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Creating a GP practice garden

This project is likely to take:
<10 hours if creating a small 'micro-garden'
Several months if creating a larger garden with regular gardening group

Can be done by any staff member

Green Impact for Health Toolkit area: Prescribing & Quality Improvement

CQC Areas

  • Effective (Supporting People to Live Healthier Lives)
  • Caring (Workforce Wellbeing)
  • Well-led (Environmental Sustainability)

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The benefits of this project

Project benefits for Your Patients

Benefits for Your Patients

  • Improved mental and physical health
  • Reduced loneliness
  • Boosted local communities especially for vulnerable groups
Project benefits for Your Practice

Benefits for Your Practice

  • Reduced demand for appointments due to improved patient health
  • Financial savings due to reduced need for GP appointments which cost the NHS an average of £56 per appointment
  • Every £1 invested in green spaces can contribute £30 towards health and wellbeing benefits
Project benefits for The Planet

Benefits for The Planet

  • Healthier people mean reduced healthcare emissions
  • Carbon savings due to reduced need for GP appointments which generate an average of 9.9 kgCO2e8 per appointment

Opportunity for improvement

  • Ill health caused by a poor diet costs the NHS and wider society £5.1 billion per year. Gardening and food growing projects can improve health and wellbeing in a multitude of ways – leading to healthier diets, healthier weight, reduced falls and better pain control. Nature-based outdoor activities can significantly improve mental health and community growing projects can be a powerful method to engage vulnerable groups.  
  • Recent studies show Green social prescribing can lead to £635m of NHS savings. 
  • This project outlines how to start up a practice garden and gardening group (see disclaimers), increasing access to green space for patients and staff, linking them to their community and leading to a multitude of health benefits.  
  • You might like to create SMART goals for this project e.g. Create at least one extra green space in the gp practice grounds in the next 2 months such as a planter with herbs and flowers and invite patients and staff to suggest ideas for it and help plant it.     
  • A wealth of more detailed information on starting a practice garden with practical suggestions as well as summary of the evidence base is available in this Gardening and food growing in Newham – GP toolkit.  

How to carry out this project

  1. Investigate

    What is already happening in the local area? Consider PCNs/Clusters, social prescribing services, local council, educational institutions, voluntary groups. Where is there already a network? 

  2. Source funding

    Consider funding sources eg. From Wildlife Trust, underspend funding, Staff wellbeing / GP retention & recruitment funding, NHS property services, Household Support Fund, Lottery funding – see Newham GP Toolkit for suggestions and read their report here.  NHS Forest also have free tree bundles on offer as does the Woodland Trust.  

     

  3. Plan

    Identify and involve stakeholders including patients.  Select and design a space. See toolkit above for considerations. Ensure landlord involved/aware including premise liability insurance for gardening activities.  

     

    Consider involving local gardener or community garden for assistance in deciding the planting calendar, Love The Garden and Royal Horticulture Society have helpful guides.  There may also be a local horticultural college where people can donate time. NHS Forest also has some drop-in support sessions.  

  4. Assign roles

    Establish staff and patient responsibilities for the garden going forward – will there be a paid gardener, or will it be run by volunteers within or outside the surgery? Set expectations of time commitment needed and consider co–production with patients and a steering group.  Who will run the gardening sessions? Consider need for DBS checking of therapeutic gardens/voluntary staff. 

  5. Invite patients

    To ensure inclusive access consider a range of techniques to recruit patients, mindful of digital exclusion.  This might include posters in clinical rooms, a noticeboard and/or video in waiting room, word of mouth and text messages.

    Social prescribing team can directly refer into sessions.  

    Resource: Practice Garden

    “We are excited to share our new practice garden with our patients. Please drop in for our Open Day on ………. at ……… to find out more about our gardening sessions”

  6. Pre-intervention data collection

    With consent, collect baseline data for initial group of patients invited to gardening sessions (Choose from below depending on timescale): 

    • Number of people attending gardening sessions/length of time involved 
    • Number of pieces of fruit and veg eaten each day  
    • Wellbeing questionnaires for participants (and staff members involved) 
    • PHQ9 scores for patients 
    • Weight, height, waist circumference, BP, Hba1c, Lipid profile (note this is NOT advocating for additional testing, use existing data). 
    • Number of GP consults and prescriptions for Long Term Conditions  

  7. Relax in the garden and attend some gardening sessions

  8. Post-intervention data collection

    After patients have attended a certain number of gardening sessions e.g. 6 weeks, re-collect the data. 

  9. Study

    Review the results, summarise learning, share with practice team + patient participation group and decide what changes are needed to improve the process. Decide how often the garden steering group and use the Project Monitoring form to keep track.  

    Consider how to widen access and reduce barriers faced by certain groups – eg working parents, those with physical disabilities, any other group missing from initial cohort.  

Top tip

Don’t have much space? Don’t worry! 

Many urban areas struggle to get space for gardens. However a number of practices have made improvement with indoor plants, herb boxes or potted plants.  You can still create projects for patients and staff wellbeing with small spaces. 

How to scale this project up or down

Please note - Use of this project requires NetworkPLUS membership. If you would like to share this project with others, please invite them to purchase their own membership—access must not be shared with non-members.

Explore your local community to find further groups to bring into the project e.g. Incredible Edible.  You might want to collaborate with other local practices e.g. offering the garden to more patients, hiring a joint gardener etc. 

Case study

Vauxhall Health Centre teamed up with a local community interest company to set up a practice garden in a small pocket of space in the practice grounds.  They have had great success transforming this small strip and have run regular workshops for staff and patients including bulb planting, apple pressing and jam making.   

Here is their advice: 

Start small and let it grow. 

Budget does not have to be big.  We started with just over £1000 matched funding (two thirds funded by the practice and one third from Kindred, a local organisation that encourages community initiatives). 

Make sure there is a core group of people dedicated to the project and engage with patients and volunteers.  People are often keen to donate things such as plants and pots.   

Don’t worry if it doesn’t take off immediately, even 2 patients turning up to the weekly gardening event is a success 

Organise workshops to get things kickstarted. We have done this by liaising and having support from a local gardening group enterprise (Collective Gateways) and supported by a third sector organisation (Kindred). 

Involve the social prescribing team - ours use the garden for some of their patient consultations now. 

Keep advertising and discussing it and involve all staff – it’s great for staff wellbeing. 

Vauxhall Health Centre, Liverpool - a pocket garden

Another example of a garden project in the GP practice. 

£100 budget.  Lots of staff involvement. 

Improving Green Spaces

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Tell us a little about your project and enter your data in order to generate a certificate showing the probable cost savings and other benefits. This project may help with CQC evidence submission (see disclaimers).

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