THE HEALTHCARE ESTATE
Procedure: Minor Procedure Room, Preparation Room, Patient Cabin, Discharge Lounge, Staff Base, Cleaner’s Room, Storage
Staff: Staff Rest Room, Staff Changing, Workstations
Arrival: Reception, Waiting, WC, Phlebotomy / Consenting
Outpatients: Consult / Exam, Ophthalmology Testing, Clean Utility, Dirty Utility, Stores
Cleaner’s Cabin Store Staff Base Cabin Prep Waiting Phlebotomy Clean Utility Consult / Exam Staff Rest Staff Change, Lockers and Showers Dirty Utility
Arrival / Check-in
Acc. WC
Storage
Ophthalmic Test / Exam
Discharge Suite Minor Procedures Workstation
Imaging: X-Ray, Sub-Wait, Patient Changing
Creating ‘families’ of these clusters and rooms with ‘flex’ parameters built in enables them to be modified to match the dimensions of the chosen building. The ‘flex’ parameters will be determined by the brief and relevant standards. This kit of parts works from design level through to construction.
A diagram showing families of room clusters used to test suitability of non-specialist buildings.
client ‘wish list’, and then it is our job to test this, which might ultimately lead to changes in the functionality of the building being agreed upon to ensure that the economic, operational, statutory, and regulatory requirements for the project can all be met.
Pursuing Net Zero carbon The increasing re-use of buildings for healthcare is also an opportunity to promote sustainable design and, in the case of buildings for the NHS, to contribute to a ‘Net Zero’ National Health Service. Our industry has championed a retrofit-first (distinct from retrofit-only) approach, for example the Architects Journal’s Introducing RetroFirst: A campaign championing reuse in the built environment (2019), and “Maximise Reuse” is one of the five guiding principles in the United Kingdom Green Building Council’s (UKGBC) Circular economy guidance for construction clients. It is important to understand that each building, whether historic or modern, will require its own bespoke pathway to meet Net Zero carbon targets. This often takes the form of an iterative strategy, with an outline direction set at the start of the project that gets refined during the analytical stages. We have in-house developed guidance
and tools for measuring whole-life carbon, but there remains a lack of definitive and consistent information across the industry. The hotly anticipated UK Net Zero Carbon Buildings Standard (due later in 2023) aspires to create this consistency, but until then, on non-healthcare buildings, we are taking a ‘stepping stone’ approach. Rather than designing the building in its final form, our retrofit approach involves moving the
102 Health Estate Journal October 2023
building onto its next logical step on the pathway to Net Zero carbon, while not precluding future steps on the journey. Meanwhile, on healthcare projects,
the recently published NHS Net Zero Building Standard (February 2023) now provides us with the framework to ensure consistency. The standard will apply to all investments in new buildings, and – importantly – upgrades to existing facilities that are subject to the HM Treasury business case approval process, and are at the pre-strategic outline business case approval stage from 1 October 2023 onwards.
Sustainability at the heart Sustainability is at the heart of what we do as a practice, and we will have
to continue to invest in deepening our knowledge to help mitigate the risks and keep pace with the quick-moving issues around reviving existing buildings for healthcare use. Judiciously using a menu of design ideas to optimise embodied carbon and reduce operational energy, as well as improve a building’s condition, the designer also needs to be open-minded about what future innovation may bring. By keeping solutions simple, and making the possibilities of future adaptations straightforward, we will help the next sustainable chapter of the building’s life to be written, as part of a story of economic and social recovery on the high street, and increased access to healthcare services for the communities they serve.
Colin Hockley
Colin Hockley is a Partner at architectural practice, Sheppard Robson, which has a long track record in healthcare, and is currently working on North Manchester General Hospital, as well as several re-use projects for both the NHS and private sector. He uses his 25 years of experience in healthcare to help drive the sector forward at Sheppard Robson. After studying to be an architect, he joined the NHS’s design team. In this role, he explored the impact of space and natural light on recovery, which initiated his long-standing interest in how evidence-based
design can benefit clinicians, hospital staff, and patients.
He went on to deliver major healthcare projects at architectural practices, both in the UK and internationally. By also leading education and workplace projects, he has developed fresh perspectives to address the pertinent issues impacting healthcare, including sustainable design approaches, wellness in the workplace, and harnessing Modern Methods of Construction to create engaging architecture. His specialist knowledge has deepened through health-related research projects, and the re-writing of several Department of Health HBN documents, as well as a number of advisory roles for the NHS.
Patient Change
X-Ray Sub- Waiting
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