Social prescribing may not lead to a reduction in the use of primary health care services or improve patient health outcomes, according to a new review by the BMJ.
In a review of social prescribing studies, researchers found there was also ‘no consistent evidence’ for increased social support or an improvement in patients physical function.
The researchers found that the practice may have ‘little or no impact’ on health-related quality of life or the mental health of patients and may be more expensive than regular care.
The findings, which are published in the BMJ Open, suggest there are a few benefits to rolling out social prescribing internationally.
Social prescribing is part of a holistic approach to patient care. It enables GPs, nurses, and other primary care professionals to refer patients to local, non-clinical services to support a patient’s health and well-being.
NHS England funds link workers to work within primary care settings to help patients with complex mental and social needs access local non-medical support, particularly in deprived communities. Social prescribing is becoming more common, but past reviews of how well it works or whether it is a cost-effective solution have been inconclusive and mainly based on UK data.
To assess the international potential of social prescribing, the researchers analysed data from eight studies involving 6500 people based in the US and the UK. The intervention period for social prescribing ranged from one month to two years, with most lasting between three and nine months and involved patients being signposted to counselling services, social and craft groups, exercise classes, as well as welfare and employment advice.
Only one of the trials reported an economic evaluation of social prescribing, and few reported on the caseload of the link worker.
The findings suggest that there is little consistent evidence that social prescribing improves patient health or is cost-effective. Half of the studies reviewed found that social prescribing did not affect health-related quality of life.
Of the four studies which reported mental health outcomes, social prescribing was only found to make a difference in one of these studies. Exercise and physical activity interventions were reported in four of the studies, and only one of these saw an improvement in functional health.
In one study, social prescribing led to an increase in the use of primary care services, with two other studies seeing no change in use and one study seeing a reduction in the use of primary care services in the intervention group. Only one study found that healthcare costs fell because of fewer referrals, however, these savings did not offset the costs of the intervention itself.
Two US studies found that patients rated their health care more highly when social prescribing was used, and that hospital admissions were reduced for socially isolated people or those with several co-existing conditions.
The researchers highlighted that there are no agreed outcomes to measure the effectiveness of social prescribing and very few studies within this area, weakening the review.
‘Policymakers need to be aware that there is insufficient evidence to assess the effectiveness of social prescribing link workers and none on the cost-effectiveness, so the opportunity cost is unknown,’ wrote the researchers.
They conclude: ‘The opportunity costs of investing in social prescribing link workers are unknown, and it is essential that high-quality trials determining cost-effectiveness are conducted so that the evidence can catch up with the policy and we avoid wasting valuable time and resources.’
