Social prescribing for children and young people in the UK: characterising access and care pathways using electronic health records

Objectives

We aimed to describe the characteristics of children and young people referred to social prescribing across the UK and understand what social prescribing looks like for these young people. Additionally, we aimed to explore whether access to and experiences of social prescribing vary with age and have changed from 2017 to 2025. Overall, we aimed to identify whether social prescribing reduces or exacerbates health inequalities among children and young people, and whether this has changed over time.

Design

Analysis of social prescribing electronic health records

Setting

Social prescribing hubs and services across the UK that use Access Elemental (a cloud-based social prescribing platform)

Participants

52,585 individuals referred to social prescribing in 2017-2025 aged 4-25 years (mean=20.04, SD=4.71), of whom 57% were female, 39% male, <2% were in other gender groups, and 3% did not disclose their gender

Primary and secondary outcome measures

We summarised young people’s characteristics and described the care pathway received. We then used regression models to test whether these factors differed by age and over time.

Results

Most individuals were aged 18 and over, 91% lived in urban areas and 58% lived in the top three most deprived deciles of the UK. Most were referred by GPs or other allied health workers (79%) and mental health was the leading reason for referral (44%). The typical pathway included 4.64 social prescribing contacts (SD=7.70) totalling 66 minutes (SD=108), with 34% receiving an onward referral to community support. The average age of those referred to social prescribing increased over time.

Conclusions

Our findings indicate that social prescribing currently has limited reach for those under 18 and this disparity may be increasing. It was promising that children and young people referred to social prescribing were more likely to live in deprived areas. However, given current findings, more work is needed to increase the reach of social prescribing for children and young people across the UK.

Strengths and limitations of this study

• We used data from the most widely adopted social prescribing platform in the UK, including a large and diverse population of children and young people

• We included young people referred to social prescribing through medical and non-medical pathways, which is key for understanding inequalities in service provision

• Administrative data were limited by missingness and varying data quality, meaning we could not explore the role of ethnicity among other factors

• It was unclear whether individuals with no recorded interventions did not receive any prescriptions or were missing these data

• We could only explore access to and delivery of social prescribing by sites that have chosen to use the Access Elemental platform, making it difficult to understand what was driving changes over time