Culm Valley Centre case study

Culm Valley Integrated Centre for Health, Devon


Culm Valley Integrated Centre lies at the core of an innovative and national self-care project, supported by the Department of Health. This project is an attempt to push the boundaries of Primary Care in terms of patient involvement and encouraging self-help, thus generating better community health.

Project description

The Centre is especially interested in ways of being (or preferably staying) healthy that work at home, that are simple, safe yet effective, and that may reduce the need for prescription medicines and other more serious interventions. It is keen to support all aspects of wellbeing, at social, emotional, mental, spiritual as well as physical levels. Preventing disease, treating symptoms and managing chronic illness should engage all involved: patients, families and health professionals.

The surgery's community health café, gardens, self- diagnostic facilities and its extended virtual and group self- help programme are all designed to help patients better care for themselves. The Centre includes a Natural Health Practice offering a range of complementary therapies, as well as a café (Café Sustain), which acts as a community hub inside the health centre. Patients visiting their doctor, health professional or the pharmacy have become used to stopping in for a drink and snack and often finding new ways to look after themselves as they do. A Health Facilitator acts as a ‘gateway’ to the numerous activities which patients can take advantage of, pointing them towards those which are most appropriate.

The Centre makes good use of the surrounding garden areas which include a productive Kitchen Garden as well as a small Physic Garden. Initial work concentrated on the Physic garden with information on British medicinal plants that can be grown in our own gardens, including a featured ‘herb of the month’ in the lobby with associated take-home postcards. The Physic Garden also has a bench where both patients and staff can spend time relaxing outside in a calming environment.

In the Kitchen Garden, food is grown for the café kitchen to show the local community how little space is needed to grow food, to highlight the importance of using seasonal produce and to save money for the community café enterprise by growing some of its food. Evening sessions have been held with herbalists on ‘Making medicines from the Garden’ and ‘Winter Remedies’. These workshops encourage people to take responsibility for their health as well as being social events, giving people a chance to meet their neighbours and build friendships.

Key achievement

The Centre advocates a new and more creative approach to primary care – ‘self-care’ - which encourages people to take more responsibility for their health. With an equal focus on prevention and cure this represents an approach which will become more relevant in the future as pressure on hard-pressed NHS resources continues to increase.

What are the health benefits?

The benefits for health of an emphasis on ‘self-care’ in the widest sense will become increasingly relevant in a world where natural resources are becoming more scarce and the costs of maintaining a public health service have to be minimised, requiring an approach to healthcare less focused on technology.

Members of the community gardening group have the gardening ‘prescribed’ to them, encouraging them to exercise and to get involved in social activity. The increased contact generated by the activities on the site generally (but especially the gardening group) have helped bring about improvements in people’s mental health. Many people join the gardening group for around three months and then move on, once their confidence has grown and they feel better. One patient group is also involved in the planning and provision of graduated 'walk and talks' led by patients themselves, to improve fitness.

A Project Director’s view

Joey has been very involved in helping patients work in the garden.

“We have raised beds for people with limited mobility, so patients can garden at a level that is appropriate for them. We soon realised that some people like to work in the garden alone or at weekends so we put in a shed with a combination padlock so people could access the equipment whenever they wanted. We keep a diary so we can plan ahead and know which jobs had been done. The group plan and write jobs lists during coffee time after gardening.

Maddocks Farm Organics, our café’s salad supplier, regularly donates plugs and plants so customers can see the same plants on their plates as in the garden. We also put signs up in the café and around the centre asking for seedling, seeds and resources like spades and hoes, and we were inundated. Donors began to feel involved in the project and would come and check up on the gardeners’ progress.

We were able to sell produce to take home when we had a glut and the gardeners and café kitchen had had their share, and we sold produce to raise funds for the community gardening project. Nothing was wasted!”

(Joey Lee, former Community Projects Director for SustainCare CIC & Cafe Sustain)

Lessons learned

  • The main challenge has always been financial sustainability. None of the 'extras' at the Centre come from mainstream NHS funding but are financed through grants, social enterprise and local fundraising;
  • The Community Interest Café is an innovative means of creating social capital, education on food and cooking as well as providing a meeting place for different patient groups;
  • The surgery runs on a great deal of local goodwill – volunteers tend the gardens and the walks on open days. Retired professionals provide help with difficult family relationships.


Andrew Stennett - Practice Manager. Email: This email address is being protected from spambots. You need JavaScript enabled to view it.


Picture credits: Culm Valley Centre