Articulating voluntarism, wellbeing, and sustainability in the practice of green prescribing in the UK

This research will investigate the extent to which voluntarism is promoting healthy, sustainable communities through green prescribing initiatives. Social prescribing is a fast-growing intervention seen to strengthen links between health care providers and community, voluntary and local authority services, enabling patient referral to a variety of holistic, non-clinical services. Green prescribing refers to social prescriptions of clients to nature-based interventions. This thesis aims to offer policy makers and practitioners accessible ways to better understand the system in which green prescribing operates and how volunteer, community led change happens.
Objectives of the research include:
* To critically examine and contribute to the conceptualisation of voluntarism, wellbeing, and sustainability in the context of green prescribing.
* To explore the respective experiences of volunteers and clients involved in green prescribing interventions building an understanding of what works/ does not work for whom, and why
* To investigate organisational and practitioner perspectives on how green prescribing is evolving, including tensions at the interface of health and social care and the voluntary sector
* To further understand the conditions that enable and limit success of green prescribing exploring issues of power, governance, community action, relationships, informal networks, collaborative change, and environment

I envisage a comparative case study design approach looking at two green prescribing projects. These will be decided after a purposive review in the first phase of the study. Parameters that will inform the choice of comparators are likely to include the geographical, social, and political context of the project; duration and scale of the project; project design and governance. An ethnographic, practice-based research approach will be used and is likely to include participatory and creative methods, action learning sets and qualitative interviewing involving professionals, volunteers, and clients. Examples of projects include Somerset Wildlife Trust Nature connections; Nature Scot Green Health partnership; Somer Valley green infrastructure project; Health connections Mendip; and the British Red Cross connecting communities programme.

The government loneliness strategy (2018) and the NHS 10-year plan (2019) identify social prescribing as a key intervention for addressing growth in social isolation, loneliness, and mental illness- all issues amplified by the current COVID 19 crises. In addition, evidence that primary care services are under increasing strain has accelerated the uptake of social prescribing within the NHS, indicated by increased investment of 1000 link workers in 2020/21. The concept of wellbeing and where responsibility for this lie has become an ideological battleground in recent decades and is pertinent in the context of social and green prescribing. There is some controversy about how far social prescribing has the effect of shifting the burden away from the NHS onto the voluntary sector to meet more complex needs and improve wellbeing. This has created fundamental debates about the boundaries of state provision, voluntarism, and the role of communities in health and wellbeing.

In line with ESRC research priorities, this research will focus on 'innovation in health and social care'. The research will have a strong focus on collaboration, knowledge exchange and impact and falls within the SWDTP 'area and development pathway'.