Green space for good health

Retired GP and Non-executive Director of NHS Lothian, Dr Patricia Donald, was practising ‘green health’ long before the concept was known by that label. Nowadays, the benefits of outdoor activities on health and wellbeing are well documented and even referred to sometimes as the ‘natural health service’.

In my personal life, I always liked to go climbing hills and walking,” says the fourth-generation doctor. “The benefits of the outdoors for physical and mental wellbeing are nothing new, but they have come to the forefront in recent times, particularly through the COVID pandemic, when we were restricted to stay in our homes and needed permission to go outside.”

The former GP, who prefers to be known as Tricia, was appointed as a Trustee of NHS Lothian Charity (formerly Edinburgh & Lothians Health Foundation), the official charity of NHS Lothian, upon her retirement. This was when the Charity was also looking into developing their strategic support of green health initiatives to help NHS Lothian unlock the potential of their green spaces to benefit patients.

The Charity launched their Greenspace and Health Programme in 2019, working in partnership with other stakeholders to develop green health initiatives across Lothian. Tricia chairs the Green Health Advisory Group that oversees the strategies that are now being rolled out as part of the Programme.

Along with NHS Lothian Charity, stakeholders including NatureScot, NHS National Services Scotland, greenspace scotland, NHS Lothian Public Health, and NHS Lothian Facilities, also sit on the Advisory Board, working together to embed green practices across Lothian.

During the pandemic, we could only go out for an hour’s walk (at one stage of lockdown), so we felt that one of the priorities was to capture this moment, when people began to value the outdoors,” she says. “We felt it was the right time to promote green health prescribing.”

Green Health Prescribing

Promoting Green Health Prescribing has involved a two-pronged approach.

Firstly, the advisory group has been evaluating and promoting the health board’s estates where green spaces, such as gardens, can provide respite and upliftment for both NHS staff and patients.

Secondly, the group identified green health prescribers and providers to help patients who might benefit from outdoor activities and events.

The results of this approach are published in the Green Health Prescribing Report. This report also highlights the barriers and enablers, as well as what needs to be in place to embed green health prescribing across the health and care system.

Following the publication of the report, in February 2022, the first Green Health Prescribing project was being piloted in Midlothian.

While many people have easy access to the outdoors, others are not so lucky, so the group is also looking at ways to address these inequalities which were exacerbated during lockdown.

Addressing Inequalities

For people living in blocks of flats, it’s not always as easy to enjoy the outdoors as they don’t feel they have the same direct access to nature. By highlighting the possibilities that exist locally and how beneficial these activities can be, it will encourage people to access the outdoors more.

As Tricia points out, many outdoor activities are free or low-cost, from walking and watching the changing colours of the seasons, to taking part in group or other outdoor pursuits, such as group gardening.

Every season has colour, and you can observe – even in a very small area – the changes and the wildlife,” says Tricia. “If you watch wildlife (like squirrels) playing, you cannot help but smile. Even two people sitting on a park bench, socially distanced at either end, perhaps with a flask of tea or coffee, can meet up, and then you are connected.”

Tricia’s main role with the Green Health Prescribing Project it to promote strategic direction and be a champion for green health activities across the region.

Strategic Direction

I am enthusiastic and delighted that there are so many people who want to do that connecting (linking patients with prescribers and providers of green health),” she says. “There are huge opportunities to enjoy what nature has to offer and lots of organisations willing to help.”

While the project is currently being rolled out in Midlothian, where the hope is for all GP practices to be involved, the vision is for the concept to ultimately be applied across Scotland, with many great examples already being implemented.

We in Lothian are actively participating in the national direction to promote green health,” says Tricia.

As well as the health benefits of the Green Health Prescribing Project, she notes that it also contributes to Lothian’s sustainability strategy.

She also pays tribute to local government authorities for supporting green services and activities.

Overall, Tricia views it as a privilege to chair the group helping to re-shape the ways in which the National Health Service and the public think about the role of nature in health and wellbeing.

The NHS is under pressure at the moment, so if we can keep people well, and out of hospital, it must be a good thing,” she says.