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

本研究将调查志愿主义通过绿色处方倡议促进健康、可持续社区的程度。社会处方是一种快速发展的干预措施，被视为加强保健提供者与社区、自愿和地方当局服务之间的联系，使患者能够转诊到各种全面的非临床服务。绿色处方是指客户对自然干预的社会处方。本文旨在为政策制定者和实践者提供可访问的方法，以更好地了解绿色处方运作的系统以及志愿者，社区主导的变革如何发生。本研究的目标包括：*在绿色处方的背景下，批判性地审视并促进自愿性、福利和可持续性的概念化。*探索参与绿色处方干预的志愿者和客户的各自经验，建立对什么对谁有效/不对谁有效以及为什么有效的理解*调查组织和从业者对绿色处方如何演变的观点，包括健康和社会护理与志愿部门之间的紧张关系*进一步了解促进和限制绿色处方成功的条件，探索权力、治理问题；社区行动、关系、非正式网络、协作变革和环境我设想了一个比较案例研究设计方法，着眼于两个绿色处方项目。这些将在研究的第一阶段进行有目的的审查后决定。用于选择比较国的参数可能包括项目的地理、社会和政治背景；项目持续时间和规模；项目设计和治理。将使用民族志、基于实践的研究方法，可能包括参与性和创造性方法、行动学习集和涉及专业人员、志愿者和客户的定性访谈。项目的例子包括萨默塞特野生动物信托自然联系；自然-苏格兰绿色健康伙伴关系；萨默谷绿色基础设施项目；健康联系Mendip；以及英国红十字会连接社区项目。政府的孤独战略（2018年）和NHS 10年计划（2019年）将社会处方确定为解决社会孤立、孤独和精神疾病增长的关键干预措施，而当前的COVID - 19危机加剧了所有这些问题。此外，有证据表明，初级保健服务面临越来越大的压力，这加速了NHS对社会处方的吸收，2020/21年度增加了1000名联系人员的投资表明。近几十年来，幸福的概念和对这一谎言的责任已经成为一个意识形态的战场，在社会和绿色处方的背景下是相关的。社会处方在多大程度上将负担从NHS转移到志愿部门，以满足更复杂的需求并改善福祉，这方面存在一些争议。这引发了关于国家提供的界限、自愿主义以及社区在健康和福祉方面的作用的根本辩论。根据ESRC的研究重点，这项研究将侧重于“卫生和社会保健方面的创新”。该研究将强烈关注协作、知识交流和影响，并属于SWDTP的“领域和发展途径”。

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 environmentI 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'.