A rooftop can provide a dramatic setting for a hospital garden. Panoramic views and big skies have the potential to add to the restorative effects of the green space, while the inherent proximity to wards and workspaces can make these particularly accessible spaces for staff, patients and visitors.

The restricted nature of a rooftop garden means that they can be safe spaces, with no access to busy roads or other hazards. This can make them excellent additions to children’s wards, for example, as a space for young patients and their carers to enjoy fresh air and nature without leaving the ward, particularly if some playground features are built in. The level ground can make them accessible for wheelchair users or people with mobility issues and walking aids, and this gives them the potential for use in physiotherapy. In some cases it may be possible to look out onto the rooftop from windows in the wards, meaning that those who are not well enough to access them can still benefit from the green space views.

Southmead Hospital's rooftop herb garden, leading off the Vu Restaurant for staff
Southmead Hospital’s rooftop herb garden, leading off the Vu Restaurant for staff. Photo: Vicki Brown / Centre for Sustainable Healthcare 2021. Attribution 4.0 International (CC BY 4.0).
Bristol Precinct Urban Gardens - Bristol Haematology and Oncology Centre roof garden
Bristol Precinct Urban Gardens – Bristol Haematology and Oncology Centre roof garden. All rights reserved.

Rooftop gardens can also function as green sanctuaries for healthcare workers. This has worked well at Southmead Hospital in Bristol, where the staff’s Vu Restaurant leads onto the large rooftop herb garden. Here, staff can take a break from the hospital environment, socialise in the sunshine and take in the views from this fifth-floor green space. The proximity to the restaurant is also handy; the garden’s planters are filled with fragrant herbs which are used by the chefs.

Depending on the type of garden and how much of the roof space is ‘greened up’ using moss or turf, for example, they may reduce rainwater runoff and provide natural insulation for the buildings below. Rooftop gardens can reduce the urban heat island effect, improve air quality and provide important habitat for city wildlife, including birds and pollinating insects.

Consideration for people and plants

Rooftops are particularly exposed to the elements. Sites that are not hemmed in by taller buildings may offer no natural shade, so installing permanent or temporary shelters or parasols can ensure the spaces can still be enjoyed on sunnier summer days, as well as during drizzly periods. A longer-term solution might be a pergola or arbour with climbing plants, whose seasonal foliage provides shade during the summer while allowing  light through in winter. Prevailing winds will need to be considered if the rooftop is exposed, or if a wind tunnel effect is created between walls.

The setting will impact planting plans, too, with plants that can withstand full sun or strong gusts needed in more exposed spots. While you’re unlikely to have mice, squirrels and foxes digging up the plants, birds can be an issue, so think about how to protect veg patches from marauding pigeons, seagulls or crows, for example.

In many cases, due to structural limitations, it may be more practical to install planters and raised beds to create green oases around seating areas and walkways. While these tend to need less weeding than plants grown in the ground, they will require more frequent watering. Consider the size, too: ensure that shrubs and small trees won’t outgrow their pots too quickly. And bear in mind that planters are not always easily portable: soil is extremely heavy.

While rooftop gardens are not currently widespread in the UK hospitals, the increasing recognition of the need for green space means that more and more sites are showing interest in developing such spaces for the benefit of their staff, patients and visitors. Some are looking across the Atlantic for inspiration: Boston Medical Centre’s Higher Ground Rooftop Farm spans some 185 square metres and produces up to 2,700kg of fruit and veg each year. This flagship site supports food-insecure patients, and the farm is visible from the wards to ensure a view of green space for patients who are not able to access it. The farm’s operations director Lindsay Allen spoke about the project at our 2021 NHS Forest Conference (see from 1h 55 mins in the conference video).

Further reading

Hospital Rooftop Garden (2017). Research carried out by Sima Pouya and Oner Demirel

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