Research by the Centre for Sustainable Healthcare (CSH) shows that the most common way for health staff to spend time in green space at work is by taking a walk during a break. Interviewees often described heading out for a turn round the grounds: “I have a sort of lap that I do.”

Incidental outdoor walking is also popular, with many staff choosing the scenic route when running errands. All of this points to the role of green walking routes at healthcare sites in helping staff to access nature for their own wellbeing. Well-designed routes are also great for patients, making complex sites easier to navigate and creating opportunities for rehabilitation and recovery.

NHS Forest sites with trails and walkways

Mount Vernon Cancer Centre in northwest London developed its ‘Woodland Walkway’, to provide a pleasant, on-site walking route for staff. In discussions, consultees said they disliked walking around parked cars. They wanted more seating, more shade, and opportunities to celebrate the hospital’s history as a sanatorium.

The fully accessible, circular pathway loops around the main lawn and through a small woodland. A sign makes the link between the site’s past as a centre for open air treatment of tuberculosis, and Mount Vernon’s present-day initiatives to encourage the use of its green space for health. Wooden way-marker posts are each engraved with one of six ‘ways to wellbeing’, and a picnic table is hidden among the trees. The walkway has been warmly welcomed by staff and is in constant use in summer.

Donors, staff and volunteers on the new woodland walkway at Mount Vernon Cancer Centre
Donors, staff and volunteers on the new woodland walkway at Mount Vernon Cancer Centre. Photo: Vicki Brown / Centre for Sustainable Healthcare 2021. Attribution 4.0 International (CC BY 4.0)
5 Ways to Wellbeing - Alder Hey Children's Hospital
5 Ways to Wellbeing – Alder Hey Children’s Hospital. Photo: Miriam Dobson / Centre for Sustainable Healthcare 2021. Attribution 4.0 International (CC BY 4.0).

At the Bangor hospital, Ysbyty Gwynedd, in Northwest Wales, CSH and Plantlife created a Meadows Health and Wellbeing Route between the hospital and a nature reserve. The trail is marked with arrows and interpretation and has been publicised through a leaflet and posters. Patients can also access the route on tablets through a virtual StoryMap which features the sounds of birds and insects. Similarly, Alder Hey Children’s Hospital in Liverpool has made wildlife a theme of its wayfinding signs, with a cast of cartoon animals, such as hedgehogs and rabbits, leading young patients around the hospital.

Walkways can be important in encouraging active travel. At Cirencester Hospital, the creation of a pathway through hospital woodland has opened a walking route into the site for local residents. At Gloucestershire Royal Hospital, the landscaping of a new walking link offers staff an alternative exit and a short cut to the railway station.

Woodland walkway to amphitheatre, Cirencester Hospital
Woodland walkway to amphitheatre, Cirencester Hospital. Photo: Carey Newson / Centre for Sustainable Healthcare 2021. Attribution 4.0 International (CC BY 4.0).
Broomfield Hospital's landscaped 'Walk through Time' area
Broomfield Hospital’s landscaped ‘Walk through Time’ area. Photo: Carey Newson / Centre for Sustainable Healthcare 2021. Attribution 4.0 International (CC BY 4.0).

Well-designed maps can encourage the use of walking routes and raise awareness of the hospital’s green spaces as destinations. At Broomfield Hospital in Essex, a site nature map suggests a simple circular route of the grounds linking Broomfield’s two woodlands, with seasonal tips for spotting wildlife. A planned ‘History Walk’ close to the hospital’s main entrance will feature a willow sculpture trail that curves between buildings. Interpretation boards will tell the story of Broomfield since its foundation in 1937.

In Bristol, Southmead Hospital, consulted widely with staff to produce its green Explorer Map. The resulting design includes ‘green exits’ to give staff quick access to gardens and other green spaces across the site and ‘green treasures’ such as bronze animals around the grounds.

Southmead Hospital Explorer Map
Southmead Hospital Explorer Map. All rights reserved.

Creating trails and walkways

Consultation will help shape your plans and root them in the daily realities of the site, as well as giving staff more ownership of the project. Existing site maps provide a good basis for discussion and labelling. Use them to surface the tacit knowledge of site users, and identify key landmarks and green destinations. OpenStreetMap is also excellent for detailed, opensource data.

Clarify the purpose of your project. Are you creating an amenity for staff, celebrating the site’s heritage, providing a pleasant experience for patients, raising awareness of wildlife, supporting active travel, encouraging site users to take a particular route or to use a particular space? Agree on priorities and what success will look like. You may want to collect observational data at the outset so you can later assess impact.

Clinical staff especially are more likely to use green space that is close to where they work, so bear this in mind in marking locations and designating routes. ‘Permission’ to use a space is also critical, so consider how signs and designs can help in providing this. Take time to ‘ground truth’ your map, checking names, locations, route timings and safety issues. Audit your route’s accessibility: at Mount Vernon Cancer Centre, for instance, this led to the choice of a bound gravel path. If you’re producing materials to promote green space and nature, make sure they are suitably colourful and appealing: a taste of the wild outdoors beyond your buildings.

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