6 minute read
Green infrastructure and the NHS estate
The Cherry House at Fairfield Green Space for NHS Yorkshire Ambulance. © Alexis Percival
Natural England North East and Yorkshire looks at how to activate the NHS estate for positive health outcomes for people and nature.
Recent years have seen a growing recognition of the profound impact that natural environments can have on health and wellbeing.
Natural England’s vision for healthcare facilities, as with all urban landscapes, includes working with nature to make places with which people connect and resonate. This includes beautiful spaces for recreation and reflection that also foster biodiversity, mitigate air and noise pollution, sequester carbon and alleviate urban heat island effects and flooding risks.
The NHS estate, with its vast network of facilities and land at the heart of communities, presents an unprecedented opportunity to adopt an approach that considers how nature and people can thrive together.
“Working in a more integrated way benefits people, place and the environment. Bringing these aspects together in hospital and community settings helps to connect us all back to nature,” says Cara Courage, Natural England’s Principal Manager for Sustainable Development in Northumbria. “Nature’s role in healing is well known, so there is no better place to bring it all together than in hospital estates.”
NHS initiatives such as Greener NHS and joint enterprises like Green Social Prescribing are building the case for health and nature, and along with the Biodiversity Net Gain (BNG) legislation introduced by the government earlier this year, they are helping to improve the natural environment in and around healthcare facilities.
BNG provides a real opportunity for embedding environmental outcomes for healthcare facilities as the developer and as the landowner. Firstly, healthcare facilities looking to meet the 10% BNG can create rich and biodiverse areas for patients and staff to enjoy. In this scenario it is important the BNG is considered early in the project, starting with an ecological survey of the existing biodiversity value and utilising the biodiversity metric to design a scheme that benefits both people and nature.
There are perhaps even more significant opportunities for the NHS as a landowner, through ‘habitat banking’, which involves enhancing or creating habitats that can be sold to developers looking to meet their BNG. Discussions are underway with various NHS trusts in Yorkshire as to how they might use their land (such as the edges of helipad fields) to improve the habitats and sell units.
For healthcare estates considering what BNG could mean for them, the best place to start is to understand the value of biodiversity units that exist, speak with local planning authorities about the potential local demand for different units, and start exploring the possibilities.
Action on the ground
In Bradford, the local NHS Trust is pioneering a ‘green therapy’ initiative that harnesses the natural environment to improve health outcomes within psychiatric care. This understanding informs practical site management plans, supported by patient and staff activities including crafting bird boxes, installing accessible planters for staff and patient gardening, and participation in the NHS Forest tree planting scheme. These initiatives provide spaces for green therapy and contribute to environmental outcomes as well as boosting nature.
In Yorkshire, the NHS Yorkshire Ambulance Service’s Fairfield Green Space project is transforming a major site near York into a thriving hub for people and nature.
The project draws on funding from NHS Charities Together and supports species such as tansy beetles and water voles. Sheltered, reflective spaces also provide busy NHS Ambulance employees with time out in nature, and natural learning spaces provide innovative outdoor classrooms for the NHS and other organisations that are keen to improve site development for nature and people.
The site supports the creation of green corridors in the area, ultimately linking to one of Natural England’s National Nature Reserves further south, and it has been featured in Local Nature Recovery Strategy publications.
Meanwhile, the NHS Mid Yorkshire Teaching Trust has undertaken significant development projects to integrate nature into their healthcare settings. The Trust has maximised its green spaces, creating a mosaic of habitats that support rare species such as wych elm, including a palliative care site replete with wildflower matting, living walls, fruit trees, scented plants and a wisteria arch.
The success of these initiatives highlights the need for effective collaboration across disciplines and sectors, and the Tees Valley Nature Partnership’s Health and Wellbeing working group demonstrates the power of a joined-up approach across a broader area. By bringing together partners including local authorities and voluntary organisations, the group has provided significant input into the development of the South Tees Joint Strategic Needs Assessment for the creation of high-quality green and blue spaces.
Natural England is playing a key role in facilitating this cross-sector dialogue and contributed to an NHS England Education Northeast Workshop at a recent conference. Using an interactive approach with a wide range of NHS colleagues, participants explored green infrastructure design features from both natural environment and human health perspectives.
Green infrastructure resources such as the Natural England Green Infrastructure Planning and Design Guide 2023 have proven especially useful to support an imaginative approach to site development, providing a model for healthcare sites with a range of possible management interventions and related benefits.
Antony Muller, a Natural England Senior Officer for Strategic Plans for Places, said, “Feedback from the delegates was thoughtful and positive, with key messages emerging around the value of a toolkit to help healthcare facilities to understand costs and identify practical options for the retrofitting of green infrastructure features. Separately, we identified the need to engage with NHS estates colleagues to share the Green Infrastructure Framework and influence both the design of new facilities and the maintenance of existing ones.”
As these groundbreaking examples demonstrate, the opportunities outweigh the challenges
Challenges and opportunities
These innovative partnerships are inspiring, yet challenges in securing consistent funding, aligning diverse stakeholder priorities and ensuring long-term site maintenance remain.
Natural England will support these challenges through partnership working in place, using the Green Infrastructure Framework, BNG and links to healthy placemaking and nature recovery. Links between NHS Green Plans, Local Nature Recovery Strategies and local authorities’ urban greening ambitions offer great opportunities here to create networks of multifunctional, wildlife-rich green urban spaces linking to each other and wider, wilder networks for nature which also contribute to the health and responsible enjoyment of our communities.
As these groundbreaking examples demonstrate, the opportunities outweigh the challenges. As more healthcare providers take a considered and collaborative approach to nature and people on their sites, the benefits are clear. From improved patient outcomes and staff wellbeing, to enhanced nature and climate resilience, the results will speak for themselves, and we can expect to see a continued expansion of these initiatives.
Esther Smith is a Senior Adviser at Natural England Health and Environment North East and Yorkshire and works at a regional level to strengthen partnerships between health, nature and environment sectors.
