The rollout of social prescribing link workers in primary care services in England appears to have had a positive impact on patient experience and outcomes, according to an academic study led by researchers from The University of Manchester.
The report is the first to analyse the impact of the Government's 2019 drive to increase the numbers of these workers, who connect patients to activities and support in their communities which boost health and well-being.
The 2019 NHS Long-term Plan pledged NHS England funding to provide 1,000 trained social prescribing link workers in place by the end of 2021 - and to ensure that every patient in England could access the service by 2022.
This National Institute for Health and Care Research (NIHR) funded study - led by researchers from The University of Manchester and co-authored with the University of Edinburgh, Newcastle University and University of Bristol- indicates that the scheme has led to improved outcomes and experience of and or both patients with long-term conditions and mental health needs. However, researchers were unable to pinpoint any noteworthy impact on loneliness and isolation.
The study combined administrative workforce data and information from the General Practice Patient Survey between 2018 and 2023, which includes more than 4.1million responses in total. It calculated the impact of adding one full-time equivalent (FTE) link worker per 50,000 patients to assess whether the NHS' aims for the rollout were fulfilled. The outcomes from the survey assessed for this study were:
o Increasing the patient's confidence in managing their long-term condition
o Making them feel more supported by local services and organisations
o Making them feel less isolated from others
o Improving their experience with their GP
o An increased feeling that their mental health needs were understood
The study found that for those with one or more long term conditions, patient confidence in managing their long-term condition increased, as well as feeling more supported by local services and in their overall experience with general practice.
Similar improvements were seen for those with mental health needs and in feeling that their needs were understood. However, no evidence of benefit was found for those experiencing loneliness and social isolation.
The results indicate that an increase in social prescribing provision has had a positive effect on the population level. While the figures appear low, only 3.2% of the registered GP population had actually been referred to a social prescribing service by March 2023, so being able to detect an impact of this size at the population level is "clinically significant".
The researchers estimated the population effects, and the findings suggest that an additional FTE social prescribing link worker per 50,000 population in all Primary Care Networks (PCNs) - which equates to approximately one extra link worker per average PCN - was associated with an increase nationally in approximately 47,000 people reporting confidence in managing their long-term conditions and 132,000 people reporting having had a good GP experience.
However, the authors suggest that more work needs to be done to establish whether the rollout has any impact on use of hospital services, and whether there has been an impact on known health inequalities.
They also note that the initiative cost the NHS an estimated £130million in 2022/23, without taking onward referral costs into account. They conclude that further research is required to determine "whether the scheme is financially sustainable as a whole".
Paul Wilson, Professor of Implementation Science at The University of Manchester, said: "The Government's plan to increase the provision of social prescribing was an attempt to tackle crucial challenges, including helping patients feel more supported, empowered, and positive about the health services available to them.
"As such, it is important that studies such as this exist, to assess whether initiatives have the desired effect, and that they provide the right assistance to people who are most in need of care and connection.
"Our results indicate that the Government's focus on link worker provision has had a positive effect, and that social prescribing can help patients feel more supported by healthcare services and professionals.
"However, we would welcome future research into the sustainability and cost-efficiency of the scheme, particularly when more is known about its full cost including referrals."
Anna Wilding, Research Fellow in Health Economics at The University of Manchester, said: "This report provides useful food for thought for policymakers assessing this scheme, and other similar initiatives designed to improve the health of the country.
"Considering the service has been used by a relatively small percentage of the population, the results seem to indicate that social prescribing has a notable effect on a patient's GP experience and their sense that their needs are understood.
"However, there is still much work to do before we can determine the impact and sustainability of schemes such as this one. There is definite scope for future studies which determine whether such referrals have an effect on unplanned hospital admissions, and whether the current approach offers the best possible care for the country at an optimal cost."
Charlotte Osborn-Forde, Chief Executive of the National Academy for Social Prescribing, said: "This is an important and groundbreaking piece of research. There is already a wide range of evidence demonstrating that social prescribing is highly impactful and can save the NHS money, but this is the first time research has been published showing statistically significant improvements for the whole population. It's simple: the more Link Workers that are employed, the more likely it is that patients are able to manage their own health, and have a good experience of their GP.
"This is because Link Workers get to know patients, supporting them step by step to access local services, tackling issues like housing, debt, food or fuel poverty, loneliness and unemployment - the issues that matter to people and can have a big impact on our health. This vital research further supports the case for the expansion of social prescribing in the NHS so that is available to more patients who could benefit."
The full study - entitled 'Impact of the rollout of the national social prescribing link worker programme on population outcomes: evidence from a repeated cross-sectional survey' has been published in The British Journal of General Practice. You can read the report and its results here: https://bjgp.org/content/early/2025/06/04/BJGP.2024.0542
