Using electronic health records to evaluate a children and young people's social prescribing service: challenges and implications for research and practice

Clinical Snapshot

Key Findings

• P Value: p<0.001

• Effect Size: 20% relative increase in wellbeing scores

• Primary Outcome: SWEMWBS wellbeing score improvement of 3.72 points

• Nnt Or Sensitivity: Effect modification suggested for those with lower baseline wellbeing (exploratory analysis)

• Confidence Interval: 95% CI: 3.30 to 4.14

Clinical Application

Requires trained link workers, standardised protocols, and improved data systems Relevant as social prescribing pilots expanding in Australia through PHNs, but would need adaptation to local health system and cultural context Children and young people with mental health concerns referred by GPs or schools

Abstract

BACKGROUND: Preliminary evidence indicates that social prescribing (SP) can improve children and young people's (CYP) well-being but is limited by small non-representative samples and often relies on descriptive statistics. Given the wide implementation of SP in the UK, administrative records provide a unique opportunity to understand current practice and assess impacts on well-being. OBJECTIVES: (1) To understand the quality of data captured in SP administrative records. (2) To explore which CYP are currently receiving SP and what SP entails in practice. (3) To assess the impact of SP on well-being. METHODS: We used administrative records from one CYP SP service in England. Records were extracted from Joy, an online platform for managing SP. Over 18 months, 770 age-eligible CYP were referred to SP, 203 of whom were successfully discharged and completed two pre-post measures of well-being (the short Warwick-Edinburgh Mental Wellbeing Scale; SWEMWBS) at least 7 days apart. We used descriptive statistics, a paired t-test to assess changes in well-being and linear regressions with interactions to test effect modification. FINDINGS: Missing data was the largest issue, with ethnicity missing for 94% of CYP. A lack of detail and inconsistent recording for both individual characteristics and SP practices also presented challenges. Despite this, we identified that most CYP were referred by their GP, followed by their school, with 97% referred because of their mental health. The most common pathway was to receive SP for around 90 days, with 10-15 link worker contacts and 6 contact hours. Following SP, SWEMWBS scores improved by 3.72 points (t(202)=17.50, 95% CI 3.30 to 4.14, p<0.001), a 20% relative increase. Exploratory analyses suggested that this increase was greater for those with lower baseline well-being. CONCLUSIONS: Despite numerous challenges with missing data and data quality, we found that CYP well-being increases following SP (as it is currently implemented). The moderate effect size was consistent with larger studies of adults. CLINICAL IMPLICATIONS: Further development of online platforms is needed to monitor access to, nature of and efficacy of SP. For those working in SP, we recommend more training, implementation of standardised guidelines and designated time to update records.

References

1. 1.Bone, J. K., Bu, F., Fancourt, D., & Hayes, D. (2026). Using electronic health records to evaluate a children and young people's social prescribing service: challenges and implications for research and practice. BMJ Mental Health. https://doi.org/10.1136/bmjment-2025-302442