How Hywel Dda University Health Board are using nature to support staff wellbeing
Hywel Dda University Health Board has been supporting staff and reducing burnout with its Recovery in Nature Programme. By combining time in nature, therapeutic interventions, education about mental health and guided wellbeing activities, the programme has shown clear benefits to staff wellbeing.
Organisation overview
Hywel Dda University Health Board (HDUHB) is an NHS organisation covering three counties in South-West Wales- Carmarthenshire, Ceredigion and Pembrokeshire and employs around 13,000 staff.
The challenge
The Staff Psychological Wellbeing Service (SPWBS) within HDUHB, like many NHS organisations, has been exploring ways to address rising levels of stress, burnout, and mental health-related absences.
Since the COVID-19 pandemic, reported levels of stress and burnout among staff have increased, reflecting national trends. Stress, anxiety and depression are also the leading causes of sickness absence within HDUHB.
While counselling and training opportunities were already available, a gap remained in the provision of group-based therapeutic support.
What did the organisation do
To address these challenges, SPWBS developed an evidence-based Recovery in Nature Programme aimed at reducing stress and burnout while improving staff wellbeing.
The team initially secured funding from NHS Charities Together, enabling a two-year pilot. They then developed the programme with two key components:
- Four-day EcoTherapy retreats, delivered as one day per week over four weeks, offering structured therapeutic intervention
- Single Recovery in Nature Days, providing staff with practical tools and knowledge to support their mental health through nature
The programme took place in local woodlands, using a combination of public and privately owned spaces (with permission). Sessions included a range of guided therapeutic activities rooted in EcoTherapy, a nature-based therapeutic approach, such as mindfulness, self-compassion and educational elements.
A structured administrative and evaluation process supported delivery. Participants applied and were screened to ensure suitability. Those attending the 4-day programme completed pre-programme questionnaires measuring wellbeing and burnout.
After completing the programme, participants were asked to provide feedback and, where appropriate, repeat the questionnaires to measure change. Follow-up emails with additional resources and prompts were also provided to reinforce learning.
Evaluation data from the pilot demonstrated positive outcomes, helping secure further funding to continue the programme.
Some challenges were encountered during delivery. This included promoting the programme to staff in hard-to-reach roles, securing woodland spaces for consecutive sessions and enabling staff to attend, particularly for the full four-week programme. A more consistent, organisation-wide approach to supporting attendance would have helped address these barriers.
The results
Evaluation of the programme showed a strong positive response from the programme from both the data and participant feedback.
Wellbeing scores improved following the programme and remained higher at the three-month follow-up. Burnout measures also showed reductions in emotional exhaustion and an increased sense of personal accomplishment, although no significant change was observed in depersonalisation.
A ‘Most Significant Change’ evaluation captured participant stories, which were shared with stakeholders and contributed to securing continued funding.
Although it was not possible to measure the direct impact on sickness absence, feedback from participants highlighted the programme’s value. Participants described it as:
“The best use of study leave in 10 years”
“Life-changing”
Here are a few quotes from staff who attended:
“Thank you beyond words for a truly thought provoking and encouraging experience, I loved every minute of it.”
“Welcoming, open and accepting of suffering which was held and recognised in a kind, safe and compassionate way. Reflective and progressive in providing/promoting a personally meaningful journey of being/existing on this planet, with nature and with other people.”
“This was truly an enjoyable and beneficial experience and one that I would whole heartedly recommend to others.”
Top tip for other employers
One of the biggest barriers was staff being unable to attend due to workload or lack of managerial support.
Organisations should aim to make access to wellbeing support as easy as possible, whether that be during work hours, through study leave, or embedding an organisation-wide policy.