Envisaging a Social Prescribing Fund in England
Case study
England (United-Kingdom)
Local funds and national investor(s)
England scales up social prescribing with a groundbreaking £100m+ national fund and hybrid financing model. By blending local investment from health partnerships, businesses, and philanthropy with national support, the 10-year Social Prescribing Fund aims to expand access, measure impact through wellbeing metrics like WELLBY, and turn referrals into lasting community health gains. The approach builds on the success of 2.6 million NHS referrals and the Big Local Programme, targeting areas of greatest need.
Context and problems addressed
England has been a forerunner in appraising innovative methods to improve health and wellbeing, notably through social prescribing non-clinical and non-medical prescriptions.
The National Health Service (NHS) invests over £100m a year in over 3,600 full-time-equivalent social prescribing link workers, resulting in over 2.6 million referrals to social prescribing activities. NHS funding for social prescribing link workers currently operates through a system of legal entitlements in the 2019 five-year update to the national GP contract.
In Autumn 2023, the National Lottery Community Fund awarded the National Academy for Social Prescribing(NASP) a grant to develop models of shared investment in social prescribing services. The NASP has been designated as the World Health Organization (WHO) Collaborating Centre for Social Prescribing Policy and Development. As part of this role, the Social Prescribing Fund aims to demonstrate how new funding models could expand and scale up the use of social prescribing. As part of this role, the Social Prescribing Fund aims to demonstrate how new funding models could expand and scale up the use of social prescribing.
Intervention and financing model
The British Social Prescribing Fund project delivered by the National Academy for Social Prescribing is a funding project aiming to replace fragmented funding with an integrated system. This model mixes (i) local financing through local Integrated Care Partnerships (ICPs), working together with local businesses and philanthropists, with (ii) national-level financing through national investor(s). This hybrid model aspires to make investment more attractive for all parties. It aims at fixing requirements for guaranteed equal new investment contributions, drawing on investors’ feedback on financing models to improve commitment and secure additional capacity and impact.
To generate lasting commitment and increase efficiency, the fund is based on a 10-year investment period. This approach mirrors the design of the Big Local Programme, which gave 150 communities approximately £1 million to improve health and wellbeing over 10 years. The fund does not aim to replace core funding by statutory bodies. Rather, it seeks to complement it. For example, NHS’s investment in link workers and referrals would be supplement with investment in activities, services and organisations for those referrals.
ICPs were identified as the best partner to the Social Prescribing Fund. They have a critical role in promoting action and investment to improve health, reducing inequality and strengthening partnerships working across private and public sectors without acting as the NHS or Local Authority budget holders. The Social Prescribing Fund would be a specific, clear, and actionable opportunity for them to generate added value.
Local systems would have almost total flexibility as to how they source their local investment share. The only requirement is that they must include contributions from at least three separate sources: (i) the NHS, (ii) local government, and (iii) local employers and/or philanthropists. The balance of contributions between different parties is for local determination. Local investment would be set at 90 pence per capita per year across the ICP population, amounting to around £50 million nationally if all ICPs take part.
For greater efficacy, the model favours targeted investment based on (i) the demand for activities as revealed by link workers and their referrals; and (ii) the Community Needs Index 2023, which assembles a wide variety of measures of community needs and assets.
This approach mirrors the design of the Big Local Programme, which gave 150 communities approximately £1 million to improve health and wellbeing over 10 years.
Key outcomes and associated measurements
The National Academy for Social Prescribing has identified a set of tools to measure both the impact of the Social Prescribing Fund and that of social prescribing more broadly.
The report introduces the concept of Wellbeing Adjusted Life Year (WELLBY), which helps to calculate the total amount of well-being experienced by an individual over one year by quantifying wellbeing in economic terms. The WELLBY is complemented by the ONS4 criteria to measure personal wellbeing. The ONS4 measures ask people to evaluate how satisfied they are with their lives overall, whether they feel they have meaning and purpose in their lives and their emotions during a particular period (both positive and negative) as a measure of wellbeing.
Additionally, the National Academy for Social Prescribing produced 15 evidence reviews and plain English Summaries showing a positive impact of social prescribing on wellbeing, economy and health.
Publications
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