ESTATE PROVISION
Pandemic preparedness As Unicel Architectural reports,8
global pandemics were
previously once-in-a-century events, but due to climate change, a more connected world, and the continued rise of zoonotic diseases, most experts predict that large- scale pandemics are likely to be more common in the future. The changes to healthcare facilities as described above are vital in reducing the impact of the inevitable next pandemic. However, considerations about facility design must take into account that the next pandemic may not be airborne, as COVID was. Ebola, for example, is spread by surface contact. Again, flexibility is all- important. Even before the pandemic, there was a growing recognition that buildings generally needed to be more flexible, as technological change far outpaces a typical development cycle. The continued growth in ambulatory care will be key to this. These facilities are well placed to provide faster surge capacity, with fewer disruptions than temporary hospitals, and those currently being designed take account of this increased need for flexibility.
The continued growth in ambulatory care will be key to healthcare buildings becoming more flexible, while telemedicine will invariably impact on facility sizes – as the evolution of community diagnostic centres has shown.
post-COVID. Before COVID, 3-5% of GP consultations were conducted by phone or video conference. Immediately following the requirement to lock down in March 2020, that number soared, and remains at 50- 70%.5
This, like remote working or contactless banking,
was then an ongoing but very gradual transformation, which picked up a considerable pace, literally overnight. Similarly, the growing demand for ‘touch-free’
Charlotte Hutchinson
Charlotte Hutchinson joined Carter Jonas in September 2018 as part of its Strategic Planning team based at the firm’s London headquarters, One Chapel Place. She is adept at advising on planning projects, from the inception stage through to delivery, and has experience across the breadth of the real estate sector, having worked on commercial and mixed- use projects in the South East of England.
services, which arose from a fear of cross-contamination, has impacted the design of healthcare facilities. Coupled with a need to embrace both energy efficiency and Net Zero, a more sophisticated approach to lighting, heating and cooling, and other building systems, now involves variable (often voice-activated) controls, while the use of sensors has allowed buildings to function more efficiently. Many waiting rooms now incorporate digital patient management tools for check-ins, smoother operation of triage systems, and real-time locating systems for better patient management. Another technology also in its infancy at the start of the pandemic was 3D visualisation. Its use has benefitted the design of new healthcare facilities, enabling healthcare Trusts to test out new facilities virtually as part of the design process, both operationally, but also in terms of everything from infection control and social distancing to lighting and environmental factors. A more collaborative approach, this enables adaptations and improvements to be implemented before a project goes to site. While healthcare premises will always remain important,
88% of US healthcare providers are investing in remote patient monitoring of chronic conditions, relieving demand for outpatient services. Telemedicine (from patient consultations, self-monitoring, and online prescribing to digital operating theatres, robotics, and artificial intelligence) will invariably impact on facility sizes – as the evolution of community diagnostic centres has shown. Compared with land, bricks, and mortar, technology (especially over the long term) is relatively cheap and efficient. Technology and processes are changing so fast that adaptability has never been more crucial. This will impact on decisions to locate heavy machinery such as CAT and MRI scanners, and the caballing and tracking systems needed to provide specific services.
technology is enabling traditional hospital work to take place elsewhere. According to Spyglass Consulting Group,4
130 Health Estate Journal October 2024
Conclusion In addition to those mentioned, there are many ways in which healthcare design has been impacted by COVID: improvements to air filtration and air exchanges; layout of corridors to support visitor flow and social distancing; the use of outside spaces, perhaps to incorporate visitation pods, and, importantly, the provision of adequate facilities to support and motivate staff – vital in addressing the undersupply of healthcare workers, which is feared to reach 18 million by 2030.9 The COVID pandemic has unquestionably expedited
change in healthcare: not solely in how healthcare settings respond to a pandemic, but how they respond to secondary change – to technology, lifestyle, and economic factors. Policy is shifting, but social change is shifting faster; hence the priority for agility in all aspects of healthcare facilities.
References 1 The Bartlett Real Estate Institute (16 March 2020) How COVID-19 will impact residential development (Housing today), 16 March 2020.
https://tinyurl.com/yva2628z
2 Watts N, Amann M, Arnell N, Ayeb-Karlsson S, Belesova S, Boykoff M. The 2019 report of The Lancet Countdown on health and climate change: ensuring that the health of a child born today is not defined by a changing climate. Lancet Countdown 2019; 394 (10211): 1836-1878.
https://tinyurl.com/3resyzdb
3 Hamilton G. in
WSP.com Hospitals After COVID-19: How Do We Design For An Uncertain Future? 6 October 2020.
https://tinyurl.com/4bc3956n
4 Cash, J. How did a global pandemic change hospital design? RICS Modus. 26 May 2022.
https://tinyurl.com/y36b8hud
5 Cousins S. (24 June 2020) Rethink: How will Covid-19 affect healthcare design? RIBA Journal, 24 June 2020. https://tinyurl. com/2x652cem
6 Hughes S. Poll finds support for traditional hospital design. Policy Exchange. 6 August 2020.
https://tinyurl.com/ yc33et3h
7 Home Comforts. How the design of our homes and neighbourhoods affected our experience of the Covid-19 lockdown and what we can learn for the future. Place Alliance. October 2020.
https://tinyurl.com/3s4thz3h
8 The post-Covid hospital: Designing healthcare spaces to address pandemics. Unicel Architectural. https://tinyurl. com/366ky5mr
9 Rezk M. in LinkedIn (28 June 2021) Healthcare Architecture in the Post-Covid-19 Era.
https://tinyurl.com/3chrtuwy
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