NHS 10-Year Health Plan Lacks Key: Nature

The UK government has finally unveiled its much anticipated ten-year Plan for improving England's health. It contains a long overdue focus on prevention, after years of sidestepping by previous administrations.

The plan rightly recognises that preventing illness before it begins is the most effective way to improve people's wellbeing. It should have the added benefit of reducing strain on the NHS and easing the nation's financial burden.

Mental health, too, is given the attention it deserves. Recognised as integral to our overall health, its inclusion couldn't be more timely. A 2023 international study found that one in two people will experience a mental health condition in their lifetime - a much higher figure than previously estimated.

But one striking omission threatens to undermine the plan's success: nature. Evidence tells us that it's one of the most powerful means of supporting physical and mental health . And yet is not mentioned once in the plan's 168 pages.

If this plan is about prevention, then nature should be central to it. The science is unequivocal: contact with the natural world supports human health in wide ranging and profound ways. It lowers stress , improves mood, and alleviates symptoms of anxiety.

For children, time in nature can even aid brain development . Nature helps reduce exposure to air pollution, moderates urban heat, and fosters physical activity and social connection.

It can also reduce feelings of loneliness , improve the diversity of our gut microbiota - by exposing us to a wider range of environmental microbes that help train and balance the immune system - and support the immune system by reducing inflammation. All of these play a vital role in protecting against chronic disease.

Then there are the intangible yet no less important benefits. Nature provides a sense of awe and wonder - feelings that help us gain perspective, boost emotional resilience and find deeper meaning in everyday life.

Our own research, conducted in collaboration with Nick Bridge , UK special representative for climate change 2017-2023, and Michael Smythe , artist, activist and researcher and supported by a growing body of evidence, shows that even small, everyday moments in nature, watching birds from your window, for example, or pausing under a blooming tree on your way to the shop, can significantly boost mental wellbeing.

Consider this: a Danish study found that growing up near green spaces during the first ten years of life reduces the risk of developing mental health problems in adulthood by a staggering 55%. A UK study similarly showed that people living in greener neighbourhoods were 16% less likely to experience depression and 14% less likely to develop anxiety.

And as heatwaves become more frequent and intense - with soaring illness and mortality rates - the cooling effects of trees and parks will become more vital than ever for protecting our health.

Not all green space is equal

But it's not just access to green space that matters - it's also the quality of that space.

Green areas rich in biodiversity , with a wide variety of plant life, birds, insects and fungi, provide much greater health benefits than sparse or manicured lawns. Biodiversity builds resilience not just in ecosystems, but in our bodies and minds.

A recent study in The Lancet Planetary Health found that people living in areas with greater bird diversity were significantly less likely to experience depression and anxiety , even after accounting for socioeconomic and demographic factors.

This research underlines a simple but urgent truth: we cannot talk about human health without talking about biodiversity.

To deliver true prevention and resilience, we need a joined-up approach across government: one that aligns health policy with environmental protection, housing, urban design, education and transport. This means rethinking how we plan and build our communities: what kind of housing we develop, how we move around, what we grow and eat and how we live in relationship with the ecosystems that support us.

There are many ways this vision can be put into action. The Neighbourhood Health Service outlined in the ten-year plan could be tied directly to local, community-led efforts such as Southwark's Right to Grow campaign , which gives residents the right to cultivate unused land. This kind of initiative improves access to fresh food, promotes physical activity, strengthens community bonds and increases green cover - all of which support long-term health.

School curricula could be revised to give children the opportunity to learn not just about nature, but also in nature - developing ecological literacy, emotional resilience and healthier habits for life. Health professionals could be trained to understand and promote the value of time outdoors for managing chronic conditions and supporting recovery. Green social prescribing - already gaining ground across the UK - should be fully integrated into standard care, with robust resourcing and cross-sector support.

Learning from success

Scotland's Green Health Partnerships show what's possible. These initiatives bring together sectors including health, environment, education, sport and transport to promote nature-based health solutions - from outdoor learning and physical activity in parks, to conservation volunteering and nature therapy.

They don't just improve health; they strengthen communities, build climate resilience and create cost-effective, scaleable solutions for prevention.

The ten-year plan is a once-in-a-generation opportunity. It could help remove departmental silos and unify national goals across health, climate, inequality and economic recovery, while saving billions in the process. But in its current form, it misses a crucial ingredient.

By failing to recognise the centrality of nature in our health, the government overlooks one of the simplest and most effective ways to build resilience - both human and ecological. Surely it is not beyond a nation of nature lovers to put nature at the heart of our future health?

Andrea Mechelli receives funding from Wellcome Trust.

Giulia Vivaldi, Michael Smythe, and Nick Bridge do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.