NHS Scotland - climate emergency and sustainability: annual report 2021 to 2022

6.1 Greenspace and Health

The Our Natural Health Service Programme (ONHS) brings together health, environment and other organisations that provide infrastructure, supportive programmes or promote nature-based activities that can improve health and wellbeing. As part of ONHS, four pilot Green Health Partnerships (GHP) were established in 2018. Led by local health boards and local authorities, these partnerships bring together the health, social care, environment, leisure, sport and active travel sectors in order to make better use of local green space as a health-promoting resource

In 2021/22 the Lanarkshire GHP was integrated within the area health board ensuring the aims of the group can be continued longer term and securing more stable funding for core costs.

A further phase of funding was identified by ONHS partners to enable the Dundee, North Ayrshire and Highland GHPs to continue for two more years with an aim of securing a longer-term future.

In November 2022, the report Green Health Partnerships in Scotland – evaluation of the first three years was published by NatureScot. This will be used to support the work ‘to establish and embed GHPs and similar approaches to increasing the use of nature-based solutions to deliver health outcomes’.

NHS Lothian has prepared a Greenspace and Health Strategic Framework (June 2019) and has been guided by the GHP approach. The framework led to a natural capital assessment in 2021 and more work to increase use of the NHS estate for nature-based activities. Other areas, including South Ayrshire, Perth & Kinross, Angus, Glasgow and Fife, have also been exploring how to develop a stronger focus on green health to contribute to better physical, mental and social health.

6.2 Green Exercise Partnerships

In 2021/22, Green Excise Partnerships, a collaboration between NHS National Services Scotland, Public Health Scotland, NatureScot and Scottish Forestry continued to support projects to demonstrate the benefits of improving greenspace at NHS sites. Funding was provided by the Scottish Government to support the following project at the Royal Alexandra Hospital in Paisley:

Case study – Royal Alexandra Hospital Paisley, NHS Greater Glasgow and Clyde - the Pond and Beyond project – phase 1

When the Royal Alexandra Hospital (RAH) was built in Paisley in 1988, the pond area was designed as a space for staff to relax, eat and socialise. However, over time, the pond became neglected and was no longer an inviting space. Invasive vegetation became overgrown within the pond, limiting habitat for wildlife.

In 2019 a project was started to revitalise the hospital’s outdoor space which would include restoring the abandoned pond and woodland areas. The aims were to provide staff, patients and members of the local community with the opportunity to use the outdoor space, increase contact with nature and improve biodiversity.

Following delays caused by the Covid-19 pandemic, proposals were developed in consultation with staff and patients and plans made to carry out improvements in three phases. Construction of the first phase started in autumn 2021.

Completed work includes a new pathway around the pond, with a wooden boardwalk and interpretation signage; new benches and seating; natural play equipment; and a ‘living archway’ made from the canopy of existing trees. The improvements to the pond have created a quiet, reflective spot where staff, patients and members of the community can spend time in nature. There are areas for outdoor meetings and picnic benches. The new footpath around the pond provides access for an extended walk among the trees, wildflowers and wetlands. All these elements provide a wellbeing benefit to users.

Quotes from staff closely involved in the project:

“The pond is lovely to look at through the different seasons, especially when we have the swans, moorhens etc. Staff use the picnic tables, weather permitting. A member of staff commented that the pond was beautiful, calm and very peaceful.”

“Staff take an interest in the wildlife that the pond brings – swans, ducks and last year a heron made an appearance.”

The project has taken steps to enhance biodiversity, through diverse woodland and wildflower planting, the installation of habitat features including bird and bat boxes, and the clearance of invasive vegetation from the pond. The resident swans have returned, and cygnets have been born recently. Other wildlife which has returned to the pond include a heron, moorhens, and ducks.

It is intended that the expanded nature area at RAH will demonstrate the benefits of this approach for biodiversity, climate, and health and wellbeing. The longer-term ambition is the development of an overall campus-wide sustainable management plan and approach, providing training opportunities for staff in managing the estate for improved biodiversity.

There are clear benefits to sustainable performance within many areas, including nature, biodiversity, and staff and patient wellbeing. The completed project is already well-used by staff and patients, and the presence of aquatic bird species demonstrates the additional habitat value for local populations. RAH is not alone in having a pond within the grounds, and this project provides a replicable example for similar projects across NHS Scotland.

The pond at Royal Alexandra Hospital prior to construction, with invasive plants overgrown and no seating areas or clear access.

A sitting space at the pond after construction, with three blocks of wood circled around a tree. A swan feeding in the sun.

The pond in Royal Alexandra Hospital after construction in the sunshine. The pond is cleared with space for native plants to grow.