A major new study has found patients living in England's most deprived communities are significantly less likely to be offered 'social prescribing', an NHS scheme designed to connect people with community support such as exercise groups, debt advice, arts activities and social clubs.
Researchers from The University of Manchester analysed primary care records from more than 12 million NHS patients, and found referrals to social prescribing services were disproportionately concentrated among people living in less deprived areas.
The researchers warn that the findings raise concerns that a programme intended to reduce health inequalities may instead risk reinforcing them unless access improves in poorer communities.
The study examined data collected between 2019 and 2024 following the national rollout of NHS social prescribing link workers across England.
Key findings
Just 4% of patients in the dataset were offered social prescribing between 2019 and 2024
Patients living in the least deprived areas were significantly more likely to be offered social prescribing than those in the most deprived communities
Women were substantially more likely than men to be offered social prescribing
Older patients and people with multiple long-term conditions were more likely to receive offers
More than three quarters (77.7%) of those offered social prescribing received a referral
Ethnic minority patients were generally as likely - or more likely - to accept referrals
What else did the study find?
The researchers analysed anonymised NHS primary care records from the Clinical Practice Research Datalink (CPRD), one of the largest healthcare datasets in England.
The study explored which groups of patients were offered social prescribing and which went on to receive referrals after offers were made.
Social prescribing schemes aim to support people whose health may be affected by wider social issues such as loneliness, poor housing, financial stress or isolation by linking them with non-medical community services through dedicated NHS link workers.
Clear inequalities
Patients in more affluent areas consistently had higher odds of being offered social prescribing than those in deprived areas, despite evidence that poorer communities often experience worse health outcomes and greater levels of long-term illness.
Women were also more likely to be offered referrals than men across almost every age group examined.
The study found strong links between long-term illness and social prescribing access, with patients suffering multiple health conditions far more likely to receive offers and referrals.
Why it matters
Researchers say the findings are significant because social prescribing has become a major part of NHS plans to reduce pressure on healthcare services and improve public health.
Since 2019, thousands of social prescribing link workers have been recruited across England through the NHS Additional Roles Reimbursement Scheme.
The researchers warn that unequal access to these services could risk widening existing health inequalities if patients in deprived communities are less likely to benefit. However, the study also found encouraging signs once offers had been made.
Patients from ethnic minority backgrounds were often more likely than white patients to accept referrals, while deprivation itself did not appear to reduce uptake after an offer was made.
Researchers say this suggests the key inequality may lie in access to offers rather than willingness to engage.
Men and older patients less likely to engage
The study also found important differences between being offered social prescribing and accepting referrals.
While older patients were more likely to be offered support, they were less likely to go on to receive referrals once offered. Male patients were consistently less likely than women to both receive offers and proceed to referral.
Researchers say more work is needed to understand why some groups may be underrepresented or less likely to engage with social prescribing services.
What the researchers say
"It is concerning that the patients most likely to benefit from social prescribing support appear to be among the least likely to be offered it," said Research Fellow Anna Wilding. "People living in deprived communities are more likely to experience long-term illness, financial hardship, isolation and poor mental health - the very issues social prescribing is designed to help address."
"Our findings suggest the biggest challenge is not whether people will engage with social prescribing once offered support, but ensuring disadvantaged communities are not left behind in the first place."
Publication details
The study was published in journal PLOS One.
DOI: https://doi.org/10.1371/journal.pone.0350842
