Green social prescribing in Scotland
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Green Health Week has been held in Scotland over the last 5 years as part of the Our Natural Health Service programme led by NatureScot. This year it will run 13 – 19 May. Here we take a look at what green health is, and how the environment sector is contributing.
With continued pressure on public sector resources, encouraging more engagement in ‘green health’ activities such as walking, cycling, sitting on a park bench, environmental volunteering, outdoor play and learning, gardening and active travel can contribute to public health outcomes and also raise awareness of sustainability issues around climate change and biodiversity loss.
Green exercise, green care, green health, call it what you will, but fundamentally, it’s about how spending time in and with nature can help sustain individuals’ health and happiness by providing connections to places, people and purpose. And it’s not a new concept.
We are part of nature, we’ve lived off the land and the seas’ bounties, we’ve adapted to the environment and now the environment’s adapting to us – and not in a good way. The environment sector has a long and positive track record of encouraging people to spend time outdoors, in part to raise awareness of the importance of landscapes, habitats and species and to educate, but also in the knowledge that there is huge value to individuals in connecting with nature and green space. Nature’s power to thrill, to challenge, to inspire, and to restore us, body and soul.
The Covid-19 pandemic has demonstrated as never before how important regular access to the natural environment is for everyone, with both active and passive engagement providing physical, mental and emotional benefits. Research by NatureScot during August and September 2021 found that 73% of people felt that spending time outdoors in nature helped them to de-stress, relax and unwind; and 63% agreed that it improved their physical health. 48% stated that they expected to visit the outdoors more often in future than before the first lockdown.
From remote mountain tops to high quality accessible urban greenspace, people make use of the environment as a health-improvement resource, but it’s an under-utilised asset and stronger links need to be made between healthy environments and healthy people. Happily, the contribution the natural environment can make to the delivery of public health objectives around physical inactivity, poor mental health and health inequalities is now being written into the strategies of the environment and many other sectors.
In Scotland, the Our Natural Health Service programme has helped health, environment, leisure services, transport, education, sport, academia, local communities and the voluntary sector work more closely together to show how the outdoors can support area-based healthcare priorities. At a local level, this joined-up approach has seen the establishment of four pilot Green Health Partnerships (GHPs) in Lanarkshire, North Ayrshire, Dundee and Highland. Each GHP operates to suit the systems and structures in its own area, but common aspects of their work include the collation of local green health information, raising awareness across health & social care and the public to encourage participation, and developing better ways to connect people to supportive local green health opportunities including links to social prescribing programmes.
Not all ill-health needs clinical intervention or medicine. Social prescribing is a way of connecting people to local community-based activities, groups and support, and can help prevent illness or contribute to recovery. Green social prescribing is an example of a nature-based solution to health and wellbeing issues and links people to green health activities.
Initiated in 2019, the green prescribing system developed by the Dundee Green Health Partnership is an example of a bespoke system that enables people in receipt of referrals to be matched with local green health opportunities. Having carried out an audit of green health providers and projects across Dundee, around a dozen agreed to be part of the referral service. Almost 200 prescribers were identified and briefed, including GPs and practice nurses, Allied Health Professionals, psychologists, specific clinical teams and community pharmacists. Prescription pads were printed and issued, the main part of which was given to the referee, providing information about the range of activities available and the contact details for the ‘Dial-Op & Go’ telephone advice service operated by Dundee Volunteer & Voluntary Service (DVVA), a key partner within the GHP. A tear-off slip with the prescriber’s code and basic patient info was sent by the prescriber to DVVA whose team were then responsible for taking calls from / making calls to the referee. Partly as a consequence of Covid-19, digital green prescription templates compatible with IT systems used by healthcare staff were also made available. See research paper on the Dundee green health prescription system 2022: Developing Scotland’s First Green Health Prescription Pathway: A One-Stop Shop for Nature-Based Intervention Referrals
The other GHPs have also helped to increase the use of green health resources for social prescribing, principally by raising awareness of local supportive green health projects across healthcare practitioners and encouraging their inclusion within existing referral pathways. The increase in provision of Community Link Workers is seen as a way to significantly increase social prescribing to green health opportunities such as health walks groups, community gardens and environmental volunteering schemes. See the Highland GHP’s Toolkit for Green Prescriptions 2022
Work to promote and facilitate green social prescribing is happening in other parts of Scotland, for example in Edinburgh and the Lothians; and the RSPB’s Nature Prescriptions programme is supporting local partners to develop materials and referral pathways.
Scotland’s great outdoors is outstanding, and enables us to connect with and value nature. It provides a conducive setting close to home for physical activity and mental refreshment, and can offer a level playing field for purposeful group activity. Supporting people to engage in and enjoy the outdoors can contribute to the prevention, treatment and care of ill-health, as well as helping to tackle loneliness and social isolation.
The cross-sectoral approach to Green Health is supported by Scotland‘s Chief Medical Officer as a route to health improvement, and has synergy with a range of government policy including around health inequalities, social prescribing and active travel. The outdoors and green health are not remedies for all our nation’s health issues, but they can play a valuable role, and be part of achieving a healthier Scotland.
Green Health Week – 13 – 19 May
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