The future is already here COMMENT

Architect Paul Mercer discusses how designers and planners can learn from the past, as they contemplate how to adapt to the future of healthcare


ecently published, the 2018 Annual Report of the Chief Medical Officer is subtitled ‘Health 2040 – Better health within reach’. This 280-page document, overseen by Dame

Sally Davies, with contributions from numerous health visionaries, explores potential health and care provision in 20 years’ time. Early on, the report suggests that much of what will be of relevance then is available now. From Prof Davies Report, “The management writer Peter Drucker once noted that the best way to predict the future is to look around you.” For designers and planners of healthcare facilities, this might come as a relief. The NHS in England is currently experiencing further organisational change as Primary Care Networks, STPs and other configurations move goalposts again. But these changes are irrelevant to a future in 2040.

Looking backwards can be valuable but beware dwelling on the historical. There’s a place for post-occupancy evaluation – what happened; did it all work out; what can we learn? Looking forwards armed with current best practice and systems will equip our newest facilities best.

But best practice is often hard to pin down. Healthcare designers and planners are often under pressure to deliver quickly. Many clients are as transient as their organisational changes – and the temptation to repeat previous design models is pervasive. Healthcare designers and planners should be visionaries, understanding the present and future of health facility design, helping clients envision well beyond the couple of years it takes to build and open something new. This presumes that designers and planners have knowledge and skills to develop that narrative and, sadly, this is not always the case. So, designers and planners need to up their game. To be the forward thinkers in times of austerity and short-termism is a tough call but keeping on top of what is happening across nations and internationally is vital. To paraphrase Peter Drucker – look carefully at what is happening now (best practice) and devise healthcare environments that enable this.

Led by technology

Look around you – what do you see? Look for the positive, the innovative, the unexpected. We have a huge amount of clever tech, from big surgical and diagnostic to tiny personalised and even microscopic. Common factors with all of this tech are improved

WWW.ARCHITECTSDATAFILE.CO.UK INNOVATION Bromley by Bow Centre – a wider than normal range of wellbeing activities

outcomes and better lives for people – often remotely from medics and nurses. However, it is not practical to conduct all consultations and treatment remotely. It is well understood that unwell people prefer to be at home. It is also well understood that face to face consultations should be as local as possible, whether at a health centre or hospital.

As health centres and hospitals begin to adopt new tech, so will people at home. Something as simple as a telephone conversation between patient and GP is now much more common: video or Skype consultations are being trialled, and personal and wearable monitors are proving effective. For designers and planners, there are implications not only in considering increasingly widespread tech but also the probability that what happens in community health buildings will change radically. There will inevitably be a receptionists’ desk and waiting room, but beyond these, a very wide range of facilities and professionals could be installed: from GPs, nurses, therapists and counsellors – much as now – to healthy food prep and cafe, exercise and yoga, voice coaching (aids breathing and lung function), discussion groups, reading groups, knitting groups, gardening and so on.


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