King's College hospital opens UK's first rooftop intensive care garden

Frances Hodgson Burnett's The Secret Garden built its entire plot around the idea that fresh air and a patch of earth could restore the gravely unwell. The premise has always seemed like Edwardian whimsy. A garden opening this week at King's College Hospital in south London suggests it was closer to medical fact.

King's has become the first hospital in the UK — and the first in the world — to open an outdoor critical care garden on its roof. The King's Critical Care Roof Garden sits on top of the hospital's existing 60-bed unit and is designed not as a passive amenity but as a functioning extension of the ward.

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The space accommodates up to six beds, each positioned beside a weatherproof medical cabinet housing power, data, and medical gas supplies equivalent to what patients receive on the unit below. Critically ill patients, some on full life support, can be moved outside without being disconnected from anything keeping them alive.

The first patient to use the space was Hollie Allan, 29, who has been in intensive care for two months awaiting a heart operation and had been too unwell to go outside even before her admission. When she was wheeled onto the rooftop, sunshine on her face, she cried. "I forgot what it feels like to be outside," she said to the BBC.

A ward in a meadow

The original design vision, articulated by landscape architect Nigel Dunnett, was to create "a hospital ward in a meadow", what he described as "the first hospital garden in the world where ward-like care and life support can be given in an external garden."

Dunnett conceived the planting alongside British garden designer Sarah Price, with whom he had previously worked on the Olympic Park for London 2012. Dunnett died before the garden was completed.

Beds are filled with scented flowers — honeysuckle, jasmine and lavender, with grass and foliage that patients can reach from their beds. The structural engineering required to make any of this possible was considerable: a fully Class A fire-rated decking substructure was installed across the 170-square-metre fifth-floor space, with discreet access hatches built into the deck so clinical teams can reach equipment beneath without dismantling the surface.

The clinical case

Dr Tom Best, Clinical Director of King's Critical Care, said that many ICU patients experience hallucinations and delirium in the clinical environment, conditions that are frightening in themselves and that delay recovery. "It is vital that we care for the mind as well as the body," he said. Research shows that time spent in nature can reduce delirium, lower blood pressure, ease stress, and lift mood; for patients in critical care, those effects are especially significant.

The idea originated with Dr Best. Funded by a £2 million charitable donation from King's College Hospital Charity, with additional Trust funding, the garden was always conceived as replicable. Iona Joy, Director of Grants and Insight at the charity, described the ambition plainly: "We are transforming intensive care into compassionate care, where science, technology, and empathy work together to save and rebuild lives."

The clinical team will now monitor heart rates, respiratory rates, and pain levels among patients who use the space, building an evidence base that could support adoption across the NHS. The rooftop will also be available to intensive care staff during breaks — a quiet acknowledgment of the pressure those staff are under, and of how thin the line is between caring for others and needing care yourself.