Practitioners Information: Quick Links

How to Prescribe

If you are considering a Green Social Prescription (GSP) for a patient during a consultation there are three potential pathways you can consider depending on the degree of need and the ability of the patient to self-manage. You should also consider if the patient would prefer to be alone or with a group: people with anxiety may need to undertake solo activities.

  1. Self-directed

  2. Information signposting

  3. Referral to another professional

1. A recommendation for a self-directed, outdoor activity such as walking in a park X times per week for Y weeks. This is suitable for a patient who can undertake a self-directed activity and/or requires an activity that doesn’t require being in a group.

2. Information signposting. Provide the patient with information about a local group that is providing a nature-based activity. This is suitable for a patient who is able to access the activity with no further intervention from you.

a. In some cases you may need to make a referral to the group or contact it in advance.

3. Referral to a community link worker or equivalent. Patients with complex needs for whom a GSP may be helpful as part of a wider intervention can be referred to a link worker attached to your practice.

Our research shows that patients and health care professionals find treating these recommendations as a prescription is empowering for patients.

The essential elements for a successful prescription

  • Include honest and accurate information sharing and have a ‘good conversation’ as part of the prescription. ‘Good conversation’ training may be helpful. (opens in new tab). See the resources section for more on this: Further reading

  • Be clear about why GSP is being suggested and how it can help.

  • Check that the activity is viable for the patient. Can they afford transport if they need it? Do they need to buy outdoor clothing? Are there foreseeable risks to their safety? Are there cultural or religious issues to consider?

  • Ensure that the prescription is appropriate for the provider. For example, some providers may not be able to manage clients with complex mental, physical or social needs. The provider may not have capacity for new clients or their funding may be ending soon.

    • A key element when it comes to a successful prescription of attendance at a local group is to ensure that you and the provider have built a good relationship before prescribing.

Barriers and Enablers to GSP

Enablers

  • Many groups who provide NBHAs have the ability to assign a volunteer to “buddy” a new participant.

  • Being prescribed something that can be performed immediately instead of a lengthy wait for a NHS service can be appealing.

  • Providing a prescription rather than a suggestion gives the suggestion significant extra authority and can empower a patient to act.

  • Older people sometimes associate nature-based activities with childhood memories of being in nature.

Barriers

  • Affordability

  • Accessibility (is it nearby or is transport available)

  • Weather (suitable clothing)

  • Food (if taking part in a lengthy activity, some people may not be able to take food with them)

  • Social and cultural factors

  • Issues around anxiety

  • Issues around affordability

Things to be aware of when prescribing

  • People living in an area of high deprivation may struggle to find high-quality, safe green-space areas in their neighbourhood.

  • People who are experiencing ageing-related issues may face challenges around physical capabilities and may be anxious about the risk of falls and other accidents.

  • Some GPs have told us they are reluctant to broach the topic in case the patient responds badly but evidence shows that most patients respond well to the suggestion.

  • Because most groups who provide these activities are 3rd sector organisations, funding can be erratic so it is important to have up-to-date information about their current status.