HOSPITAL PLANNING AND DESIGN
Clinical engagement key in reducing waiting lists
In March 2024 Smriti Singh – who has over 20 years’ experience providing strategic advice and delivering change and transformation programmes in the health and care sector, founded a strategic healthcare consultancy, Symbi Consulting – of which she is managing director. Here she, James Philipps, experienced architect and founder of architectural practice, Philipps & Co, and Neil Kukreja, a Medical Director and consultant surgeon, explore the key part clinical engagement can play in making new healthcare developments ‘more effective and more efficient’.
The current Government has pledged to reduce NHS waiting lists within this Parliament. Consequently, there is now greater need than ever for space for delivering care. We know that we need the views of clinicians to ensure that healthcare buildings will meet their needs. However, clinicians’ time is more constrained than ever, as a result of the new commitment to reducing waiting times, which comes on top of a period of ‘COVID recovery’ under the last Government. In this article we explore how we can make one aspect of a new healthcare development more effective and efficient – clinical engagement. We bring an innovative ‘Experts Network’i
approach to clinical engagement,
that requires less time from hospital staff, gets the information and buy-in needed for a new development, and is a better experience for staff. Streamlining clinical engagement and making the process more targeted, efficient, and enjoyable, is one way of ensuring that we have better facilities and more engaged frontline staff.
Demand outstripping supply Demand for healthcare was outstripping supply even before the COVID-19 pandemic, and has now reached unprecedented levels. The NHS ‘elective backlog’ is currently around 7.5 million cases, or over 6 million people waiting for procedures.1
In response, the Government has
said that reducing the length of these waiting lists is central to its health policy. It has committed to clear all waits of over 18 weeks (currently around three million people) within five years. To help achieve this ambitious aim, in last year’s
Autumn Budget the Chancellor announced additional funding for the NHS – £22.6 bn revenue and £3.1 bn in capital funding. While the New Hospital Programme is being finalised, the additional capital funding indicates recognition that additional capacity, in the form of hospitals and other healthcare facilities, is needed. Healthcare facilities, and particularly hospitals, are
complex, and need to be designed to support a breadth of functions – the Department of Health’s Health Building Notes (HBNs) include design guidance for 25 different types of spaces within a hospital.2
Not only do hospital
buildings have to accommodate a wide range of complex functions, but the layout also matters. The positioning of rooms and areas in relation to each other can make a difference to the quality of care and in optimising delivery. The global trend towards considering healthcare needs
in the broadest sense, and addressing the root causes of ill health – increasingly reflected in NHS policy, add another layer of complexity when it comes to hospital design. The
April 2025 Health Estate Journal 63
design of hospitals, and indeed all healthcare facilities, should not only ‘promote healing’,3
but should also support
people to live healthily. Furthermore, the hospital building needs to be designed to work for now, and – equally – to be fit for the future, as well as to support technological and social change. UK Government guidance on capital investments requires a 60-year investment appraisal on new buildings.4
While the
guidance applies to all UK Government-funded buildings, ensuring that a project is ‘future-proof’ is particularly challenging for healthcare, which is a rapidly evolving sector.
Elective care issues during the pandemic During the COVID-19 pandemic we learned many things – including that hospitals were unable to deliver elective care when there was a rapidly spreading airborne infection. There may well be another pandemic within a 60-year period,5
so future-proofing design means
we need to consider ‘megatrends’ and understand the implications of major unforeseen shocks on the workings of a hospital. Architects and the wider design team have created designs that meet the needs of the day while striving to allow for flexibility for the future. Whatever the architectural design strategy – whether to design for a specific set of functions, or for an unknown future requirement, what is clear is that we need to hear, understand, play back, and test, with those who use the buildings. ‘Clinical engagement’ is therefore key when developing investment cases and designing new healthcare buildings.
The Experts Network includes specialists from across the full spectrum of healthcare professionals – from strategists through to individual clinical specialisms, ‘all intrinsically integrated with significant capital projects’.
AdobeStock / PeakPoints/
peopleimages.com
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