Building the economic case for social prescribing

National Academy for Social Prescribing (NASP)

NASP has published 13 evidence publications to date which suggest that social prescribing can reduce costs and pressure in the health care system. Recognising the urgent need to demonstrate the health economic benefits of social prescribing, NASP commissioned a rapid scoping review of 19 studies on the economic impact of social prescribing and 7 studies on the impact of social prescribing on health service usage.

• Social prescribing can save money and findings from studies using 5 different methods show that social prescribing can have a positive economic impact
• Studies suggest that social prescribing schemes can deliver between £2.14 and £8.56 for every £1 invested
• Social prescribing can reduce pressure on the NHS, this includes reduced GP appointments, reduced hospital admissions and reduced A&E visits for people who have been referred to social prescribing
• More research is needed to access better data and demonstrate benefits more clearly

Briefing: Building the economic case for social prescribing

Full report: Building the economic case for social prescribing

Implementation and impact of a social prescribing intervention

British Journal of General Practice 2023; 73 (735): e789-e797. DOI: https://doi.org/10.3399/BJGP.2022.0638

Social prescribing involves referral of patients from primary care to link workers, who work with them to access appropriate local voluntary and community sector services. This paper explores how a social prescribing intervention was delivered by link workers and the experiences of those referred to the intervention.

Social prescribing provided significant help for some people living with long-term health conditions. However, link workers experienced challenges in embedding social prescribing in an established primary care and voluntary sector landscape. The organisations providing social prescribing drew on broader social discourses emphasising personal responsibility for health, which encouraged a drift towards an approach that emphasised empowerment for lifestyle change more than intensive support. Pressures to complete assessments, required for funding, also encouraged a drift to this lighter-touch approach. A focus on individual responsibility was helpful for some clients but had limited capacity to improve the circumstances or health of those living in the most disadvantaged circumstances.

The authors conclude that careful consideration of how social prescribing is implemented within primary care is required if it is to provide the support needed by those living in disadvantaged circumstances.

Full paper: Implementation and impact of a social prescribing intervention: an ethnographic exploration

Implementation and impact of a social prescribing intervention

British Journal of General Practice | July 2023 | DOI: https://doi.org/10.3399/BJGP.2022.0638

This paper explores how a social prescribing intervention was delivered by link workers and the experiences of those referred to the intervention. The study used ethnographic methods to conduct a process evaluation of a social prescribing intervention delivered to support those living with long-term conditions in an economically deprived urban area of the North of England.

The authors discovered that social prescribing provided significant help for some people living with long-term health conditions. However, link workers experienced challenges in embedding social prescribing in an established primary care and voluntary sector landscape. The organisations providing social prescribing drew on broader social discourses emphasising personal responsibility for health, which encouraged a drift towards an approach that emphasised empowerment for lifestyle change more than intensive support. Pressures to complete assessments, required for funding, also encouraged a drift to this lighter-touch approach. A focus on individual responsibility was helpful for some clients but had limited capacity to improve the circumstances or health of those living in the most disadvantaged circumstances.

The study concludes that careful consideration of how social prescribing is implemented within primary care is required if it is to provide the support needed by those living in disadvantaged circumstances.

Full paper: Implementation and impact of a social prescribing intervention: an ethnographic exploration

Green social prescribing: perceptions among clinicians and the public

National research focussing on public and clinical perceptions of green social prescribing | Department of Health and Social Care

Social prescribing is an intervention in which clinicians refer patients to non-medical support in their local community, to improve their health and wellbeing. Green social prescribing (GSP) involves referrals into nature-based interventions and activities that link people to natural environments.

The Department of Health and Social Care commissioned IFF Research to gather robust evidence on perceptions and behaviours related to green social prescribing (GSP). IFF conducted 2 surveys, one with 4,000 patients or potential users of GSP services and one with 501 clinicians. This was followed by some qualitative in-depth interviews to gain further insight into how GSP could be scaled up as an intervention.

Overall, the appetite for (green) social prescribing is high among both clinicians and the public:

• nearly all clinicians would refer patients to social prescribers in the future
• the majority of patients are open to discussing opportunities for mental health support in their local community with a healthcare professional, including spending time in nature.

Full detail: Exploring perceptions of green social prescribing among clinicians and the public

See also:
National green social prescribing delivery capacity assessment: final report | Department of Health and Social Care
[National research into the existing provision of green and nature-based activities and the potential for upscaling such activities].

Social prescribing: Reference guide for primary care networks

NHS England

This guide provides additional information to help PCNs introduce the social prescribing link worker role into their multi-disciplinary teams (MDTs) as part of the expansion of the primary care workforce introduced through the Network Contract Directed Enhanced Service (DES) 22/23 Additional Roles Reimbursement Scheme. It also provides information to deliver the proactive social prescribing element of the Network Contract DES Personalised Care service specification.

Full detail: Social prescribing: Reference guide and technical annex for primary care networks

Social Prescribing Information Standard

Social prescribing supports people to understand their needs and connects them to local community (non-clinical), often voluntary, services which can provide the help they need | Professional Record Standards Body

The Social Prescribing Information Standard will enable the sharing and recording of information for the whole patient journey, from initial referral, throughout the period of social prescribing and the message back to the referrer and GP at its conclusion.

The standard supports the recording and sharing of information including: 

• The information required to support the conversations between the link worker and the person
• Information to support people, show their healthcare is joined up and avoid them having to retell their story multiple times 
• Information that can be shared with the person themselves, their family or carer 
• Summary information back to the referrer and GP for the person’s overall record
• Information for secondary uses, e.g. for understanding the scale and effectiveness of social prescribing services, planning, population health etc.

The standard is UK wide with involvement from all four nations. It was commissioned by NHS England and NHS Improvement and has an important role to play in the English national drive to widen the use of social prescribing to support citizen empowerment and personalised care, as stated in the NHS Long Term Plan.

Full detail: Social Prescribing Information Standard

Workforce development framework: social prescribing link workers

via NHS England

The purpose of the social prescribing link worker (SPLW) workforce development framework is to: 

• Provide clear and consistent standards for SPLW practice, including their knowledge, skills and behaviours 
• Provide guidance on the support, supervision, and learning and development offer required from employers to support SPLWs 
• Promote the development of a strong and capable workforce of SPLWs and their future development
• Support improved quality and consistency of social prescribing and reduced variation in outcome and access standards. 
• Demonstrate the benefits of SPLWs working as part of a multidisciplinary team (MDT).

The framework includes core competencies for the role and links to resources to support employers to recruit and embed SPLWs in services. Organisations employing SPLWs, including primary care networks, can use this framework to support recruitment and retention. It will help them develop a greater understanding of the role, its scope of practice and the training and development SPLWs need to enable them to practice safely and effectively.

Full detail: Workforce development framework: social prescribing link workers

Which non-pharmaceutical primary care interventions improve mental health amongst socioeconomically disadvantaged populations?

Tanner, L.M. et al. | British Journal of General Practice | 22 November 2022 | DOI: https://doi.org/10.3399/BJGP.2022.0343

Common mental health disorders (CMDs) are especially prevalent amongst people from socioeconomically disadvantaged backgrounds. Non-pharmaceutical primary care interventions, such as social prescribing and collaborative care, provide alternatives to pharmaceutical treatments for CMDs. Little is known about the impact of these interventions for socioeconomically disadvantaged patients. the aim of this sytematic review was to synthesise evidence for the effects of non-pharmaceutical primary care interventions on CMDs and associated socioeconomic inequalities.

Thirteen studies were included, with positive results (based on effect direction) reported for the impact of the interventions on wellbeing in socioeconomically deprived groups. Inconsistent (mainly positive) results were reported for anxiety and depression.

The authors conclude that targeting non-pharmaceutical primary care interventions at socioeconomically deprived areas may help to reduce inequalities in mental health outcomes. However, only tentative conclusions can be drawn from the evidence in this review and more robust research is required.

Full paper: Which non-pharmaceutical primary care interventions improve mental health amongst socioeconomically disadvantaged populations? Systematic review.

Walking, wheeling and cycling to be offered on prescription in nationwide trial

Social prescriptions, including walking, wheeling and cycling, will be offered by GPs as part of a new trial to improve mental and physical health and reduce disparities across the country | Department of Health and Social Care

The government has awarded £12.7 million in multi-year funding to 11 local authority areas in England. The funding will go towards several pilot projects in each location, including:

• adult cycle training
• free bike loans
• walking groups

Other schemes include all-ability cycling taster days where people who may not have cycled before can try to in a friendly environment, or walking and cycling mental health groups where people can connect with their communities as they get active. The pilots must be delivered alongside improved infrastructure so people feel safe to cycle and walk.

Full detail: Walking, wheeling and cycling to be offered on prescription in nationwide trial