Social prescribing boosts health checks without raising costs

Patients referred to social prescribing are more likely to seek health care in the short term but could end up needing their primary care physician less often within a year, according to a new study by University of Manchester researchers published in eClinicalMedicine.

Researchers analyzing the records of more than 1.4 million people found that social prescribing—where patients are referred to support such as community groups, exercise programs or financial advice—was linked to an early rise in health care use, followed by a small drop in primary care physician appointments.

Social prescribing became a key part of NHS plans in 2019, with thousands of link workers recruited across England to connect patients with community support.

It has become a central part of NHS efforts to address the wider social factors that influence health, including loneliness, housing problems, debt and inactivity.

Despite the program’s rapid expansion, until now there has been little robust evidence showing whether social prescribing affects NHS demand, health care use or costs.

The findings come from one of the largest studies of its kind, using anonymized NHS records from the Clinical Practice Research Datalink (CPRD), covering around a quarter of England’s population.

The research team compared 168,699 patients referred to social prescribing between July 2019 and April 2022 with more than 1.3 million similar patients who were not referred.

In the first six months after referral, patients receiving social prescribing had an average of 2.25 more contacts with health care services than those who were not referred—a rise of around 24%. The increase was largely driven by more visits to primary care services and attendance at planned outpatient appointments in hospitals.

This, they say, may reflect patients becoming more proactive about managing their health and seeking help for conditions that might previously have gone untreated. But by one year after referral, the picture had changed.

The increase in health care contacts had fallen substantially, and patients referred to social prescribing were attending slightly fewer primary care physician appointments than those who had not been referred. Despite the higher number of health care interactions, the overall cost to the NHS was virtually unchanged.

The study found health care costs were less than 0.1% higher among referred patients, a difference researchers described as clinically insignificant. The small increase in spending was mainly linked to additional secondary care admissions.

Lead author Dr. Anna Wilding from The University of Manchester said, “Our findings suggest that social prescribing may encourage people to engage with health care services in the short term, particularly with planned and preventive care.

“Importantly, we found that this increase did not translate into meaningful increases in overall health care costs, and by one year patients were having slightly fewer primary care physician appointments.

“This could indicate that social prescribing helps direct people toward more appropriate forms of support while reducing pressure on primary care.

“Better integration between social prescribing data systems and electronic health records will be needed to understand whether patients who fully engage with these services gain even greater benefits.”

Charlotte Osborn-Forde, CEO of the National Academy for Social Prescribing, added, “There is now strong evidence that social prescribing leads to improved well-being and that it can support people with a range of health conditions.

“This research provides useful analysis of how referrals to link workers affected health care use during the COVID pandemic, potentially leading to a long-term fall in primary care physician appointments.

“It also shows the need for further exploration of how to account for the unmeasured social needs that lead to a referral for social prescribing, and better data on support received after the referral, to track the impact of social prescribing more robustly.”

Who’s behind this story?

Lisa Lock

BA art history, MA material culture. Former museum editor, paramedic, and transplant coordinator. Editing for Science X since 2021.

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Alexander Pol

PhD nano-engineering from Delft University. Published researcher and journal reviewer. Brings scientific insight to content standards.

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