Isla Horton, Claire Terry and Karen Pardy
Cardiff and Vale University Health Board and Grow Cardiff
We are a partnership between registered charity ‘Grow Cardiff’ and the South West Cardiff Primary Care Cluster, comprising 10 surgeries supporting patients in some of the most disadvantaged communities in Wales (Welsh Index for Multiple Deprivation (WIMD), 2019). Patients are referred through the cluster’s social prescribing pathway or self-refer to weekly, hyper local, therapeutic community gardening sessions run by Grow Cardiff which aim to engage those experiencing on-going physical or mental health difficulties, loneliness and isolation.
- Launch the Grow Well Project in Riverside, a densely populated, inner city area within the cluster, with a high BAME population and little green space. We wanted to engage local people in creating a therapeutic community garden in the grounds of Riverside Health Centre, home to two local GP practices and the Cardiff Dietetics team with the purpose of increasing patient health and well-being
- Improve the social prescribing referral pathway, which was ad hoc and largely paper-based
- Co-produce a ‘health and well-being’ evaluation tool with patients, primary care staff and Grow Cardiff staff that measured project impact. Quantifiably measuring health and well-being is notoriously difficult. Despite significant time researching existing tools and evaluation methods, a satisfactory method had not been found: we set out to co-create our own and to share this with others.
Grow Well resonates strongly with the prudent model of health in a number of ways. We ensure that patients are at the heart of its development. As key stakeholders they are equal partners co-producing every aspect of the project from garden design to session structure, evaluation tools and project development. They often present the project and its impact on their lives. Many patient volunteers have complex, multiple health and wellbeing needs and live in areas representing the most deprived 10% of all wards in Wales (WIMD 2019). As such the project places those with the greatest health needs first. The project enables equality of access – every patient across the cluster now has a local expression of the project on their doorstep.
When Covid-19 hit, we thought the unthinkable and decided to change our DNA! Instead of patients coming to our gardens, we would go to them. Utilising existing strong partner networks and social media, we advertised home growing kits to patients in the cluster. Hundreds of local people got in touch. We posted ‘everything you need to grow at home’ kits to over 250 households and dropped 100 grow bags and plants to doorsteps, supported by instructions, videos and on-line groups.
Isla shared her experiences during this time through a blog post – read it here.
We developed a new partnership with South Riverside Community Development centre and helped forge a new city-wide growers network, Cardiff Growing Together, in response to the pandemic, which together gave away over 15,000 plants for local people to grow at home in Covid-considered community events.
As many services and green spaces closed during lockdown, we engaged new local patients, over-coming Covid barriers to develop a new service, that enabled people who were self-isolating to grow at home. Many participants told us that being part of the project, engaging with nature and growing something, significantly impacted their mental health and well-being at an extremely difficult time.
Patients (80% of whom had little/no previous gardening experience) told us that taking part in the project meant:
Due to lockdown restrictions we were unable to begin to develop a community garden in the Riverside Health Centre grounds. Instead, working with new partners we gave out hundreds of vegetable and herb plants to 256 households in Riverside, enabling patients to connect with nature and grow their own food. With permission we saved contact details of all participants who expressed an interest in further growing so that as lockdown restrictions ease we have a ‘ready-made’ group of patients who want to engage in the development of the Riverside Health Centre community garden.
During lockdown the social prescribing referral pathway was significantly improved by the launch of ‘Elemental’, an on-line platform which enables a smooth pathway from patient consultation to the garden gate. Staff have been trained and referrals are in-coming.
To develop our evaluation methodologies, Grow Cardiff has partnered with the University of South Wales to scope, research and develop a co-produced evaluation tool that will measure the impact of community gardening on patient health and wellbeing.
The next steps are to consolidate our work, to continue to re-engage with patients who participated in our lockdown programme and actively encourage them to take part in designing and co-creating a patients’ garden at Riverside Health Centre. We need to secure further funding to enable this.
We continue to use the ‘Elemental’ on-line social prescribing tool to receive referrals, monitor and evaluate patient progress through the project.
We continue to work with University of South Wales to develop our ‘health and well-being’ tool which we plan to launch with patient volunteers in summer 2021 and share with other social prescribing projects.
In addition we have launched a new ‘grow from home’ doorstep service, Growing Companions for the most vulnerable patients with health concerns who choose to continue to self-isolate.
Our Exemplar Experience:
We were actively encouraged to embrace change: just because you’ve never done it before, doesn’t mean you can’t do it!