What is social prescribing?

Alison developed anorexia in her mid-40s, after experiencing depression and anxiety since moving to London in the 1990s.

“Sometimes I would rather just break a leg because it mends; you heal and you get on with your life, whereas anxiety and depression are always close and a constant battle to be kept in check,” she wrote on the Mind.org blog.

Alison tried a talking therapy called dialectical behaviour therapy (DBT) and found it to be helpful, but managing her mental health was an ongoing process.

In 2019, Alison’s GP suggested that she try social prescribing — where patients are referred to local, non-clinical services that are typically delivered by voluntary and community organisations. These services can be anything from getting financial advice to joining a walking group, to taking a gardening class.

Alison was put in touch with Rhiannon, a link worker, who suggested local services and activities for her to try. Since then, Alison has built up the confidence to open up and be vulnerable, has picked up swimming, and has started to rekindle her love for photography.

It is estimated that around 20% of patients consult their GP for primarily social issues

The positive effect of community and social support on health is not a new idea, but has been practiced through the NHS as social prescribing since roughly the 1990s. Its popularity has grown in recent years — it is estimated that around 20% of patients consult their GP for primarily social issues.¹

By 2020/21, NHS England hopes to have 1,000 more link workers in place, with at least 900,000 people referred through social prescribing by 2023/24. Here, we explain this developing service and what it could mean for healthcare in the UK.

How can social prescribing help?

Social prescribing draws on community-based practitioners to deliver individualised care, depending on a person’s needs. In this instance, the care is delivered through engagement with activities that can best support that person rather than in a clinical setting by a doctor.

As well as preventing or reducing the progression of diseases, social prescribing can be used to address social determinants of health, such as financial difficulty or loneliness. Approaches can differ between populations — for example, in areas where substance abuse is more prevalent, access to support groups might be delivered in tandem with medical solutions.

Alongside anecdotes such as Alison’s, there is some evidence to indicate that social prescribing can be beneficial

Social prescribing may be especially helpful for people who need mental health support, are lonely or isolated, or have complex social needs that affect their wellbeing.

Typically, people are referred to link workers, who will listen to their needs and then connect them to a variety of community groups and organisations based on what they think will best support them. This can include a wide range of non-clinical services, including housing or financial advice; access to volunteering, education, and training; and access to counselling and support groups.

As well as by your GP, you can be referred to a link worker from pharmacies, hospitals, social care services, and even police and job centres. It’s also possible to self-refer by contacting social prescribing services directly, such as the Bromley by Bow Centre, if you think you might benefit.

Does social prescribing work?

Although there is ample evidence that social support has a positive impact on mental health,² evidence supporting social prescribing is limited. Some have noted that this is partly because of how many different types of activities and approaches are included within the practice, making it difficult to compare different programmes, and limited resources in evaluating the outcomes of these activities.

However, alongside anecdotes such as Alison’s shared above, there is some evidence to indicate that social prescribing can be beneficial.

The patients who were referred on had significant improvements in anxiety and improved feelings about general health and quality of life

One randomised controlled trial in Wales gave patients with psychosocial problems access to voluntary organisations, who provided services such as support groups and connected them with charities. The patients who were referred on had significant improvements in anxiety, improved ability to carry out everyday activities, and improved feelings about general health and quality of life.³

Another study, conducted by the University of Bath, collected data from social prescribing activities and found a positive trend towards improved mental health and general wellbeing among participants.⁴

However, other studies have concluded that there wasn’t enough robust data to assess success of the programmes or justify their value for money.⁵

As well as in improving patient outcomes, there is interest in how social prescribing can be used to reduce the burden on GPs. Again, evidence has been mixed — some studies have found that the programmes did not reduce GP workload,⁶ while a report from three focus groups (GPs, practitioners, and service users) found that six in ten people referred to community services had since visited the GP less.⁷

Is social prescribing right for me?

As with any aspect of care, your doctor is best-placed to advise on whether a social prescribing programme may be beneficial. There is no fixed criteria for being referred onto these programmes, but some reasons why people may be referred include money concerns, loneliness, health and fitness issues, addiction, or language barriers.⁸

Not all areas in the UK currently offer access to social prescribing as part of primary care — it’s estimated that 60% of clinical commissioning areas in England are using social prescribing schemes.⁹ But while a dedicated scheme may not be available to you through the NHS, there’s nothing stopping you from reaching out directly to community groups and activities that you’d like to be involved in.

Featured image is of a group of people gardening together, as if part of a community gardening group

Page last updated October 2021