Project: Nature Prescriptions at the Western General Hospital

Through the summer and spring of 2023, NHS Lothian Charity worked with RSPB Scotland to test nature connection activities and a series of wellbeing workshops with staff and patients at the Western General Hospital. Despite growing evidence that nature connections make us healthier and happier, they are not routinely integrated into our healthcare journeys.

NHS Lothian Charity’s Green Health team partnered with the Royal Society for the Protection of Birds Scotland (RSPB Scotland) in this pioneering pilot project to explore how nature based activity could be delivered in a busy acute hospital. It showed that using natural materials and stories to improve nature connection decreased feelings of isolation, and contributed to improving patients‘ health and wellbeing. The activities were particularly important for patients on wards with no access to gardens or greenspace.

This little bird can be my little pet friend. It makes me think of my mother’s garden and of my garden back home.”

Patient

The objectives of the pilot project were as follows:

Test out Nature Prescriptions and nature connection activities for a range of users in this acute hospital setting.
Increase patient activity in the courtyards and gardens of the hospital as part of rehabilitation and recovery pathways in the Medicine for the Elderly Wards.
Enhance the therapeutic and biodiversity value of the grounds by collaborating with the grounds and gardens team.
Assess the benefits experienced by patients and hospital staff from being more connected to their local greenspaces and wildlife.
Explore how patients on wards with limited access to greenspace can feel more connected to nature for its therapeutic benefits.

All our patients loved the singing birds, and it was a good prompt for them to remember nature.”

NHS Lothian staff member

Highlights of the Nature Connections project:

Conducting three weekly nature connection workshops across four different Medicine for the Elderly wards, featuring sensory activities with plants and flowers, as well as collecting and capturing personal nature stories with individuals living with dementia.
Creating a new suite of resources called ‘Nature Handling Boxes’ for use on the wards, including activity cards.
Conducting a biodiversity audit of the Western General Hospital and providing recommendations to maximise wildlife and establish ‘Our Natural Health Service’ on the site.
Organising therapeutic wood carving workshops for staff onsite, as wood carving has been shown to reduce stress levels, blood pressure and anxiety levels.
Holding staff training sessions on utilising nature connections in the caregiving environment outdoors at a local nature reserve.
Organising clean-up activities in hospital courtyards with staff and patients, followed by replanting with native species to promote biodiversity on the site.
Offering drop-in nature connection sessions for staff and patients to share practical tips for finding moments of calm and respite in the greenspaces on the Western General Hospital site.

Carey Moss, Meaningful Activity Coordinator, expressed her thoughts on the impact of a mindful morning bird walk around the hospital site, stating

Every staff member should start their working day like this, it has made me feel ready for anything.”

Outcomes

The activities had profoundly positive effects, and participants told us the project led to the following outcomes:

Improved mental and physical wellbeing
Greater awareness of and access to nature
Improved connection to local green spaces and wildlife
Improved confidence in use of nature connection resources
Increased knowledge of biodiversity

The most telling of all the outcomes was both patients and staff reporting an improvement in health and wellbeing, the pinnacle of the pilot, showing the positive impacts and benefits of connections to nature on overall wellbeing.

Many of the NHS staff involved in the project have committed to continuing using the nature resources ensuring the project has an ongoing legacy.

It was really good getting the patients out into the courtyard. They seem to be eating their lunch better today after being out.”

NHS Lothian staff member

Learning and Legacy

This collaboration between NHS Lothian Charity’s Green Health team and RSPB Scotland has brought about progress in fostering nature connections and promoting wellbeing at the Western General Hospital. Through the innovative approach of Nature Prescriptions and nature connection activities, we are working towards a greener healing environment. With ongoing efforts to maximise the biodiversity and therapeutic value of the hospital grounds, we look forward to the continuing success of this transformative project in the months ahead.

The workshops have brought a very different dimension to my life, and I really appreciate having my eyes open to what nature has to offer us all.”

NHS Lothian staff member