How virtual green space is transforming NHS wards
At NHS Forest, we know how vital green spaces are for mental and physical wellbeing. Yet for many NHS patients—particularly those in long-term care, urban hospitals or with limited mobility—accessing nature isn’t always possible. This is where virtual green space comes in.
While all NHS sites should strive to provide quality outdoor space, this may not be practical due to location or patient vulnerability. That’s why some NHS trusts are finding innovative ways to bring nature indoors through digital green space.
A Window to Nature at University Hospitals of Derby
We spoke with Environment and Sustainability Officers from the University Hospitals of Derby and Burton (UHDB) about the virtual green space projects currently underway across their sites. While many of their hospitals are fortunate to be surrounded by natural green space, others are not. To help bridge this gap, the team has been developing projects to bring the benefits of nature indoors for patients, staff and visitors.
These digital initiatives are particularly valuable for individuals with limited mobility, such as those who are bedbound or receiving palliative care. By making nature virtually accessible, they ensure that more people can experience the calming and restorative effects of green environments.
The trust’s virtual green space offerings include soundscapes, 360-degree videos, and footage from rail-mounted cameras, which are broadcast on patient screens at Royal Derby Hospital. Much of this footage has been captured in Badger’s Wood, a woodland area located behind Queen’s Hospital Burton.
Significant effort has gone into revitalising this once-overlooked woodland. Thanks to extensive local volunteer support, conservation activities and re-landscaping, Badger’s Wood is being transformed into an extension of the hospital’s green space. It now hosts events such as forest walks, mindfulness sessions, forest bathing and willow weaving workshops. Interestingly, one of the most common responses from staff who take part in these events is surprise—they often didn’t realise there was a woodland on site.
A recent biodiversity survey recorded 137 different species in the woodland. To support and monitor this thriving ecosystem, volunteers have installed owl, bird and bat boxes, along with wildlife cameras. These cameras not only contribute to ecological understanding and species monitoring, but also provide engaging footage that is displayed in hospital waiting rooms. Alongside standard NHS updates and health information, patient-facing screens now feature 40–50 clips of local wildlife, including muntjac deer, badgers and rabbits. This content helps to create a more soothing and calming atmosphere in the hospital, making visits less stressful and raising awareness about the natural environment just outside the building.
Footage from Badger’s Wood is also featured in the Wildscapes for Wellbeing project—a collaboration between Derbyshire Wildlife Trust, UHDB’s Library and Knowledge Service and the Audio-Visual Suite, supported by the Cadent Foundation. This ongoing initiative aims to enhance the wellbeing of patients and staff through virtual green space content.
The videos include a variety of scenes filmed in local woodlands, from wildlife camera compilations to longer 30–60-minute static recordings where viewers can simply watch the brook trickle by or leaves rustle gently in the breeze. There are also immersive 360-degree virtual reality (VR) relaxation soundscapes that allow viewers to explore the woodland as if they were walking through it. These experiences can be rotated and interacted with to give a full 360° perspective, and even include aerial drone shots gliding over Derby’s woodlands.
Langdon Hospital
Nature capture cameras have also been installed to film wildlife in the grounds of secure mental health site, Langdon Hospital. A huge amount of work has been undertaken to take occupational therapy outside through integrating conservation work into care pathways.
For patients unable to go outside the wildlife cameras have provided a brilliant way of bringing the outside in. So far, they have seen badgers, hazel dormice, squirrels, rabbits and a range of birds, including a possible barn owl. Showing the wildlife footage on a laptop has been a great way for Alex Watkins, Occupational Therapy Technician, to share the ourdoors with individuals on wards. The images and film create conversation points and bring focus to the world outside the hospital.
The greatest positive impact has been with the patients who set up the cameras and work outside on the hedgerow and orchard project. Alex says: “There seems to be a genuine connection between the patients and the wildlife that they can see sharing the same spaces as them. I can testify that it brings joy and interest to individuals and gives meaningful purpose to all those involved.”
The cost of these cameras is low and Langdon hospital were able to get funding for both of their cameras and the extra necessary security for £250.
Alex explains: “The range of involvement can easily be tailored to the individual and knowledge of the local environment can be developed to enhance the likelihood of capturing footage. Wildlife finds a way to exploit opportunities so projects can also involve developing places wildlife will find attractive to position your cameras. Thinking about where to put the cameras can be a lot of fun and it is always exciting opening the files to see what you’ve got. Once the hardware is purchased it is basically a case of using your imagination and a bit of knowledge to start finding out what is living around you. It is also ok to put down some bait to invite wildlife to make an appearance, you just need to be sensible about it.”
West Middlesex University Hospital
The Breeze Outside project is a digital installation by artist Zheyuan Zhang for Redlees Ward, West Middlesex University Hospital. The installation, commissioned by CW+, the charity of Chelsea and Westminster Hospital NHS Foundation Trust, brings the outside world indoors for patients that only have a limited view. It displays a scene of swaying grasses, local plants and shifting light, which evolves in real time with the weather, wind and daylight conditions. This project seeks to connect patients to the passage of time, the movement of air and nature. This installation aims to support patients to regain their circadian rhythms and re-connect with nature.
Forests from anywhere
Forestry England has created a hub of virtual nature experiences to help people feel calm, increase emotional connection to nature and improve wellbeing – wherever they are.
Ellen Devine, Wellbeing Projects Manager at Forestry England explained more: “The inspiration for the project came from my personal experience of being an inpatient in a hospital setting for a prolonged period of time. Due to illness, I was unable to get out into nature and craved the calming and restoring effect of natural spaces. I knew that Forestry England had various resources such as videos, podcasts, audio recordings, creative activities, but these were linked to different projects and not accessible to the public in one central space. From my hospital bed, I wondered if it might be possible to create a ‘one-stop shop’ of virtual forest resources which could help people facing similar challenges to myself to access nature. This led me to research the barriers people face to accessing nature which included limited access to the outdoors due to ill health or disability, not being able to get to safe natural spaces from where they live and not having the confidence to explore natural spaces.”
The virtual forest hub brings together resources including 360 degree videos of the forest, podcasts, audio meditations and creative activities on one webpage. It provides a simple way for people to find and use virtual forest resources from their mobile, tablet or laptop. To support people to access the resources, Forestry England have created a simple poster which can be downloaded for free and displayed in health care settings or anywhere people may wish to experience a few minutes of escape into nature. The poster has a QR code on it which people can scan to be taken to peaceful forest videos. Other resources include a 360 degree tour of our Wellbeing Trail at Guisborough Forest featuring a voiceover inviting people to try simple mindfulness activities to connect with nature. As well as bringing wellbeing benefits to people via the virtual experience, the tour also helps people picture what to expect on a future forest visit and inspire them to explore nature for real as and when they are able to do so.
Virtual forests in healthcare
Dorothy House Hospice Care is using 18 of Forestry England’s virtual forest videos in a virtual reality (VR) project trailing the use of VR to help reduce symptoms and improve relaxation for patients receiving end of life care. The project had funding from the Masonic Charitable Foundation via Hospice UK, but by using Forestry England’s existing VR resources, they were able to offer patients a greater variety of experiences and amplify the impact of their funding.
The virtual forests resources are being by an occupational therapy team at Sussex Community NHS Foundation Trust, as part of a new approach to delivering stroke rehabilitation in patients’ own homes. Sharing the virtual forest resources at no charge, enables projects such as this one to test pioneering approaches and generate an evidence base for their efficacy.
In Gloucestershire, the virtual forest resources have been used as part of a Virtual Wards project supporting patients on at-home virtual wards. This pilot will develop evidence for the inclusion of nature-based activities in future virtual ward delivery, helping to keep people out of hospital.
Visit the virtual forests hub: Virtual forests hub| Wellbeing| Forestry England
Read about Forestry England’s work with Dorothy House Hospice Care: Virtual forests bring the outdoors to hospice patients | Forestry England. If you’d like to find out more about the virtual forests hub or use the resources in your setting, contact Ellen Devine, ellen.devine@forestryengland.uk
Where next for virtual green space?
As demonstrated, some of these interventions can be low-cost and accessible options for hospitals. Furthermore, there is huge potential for implementation of virtual green space across even more NHS sites. There is also huge potential for collaborations with wildlife organisations as illustrated by University Hospitals of Derby and Burton’s work at Badger’s Wood with Derbyshire Wildlife Trust.
Further research is needed into whether VR and digital green spaces can simulate similar effects when real access isn’t possible. One interesting paper is the 2019 journal article by Hedblom et al. titled Reduction of physiological stress by urban green space in a multisensory virtual experiment. The article showcases research where recovery from physiological stressors was tested using virtual reality of an urban environment and two green spaces. Not surprisingly, the VR green spaces were more successful in reducing stress.
The study also looked at creating multi-sensory virtual reality. When comparing the senses odours had the largest effect on the stress response. Indicating that olfactory sensory inputs may be even more important than visual and auditory features when creating environments that reduce stress. For VR green space to have extra impact it should consider smell too!
This work is in its infancy, if you are exploring these topics, we’d love to hear from you. How does your trust use digital green space? How has exposure to it help to reduces stress, anxiety and improve recovery times?