This article written by Charlotte Osborn-Forde, NASP's Chief Executive, was first published by GP Online.
We all know that many factors associated with poor health cannot be addressed by doctors and medicine alone. There is no simple, medical fix to complex problems related to debt, housing, loneliness or isolation, which can have such a big knock-on effect on people’s wider health and wellbeing.
The introduction of social prescribing into national health policy in 2019 was an attempt to address this. Social Prescribing Link Workers have time to understand the complexities of people’s lives. They can then connect people to a range of support, based on what matters to each patient, from advice and information to helping people join groups that combat loneliness or promote physical activity.
The theory was that this approach could help to tackle the root causes of poor health and wellbeing. By doing so, it could improve patient health and also help relieve pressure on GPs.
The impact to health service use and costs
So has it worked? In our new report, The Impact of Social Prescribing on Health Service Use and Costs: Examples of local evaluations in practice , we looked at analyses of system data from nine areas to unpick the difference that social prescribing is making.
While the methodologies varied, the overall results suggest that social prescribing can lead to substantial reductions in health service use and costs, particularly among patients who frequently use NHS services.
An evaluation of 1,751 people referred to social prescribing in Tameside and Glossop reported a 42.2% reduction in GP appointments for those patients after 12 months, compared to a 5.6% reduction in a control group, who did not access social prescribing.
In Kent, A&E attendances were reduced by up to 23% among patients who accessed social prescribing, when comparing the six months before and the six months after.
In Sussex, studies compared patient data over two years and found a 25% fall in demand for GP appointments among those supported by social prescribing, compared to 78% rise in those just starting support.
In some cases, the data tells a more complex story, with patients who rarely access NHS services seeing a rise in appointments after social prescribing, while those who use services frequently see significant falls.
Reaching more people
The rise in healthcare usage for some patients may be a good thing. Increasingly, through proactive social prescribing, Link Workers are using data to reach out to people identified as being at risk, and making appropriate referrals into the NHS and beyond.
For example, we hear stories about Link Workers meeting people with respiratory problems who rarely leave their homes and who struggle to access information sent through texts or links to websites. Link Workers can help them navigate the system and attend reviews that would otherwise have been missed. The combination of excellent use of data and human connection can reap huge benefits in the long term.
It is also important to stress that the ultimate aim of social prescribing is not to relieve pressure on the NHS. It is about helping people to stay healthy for longer and live the best lives they can, and it is about building communities. The benefits for the wider NHS are a direct result of this.
Since 2019, more than 3,500 Link Workers have been recruited to work in primary care teams, receiving more than 2.6 million referrals. Numerous studies show the impact of the kinds of activities Link Workers refer people into – often related to physical activity, arts and creativity, nature or advice and information.
Green Social Prescribing programme
There is also now clear evidence for the benefits of the social prescribing approach itself. For example, a recent evaluation of the cross-Government Green Social Prescribing programme showed statistically significant improvements in wellbeing, and reductions in anxiety and depression. It demonstrated that nature-based social prescribing programmes are effective, accessible and cost-effective compared to other interventions available through the NHS.
In other cases, there are serious gaps in the services and opportunities available in communities. Brilliant local projects come to an end because of a lack of funding. Better connections are sometimes needed between the NHS and local initiatives, so that Link Workers are fully confident about the referrals they make.
At the National Academy for Social Prescribing, we aim to look at what works, and then share that with decision-makers, clinicians and link workers. We want to join up the health service with groundbreaking community initiatives – like galvanising the power of football clubs to support men’s mental health. We also look at ways to bring together funding, so that projects that make a difference to people’s health and wellbeing are supported for the long term.
GPs and practice teams are under pressure, and the Government is rightly focusing on prevention and bringing more care into communities. Social prescribing is not a panacea, but it can provide a crucial bridge between the NHS and the voluntary sector. The evidence increasingly suggests that is effective not just for patients but for the wider health system too. That is why it should be a key part of the NHS plan for the next ten years.
