‘No clear evidence’ for key long-term plan policy, says PHE

The PHE paper said: “Despite widespread national support for social prescribing, this synthesis found no clear evidence for effectiveness.”

The paper examined the research into social prescribing’s effectiveness against two measures: contact with primary care and changes in the physical or mental health of patients. It found most of the studies it analysed were of low quality, adding: “Better quality, robust evaluation plans are needed alongside the national rollout of social prescribing.”

Social prescribing – a loose term covering ways of linking primary care patients with non-medical community support – is a central component of NHS England’s plans for primary care and personalised healthcare under the long-term plan. 

The NHS has said 1,000 additional social prescribing link workers will be employed across England by 2020-21, who will be integral to the NHS’ plans to place 20,000 additional non-GP, clinical staff into primary care through the five-year network contract. This hiring spree is aimed at alleviating GPs’ workload. 

However, the PHE research – published in July but not widely publicised – is not the first to warn of the lack of evidence for social prescribing. A 2017 study which systematically reviewed the evidence of the effectiveness of social prescribing schemes also found there was insufficient evidence to judge how effective it is, or if it constitutes value for money.

Paul Wilson, a senior research fellow from the University of Manchester and a researcher on the 2017 paper, told HSJ: “We’re having a national rollout of a core model of social prescribing provision and we don’t really know how it works or who benefits from it… and with a lot of unproven interventions there’s always the consequence that other existing services may be pressed and displaced as a consequence.” 

He said research in this area is “usually locally funded… often limited by design and [there’s] often resource constraints as well”.

Mr Wilson added: “These sorts of studies, particularly for complex interventions like social prescribing, are not straightforward evaluations so they do actually need to be adequately resourced, adequately conducted and appropriately reported.”

These elements “tend to fall by the wayside” in local evaluations conducted for the bodies that commission this kind of service, he said, adding the whole area would benefit from a national research call from the National Institute for Health Research to try to bring some adequate resource and better-quality research.

NHS England has published guidance for social prescribing, including a common outcomes framework to help PCNs and social prescribing link workers to gather data.

Various tools are currently used to measure the impact of social prescribing. NHSE plans to gather feedback on the different systems with a view to potentially producing a new wellbeing measure for anyone to use.

An NHSE spokeswoman said: “Tens of thousands of people’s lives have been improved thanks to NHS social prescribing. Often the underlying reason a patient visits their GP is not medical, which is why the NHS is supporting schemes like this. If PHE funds further research on this the NHS would be happy to partner with them.”