Evaluation of Central Locality Integrated Care Services (CLICS), Bradford

Key statistics

• CLICS engaged 917 patients, matched with 3,668 controls based on age, gender, ethnicity and comorbidity status.
• Odds of unplanned hospital admission were 17% lower in the CLICS group compared to matched controls, though estimates were imprecise.
• Sub-analysis indicated a 49% lower odds of unplanned admissions for White British patients receiving CLICS compared with controls; no reduction was observed for Pakistani heritage patients.
• Wellbeing (SWEMWBS) increased by an average of 3.6 points among CLICS participants; health-related quality of life (EQ-5D) also improved on average.

Key messages

• the CLICS intervention, which integrates social prescribing with general practice, shows promise in reducing unplanned hospital admissions and improving wellbeing and quality of life in a deprived, diverse population
• early evidence suggests differential effects by ethnicity, with White British patients showing greater reduction in admissions than Pakistani heritage patients
• social prescribing, as delivered within CLICS, can support personalised care that addresses both clinical and non-clinical needs through connections with community resources
• evidence on cost, long-term outcomes and mechanisms of effect remains limited, and causality cannot be established with certainty.

Policy implications

• integrated neighbourhood services that link clinical care with community and social resources may reduce demand on acute services and support quality of life improvements
• evaluation designs need to include ethnicity-sensitive analyses and explore how interventions can reach and benefit diverse population groups equitably
• place-based initiatives should consider referral and recruitment pathways to ensure high-risk groups are engaged
• longer follow-up and comparative evaluation are necessary to inform commissioning decisions and scalability.

Gaps

• no causal inference due to observational design and lack of control data for wellbeing and quality of life measures.
• early estimates are imprecise with wide confidence intervals on key outcomes
• subgroup findings suggest potential inequities that require more in-depth study
• limited evidence on sustained impacts beyond 12 months and on cost-effectiveness.

Commentary
This evaluation contributes to neighbourhood health and care evidence by examining a real-world integrated service that deliberately combines clinical primary care with community-oriented support through social prescribing. It aligns with place-based approaches that seek to address both medical and social determinants of health in deprived urban settings.

The finding that CLICS may reduce unplanned hospital admissions is promising, particularly in the context of cities with high baseline rates of acute service use. However, the differences observed by ethnic group raise important equity questions about why benefits appear stronger for some populations than for others. This reflects broader concerns in neighbourhood health that services must not only be integrated but also culturally accessible and inclusive.

Improvements in wellbeing and health-related quality of life suggest that integrating social prescribing and primary care has potential benefits beyond service utilisation. These outcomes are particularly relevant for place-based strategies that aim to support resilience, self-management and connection to community resources.

However, the evaluation’s limitations (particularly its observational design and short follow-up) mean that evidence of effectiveness remains tentative. For policymakers and local teams investing in integrated neighbourhood services, this highlights the importance of building evaluation into programme design and ensuring that data collection supports equity-focused analyses.