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Social prescribing: less rhetoric and more reality. A systematic review of the evidence
  1. Liz Bickerdike1,
  2. Alison Booth2,
  3. Paul M Wilson3,
  4. Kate Farley4,
  5. Kath Wright1
  1. 1Centre for Reviews and Dissemination, University of York, York, UK
  2. 2York Trials Unit, University of York, York, UK
  3. 3Alliance Manchester Business School, University of Manchester, Manchester, UK
  4. 4School of Healthcare, University of Leeds, Leeds, UK
  1. Correspondence to Paul Wilson; paul.wilson{at}manchester.ac.uk

Abstract

Objectives Social prescribing is a way of linking patients in primary care with sources of support within the community to help improve their health and well-being. Social prescribing programmes are being widely promoted and adopted in the UK National Health Service and so we conducted a systematic review to assess the evidence for their effectiveness.

Setting/data sources Nine databases were searched from 2000 to January 2016 for studies conducted in the UK. Relevant reports and guidelines, websites and reference lists of retrieved articles were scanned to identify additional studies. All the searches were restricted to English language only.

Participants Systematic reviews and any published evaluation of programmes where patient referral was made from a primary care setting to a link worker or facilitator of social prescribing were eligible for inclusion. Risk of bias for included studies was undertaken independently by two reviewers and a narrative synthesis was performed.

Primary and secondary outcome measures Primary outcomes of interest were any measures of health and well-being and/or usage of health services.

Results We included a total of 15 evaluations of social prescribing programmes. Most were small scale and limited by poor design and reporting. All were rated as a having a high risk of bias. Common design issues included a lack of comparative controls, short follow-up durations, a lack of standardised and validated measuring tools, missing data and a failure to consider potential confounding factors. Despite clear methodological shortcomings, most evaluations presented positive conclusions.

Conclusions Social prescribing is being widely advocated and implemented but current evidence fails to provide sufficient detail to judge either success or value for money. If social prescribing is to realise its potential, future evaluations must be comparative by design and consider when, by whom, for whom, how well and at what cost.

Trial registration number PROSPERO Registration: CRD42015023501.

  • PRIMARY CARE

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

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Footnotes

  • Twitter Follow Alison Booth @AliBooth42 and Paul Wilson @pmw777

  • Contributors PMW took overall responsibility for the systematic review. LB, AB and PMW were involved in all stages of the review from development of the protocol, through screening studies and data extraction, to analysis and synthesis and production of the final manuscript. KF provided input at all stages of the review and commented on drafts of the review. KW conducted literature searches and contributed to the ‘Methods’ section of the review. All authors approved the final version and PMW is the guarantor.

  • Funding This review was funded by the National Institute for Health Research (NIHR). As part of research funded by the NIHR Health Services and Delivery Research programme (Project ref: 12/5002/18), Additional funding for PMW was received from the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Greater Manchester.

  • Disclaimer The views expressed are those of the authors and do not necessarily reflect those of the NIHR Health Services and Delivery Research programme, NIHR CLAHRC Greater Manchester or the Department of Health.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All available data can be obtained from the corresponding author.

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