By Charlotte Osborn-Forde, Chief Executive at The National Academy for Social Prescribing
We all know that there are many health-related factors that can affect people’s ability to find and stay in fulfilling work. People may struggle to apply for jobs or to remain in them because of their mental health or chronic pain, for example, and conditions at their workplace may exacerbate these issues.
So how should the health system work with employers and wider communities to support people at work, and help them live the best lives they can?
There have recently been criticisms of GPs for too often giving people ‘sick notes’ rather than finding ways to help them stay in work. This criticism seems unfair on GPs, who have limited options in 10-minute appointments and who are looking to do the best thing for the health of the patient in front of them. However, there is clearly a need to improve the current system. One important way of doing this is through social prescribing.
The internationally agreed definition of social prescribing is that it is ‘a means for trusted individuals in clinical and community settings to identify that a person has non-medical, health-related social needs and to subsequently connect them to non-clinical supports and services within the community by co-producing a social prescription – a non-medical prescription, to improve health and well-being and to strengthen community connections.’¹
In England, what this means in practice is that GPs (and other health and care professionals) can refer patients to a Social Prescribing Link Worker. Link workers are usually employed with NHS funding and are typically either based in GP practices or in voluntary sector organisations. They have time to get to know patients, understand their circumstances and preferences, and then connect people to non-medical support that can benefit their health and wellbeing.
For example, if someone with breathing difficulties is living in a flat with mould growing up their walls, a link worker might help them speak to the right person at the local housing authority or connect them to Citizens Advice. If someone has become isolated after a bereavement, a link worker could help them to join a local community group, so that they can do an activity they enjoy in a place where they can potentially meet new people.
The approach is based on what matters to each person. Despite the use of the word ‘prescribing’, it is not about telling people what to do, so much as listening to what matters to them and then co-producing a personalised plan.
Social prescribing has been practiced in some areas for decades, but became universally available after the NHS Long Term Plan in 2019. Currently (September 2025), there are around 3,300 link workers employed across England, and more than a million referrals to them per year by GPs.²
The evidence base is now strong. A recent national evaluation³, funded by NIHR, showed than Social Prescribing Link Workers improved a range of outcomes in primary care – helping people with mental health problems and long-term conditions to feel more supported, and ensuring people had better connections to local community services.
An evaluation of the cross-Government Green Social Prescribing programme⁴ showed statistically significant improvements in the mental health of participants. And a wide range of smaller scale studies show benefits for wellbeing and mental health, as well as a positive impact on people living with a range of long-term conditions.⁵
While social prescribing usually relies on GPs referring people to link workers, many Primary Care Networks also take a more proactive approach, using data to identify and support patients who may be most in need of support. For example, they might identify patients living with multiple long-term conditions in more deprived areas who have not recently had health checks, and reach out to them. In some cases, this has involved using data about who has received sick notes to identify people who could most benefit from social prescribing to improve their health and, where appropriate, potentially return to work.
We worked with the National Association of Primary Care to analyse data from NHS Primary Care Networks. In one area, as you might expect, this data suggested that people who had frequently received fit notes had significantly higher physical and mental health needs than the general population. They were also more likely to live in deprived areas, had greater social need, and tended to have worse diets. They were far more likely to experience chronic pain, depression and high blood pressure.
This data suggested that the reasons people were absent from work were complex and multifaceted. Most people cited a single reason, but there were often multiple, interconnected physical, mental and social factors at play.
Results from another practice show the potential impact of proactively supporting people⁶. The 630 people who were supported by Social Prescribing Link Workers saw 53% fewer sick notes, 50% less chronic pain, and 82% fewer cases of anxiety or depression, while a control group saw increases in all of these. Some improvements may have happened naturally, but the large differences suggest social prescribing is making a real impact.
In its 10-year plan for the NHS, the Government has committed to opening Neighbourhood Health Centres, which would bring together GP services with other forms of support, including employment advice. Social Prescribing Link Workers can play a key role in these neighbourhood health teams, taking a holistic approach and forming a bridge between the health system and other services, including those that help people get back to work.
While there are already some excellent examples of services that combine healthcare with advice and information – for example at the Bromley by Bow Centre in London – the new 10-year plan presents an opportunity to improve connections and clarify pathways.
We have been working with the Department of Work and Pensions to look at how social prescribing can work alongside services supporting people back to work.
The recent Britain Get Working review highlighted the role of employers in supporting the health of employees and proposed a new model of workplace health provision. New models will be tested through Vanguard sites, but we welcomed the report’s focus on building on existing services, including those provided by Social Prescribing Link Workers.
Through intelligent use of NHS data, there is also an opportunity to identify people who are more often signed off work and provide a combination of medical and non-medical support to help them live the best lives they can.
The aim of social prescribing is to improve people’s health and wellbeing, not to reduce unemployment, and clearly there are many reasons why people may not be able to work. However, if social prescribing can help people to overcome practical and emotional challenges that limit what they can do, and to live happier and healthier lives, this can only be a good thing.
Bibliography
1 Establishing internationally accepted conceptual and operational definitions of social prescribing through expert consensus: a Delphi study | BMJ Open
2 Primary Care Workforce Quarterly Update, 30 June 2025 – NHS England Digital
3 Largest ever social prescribing study proves positive impact on patients – latest news from the National Academy for Social Prescribing | NASP
4 Green social prescribing improves your mental health – National Academy for Social Prescribing | NASP
5 What is the evidence for social prescribing? – National Academy for Social Prescribing | NASP
6 Can data-driven social prescribing reduce demand? – Pulse PCN