Social prescribing
What is social prescribing? The regular man in the street may not know what this is, but the House of Commons Library defines it as ‘a means for General Practitioners and other healthcare professionals to refer patients to non-clinical services in the local community’.
Social Prescribing is a different method for medical professionals to help people under their care, who may be adversely affected by:
- anxiety
- chronic health issues;
- mental health problems;
- long-term conditions; and
- social isolation.
Offering services of a non-medical nature can also help their well-being and health. Not like just prescribing medication, this way patients could be referred to activities going on in their local area such as:
- Art classes
- Projects involving gardening; and
- Walking groups.
People may also be directed to services that can help them with
- debt,
- places where they can volunteer; or
- hobbies they can get involved with.
Prescriptions of Social prescribing are often organised by a well-being advisor. Who assesses the type of assistance may be most helpful.
Some people don’t think it will work
However, Rob Poole, Professor of Social Psychiatry in the Centre for Mental Health and Society at Bangor University and Peter Huxley, Professor of Mental Health Research in the Centre for Mental Health and Society at Bangor University in their jointly published article entitled ‘Social prescribing: an inadequate response to the degradation of social care in mental health, state that ‘since the financial crisis of 2008, the physical and mental health of a significant proportion of the UK population has worsened to the point where life expectancy has reduced for some people’. The Professors are of the view that political decisions have:
- resulted in increased inequality
- created downward pressure on people on low incomes
- increased the taxation burden for the poorest part of the population
- systematically destroyed manufacturing industries and their associated communities
- defunded the social infrastructure; and
- generally degraded the social fabric for that part of the population that has always experienced the greatest burden of mental and physical ill health.
The professors claim that the term ‘social prescribing’ is full of ambiguity and that it has emerged without any clear theoretical underpinning, making it hard to say what exactly it is or what outcomes it achieves. Professors Poole and Huxley observe that it is ‘striking that the term ‘social prescribing’ has no generally agreed definition’. They looked at the history of this type of help and compared it to the term ‘assertive outreach’ which existed before and ‘referred to a heterogenous group of interventions’. When they did so, the Professors found that ‘most of these interventions involved some form of link worker who brokers an individualised package of non-medical activity for the patient’. They note that the ‘intervention is typically time-limited’.
What does social prescribing include?
What services are included in the definition of social prescribing? The House of Commons clarifies this and advises that it includes:
- arts
- nature-based activities
- physical activity classes, and
- counselling.
On 6 March 2025 Lucy Powell, the Leader of the House of Commons and representing her Manchester Central constituency, answered a question from Paul Davies the Member of Parliament representing the Parliamentary constituency of the Colne Valley. Mr Davies wanted to highlight the ‘crucial role social prescribing can potentially play in:
- addressing social, emotional, and practical needs; and
- promoting holistic health.
In her response to the question posed by the Colne Valley Member of Parliament, Lucy Powell stated that the UK ‘Government supports social prescribing’. She explained this was because, in the authorities’ view, it can be used to ‘improve people’s wellbeing’. However, to those not in the Westminster bubble, the concepts of social prescribing and its wider health determinants may be vague as the ordinary man in the street may not understand what they mean.
How successful has social prescribing been?
So, how successful has social prescribing been? The House of Commons Library carried out an evaluation of ‘the existing social prescribing schemes’ and whether it has saved any money from the Government’s budget’. Having done so, this evaluation claimed social prescribing has ‘reduced the demand for health services’ and reported that it has had a ‘positive impact on people’s mental health and wellbeing’.
However, contrary to the view of the Government and the House of Commons Library Professors Poole and Huxley claim that:
- ‘it is poorly defined’
- there is little evidence for its effectiveness
- it cannot address the social determinants of mental health, such as social justice, poverty, general inequality, and gender equality; and
- it is unlikely to produce enduring change for that part of the population that suffers the worst physical and mental health’, for example the most ‘marginalised’ and ‘deprived’.
The professors observe that social prescribing has ‘emerged at a time of growing health inequity and has ‘occurred alongside the neglect of social care and social aspects of mental health intervention’. They claim that ‘social prescribing gives a false impression of addressing social factors, and as such is counterproductive’. The experts claim that ‘we can do better than this. They expressed views of feeling ‘troubled that social prescribing is being hyped in a way that is entirely inappropriate’ and suggest that the current enthusiasm for social prescribing is wildly disproportionate to the very weak evidence for its effectiveness.
So how helpful is the emphasis on social prescribing?
Professors Poole and Huxley believe that there is an ‘overemphasis on social prescribing’ which in their view is ‘seriously unhelpful in addressing the social origins of mental ill health’. The Professors contend that social prescribing has developed as a non-medical intervention after decades of underfunding and restrictive redefinition of social care in mental health and are of the view that ‘it is no solution to the serious problems that this has caused’. So, is social prescribing really the answer and should the Government move away from it?
