Green social prescribing

Nature-based or green social prescribing links people with structured and facilitated nature-based activities that have been specifically designed for people with defined health needs. Chief among nature-based interventions are social and therapeutic horticulture (using gardening, food growing and plants to support wellbeing); care farming (involving the therapeutic use of agricultural landscape and farming practices); and environmental conservation (involving activities designed for conservation and management of natural places for health and wellbeing). Green social prescribing is an important component of the government’s Covid-19 mental health recovery plan, which sets out a whole-person strategy to support people living with mental illness.

In 2021 Defra, NHS England and NHS Improvement, Ministry of Housing, Communities and Local Government, Department of Health and Social Care, Natural England and Public Health England have made an investment of over £5.5 million in setting up seven ‘test and learn’ green social prescribing sites in England, focusing especially on communities whose mental health has been disproportionately affected by Covid-19.

The aim of the ‘test and learn’ sites is to embed green social prescribing into communities in order to:

  • Improve mental health outcomes.

  • Reduce health inequalities.

  • Reduce demand on the health and social care system.

  • Develop best practice in making green social activities more resilient and accessible.

The Humber and North Yorkshire Health and Care Partnership are among the seven test and learn sites. This programme, is being led by the HEY Smile Foundation and aims to develop a ‘test and learn’ site for Green Social Prescribing across the six places of East Yorkshire, Hull, North Yorkshire, Vale of York, North Lincolnshire and North East Lincolnshire.

The programme will follow a clinical cohort of individuals with identified mild to moderate common mental health problems through a green social prescribing journey to measure the impact of taking part in ‘green’ (outdoors and in nature) or ‘blue’ (on water or at the coast) activities on their mental health and wellbeing. Individuals will be identified by Link Workers (or equivalent job title) embedded in services and organisations delivering social prescribing programmes.

The NIHR Yorkshire and Humber ARC will host the evaluation of the Humber, Coast and Vale green social prescribing programme. The evaluation project, co-led by Dr Peter Coventry (Department of Health Sciences) and Prof Piran White (Environment and Geography), will be split across two cohort phases, starting in January 2022 and ending in November 2022. Outcome measures will be taken at two time points: before participants engage with the ‘green’ or ‘blue’ activity and on completion of their interaction with the activity (or at 3 months, whichever is sooner). The outcome measures used will be ONS-4 and the Hospital Anxiety and Depression Scale (HADS) and will be administered by the link workers (or equivalent job title) or mental health services. Data will also be captured on demographics, reason for referral, clinical characteristics, and referral route of individuals taking part in the cohort, alongside the activity they take part in and the number of sessions they attend.

The findings will feed into and inform the overall national evaluation of the green social prescribing test and learn sites which aims to understand how to scale and embed green social prescribing into primary and community care effectively.

The NIHR YHARC, in partnership with UCLAN and the University of York, also

hosts the evaluation of a green social prescribing initiative led by the West

Yorkshire Health & Care Partnership.