Social Prescribing at a Crossroads

Social prescribing is a policy innovation that aims to improve health and wellbeing for people with complex health conditions by enabling healthcare practitioners to refer patients to activities provided by voluntary, community and social enterprise organisations (VCSEs) in their local area. Having started out as a bottom-up social movement lead by GPs and community organisations working together at a neighbourhood level social prescribing has quickly become a top down national policy priority.

In 2019 the NHS Long Term Plan announced new funding worth £35m per year to provide universal access to social prescribing across England. Each Primary Care Network – covering a population of 30,000-50,000 people – will receive funding to employ a social prescribing link worker who will work with people to develop tailored plans and connect them to local groups and support services. This funding means that more than 1,000 trained link workers will be in place by the end of 2020/21 with the aim that over 900,000 people can be referred to social prescribing schemes each year so that they can access new forms of social and community activity that will help improve their health and wellbeing and reduce their need for unplanned care.

High quality research and evaluation – including several studies led by Sheffield Hallam University – has been absolutely vital in driving forward this change by showing that the outcomes from social prescribing fall into the following categories:

  • Outcomes for people accessing social prescribing services, in particular improvements to their health, wellbeing and quality of life. Consistently evaluations show that patients with the lowest levels wellbeing prior to referral benefit the most, and that people’s mental health can improve significantly in the short term.
  • Outcomes for the health and care system, including reductions in accident and emergency attendances, non-elective in-patient stays and repeat GP appointments. There is also evidence that when focussed on mental health services social prescribing can support discharge and help avoid re-admission
  • Outcomes for the community, in some areas social prescribing has enabled local voluntary and community organisations to attract further grant funding, provide new opportunities for volunteering and social action, and help develop new models of service commissioning that better suit small local organisations.

 Despite these high profile developments, and the positive role being promoted for local voluntary and community action, there is a concern that the emphasis and resources being put into link workers and primary care has not been accompanied by strategies that build capacity in, and provide resources for, frontline voluntary organisations and community groups. Without this, their ability to contribute to social prescribing in a way that is sustainable and meets the needs of local people is a major concern.

Other ‘knotty’ issues facing social prescribing include disagreement about the quality of the evidence base and theoretical underpinnings of different modes of intervention; the variety of different social prescribing models being implemented in different places, and their relative efficacy; how the local roll-out of NHS funded link workers will be integrated with existing social prescribing services; and how the ‘success’ of social prescribing will be judged in the long term.

All of these factors, and more besides, combine to create a sense that social prescribing is ‘at a crossroads’, and that time, space, openness and honesty is needed to critically reflect on the implications of what has been one the most prominent and fastest growing social movements of recent times. Hopefully the Sheffield Institute for Policy Studies seminar on 22nd January (See here for booking details) will provide a platform for these discussions by bringing together researchers, practitioners and policy makers together for healthy debate and discussion. We look forward to seeing you there!

You may also be interested in other blogs written on this topic

https://sheffieldinstituteforpolicystudies.com/2017/11/17/social-prescribing-shiny-new-policy-thing-or-something-more-important/

https://policyandpoliticsblog.com/2016/11/23/how-should-public-sector-policymakers-understand-the-social-value-of-socially-innovative-services/

Find out more from this TED talk

https://www.youtube.com/watch?v=Pc9-L7u3Cno

And these articles

Dayson, C., Fraser, A., & Lowe, T. (2019). A comparative analysis of Social Impact Bond and conventional financing approaches to health service commissioning in England: the case of social prescribingJournal of Comparative Policy Analysis.

Dayson, C. (2017). Social prescribing ‘plus’: a model of asset-based collaborative innovation? People, Place and Policy, 11 (2), 90-104.

Dayson, C. (2017). Evaluating social innovations and their contribution to social value: the benefits of a ‘blended value’ approachPolicy and Politics, 45 (3), 395-411.

Chris Dayson is a Principal Research Fellow at Sheffield Hallam University

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