‘FUTURE-PROOFING’ HEALTHCARE FACILITY DESIGN
In delivering the new Pears Maudsley Centre for the South London and Maudsley NHS Foundation Trust, Arcadis ‘harnessed innovative design measures to provide a welcoming, comforting, open-plan, green, light, and airy, healthcare setting’.
and facilities. It has published its Net Zero Building Standard, which sets out guidance on a greener future for the NHS, but getting there requires overcoming several complicated roadblocks at once. Public health and the health of the planet are, after all, inherently linked, so it is critical to find ways to support the sector’s green agenda.
Preventing us ‘tipping into crisis’ The NHS has served us well for so long, and, now that it is under intensifying pressure, we cannot take it for granted. At Arcadis, we believe we all have a responsibility to prevent the situation from tipping into crisis, and this means closer collaboration across both industry and government to do everything possible to make the NHS robust and future- ready. Architecture and design can play a huge role here, by embracing innovative approaches to deliver smarter spaces tailored to society’s needs – with longevity, sustainability, and wellbeing, front of mind. It is important to remember that the meaning of high-quality healthcare extends beyond hospitals, and must be seamlessly interwoven into all areas of life to have the greatest benefits. Over time, there has been encouraging progress when it comes to embedding healthcare deeper into the fabric of communities. In fact, the total number of NHS hospital beds in England has fallen from 480,000 in 1948 to around 140,000 at present, with the much reduced number due to better provision of care in communities. ‘Prevention is better than cure’ is an age-old maxim that still holds true, and should be the underlying message of any strategic decision-making when delivering healthcare environments in a community setting. To minimise the burden on the NHS, the
50 Health Estate Journal November 2023
first step is to shift some processes out of hospitals (barring major procedures and treatments) that can be just as effectively, if not more so, supplied at local level. Boosting more easily accessible, preventative outpatient care can cut the length and frequency of inpatient stays, and create a more sustainable care model for the future. Further, it would have a beneficial impact on the environmental footprint of healthcare facilities by lessening the over-reliance on hospitals. Integrating the provision of high-quality healthcare into communities can also go a long way to eliminating existing health inequalities in the UK, where a so-called ‘postcode lottery’ still persists. Conditions are not caught as early or treated as quickly in economically deprived areas, ultimately meaning a lower life expectancy for the most disadvantaged in society. The Health Foundation finds that people living in more deprived areas, on average, have more diagnosed illnesses – with cardiovascular disease, COPD, diabetes, depression, chronic pain, and alcohol issues accounting for 64% of the conditions in the most deprived decile (as opposed to 49% in the least deprived). There is a pressing need to safeguard
all communities by ensuring a fairer distribution of quality services, and access to equitable healthcare. An excerpt from the former Minister of Health Aneurin Bevan’s speech, made during the second reading of the NHS Bill in 1946, set out the original intention and ethos for the NHS: ‘It is available to the whole population, and not only is it available to the whole population freely, but it is intended, through the health service, to generalise the best health advice and treatment…. [It] will place this country in the forefront of all countries of the world in medical services. I believe it will lift the shadow from millions
of homes. It will keep very many people alive who might otherwise be dead. It will relieve suffering. It will produce higher standards for the medical profession. It will be a great contribution towards the wellbeing of the common people of Great Britain.’ It is crucial that we enable the NHS to keep to these objectives. Arcadis strives to reimagine what healthcare design can look like, and the key common thread across a number of our stand-out projects is that they look beyond the purely functional to deliver multi-faceted, integrated healthcare and community benefits. The multi-service Gorton Community Hub in Manchester, for instance, is the city’s first facility to combine a complementary mix of health and community features that include NHS services, a job centre, adult education services, and a public library. England’s Index of Multiple Deprivation areas lists Gorton in the bottom 1%, and co-locating all of these services in one place can contribute to breaking the cycle of deprivation, and position the region for a thriving future by generating skills and job opportunities as a catalyst for growth. Moreover, deprivation can directly correlate with poor mental health, thereby adding even more pressure to primary care in the area. So, it is vital to take a forward-looking approach by improving early diagnosis and access to effective help for the predominant conditions affecting Gorton, with depression and dementia high on the list. We also worked on delivering the Bevan Health and Wellbeing Centre in Tredegar, Wales, comprising outpatient clinics, a pharmacy, and two GP surgeries, offering a route to a variety of health and social care staff. Creating this accessible ‘super surgery’ addresses some of the biggest challenges that were felt locally previously, such as a lack of community-facing care staff, insufficient wellbeing-related services, and outdated GP surgeries. The community was also experiencing high levels of deprivation, which again corresponded with worsening health overall.
Supporting staff retention The project team wanted to create an environment that is attractive, collaborative, and efficient – not only for people accessing the services, but also for existing and prospective healthcare professionals, to support staff retention. To that end, we introduced a unique ‘social stair’ concept to link the floors within the centre and encourage interaction between clinical and community teams. The design also connects the centre to the historic park and grounds at nearby Bedwellty House, to provide patients with an active wellbeing landscape. The interior will also include artwork that documents the significance of Tredegar as part of the
Courtesy of Arcadis
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