CONSTRUCTION
Designing buildings that promote health
Architecture should actively promote health, not just treat illness. By integrating outdoor spaces, healthy choices, education, and co-located non-clinical services, we can embed prevention into care settings. However, this requires both bold leadership and capital project reform, as Matt Griffiths, health sector director at Kier, explains.
For decades, the value of healthcare construction was measured at handover: on time, on budget, and to specification. Yet the real world now tells us something very different. Many of the illnesses filling hospital beds originate years earlier in the places people live, work, and grow up. With the NHS under unprecedented pressure – including over 2.8 million working-age adults now economically inactive due to ill health – healthcare construction has reached an inflection point: should buildings simply receive illness, or actively help prevent it? This decline in population health is driving demand for NHS services, shrinking the workforce available to staff them, and weakening the national economy. Prevention cannot be delivered by the NHS alone; it depends on all public investment strengthening the social determinants of health (SDOH). Construction, which shapes the environments in which people live and work, faces similar workforce pressures to healthcare and has significant power to improve population health by shifting focus from treatment to prevention.
Social value as a lever for prevention
Health enables people to work, learn, and contribute to the economy, and a national rise in economic inactivity is a preventable one. And this is precisely where construction’s social value commitments can be transformative. In construction, social value refers to the wider benefits a project delivers for local people – such as employment, skills, education, support for local businesses, and community wellbeing – during delivery and beyond. But social value is not a tick box exercise – it is a framework through which the industry can actively counteract the drivers of ill health, inequalities, and economic inactivity. The primary purpose in healthcare construction is to deliver high-quality, compliant, and safe facilities. That expectation from the NHS rightly remains. But the sector can no longer be defined only by the delivery of rooms, equipment, and compliant infrastructure. It should also be judged on its contribution to healthier communities, healthier workforces, and healthier futures – they must become assets for prevention. This shift matters because prevention is now a clear
priority for government and the NHS. A healthier population reduces pressure on services and boosts productivity. As a major delivery partner for government,
Above: The Learning Quarter at The Forum provides a free space for training.
Left: Construction should drive population health.
construction has both a responsibility and an opportunity to support this focus through how projects are designed, procured, and delivered.
Construction as a driver of population health Health does not begin in hospitals. It begins in the conditions that shape daily life: secure housing, stable income, supportive communities, access to nature, safe environments, and opportunities to learn and move. These social determinants of health account for the vast majority of our health outcomes. Construction shapes the country on a huge scale.
Public sector building programmes involve billions each year, and the CWAS3/P24 framework currently under procurement is worth up to £120bn over eight years. Ten per cent of its scoring, as with all public sector
June 2026 Health Estate Journal 43
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