Abstract
BackgroundNational Health Service (NHS) England supports social prescribing in order to address social determinants of health, which account for approximately 80% of all health outcomes. Nevertheless, data on ongoing social prescribing activities are lacking. Although NHS England has attempted to overcome this problem by recommending 3 standardized primary care codes, these codes do not capture the social prescribing activity to a level of granularity that would allow for fair attribution of outcomes to social prescribing.ObjectiveIn this study, we explored whether an alternative approach to coding social prescribing activity, specifically through a social prescribing ontology, can be used to capture the social prescriptions used in primary care in greater detail.MethodsThe social prescribing ontology, implemented according to the Web Ontology Language, was designed to cover several key concepts encompassing social determinants of health. Readv2 and Clinical Terms Version 3 codes were identified using the NHS Terms Browser. The Royal College of General Practitioners Research Surveillance Centre, a sentinel network of over 1000 primary care practices across England covering a population of more than 4,000,000 registered patients, was used for data analyses for a defined period (ie, January 2011 to December 2019).ResultsIn all, 668 codes capturing social prescriptions addressing different social determinants of health were identified for the social prescribing ontology. For the study period, social prescribing ontology codes were used 5,504,037 times by primary care practices of the Royal College of General Practitioners Research Surveillance Centre as compared to 29,606 instances of use of social prescribing codes, including NHS England’s recommended codes.ConclusionsA social prescribing ontology provides a powerful alternative to the codes currently recommended by NHS England to capture detailed social prescribing activity in England. The more detailed information thus obtained will allow for explorations about whether outputs or outcomes of care delivery can be attributed to social prescriptions, which is essential for demonstrating the overall value that social prescribing can deliver to the NHS and health care systems.
Highlights
80% of health outcomes are linked to social determinants of health, which include health-related behaviors as well as socioeconomic and environmental factors [1,2]
The RCGP RSC dataset was searched from January 01, 2011 to December 31, 2019, to determine the extent to which codes within the social prescribing ontology were used by RCGP RSC primary care practices in England
Codes for “social prescribing,” including the 3 codes recommended in the National Health Service (NHS) England Common Outcomes Framework (COF), were investigated
Summary
80% of health outcomes are linked to social determinants of health, which include health-related behaviors as well as socioeconomic and environmental factors [1,2]. A major barrier to the evaluation of social prescribing is the lack of data on what social prescribing activity is taking place and the outcomes delivered for people participating in these activities. Objective: In this study, we explored whether an alternative approach to coding social prescribing activity, through a social prescribing ontology, can be used to capture the social prescriptions used in primary care in greater detail. Results: In all, 668 codes capturing social prescriptions addressing different social determinants of health were identified for the social prescribing ontology. Social prescribing ontology codes were used 5,504,037 times by primary care practices of the Royal College of General Practitioners Research Surveillance Centre as compared to 29,606 instances of use of social prescribing codes, including NHS England’s recommended codes. The more detailed information obtained will allow for explorations about whether outputs or outcomes of care delivery can be attributed to social prescriptions, which is essential for demonstrating the overall value that social prescribing can deliver to the NHS and health care systems
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