A dataset of 438,000 social prescribing referrals—where doctors and other professionals send people to community activities like gardening groups, debt advice, or exercise classes instead of prescribing drugs—is being analysed to find out who actually gets this kind of support and whether it works. Social prescribing has been rolled out across the UK and in 30 other countries, but the evidence behind it is thin. It is not clear whether the people most in need are being reached, what a typical referral pathway looks like, or whether it reduces pressure on GPs and hospitals. Current records are patchy: GP data often miss referrals from other sources, and local evaluations are too small to draw firm conclusions. This project uses the largest available dataset, from the Access Elemental platform covering over 20 million people, to answer those questions. If successful, the findings could reshape how social prescribing is commissioned and delivered. Policymakers would know which populations are underserved, what interventions actually improve mental wellbeing, and how to design referral pathways that do not reinforce existing inequalities. The research also aims to produce guidelines for other platforms to improve data quality, making future evaluations more reliable.
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Social prescribing (SP) is a mechanism of care referring people to non-clinical forms of support and services in their local communities to improve health and wellbeing.1 In the last decade, there has been a rapid development of SP to help tackle social or complex health needs. SP is being widely implemented in England, Wales, Scotland and Northern Ireland. SP is also gaining traction in over 30 countries worldwide, including the United States, Canada, Germany, Denmark, Spain, China, Singapore, Australia, New Zealand, Nigeria, Philippines etc.2,3 Despite this global proliferation in practice, the evidence base for SP is insufficient.4–7 It’s still unclear if SP is reaching those in greatest need, how it is working in practice, what makes “good” SP, and what impact it can actually have at scale. In the UK, SP is included in the NHS Long Term Plan for “tackling health inequalities”,8 and its national roll-out as a programme provides a fertile opportunity to explore equity of access. However, it is a major challenge to assess who is receiving SP. Local evaluations can be too small in scale, while electronic patient records often contain inconsistent coding of SP referrals, poor recording of wider determinants of health, and no details of referrals from sources other than GPs, leading to conclusions that they cannot be used to assess equity of referrals.9,10 These research gaps are imposing a major challenge for policy and further development of SP. Thus, exploring SP referral patterns in wider data sources is crucial to understanding if SP is truly reaching individuals most in need. The proposed project aims to advance our understanding of SP implementation in the UK, through analyses of a major dataset of 438,000 SP referrals collected by Access Elemental 2017-2024 (number set to triple during this grant). Access Elemental is the most widely adopted SP platform in the UK to date, serving a population of over 20 million people in the UK. We will use this dataset to explore four research questions: Referrals: who has been receiving SP in the UK in the past 7 years as SP programmes have rolled out at scale, for what referral reasons, and how does this vary in different locations? Pathways: what do SP pathways look like? What contacts and interventions do patients receive, how is inequality produced or reinforced at different stages of the SP lifecycle, and what factors predict continued engagement with the pathway? Impacts: what impact does SP have on mental wellbeing and primary care service utilisation in different population groups? Does pathway delivery affect whether these outcomes are achieved? Data quality: how can this novel dataset be developed for future research purposes? What recommendations and guidelines can be made for other SP platforms to optimise their data quality and support future research in this burgeoning area? We will support our research with a comprehensive impact and engagement programme targeting academics (academic articles, conference presentations, data user manual, data workshop), policy makers/commissioners (policy briefs, roundtable), health/social care professionals, SP professionals and community organisations (blogs, data dashboard) and the public (media, infographics). In all, this project is timely in providing large-scale detailed data on the “nuts and bolts” of SP as a national programme and is anticipated to have a major relevance to a wide national and international audience.
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