HEALTHCARE DESIGN & CONSTRUCTION


coronavirus needs into existing hospitals, with strategies including refurbishment. As more outpatient services have been delivered virtually during the pandemic, it could be that these spaces could be reconfigured or reused in the event of a surge in COVID-19 cases.


Specific flexibility


New-build spaces should be designed with this specific flexibility in mind, so that any space could potentially have multiple uses over its lifespan. So, for example, if hospitals require less outpatient space, layouts could be reconfigured to increase diagnostic and treatment capacity. When BDP designed Southmead Hospital for the North Bristol NHS Trust, for example, we did so on the basis of standardisation. Rooms were ‘loose fit’, with services provided to accommodate multiple functions, and arranged in defined clusters. Scenario testing showed that major items of equipment could be replaced with minimal reconfiguration, giving operational flexibility over the life of the building.


3 Focus on staff wellbeing It’s safe to say that the incredible work that NHS staff do every day has become much better recognised among the wider public as a result of the pandemic. NHS Trusts must retain and attract the very best staff; the need to design spaces for them so they feel looked after and valued has always been important, but it’s now rising up the agenda further. From career development to environments conducive to relaxation, we need to create places where staff feel truly valued, as this will really help the NHS moving forward. Southmead Hospital’s rooftop restaurant offers informal networking, break-out, and meals, with a dedicated roof terrace, and has a constant buzz throughout the day, as staff drop in to this space – the terrace now


accommodates herbs grown by staff and used in the restaurant. The masterplan offers active travel routes and spaces designed for cycling, walking, or reflecting, which has seen a significant increase in the use of cycling in particular.


Mobile augmented reality technology.


4 Streamline patient flows As the virus is likely to be present in society for a period longer than the lifespan of the Nightingale Hospitals, acute hospitals will need to provide care for COVID-19 patients at the same time as returning to business as usual. This means that facilities will need to consider a careful re-design of emergency departments and other patient admission points. One idea being developed is streamlining patients in existing hospitals so that admission areas are expanded to become triage points where patients are directed into clearly streamed flows. This way infected people would be separated from others to reduce the likelihood of infection. A ‘green zone’ would be a ‘clean zone’, where you can be reasonably certain that nobody is infected. A ‘blue zone’ is where COVID-infected patients would be sent, and an ‘amber zone’ is where the state of the patient would not be known. Such a system would not only address clinical needs more efficiently, but would also give the wider public confidence that it is safe to use emergency services again.


5 Certainty of delivery


Healthcare spaces of the future will need to make use of offsite construction methods, such as modular and mobile facilities. At BDP we use the principles of Design for Manufacture and Assembly (DfMA) in our hospital designs, combined with extensive offsite fabrication, to ensure that projects are delivered in a timely manner, and indeed often ahead of time. For the Nightingale hospitals, for


example, the unistrut framing supporting the oxygen ring main assembly was manufactured offsite. We adopted a ‘kit of parts’ approach, creating a beautifully engineered solution, to solve a very practical problem. At the Grange University Hospital in Wales, a new specialist and critical care centre, the design concept was based on the use of extensive offsite manufacturing. Combining this with Laing O’Rourke’s exemplary construction management and delivery, the hospital was able to open a part of the facility a year early to help fight the COVID-19 crisis, and will open fully for patients four months earlier than planned – a time saving of 23% on a traditional programme.


6 Testing scenarios


As we consider the future of healthcare design, and how spaces need to be more flexible than ever to address the potential ebb and flow of COVID-19 cases, the ability for our clients to visualise and test out potential scenarios in the most realistic way possible adds real value to business case optioneering. Architects should use technology to bring a design to life at the earliest stages of the process. Using 3D visualisation to test out different scenarios and how they could play out in a design space will allow healthcare providers to see their project in 3D, so that adaptations and improvements are implemented before a project goes to site.


The possibilities here are endless – there are a variety of platforms, including immersive visualisation and virtual reality, where you can put on a headset and walk around your new building months before the construction even starts. This approach can transform the effectiveness of healthcare facilities, long before they are built. The client is more informed, and can then collaborate from the first stages of a project. It also informs the operational management of buildings, and can test many options – from infection control and social distancing, to lighting and environmental factors. Furthermore, if a space is to be used flexibly, you are able to see how the


The NHS Nightingale Hospital Bristol. In designing six Nightingale hospital facilities, BDP had a project management office which defined and maintained standards across each site.


34 Health Estate Journal April 2021


©Tim Pestridge


©Kier/Tim Pestridge


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