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

这项研究将调查在何种程度上，素食主义是促进健康，可持续发展的社区，通过绿色处方倡议。社会处方是一种快速增长的干预措施，旨在加强卫生保健提供者与社区、志愿者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基于自然的干预措施的社会处方。本论文旨在为政策制定者和实践者提供更好地理解绿色处方运作的系统以及志愿者和社区领导的变革如何发生的方法。研究的目标包括：* 批判性地审视和促进概念化的非物质性，福祉和可持续发展的背景下，绿色处方。* 探索参与绿色处方干预的志愿者和客户的各自经验，了解什么对谁有效/无效，以及为什么 * 调查组织和从业者对绿色处方如何演变的看法，包括保健和社会护理与志愿部门之间的紧张关系 * 为了进一步了解能够和限制绿色处方成功的条件，探索权力、治理、社区行动、关系、非正式网络、协作变革等问题，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。这些将在研究第一阶段进行有目的的审查后决定。选择比较对象的参考因素可能包括项目的地理、社会和政治背景;项目的期限和规模;项目设计和治理。一个民族志，以实践为基础的研究方法将被使用，并可能包括参与和创造性的方法，行动学习集和定性访谈涉及专业人士，志愿者和客户。这些项目的例子包括：萨默塞特野生动物信托基金与自然的联系;苏格兰自然绿色保健伙伴关系; Somer Valley绿色基础设施项目;保健联系门迪普;以及英国红十字会与社区的联系方案。政府孤独战略（2018年）和NHS十年计划（2019年）将社会处方确定为解决社会隔离，孤独和精神疾病增长的关键干预措施-所有问题都被当前的COVID 19危机放大。此外，有证据表明，初级保健服务正面临越来越大的压力，这加速了NHS内社会处方的采用，这表明2020/21年度增加了1000名链接工作人员的投资。近几十年来，福祉的概念以及这一责任的归属已成为意识形态的战场，在社会和绿色处方的背景下也很重要。关于社会处方在多大程度上能够将负担从NHS转移到志愿部门以满足更复杂的需求并改善福祉，存在一些争议。这引发了关于国家提供的边界、非营利组织以及社区在健康和福祉中的作用的根本性辩论。根据ESRC的研究重点，这项研究将集中在“健康和社会护理创新”。该研究将重点关注协作、知识交流和影响，并将福尔斯纳入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'.