ESSENCE CASE STUDY
|Author(s): ||Annette Bauera; |
|Institution(s): ||a Care Policy and Evaluation Centre, London School of Economics and Political Science; |
|Production date: ||March 2023|
|Last reviewed: ||March 2023|
|Acknowledgements: ||We are grateful to the ESSENCE project advisory group for their helpful comments on earlier versions of this case summary.|
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Social prescribing has been introduced as a measure to address social problems in a healthcare setting context. It seeks to reduce pressure on GPs who face an increasing demand of people who have social needs.
- In England, social prescribing schemes have been (re-)introduced as a policy tool for reducing pressure on GPs and promoted as a solution for health service-budgeting constrains; they consist of link workers integrated into primary care structures, which support people in managing their health conditions and accessing resources in the community thus addressing the social determinants of health.
- A large number of studies have investigated the impact on health and wellbeing outcomes as well as on healthcare resources; findings suggest that schemes have the potential to change health behaviour and outcomes; they can also enhance people’s self-confidence. However, not everyone accesses or benefits from social prescribing schemes; and those most vulnerable are less likely to benefit.
- There is some evidence to suggest that social prescribing schemes can reduce demand on primary and secondary care service and offset the costs of the intervention.
- Main gaps in evidence include: their relative cost-effectiveness compared to other interventions that seek to address the social determinants of health; how social prescribing schemes need to be designed and implemented in order to achieve good value for money, and which population they should target; the wider community impacts of schemes.
Social prescribing is a way of linking patients in primary care with sources of support within the community. It is being widely promoted and adopted as means of dealing with some of the pressures on general practice and the National Health Service (NHS).1 For example, it is estimated that around 20% of patients consult their general practitioner (GP) for what is primarily a social problem.2 By facilitating access to community resources and encouraging volunteering, social prescribing seeks to address non-medical problems at the individual level, whilst also promoting healthy communities and social capital more widely.
Social prescribing is not a new idea: In England, it has existed, under different names such as community navigators or health champions, for a long time. For example, in 2006, the Department of Health (now Department for Health and Social Care) advocated for the introduction of social prescriptions for those with long-term conditions. Over recent years there has been strong policy support for social prescribing from the Department of Health and Social Care and National Health Service (NHS) England, in particular for social prescribing schemes that target people with long-term conditions, with mental health needs, who are lonely and who have complex social needs. The NHS Five Year Forward Viewgives innovative personalised care approaches like social prescribing a role in addressing funding gaps in the NHS and social care.
Annette Bauer (firstname.lastname@example.org), London School of Economics and Political Science.
- Social Prescribing Network Conference (2016) Report of the annual social prescribing network conference. London: University of Westminster, Wellcome Trust, & College of Medicine.
- Low Commission. (2015) The role of advice services in health outcomes: evidence review and mapping study.
- Bickerdike L, Booth A, Wilson PM, et al (2017), Social prescribing: less rhetoric and more reality. A systematic review of the evidence. BMJ Open 2017;7:e013384. doi: 10.1136/bmjopen-2016-01338.
- University of Westminster. Report of the annual Social Prescribing Network conference. London: University of Westminster, 2016.
- Grant, C., Goodenough, T., Harvey, I. and Hine, C.(2000) A randomized controlled trial and economic evaluation of a referrals facilitator between primary care and the voluntary sector. BMJ , 320, 419–23.
- Grayer, J., Cape J., Orpwood, L., Leibowitz, J, and Buszewics, M. (2008) Facilitating access to voluntary and community services for patients with psychosocial problems: a before-after evaluation, BMC Family Practice, 9(27).
- Dayson, C. and Bashir, N. (2014). The social and economic impact of the Rotherham Social Prescribing Pilot: Main Evaluation Report, Centre for Regional Economic and Social Research (CRESR), Sheffield Hallam University.
- Friedli L, Themessl-Huber M, Butchart M. Evaluation of Dundee equally well sources of support: social prescribing in Maryﬁeld. Evaluation Report Four, 2012.
- ERS Research and Consultancy. Newcastle Social Prescribing Project: final report, 2013.
- Longwill, A, (2014) Independent Evaluation of Hackney Well Family Service, Family Action.
- Kimberlee, R., Ward, R., Jones M. and Powell J. (2014) Proving Our Value: Measuring the economic impact of Wellspring Healthy Living Centre’s Social Prescribing Wellbeing Programme for low level mental health issues encountered by GP services. University of West England.
- Pescheny, J. V. et al. (2019). The impact of social prescribing services on service users: a systematic review of the evidence. European Journal of Public Health.
- Smith, M. and Skivington, K. (2016) Community Links Perspectives of community organizations on the Community Links Workers Programme pilot and on collaborative working with primary health care, Institute for Health and Wellbeing, University of Glasgow.
- Faulkner M. Supporting the psychosocial needs of patients in general practice: the role of a voluntary referral service. Patient Educ Couns 2004;52:41–6.
- Baines A. Rugby Social Prescribing Project ConnectWELL. Harnessing community capacity to improve health and wellbeing Roundberry Projects: Mid-term evaluation report, 2015.
- Husk, K., Blockley, K., Lovell, R., Bethel, A., Lang, I., Byng, R., & Garside, R. (2020). What approaches to social prescribing work, for whom, and in what circumstances? A realist review. Health & social care in the community, 28(2), 309-324.
- South J, Higgins TJ, Woodall J, et al. Can social prescribing provide the missing link? Prim Health Care Res Dev 2008;9: 310–18.
- Woodhall J, South J. The Evaluation of the CHAT Social Prescribing Scheme in Bradford South and West PCT. Centre for Health Promotion Research, 2005.
- Morris, S.L., Gibson, K., Wildman, J.M. et al. Social prescribing during the COVID-19 pandemic: a qualitative study of service providers’ and clients’ experiences. BMC Health Serv Res 22, 258 (2022).
- Bertotti, M., Frostick, C., Findlay, G. Harden, A., Netuveli, G., Renton, A., Carnes, D., Sohanpal, R. Hull, S and Hutt, P (2015) Shine 2014 final report Social Prescribing: integrating GP and Community Assets for Health, Health Foundation.
- Farenden, C., Mitchell, C., Feast, S. and Verdenicci, S. (2015) Community Navigation in Brighton & Hove. Evaluation of a social prescribing pilot, carried out by Impetus.
- Dayson C and Bennett E (2016) Evaluation of the Doncaster Social Prescribing Service. Sheffield Hallam University. Centre for Regional Economic and Social Research Report.
- Maughan, D. L. Patel, A. and Cooke, M. (2015) Primary-care-based social prescribing for mental health: an analysis of financial and environmental sustainability, Primary Health Care Research & Development, doi:10.1017/S1463423615000328.
- Calderón-Larrañaga S, Milner Y, Clinch M, Greenhalgh T, Finer S. Tensions and opportunities in social prescribing. Developing a framework to facilitate its implementation and evaluation in primary care: a realist review. BJGP Open. 2021 Jun 30;5(3):BJGPO.2021.0017. doi: 10.3399/BJGPO.2021.0017. PMID: 33849895; PMCID: PMC8278514.
- Morris, D., Thomas, P., Ridley, J., & Webber, M. P. (2020). Community-Enhanced Social Prescribing: Integrating Community in Policy and Practice. International Journal of Community Well-Being, 5(1), 179-195. https://doi.org/10.1007/s42413-020-00080-9.
- NHS England, (2018). The NHS long term plan. London: NHS England. https://www.england.nhs.uk/long-term-plan/.
- White J, Kinsella K, South J. An evaluation of social prescribing health trainers in south and west Bradford, Yorkshire and Humber Regional Health Trainers Hub / Leeds Metropolitan University, 2010
Other useful references
Polley, M., Bertotti, M., Kimberlee, R, Pilkington, K. Refsum, C. (2017), A review of the evidence assessing impact of social prescribing on healthcare demand and cost implications, University of Westminster.
Dayson C and Damm C (2017) The Rotherham Social Prescribing Service for People with long-term conditions: evaluation update. Sheffield Hallam University. Centre for Regional Economic and Social Research.
Kimberlee, R. (2016) Gloucestershire Clinical Commissioning Group Social Prescribing Service: Evaluation Report, University of the West of England, Bristol.
Palmer, D. Wheeler J, Hendrix, E., Sango, P N, Hatzidimitriadou E. (2017) Social Prescribing in Bexley: pilot evaluation report, Mind in Bexley.
Rempel, E.S., Wilson E.N., Durrant, H. et al. (2017), Preparing the prescription: a review of the aim and measurement of social referral programmes. BMJ Open 2017;7:e017734. doi:10.1136/ bmjopen-2017-017734.
Woodall J, Trigwell J, Bunyan A-M, et al. Understanding the effectiveness and mechanisms of a social prescribing service: a mixed method analysis. BMC Health Serv Res. 2018;18(1):604. doi: 10.1186/s12913-018-3437-7.