Group membership can reduce health care appointments by a quarter, new study shows

The survey measured sense of belonging in community groups

Researchers at Nottingham Trent University (NTU) looked at the practice of social prescribing, which involves treating patients with chronic conditions exacerbated by loneliness – such as depression and obesity – through a personalised programme of practical, emotional and social support, rather than just medication.

The two-part study, published in BMJ Open, explored how and when social prescribing works, and for whom, with a focus on the Social Cure perspective: a theory which highlights that the social groups to which we belong have important positive effects on our health and well-being, but only to the extent that we identify with them.

The first part of the research included in-depth interviews with general practitioners (GPs), health coaches, link workers and patients on a social prescribing pathway to understand how social factors influence health and the use of primary care services. It also investigated how GPs and practitioners recognise whether people are disconnected socially, and the role social prescribing and group membership can play in addressing this.

Dr Blerina Kellezi, lead researcher and senior lecturer at NTU’s School of Social Sciences, said: “The GPs we spoke to recognise the limits of the traditional medical model in addressing patient well-being, especially those with complex chronic conditions. They expressed that a change is required in terms of how health, well-being and social concerns are understood and addressed by health services and society, as the NHS traditionally does not address social isolation. Achieving this would require a broader approach addressing mental, physical and social health.

“All participants recognised the potential role of social prescribing in addressing social needs, and the unique role that link workers, groups, and communities can play in establishing these benefits. Importantly, our analysis also confirmed that patients recognise how social factors can affect their health and how they benefit from connecting with others.”

The second part of the study asked patients to answer a survey of questions at the time they were referred onto the pathway and four months later. The survey covered membership of social groups – such as family, sports clubs, church, music and arts groups –  their sense of community belonging in these groups, the level of loneliness they experienced and their use of primary care.

Results showed that an increase in group membership between surveys led to a significant reduction in primary care use, including a 25% reduction in appointments, due to patients experiencing an increased sense of community belonging and decreased feelings of loneliness.

Dr Kellezi added: “Until now, research hasn’t explored how and why social prescribing really works. Our findings support the theory that Social Cure, when people identify and feel a sense of belonging with a group, should inform how social prescribing pathways are designed to achieve maximum benefit. For instance, these initiatives should reconnect isolated patients with their local community in order to help them better cope with loneliness and focus on the important role played by patients’ local communities in enhancing this sense of connectedness and belonging.”

The research was carried out by Dr Blerina Kellezi in conjunction with colleagues from the Department of Psychology at NTU’s School of Social Sciences. Read the full paper on BMJ Open.