Evidence for Social Prescribing - Does it really work?

If you're wondering what is social prescribing, it's a collaborative scheme to help individuals improve their health and wellbeing. It uses a Social Prescribing Link Worker to refer the individuals to services or interventions to help them resolve the issues and problems they are experiencing.  

Social prescribing addresses the wider social determinants of health anyone at any time could be suffering from. Some examples include: education, housing, and economic stability to name a few.

The increase of using social prescribing schemes have seen great achievements across the country. But it is clear this collaborative approach isn’t always known as social prescribing, other communities may refer to it differently. What is crucial is that all versions will work towards the shared goal of improving health and wellbeing regardless of the social determinant they are tackling. With the demand increasing and popularity growing it is vital to know what evidence there is for the approach and whether it is worth it.

With social prescribing services and interventions gaining more and more popularity across the UK and Ireland there is a lot of discussion on whether it really works.

Originally operating in more socio-economically deprived areas. There are often myths and common misconceptions relating to social prescribing.

It tends to be believed that social prescribing is only available within the healthcare sector and it is more typically for older people.

But, social prescribing expands further than that by addressing a wider range of issues and being open to people of all ages across a variety of sectors. 

At Access Elemental Social Prescribing we show how that can happen. We have customers across a variety of industries including in education, housing, and in prison care. Our digital social prescribing platform helps bridge the gaps between health, housing, community and voluntary groups within a local authority to help improve your community's health and wellbeing. 

One of our customers, Besti Cadwaladar University Health Board, for example, won the North Wales Police and Crime Commissioner Award for Early Intervention and Resilience Building since they started their social prescribing programme. They work hard to ensure both their students and lecturers get the support they need when they need it to improve their mental health and wellbeing, and address and overcome any of the social determinants of health they may be suffering with.

For more information in how the social prescribing model can be adopted in universities download our social prescribing in universities guide today. 

Each social prescribing project ultimately is working towards the same shared goal, however they may use a different approach. In order to measure the successes of these projects there are a variety of ways they can be assessed both qualitatively (concentrating on the user experience and what it means to them) and quantitatively (assessing numbers and statistics from the scheme).  

It's important to find the best methods of measuring social prescribing that fit your goals and needs in your local community. Below are some examples of how the outcomes of social prescribing in your local area could be measured.

Social Prescribing evidence – examples of qualitative data

• Surveys and questionnaires 
• Interviews 
• Focus groups  

Social Prescribing evidence – examples of quantitative data 

• GP attendance rates  
• Unscheduled care attendance – including A and E attendance, acute care and minor injuries  
• Number of prescriptions  
• NHS resources used  

Over the last decade studies have used qualitative and quantitative data methods to evaluate the successes of social prescribing in their own right. However there have been limitations to the data, only using qualitative data can be seen as biased and only using quantitative data can mean very little in context when evaluating whether social prescribing actually benefits individuals’ health and wellbeing.

Currently, the best approach is to use both methods to see if data from patients’ surveys match up with their attendance in NHS services.  

At Access Elemental Social Prescribing to track and monitor individuals social prescribing journeys we do both. In this year alone we have received 135,820 referrals across a wide range of sectors and we have seen 88% of people in Scotland experience a positive change in their mental health or wellbeing.

We are always proud of our achievements and how we can help our customers progress that we have rounded up some of our best achievements of the last year to show how we have helped social prescribing services across the UK and Ireland. 

With the popularity of social prescribing increasing and increasing rapidly, there is more and more evidence evaluating the effectiveness of it. For example, Social Prescribing Link Workers can offer more extensive approaches to individuals which are not possible in routine care. Evidence also shows that there has been a positive array of outcomes including: 

• Decreasing loneliness to improve mental health in social connections and overall wellbeing
• Constant improvement in quantitative studies such as: blood pressure, weight loss and reduced cholesterol 
• More engagement in making the correct connections between health and lifestyle choices 
• Constant improvement in qualitative studies such as: improved self-esteem, value, confidence and worthiness
• Increased and improved social interactions
• Improved overall day-to-day activities from employment to home life

Over the last decade an abundance of studies have taken place to evaluate the effectiveness of social prescribing.  

A study investigating the effectiveness of social prescribing to identify the reliability of previous results collected has been conducted. 29 studies were examined in total and a variety of findings were discovered including:

• 41% of the studies involved co-produced personalized plans with a Link Worker and patient and combined both quantitative and qualitative measures to assess their outlines.
• The majority of the time wellbeing scores increased after participating in social prescribing, and for the minority that didn’t they had other external factors to contend with e.g. a limitation of services they could attend due to working full time.
• It showed as a result of social prescribing there was a reduction of hospital resources. 
• Attendance of emergency care was also lower after patients participated in social prescribing. 

However, what was clear is that evidence can be subjective and also hard to record, measure, and assess if there is equally too little or too much data. Most of the time there is a lot of evidence readily available to compare when a pilot stage of a social prescribing has started, however post that evidence is not always readily accessible.  

Due to these implications some data, particularly surrounding GP attendance, has been contradictory. Panagioti and colleagues study on emergency care and GP attendance found emergency care attendance was lower but planned services including GP attendance was higher. Other schemes involving our customers, such as Age UK Barnet have seen a decrease of 59.4% in GP attendance after patients have attended social prescribing projects. It is clear from studies that have been conducted and reviewed over the last decade more work needs to be done on how to manage data. 

Social Return on Investment (SROI) is a method of cost-benefit analysis that assigns monetary values to outcomes often overlooked in traditional financial accounts, such as social, environmental, and economic impacts. This approach helps to determine the broader social value of projects or interventions, giving a voice to those typically excluded from market decisions.

Several studies have highlighted the significant SROI of social prescribing schemes. For instance, a national scheme serving 2,250 individuals at risk of loneliness reported an SROI of £3.42 for every £1 invested. The PrAISED (Promoting Activity, Independence, and Stability in Early Dementia) feasibility study found SROI ratios ranging from £3.46 to £5.94 for every £1 invested, using a control group to ensure accuracy.

These studies reveal the impressive effectiveness of social prescribing in generating significant social and economic benefits. This highlights its value as a holistic intervention approach. By measuring the positive impacts on individuals and communities, SROI offers a powerful case for continued investment and expansion of social prescribing programs.

There are three main reasons why there are difficulties in generating social prescribing evidence: 

1. Methodological issues– There can often be confusion about what constitutes social prescribing making evaluations difficult to manage, compare, and assess with others similar in their nature. 
   
   
2. Making generalised claims about social prescribing as a whole can be limited– Often with social prescribing projects it is very subjective not just where the scheme is located but who the specific scheme is aimed for. Due to these factors designing evidence that is useful outside that particular area can be increasingly difficult to create baselines of achievements. 
   
   
3. Practical challenges– As well as managing the collaborative relationships between patients and their link workers, consenting and gathering information can be extremely hard to navigate.