ARCHITECTURE AND DESIGN
Biophilic spaces for mental health and wellbeing
As the New Hospital Programme prepares to deliver 40 new hospitals by 2030, the UK stands at a pivotal moment in healthcare design, says Laura Carrara-Cagni, founding director at architect firm Cagni Williams Associates. These facilities will serve communities for decades, making this a defining opportunity to revolutionise how healthcare environments support both patient recovery and staff wellbeing.
Below right: Internal courtyard at the Midland Metropolitan University Hospital in Sandwell, UK, allowing staff and patients to enjoy views of greenery from hot clinical floors.
Below: The vast wintergarden at the Midland Metropolitan University Hospital in Sandwell, UK, where everyone can meet and relax in a world perceived as far apart from a hospital environment.
Central to this transformation is the integration of biophilic design (design that connects people with nature) principles that prioritise mental health and psychological wellness alongside clinical excellence. Stress in healthcare settings stems not only from experiences of suffering, illness or pain, but also from lack of privacy, exposure to unfamiliar or anxiety-inducing sounds, inadequate lighting and unpleasant odours. Such stressors can exacerbate anxiety and concern for health, leading to broader physiological effects. Fortunately, exposure to nature is proven to reduce stress. Healthcare environments have long been sterile, institutional spaces that inadvertently contribute to stress and anxiety for both patients and staff. Research consistently demonstrates that exposure to natural elements can significantly reduce cortisol levels, lower blood pressure and accelerate healing processes. For healthcare workers facing unprecedented burnout
rates, and patients experiencing the vulnerability of illness, biophilic design offers evidence-based solutions that address mental health at the environmental level.
The NHS’s journey toward Net Zero by 2040 creates a unique opportunity to align sustainability goals with wellbeing outcomes. Biophilic spaces inherently support environmental objectives while delivering measurable improvements in psychological health, creating a powerful synergy between planetary and human wellness.
Evidence-based biophilic interventions Modern healthcare architecture must move beyond token gestures of ‘adding some plants’ to embrace comprehensive biophilic strategies supported by robust research.
Experience from specialised facilities like UCLH’s
Proton Beam Therapy Centre has demonstrated that even the most technologically advanced healthcare environments benefit significantly from biophilic integration, where patients facing intensive treatments show measurably reduced anxiety levels when surrounded by natural elements. Key interventions include:
n Natural light optimisation: Circadian-responsive lighting systems that mirror natural daylight patterns have been shown to improve sleep quality for patients and reduce seasonal affective symptoms among staff working long shifts. Strategic window placement and light wells can transform clinical spaces from anxiety- inducing environments into calming, healing spaces.
n Living green systems: Proper natural planting and views or access to external gardens provide more than aesthetic appeal in their winning combination of daylight and nature. Studies indicate that patients with views of nature require shorter hospital stays and less pain medication. For staff, access to green spaces during breaks
60 Health Estate Journal November 2025
Jack Hobhouse
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