Veg on prescription: Truro GP sends patients to a Roseland farm
Michael’s last blood test showed his blood sugar had dropped by more than half. For the past 12 weeks he has been watering tomatoes in a polytunnel on the Roseland Peninsula, taking home a free box of vegetables and learning what to cook with them.
He is one of the first people through WellFed Cornwall, a pilot asking whether veg, gardening and a bit of company could work as an alternative intervention for people with type 2 diabetes and prediabetes.
How WellFed Cornwall works
The scheme connects patients with local growing sites, where they get free veg boxes plus gardening and cookery classes. It is being run by Volunteer Cornwall in partnership with Cornwall Council Public Health and NHS Cornwall and Isles of Scilly.
WellFed project lead Claire Judd says working with local growers is a big part of it.
“People get their free veg for 12 weeks which is locally sourced and agroecologically grown, and they get support to use the veg with really simple social cookery aimed at improving their confidence to have a go in a risk-free environment.”
The cookery sessions show participants how to put together easy meals, often with seasonal veg they may never have tried. That takes some of the overwhelm out of unfamiliar food and helps people make simple swaps in their diets that can add up to a lot.
“Some of the people who come along are not eating much veg at all and so they need to start from scratch in terms of ‘what is this and what do you do with it?'” explains Claire.
Blood sugar down and new friends made
CHAOS Farm on the Roseland Peninsula is one of 20 sites piloting the project as part of a “test and learn” trial. Its participants have just finished their 12 weeks, and they say the sessions have made a real difference to their wellbeing.
Michael says his energy levels have improved and he feels less lethargic. His blood tests are looking good too.
“The last one I’d cut my blood sugar by over half, and I’ve got one coming up so I’m hoping it’s gone down again.”
Mental wellbeing is part of the picture as well. The project has found big benefits in people coming together as a group and having peer support while they make lifestyle changes.
Tracey has made new friends through the sessions.
“It’s been nice to get out – I’ve never met any of our group before and now I look forward to seeing them every week.”
CHAOS stands for Community Helping All of Society. The CHAOS Group is a Cornish B-Corp that works with a range of partners to deliver health and social care initiatives across the county. It delivers WellFed in collaboration with Truro Primary Care Network.
A Truro GP’s view
GP Katy Bray referred her patients at Three Spires Medical Practice in Truro to the WellFed pilot at CHAOS Farm.
“In terms of the health benefits, the gardening side just ticks all the boxes because it’s being outside, being in nature, as well as the benefits we know that come from being active.
“In the NHS at the moment, with everything struggling, we can be too quick to jump to the medicines because we’re driven by numbers and tablets are the easy way of doing that, but what we’re often missing out is that first level of holistic support.”
Katy has also given up her own time, spending her day off at the sessions on CHAOS Farm and talking to participants about topics such as gut health and physio exercises.
She is keen to point out the value of simply bringing people together.
“There is also the community aspect, which is something we have lost, and the statistics are amazing about loneliness being as detrimental to your health as smoking 15 cigarettes a day.”
What it could mean for the NHS
The people behind WellFed see social prescribing as a chance to take some of the pressure off NHS and primary care services. If blood sugar comes down, potentially moving patients from the diabetic range into prediabetic, or even to normal levels, the need for long-term medication could be reduced or removed altogether.
Claire says the project may take effort to set up in the short term, but the long-term implications for patients and the wider health system are huge.
“Further down the line, if people’s diabetes progress, it can be associated with higher cardiovascular risk, amputations, damage to eyesight… so the cost to the healthcare system of treating type 2 diabetes is already huge.
“These costs are increasing at a pace and to a level whereby they would be swallowing up the entire NHS budget in the not-too-distant future.”
For now the scheme relies on funding from the Integrated Care Board and Public Health, so the pilot is working hard to evidence what it finds in the hope of securing future investment.
Babs Rounsevell MBE, founder and managing director of CHAOS, believes working together on social issues is the best way to bring about change.
“Sometimes the most important thing you can give anyone is your time – this project is the perfect example of how just 12 weeks of support can be transformative.”
The results a blood test can’t show
Not everything the trial is finding shows up in a lab report, as Katy explains.
“The lovely thing about CHAOS is that they have their own questionnaires as well that are much more patient-centred in terms of those harder-to-measure but so important sense of how patients are feeling and their self-worth.”
Those questionnaires ask participants how confident they feel about preparing nutritious meals, and whether they feel empowered to look after their own health and wellbeing.
“Their WhatsApp group just sounds amazing where the participants chat and share recipes with each other… I think that’s what’s magic about it – they’re learning together but also holding each other accountable.”
Could other areas follow Cornwall’s lead?
The hope is that data from the pilot will show what alternative interventions like this can do, and encourage communities elsewhere in the UK to look at what they could set up in their own areas.
Claire would like WellFed to inspire change to food systems nationally.
“We are trying very much to keep it about local food system resilience, climate resilience, as well as people eating good food for their health.”
Similar schemes already exist. Alexandra Rose Charity in London and Planet Card in Cardiff have both given participants vouchers to buy sustainable produce from local markets and independent grocers. But the extra step of gardening, and connecting diabetic patients with local growing sites, is believed to make the Cornwall project the first of its kind.
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