HOSPITAL PLANNING AND DESIGN


Pressures on frontline staff time are not going to reduce in the foreseeable future, yet the need to build new facilities is greater than ever. An Experts Network approach means that, overall, clinical engagement is faster, and provides better quality information. The input we obtain from the Experts Network and local clinical engagement are then used by the multi-specialist team, including, but not limited to, strategists, financial modellers, clinicians, and healthcare planners and architects, to ensure that the business case is both robust, and a solution that exceeds expectations.


Clinicians ‘tend to come from the perspective of getting what is best for their patients’, so often engage with capital projects with a ‘lobbying’ mindset.


James Philipps


James Philipps, a founding partner of specialist healthcare architectural practice, Philipps & Co, and has over 25 years’ healthcare experience, nationally and internationally. ‘Blending practical design with patient- centric considerations’, he has spearheaded numerous landmark projects, including major works at Luton and Dunstable Hospital and the Lymington New Forest Hospital. These projects highlight his expertise in delivering healthcare facilities that support patient care and operational efficiency. He says his approach ‘combines a deep understanding of clinical requirements with a focus on creating environments that promote healing and wellbeing’. This philosophy has made him a respected figure in the field, influencing both public and private healthcare projects across the UK and internationally. Throughout his career, James has led projects recognised for their excellence, which have received awards.


Crystal ball gazing a significant challenge Asking people to think decades into the future is a huge ask, and a difficult one. Particularly when people have been working in sub-optimal facilities, often they simply want an improved version of what they have. To generate ideas and to get buy-in to significant change, we use prompts and exemplars. Where it is feasible, we take clinicians out of their day-to-day environment. This is an opportunity to show them a completely different working environment, and take them away – temporarily – from their day-to-day work pressures. In any session, we provide information on the end- to-end process of a capital project. We explain key guidance we are working within, e.g. ‘Better Business Case’, who is involved, and give an indication of timescales. We also alert the team early that timescales can change, and why that may happen. While all of this may seem obvious to those of us who work on capital projects, it is a very different type of work, with different challenges, for clinicians. The better they understand the context, the richer the conversation. Share what we have learned: At the early stages of any new development, we share our national and international experience and insights with the hospital team at the outset, and during our clinical engagement. Make it a two-way discussion: Clinical engagement workshops involve highly experienced experts, who have extensive experience. Staff are more likely to engage with experienced facilitators where they feel they are learning as well as sharing their expertise. We ensure that facilitators bring their knowledge of capital projects and examples from other projects that they have been involved with. A more interesting workshop means we get more genuine engagement. Experienced facilitators are also adept at drawing in individuals who may be quieter or reluctant to speak in a group. Sometimes, the most helpful and detailed insights can come from more junior members of a team. Constructive clinical challenge: Clinicians tend to come from the perspective of getting what is best for their patients, so often engage with capital projects with a ‘lobbying’ mindset. Where we and clients feel it is helpful, we test these views with the right specialists from our Experts Network. A structured, facilitated discussion between in-house hospital staff and external specialists will derive a more robust view of clinical needs. Using a mix of input from the Experts Network and


highly targeted clinical engagement is more efficient and cost-effective overall than a traditional approach to a new hospital development.


66 Health Estate Journal April 2025


Lengthy planning process Historically, the planning process alone for large-scale NHS hospital projects has taken between five and eight years. Bringing in more targeted, focused clinical expertise, using external as well as in-house clinicians, is one way to make new healthcare capital projects more efficient and optimise clinicians’ input. This approach leads to standardised clinical engagement, in line with standardisation across the construction industry: n by only using engagement when necessary; n by having highly targeted questions, and n by drawing on our Experts Network for one-off input.


We will cut engagement and pre-construction time, and bring clinical benefits. While this article focuses principally on ‘clinical’ engagement, we are aware that there are many more staff groups who are critical to the effective running of a hospital, and whose experiences and insights are vital when developing a new facility. The principles of the Expert Network apply equally when discussing their needs and requirements.


References 1 NHS backlog data analysis. British Medical Association, 10 January 2025. https://tinyurl.com/4jj7hem3


2 HBN 00-01: General design guidance for healthcare buildings. Department of Health. 20 March 2013. https://tinyurl.com/ kb5c9yvt


3 Callister R. Key principles transforming healthcare architecture and design. Urbanist Architecture. 26 September 2024. https://tinyurl.com/vveeueux


4 The Green Book (2022). Updated 16 May 2024. HM Treasury. https://tinyurl.com/38kjtzan


5 Joi P. New study suggests risk of extreme pandemics like COVID-19 could increase threefold in coming decades. Gavi The Vaccine Alliance. 5 September 2022. https://tinyurl. com/2xabt4au


6 Edwards N. Lessons from the last hospital building programme, and recommendations for the next. Nuffield Trust. 16 July 2020. https://tinyurl.com/yc7b3epz


7 Moses C. Effect of clinical engagement on value, standardisation, decision-making and savings in NHS product procurement. Br J Nurs 4 April 2024; 33(7):326-336. https://tinyurl.com/39unuy9v


8 Consultant working patterns. A BAPM Report. British Association of Perinatal Medicine. November 2023. https:// tinyurl.com/5e3d7sum


Further reading i Symbi Consulting has an ‘Experts Network’ of hospital consultants, social workers, pharmacists. and clinical and care specialists. Smriti Singh said: “We use the term ‘experts’ as these specialists have a number of areas of expertise in addition to their clinical or care specialism, e.g. an ED Consultant whose areas of expertise include emergency medicine and hospital flow.


ii Building blocks for clinicians course 2024. Great Ormond Street Learning Academy. https://tinyurl.com/pup7kd8k


AdobeStock / Svitlana


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