Why nature must play a bigger role in healthcare design

The hidden impact of the healthcare environment

Hospitals are highly complex environments. Clinical teams work around the clock, patients often arrive at moments of significant stress or vulnerability, and buildings must accommodate an enormous range of operational, technical and safety requirements. In many older NHS facilities, organisations are also working within estate that was never designed for modern models of care. Healthcare design must therefore respond to demanding practical realities. Materials need to be durable, surfaces must be cleanable and spaces must support clinical observation, security, accessibility and efficient movement. These requirements are essential, but they should not become the only measure of success.

A space can meet every technical standard and still feel intimidating or confusing. A waiting area may be easy to maintain but offer little privacy or reassurance, while a ward may function effectively despite giving patients almost no visual connection to the outside world.
As Kate’s experience across maternity, mental health, neonatal and bereavement environments demonstrates, people do not experience healthcare buildings through specifications and compliance standards alone. They experience light, sound, colour, texture and movement, often at the most emotionally significant moments of their lives.
Noise is one of the clearest examples. Hospitals are naturally busy places, with alarms, equipment, conversations and constant activity, but excessive sound can interfere with rest and sleep, both of which are central to recovery. As Kate explains, “Sound is more than a distraction; it can interrupt one of the most essential aspects of recovery, sleep.”

Lighting and access to the outside world can be equally important. Poorly lit or windowless spaces may intensify feelings of confinement and disorientation, while views of the sky, surrounding landscape, planting or carefully selected artwork can provide orientation and moments of relief.
These elements do not replace good care, nor can design alone resolve the pressures facing healthcare organisations. However, for leaders seeking to improve patient experience, staff wellbeing and the overall quality of care, the conditions created by the physical environment are becoming increasingly difficult to overlook.

Understanding biophilic design

Biophilia is essentially about the relationship between people and nature. It reflects our innate connection to the natural world and the simple fact that we are biologically part of it. Biophilic design brings that connection into the built environment through daylight, colour, materials, texture, views, artwork, natural forms and sensory experience. It is not a decorative style, but a broader approach to creating spaces that feel more coherent, familiar and human.
One of the challenges facing healthcare design is that artwork, interiors and environmental enhancements are still sometimes viewed as secondary considerations rather than part of the overall care experience. Kate believes this is beginning to change, “People increasingly recognise the value of good design; not simply as decoration, but as a professionally considered, holistic approach that integrates architecture, interiors and artwork.”

Image 1 – Maple Unit, Yeovil District Hospital Project. Somerset NHS Foundation Trust, Art for Life. Taken by Tom Bright

For Kate, this means understanding the architecture, finishes, colour palette and purpose of a space before introducing artwork or natural references. As she explains, “My role is to integrate nature into interiors in a safe, thoughtful and considered way, responding either to an established interior design strategy or the existing environment.”

When artwork and biophilic elements are introduced late in a project, they can feel disconnected from the wider environment. When they are considered alongside architecture and interior design from the outset, they can become part of a more cohesive strategy, supporting identity, familiarity, wayfinding and a stronger sense of connection to place.
This is particularly important in healthcare, where design cannot be driven by personal taste alone. Every decision must respond to the clinical setting, the needs of patients, visitors and staff, and the practical realities of maintaining a safe and operational environment. The value of biophilic design therefore lies not simply in how a space looks, but in how it is experienced. By creating moments of familiarity, comfort and connection, it can help healthcare environments feel less institutional without compromising the demands of clinical care.

Designing around people, place and purpose

Perhaps the strongest case for biophilic design is the effect it can have on the people who spend time within healthcare environments, but those benefits do not come from applying the same design approach everywhere. What feels appropriate in a maternity setting may not work in mental health care, while a bereavement environment requires a different emotional response again. The most successful schemes begin by understanding who will use the space, what they may be experiencing and how the environment can support them.

For patients who feel anxious, vulnerable or isolated, access to daylight, gardens, courtyards and views of nature can provide moments of calm and restoration. This can be particularly important in mental health settings, where the character of the environment may influence whether people feel comfortable engaging with therapeutic activities or spending time in shared spaces. The benefits also extend to staff. Healthcare professionals spend prolonged periods working in demanding environments that can contribute to stress, fatigue and burnout. Design cannot resolve workforce pressures on its own, but access to daylight, visual interest and places to pause can help create a more supportive working environment.

Kate’s work at University College London Hospital demonstrates why context matters. The labour ward serves an exceptionally diverse community, with patients and families representing more than 100 nationalities, so the artwork drew on plants, trees and birds with cultural significance across different parts of the world. The intention was not simply to make the space more colourful, but to create a greater sense of comfort, familiarity and belonging during an experience that can involve excitement, uncertainty and vulnerability.
Kate’s own experience of giving birth in hospital also influenced the way she approached the project, “I remember feeling a mixture of shock, vulnerability, excitement and the anticipation of a completely new beginning. That experience stayed with me throughout the project and informed many of the creative decisions.”

A research centre within Oxford Health NHS Foundation Trust required a very different response, drawing inspiration from the local landscape through wildflower meadows, orchard species, medicinal plants and subtle references to the Oxford skyline.
Both projects were rooted in nature, but their identities emerged from the people, purpose and place connected to each setting.

This same principle shaped the award-winning Silverwood mental health facility, developed through collaboration with clinicians, service users and people with lived experience. Rather than relying solely on professional assumptions, the project team sought to understand how the environment would genuinely be experienced. One particularly striking part of the process involved contractors, architects, clinicians, staff and people with lived experience spending a night within the hospital. The exercise offered an opportunity to experience the building from the perspective of someone trying to sleep, manage anxiety or spend an extended period away from home.

Image 2 – Silverwood Project – Surrey and Borders Partnership NHS Trust. Taken by Tom Bright.

That level of immersion is unusual, but the lesson is widely relevant. Healthcare environments are more likely to support dignity, inclusion and emotional wellbeing when they are designed with the people who will use them, rather than simply for them.