A taxonomy of children and young people's social prescribing models: a multi-site implementation case study in England

Introduction.
Social prescribing for children and young people (CYP) is expanding across England, yet there is limited understanding of how local services interpret and configure its core components—individual need, referrer, linking function and community activity—particularly for CYP presenting with mental health difficulties.
Methods.
Using a multi-site case study design, we examined five CYP-focused social prescribing pathways selected for their diversity of institutional anchors and implementation maturity. Data collection included pathway visualization with site leads and 34 semi-structured interviews with referrers, link workers, managers and practitioners. Thematic analysis was used to compare pathway structures and functions across cases to support development of an empirically grounded taxonomy.
Results.
Across sites, CYP accessed social prescribing through varied and uneven referral routes, with needs dominated by low-level mental health concerns amid gaps in statutory provision. Link worker roles differed substantially in embeddedness, remit and degree of mental health related support, often extending beyond traditional “linking” models. Pathways showed significant variation in institutional anchor points, eligibility criteria, linking functions and community asset connections. This variability enabled identification of key taxonomy dimensions, including institutional setting, referral pathway configuration, link worker function and community asset integration.
Discussion.
Findings show that CYP social prescribing is shaped by local context, unmet mental health need and flexible practitioner practice, resulting in diverse models rather than a standardized pathway. These differences have implications for commissioning and evaluation: rather than seeking uniformity, systems should support a ‘no wrong-door' approach and relational work, and evaluative approaches should prioritize implementation focused evidence over linear pre–post outcome measurement.