Social prescribing in Portugal: pilots, gaps and the cost of time

Social prescribing in Portugal is not yet part of the national health system. A few family health units (USF) run pilot projects, and health economists are asking whether the approach works and who pays for it. In a Healthonomics Talks episode from the Health Economics and Management Knowledge Center at Nova SBE, guest Francisca Ramirez, a master’s student in economics, explains the concept and where economics fits in.

Social prescribing in Portugal so far

Social prescribing links patients to community resources that already exist, such as community centres, volunteer groups, theatre or dance classes, and local council activities. The first Portuguese pilot started at USF da Baixa in Lisbon. The physician Cristiano Figueiredo brought the model back from a training placement in the United Kingdom, and the project has since spread to other units in Lisbon. A project in Alentejo is also being implemented, and it is being studied by the Escola Nacional de Saúde Pública at Nova.

Why it matters

The open question is causality. Some studies report benefits, but the literature has no clear consensus yet, and the data do not yet show that taking part leads to better health outcomes. Economic evaluation can help by setting out costs and benefits and comparing social prescribing with other interventions. For patients, the main cost may be time rather than money, since most community resources are free or low cost. A working parent with children may simply not have the hours to attend. Training is the other issue. The UK model relies on link workers who connect the health system with social services, so Portugal would have to retrain social workers or create a new role.