Valuing Nature-Based Communities of Care: A Social Return on Investment (SROI) Evaluation of the Fathom Trust 'Making Well' Programme

This report presents a Social Return on Investment (SROI) evaluation of the ‘Making Well: Health & Healing through Green Craft' programme (hereafter Making Well programme). Developed and delivered by The Fathom Trust as part of a six-month pilot project, the aim of this community-led, nature-based programme is to support the health and well-being of people with long-term mild to moderate psychological conditions.

1.1.Background

The UK mental health crisis following the Covid-19 pandemic has put pressure on an already overburdened health care system, resulting in longer NHS wait times (O’Shea, 2021; Rathnayake et al. 2020; Mahase, 2022). Long wait times can result in further deteriorations in health and compound suffering (Reichert & Jacobs, 2018; ; Punton, Dodd, & McNeill, 2022).

Green social prescribing is a means of connecting people with non-clinical community-led, nature-based interventions that could help alleviate pressure on health and social care systems and provide immediate support to those in need (Bragg & Aktins, 2016; Howarth & Donovan, 2019; Pretty & Barton, 2020; Vidovic et al. 2021). Understanding the social impact,
costs, and benefits of these programmes is essential to enable the development and
integration of this holistic approach into policy and practice.

1.2.The Fathom Trust ‘Making Well’ programme

Founded in 2019, The Fathom Trust is a charitable organisation that seeks to develop
innovative models of integrated holistic and cost-effective social infrastructure to care for
people and the environment through craftsmanship, conservation and contemplation.

The Fathom Trust Making Well programme is an eight-week supportive programme developed to promote health and well-being for people with long-term mental health conditions. The programme offers experience of therapeutic traditional nature-based crafts, horticulture, conservation and mindfulness within the local natural landscape in the Brecon Beacons, Wales. The programme aims to equip individuals with new skills while fostering healthy social and cognitive development for self-empowerment.

1.3 Aims and Objective

The goal of this SROI evaluation of the Making Well programme is to compare the costs of the programme with the social value generated for key stakeholders with a particular focus on health and wellbeing. The specific objectives of the evaluation are:-

To explore if the Making Well programme is effective in supporting people with long-term
mental health conditions (i.e. by facilitating an improvement in well-being).

To identify and quantify the social value generated by the Making Well programme.

To provide the Fathom Trust with social cost-benefit evidence and forecasting to help
maximise the social value of the Making Well programme in the future.

1.4.Methods

SROI explores the wider economic and social costs and benefits of activities from the
perspective of the people that experience them. Due to time constraints of a six-month pilot project, the stakeholders considered in this SROI evaluation were restricted to Making Well programme participants and NHS Wales. The health and well-being of 15 Making Well
participants and their recent health service resource use were assessed before and after the eight-week programme via questionnaires. Interviews were also conducted with 12
participants to collect in-depth data on their lived experience of the programme. Making
Well programme inputs and costs were estimated and financial proxies from the HACT Social Value Bank were applied to identified outcomes. Three alternative well-being valuation approaches were applied as an embedded sensitivity analysis to estimate a robust range of social value ratios.

1.5.Results

Results demonstrate that the Making Well programme is effective for supporting the wellbeing of people with long-term mild to moderate mental health conditions. The key outcomes acknowledged by participants were increased feelings of social connection and belonging, improved mental health and higher self-confidence. Participants also reported improved overall well-being and fewer GP appointments at the end of the programme compared to before, resulting in social value cost-savings to the NHS. Applying well-being valuation to non-monetised outcomes indicates that the six-month Making Well pilot generated significant social value in the range of £3.30 to £4.70 for every £1 invested.
When considering the social cost-benefit of the Making Well programme and The Fathom
Trust’s commitments to develop the programme going forwards, the forecast social value of the Making Well programme is estimated to be in the range of £5.40 to £7.70 for every £1 invested.

1.6.Conclusions and Recommendations

This SROI evaluation indicates that the Fathom Trust Making Well programme is effective for
supporting people with long-term mild to moderate mental health conditions and has
potential to deliver significant social value to stakeholders. Suggestions are made to help the
Fathom Trust maximise the social value of the Making Well programme in the future.
A 12-month feasibility study is recommended to validate the promising findings from this sixmonth pilot project and contribute to the growing evidence-base for the value of communityled, natured-based interventions made accessible via green social prescribing.