Social prescribing, evidence and progress; the view from England

Abstract Social prescribing enables primary care to refer individuals with health and/or social issues to a ‘link worker' whom provides ‘holistic' support to patients and refers them to further agreed non-clinical activities (e.g. walking group) and/or social services (e.g. housing). Social prescribing has the potential to help managing or addressing a wide range of health and social issues, particularly pertinent in a pandemic and post pandemic world, centred around individual choice, and based on maximising the asset offered by the voluntary sector. Yet, evidence and policy development have gone hand in hand, and sometimes in reverse in England. The NHS made a good case and rationale for implementing social prescribing before the concomitant evidence base had rigorously proven its impact. Researchers are now in a position of trying to evidence (and communicate what good evidence might be) whether what has been rolled out works, in what ways, and for whom. In contributing to the development of the evaluation of social prescribing, the main challenge experienced was that what counts as good evidence depends entirely on ‘what is meant' by social prescribing. Social prescribing was found to be a pathway consisting of a set of relationships and set of activities/complex interventions as part of that pathway, therefore asking ‘what works' is not trivial. So, for the patient pathway there is a need for robust, well conducted evidence syntheses from different parts of the pathway, good qualitative work around the experiences of referrers and individuals, secondary data analysis of the health service use, effectiveness work on the activities themselves, all crucially underpinned by strong data monitoring and capture. Working with a very broad range of stakeholders (commissioners, healthcare providers, activity providers, link workers, and individuals with lived experience) goes some way to communicating this complexity and helping base decisions on the most appropriate evidence.