DATA AND DIGITISATION
Digital twins at scale: Lessons from Monklands
As the UK’s first ‘digital-first’ hospital, the New University Hospital Monklands is breaking new ground, with a digital twin at the heart of this innovation. Paul Cooper, director at Wallace Whittle and lead on MEP design, explores how smart data, live building insights, and real-time simulation are shaping Monklands, and creating a blueprint for the future of healthcare estates. He examines how digital twins help make smarter energy, maintenance, and operational decisions, and what the industry can learn from delivering this technology at scale in one of the most complex built environments.
I’ve had a front-row seat to how digital innovation is reshaping healthcare estates management. Monklands is set to be the UK’s first digital-first hospital, and we are pioneering the use of digital twin technology to revolutionise how the facility is planned, built and operated. Our role in the project has given us unique insights into
how early integration of building services with digital twin technology can unlock significant efficiencies and support operational excellence in a complex healthcare environment. Digital twins are not simply detailed 3D models. They are dynamic, data-integrated digital mirrors of real buildings and systems, updated in real-time. In the context of Monklands, a digital twin will allow estates teams to monitor infrastructure performance, simulate decisions before acting, and identify opportunities to optimise operations. This means staff will be able to track energy consumption, monitor maintainable assets, and predict the impact of operational choices before committing resources. In a hospital setting, where safety, cost control and efficiency are all paramount, this capability is critical.
The main entrance to Monklands Hospital in North Lanarkshire, Scotland.
Delivering value The adoption of digital twins in healthcare estates is still emerging, but the sector is ripe for the application of this technology. This is largely driven by the inherent complexity and critical nature of hospital environments. In these settings, optimising energy use and asset maintenance directly supports patient care and staff effectiveness. Crucially, hospitals cannot afford downtime. Systems must operate seamlessly around the clock which makes predictive maintenance and real-time monitoring especially valuable. While initial setup costs remain high, particularly on large projects, the potential for long-term operational savings makes a compelling
112 Health Estate Journal October 2025
commercial case for the use of digital twins. Over time, as technology matures and becomes more
cost effective, digital twins are likely to follow a similar path to building information modelling (BIM). Once considered cutting edge, BIM is now standard across the industry, and the use of digital twins will likely follow the same trajectory. A key lesson from Monklands is the importance of involving MEP engineers early in the development of the digital twin. At Wallace Whittle, our role as lead MEP engineers meant we were engaged from the outset. This means that the digital twin will reflect the systems that matter most, such as lighting, heating, ventilation, and cooling. These are the systems which generate the live data that
gives the twins value. Early MEP integration avoids the need for costly retrofits and reduces the risk of data gaps, ensuring the twin delivers relevant, usable insights from day one. It also ensures that the twin is aligned with the building’s actual operational requirements. It’s important to acknowledge the collaborative
environment needed to make this happen. From the earliest design phases, engineers, architects, facilities managers, and digital consultants have been working together to define how the twins will function. The success of a digital twin hinges on the structure and quality of the data it uses. Therefore, defining data parameters and formats early has also been essential to maintaining consistency and ensuring future usability.
Digital twins in action Creating a digital twin is not about collecting as much data as possible. In fact, often it’s quite the opposite. Sensors, monitoring systems, and modelling platforms all come at a cost, and while this technology means that now, nearly everything can be monitored and tracked, that doesn’t mean it should be. Indiscriminate data collection can lead to systems that are bloated, difficult to manage, and ultimately useless. The process at Monklands has involved extensive
workshops with the client, estates teams, digital consultants, architects, and sustainability experts. These sessions have focused on carefully defining what data should be monitored and why. Identifying meaningful key performance indicators has been central to the process. The approach involves developing a single digital twin
that incorporates multiple functional aspects, including patient interface and energy performance capabilities. Within this unified digital twin, patient interface functionalities will manage how the hospital environment responds to individual patient needs. For example,
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