With the NHS under intense pressure, it can be difficult for commissioners and managers to find resources to invest in preventative services like social prescribing.
While there are a range of studies showing how social prescribing generates cost savings, these are often small-scale or specific – and there is a clear need for better data.
That is why we are working with Jag Mundra, a data analyst and health economist, to review evidence and summarise findings, so that it is as easy as possible for decision-makers to understand the economics of social prescribing and have confidence to invest their limited resources in services that make a real difference.
Creating a model
We have developed a simple, transparent model to estimate the NHS return on investment for social prescribing, focusing on patients who have had contact with the healthcare system. This is based on 19 major UK studies (9 studies published in reputable journals and 10 service evaluations) reporting on healthcare use, covering over 42,000 patients. Studies were weighted by sample size and quality.
The provisional model estimates a potential average NHS benefit of £418 per patient per year, largely driven by reductions in hospital activity: £199 from avoided non-elective admissions, £39 outpatient care, £34 A&E, and £38 elective admissions. GP and primary care savings total £108.
This represents a potential average return of investment of around £4 for every £1 spent on link worker salaries. (It does not factor in the costs of activities and support that people are ‘prescribed’, which are usually provided by voluntary or statutory organisations.)
These savings may often be workload-reducing rather than cashable. For example, reduced GP contacts may not yield financial savings under block contracts, but they create clinical headroom - shorter waits, more time for complex care, and improved staff wellbeing - all of which are vital for safe and sustainable services.
The model includes 15 studies involving general patients and four studies focused on high-intensity users. The studies focusing on high-intensity users increase the average benefit. Excluding these, the benefit drops to £201 per patient/year - still significant for a general population cohort.
The model deliberately focuses on 12-month NHS impact only, either bankable or workload-reducing, and excludes potential long-term health benefits, wellbeing gains, and cross-sector impacts (e.g. to the Department for Work and Pensions or social care).
We know that there are risks around combining studies that have used different methodologies. This model is not presented as a definitive answer, but as a clear and challengeable summary of the current evidence.
It is also important to note that in some cases social prescribing may increase short-term healthcare use, if a link worker proactively supports someone to engage (for example, if they are living with a long-term condition but have stopped attending appropriate check-ups). While this may lead to short-term additional appointments, it is likely to save costs in the longer term.
Our model is being reviewed by a range of leading academic partners and has already been reviewed by several Integrated Care Boards as part of their investment cases for social prescribing and integrated neighbourhood teams. It is intended to open up clearer conversations about value, starting from what’s already known and allowing users to adjust or refine assumptions as needed.
Exploring specific interventions
We are developing companion models to explore specific interventions (e.g. physical activity, group support) and are working with several pilot sites to test simplified evaluation approaches using real-world data. Feedback from academic and system stakeholders will continue to shape and refine the model. This is a live resource that will evolve over time, and we actively welcome scrutiny to improve its utility, transparency and accuracy.
Tracking GP appointments
Alongside the Return on Investment model, we have worked with Joy, the social prescribing software provider, to access reports on their data demonstrating the impact of social prescribing.
Joy has provided headline reports from 176,000 referrals from social prescribing services to local community support services and activities. These show both the volume of referrals to different types of activity and sector, and the relationship to reduced GP appointments, which the Joy system is able to track.
This data shows a reduction in GP appointments in the three months after referral, compared with the three months before referral. There are limitations to the data, and we are continuing to analyse it, but it is a helpful contribution to the existing research.
Looking ahead
Alongside the existing body of evidence, including academic research, this data and analysis is helping us to build a more comprehensive picture of the impact of social prescribing on the NHS. We hope that it will help demonstrate the potential for increased funding and investment.
If you would like to find out more about our models, or to develop a model for your own social prescribing service, please contact Jag Mundra: [email protected]
