THE HEALTHCARE ESTATE
Healthcare – a new way to resuscitate the high street?
Hospitals and high streets are two parts of the built environment that are under intense scrutiny at the moment, and they are perhaps more interlinked than you might think. So says Colin Hockley, Partner at Sheppard Robson, who here considers both how a range of buildings can potentially be ‘repurposed’ to provide high-quality healthcare, and what types of healthcare lend themselves well to being housed in non- specialist buildings away from main hospital facilities.
At Sheppard Robson we are seeing a sharp increase in the number of projects that are repurposing buildings on the high street and in shopping centres for alternate uses, including healthcare facilities. Most involve the creative re-working of retail and office buildings both ‘in town’ and ‘out of town’. Our work across numerous typologies, not just healthcare, gives us the experience to assess the opportunities and key considerations when repurposing buildings for healthcare, which can capitalise on the footfall of shopping destinations to increase accessibility to vital services. However, any discussion around this
topic needs to consider several key questions: What types of buildings lend themselves to reuse? What are the key considerations when retrofitting? What types of healthcare lend themselves well to being housed in non-specialist buildings away from main hospital facilities? These are the issues that I address in this article,
while also considering the impact that such issues have on sustainability targets, and also positively contributing to communities.
Harley Street example Repurposing buildings for healthcare is nothing new. We just need to look at one of the most high-profile medical destinations in the world, London’s Harley Street. Initially a middle-class residential development built in the early 18th century, it has developed into the world’s most dense cluster of medical services (over 3,000) in what are largely repurposed Georgian terraced houses. Then the driver to repurpose was to bring medical services closer to the community the doctors served – the wealthy middle classes. In the 18th century, healthcare was private and unregulated, unlike today, where there is an emphasis on regulation and standardisation. So, understanding how Health Building Notes (HBNs) and Health
Technical Memoranda (HTMs) can be applied to the broader range of buildings – from offices and retail outlets to hotels and car showrooms – is another key question. These repurposed facilities can offer additional and increasingly attractive options to accelerate the delivery of a greener healthcare estate and move some services back into the communities they serve. However, not all buildings will be suitable, so specialist evaluation is essential.
Resuscitating the high street Before we discuss how we repurpose buildings for healthcare, it’s worth highlighting its wider social impact. The built environment has been thinking about how to breathe new life into shopping destinations in response to the impact that internet shopping has had on the health of the high street, and how to tackle the reduction in office use in commercial centres as a result of changes in work patterns supercharged by the COVID-19 pandemic. Many have focused on experiential retail to fill the vacant spaces left by traditional retail, adding more experience-led activities, such as concert spaces, cinemas, and skate parks, as well as food and beverage offerings, while the focus with office buildings has been to convert to residential, hotel, and mixed- use.
As well as providing experiences, Office space repurposed into an imaging suite.
however, retail destinations and commercial centres – as places that already have a high footfall – can also more readily provide essential services. Retail and commercial centres are normally in easily accessible locations with ready- made transport links and a high allocation of parking. It is this accessibility that establishes them as attractive locations for healthcare, making it easier for people to get their diagnosis and treatment, and therefore helping to reduce waiting times and healthcare inequality more broadly. I think the built environment has been slow to realise the synergy between
October 2023 Health Estate Journal 99
Adrian Lambert
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