Ninewells Hospital case study
Forestry Commission Scotland actively supports revitalising the NHS estate. Using greenspace has significant benefits for the health and well-being of patients and staff alike. On this page, we explore this idea through a case study of Ninewells Hospital, Dundee.
Built in 1974 with panoramic views over the Tay and with mature adjacent parkland, Ninewells is a large General Hospital with 6,000 staff and extensive grounds. The hospital formed a pilot project for the Scottish 'Hospital Greenspace' Project, set up to show how creative use of the natural environment can be beneficial for health and well-being. Initial improvements including signage, seating and footpaths began to be implemented in 2011.
In 2009 a partnership was formed between NHS Tayside, FC Scotland, Dundee City Council and Maggie's Cancer Caring Centre, located in the hospital grounds. They considered how best to make use of the grounds surrounding the hospital, especially the parkland of Invergowrie House. Local residents walk through the area, but hospital activity tends to be focused on the north side where people come and go from the car park.
The steering group initiated a year of extensive consultation. Views were sought from in-patients and out-patients, from children and young people, from staff and local residents; there were focus groups and information displays. Pedestrian movement around the site was analysed in great detail, and it was discovered that people were generally unaware of the nearby green space, but were keen to gain access to it. They wanted better signs, paths and seats; and they were interested in health walks, relaxation exercises and art activities.
A landscape master plan was developed to ensure comprehensive consideration of the whole site, which includes 40 hectares of open ground with 23 hectares of woodland and proposals emerged which focused on making the site more accessible. All-weather paths have now been laid out with careful attention to gradient and surface and routes have been designed to feature prominent viewing points over the Tay estuary. There are seats and interpretation boards explaining some of the local history, as well as an information leaflet and map to encourage use. The grounds are now part of the wider Dundee cycle network. Trees have been surveyed and where necessary remedial safety works have been done.
A key feature of the project has been the need to improve links between the indoors and outdoors and this has been achieved with the introduction of new signage within the building directing people to the green-space outside.
Ninewells Hospital site features an extensive area of green-space which was practically inaccessible from the hospital until the improvements were implemented. By taking a holistic view of the hospital grounds and employing the expertise of a specialist landscape designer, the opportunities to improve this challenging site were identified and maximised. The changes have benefited hospital staff, patients and visitors and the improved paths in particular have helped strengthen links between the hospital site and the surrounding community.
What are the health benefits?
The original hospital intended to make use of the natural assets of the site and this project is rediscovering them in new ways. By providing beautiful green space within easy reach of hospital wards, recovery occurs through gentle exercise, rather than 'bed rest'. The benefits of small regular periods of exercise, especially out-of-doors, are now well known and are increasingly being prescribed in preference to medication. Staff also benefit from taking breaks in natural surroundings. And everyone benefits from looking out onto mature trees and spectacular views.
These improvements are designed to be accessible to as many people as possible. They are free to use and will help to reduce health inequalities.
A manager’s perspective:
“Developing access through hospital corridors and grounds to arrive at the green space has required much consultation and negotiation with hospital departments (including A&E, Estates, Occupational Therapists) to overcome concerns from the wards about security and infection control. Some consultation was conducted using an online survey method.
Support from a senior level in the organisation was important, as was the participation of the Estates Department. The vision, expertise and good leadership of the Forestry Commission was essential too.
While some aspects of the work took longer than expected we got there eventually!”
- The Hospital Greenspace project was made possible by supportive Scottish policy drivers such as 'Good Places, Better Health', 'Equally Well', Green Exercise, Active Nation (for Commonwealth Games 2014), Healthy Working Lives, Woods In and Around Town;
- Analysis of pedestrian ‘footfall’ is often a good starting-point for understanding how a site is used, especially on large, complex sites such as Ninewells;
- Opportunities for match funding contributed hugely to the success of the work;
- Time, perseverance, and good negotiation skills are all essential.
Mary Colvin, Health Promotion Programmes Manager.
Case study: Ninewells Greenspace Case Study