To accelerate the economic and social impact of NERC science within human health and wellbeing, by improving and targeting knowledge exchange.

Lead Research Organisation: University of Exeter
Department Name: Biosciences


What is the main aim?
It is to bring businesses, scientists and health professionals together to share their knowledge, and to form a new project partnership. That project will simultaneously provide new insights in the value and management of nature, and improve people's health. This is done in the context of the broader objective of increasing the social and economic impact of natural science research.

What research?
Some relevant topics include: ecology; the ways in which evolution and co-evolution occur; the function of microbes in the soil; the ways in which animals behave; and the ways in which nature provides 'services' like flood defence, pest control and carbon storage.

If it's about environmental research, then why focus on health?
Health is central to our happiness and to our economy. 10% of UK GDP is spent on health and social care; the sheer scale of this means that there are business opportunities for those who can find ways to reduce overall costs. Saying that we know nature can improve health is not enough; we need to know how and why, for ecological reasons as well as social or economic ones.

What will the project actually involve?
The precise form will be defined as the work proceeds, but the term 'green prescriptions' covers a whole range of possible interventions where doctors - GPs and clinicians - get patients to engage with nature and monitor the effects. It can be understood as a course of treatment, or a preventative activity.

Why involve natural scientists?
The answer is in three parts. Firstly, people engaging with nature, - either just on their own or through organisations, is an everyday occurrence. But increasingly people involved in health are looking at 'green prescriptions' as a course of treatment. They need to know, from research scientists, what works best. The health benefit of nature is the result of a subtle and complex relationship, and it does not derive merely from being in it, but by understanding it, and from interacting within it in different ways. Secondly, vice versa; those natural scientists who model and calculate the value to health from nature need to understand this complexity to improve their studies. So expertise needs to be transferred in both directions. Thirdly, there is another dimension to this which has not been looked at much; what are the ecological impacts, the changes to ecosystems and the 'services' they provide, of increasing green prescriptions? Are there risks or possible problems? The assumption is that it is 'all good', and in both science and policy, assumptions need to be challenged.

How would, or could, people interact with nature differently?
Again it's important to let ideas run freely at this initial stage, but this might involve such things as: working with scientists; outdoor counselling and therapy; and nature apps tied to exercise monitors.

What examples are there, and what is the business potential?
At the moment we have examples of GPs using the 'Natural Health Service' to put patients in touch with community resources. It is ad hoc, and the impact - whether on nature or on health - is not well captured. Nearly all conservation volunteering does not involve either scientific or health input. By closing the circle and using insight from scientific researchers (and only natural science, but also social and medical science; we want to join up across disciplines as much as possible), as well as from doctors, there is scope for improving the business of existing providers, and even creating new economic activity, for example through the opportunities created by mobile electronic devices and digital media. For example, Surfers Against Sewage are creating an app that provides health researchers with epidemiological data on hepatitis infections in real time. This is the kind of activity that natural scientists could benefit from too, and the kind of thing I think this project can deliver.


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Description This grant is not for research per se, but for the exchange of knowledge between academics and people elsewhere in society; in this case, the health and environment sectors.

The project is about developing partnerships between all three groups of people to expand upon areas of collaboration and joint interest. The health system,in particular the primary care system, is interested in knowing how and why the prescription of nature may benefit patients. Environmental charities are interested in knowing how they can use their resources, such as nature reserves, to help people improve their health and wellbeing. And academics, from medical, environmental and other disciplines, are interested in knowing what they can do to help. The project is about bringing all three together.

When the project began it was assumed that the medical profession might be hard to convince, in some quarters, that a 'dose of nature' was an efficacious thing for a doctor to recommend to a patient. What we have found is that on the contrary, in the context of tightening and decentralised commissioning budgets, and an increasing awareness of GPS of their role and function within community and social networks, the idea falls on very fertile ground.

At the same time there is considerable enthusiasm amongst those who own and manage nature reserves and other areas to see the benefits and services that their land and/or biodiversity provides to all of society more clearly understood and valued.

The biggest problems have been practical; giving a nature prescription is a personal, patient-focused thing and one size certainly does not fit all. Patients/clients have complex needs, such as transport or access, and these need to be creatively and thoughtfully addressed.
Exploitation Route We are aiming to expand what we have been doing regional yin the first instance, by spreading up into Devon and working with partners across the border, and also further afield in some of the larger cities. We are are working on a proposal for NIHR to take forwards a larger project to build on this one that will deliver comparable research findings at scale. In the meantime we will produce a simple guide for others in all three sectors on how to set up a local nature prescription project.
Sectors Environment,Healthcare

Description The funding has delivered a new intersectional network in Cornwall and beyond ('A Dose of Nature'), and provided additional work for three SME/charities (Nature Workshops, MIND Restormel and Gaia Trust). The project has provided resources to create two further bids to NIHR (PenCLAHRC and NIHR Research Design Service). Additional impacts have included: 1 Co-authored paper (in draft; lead author) to go to British Psychological Society in Jan 2015. 2 Presentation for trainee GPs in Cornwall at one of their training days, on the project and how NERC funded science could be applied to their prescription models. 3 Three meetings with Dr Sara Warber, from Michigan State University, who has a Fulbright Scholarship with the University of Exeter to define Nature Deficit Disorder. Dr Warber and I plan to meet throughout the coming year and have jointly authored an opinion piece on Nature Deficit Disorder for The Lancet. 4 Presentation at "Bring the Happy', a touring art installation project, in Exeter. This was a public meeting (45 attendees), to discuss the relationship between antural science and public and personal health and wellbeing. 5 Met with Sustaincare, Community Interest Company in Devon, that has created a consortium of environmental organisations able to be commissioned directly to provide green prescriptions. Ongoing work to help develop a Cornish counterpart. 6 Mention in Woman's Weekly (health section) October 2014. 7 Interviewed by the Policy Exchange for their forthcoming policy report on the use and value of green spaces for public health (will be acknowledged in their report later this year). 8 Met and/or discussed the project with the over thirty private, public and voluntary stakeholders: SW Academic Health Science Network; Local Economic Partnership; Health and Wellbeing Board; Local Nature Partnership; National Trust; Natural England; Mind; Rethink; six GP surgeries; Cornwall Council; Cornwall AONB; four outdoor activity providers; Gaia Trust; Cornwall Volunteers; Sea Sanctuary; Westley Design; Sea Communications; Wageningen University (The Hague); Project Wild Thing; Public Health England's Health Protection Research Unit; Centre for Sustainable Healthcare; Organic ARTS. 9 Joined the Ecosystems Knowledge Network, drafted a suggested workshop agenda for their future programme, and agreed to present to a EKN / Society of Biology / Defra-sponsored conference in 2015 on nature and health. 10 Presentation in Esher to the South East England Green Spaces Forum 11 Presented two sessions at a workshop for clinical psychiatrists at the Royal College of Psychiatrists in October, on Environment, Psychiatry and Society. 12 Secured project oversight from Professor Brian Kirby OBE, retired clinical cardiologist. 13 Presented material for engagement session with internal Public Health England Section (Environmental Public Health Science) in June. 14 September 2014 blog piece for British Medical Journal on nature prescription. 15 October 2014 presentation to the College of Life and Environmental Sciences. 16 Keynote presentation at the Outdoor Recreation Network meeting in March 2015, Newport accepted.
First Year Of Impact 2013
Sector Environment,Healthcare
Impact Types Cultural,Societal