Photo credit York St John University

Growing Green and Blue Health is HEY Smile’s programme of work to enhance the use of outdoor and in-nature activity to support the health and wellbeing of communities across Humber and North Yorkshire. Since April 2021 Smile has been working closely with both healthcare partners and the voluntary, community and social enterprise (VCSE) sector to champion, support and evidence the role that outdoor and nature-based activity has on mental health. Our work began through delivery of the Humber and North Yorkshire Green Social Prescribing (GSP) Test and Learn programme on behalf of the Humber and North Yorkshire Health and Care Partnership. You can find out more on this at the bottom of the page.

Our current programme encompasses the following workstreams:

Growing Green and Blue Health:

During the Humber and North Yorkshire Green Social Prescribing Test and Learn programme, Smile found groups and organisations that run green (outdoors in parks, gardens, woodlands and other ‘green’ spaces) and blue (on, in or near water) activities sought further support, training and upskilling to ensure they meet the health and wellbeing needs of referrals from health services including GPs, social prescribers and mental health teams. Thanks to £247,500 of investment from the Community Fund, Smile is delivering this project over three years (January 2023 to December 2025). 

Growing Green and Blue Health is working to provide this support, consulting with community-based organisations running activities about their specific needs and working collaboratively with our partner voluntary sector development organisations to either connect them with existing support, or organise and deliver bespoke training to meet the needs of the sector.

 “Connecting with nature has huge benefits for our health and wellbeing and local community groups play an essential role in making these connections happen, be it through walk and talk groups, community gardens or improving wildlife habitat. As pressure grows on our health system, and holistic person-centred care becomes more prevalent, we need to ensure those organisations delivering outdoor and in-nature activities are supported in their role in promoting the health and wellbeing of communities. This funding allows Smile to maintain the momentum we have generated around utlising the outdoors and nature in healthcare delivery, while building on our learning from the test and learn programme. It will also allow us to work towards a more sustainable model for community-based green and blue health delivery.” 

Anthony Hurd, Programme Manager for Green Social Prescribing at Smile

Evidence suggests that taking part in green and blue activities has significant health and wellbeing benefits for those involved. University of Exeter research suggests a 2 hour “dose” of nature each week, significantly boosts health and wellbeing, while connecting with nature is associated with lower levels of poor mental health, in particular lower depression and anxiety levels.  

 

This ambitious project is working across the six places of Humber and North Yorkshire: North East Lincolnshire; North Lincolnshire; Hull; East Riding of Yorkshire; Vale of York; and North Yorkshire. Delivery would not be possible without working in partnership with our place-based counterparts (below), alongside the support of the Humber and North Yorkshire VCSE Collaborative.

If you would like to find out more about Growing Green and Blue Health, get involved or sign up to our monthly newsletter then please email us at GreenSP@heysmilefoundation.org

 

‘Preventing and tackling mental ill health through green social prescribing’ extension programme

HEY Smile Foundation are once again leading on the delivery of a programme of works to support the national GSP test and learn programme. On behalf of the Humber and North Yorkshire Health and Care Partnership, HEY Smile are working with partners across the region to build the evidence base for the role that GSP plays in supporting mental ill health and the benefits it has to the wider NHS system. This work is part of a national programme and is helping to develop the evidence base in two areas of interest to the national partners: value for money of GSP and data tracking across the GSP pathway. This work has been made possible through the award of £295,000 to Humber and North Yorkshire as part of £4 million of funding from HM Treasury’s Shared Outcomes Fund and partner organisations to extend the seven original GSP test and learn sites for another year. This work will be completed in March 2025. 

The programme in Humber and North Yorkshire is made up of two projects:

Green Social Prescribing in North East Lincolnshire

Working with Navigo, the commissioned provider of mental health services in North East Lincolnshire, and Centre 4, leaders in social prescribing delivery, we are not only following people on their GSP journey, evidencing the impact such activity has on health and wellbeing, we are also working with Business Intelligence, Bridges Outcome Partnership and the North East Lincolnshire Health and Care Partnership to explore the wider ‘system’ impacts of people engaging in GSP activity, such as any reductions in use of NHS services. This work is not only showcasing how multiple partners can work together to pool data on GSP impact, but will also explore the value for money that GSP delivers through community-based holistic health care delivery.  

Green Social Prescribing for Ethnically Diverse Communities in Humber and North Yorkshire

In collaboration with Humber Teaching NHS Foundation Trust and Hull and York Medical School, HEY Smile have funded a collaborative of organisations who all support migrant, refugee and asylum seeking communities to deliver GSP activities and monitor and evaluate the impact they are having. The collaborative is made up of BAMEEN, Bora Shabaa, Hull Afro Caribbean Association, Solidarity Hull CIC, Welcome House and York St John University and each organisation is contributing data to the programme to help us understand who they are reaching, what GSP activity they are doing and how frequently, how they found out about the activity and the impact on their wellbeing using the ONS4 outcome measure. The collaborative have now exceeded their target of gathering baseline data on 100 participants and will be following up at 3 months and 6 months of engagement to measure the impact on the wellbeing of those taking part in GSP activity.

Photo credit Bora Shabaa

Humber Teaching NHS Foundation Trust and Hull and York Medical School are leading on a piece of research to compliment the data collected by the collaborative, using interviews to further explore the role of self and community referral into GSP activity, and what it is about the outdoors and nature that supports those that take part. HEY Smile meanwhile are exploring how the Social Value Engine can be used to evidence the value for money of investing in community based activities to tackle health inequalities in Hull and York.

 

Nature Champions

Photo credit HEY Smile Foundation

Thanks to financial support from Natural England, Smile have been able to fund a series of empowering ‘Nature Champion’ training sessions with a cohort of 10 individual from BAMEEN, Bora Shabaa, Hull Afro Caribbean Association, Solidarity Hull CIC and Welcome House.

Under the expert guidance of Yorkshire Wildlife Trust, the ‘Nature Champions’ received interactive training in wildlife identification and nature connection. The training sessions were enriched with activities focusing on using technology, art, senses and mindfulness to foster a deeper connection to, and understanding of, nature. ‘Nature Champions’ also received Mental Health Champion training with HEY Mind, fostering the links between the outdoors and nature and supporting mental health.  

The final session was a co-production workshop where the Champions engaged in fruitful discussions on strategies to encourage their communities to connect with nature, as well as identifying barriers preventing outdoor engagement.

The enthusiasm and positivity of the group remained throughout the activities, leaving them feeling empowered to spread their knowledge and passion as ‘Nature Champions’ within their communities. Watch this wonderful film to find out more. 

 

Compiled by our partners at York St John University, an evaluation of the programme can be viewed here. This outlines the impact the training has had on the knowledge, skills development and confidence of the ‘Nature Champions’ to engage and support their wider communities to develop their relationship with nature to support good health and wellbeing. 

 

Healthy Humber

Photo credit HEY Smile Foundation

Thanks to funding from Natural England, and in partnership with the University of York, this participatory workshop bought together healthcare referral organisations, including Centre 4, Humber Teaching NHS Foundation Trust and River and Wolds Primary Care Network, together with organisations working in nature conservation, including Groundwork Hull, Humber Forest, the RSPB and Friends of Bottesford Beck, to foster connection between sectors, develop ideas for more collaborative working, explore what nature can do for people and what people can do for nature.

A summary report has been produced by the University of York here, while a video capturing the day can be viewed below:

 

 

Humber and North Yorkshire Green Social Prescribing Test and Learn programme

Between April 2021 and March 2023, HEY Smile Foundation led Humber and North Yorkshire Health and Care Partnership’s Green Social Prescribing ‘test and learn’ across all six places in the partnership: North East Lincolnshire; North Lincolnshire; Hull; East Riding of Yorkshire; Vale of York; and North Yorkshire.

The programme was funded and supported by: the Department for Environment, Food and Rural Affairs; NHS England; Office for Health Improvement & Disparities; National Academy of Social Prescribing; Natural England; Sport England; Department for Levelling Up, Housing & Communities; and Department of Health & Social Care.

Humber and North Yorkshire was one of just seven ‘test and learn’ sites established in England to explore how the use of, and connection with, the outdoors and nature through referral to ‘green’ and ‘blue’ community-based projects and activities could be increased. The work formed part of the national £5.77m cross-governmental, ‘Preventing and tackling mental ill health through green social prescribing’ project. Humber and North Yorkshire was awarded £500,000 of national funding, while a further £206,453 was secured by The Health Tree Foundation from NHS Charities Together to support the programme.

This national programme built on the government’s commitment to transform mental health services and increase social prescribing, as set out in the NHS Long Term Plan. It also sought to deliver on the ambition set out in the government’s 25 Year Environment Plan to help more people, from all backgrounds, to engage with and spend time in ‘green’ and ‘blue’ spaces in their everyday lives.

Smile’s final programme report can be read here.

An accompanying report from the University of York who analysed data collected through the programme’s work to ‘Follow People on their Green Social Prescribing Journey’ can be read here.

 

Key outputs of the Humber and North Yorkshire GSP ‘test and learn’ programme included:

  • £354,589 of funding being administered to 36 community-based projects to deliver activities in the outdoors and nature that supported good health and wellbeing.
  • Working with 12 organisations, representing social prescribing, mental health and occupational therapy services, to gather data on 224 individuals being referred into community-based outdoor and in-nature activity to support their mental health and wellbeing.
  • Following 171 individuals on their complete GSP journey to understand the impact on their wellbeing, anxiety and depression. Analysis by the University of York found that GSP had a significant impact, showing that:
    • 67% saw improvements in overall wellbeing (as measured by questions 1-3 of ONS4)*
    • 70% saw improvements in anxiety (as measured by the Hospital Anxiety and Depression Scale)*
    • 62% saw improvements in depression (as measured by the Hospital Anxiety and Depression Scale)*

*percentage of participants that saw any improvements between their ‘before’ and ‘after’ scores following 12 weeks of activity, or when the activity ended if time limited.     

  • Developed GSP training, in partnership with Yorkshire Wildlife Trust and Natural England, and delivered it to 48 social prescribing staff across HNY.
  • Ran three ‘immersive days’ for healthcare staff involved in connecting people to community-based activity in partnership with Natural England and North York Moors National Park.

Photo credit Raincliffe Wood Community Enterprise

Learning from the test and learn programme showed GSP to be an effective tool to support the health and wellbeing of individuals across Humber and North Yorkshire both accessing health and care services, and within communities, to stay fit and healthy. While the focus was on mental ill health, the programme’s findings suggest that connecting people with the outdoors and nature could have positive benefits for many different services and priorities across the Partnership, and can play an important role in person-centred, holistic healthcare.

The team recommend the following be invested in to maintain momentum in supporting the health and wellbeing of those that live in HNY by connecting them with the outdoors and nature.

  • ‘Systematise GSP’ to ensure the practice of referring into GSP becomes embedded in ‘business as usual’ for services throughout primary care, social prescribing and mental health.
  • Continued training and development to ensure connection with the outdoors and nature plays a key role in supporting the health and wellbeing of communities and that relevant partners have the knowledge and confidence to both make, and support, referrals.
  • Sustainable investment into the VCSE sector through developing and piloting shared investment approaches to ensure groups and organisations have the stability and confidence to invest in their workforce and increase the number of activities available that can be easily accessed by different referral pathways.
  • Build the capacity of providers of outdoor and in-nature activity to be responsive to local healthcare need and demand.
  • Increasing the evidence base for GSP in Humber and North Yorkshire.
  • Improved connection and networking between referrers and activity providers.

In September 2024 the Preventing and Tackling Mental Ill Health through Green Social Prescribing Project Evaluation was released by Defra which took data and learning from all seven GSP test and learn sites, offering the following findings and recommendations:

  • Statistically significant improvements were shown in wellbeing (ONS4) following nature-based activities:
    • Happiness increased from an average of 5.3 to 7.5
    • Life satisfaction increased from an average of 4.7 to 6.8
    • Feeling that life is worthwhile increased from an average of 5.1 to 6.8
    • Levels of anxiety reduced from an average of 4.8 to 3.4.
  • Humber and North Yorkshire showed depression symptoms to reduce from 8.1 to 5.6 and anxiety from 11.1 to 8.5 using the Hospital Anxiety and Depression Scale.
  • The evaluation estimated a social return on investment of £2.42 per £1 invested by HM Treasury Shared Outcomes Fund and national partners.
  • The evaluation also found the cost of a green prescription was about £500, making it cost-effective compared with other clinical treatments.

Key recommendation for policy makers included:

  • There is a need for new commissioning and procurement arrangements to ensure that nature-based providers can be embedded within health service delivery and the wider social prescribing landscape.
  • It is necessary to grow and develop nature-based providers to ensure there are a range of appropriate, diverse, geographically spread GSP opportunities.
  • Improvements to the gathering and sharing of data about GSP outputs and outcomes are necessary to build confidence in the efficacy of GSP.
  • Building referrers’ capability, opportunity, and motivation to refer to GSP will improve access to appropriate green opportunities.