the natural health service in scotland - rebecca wade...
TRANSCRIPT
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'Developing Green Prescribing in Sheffield'
27th March 2018
Event jointly organised by IWUN and the Sheffield and Rotherham Wildlife Trust.
Our Natural Health Service in Scotland - Local Green Health Partnerships, the Dundee Experience
Rebecca Wade (Abertay University)Mary Colvin (NHS Tayside)
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• Brief background –greenspace and health in Scotland
• ONHS – Our Natural Health Service in Scotland
• Dundee – the plans for Dundee's Local Green Health Partnership
• Social Prescribing
• Green prescribing
Outline
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Greenspace and health in Scotland - 2008
Health Impact Assessment of Greenspace 2008
Health Scotland, greenspace scotland, Scottish Natural Heritage and Institute of Occupational Medicinehttp://greenspacescotland.org.uk/SharedFiles/Download.aspx?pageid=133&mid=129&fileid=41
Previous work identified important links between health and greenspace, relating to mental, physical and community health. This project came about because both greenspace and health professionals felt that guidance on the health and equity impacts of greenspace would contribute to greater recognition of the role of greenspace in improving health, and a greater emphasis on healthy greenspace in proposals.
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Most adults in Scotland (82%) visit the outdoors for recreation at least occasionally – and more than 9 in 10 of these visitors report improvements to their physical and mental health as a result:
• ~ 94% say it helps them de-stress, relax and unwind
• ~ 92% found it improved their physical health
• ~ 90% report that it makes them feel energised and re-vitalised
• ~ 81% say they enjoy getting closer to nature
• ~ 76% value the social experience
However,
• Less than half of adults in Scotland (49%) visit the outdoors on a regular, weekly basis - and 14% don’t visit at all.
Greenspace use in Scotland 2011-2017
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2018 State of Scotland Greenspace – Report
The State of Scotland’s Greenspace report provides data on the amount and type of greenspace for all of urban Scotland. It also examines changes and trends in people’s use and attitude to greenspace, and looks at the resourcing of Council parks and open space services.
Scotland’s towns and cities are more green than grey
Key findings include:
• Scotland’s towns and cities are more green than grey – 54% of the urban land area is greenspace
• The total area of greenspace in urban Scotland is 1,593 square kilometres (27 hectares of greenspace per 1000 people (excluding private gardens)) - that translates into a tennis court sized area of ‘publicly accessible’ greenspace per person.
• 28% of greenspace is classified as private gardens and grounds, with amenity greenspace making up a further 37% - together these two types account for two-thirds of Scotland’s greenspace
• public parks and sports areas (which are the accessible public spaces most often used in daily life) account for 4% and 9% of greenspace respectively
• Scots love their parks and greenspaces - with over 90% saying it is important to have greenspace in their local area
• Urban greenspaces are popular outdoor destinations - with nearly half (43%) of urban Scots visiting their local greenspace once a week or more often (but frequency of use has fallen from a peak in 2009 when nearly two-thirds (63%) visited weekly)
• Whilst most respondents (74%) were satisfied to some extent with the quality of their local greenspace, 40% agreed or agreed strongly that ‘the quality of my local greenspace has reduced in the past 5 years’ (up from 33% in 2011 – and rising to 50% for respondents from the most deprived areas)
• The falls in greenspace quality and use, mirror falls in expenditure – with Council expenditure on parks and greenspace falling from £27,814 per 1000 people in 2010/11 to £21,794 in 2015/16
http://www.greenspacescotland.org.uk/state-of-scotland%E2%80%99s-greenspace-report-published.aspx
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SNH corporate plan launched 26th March 2018
https://www.nature.scot/connecting-people-and-nature-corporate-plan-2018-2022
Connecting People and Nature in Scotland
Our Natural Health Service – ONHS - Partners
• Scottish Natural Heritage (SNH)
• NHS Health Scotland
• Forestry Commission Scotland
• Transport Scotland
• Implemented in partnership with other National and Local organisations
Our Natural Health Service
Making use of Scotland’s Outdoors
www.naturalhealthservice.scot
Improving public health & reducing health inequalities
= key priorities in Scotland
A range of diseases & chronic conditions, often associated
with lifestyles and life issues, coupled with an ageing
population and more people experiencing multiple
conditions, are putting increasing pressure on our health
and social care systems.
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Our Natural Health Service In Scotland
Natural health service concept
Health benefits from being active and/or spending time in the natural environment
ONHS Action Programme
Package of work
Step change in how the natural environment is used to improve people’s health & contribute to health outcomes
ONHS Scotland promotesGreen exercise and its benefits
'Green exercise' = active or passive engagement with greenspace and nature, which improves physical, mental and social health and well-being.
Green exercise includes:• walking and relaxation• outdoor learning and play• recreation and sport• practical conservation• gardening• rehabilitation and recovery• active travel
This is why Scotland’s outdoors is the foundation of Our Natural Health Service.
Multiple Benefits:Contribution to effective recovery• The natural environment can have important ‘restorative’ qualities Nature as preventive medicine• Just being outdoors during the day can bring mental and physical health benefits
and help to guard against illness. ‘Realistic Medicine’Wider social health benefits• As more people connect with local green places and get involved in their care,
communities become stronger, more inclusive and more sustainable.Sustained benefits for young people• Pomote a healthier lifestyle for a lifetime.Evidence base for health benefits• Health benefits from the outdoors and nature provides more detail on the
benefits of green exercise, plus key sources of evidence.
From SNH: https://www.nature.scot/professional-advice/contributing-healthier-scotland/green-exercise-and-its-benefits
ONHS Action Programme
Unlock the potential - contribution of the natural environment to a healthier Scotland
1. Information and communications
2. Product and pathway development• Tackling barriers to mainstreaming
3. Strategic interventions• Cross-sectoral partnerships to demonstrate the benefits of
the approach• Green Health Partnerships
4. Evaluation and research
Local Green Health Partnerships
• mainstream green exercise programmes in local health delivery & promotion
• co-ordinate & up-scale cross sectoral action
• shaped around local health priorities
• targeted approach, responding to inequalities
• shift to a demand led approach
Support from ONHS Action Programme
Green Health
Partnerships
Evidence & Research
- evaluation of ONHS
- advice & co-ordination
- knowledge exchange
- research links
Communications
- key messages
- target audiences
- creative products
- promotion & information
Green Exercise
- Workforce Development (awareness, knowledge & skills)
- Product QA
- Intra / inter sector networking & sharing good practice
Key elements
• Green health services: further development
• Accessing services (incl. referral / signposting)
• Integration with other programmes & services
• Co-ordinated communication on local green exercise opportunities
• Evaluation
Dundee’s Local Green Health Partnership
• New initiative
• Partnership work on a proposal
• Project officer position
Dundee Health Stats - 2011 census
• Dundee’s children = third most overweight/obese in Scotland. • Dundee has fifth highest rate per 1,000 population (6,319 people in the 16 to 64 age
group) who reported that they had a mental health condition - above the National average.
• people who identified themselves as having mental health conditions are less likely to be engaged in work than in Dundee’s general population (Only 28% are in employment, 48% are either long term sick or disabled).
• Dundee has the third highest prevalence of drug misuse in Scotland. The high proportion of women who are drug users is significant, given the known impact of substance misuse on parenting capacity and the ability to keep children safe.
• The prevalence of alcohol related health harm in the city is very serious. • At least 23% of the population are totally inactive, meaning that they do not do 30
minutes of moderate activity in a week. They therefore predispose themselves to higher risks of cancer, cardiovascular disease, diabetes, stroke and poor wellbeing.
Current picture . . .Loads happening but
• Fragmented, uncoordinated, opportunistic
• Limited impact
• Untargeted
• Unsustainable
But . . .• Clear potential
DUNDEE - A SNAPSHOT OF CURRENT PROVISION
• mental health issue (Branching Out)• struggling with low self-esteem/confidence and anxiety (Green Buds)• recovering from substance misuse (walking football)• whose health and wellbeing are impacted on by their social circumstances• affected by cancer (Move More Macmillan)• who are generally physically inactive (Health walks)• undergoing rehabilitation and recovery programmes • with long term conditions.• children & families (Family Fresh Air Club)• individual with a risk of overweight and obesity (Gardening, exercise and
walking programmes)
Our vision of Dundee – An Active City with Active People
1. Commission additional green exercise programmes to respond to existing and new priorities.2. Strengthen signposting and referral mechanisms to better connect with those who want to use them.3. Integrate green exercise into other programmes and services across the city e.g. play, raising attainment, active travel, and older people.4. Scale up the work currently happening with groups affected by cancer, poor health, substance misuse and vulnerability due to poverty, low self-esteem and long term conditions.5. Co-ordinate promotion and communication of activity opportunities 6. Ensure that Parks, Greenspace and Green Infrastructure successfully support a range of Green Health opportunities and initiatives.
WHAT HAS HAPPENED SO FAR
• Scoping study
• Engagement event – Chairman of NHS Tayside Board and Executive Directors pledged their support to an emerging GHP
• Invitation to Dundee Partnership – presentation to Health and Wellbeing Executive Board
• Dundee University established Pollinating Wellbeing network of practitioners and academics. SNH, NHS, DCC and University of Abertay are partners.
• Synergy between existing work at University of Abertay and DCC / NHS to take forward GHP.
• Scottish Government allocation of additional Link Workers to increase social prescribing model.
• Polypharmacy - NHST Transformation Board consideration of Lifestyle
• Specific reference to forming a Green Health Partnership in the City Plan and in the wider Physical Activity Strategy for the city.
What will success look like?
• Indicators indirectly impacted: physical activity; healthy weight; mental wellbeing and social isolation.
• Greater public and professional awareness of the benefits & opportunities for contact with nature as part of everyday lives.
• An increase in the number of Health & Social Care initiatives routinely embracing nature-based interventions for prevention, treatment and care.
• An increase in the number of people being active through contact with the nature.
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“Modest Ninewells Leaf Room named Scotland’s best place”
• March 22 2018
• Ninewells Leaf Room named Scotland’s best place
• Scottish Civic Trust ‘My Place’ Awards.
Dundee - hospital greenspace
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Community benefits – Dundee and beyond
2017 Recovery Walk Scotland
Walking together, remembering together, waterfront and greenspace focus for community cohesion and support
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• “We hope that this will enable participants to be better at recognising and monitoring their own mental health and that of others, and be better able to change their environments in order to improve mental wellbeing.”
• Participants: School children, supported community groups
• Methods: Photography, commentary, workshops
• In previous research, Dr Moore and her colleagues worked with the NHS 24 'Breathing Space' helpline in order to map the effects of the social and physical environment on emotional distress. They are now looking to build on this to examine the impact of the local environment.
University of Dundee and Abertay University
Dundee and Me: How the City Shapes our Moods’
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Dundee community greenspace examples
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Health challenges and Health Inequalities –Dundee – city centre and outer communities
