PATIENT-CENTRED DESIGN
Acute inpatient rehabilitation reimagined
Rehabilitating inpatients in the average UK hospital is almost an impossible task. Even the most skilled and experienced healthcare professional is limited by what they can achieve within confined patient rooms and busy hallways cluttered with trolleys and unused chairs and beds. Where gyms exist, they are mostly small and overcapacity. This article, written by Peter Eckersley, Iona McAllister, Rebecca Dunkerley, and Annase Wu, explores how thoughtfully designed inpatient rehabilitation spaces can improve patient outcomes, staff efficiency, and the overall recovery experience.
At a time when immobility continues to define patient care, not having the right space to help patient’s recover is a major health risk. For many patients, especially the elderly, therapy is a clinical necessity – not an optional extra. Evidence suggests that hospitalised patients spend up to 95 per cent of their time in bed. For older adults, this is particularly concerning as they are 61 times more likely to experience functional decline following hospital admission. Case studies show that inpatient mobilisation efforts can result in a 37% reduction in falls and 86% fewer pressure ulcers. To address these gaps and unmet needs, a multidisciplinary team came together at North Manchester General Hospital (NMGH) to investigate whether dedicated inpatient rehabilitation spaces, located close to wards, could improve outcomes and efficiency. They arrived at clear and tangible ways we can improve the current state-of-play. Working with healthcare planners and designers, they illustrate what an effective acute inpatient rehabilitation space looks like.
The current state-of-play After running a series of collaborative user group meetings with allied health professionals (AHPs) and health and social care professions (HSCPs) across the UK and Ireland, a common theme emerged. Physiotherapists and occupational therapists often feel underrepresented in hospital design and innovation. Despite playing a vital role in patient recovery and discharge planning, their work is frequently undertaken in multifunctional or repurposed areas which are not suited for the recovery process. As such, this lack of dedicated space limits their ability to deliver timely, effective mobilisation and assessments, and, in turn, affects patient outcomes. The current therapy spaces at NMGH illustrate
this well. A single shared gym accommodates both inpatient and outpatient therapy. Assessments such as stair reviews, kitchen assessments, and basic mobility exercises must be scheduled around outpatient appointments or conducted in corridors and stairwells. These environments can compromise patient safety, privacy, and dignity, and can be challenging for older adults with cognitive impairments or delirium. As the NHS 10 Year Plan shifts care delivery
October 2025 Health Estate Journal 145 110 25 minutes 30-60 minutes 25 minutes 5 minutes 30-60 minutes 5 minutes minutes 70
75% increase in capacity
from hospitals to community-based neighbourhood health services, separating inpatient and outpatient pathways, physiotherapy provision will need to adapt by reconfiguring services to ensure high-quality rehabilitation is accessible both within acute settings and closer to patients’ homes.
The critical role of therapy in acute settings Physiotherapists and occupational therapists do not simply support recovery; they enable it. Their assessments help determine if a patient can return to their previous level of independence, whether they can safely return home, any adaptations they may need, and whether additional support is required through community services or social care.
Mobilising patients early and often has been shown to
Figure 1: Time-in-motion study for acute inpatient rehabilitation.
minutes
Figure 2: Ward and ward core layout and suggested acute inpatient gym location.
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100 |
Page 101 |
Page 102 |
Page 103 |
Page 104 |
Page 105 |
Page 106 |
Page 107 |
Page 108 |
Page 109 |
Page 110 |
Page 111 |
Page 112 |
Page 113 |
Page 114 |
Page 115 |
Page 116 |
Page 117 |
Page 118 |
Page 119 |
Page 120 |
Page 121 |
Page 122 |
Page 123 |
Page 124 |
Page 125 |
Page 126 |
Page 127 |
Page 128 |
Page 129 |
Page 130 |
Page 131 |
Page 132 |
Page 133 |
Page 134 |
Page 135 |
Page 136 |
Page 137 |
Page 138 |
Page 139 |
Page 140 |
Page 141 |
Page 142 |
Page 143 |
Page 144 |
Page 145 |
Page 146 |
Page 147 |
Page 148 |
Page 149 |
Page 150 |
Page 151 |
Page 152 |
Page 153 |
Page 154 |
Page 155 |
Page 156 |
Page 157 |
Page 158 |
Page 159 |
Page 160 |
Page 161 |
Page 162 |
Page 163 |
Page 164 |
Page 165 |
Page 166 |
Page 167 |
Page 168 |
Page 169 |
Page 170 |
Page 171 |
Page 172 |
Page 173 |
Page 174 |
Page 175 |
Page 176 |
Page 177 |
Page 178 |
Page 179 |
Page 180 |
Page 181 |
Page 182 |
Page 183 |
Page 184
