Nature and communities

Introduction

Nature and Communities covers nature connectedness, social prescribing in nature, and protecting nature.

Nature-based interventions

Nature-Based Health Interventions are programmes, activities or strategies that aim to engage people in nature–based experiences with the specific goal of achieving improved health and wellbeing.   

Population level interventions

These aim to change the environment in which people live, work, learn, or heal (e.g. the provision of gardens in hospitals or parks in cities). These interventions can help prevent ill-health, improve recovery from ill-health and reduce the impact of long-term conditions. Developing these interventions may be at the level of urban planning or at a more local level such as creating a pocket garden in a GP surgery or a community allotment. NHS forest has an abundance of resources including free tree starter packs.  

Patient-level interventions

These directly engage people in activities or organised programmes. These are also known by the terms ‘Green and Blue Prescribing’ (with Blue Prescribing referring to nature activities related to water). Green Prescribing can range from suggesting patients go for a daily walk in the park, through to group-based activities in nature.   

Evidence

Spending time in nature and engaging with nature-based activities have been found to improve health outcomes, from decreasing stress and anxiety to improving immune functioning and reduced all-cause mortality. This commentary from 2019 offers an excellent summary.  

Financial savings

The Wildlife Trust has shown that Green Prescribing can save the NHS millions of pounds through a Natural Health Service. For example, Programmes (summaries shown below) were evaluated and if just one of these programmes was offered to an estimate of 1.2 million people it could result in annual cost savings of £635.6 million. 

Wild at Heart

Wild at Heart by Sheffield and Rotherham Wildlife Trust is a social group that runs nature-based activities and helps people learn new skills. The analysis found healthcare cost savings of £38,646 of 82 participants over a year. For every £1 invested, there is £1.19 of additional benefit in terms of reduced costs to the NHS.

MyPlace

MyPlace by Lancashire Wildlife Trust helps people improve mental and physical health. The analysis found healthcare cost savings of £7,024 and reduced employment-related costs due to mental health of £28,442. For every £1 invested, there is £2.16 of additional benefit in terms of reduced costs to the NHS.

Feed the Birds

Feed the Birds by Shropshire Wildlife Trust addresses social isolation and loneliness by linking individuals with volunteers who help them feed birds. Analysis found healthcare cost savings of £15,460 per year of 57 people. For every £1 invested, there is £0.40 of additional benefit in terms of reduced costs to the NHS. Assuming all participants were fully engaged over the full 31-month duration, the accumulated benefits over this period are much higher, at around £102,440.

Wild Health

Wild Health by Gwent Wildlife Trust provides opportunities for recreational, social, and work-based outdoor activities that benefit physical and emotional well-being. Analysis found healthcare cost savings of £66,882, equating to £471 saving per participant. For every £1 invested, there is £0.58 –£1.10 of additional benefit in terms of reduced costs to the NHS

Many nature based interventions have been shown to have return on investment. For example, walks taken by people in UK woodlands save £185m a year in mental health costs.

Resources

• Improving Welfare through Urban Nature (IWUN) completed a research project into how Sheffield’s natural environment improve the well-being of the city’s residents. They have a hefty repository of reports and academic papers, with this excellent report designed specifically for healthcare workers wishing to learn more or take action. 

• Information on the RSPB’s Nature Prescription initiatives, including a report from the pilot in Edinburgh (2022) 
• Growing Health Together is a fantastic intiative in Surrey recognising the huge assets for health and wellbeing that exist outside of the formal health service. From walking groups, coffee mornings and mutual aid groups, through to our local parks, lakes and wild spaces, they provide support for wellbeing. You can also read this summary article about their work.

Offering challenge and joy in equal measure, I implore anyone excited by such a vision to give it a try.

Dr Gillian Orrow on Growing together