With the increase in ‘social prescribing’ aimed at easing the burden on the NHS, there is renewed focus on the health benefits of gardens, and particularly on the physical act of gardening, among healthcare professionals and those within the care sector. Joshua Clark, Estimator from landscaping contractor, Gavin Jones, part of Nurture Group, explores existing research into the health benefits of horticulture, recommendations for planting, and how Gavin Jones has helped support several hospital projects in creating a garden space for patients, visitors, and staff.
The health benefits of gardens have long been supported, even as far back as Florence Nightingale, who refers to the benefits of outdoor space in her book published in the 1800s, Notes on Nursing. Outdoor spaces should be accessible for everyone in the care setting, whether it be patients, their carers, or the staff who work on the premises. They offer a welcome refuge, away from the hustle and bustle of a busy ward, providing peace in some of life’s most challenging times. They also provide a chance for social interaction for those who may not be able to leave the hospital, or for groups of friends to meet while one is a patient.
The pandemic taught us the importance of outdoor space more than ever before, and The National Garden Scheme and National Trust saw an increase in footfall to properties as a result. Gardens and health continue to be championed by the National Gardens Scheme, which provides funding for gardens that offer therapeutic support, including those in NHS healthcare settings, Horatio’s Garden, and Maggie’s cancer centres.
The NHS and some local government bodies have begun ‘social prescribing’ and ‘green social prescribing’, to ‘connect people to activities, groups, and services in their community to meet the practical, social, and emotional needs that affect their health and wellbeing’.1
The aim is to give people more control over their lives, and the evidence so far suggests that the schemes have decreased pressure on NHS services, reduced GP consultations, and meant fewer A&E attendances and hospital bed stays.2 This supports the notion that we can do better for people, without the use of drugs.3
Evidence for ‘wellness gardens’
Scientific evidence for the direct effects of gardening on the brain is hard to come by, but many studies have shown improvements to health. Some research has found that exposure to simple pictures of greenery and plants can help to reduce the need for medical intervention, and that views of trees and plants from post-op wards can reduce the need for analgesics, and improve the mood of patients.
A recent study, published in June 2024 at Edinburgh University, has found that time spent gardening reduces cases of dementia up to the age of 80, regardless of wealth and education.4 The long-term study tracked participants throughout their lifetimes, and 43% of the 467 people tested who said they regularly gardened showed greater lifetime improvement in cognitive ability, compared with those who never gardened or rarely did so.
There have been many more studies over the past 10 years, including one by Exeter University,5 that showed that people who moved near to green space reported an immediate improvement in their mental health, whilst those who moved to a built-up area suffered a drop in mental health.
Gardens and planting, particularly of trees, can also improve air quality, which can impact a wide range of physical and mental health issues. Air pollution has been shown to exacerbate respiratory problems, heart disease, and cancer, as well as to impact mental health, including depression and anxiety. The creation of a garden offers those involved a sense of achievement, satisfaction, and pride, helping to support community spirit, particularly when the garden is a result of fundraising.
The physical act of gardening
The physical act of gardening is well known for improving strength, endurance, and flexibility, which can reduce the risk of a heart attack and stroke. Digging, de-weeding, planting, and raking, are some of the best forms of exercise that use the majority of a person’s muscle groups. Interestingly, calories burned in just 30 minutes of gardening are the same as through playing badminton, volleyball, or yoga.6
In a care setting, some patients won’t be able to participate in this sort of activity, but inclusion can be tailored to the individual, with simple, seated actions such as potting a plant or watering, helping to aid movement and breathing, without exercise being the primary focus.
Exposure to sunlight can be just as beneficial to health, if it is enjoyed safely. Natural light provides us with vitamin D, which helps regulate calcium and phosphate in the body, in turn keeping our bones, teeth, and muscles, healthy.7 If it is safe to do so for the patient, putting your hands into the soil can expose us to bacteria. These are healthy bacteria that work to strengthen our immune systems and reduce inflammatory responses. Some research has even shown that there is a link between children not being exposed to soil, and rates of allergies, asthma, and mental disorders.
What to plant in a wellness garden
One of the most important elements to consider when designing a wellness garden is privacy. Patients, their visitors, and staff, need space and time to be at one with the garden, and to embrace their emotional response to being in the healthcare setting. Privacy can be achieved through tall plants such as laurels, or climbers such as jasmine, clematis, or wisteria, on an arbour or screening. It is important to incorporate sheltered areas within the garden itself, and that people cannot be seen easily from the main building, walkways, or car park.
A clever wellness garden needs to ensure that it is accessible for all types of visitors and their physical abilities. One of the key opportunities of a garden is the chance for social interaction, and so a seating area or space for meeting others is essential.
Surrounding this space, you might want to consider including plants that have the most sensory impact; for example those that are highly scented, have leaves that are soft to the touch, create a sound when the wind blows, or have spectacular colour in the sun or rain.
Plants that are good for this include those of an herbaceous species. An herbaceous plant is one that does not have any true woody tissues. Nearly all annual and biennial plants are herbaceous, reaching their full height and producing flowers in one year, before dying back over the winter. They then return in the following spring. Plants including salvia, lavender, and rosemary, are good choices for a wellness garden.
Bright colours can be introduced at all times of year, depending on location and site conditions, and successional planting brings new life into the garden through the whole year. The sound of grasses blowing in the wind can be calming, whilst safe to touch. Planting fruit trees has been successful in some of our projects, allowing the garden users to see and enjoy the full lifecycle of the tree, from sapling to fruit bearing, and then trying the fruit for themselves.
Throughout the world, people still rely on traditional herbal medicine, and many drugs we use today come directly or indirectly from plant extracts or copies of plant compounds.8 In fact, around 11% of the drugs considered ‘basic’ and ‘essential’ by the World Health Organization originated in flowering plants.9 You can tell which plant has a herbal, as it will often have ‘officinalis’ in its name, which is the Latin for apothecary’s workshop. Possibly one of the most well-known examples you might think of is of morphine, a strong painkiller originally isolated from poppies before being synthesised in labs today.
Many everyday herbs used in cooking have medicinal uses, such as coriander for helping digestion, peppermint for intestinal disorders, and garlic — which has been shown to reduce blood pressure.
You might consider planting traditional medicinal plants such as St John’s Wort, which has been used to treat depression, lavender to reduce headache, stress, and insomnia, and roses for their petals that contain vitamin C, ascorbic acid, and iron. Many people may already drink nettle tea, which is being studied to find a connection with Alzheimer’s. Camomile, echinacea, and aloe vera, are commonly used in healthcare products for their properties for treating the skin and minor wounds.
Treating insect bites
Less commonly known, the dried marigold flower can be rubbed onto insect bites or stings to help reduce pain and swelling, and elderflower has been used as both an antiseptic, and for its anti-inflammatory properties. Including plants such as these is a nod to our herbal past, and they provide sensory stimulation with strong scent and textures.
A wellness garden is not complete without a seating area or multiple spots to rest. The purpose of a wellness garden is for visitors to join, or a place to seek solace when needed.
Sensory elements such as the use of gravel or other flooring textures can help to add sound and colour, but be careful that these are suitable for wheelchair users, or those with mobility needs. I’d recommend a pea gravel or rubber, which is more suited to those who find different surfaces hard to manage. Rubber offers a softer landing should a person be unsteady on their feet.
To allow access to garden activities such as potting or watering, a raised bed or potting table should be incorporated. Allowing plants to grow at different levels also adds interest to the garden. The use of water not only adds sensory impact, but it can also encourage wildlife to visit as a source of water, and even a breeding ground. If running water is not possible, and a pond unsafe, the use of bird baths interspersed amongst the flowers is helpful for our feathered friends. To add to the atmosphere of the garden, wind chimes offer a sound experience, while mirrors and solar lights can reflect light, shape, and colour.
Wellness gardens in practice
- Dementia garden at Queen Elizabeth Hospital, King’s Lynn
In a recent project the landscaping team at Gavin Jones created a dementia garden at the Queen Elizabeth Hospital in King’s Lynn, Norfolk, intended as a therapeutic space for patients to get outside.
Among the key requirements were to make the plants accessible with the use of raised planters, while some edible plants included spearmint, sweet basil, and parsley, for an additional sensory experience. With concern that patients could suffer a fall, soft rubber matting was used on the ground, with benches, while the whole site is wheelchair-accessible. A pergola was installed to add support for climbing vines, and to add to the already private garden space, which cannot be seen from other parts of the hospital.
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Social prescribing garden at NHS Corby
We supported the creation of a garden for social prescribing on behalf of NHS Corby at Willowbrook Health Complex in the Northamptonshire town. The aim was to create a wheelchair-friendly space where patients can participate in garden-based activities. As part of the garden, we installed a shed to store tools, and a water butt to harvest rainwater. Planters were created, using our carefully considered planting scheme, and some were left empty for the patients to fill as part of their wellness activities. The result was a garden that can be used for a whole host of different purposes, and by different groups for social prescribing.
The beauty of gardening in a space such as this is that it is a safe environment that is therapeutic and relatively inexpensive to run and use. Planting seedlings and watching them grow is beneficial to wellbeing, and with the added responsibility of looking after something through its lifecycle, people become connected to what they have created.
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Maternity bereavement garden, Queen Elizabeth Hospital, King’s Lynn
The new maternity bereavement garden at this King’s Lynn hospital was created as a bereavement and memorial garden for parents and carers who have suffered the loss of a baby. The garden needed to be a safe space, with a high level of privacy, and accessibility for all. The theme of the garden was butterflies, and an artist blacksmith, Nigel Barnett, was commissioned to create 250 purple Norfolk butterflies that will each bear a special message.
The butterfly sculptures will be installed on a memorial wall, and carefully chosen purple planting will fill the borders.
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Staff wellness garden at British Sugar, Bury St Edmunds
Another garden we had a hand in was at the historic British Sugar factory in Bury St Edmunds in Suffolk. The site is predominantly an industrial one, with the factory and staff facilities at its heart. We were tasked with creating a staff wellness area where the teams can get outside and have a break from the smells and sounds of the factory indoors. The resulting garden was a restful place for staff to visit on their breaks, and a local school has been invited to position bird boxes in the garden to help with nesting.
The evidence is clear: wellness gardens are not just aesthetically pleasing additions to healthcare settings, but rather vital components of holistic patient care. By providing opportunities for physical activity, stress reduction, social interaction, and sensory stimulation, these green spaces offer a powerful tool for improving both physical and mental health.
As healthcare systems continue to seek innovative approaches to patient wellbeing, the incorporation of wellness gardens should be a priority. By investing in these spaces, we are investing in the health and happiness of patients, staff, and the wider community.
At Gavin Jones, we are proud to help cultivate a future where healthcare is enriched by the healing power of nature.
Joshua Clark
Joshua Clark started his career as an apprentice, and immediately loved the outdoor working environment, and seeing his hard work come to fruition. He progressed to his current role of Estimator, and has been pivotal in many contracts since, including the ones described in this article – which he says have been some of the most fulfilling – where he gets to add his personal touch.
With a keen eye for detail, he is a self-professed perfectionist, making him a great asset to the Gavin Jones team. His extensive plant knowledge stems from years of training and experience, ‘working with some of the best in the business’. One aspect he especially relishes is spending time creating bespoke planting palettes to unify aesthetics, themes, or patterns, designed for the garden. Joshua enjoys problem solving and working on a ‘garden with purpose’, such as wellness gardens and projects at healthcare sites. He loves the challenge of combining scale, form, colour, and soil type to create a finished space that works in harmony for the plants, layout, and end-users.
References and further reading
1 What is social prescribing? NHS England. https://tinyurl.com/3umfabbp
2 Social prescribing — frequently asked questions. NHS England https://tinyurl.com/3az9utj5
3 Thompson R. Gardening for health: a regular dose of gardening. Clin Med (Lond). 2018 Jun; 18(3): 201—205.
4 Colley J, Pattie A, Deary IJ, Cox RS. Gardening linked to staying sharp in later life. Journ of Environ Psych; August 2024; 97. Elsevier.
5 Green spaces deliver lasting mental health benefits. University of Exeter. https://news-archive.exeter.ac.uk/featurednews/title_349054_en.html
6 Calories burned in 30 minutes for people of three different weights. Harvard Health Publishing. 8 March 2021. https://tinyurl.com/hw53r8b6
7 The Physical, Mental, and Social Benefits Of Gardening. Coir Products. https://tinyurl.com/yc4cu9tk
8 ‘The healing power of plants’ information sheet. RHS Campaign for School Gardening. https://tinyurl.com/3wvkyk9u
9 Pavid K. Aspirin, morphine and chemotherapy: the essential medicines powered by plants. Natural History Museum 19 February 2021. https://tinyurl.com/3s7u958r