This is a programme that can be activated, for example, by general practitioners within primary care, through the involvement of a dedicated professional figure – the link worker – formally introduced in England in 2019 as part of the Primary Care Networks (PCNs). The link worker’s role is to connect individuals with resources available within the community, facilitating access to cultural, artistic, social and sporting activities, as well as nature-based initiatives.
Social prescribing not only supports the health of the individual, but also generates benefits for the wider social fabric, helping to ease the burden on healthcare systems and family networks. It primarily functions as a preventive intervention, capable of counteracting the progression of health conditions and reducing reliance on medication, specialist care and hospital admissions. At the same time, it provides meaningful support in the day-to-day management of illness, improving overall quality of life.
There is growing scientific evidence of the positive impact of social prescribing, especially for people living with chronic conditions. That includes complex, long-term multimorbidity, often correlated with factors such as increasing age, female gender, low income and a poor social network (SR. Chowdhury et al., 2023).
According to the Global Health Observatory, non-communicable diseases (NCDs) – such as cardiovascular diseases, cancers, diabetes and respiratory diseases – present one of the most significant challenges for public health care worldwide. In 2021, NCDs were behind more than 43 million deaths, and approximately 82% of premature deaths (before the age of 70) caused by NCDs were in low- and middle-income countries.
Cardiovascular diseases are the number one cause of mortality worldwide, resulting in more than 19 million deaths a year. This is followed by cancers (approximately 10 million) and chronic respiratory diseases (more than 4 million).
It has been estimated that in 2022, there were more than 800 million people living with diabetes, with a prevalence in adults of 14%. In the same year, no fewer than 445 million people aged over 30 with diabetes had no access to the medication they needed. Diabetes was the direct cause of approximately 1.6 million deaths, 47% of which came before the age of 70, underlining what a big impact it has in terms of premature death
People’s quality of life is compromised by chronic diseases, which are placing increasing demands on health care systems both clinically and economically, due to the need for early diagnoses, long-lasting care and frequent hospitalisations. The associated costs are high. They include direct costs – such as medicines, monitoring and appointments with specialists – and indirect costs associated with ongoing support and long-term management of conditions. These expenses put financial pressure not only on public health services but also on families, especially in countries where the health systems are underfunded or access to preventive care is limited.
Social prescribing is a service that can be made available by figures such as GPs as part of primary care. They do so through link workers, whose role in Primary Care Networks (PCNs) was formally introduced in the UK in 2019.
Link workers connect people with resources in their communities, facilitating access to art, culture, social, sport and nature-based activities.
We discussed it in more detail here.
As well as enhancing individual health, social prescribing brings benefits for society as a whole, helping to lighten the load on the heath care system and family networks. First and foremost, it is a preventive measure that can prevent health conditions from worsening and reduce the use of medicines, specialist services and hospitalisations. Meanwhile, it also provides significant support with everyday management of diseases and helps to improve quality of life.
Bearing all of this in mind, social prescribing can be considered a complementary, accessible and sustainable approach. Its effectiveness was underlined by a systematic review and meta-analysis published in 2024, which assessed the impact of social prescribing on chronic condition management in adults.
The review involved analysis of 12 studies featuring randomised and quasi-randomised controlled trials in the United States, United Kingdom, Belgium and Australia, examining outcomes such as quality of life, physical activity, psychological well-being, and clinical, disease-specific measures.
Cancer and diabetes were the main long-term conditions identified. The duration of the measures ranged from 8 weeks to 18 months. The total number of patients was 3,566, with an average age of 48 years. 61.1% of them were female.
The results revealed significant improvements in quality of life in both the short and the long term, especially for those who took part in social prescribing measures more often (more than three engagements).
Only two studies reported a significant increase in the frequency (at least three times a week) and duration of physical activity by participants.
With regard to specific clinical indicators, seven studies analysed the effect of social prescribing on glycated haemoglobin levels in people with diabetes. Four of them reported significant between-group improvements in HbA1c levels, with positive outcomes at the 6-month, 12-month and 18-month follow-ups. In addition, a reduction was noted in diabetes-related distress and diabetes-related depressive episodes
Art on Prescription (AoP), i.e. prescribing cultural participation and creative expression measures, has proved beneficial for patients with chronic lung diseases, which are often associated with significant biopsychosocial impacts. Symptoms such as shortness of breath, coughing, wheezing, weakness, fatigue and restricted ability to exercise affect quality of life and gradually lead to reduced social participation. A review published in 2019 suggests that including activities such as music and dance in treatment programmes for chronic respiratory diseases is associated with improved capacity for physical exercise and functioning of respiratory muscles. In addition, it promotes participation in group activities, boosting relational well-being and the sense of social satisfaction.
Proof of many of the positive outcomes associated with social prescribing is provided by cases when it has been put into practice. There are many success stories, especially in the United Kingdom, which is at the forefront of implementation of the approach. Details of some of the most significant initiatives are recorded by the National Academy for Social Prescribing (NASP), which was established as a charity in 2019 to promote and support the spread of social prescribing.
One notable example is the Ways to Wellness programme launched in Newcastle in 2015. Link workers guide people with long-term health conditions towards a network of community resources and activities, including art, culture, volunteering, social support and exercise. The results show that 86% of participants reported an improvement in their well-being, while the secondary (hospital and specialist) care costs per patient were 27% lower than a comparison cohort.
Another practical example is the AoP programme in Gloucestershire, which sees a consortium of organisations promoting health measures based on art and creativity. Commissioned by the National Health Service for people living with a range of conditions – including type 1 diabetes, epilepsy and cancer – it has recorded significant improvements in levels of anxiety and depression.
Programmes such as these, along with scientific findings about the outcomes, are reinforcing the reputation of social prescribing as a solution that can be included as part of primary care and provide a broader, more personalised response to health needs. This is made possible thanks in part to link workers, who make a key contribution by using their time and expertise to find out about the physical, psychological, social and personal conditions of patients, then help to guide them towards the health care services and resources available in their communities
Further reading:
Catterina Seia e Elena Rosica, Loneliness: the invisible epidemic, 30 maggio 2025;
Catterina Seia e Sara Uboldi, Patients or people? Seven steps towards a paradigm shift., 29 marzo 2023;
Catterina Seia e Sara Uboldi, How to fight anxiety without drugs with 'social prescribing', 26 luglio 2022