King’s has become the first hospital to open an outdoor critical care garden on its roof
King’s has become the first hospital to open a critical care garden on its roof(Image: King’s College Hospital NHS Foundation Trust)
A South London hospital has opened the first therapeutic roof garden which aims to improve the overall well-being and recovery of patients who are critically ill.
The Critical Care Roof Garden on top of King’s College Hospital in Denmark Hill has space for up to six beds which will allow patients to enjoy the therapeutic benefits of being with nature while being safely cared for outdoors.
Patients will have access to the roof garden all year round, thanks to specially designed medical cabinets which are weatherproof. These cabinets contain power, data and medical gas supplies which are similar to the indoor 60-bed critical care unit at King’s.
Many critical care patients can experience Intensive Care Unit (ICU) delirium, which causes them to be in a state of confusion where they can suffer from disturbing hallucinations and profound dreams which distort their reality and can leave them unable to think or speak clearly.
ICU delirium can affect up to 80 per cent of patients and can slow down their recovery.
Dr Tom Best, Clinical Director of King’s Critical Care, told the Local Democracy Reporting Service (LDRS): “You essentially become mentally ill because you’re so physically unwell, but also because a lot of the drugs that we use around sedation include very strong opiates for pain relief.
“[It’s also caused by] the environment that you’re in and being semi-conscious and connected to tons of cables and wires and drips and then to machines that make noises all night.”
Dr Best, who has been in charge of the design and delivery of the project, started to develop a deeper understanding of ICU delirium when came to King’s as an intensive care consultant in 2007.
He spent time interviewing hundreds of patients about their experiences in intensive care and learnt first hand about the impact of ICU delirium.
He said: “I was seeing them maybe a month or so afterwards and started to hear about ICU delirium in much more detail.
“I couldn’t help but feel that the environment, even things as simple as ceiling tiles and certainly the machines around them, [were having] a profound impact on the degree of delirium.”
He went on to say: “Patients would talk about moments when we perhaps managed to get them outside of the unit, maybe just to the front steps of the hospital with some breathing support, but to a place where the family could perhaps bring the dog up to see them.
“They could just get a feeling of wind on their face, something as simple as that or a bit of sun even in the not very attractive parts of the hospital, but these were often really pivotal moments in patients’ recoveries.”
Dr Best and his team will be able to use the space to research how exposure to fresh air, greenery and sunlight reduces stress, lowers blood pressure, and improves the well-being of patients, their families and the staff who care for them.
The team will also assess whether access to the garden improves patient recovery and reduces length of stay, as well as tracking patients’ long-term physical, cognitive and psychological outcomes. There will also be a focus on how staff and families benefit from the space, particularly in managing stress levels.
Dr Best added: “I am confident this is going to reduce people’s length of stay in hospital. It’ll improve their outcomes. It’ll improve their mental state.
“This concept of mind and body, you can’t separate them. If your body’s injured or you’re sick physically, your mind is going to be affected in some way. It might just be mild. It may be low mood, or a bit of anxiety, but in intensive care, it’s often very significant.”
The project has been 15 years in the making and was funded with a £2 million donation from King’s College Hospital Charity as well as some funding from the King’s College Hospital NHS Foundation Trust.
Iona Joy, Director of Grants and Insight at King’s College Hospital Charity, told the LDRS: “It’s been a fantastic partnership with the Trust, we participated on the project board that was overseeing the design and delivery of the project and it was a real privilege to be working alongside Dr Best and his colleagues such as Dr Phil Hopkins.
“I can’t emphasise enough the fact that this is really innovative and it’s an example of where a charity can really add value to something and make it really special.”
The garden was designed by globally renowned landscape architect and horticulturist, Nigel Dunnett, who sadly passed away at the age of 63 on April 26, 2026.
British garden designer Sarah Price, a three-time RHS Chelsea Flower Show gold medallist, collaborated with Mr Dunnett on the design on the garden.
Aromatic species, including rosemary, sage, and oregano, will feature in the garden alongside native species and tactile plants such as lamb’s ear, resulting in a low-maintenance garden designed to encourage active engagement rather than passive observation.
Professor Clive Kay, CEO of King’s College Hospital NHS Foundation Trust, said the opening of the roof garden is an important milestone for the hospital and is dedicated to those with serious and life-threatening conditions.
He continued: “It’s been built with purpose and guided by the needs of patients and their families and reflects a deep commitment to dignity, support, and hope.
“I’d like to take this opportunity to recognise and thank King’s College Hospital Charity, as well as colleagues at the Trust who have made this possible. Their expertise, dedication, and compassion are at the heart of everything we do at King’s.”
The King’s Critical Care Roof Garden completes the final part of the King’s Critical Care Centre, which is one of the largest intensive care facilities in the UK and possibly Europe. It supports over 5,000 patients and 15,000 loved ones each year.
In 2023, the Royal Cornwall Hospitals NHS Trust opened a new rehabilitation and sensory garden for critically ill patients at the Royal Cornwall Hospital in Truro.
The Critical Care Healing Garden at the Royal Cornwall won Community Engagement Project of the Year at the Construction News Awards in 2024.
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