HOSPITAL DESIGN
infrastructure to ensure it can provide excellent health and social care.” Good design, he believed, not only improved productivity, allowing for more efficient processes and flows, but also improved both patient outcomes and the patient experience. He said: “We all know how well loved the NHS is, but that patient experience within it is, at times, sub- optimal in many existing facilities. Of course good healthcare facility design also supports recruitment and retention. After all, healthcare is a global business, and attracting the best clinical staff particularly entails competing on a worldwide stage.” Christopher Shaw said he would later ‘touch on how far the UK is behind some other countries in terms of the environments we offer our staff in the NHS’.
Christopher Shaw.
Flexibility and adaptability Fundamental to good healthcare facility design in today’s fast-changing climate, he believed, were ‘flexibility and adaptability’. He explained: “Good design understands that buildings and their role will change over their 50-60 year lifetime, which requires foresight and the right approach to standardisation and generic space. This needs to acknowledge that if you can reduce the number of individual room types, you can provide the kind of infrastructure that will grow and change with health services over a fairly long horizon. All of this, of course,” Christopher Shaw stressed, “is also about public money. Hospitals are civic buildings, and the public expects to see value from a very substantial period of investment. Clearly, there is a political onus, but I also feel people want to see NHS infrastructure being part of their cities and towns, and playing a role within their civic life.” Hospitals may well, he added, be the largest employer in many cities ‘for miles around’, and thus investment in local healthcare infrastructure was
part of the landmark of urban and city life. “Unfortunately,” the speaker continued, “the quality of design historically in the NHS has been not particularly great. I think we have had pockets of investment, but the level of spending on our infrastructure has – as the Health Foundation pointed out in a 2019 report – been comparatively low at an OECD level. We now have the opportunity to really raise both the bar, and our expectations and ambitions.”
Putting design at the heart of decision-making
Answering his own question, ‘How do we do that?’, Christopher Shaw said the key was to put design ‘much more at the centre of the decision-making than it has historically been’. Here he showed a slide of what he dubbed ‘one of the superhospitals’ in North Denmark, to give an idea of really imaginative hospital design – the Hillerod Hospital North Zealand, designed by Herzog deMeuron &Vilhelm Lauritzen Architects, a striking-
looking structure surrounded by natural greenery. He said: “In Denmark they have been investing in healthcare and health infrastructure with a new round of very large hospitals, and this is seen as of national importance. It’s moving the Danish economy from an agricultural to a health and biosciences economy. Go into any meeting with the design team in Denmark, and you you’ll not only find the hospital management there, but also the university sector and the biotechnology industry represented. Design in Denmark – as you would expect in Scandinavia – plays a key role in the country’s new healthcare building programme.” The associated design quality was, he added, ‘really in a completely different league to what we are used to in the UK’. Showing further slides of the same Danish hospital, he pointed out that among the major design ‘themes’ were low energy, adjacency to nature, and therapeutic environments, ‘on a very large scale’. He added: “Of course all this needs to fit within a wider process of procurement and design. All of us are familiar with the OJEUs, and the appointment of a design team through a framework, and it’s all very routine, because we are having to do this very fast. I think that what’s coming out of it currently is not great; we need to have much more ambition coming from NHS organisations, and those commissioning HIP projects. There needs to be a clear understanding of where design quality matters – culturally, practically, and in terms of organisations’ future sustainability.”
A ‘comparatively small pool’ Reprising what he had said earlier, Christopher Shaw said that, ‘due to low levels of investment’, there was ‘a very limited pool of design and planning experience’ – not just among architects, but equally among health planners,
The New Oakville Hospital, Ontario, Canada – Competition. 20 Health Estate Journal March 2021
The masterplan for the Royal Adelaide Hospital, South Australia.
©Kasian Architecture
©Medical Architecture
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