Green Prescribing and Vitamin N: Why Accessibility Matters for Disabled and Hard-to-Reach Patients

As Disability and Access Ambassador for the Countryside, I’ve seen firsthand the incredible impact that time in nature can have on people’s health. We often talk about “Vitamin N”, Vitamin Nature, and it’s not an exaggeration to say that it can be life-changing.

I’ve also seen the flip side: the barriers that stop disabled people and hard-to-reach patients from enjoying the outdoors. It’s these barriers that worry me most, because they mean that the people who could benefit most from green prescribing are often the ones least able to access it.

That’s why I wrote my recent report, Green Prescribing, Vitamin N, and Accessibility for Disabled and Hard-to-Reach Patients. In it, I aimed to demonstrate not only the health benefits of incorporating nature into our lives but also the urgent need to make it accessible to everyone.

Why Green Prescribing Works

I don’t need research to tell me how good it feels to be outdoors, but the evidence is overwhelming. Spending time in nature can benefit individuals with long-term conditions, such as diabetes or heart disease. It lifts mood, eases anxiety, and reduces feelings of loneliness.

Some of the key findings from NHS pilots and research really stood out to me:

• 95% of GPs believe nature benefits patients with long-term conditions.

• 88% of participants in a Green Prescribing pilot reported improved well-being.

• 75% felt less isolated, and 63% said their anxiety reduced.

Yet, here’s the problem: disabled people are three times less likely to visit natural environments than non-disabled people. That statistic is heartbreaking because it shows just how unequal access to nature currently is.

How We Can Scale This Up

I believe Integrated Care Systems (ICSs) are central to making green prescribing work for everyone. ICSs bring together the NHS, local councils, charities, and voluntary organisations. They’re in the perfect position to link GPs and link workers with outdoor providers who understand accessibility.

When healthcare professionals feel confident that there are safe, inclusive outdoor opportunities available, they’re more likely to prescribe them. And when patients can trust that the information they’re given is reliable, they’re more likely to take part.

A Central GOV.UK Portal: My Big Idea

One of my strongest recommendations is for a national GOV.UK page that lists accessible outdoor opportunities across the UK.

At the moment, accessibility information is scattered across dozens of different websites — council pages, charity databases, tourism boards — and it’s often out of date. This creates anxiety for disabled people, their families, and carers. A day out shouldn’t feel like a gamble.

A central, government-backed directory would change that. It could:

• Signpost national and regional organisations offering accessible outdoor activities.

• Provide clear, standardised details about facilities, terrain, transport, and sensory features.

• Link directly into NHS green prescribing pathways.

In short, it would take away the guesswork and make nature genuinely accessible to everyone.

Why Accessibility Benefits Everyone

I’m often asked why accessibility matters so much, and my answer is simple: accessibility is not just for disabled people — it’s for everyone. When we design with inclusion in mind, we create spaces that are easier, safer, and more welcoming for all of us.

It’s a legal and moral requirement. The Equality Act 2010 makes it clear that services must be inclusive. Green space is no exception. But beyond compliance, it’s about fairness and dignity. Everyone deserves the chance to enjoy nature, whether they’re pushing a pram, recovering from injury, using a wheelchair, or simply ageing. An accessible environment says: you belong here.

It improves public health. Access to nature is one of the most effective, low-cost public health interventions we have. Inclusive green spaces mean more people can get outside, no matter their circumstances. That translates into reduced loneliness, better mental well-being, and more opportunities for physical activity. From parents taking their children to the park to older adults walking with friends, accessibility multiplies the benefits of the outdoors.

It boosts local economies. Accessible design isn’t just socially responsible — it’s economically smart. Accessible tourism is already worth billions to the UK economy. When green spaces, trails, and visitor sites are designed inclusively, they attract a wider audience: families, older visitors, disabled people, and international tourists. That means more overnight stays, more spending in local shops, and stronger rural economies.

It puts the UK on the map. By leading on inclusive green prescribing — where healthcare professionals can confidently recommend accessible nature experiences — the UK has the opportunity to set a global example. We can show the world that equality, health, and the environment don’t have to sit in silos, but can work together to create stronger, fairer, healthier societies.

In short, accessibility helps everyone. When we remove barriers for some, we create opportunities for all.

The Barriers We Must Break Down

Of course, we can’t pretend the challenges don’t exist. I hear the same frustrations time and again from disabled people — and they’re not just small inconveniences. They are real, practical barriers that make nature feel out of reach.

Paths that are too steep or uneven footpath that looks inviting to most can be impossible for someone using a wheelchair, a walking aid, or even a pushchair. Steep gradients, loose gravel, and narrow gates turn what should be a relaxing walk into an exhausting or even dangerous experience. For many, that means turning back before the journey has even begun.

A lack of accessible. The absence of reliable, clean, and accessible toilets is one of the most commonly cited reasons people avoid visiting outdoor spaces. Without this basic facility, trips have to be cut short — or avoided entirely. This doesn’t just affect disabled people; parents with young children, older visitors, and people with health conditions all depend on toilets to feel confident venturing out.

Out-of-date or unreliable information often, websites and visitor guides paint a picture of accessibility that doesn’t match reality. A “wheelchair accessible” trail may, in fact, have steps, gates, or steep sections. When people take a chance and find the information misleading, the result isn’t just disappointment — it’s broken trust. Accurate, honest, and up-to-date information is vital if we want people to feel welcomed and respected.

GPs who don’t know what inclusive opportunities are available locally. Green prescribing has huge potential, but it falls flat if healthcare professionals don’t have the tools or knowledge to signpost effectively. Many GPs want to recommend nature-based activities but simply don’t know which local parks, gardens, or trails are truly inclusive. Without clear pathways between health services and accessible green spaces, patients miss out on opportunities that could transform their wellbeing.

These aren’t minor inconveniences; they are deal-breakers. They stop people from getting outdoors altogether. And when that happens, health inequalities only grow deeper. We end up with a system where those who could benefit most from nature are the least able to access it. Breaking down these barriers isn’t optional — it’s essential if we are serious about equality, health, and community wellbeing.

My Recommendations

To make green prescribing truly inclusive, I’ve set out four key steps. These aren’t grand, unachievable ambitions — they are practical actions that could transform lives.

1. Integrate accessibility into prescribing pathways. Accessibility must not be an afterthought. If green prescribing is to work, inclusivity needs to be designed in from the start. That means ensuring prescribing platforms and referral systems highlight accessible opportunities as standard, not hidden away in footnotes. A person should never receive a recommendation for a local walk or activity, only to discover they physically can’t take part. Building accessibility checks into the system itself prevents exclusion before it happens.

2. Upskill GPs and clinicians. Healthcare professionals are enthusiastic about social prescribing, but many feel underprepared when it comes to accessibility. Training and resources can change that. By equipping GPs, nurses, and link workers with the confidence to ask the right questions and the knowledge of inclusive options nearby, we unlock the true potential of green prescribing. Patients deserve advice that matches their needs, not one-size-fits-all recommendations.

3. Create a national GOV.UK directory. Right now, information about accessible green opportunities is patchy, inconsistent, and often unreliable. A central, trusted directory — hosted on GOV.UK — would change that. Imagine a single, authoritative platform where patients, families, and healthcare professionals can find clear, up-to-date details on accessible parks, gardens, trails, and activities. Accurate information empowers people to make choices with confidence and avoids the disappointment of wasted trips.

4. Invest in inclusive infrastructure. Many people, the barriers aren’t about knowledge but about the physical environment itself. Accessible toilets, mobility-friendly paths, benches for rest, and clear signage are not luxuries — they are essentials. These improvements don’t just benefit disabled people; they make green spaces easier for families with pushchairs, older adults, and anyone navigating temporary injury or illness. In short, they make nature more usable for everyone.

None of these changes are impossible. In fact, they’re low-cost, high-impact steps that could make an enormous difference. By embedding accessibility into prescribing pathways, empowering healthcare professionals, centralising reliable information, and investing in inclusive infrastructure, we can ensure green prescribing delivers on its promise — for everyone.

Nature Belongs to All of Us

The countryside is one of the UK’s greatest public health assets. But unless it is accessible, its benefits are only available to some. That’s not good enough.

I believe passionately in the healing power of nature, and I know many clinicians do too. But unless we embed accessibility into green prescribing from the start, we will continue to leave behind the very people who need it most.

My message is simple: nature must belong to everyone. A central directory, better clinician training, and inclusive infrastructure are practical steps that will help us get there.

Vitamin N should not be a privilege. It should be a prescription available to every patient, regardless of disability, mobility, or circumstance. That’s how we make green prescribing not just a health initiative, but a movement for equality.