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The THSG was formed to explore how to grow the Therapeutic Horticulture offer and to support the scaling up of Green Social Prescribing. Two roundtable workshops (March and June 2022) of providers, professionals, policy officers, and academics concluded that the barriers included a lack of:

The common language for commissioners, practitioners, providers and service users.

  • This issue was highlighted in the 2016 report by Bragg and Atkins for Natural England and despite work done by the Green Care Coalition and others, it was felt that this was still an issue. The rise in popularity of the use of nature for wellbeing, particularly during and following the Covid pandemic was felt to have exacerbated the issue with many more people considering any activity in nature to be Green Care.

Awareness of the impacts of nature-based activities/interventions.

  • Related to the language point above, concerns were raised about how a lack of awareness of the different ways in which nature can be used to benefit health could lead to poor alignment with the beneficiary’s needs; provision needs to be matched with the needs of the beneficiary to support the best outcomes and avoid inappropriate referrals. It was felt that a comprehensive, but accessible summary of key research findings and the theoretical backcloth was needed alongside training and development for health and care professionals, and providers. Accessible information is also needed for the public/potential beneficiaries.

Commonly understood standards for delivery (quality assurance and training), impact measurement, etc.

  • It was recognised that without such standards and evidence that they are actively implemented, STH is not seen as a viable alternative or complimentary ‘treatment’ option. Within the STH sector, work on setting and maintaining standards has already been started.

Funding for service provision and development within the sector.

  • This has been recognised not least within the Green Social Prescribing Interim Evaluation Report, which found that in many circumstances, providers are reliant on short-term, piecemeal funding, which limits their ability to invest in their businesses and expand, where there is demand. The delivery, and continuation, of good quality, consistently available VCSE services in the community is dependent upon predictable and sustainable investment.
  • One member of the stakeholder group highlighted the lack of funding available to the primary care networks with STH not recognised among the ARRS roles.

Support for providers to work together to offer STH at scale.

  • The issue of how to scale up as individual organisations, collectives working together, and nationally across Integrated Care Systems, including amplifying evidence was raised. With the sector dominated by a large number of small-scale providers, it was felt that there was a need to provide support to enable new providers to set up (especially in areas where there is little or no current provision) as well as for existing providers to grow their provision and to collaborate to provide scale at a PCN or ICS level.