social prescribing may be helpful for young people accessing CEW but has not yet been formally used or evaluated with this population. This study used a realist approach to explore how, in what ways and under what circumstances social prescribing may (or may not) work in CEW clinics to support the health and wellbeing of young people living with severe obesity. Initial programme theories were developed over three stages, 1) mapping of community services local to one CEW clinic, 2) a national survey of CEW professionals, and 3) a realist review of relevant literature. These theories were then refined through interviews with young people accessing CEW and their parents/carers, staff from a CEW multidisciplinary team and representatives from community services. Recommendations for policy and practice were developed, drawing on the findings and subsequent discussions with key stakeholders. This thesis shows that social prescribing can provide holistic, person-centred care, which empowers families, and helps to meet their wider, non-medical needs. Social prescribing can help to build trust between families and the CEW service, increasing engagement with the service and wider community support. However, challenges were identified in finding community activities which were accessible for young people living with obesity. This study has developed theory to explain how social prescribing could work in weight management services like CEW clinics. This extends current understanding of social prescribing to a new population and clinical treatment pathway. Recommendations include embedding a social prescribing approach into CEW delivery and investing in community services to increase the availability of accessible opportunities for young people with complex health needs.