Objective To understand the growth of social prescribing in primary care and the scale and equity of the roll-out

Participants 1.2 million patients from 1,736 practices in the Clinical Practice Research Datalink from 2009 to the end of 2023

Main outcome measures Social prescribing discussions and referrals

Results Since the start of the national roll-out of social prescribing in 2019, there has been a clear linear increase in social prescribing being coded within primary care records. As of the end of 2023, an estimated 9.5m GP consultations in England have involved social prescribing codes, and 5.6m consultations have specifically led to social prescribing referrals. In 2023, social prescribing referrals exceeded NHS targets by 26.7 to 51.1%, reflecting rapid adoption. In 2023, females constituted 60.4% of social prescribing patients and ethnic minority groups represented 21.7%. Representation from patients living in more deprived areas increased from 21.7% prior to the national roll-out to 42% in 2023. Service refusal declined from 22.2% to 10.6% between 2019 and 2023. Females and less deprived patients were less likely to decline referrals, risking reinforcing existing group disparities, while younger age groups (<30) exhibited high referral uptake despite their lower level of referrals.

Conclusions Social prescribing has expanded rapidly in England, exceeding initial NHS targets and demonstrating the importance of the service. Progress is being made in reaching certain target groups such as more deprived communities. However, there are still disparities in accessibility and engagement, calling for targeted strategies and diverse referral pathways to fulfil social prescribing’s full potential.

The authors have declared no competing interest.

This work is supported by the MQ Transforming Mental Health and Rosetrees - Stoneygate Trust Fellowship (MQF22\6) awarded to AB. NL is supported by a Health Data Research UK personal fellowship. This work is affiliated to Health Data Research UK (Big Data for Complex Disease- HDR-23012), which is funded by the Medical Research Council (UKRI), the National Institute for Health Research, the British Heart Foundation, Cancer Research UK, the Economic and Social Research Council (UKRI), the Engineering and Physical Sciences Research Council (UKRI), Health and Care Research Wales, Chief Scientist Office of the Scottish Government Health and Social Care Directorates, and Health and Social Care Research and Development Division (Public Health Agency, Northern Ireland).

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical approval for this study was obtained from the Independent Scientific Advisory Committee of Clinical Practice Research DataLink (protocol no. 24_004142).

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes