NASP’s Joelle Bradly looks at what research tells us about the role of social prescribing in managing long-term conditions.
There is strong evidence to show the benefits of social prescribing for wellbeing, mental health and social connection for people in general. The evidence base for people living with long-term conditions specifically is growing – with evaluations of targeted projects often showing promising results.
Academic research is catching up with practice on the ground, but demonstrates the impact of a range of programmes.
A 2024 systematic review and meta-analysis looked at social prescribing initiatives designed to target long-term conditions in adults, focusing on 12 studies. Social prescribing interventions designed for specific long-term conditions (e.g. cancer and diabetes) demonstrated significant improvements in quality of life and disease-specific psychological outcomes respectively. There was some evidence for improvement in physical activity.
A separate rapid review of opportunities and challenges in the implementation for chronic social prescribing for people living with long-term conditions highlighted the power of strong relationships between Social Prescribing Link Workers and patients, and the benefits of taking a holistic approach. However, it also highlighted a range of challenges to overcome – including around awareness, coordination and training.
Social prescribing and diabetes
There have been a number of studies on the impacts of social prescribing on those with, or as risk of, diabetes. A study in Tower Hamlets showed that people at high risk of Type 2 diabetes were four times more likely to be referred into social prescribing than the general population – and suggested that social prescribing could provide longer-term and more personalised support than other approaches.
Other research evaluated the impact of social prescribing on health and healthcare costs for patients with Type 2 diabetes in North-East England. Small improvements in glycaemic control were recorded, compared to control groups.
CoDES (Community Diabetes Education and Support) was established in 2018 as a pilot project to integrate Type 2 diabetes care between primary, secondary and community services in Central Manchester. Within the service, there was a strong emphasis on links to social prescribing initiatives and wider community support. Research concluded that CoDES succeeded in promoting holistic support for diabetes management, and that there was the potential for a reduction in spend on microvacsular complications.
Supporting people living with lung conditions
Social prescribing can also be used to support patients with lung conditions, informed by evidence relating to broader benefits of social prescribing activities. One academic review suggests that the use of music and dance to support patients with chronic respiratory disease is associated with improvement in exercise capacity, health-related quality of life and respiratory muscle function. The evaluation of the ENO Breathe programme showed reduced breathlessness and improvements in mental health for participants living with Long Covid, compared to a control group.
Supporting people living with dementia: the power of music
There is a range of evidence for the role of music and arts more generally in supporting people living with dementia. Studies suggest that music-based support can reduce agitation and the need for medication, and potentially save costs for the NHS.
In order to build on this, we have worked with Manchester Camerata and a range of partners to establish a Centre of Excellence for Music and Dementia in Manchester. Through the centre, the University of Manchester and NHS Manchester will analyse anonymised data to explore the impact of music sessions on people living with dementia. The research will also look at how these can reduce pressure on frontline NHS and social care services, supporting the case for social prescribing for people with dementia.
Strengthening and sharing the evidence
There are many more examples of community-based projects supporting people with health conditions through physical activity, arts, culture, heritage, and nature – many of which would benefit from closer integration with the health system.
There is good evidence, for example, about the role of physical activity in preventing and supporting people with a wide range of health conditions – so much so that the previous Chief Medical Officer referred to it as the equivalent of a “miracle cure”. Projects that help people become more active in a way that works for them can have huge benefits, for instance, for people living with cancer. However, we need to keep improving the evidence about the role of social prescribing in making these connections.
There are also clear correlations between social deprivation and the incidence and outcomes of many long-term conditions – and social prescribing could play a role in tackling health inequalities. But we need ongoing research to build a clearer picture of the most effective approaches to both prevention and managing long-term health conditions.
At the National Academy for Social Prescribing, there are four main areas that we are prioritising in relation to long-term conditions and social prescribing:
- strengthening and sharing the evidence
- understanding and sharing good practice and learning
- supporting Integrated Care Systems
- raising awareness.
Over the coming weeks, we will publish a series of case studies about programmes across the country, which will help to create a clearer picture of the benefits and challenges of different approaches.
If you have good evidence for a particular programme, we would love to hear about your work.
If you would like to contribute a case study or share evidence, please contact us at [email protected]
Resources
Further resources and case studies on social prescribing and long-term conditions
