A qualitative exploration of a UK nature-based social prescribing scheme: The service user perspective

Social prescribing schemes are growing in the UK. Evidence in support of nature-based social prescribing referrals, a specific sub-set of social prescribing, is mounting, however there are several challenges to capturing impact. Many evaluations have focused on health improvement to gauge impact. The service user perspective is critical to understanding the wider value and warrants continued exploration. Potential for participant insights to identify ‘active ingredients’ of schemes could inform the development of future frameworks designed to understand best practice, ensure efficient use of NHS funds, resource allocation and reduce the burden on primary care. Thus, this study aimed to understand the value of nature-based social prescribing schemes from the service user perspective. Three focus group discussions (n=22) and 17 one-to-one interviews were conducted (59% male participants). The thematic analysis generated three themes: ‘Community’, ‘nature connection and exposure’ and ‘ripple effects’; which highlighted the value of participation. Nature-based social prescribing schemes benefit participants in a multitude of ways. They help provide a safe and supported place to develop personal identity and social skills which are vital for social connection and a sense of purpose. Nature exposure and connection afforded was important in facilitating these benefits. Specific features of the local scheme studied also highlighted the critical importance third sector staff play in delivering services to those facing deprivation, unemployment and or poor wellbeing. The relationships between scheme leaders and service users created opportunities to develop skills, and self-confidence which created ripple effects that extended beyond the immediate setting.