Connecting Roots: Co-creating a Green Social Prescribing Network in Walsall for Health and Wellbeing

Lead Research Organisation: Royal College of Art
Department Name: School of Design

Abstract

Spending time in nature supports both mental and physical health and has been one of the key factors enabling people to cope with the stress of the COVID-19 pandemic. It is associated with a sense of gratitude and self-worth and can help people recover from stress and mental illness. This kind of experience with nature also helps to build a sense of place and community and foster feelings of belonging. GPs, nurses and other healthcare professionals can now prescribe nature-based activities, such as walking for health schemes and community gardening, to those who could benefit from them. This is called green social prescribing. There is growing NHS support to use it more widely, particularly for those with poor access to healthcare who often also access nature less.

The Voluntary, Community and Social Enterprise (VCSE) sector delivers the majority of the green social prescribing services to local communities in the UK. These VCSEs are faced with challenges to grow so that a greater proportion of those in need can benefit from what nature offers. Following the COVID-19 pandemic, VCSE organisations are experiencing greater demand for their services.

Significant barriers exist for many VCSEs acting alone to scale. Collaboration with each other provides one avenue toward much-needed growth in order to reduce fragmentation, duplication and inefficiency. It helps improve the collective impact of the sector and its sustainability, and creates many mutual benefits including providing access to expertise and resources, increasing reach, and improving internal processes.

Our aim is to use design to support the scaling of green social prescribing services through (i) envisaging a system that creates the right conditions to best support scaling local green social prescribing at the system level; (ii) co-creating a green social prescribing network with local VCSEs in Walsall that improve the sector's collective impact and give voice to those who have been less heard. From the learning, we will (iii) devise the methods and make them widely available through engagement and dissemination.

We have recognised the importance of a genuinely bottom up and place-based approach that considers the totality of local assets, including the realities of the physical locality and local lived experience. Therefore, through design, this project will engage people in an open dialogue that enables more diverse insights on the needs of different stakeholders to be shared and opens new avenues for developing visions, bottom-up policies and collaboration amongst these local VCSEs.

This project will focus on Walsall as an example representing many deprived regions in the UK where public health is challenged by issues e.g. health inequality and physical inactivity that could potentially be addressed effectively through green social prescribing. It will be led by the Royal College of Art, in partnership with One Walsall, Active Black Country, The MindKind Projects, and Caldmore Community Garden to deliver a 12-month research programme.

The main outcomes of the project are:

(i) a system vision and policy recommendations to support scaling green social prescribing;

(ii) a green social prescribing network in Walsall to support VCSEs to grow so that nature-based activities can benefit more people in need;

(iii) methods and processes to scale VCSEs in green social prescribing through design that can be widely adopted.

Publications

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Sun Q (2023) Design for social imagination

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Sun Q (2023) Green Social Prescribing in Practice: A Case Study of Walsall, UK. in International journal of environmental research and public health

 
Description - Revealing how the local GSP schemes are structured, resourced and delivered through a case study

The project activities so far have led to the development of a case study of Green Social Prescribing (GSP) in Walsall, building on the in-depth understanding of the local context and people's lived experience. It fills the gap in our knowledge of how the local GSP schemes are structured, resourced and delivered.
Creating a wellbeing borough is at the core of the Walsall council's agenda. Walsall has already taken some significant steps in developing support available to its residents, especially support for mental wellbeing. Introducing SP and link workers is one of these key steps.
Walsall's SP referrals are distributed across different pathways both within the local Primary Care Network system and outside (Making Connections & Walsall Housing Groups). The unique setting of each pathway means each has its own advantages and challenges. Having multiple referral routes means that individuals have multiple access points and SP has a wider reach/exposure to the community to support more people. However, this also adds complexity for people to navigate through the system. Analysing these pathways, the project has identified a range of challenges, including (1) lack of sharing, learning and collaboration channels across different pathways; (2) the need for a better integration of the VCSEs into the GSP system; (3) inconsistency and inequality in access to GSP services; and (4) lack of consistent investment into blue and green infrastructure.

- Opening up an important research question as to how the value of nature and other forms of local assets to health and health inequality can be scaled beyond GSP to include wider communities

The value of referral is to bring people to community-based services they do not normally have access to. It is extremely valuable when people who need the services are identified and referred; then they can fully engage the services consistently, as evidenced by the success cases. The ultimate aim of providing a referral is to increase the ability of citizens to access health support. However, the benefit of referral will only be achieved when all the conditions - enjoyment, ability level, applicability and eligibility for example - are met. Therefore, to scale the practice to benefit a larger population requires system changes and consistent investment. We question if there are other areas that deserve attention and investment similar to that of SP, to address the wider determinants of population health and to develop the intrinsic capacity for health.

- Developing a design-led community engagement approach
The project has engaged a large number of stakeholders at local and regional/national levels. The process of engagement has led to the development and refinement of a design-led community engagement approach through workshops, networking building and other forms of activities. The design-led approach works on a number of principles including (1) being an 'honest broker' to nurture trust and long-term relationships with people; (2) being playful to introduce /restore imagination within people, and giving space for them to imagine beyond what they think is possible; (3) recognising and respecting their expertise in their own lived experience to collaborate with existing capacities and legacies within the communities across the board; and (4) empowering people to collaborate and to make decisions.
Exploitation Route The outcomes of this project will be the setting up of a network for the scaling of GSP in Walsall, and a set of methods for wider sharing, in addition to policy recommendations for achieving this.

Key audiences for these outcomes are individuals already engaged in GSP provision, those interested in initiating new GSP projects, and policy-makers. As such, the project aims to influence both top-down and bottom-up provision of GSP.

All participating stakeholder and partner organisations will be informed as to the project's findings, and many are participating in the network being developed. The project outcomes are also being taken forward into new proposed partnerships, such as skills development for local citizens to ensure legacy and transfer of communication routes. At the project's culmination an outcomes sharing event will be held.
Sectors Agriculture

Food and Drink

Communities and Social Services/Policy

Creative Economy

Education

Environment

Healthcare

Leisure Activities

including Sports

Recreation and Tourism

Government

Democracy and Justice

Culture

Heritage

Museums and Collections
 
Description Project findings have been analysed, translated visually, and employed in the development of outputs for academic conferences and journals. Beyond this, the project findings have been reported externally in workshops, meetings and seminars and VCSE forums, in particular through the following activities/media: A video to show how local communities see nature, health and community based on the workshop findings: https://www.youtube.com/watch?v=EvddMt_W4lY An exhibition in Walsall - opening on the 7th July in Walsall Arboretum cafe - which included reporting on our findings, displaying some of the beautiful art and thoughts created by our workshop participants, and inviting further engagement by the public of Walsall. A network of green social prescribing in Walsall: regular meetings and newsletters which will be further developed by local partners once the funding ends. Dissemination event with two sessions engaging different audiences. Through these activities, the project has created impact to local VCSEs, as exampled by what the CEO of The MindKind Projects CIC, a partner organisation, said: " Working with the RCA has impacted how we work with our communities. Whilst we have always been underpinned by person & community centred values and co-created interventions and solutions with our community, human centred service design principles now act as the golden thread that runs through our work. One example of this is the creation of a hyper-local network in the form of a culture club. This came about from our food growing project which saw the Ghanaian, Romanian, Bulgarian and South Asian communities sharing their own growing techniques and recipes. We brought participants together and utilised co-creation workshops to create a group vision of community, and from these visions we co-created and co-designed the fortnightly Culture Club. These skills were developed through our work with the RCA. We have benefited from working with the RCA in bringing service design thinking into how we co-produce solutions and services for our communities; equally we have been able to support the RCA with access to our network and our rich knowledge on how the VCSE sector operates and also access to marginalised communities to understand how they are impacted by health inequalities in turn amplifying the voices of the community and individuals we serve through academic research."
First Year Of Impact 2023
Sector Communities and Social Services/Policy,Creative Economy,Healthcare
Impact Types Societal

Policy & public services
 
Description Disseminating findings of the project at BLOXWICH Town Deal Officers Assembly
Geographic Reach National 
Policy Influence Type Participation in a guidance/advisory committee
Impact The assembly is the regular meeting by the Town Deal Officers. They deliver projects for the recent Town Deal funding. At the moment of this event, they consider how to take a more holistic approach to take health and wellbeing as part of their regeneration plan. The project findings have informed the decision making in the direction they take.
 
Description National Lottery: Connecting Roots 
Organisation National Lottery
Country United Kingdom 
Sector Private 
PI Contribution The National Lottery is keen to be part of the network being developed in the project to enable them to reach, communicate and collaborate with groups and individuals they have not previously worked with. The network activities provide a platform for the National Lottery.
Collaborator Contribution The National Lottery offers advice and funding opportunities for members of the network. Participation in the network will allow for information and workshopping possibilities for a range of participants, in a supportive setting.
Impact The output of this collaboration has been a scaled and strengthened network which is working to provide opportunities across its membership.
Start Year 2023
 
Description Natural England: Connecting Roots 
Organisation Natural England
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution Natural England is keen to be part of the network being developed in the project to enable them to reach, communicate and collaborate with groups and individuals they have not previously worked with. The network activities provide a platform for Natural England.
Collaborator Contribution Natural England offers advice and opportunities for members of the network. Participation in the network will allow for information and workshopping possibilities for a range of participants, in a supportive setting. Additionally, the network provides opportunities for participation in meetings providing expertise regarding opportunities for VCSE providers of green spaces.
Impact The output of this collaboration has been a scaled and strengthened network which is working to provide opportunities across its membership.The collaboration has also provided expert insight to feed into the publications developed for this project.
Start Year 2023
 
Description Towns Deal: Connecting Roots 
Organisation Walsall Council
Country United Kingdom 
Sector Public 
PI Contribution Presenting project research and findings to experts for feedback. Developing a strategy for impact within the case study areas.
Collaborator Contribution This is a £25 million fund that is being spent in Walsall and Bloxwich from now until 2026. It is in the initial 'design' stages currently. They are focusing on many different areas including healthcare, green spaces and community cohesion. We have been invited to present CR at one of the monthly meetings in the 'healthcare' section to see where our research might cross over with the plans for the future. This is a chance to discuss possible areas of collaboration and mutual support.
Impact The collaboration has benefitted the project in the form of guiding the research development to possible areas of collaboration and mutual support.
Start Year 2023
 
Description Walsall Arboretum: Connecting Roots 
Organisation Walsall Council
Country United Kingdom 
Sector Public 
PI Contribution The participation has been within workshops taking part in the conversation and consortium meeting to reflect on project progress. Hosting live workshops with representatives of local GSP providers and supporters.
Collaborator Contribution They are a public/ council space supported by the healthy spaces team (part of Walsall Council) and have provided space and facilities for meetings.
Impact Outputs of this collaboration have been in the form of engagement activities on site with potential users of the project as well as information dissemination to raise awareness.
Start Year 2022
 
Description Walsall College: Connecting Roots 
Organisation Walsall College
Country United Kingdom 
Sector Academic/University 
PI Contribution The participation has been within workshops taking part in the conversation to reflect on project focus and outcomes. Facilitation of the design workshop allowed for young people in Walsall to contribute to the vision of future GSP in Walsall.
Collaborator Contribution The participation has been within workshops taking part in the conversation to reflect on project progress. Young citizens of Walsall participate in workshops to gain insight to inform policy and project direction.Young people feel connected and as stakeholders in Walsall's future
Impact The output of this collaboration has been in providing expert insight to feed into the publications developed for this project. This insight has featured and directed the publications and public talks presenting the project findings.
Start Year 2023
 
Description Case Study Site Visits: Walsall, UK 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Third sector organisations
Results and Impact Regular site visits have been conducted to build relationships with the local VCSEs/community groups involved with Social Prescribing and Green Social Prescribing in Walsall. These visits have been conducted over the period of seven months, but also build on visits made previously in the Nature's Way project.The site visits have been in the form of casual introductions between local community groups, policy makers and relevant organisations. These visits allowed us to develop a holistic understanding of the place, the environment and atmosphere in the local green spaces, and have enabled us to include the community members in the discussion around what the Connecting Roots project should be engaging with and focusing on, and have been instrumental in mapping the networks in Walsall which may be involved. This has resulted in further invitations to meet other inspiring groups to reference in our project.
Year(s) Of Engagement Activity 2022
 
Description Connecting Roots Consortium Meetings 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact The consortium meetings bring together all the partners on the project at regular meetings which present and discuss the current research findings and future opportunities for engagement. It is an expert panel of professionals that support the project research.
Year(s) Of Engagement Activity 2022,2023
 
Description Connecting Roots Network Session 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Third sector organisations
Results and Impact The project has developed a network of third sector organisations in Walsall that are interested in / practicing green social prescribing. A total of 6 meetings have been delivered, engaging 12-20 participants each time. This has raised awareness of this practice amongst the 3rd sector organisations in Walsall.
Year(s) Of Engagement Activity 2023
 
Description Connecting Roots: Connecting Roots: The Future of GSP - What do we envision? Workshop 2 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Industry/Business
Results and Impact This was a design-led workshop aimed at Futures Thinking, using a set of approaches used to think about different scenarios that can happen in the future in a structured way. This was approached from a top down high level perspective on how GSP might look in the future.The workshop shifted thinking from reactive to proactive.
Year(s) Of Engagement Activity 2022
 
Description Connecting Roots: Design Workshop - Defining the future of nature, communities and wellbeing 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Study participants or study members
Results and Impact During the two hour long workshop, participants explored and reflected on their own nature space, communities and well-being, as well as working together in groups to collectively create a vision of what a shared nature space and community would look and feel like. The activity culminated in them writing a 'postcard' with recommendations of change or improvement to be delivered by councils and government in Walsall today to reach their collective visions of the future. These will directly inform policy recommendations.

A range of people representing true and diverse Walsall communities, of all age groups, backgrounds and abilities attended and engaged in the workshop, allowing us access to previously unheard voices. Participants asked if the workshops could be repeated - a programme of workshops engaging a number of sectors and communities is underway.
Year(s) Of Engagement Activity 2023
 
Description Connecting Roots: Formal Interviews 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact We held interviews with stakeholders to establish a comprehensive understanding of the schemes and pathways of the Green Social Prescribing sites and activities available in Walsall and to understand people's experiences involving GSP. This allowed us to build up a comprehensive overview as well as detailed individual data giving us a firm foundation for our project direction and further activities. Interviews have been held with representatives of institutions or groups that include: Resilient Communities, Public Health Development, and Healthy Spaces (all from Walsall Council); NHS partners NHS Black Country and Walsall Together, organisations including Walsall For All, One You Walsall, One Walsall, The MindKind Projects, Brownhills Community Association, Active Black Country, the British Triathlon Association, VCSEs including Goscote Greenacres, Caldmore Community Gardens, Winterley Lane Allotments, Lane Avenue Allotments, and groups providing Social Prescribing including PCN Walsall South 2, Walsall Housing Group (whg), Making Connections Walsall, and Bloxwich Community Partnership
Health Exchange.
Year(s) Of Engagement Activity 2022
 
Description Connecting Roots: Informal interviews 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Study participants or study members
Results and Impact Informal interviews were held with stakeholders in Walsall who engaged with nature and/or social prescribing, allowing us to gauge local people's engagement and experience involving the health benefits of nature. These informal interviews offered us alternative perspectives based on citizens' opinions and experiences rather than those already involved in GSP.
Year(s) Of Engagement Activity 2022
 
Description Connecting Roots: Journey mapping 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact Following interviews, maps were developed of the journeys taken by the stakeholders within the Social Prescribing system of Walsall. These provided clarity for the research
Year(s) Of Engagement Activity 2022
 
Description Connecting Roots: Presentation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Industry/Business
Results and Impact OneWalsall: Introduction of the project to date and overviews of the current findings were presented at a meeting with One Walsall. Continued to expand our network and invited participation to the next stage of research.
Year(s) Of Engagement Activity 2023
 
Description Connecting Roots: Shadowing 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Industry/Business
Results and Impact Embedded observation and shadowing was undertaken at a VCSE in Walsall delivering social prescribing to generate an in-depth understanding of the daily experience of link workers and VCSEs. This allowed the team to check the validity of the findings to date, and generated more granular information about the processes and experiences of workers and clients involved in GSP.
Year(s) Of Engagement Activity 2022
 
Description Connecting Roots: The Future of GSP - What do we envision? Workshop 1 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Industry/Business
Results and Impact A workshop was conducted in Walsall Arboretum with members of some of the Walsall organisations that have contributed to the Connecting Roots research. Introduction and overviews of the research findings to date were presented and a workshop led for the group to share their thoughts and opinions on GSP now and what it might look like in the future. It explored if the stakeholders shared common goals that they would like to work towards. This was an exploratory session to collaborate with individuals currently in the GSP system to help direct our research and let us know what we need to be addressing. This provided several previously unexplored research insights and directions.
Year(s) Of Engagement Activity 2022
 
Description Connecting Roots: Weekly meetings 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Study participants or study members
Results and Impact Meetings are conducted regularly so that the research team can come together and share their research findings. These meetings also provide an opportunity to check the alignment and direction of the research.
Year(s) Of Engagement Activity 2022,2023
 
Description Connecting Roots: blog 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Study participants or study members
Results and Impact A blog has been set up to direct traffic to the Nature's Way platform and as a way of keeping stakeholders informed about project activities. The blog will also be a training activity in the final phase of the project.
Year(s) Of Engagement Activity 2023
 
Description Exhibition (Walsall) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact As part of the research activities, the project has conducted community workshops when the participants have produced creative drawings to reflect and to explain the views of people from Walsall. The project delivered a 5 day public event to exhibit these creative drawings by local participants, to showcase the insightful views the community has envisioned. This has allowed local communities to have the opportunity see their work and hear their voice, and more importantly, be inspired to join nature-based activities for better health and well-being.
Year(s) Of Engagement Activity 2023
 
Description IASDR 2023: Life-changing Design 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact Presented an article "design for social imagination' based on findings from Connect Roots, which sparked discussions and questions afterwards leading to increased interest in this topic.
Year(s) Of Engagement Activity 2023
 
Description London Design Festival 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact The PI was invited to give talks about Connecting Roots project at 'Understanding Canals: The Veins of the City' as part of the London Design Festival on 20/9/23.
Year(s) Of Engagement Activity 2023
 
Description Project Dissemination Event 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact Towards the end of the project, a dissemination event was delivered at the RCA and online.
In the morning, the team shared the project findings focusing on learnings about the practice of Green Social Prescribing in Walsall, and its challenges and opportunities. This was followed by a panel discussion including 5 project partners from Walsall.

In the afternoon, the discuss focuses on the learnings about the design-led approach used in the project as an action research method. A guest speaker, Dr Katherine Mollenhauer, from Chile joined us to discuss how this approach is used in a different context.
Year(s) Of Engagement Activity 2023
URL https://www.youtube.com/watch?v=XxQe6EMvmcc&t=3276s
 
Description The future of Nature, Community and Health 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Third sector organisations
Results and Impact A total of 6 workshops were delivered as part of the project activities over the time period of Feb to May 2023, that have engaged 80 people in Walsall. They represents true and diverse Walsall communities, of all age groups, backgrounds and abilities attended and engaged in the workshop, allowing us access to previously unheard voices.
In the workshops, the participants explored and reflected on their own nature space, communities and well-being, as well as worked together in groups to collectively create a vision of what a shared nature space and community would look and feel like. The activity culminated in them writing a 'postcard' with recommendations of change or improvement to be delivered by councils and government in Walsall today to reach their collective visions of the future. These will directly inform policy recommendations.
Year(s) Of Engagement Activity 2023