TRAINING & SKILLS
Exploring the key roles in a project governance structure – from clinician, to contractor, to Estates director, during a panel discussion.
some of the technical parameters that facilitate or constrain decision making. As such healthcare leaders are often unable to become fully engaged in the multidisciplinary design of clinical services and built environments, potentially compromising the quality of the final outcome. The knowledge and expertise of NHS
teams needs to be harnessed in the right way to enable design teams, engineers, and building contractors to provide the best possible solution. A growing body of research has identified that, all too often, a gap in understanding and skills means that the value these stakeholders’ input has on the design and development process is less than it could be. The resulting design is then sub-optimal, frustrating potential efficiency gains and compromising the improvements in clinical care realised when organisation and building are working in unison.
Change requests This knowledge gap can also be the cause of change requests during the project. The cost of change is low during the design stage of a hospital project, while the opportunity for influence is high. This diminishes as the process goes on, and the cost of change increases rapidly. The more effective client teams are in the early stages of a new healthcare project, the better and more cost-effective the end result will be. Evidence from research undertaken
by Professor Ulrich in 2005 and 2006 – based on Evans et al. 1998 Royal Academy of Engineers, and J Cole, NHS Northern Ireland, demonstrated that a healthcare building is likely to have a whole-life cost of approximately 50 times its original capital cost. A badly designed healthcare building will have an increased whole life cost of in excess of 75 times its original cost. We believe that with informed and engaged NHS teams we can ensure that we have well-designed and effective healthcare buildings which enhance clinical
54 Health Estate Journal March 2024
A practical workshop on developing a brief.
care, reduce operating costs, and bring the whole-life cost of new healthcare buildings down drastically. Healthcare Design Leadership, a not-
for-profit community interest company (CIC), was established in October 2022. It was set up by a group of leading experts across the fields of healthcare, academia, and the built environment, with the aim of empowering healthcare leaders within the NHS with the skills, knowledge, and tools, to maximise the value and impact of their participation in capital development projects. Working together on a number of
large healthcare projects, the founders of HDL had identified that the skillset within the NHS related to the development of new healthcare facilities had diminished. Capital development teams across the NHS have been losing the experience gained through previous building programmes as team members retire or change careers. Added to this, many of the stakeholders whose opinions were sought, and from
whom sign-off proposals were requested, did not really understand what they were looking at, or how it could be influenced. Many clinicians, for example, had never seen a plan of a building before, yet they were being asked to sign the design off as acceptable. As founders of the organisation,
we firmly believed that the design and construction industry should be doing more to support the NHS. It was particularly important to us that this was done on a not-for-profit basis. We had seen a number of consultancies attempting to manipulate this need for profit, but we firmly believed that there is a social value need where we could drive the industry to support the NHS.
An immersive introduction The Healthcare Design Leadership courses provide an immersive introduction to the whole project lifecycle, providing opportunities for hands-on experience of the process and products developed at each stage. The training enables NHS
A photo from HDL’s bespoke course developed for Imperial College Healthcare NHS Trust.
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