Project: Green Health Activity Pathway

Overview

This three year project, funded by NHS Lothian Charity and led by the Cyrenians, aimed to establish a sustainable person-centred green health activity pathway at the Royal Edinburgh Hospital. The therapeutic activities supported the patient community to use the community gardens and associated greenspace to improve their health and wellbeing. From the first connections with nature and gardens on the wards through to ongoing support on discharge, the project supported people who are experiencing severe mental health problems to access nature-based activities in the community garden and move towards positive, more stable futures. Working with staff and partners across the site, the project aimed to embed this pathway for the future.

What we wanted to do

We wanted to develop a sustainable pathway for Green Health Activities at the Royal Edinburgh Hospital. Our experience has shown us the benefits of therapeutic activities within the community gardens and the demand for these activities, particularly after the pandemic, has never been higher. Previous funding allowed us to pilot different approaches and we then brought these together into a co-ordinated programme.

We wanted to create a pathway that supported members of the hospital community who were experiencing severe mental health problems to access green health therapeutic opportunities. We knew that for many patients the support to use the community gardens needed to start before they had stepped out of the ward, and for others they needed to know that there would still be a place for them once they had been discharged.

This project built on the relationships and trust we had established with NHS Lothian staff and aligned with the aim to become a key anchor organisation for the delivery of green health activity on the NHS estate. The aim was to lead to improved health and wellbeing of NHS Lothian patients and directly support the delivery of the Lothians Greenspace and Health Strategic Framework.

How we set out to achieve our aims

The person-centred approach taken by Cyrenians ensured that there was a clear progression pathway from first contact with patients on wards through to discharge, and beyond. We offered a range of green health activities that matched the needs of both inpatients and outpatients. These activities were broadly split into the following 3 groups:

Early engagement activities – starting the green health journey for hospital inpatients

For many people the green health journey starts on the wards and opportunities to access greenspace or gardening activities can vary substantially. By providing activities that can be done on the ward, we supported the patients and staff to develop a connection with nature. For many this was their first step into using the outdoors as a therapeutic environment.

Supporting inpatients to access therapeutic activities

The Royal Edinburgh Hospital Community Garden provides an ideal space for therapeutic activities but patients need to be able to get there and, in our experience, the inpatients who have the most to gain often need the most support to access the opportunities. People experiencing severe mental ill health will often need a member of ward staff and other support to take part in gardening activities.

As part of an NHS Lothian Charity funded pilot, we successfully tested a volunteer-led patient buddying scheme. The buddies developed relationships with the patients and staff and supported them to access 1:1 and small group gardening activities. The approach was popular with staff and patients and we now have a bank of trained volunteer buddies and a waiting list of patients but need the capacity to support and manage this to achieve its full potential.

Connecting outpatients – Bridging the gap on discharge

For people being discharged from hospital it is important that they have services in place to help them in their transition back into the community. We wanted to provide a bridge to support this transition. We wanted to provide a streamlined pathway for people leaving hospital, to ensure they were able to take part in green health activities post-discharge.

Outcomes

Participants have told us the project is having a positive impact on their health and wellbeing in the following ways:

Improved mood and confidence
Sense of achievement
Better connection to others and nature

It is easier for me to think properly and actually talk properly when I’m at the gardens.”

Patient

The project is also having a wider impact on the hospital. NHS staff have learnt new skills and can work with patients to engage in a variety of activities in the gardens. Additional greenspaces across the estate have been adopted by the project and are thriving as a result. New wildlife areas have been created and the maintenance of the orchard enhanced.

Through the project, stronger relationships and better understanding have been built with the site and the estate management teams.

I’ve learned a lot about gardening but also people….about how to interact with people, people who are different or have different needs.”

Volunteer

This is what keeps me well, it gives me a sense of purpose and achievement.”

Patient

If you would like to take part or volunteer contact [email protected]

Project partner