UCL study of social prescribing
New study provides evidence of the referral routes and reasons for social prescribing, and notes inequalities.
Researchers from University College London (UCL) have published the first comprehensive analysis of ‘social prescribing’ across diverse referral pathways in the UK. Social prescribing (SP) is where a patient is directed to local groups, activities and services that can meet their practical, social and emotional needs and so improve their health and well-being. It’s an increasing component in the provision of universal personalised care.
The new research provides insight into how widely SP is used and the disparities in provision.
Daisy Fancourt, Professor of Psychobiology & Epidemiology and Head of the Social Biobehavioural Research Group at UCL, and lead author of the new study.
It’s based on a study of data provided by digital social prescribing platform Access Elemental, covering 201,037 SP cases involving 169,818 individuals between January 2017 and November 2022, the majority (88%) between 2020 and 2022 in the UK following the formal launch of the SP scheme as part of the NHS England Long-Term Plan. While the data was, of course, anonymised, it included a range of core demographic information such as age, gender, ethnicity and – for 94.3% of the individuals – a valid postcode.
One key finding from studying this data is that the vast majority of social prescribing referrals came via medical routes: 85.3% in England, 84.8% in Scotland and 72.3% in Wales. Yet there’s a notable difference between these high figures and the 22.8% in Northern Ireland, a disparity that authors speculate may be down to ‘a high missing rate.’
Wales and Northern Ireland saw higher referrals for children and young people under the age of 18, as well as for individuals from deprived backgrounds.
- Read the full study, Equal, equitable or exacerbating inequalities? Patterns and predictors of social prescribing referrals in 160,128 UK patients
The most common reason for referral was mental health and well-being (33.5%), showing the relevance of SP to psychiatrists and mental health professionals. This was followed by practical support (26.1%), social relationship (22.5%), physical health (16.4%) and employment or education/skills (10.3%).
The research also shows the equitable reach of SP to diverse socio-demographic groups, particularly those from deprived areas, younger adults, men and ethnic minority groups.
The study also breaks down what happens once a referral is made, providing figures for contacts with link workers and interventions. While some 90% of referrals led to contact with a link worker, only 38% resulted in any intervention. As the authors say, this suggests a shortage in community activities and resources, especially related to mental health, practical support and social relationships.
Scotland and Northern Ireland exhibited higher rates of interventions.
In conclusion, the authors suggest that non-medical referral routes could play a crucial role in promoting fair and impartial access to social prescribing services. Increased financial and infrastructural resources, and strategic planning, will also be needed to address low intervention rates and ensure more effective delivery.
The Access Elemental platform is currently used by more than 20m people across the UK, involving more than 37,500 health and care professionals as well as more than 4,400 social prescribers. Indeed, it is the most widely adopted social prescribing platform in the UK, recording some 2.1m contacts between patients and social prescribing link workers, with over 438,000 referrals to community-based programmes, services and interventions.
Prof Daisy Fancourt, lead author of the study, says: ‘There have been concerns that social prescribing is being given largely to people who are healthier and more affluent. But most previous studies have focused on small-scale local evaluation data or limited types of referrals like just those from GP practices. Our study takes the first broad view of all types of referral pathways, including through primary care, social care, education, charities and self-referrals and shows a much more positive picture. Individuals living in deprived areas, younger adults, men, and ethnic minority groups are accessing the service predominantly via non-medical routes, showing the importance not just in investing in GP referrals but also in other diverse ways of referring these individuals to the community resources they could benefit from.’
Dr. Feifei Bu, co-author of the study, adds: ‘Addressing healthcare inequality is crucial and requires innovative approaches, with social prescribing standing out as a vital tool in this effort. Our research underscores that when effectively implemented, social prescribing can bridge gaps in traditional healthcare systems and reach those who are often left behind.’
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