What can England’s link workers tell us about implementing social prescribing?
Author: Dhara Patel
As social prescribing continues to expand across Europe, understanding the workforce delivering it is becoming as important as measuring the outcomes.
Since 2019, England has embedded more than 3,300 link workers within primary care teams, creating the world’s largest social prescribing workforce. Link workers support patients, who are often referred by a GP, by connecting them with opportunities, activities and services in their local community to address their wider needs. This community-based support is often provided by voluntary, community, faith and social enterprise (VCFSE) organisations.
As the evidence base for social prescribing grows, recent research has suggested that referrals to link workers are associated with “consistent and sizeable improvements across multiple domains of wellbeing within one to six months of referral.”
Drawing on findings from two recent studies – the 2026 Link Worker Survey carried out by The National Academy for Social Prescribing (NASP) and research from the University of Manchester published in The Lancet Primary Care – this article explores what the experience of England’s link workers can teach us about implementing social prescribing at scale, offering lessons for integrating this role in Europe’s model.
Positive experiences of the role
England’s link workers report overwhelmingly positive experiences in the role. The National Academy for Social Prescribing’s 2026 survey found that 90% of link workers enjoyed their role, while 96% believe they make meaningful differences in people’s lives. Building relationships, alongside the role’s flexibility and autonomy, is consistently described as the most rewarding part of the job. These experiences are reflected in service delivery, with most patients referred to a link worker being seen within four weeks and typically receiving ongoing support through four to twelve interactions.
The Lancet study similarly found that patients, healthcare professionals, and strategic leads all recognise the valuable contribution link workers make in supporting people whose needs often extend beyond traditional healthcare.
Much of this impact stems from the relationships link workers form with patients. Unlike typical clinical appointments, link workers have longer appointment times to understand the wider circumstances affecting an individual’s health and wellbeing, with appointments for people with more complex needs sometimes lasting up to an hour.
Patients interviewed for The Lancet’s study highlighted empathy, active listening, and a non-judgmental approach as defining characteristics of effective link workers. Viewing link workers as “everyday people”, rather than authority figures, allowed patients to feel listened to and comfortable sharing their experiences, leading to trusting relationships developing over multiple appointments. These relationships are seen not only to help patients access community support, but also to build confidence, increase independence, and strengthen social connections through greater engagement with their local communities.
Supporting people with complex social needs
The two pieces of research also challenge common misconceptions about the role of link workers. While social prescribing is often associated with social activities, the studies show that link workers increasingly support people experiencing complex and interconnected social needs, such as housing, heating, welfare, benefits, and food supply.
As a link worker quoted in The Lancet put it, there is a perception that “you’re taking people to knitting groups and things like that, but that’s just not the reality. I’d say about 10% of cases are around social activities. I do a lot of phone calls about housing.” Both the NASP survey and The Lancet study found that referrals are most often related to mental health, financial security, addiction, and housing struggles; however, some link workers feel they are unable to offer sufficient support.
Challenges around caseloads, training and career development
Alongside these successes, both studies also identify challenges that will need to be addressed to ensure the long-term sustainability of the workforce. Growing caseloads and increasingly complex referrals place considerable demands on link workers, with almost a quarter of respondents to the NASP survey reporting that they support more than 300 people each year.
Many felt their role remained poorly understood within primary care, with one survey respondent commenting that link workers are sometimes viewed as a “dumping ground” for patients with complex needs rather than recognised as skilled professionals with a distinct role. They also called for better training, supervision, career development, and mental health education.
At the same time, pressures on the wider VCFSE sector, including long waiting lists and insecure funding, often leave link workers continuing to support patients as appropriate community services remain unavailable. As the Lancet study notes, link workers are neither mental health professionals nor case managers, making clear role boundaries and sustainable community services essential to effective practice.
These two studies add to previous research into the role of link workers in primary care in England, including a realist evaluation in 2025 and other research led by the Nuffield Department of Primary Care Health Sciences.
England’s experience demonstrates that embedding social prescribing requires more than introducing a new workforce. It requires continued investment in the people, partnerships, and community organisations that make the model possible.
The experiences of link workers provide valuable lessons about both the opportunities and practical realities of delivering social prescribing at scale. As social prescribing continues to develop across Europe, the SP-EU project will build on this growing evidence base by exploring how social prescribing and the link worker model can be adapted across different populations, communities, and healthcare systems.
By strengthening our understanding of what works, for whom and under what conditions, this research will help inform the future development of sustainable and effective social prescribing across Europe.
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