Importance of community role in patient care highlighted in new social prescribing study at NTU

Local communities play a fundamental role in improving health-related quality of life for people suffering from loneliness or social anxiety, according to a new study by Nottingham Trent University (NTU).

Researchers questioned patients on an NHS-based social prescribing pathway, which supplements usual healthcare by providing patients with connections to voluntary and community groups. It is aimed at adults who are managing one or more long-term physical or mental health conditions, and are feeling isolated, lonely, or socially anxious.

On the day that participants joined the social prescribing pathway, their number of group memberships was measured, as well as their sense of community belonging, the extent to which they feel they receive support from others (social support), feelings of loneliness and their health-related quality of life. These variables were measured again after participants had been on the social prescribing pathway for about four months, and once more after about six months, once they had left the pathway.

Findings revealed that quality of life improved after being on the pathway for four months, and this improvement was maintained after participants left the pathway. Additionally, the more groups a participant joined while on the pathway, the stronger their sense of community belonging became. In turn, this sense of community belonging predicted enhanced feelings of social support and reduced loneliness and, through this, better health-related quality of life.

The study is part of a larger research project which looks at how and why social prescribing works. Researchers at NTU’s School of Social Sciences have already found that an increase in the number of group memberships during a patient’s engagement with a social prescribing initiative predicts a 25% reduction in health care use.

Dr Juliet Wakefield, senior lecturer in Psychology and lead researcher, said: “A major problem with social prescribing initiatives is that there has been limited understanding of why and for whom it works, which makes it difficult for health professionals to devise effective initiatives.

“We can now show that social prescribing works by allowing patients to connect better with their social worlds: to join more social groups, to become more engaged in their community, to receive more support from the people around them, and to feel less lonely, and it is through these processes that the health-related benefits are felt.

“Often, community is simply seen as a set of resources to be drawn upon by health professionals in order to address the healthcare burden. Our research suggests that local community plays a more fundamental role than this, impacting directly upon quality of life. It is important for those who design social prescribing initiatives to be clear on its purpose and to appreciate the important role played by the community.

“This research was conducted before the pandemic, during which local communities have faced huge psychological and economic challenges which could limit their ability to benefit patients now and in the future. It is now more important than ever that the government addresses these issues by supporting communities, so they can support their most vulnerable residents.”

The research also highlights the need to clearly communicate the programme as a social intervention when recruiting participants, as many patients could be confused by the aims of social prescribing.

Dr Wakefield added: “Patients on the pathway we explored had little understanding of the social factors impacting on their health, or the purpose of social prescribing in reducing social isolation. This could create confusion and disengagement if patients’ understandings diverge from those of pathway staff.

“Social prescribing is a unique opportunity to engage patients in an open decision-making process regarding how best to harness social factors to improve health, but for this to happen, social prescribing needs to be clearly advertised as a social intervention and the social, psychological, and health-related benefits of these programmes need to be systematically captured.”