Screening for social determinants of health in primary care v1.0
Research type
Research Study
Full title
Screening for social determinants of health in primary care: A feasibility study
IRAS ID
338784
Contact name
Emma Parry
Contact email
Sponsor organisation
Keele University
Duration of Study in the UK
1 years, 3 months, 30 days
Research summary
Research Summary:
Social determinants of health are non-medical factors that impact on health, such as education, socioeconomic status, housing, and living environment. Recording these important details in a person’s GP record may lead to care plans that are better tailored to people’s unique circumstances and situation, and therefore, improved health outcomes. In addition, this information might help us to better understand health inequalities and to estimate where resources are most needed. However, there is currently no way of routinely collecting information about the social determinants of health in the United Kingdom. Therefore, this study aims to explore how feasible and acceptable it is to use a screening tool in primary care to collect information about the social determinants of health. In addition, it aims to provide information about the burden of social needs in the study population.
This study is a mixed methods study, using both quantitative and qualitative methods. Initially, we plan to recruit a sample of adult participants from three general practices in the West Midlands, to complete the screening tool using one of three different modes: SMS text, post, or telephone. Screening will also be conducted opportunistically during consultations. The different modes of collecting information about the social determinants of health will be compared using recruitment and non-response rates, the screening tool will be validated, and refined, and screening tool responses will be linked with information held in the Electronic Health Record, allowing us to explore associations of social need with healthcare burden. This quantitative data collection will be followed by semi-structured interviews with a sample of participants, and focus groups with practice staff and community stakeholders, to explore the acceptability of screening for social needs and the practicalities of using this screening tool in primary care.Lay summary of study results:
Why We Did This Research Non-medical challenges, such as money, housing, and food struggles, account for 20% of UK GP visits. Currently, the NHS estimates these needs using postcodes rather than asking patients individually, which often misses struggling households living in wealthier areas. We tested a UK-specific screening tool in GP practices to see if collecting personal social information is practical, acceptable, and useful for improving care.
What We Did
We invited 1,208 patients across four West Midlands practices via text, post, phone, and in-person invitations to complete a social needs questionnaire, linking their answers to 12 months of health records. We also interviewed 9 patients, 7 GP staff, and 15 community health workers to understand their experiences.What We Found
While overall response rates were low (44 patients completed the tool; 3.2%–3.7% across invitation methods), screening uncovered significant hidden needs: 27.0% of respondents reported financial instability and 15.9% reported food insecurity. Patients expressed worry and embarrassment about disclosing personal struggles, emphasising that trust and privacy are essential. Staff highlighted that screening must offer immediate, practical support, such as referrals to social prescribers, rather than feeling like a "tick-box" exercise.What This Means for Care & Future Research Asking patients directly about social needs reveals important health drivers that postcode averages miss. However, low participation shows that screening must be handled sensitively. Future efforts should integrate non-judgmental, easy-to-read questionnaires into routine care (like annual health reviews or the NHS App) and link them directly to social prescribers and care coordinators to support patients without overloading GPs. Patient and public contributors helped shape our materials and will continue to guide future work co-designing trusted referral pathways.
REC name
Yorkshire & The Humber - Leeds West Research Ethics Committee
REC reference
25/YH/0057
Date of REC Opinion
21 Mar 2025
REC opinion
Favourable Opinion