Social Prescribing

LTP Priority: Personalised Care

Population Intervention Triangle: Segments (link to Section 1 PHE PBA): Service

Type of Interventions: Personalised Care – Social Prescribing

Major driver of health inequalities in your area of work

Chapter one of the Long Term Plan sets out personalised care as one of the five major changes that will establish the new service model for the NHS. Personalised care means people have choice and control over the way their care is planned and delivered, based on ‘what matters’ to them and their individual strengths, needs and preferences. This happens within a system that supports people to stay well for longer and makes the most of the expertise, capacity and potential of people, families and communities in delivering better health and wellbeing outcomes and experiences. As a result of personalised care, healthcare is tailored to what matters to the individual, in the context of their whole life, such that personalised care can support programmes and systems to address inequalities in access, experience and outcomes.

Personalised care is listed as part of one of the five major, practical changes to the NHS Service Model over the next 5 years: People will get more control over their own health, and more personalised care when they need it.

The LTP sets out that 2.5 million people will benefit from the Comprehensive Model for Personalised Care. This includes the following commitments across six components of personalised care (in addition to a number of other commitments that rely on personalised care):

  • Accelerate roll out of Personal Health Budgets… Up to 200,000 people will benefit from a PHB by 2023/24 (para 1.41)
  • Over 1,000 trained social prescribing link workers by 2020/21 and 900,000 people referred to social prescribing link workers by 2023/24 (para 1.40)
  • Ramp up support for people to self-manage their own health (para 1.38)
  • People have choice of options for quick elective care, including choice at point of referral and proactively for people waiting for six months (para 3.109
  • Support and help train staff to have personalised care conversations (para 1.37)
  • Use decision-support tools (para 3.106) and ensure the least effective interventions are not routinely performed… potentially avoiding needless harm (para 6.17viii))

Below we expand on how each of these commitments can support the approach to reducing health inequalities.

Target groups

People living in deprived areas and protected groups –

Details of the recommended intervention. All protected characteristic and inclusion health groups are covered by the social prescribing approach. However, at a local level, schemes are tailored to their local health need and population.


Social Prescribing


Social prescribing link workers connect people with wider social needs to community groups and services. They are employed to give time to people, focus on ‘what matters to me’ and based on the person’s priorities, introduce them to community support, taking them to their first community group meeting, where needed. Funding is available in 19/20 to Primary Care Networks through the PCN DES for primary care networks to reimburse 100% of the salary of a social prescribing link worker (up to a maximum of £34,113). This helps to reduce health inequalities by supporting people who struggle to make their own connections. Social prescribing has emerged as a highly creative and collaborative approach in local areas and is key to supporting local areas address health inequalities. It is an all-age model, from maternity and childhood through to end of life, encompassing both mental and physical health support. It can contribute to advancing equality and reducing inequalities in access and outcomes for all.


The evidence base for social prescribing is still growing but it is already recognised by many as a key intervention for reaching and engaging with whole population – particularly working with health inclusion groups. This has been recognised by the RCGP local evaluations of social prescribing have reported improvements in quality of life and emotional wellbeing, as well as lower use of primary care and other NHS services. See: Dayson, C. and Bashir, N. (2014), The social and economic impact of the Rotherham Social Prescribing Pilot. Sheffield: Sheffield Hallam University.

The development of the common outcomes framework will bolster this and the impending recruitment of link workers into primary care will look to gather data on health inequalities going forward.

Guidance for Commissioners

Social prescribing and community based support summary guide