Hiking social prescribing

Social prescribing consists of linking individuals from primary care (often their GP) to social interventions which have the potential to improve health and wellbeing. This pathway expands the options available to clinicians whose patients have complex social needs as well as medical, by connecting people to community resources, information and social activities, as well as linking people to a range of statutory and non-statutory agencies.

Potentially, social prescriptions can enable healthcare professionals to respond more effectively respond to a range of non-clinical needs and engage patients with professionals who are able to provide longer consultations and who have detailed knowledge of local social activities.

The range of activities that people engage with is diverse and can include gardening programmes, books on prescription, exercise on referral, referral for debt counselling, or housing advice. The range is such that the mechanisms of action are also diverse and can be activated through being with people, cognitive stimulation, or identity generation. In this way, social prescriptions are potentially applicable for treating a broad range of conditions or their prevention.

The practice of social prescribing is growing in popularity, but delivery is also disparate, variable and complex. A variety of referral models exist, ranging from signposting by primary care practitioners through to iterative activity choices, facilitated by link workers who can meet at length with patients and collate available activities to suit need and lifestyle, as well as provide a point of ongoing contact. There are a myriad of ways in which this process can be disrupted, for example if staff are not aware or unsupportive of the idea, or patients are unable to initiate their particular social prescription, it is impossible to maximise the potential of the service, ensure appropriate use, and avoid wasting resources.

There is then a risk of social prescribing services being developed without evidence about what should be offered or the processes that are required to support them, with a disconnect between health and other services resulting in patients not getting a social prescription appropriate to their needs. Our research programme seeks to generate robust evidence about what works, for whom, and in what ways.

Active projects

1. We were commissioned by Torbay and South Devon NHS Foundation Trust to support the evaluation of social prescribing: ‘researcher-in-residence’ projects.
2. We were commissioned by Sport England for the Flourish in Nature project.
3. Our researchers led the creation of the Academic Partners Collaborative for the National Academy for Social Prescribing. Our suite of reviews can now be found at the National Academy for Social Prescribing website.
4. We are working to produce complex-system maps of non-NHS delivered social prescribing in the Medical Research Council Project PHIND Social Prescribing.
5. Our researchers are part of a consortium evaluating the national roll out of green social prescribing: Defra Green Social Prescribing evaluation work.
6. Our PhD researcher Charlotte Featherstone is assessing Social prescribing and horticulture therapy for autistic adults.
7. We are examining the use of social prescribing for children and young people in a new project CHOICES.
8. Working with the Wildfowl and Wetlands Trust and Newquay Orchard, we are conducting a preliminary study of nature-based activities reached through social prescribing: greENGAGE.

Completed projects

1. Our first project was a realist review of the social prescribing process: Realist review of social prescribing.
2. We worked closely with two local services in a researcher-in-residence model, one in Cornwall and one in Plymouth.
3. We conducted a project developing a Nature on Prescription Handbook led by the European Centre for Environment & Human Health.
4. We worked with Defra to identify what works in terms of nature-based therapeutic interventions for people with an identifiable mental illness. Therapeutic Nature report.
5. Our team contributed to developing resources for children and young people’s social prescribing commissioned by NHSE/I and led by Street Games.
6. We were commissioned by Devon STP to evaluate the implementation and impact of social prescribing across Devon. See:  interim mapping and evaluation and final report
7. We worked with an extensive group of collaborators to survey Global Developments in Social Prescribing, now in BMJ Global Health.
9. We undertook an Evaluation of the Torbay and South Devon Wellbeing Programme, a social prescribing and wellbeing programme delivered by the local voluntary and community sector. This built upon a previous pre-pandemic interim evaluation of the programme and among other issues, looked at the way in which the programme adjusted to both the pandemic and post-pandemic environment.

Meet the Plymouth team