Trees won’t transform your healthcare site overnight – they are a long-term investment that will grow in value year after year. If you have received and planted trees from NHS Forest you have already taken the first step on your arboreal journey – but what comes next?
In this blog, we’ll share practical tips for care and maintenance to give your trees the best possible start, setting them on a path toward healthy establishment. We’ll also look beyond aftercare and explore how planted areas can be managed as restorative green spaces within healthcare settings.
With thoughtful planning trees can provide more than just environmental benefits, boosting wellbeing, providing moments of calm and creating a welcoming setting for patients, staff and visitors alike. By nurturing both your trees and the areas around them, your green space can grow into a landscape that supports biodiversity, builds climate resilience, and fosters a meaningful connection with nature.
Post-Planting Priorities: Early Steps for Healthy Trees
Tree planting is exciting, but the make-or-break period comes in the first few years afterwards when a little extra care can determine whether those trees thrive or struggle to survive. To give your trees the best possible start in their new home, NHS Forest recommends the following actions:
Inspection
It’s a good idea to check that tree shelters and mulch mats remain securely in place at the beginning of each growing season. These are the first line of defence against browsing animals and intrusive weeds, threats that ramp up during the warmer months when the trees are in leaf.
Spring is also a good time to take stock as dead or struggling trees are easier to spot –look out for any without leaves or buds. If you are unsure, gently scratch away a small patch of bark with your fingernail; healthy trees will reveal a moist, green layer beneath (the cambium), while dead trees will appear dry, brittle, and brown.
Removing trees that haven’t survived creates more space for those that are thriving and helps keep the planting area neat and well maintained. Some losses (typically around 5 – 10%) are entirely normal and already factored into our recommended planting densities – so don’t be discouraged if a handful are not successful.
Watering
Young trees must develop root systems to efficiently absorb water and nutrients that are essential for growth. Over time they will increasingly rely on soil uptake alone, becoming largely self-sufficient with minimal human interventions, but newly planted trees with shallow roots can be vulnerable to drought during their first few years.
Regular checks and deep watering – ensuring that water soaks into the soil rather than running off on the surface – can dramatically improve survival rates. During dry spells trees should ideally be watered at least once a week to support healthy establishment, with the frequency reduced in subsequent growing seasons. Overwatering can be harmful too – try to avoid soggy soil or standing water when watering your trees.
Watch out for signs of water stress such as wilting or curling leaves, leaf discolouration or scorch, bark splitting, shoot dieback, and dry or cracked soil. Premature leaf drop may also occur and, while worrying, this is not uncommon in the first summer after planting – even when trees are being watered – so there is no need to panic.
Weeding
Weeds and long grass are more than just an eyesore – left unmanaged they compete with newly planted trees for water and light which can reduce growth rates by as much as 60%. In severe cases dense vegetation can even overwhelm young trees entirely.
Consistent removal of competing vegetation will give your trees the space they need to flourish; vegetation management not only improves survival rates but speeds up establishment helping the trees to grow stronger, faster, and healthier.
Hand-weeding around the base of each tree and inside the shelters to create a weed-free circle of about 1 metre is all that is needed. Mulch mats can help suppress growth and adding an extra layer of biodegradable mulch will also help to retain soil moisture; mowing or strimming risk damage to the trees and can stimulate weed regrowth.
Mid-Term: Understanding Tree Growth and Development
From germination to maturity, trees grow and develop through a range of biological processes that allow them to increase in size, form new tissues, and react to their surroundings. Having a basic understanding of these processes is helpful for managing and caring for your trees effectively.
Life Cycle of Trees
The trees supplied by the NHS Forest for planting are young seedlings but have alreadypassed through their earliest stage of growth in a tree nursery – typically the first year of life. Most native UK species are grown from seed, while some are propagated from cuttings to produce genetically identical clones. After germination young trees develop their first leaves and begin producing their own chemical energy from sunlight through photosynthesis, allowing them to grow independently.
Want to learn more about how trees are grown from seed? Check out our guide to tree nurseries.
Once planted, trees continue to grow taller and stronger, developing thicker stems and more branches; at this stage they are known as saplings. Although still young and vulnerable to browsing by animals and competition from vegetation, saplings are entering one of the most rapid periods of growth in their life cycle. Because of this they benefit greatly from the maintenance steps outlined above.
As trees reach maturity, they become increasingly self-sustaining and less dependent on human intervention. Mature trees can reproduce, producing flowers, fruits or cones that contain seeds. Over time as their branches expand and connect with neighbouring trees, they form a more continuous canopy cover. The increased shading creates the characteristic woodland floor environment known as the understory, where shade-tolerant plants, fungi and wildlife thrive.
Growth gradually slows as trees age, and branches or sections of the trunk may begin to die back, and eventually the trees will die. But rather than marking the end of their ecological role, this stage is an important part of the life cycle. Decomposing dead wood returns nutrients to the soil, provides valuable habitat for wildlife, and helps to support the next generation of woodland life – including young, wild-seeded trees.
Environmental Factors
A tree’s genetics set the blueprint for its potential size and lifespan, but environmental conditions ultimately determine how successfully it will grow. Sunlight is vital for photosynthesis, and trees planted in shaded spots or crowded out by other vegetation may grow more slowly, often stretching taller and thinner as they compete for light.
Soil quality is equally important. Trees rely on a balanced supply of nutrients and sufficient water to thrive. Compacted or poorly drained soils can limit root growth, reduce nutrient uptake, and leave trees more susceptible to stress and disease.
Space, both above and below ground, is another key factor. Crowded conditions create competition for light, water, and nutrients, slowing growth and increasing vulnerability to pests and illness. Providing proper spacing at planting allows each tree to develop a strong trunk, broad canopy, and healthy root system. In established areas, selective thinning may be necessary to give the strongest trees room to flourish.
Thinning
Early thinning simply involves removing weaker, poorly formed, or suppressed trees to provide more space for stronger trees to grow. Look for trees that are bent, forked low down, damaged, diseased, or heavily shaded by adjacent trees. Removing these trees will improve airflow and light levels and helps the stronger trees develop with straight stems and healthy crowns.
Thinning is better undertaken gradually rather than all at once. Simple hand tools are often sufficient for small-scale work and cut material can be stacked into habitat piles or used for firewood. Walking through the woodland regularly and making small, careful interventions every few years is better than carrying out one heavy thinning.
Pruning
Pruning to remove damaged or diseased branches will encourage straight, well-formed growth and can make it easier to move through trees while still leaving plenty of cover and habitat for wildlife. Removing lower side branches allows the main stem to grow tall and clear while discouraging animal browsing. Pruning should be done gradually, usually in winter using clean, sharp tools and cutting close to the trunk without damaging the bark. Avoid removing too much at once; it’s best not to remove more than about a third of the tree’s branches in one go.
Read more about pruning in NHS Forest’s guide to tree care and maintenance.
Biodiversity
It’s not just about the trees – here are a few simple steps that will support a wider range of plants and animals. Leaving deadwood in place is extremely valuable for wildlife; as the wood slowly decays it becomes food for fungi, insects, and microorganisms that in turn support larger animals and create a small but important habitat. You might also consider introducing native wildflowers or woodland shrubs in and around the trees to provide additional food sources and shelter.
Once canopies have developed and your trees are no longer reliant on proactive weed control, it is better to avoid excessive mowing and permit natural regeneration to take its course – albeit you may prefer to keep glades and rides clear for easier access.
Tree Shelters
Tree shelters can also be removed once trees are growing well – ideally when the main stem (excluding branching) is around three metres in height. Slower-growing species may take longer – if unsure it’s usually best to leave shelters in place a little longer.
Long-Term: Healing Environments for People and Nature
As the trees begin to shape the landscape, planted area can gradually evolve from a simple woodland plot into a restorative green space that benefits both people and nature. Even relatively small areas of tree cover can provide opportunities for quiet reflection, fresh air, and gentle contact with nature – something that is increasingly recognised as valuable within healthcare environments.
NHS Forest has another blog detailing some of the many benefits of trees for health. Why not take a look at it.
Accessible Green Space
Complex landscaping isn’t required to facilitate access. As your trees start to maturethe atmosphere will naturally become calmer, cooler and more sheltered, with subtle additions enabling people to experience the space without disturbing its natural character. Clear, accessible routes help ensure the trees can be enjoyed safely by patients, visitors, and staff alike; simple mown paths, small clearings or a bench at the edge of the planting area can transform the trees into a welcoming place to pause.
Accessibility is key. Where feasible, paths should be wide, level, and well maintained; establishing a short circular route or accessible seating area can create a meaningful opportunity for outdoor time. Maintaining clear sightlines and keeping vegetation trimmed back will help the space feel safe and welcoming. Simple signage may also be appropriate, letting visitors know that the area is part of the NHS Forest and encouraging respectful use of the woodland.
Importantly, accessibility does not mean over-managing the landscape. The aim is to strike a balance between usability and allowing the woodland to develop naturally.
A Place for Wellbeing
Research consistently shows access to green space can support mental and physical wellbeing. Time spent in nature has been linked with reduced stress levels, improved mood, and faster recovery from illness. For healthcare staff, green spaces can provide an important opportunity to step away from busy wards and take a restorative break.
Trees are particularly powerful in this regard. As they grow, they help create quieter, environments that buffer noise, improve air quality, and soften the visual landscape of clinical settings. The changing seasons – from spring blossom and summer shade to autumn colour – can bring a sense of rhythm and connection with the natural world.
Providing even small opportunities to pause beneath trees or walk through a wooded area can make a meaningful difference to how healthcare spaces feel and function.
Engagement with Nature
One rewarding aspect of trees on healthcare sites is the opportunity to involve people in their care. Staff volunteers, patient groups, or local community organisations may enjoy participating in activities such as light seasonal maintenance or wildlife surveys.
These activities can help foster a sense of shared ownership and pride in the space; for patients, particularly those involved in rehabilitation or wellbeing programmes, gentle outdoor activities can provide both physical and psychological benefits.
Even informal engagement – such as lunchtime walks or guided nature sessions – can help people build a stronger connection with the woodland as it grows.
Planning for the Future
Trees are among the longest-lived elements of any landscape, and the planting carried out today will continue to shape your healthcare site for decades to come. With thoughtful stewardship the trees you have planted through NHS Forest will mature into a thriving woodland that supports wildlife, improves climate resilience, and provides a lasting space for rest and reflection. Regular monitoring, occasional maintenance, and a willingness to permit natural processes take their course will ensure that the trees continue to flourish for generations to come.
Conclusion: Growing a Green Legacy
Planting trees through NHS Forest is just the beginning of a long, rewarding journey. The care you provide in the first few years lays the foundation for healthy, resilient trees. As they mature, your trees will become a lasting part of the NHS landscape, supporting biodiversity, improving air quality, and creating a calm, restorative space for everyone that uses your site.
Plant, care, and watch your green space thrive – every tree is a step toward a healthier, happier, and more sustainable healthcare environment.