GROWING vegetables is not the usual scope of practice for a GP, so when NHS educator Ed Rosen approached a group of clinicians with his 'gardening for health' idea, he was met with some scepticism.
However, six years (and one Royal visit) later, his ground-breaking food co-operative project is flourishing.
Today, 15 gardens have been created in the grounds of doctors' surgeries across the South London borough of Lambeth, growing everything from beetroot and mushrooms to herbs and potatoes. In these green spaces, patients and healthcare teams come together to cultivate crops as well as relationships.
Alongside the more obvious practical lessons on gardening and healthy eating, the project has provided a lifeline for those affected by loneliness, depression, anxiety and chronic conditions such as diabetes and arthritis. Ed, a self-confessed "novice gardener", is the director and driving force behind the Lambeth GP Food Co-op (LGPFC). So far the project has engaged with more than 400 patients, many of whom suffer from multiple long-term conditions and who live in high-rise tower blocks with no access to green spaces.
The gardens are an ideal, informal setting for healthcare teams – including dieticians – to highlight the importance of eating well and to offer nutritional advice.
Over the years a number of patients have shared their stories on the co-op’s website, describing how it has benefited them. One patient in Vauxhall who was struggling with his weight and a long-term health condition was inspired to transform his eating habits and is now the proud owner of a window sill herb garden at home.
Ed says: "Dieticians and nutritionists from St Thomas Hospital and Kings have come out, rolled their sleeves up and planted alongside patients. In doing so, they have spoken to patients about the nutritional value of what they are planting. They are low-key health conversations whilst they are collaborating in planting courgettes or pumpkins.
"It does improve the quality of life for some of the most vulnerable people in society."
Another patient who attended the food co-op describes how it has benefited her mental health, saying: "As a person with depression and anxiety problems, I find the project a good way to meet people and combat a sense of isolation I often feel. It has also motivated me to utilise my balcony space to grow food and has reignited my love of cooking."
Lambeth food co-operative is something of a pioneer in the movement towards more widespread 'social prescribing' (where clinicians direct patients to a variety of cultural and community activities to improve quality of life). The initiative was established well before the UK government unveiled its "loneliness strategy" in 2018, which called on GPs to engage in more social prescribing.
NHS national clinical lead for social prescribing Dr Michael Dixon has praised their work as "a model of social prescribing in action". At the same time, in February 2019, the food co-op received Royal recognition when Camilla, Duchess of Cornwall, visited the LGPFC garden at Swan Mews in Lambeth for their sixth anniversary.
And as Lambeth’s co-op goes from strength to strength, other healthcare providers are taking note. A food garden has been built at the Pulross Centre in Brixton, a 20-bed unit which cares for MS and stroke patients.
Ed says: "The OTs and physiotherapists are planting and growing vegetables with patients, many of whom have lost limbs and are in wheelchairs. That is a really important model as we continue our journey in the acute sector and the community centre."
Ed has ambitious plans for the longer term, including building gardens on hospital roofs and other unused spaces in the community. He also hopes to work with NHS catering companies so that the food grown in the grounds of local surgeries by local patients can be served in local hospitals, like Kings.
However, at present, the volumes required to make this happen are just too high, as Ed explains: "If we were able to grow one tonne of mushrooms they would buy the whole crop and make mushroom soup for staff and patients, it’s not that far down the line but it requires a slightly different model of growing compared to what we have at the moment. I can’t ask people who are not well to work their socks off, but we are looking at new technology for growing at scale. I think over the next five years, if we get the investment, we can do this.
"In terms of what we are doing just now, it is very timely and very relevant."
The Lambeth co-op have also published their first recipe book (available via their website for £7), with a second due to be published in time for Christmas. It features a selection of healthy recipes submitted by patients, GPs and nurses including red onion marmalade, spring green miso noodle soup and roasted butternut squash.
Model for success
It all seems a far cry from that initial scepticism Ed faced in 2013, and is testament to his determination to make the project a success. He is magnanimous and clearly passionate when asked what he would say to all those who doubted the garden project would ever succeed.
He says: "I would say to them 'would you like to make a financial contribution?’! No, seriously, I would invite them along. We have demonstrated that the concerns, reservations and anxieties were not grounded in the reality of developing the project. It is possible to do it and it works. It may not cure cancers but it improves the lives of some of the most vulnerable people in our communities."
Support for the food co-op comes from many different areas and is increasingly high profile. GP and media doctor Jonty Heaversedge, London regional medical director for primary care and digital transformation, has spoken of the positive impact the project is having on patients. He says: "The Lambeth GP gardens help people feel less isolated and improve the health of local people living with long-term conditions across the borough."
Aidan Cleasby, Trust community facilities lead for Guy’s and St Thomas’ adds his support, saying: "Patients can get outside, particularly in the spring and summer months, plant, water and prune the plants, which is much more stimulating than sitting on a hospital ward. This complements their recovery process and enhances their wellbeing.
"Once the planters are in place it’s just a case of refreshing the area every year with top soil, plants and seeds. There is very little impact upon the environmental footprint and the benefits to our patients are huge. We are very proud of that."
Kristin Ballantyne is a freelance writer based in Glasgow
PHOTOGRAPH: JIM WINSLET/LGPFC