HOSPITAL DESIGN
Looking elsewhere for inspiration As his presentation neared its close, Christopher Shaw showed another example of good hospital design elsewhere in Europe with a slide of the Erasmus MC Hospital in Rotterdam, which he had recently taken a team from NHSI to visit. He said: “We enjoyed a very comprehensive tour of this extremely impressive facility, really underlining that sometimes we really do need to look outside the UK for ideas and inspiration. In a recent Newsweek look at the ‘world’s top 100 hospitals’,” he added, “the highest positioned hospital in the UK – Guy’s & St Thomas’ in London –came in at number 33. So, we have many excellent health services in the UK, but I don’t think we have any really great hospitals. There are some wonderful buildings elsewhere that are reasonably easy to access, and at times I find it very disappointing that clinical, client, and stakeholder teams will think going 50 miles is about as far as they can travel. If you are planning an investment of this sort, you need to consider what is going on in Singapore, in Norway; if you don’t, your staff will. Look beyond the UK, and benchmark outside your comfort zone. Certainly, for international visits you can get in touch with organisations like the European Health Property Network, while Architects for Health can help you get in touch with people and some very good examples of hospitals throughout the world.”
The key messages
Concluding his presentation, Christopher Shaw said his ‘take-away messages’ were to look for design teams from a much wider pool, ‘to prepare your organisation to benefit from healthcare design’, including via ‘horizon gazing’, i.e. being more ambitious about what design can do, and to see healthcare infrastructure as part of the wider urban fabric. He said: “Larger hospitals, particularly, are a civic investment.” He added: “Investing in an efficient stakeholder process does require hard work, and with things changing all the time, knowledge exchange is vital. I also strongly feel we need to be more ambitious; many of the project briefings I see coming forward look pretty backward-looking. Finally, I will poach a saying from Ralf Speth, the British- German CEO of Jaguar Land Rover from 2010-2020, who famously noted: ‘If you think good design is expensive, you should look at the cost of bad design.’” This brought Chris Shaw’s IHEEM Digital Week 2020 address to a close, giving Paul Yeomans the opportunity to put to him speaker a number of questions submitted by attendees.
One attendee asked about the relative importance of modern methods of construction (MMC) when looking at the major investment in 40 new hospitals
24 Health Estate Journal March 2021
The Westmead Hospital, New South Wales, Australia – Fabric plan.
announced by the Government in early October. Christopher Shaw felt that, without the use of MMC, and given the capacity and location of the ‘industry’, the scale of new-build activity and timescales proposed for hospitals to be constructed under the Health Infrastructure Plan would not be feasible. He added: “We will inevitably need industrialisation in some form. I don’t think the answer is solely volumetric. Instead, we need to pull on the full range that is available in terms of products that the construction and wider industries can bring to bear.” One of the difficulties was that anything ‘industrialised’ required careful forethought and planning, and there were a number of areas – such as education – where the healthcare construction supply chain should be looking to see what was happening. He added: “We also need to be looking at the common public platforms being developed by the construction industry, and at how these can be brought in and applied to health.”
Standardisation
At this point, Christopher Shaw referred to ‘a recent exchange’ on a social media platform about standardisation, adding: “I don’t think anybody disagrees that it’s a
really good idea, but it is quite hard to achieve. I think at Southmead Hospital in Bristol there was an ambition to see if they could get down to using only 20 rooms as part of the build, and the idea of building a whole hospital using only a kit of parts. Those aims are very valuable, and they need to be applied and shared.” Christopher Shaw explained that earlier in his career, ‘30 years or so ago’, he had written Nucleus data packs, and at that juncture, there had been quite a high degree of standardisation. He said: “This tended, though, to be on a departmental basis, and I think it would be unwise to consider designing a hospital today using standardised departments, because I think the impact of IT and complex clinical pathways etc., means that the ‘old’ idea of a department being a ‘sealed box’ that you can plug into a hospital is now inappropriate. However, a lot of the disciplines from Nucleus era – such as standard planning systems, and standard grids – could be usefully resurrected, but please, let us do it better than we ever did with Nucleus.”
With this, Paul Yeomans thanked Christopher Shaw for presenting, and the webinar attendees for participating, and a very interesting webinar session closed. hej
Whitby Hospital redevelopment, England.
©Medical Architecture
©Medical Architecture
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