18 CONTEXT 183 : MARCH 2025 By expanding provision and access of these types of projects to a more diverse range of people with specific unmet needs, the sector can address health and wellbeing inequalities. Historic England and the Council for British Archaeology convene a working group on wellbeing and heritage with a community of practice on research and evaluation which is open to anyone. It is a place where we can share knowledge and experience, and look for solutions to common challenges. Social prescribing as opportunity Social prescribing is connecting people to activities, groups and support that improve health and wellbeing. Evidence demonstrates that around one in five GP appointments are for nonmedical reasons, such as loneliness, social isolation, housing issues and debt – in other words, issues caused by the wider social determinants of health. The most crucial element of social prescribing is that it is person-centred with social justice at its heart. It provides an opportunity, and inevitably also challenges, for the heritage sector. As an opportunity it provides a direct referral method to enable organisations to work in areas where there is actual need. It enables us to move away from self-selecting groups and into a mixed economy, including meeting specific needs, as identified not by us but by a GP or other referrer. There are two kinds of evidence in this area at the moment which seem most relevant to us: 1. Reviews from outside the heritage sector on what works and what difference it makes, which show the reduction of pressure on the NHS at primary and secondary care levels. 2. Reviews from inside the sector that show what works and provide exemplars. Examples include place-based projects such as the health and wellbeing work as part of the high street heritage action zone in Kirkham, Lancashire; organisation-led projects such as Archaeology on Prescription by York Archaeological Trust, and heritage-site-based offers where local heritage assets become hubs for local wellbeing, such as at Delapre Abbey in Northamptonshire. It hardly needs to be stated that the challenges include working well with vulnerable people, ensuring good partnerships and referral routes, and funding. The issue of funding the voluntary sector to support targeted interventions is hardly new but the rapid expansion (and with it associated expectations) of social prescribing exacerbates things. Health decisions on where to spend money are inevitably based on clear evidence that makes sense in a health context and exists within a competitive commissioning environment. At the same time, while we as a sector may feel confident that there is significant public benefit to the historic environment, including cultural assets and green spaces, there is an issue. Despite the general sense of value, local government, which has historically been a significant investor, reduced its spending per capita on arts and culture by around 36 per cent between 2009–2019. Arguably we have a perfect storm: more demand for impactful work that functions to deliver to specific wellbeing agendas and a general trend of significant reduced funding in the cultural and social infrastructure that would provide this. There are no easy fixes but some ideas emerging from the National Academy of Social Prescribing are attempting to address this, most notably through its proposal for a shared investment fund. This would draw money from a central funder and from all the integrated care boards (founded in 2022) which are responsible, through local partnership, for improving local health outcomes and tackling health inequalities in 42 areas of England. Historic England and the Council for British Archaeology convene a community of practice on social prescribing which is open to anyone. It is a place where we can share knowledge and experience and look for solutions to common challenges. The health service talks of place-based approaches all the time, with a focus on working with local community assets. This is language more than familiar to our sector. Using the growing evidence base in this area, we can make the case more clearly for the historic environment as a protective factor for health, enhancing life satisfaction and social trust, and an enabling factor for wellbeing. The current government has set out clear priorities for rebuilding the NHS and focusing on prevention and care through the community. Our sector Examining a find at Project Rejuvenate, Combe Bissett Down (Photo: Wessex Archaeology)
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