Does social prescribing provide value for money?
New data from Involve Kent, a major voluntary sector provider, suggests that social prescribing can not only improve wellbeing but do so at a level of cost-effectiveness rarely seen in similar NHS interventions.
Involve's service employs link workers, who provide personalised support and connect people to community-based activities, groups and services.
The new research estimates the value of this service based on two Treasury-approved measures: Quality-Adjusted Life Years (QALY) and Wellbeing-Adjusted Life Years (WELLBYs).
Quality-Adjusted Life Years
A QALY (Quality-Adjusted Life Year) is the standard unit the NHS uses to measure the value of health interventions. One QALY represents one year lived in perfect health.
The cost per QALY represents how much it costs to generate a year of healthy life. The lower the number, the more efficiently a service creates health for the money spent.
The study focused on findings from more than 6,000 patients, who were asked a simple question before and after they received social prescribing support: "How good or bad is your health today?"
Changes in this score were used by Involve to estimate QALY gains, using a recognised conversion method.
When combined with delivery costs the model produced a headline average figure of £2,548 per QALY - significantly lower than both the NHS marginal cost of £13,000 per QALY and the NICE willingness to pay threshold of £20,000.
Wellbeing-Adjusted Life Years
A WELLBY (Wellbeing-Adjusted Life Year) is a one-point improvement in life satisfaction on the 0–10 scale, sustained for one person for one year. The lower the cost per WELLBY, the more efficiently a service creates wellbeing for the money spent.
Across more than 6,000 patients, Involve’s service is estimated to have generated wellbeing gains at an indicative cost per WELLBY of £718, well below the indicative NHS marginal health-spending comparator (£2,500).
What this means
Strikingly, in both reports, the strongest results were seen among people with mental health conditions and complex needs.
While the reports acknowledge limitations, the research adds to a rapidly growing evidence base.
NASP’s previous modelling, based on system data related to 42,000 patients, has suggested that social prescribing can lead to a £4 saving for each £1 spent on link worker salaries (excluding wider costs).
Wider academic research has looked at a range of measures, and typically shown a Social Return on Investment of between £3 and £8 for each £1 invested.
And recent research from UCL, focusing on more than 19,000 patients, suggested that social prescribing has a value of £9 for every £1 invested, again based on analysis of WELLBYs.
