PATIENT-CENTRED DESIGN
Above: The centralised gym space for physiotherapy and occupational therapy at Manchester General Hospital. Left: Specialty teams from North Manchester General Hospital consider their requirements for the inpatient gym.
calming surroundings, natural light, and non-slip seamless flooring support wellbeing and safety, while standard ventilation and an optional link to outdoor space enhance comfort. A ceiling-mounted hoist spans
Peter Eckersley
Peter Eckersley is a physiotherapist working at North Manchester General Hospital – part of the Manchester University NHS Foundation Trust. Peter qualified from Manchester University with a degree in Physiotherapy in 2001 and has spent his career at North Manchester, working across a range of clinical specialities. In 2011-2012, Peter completed the inaugural NHS Leadership Academy Clinical Leaders Programme. As part of his current role as In-patient Physiotherapy Department lead, he is also seconded to a role representing Allied Health Professions in the project to rebuild North Manchester General Hospital.
the gym to ensure safe patient handling. The gym is accessed directly from the ward core via a wide, automated, wheelchair-accessible doorway. Inside, a circuit-based layout supports activities such as stair practice, walking, ADL simulation, and strength training, with patients moving seamlessly between their bedrooms and the therapy space. A small waiting area and accessible equipment store maintain comfort and efficiency. Key features include:
n Ceiling track hoist enables safe, efficient patient transfers across the entire space.
n Bobath plinth provides a firm surface for therapy interventions which can be used by all patients.
n Collapsible parallel bars facilitate gait training, balance work, and lower limb strength exercises.
n Mock front door and step simulate real-world discharge scenarios to test readiness for home.
n 13 step staircase supports comprehensive stair assessments and practice.
n 11 m walking track enables functional capacity assessments, particularly for cardiology and respiratory patients.
n Kitchenette for physical and cognitive rehabilitation and ADL practice.
n Dedicated storage room ensures a clutter-free, safe, and flexible working environment.
n Access to piped medical gases supports acute care requirements and future adaptability.
n Adjustable lighting enhances patient comfort and supports diverse therapy needs.
Key assumptions Key assumptions underpinning the design are that all patients have ensuite rooms for personal care assessments, outpatient rehabilitation is delivered elsewhere, and certain activities (e.g. lying therapy) require specialist equipment. The gym space should be flexible and future- proof, with the option to convert into standard inpatient accommodation if required – for pandemic resilience, for example. As aforementioned, the health planning and clinical teams identified that each acute inpatient gym would
148 Health Estate Journal October 2025
require approximately 40 sqm for the therapy area, supported by a 10 sqm equipment store. This estimate was tested and refined through a detailed space feasibility study, taking into account projected utilisation, clinical needs, and estate constraints. The proposed footprint is intentionally smaller than
the 64 sqm recommended in HBN 11-01 for primary care physiotherapy gyms. This is due to the anticipated deployment of up to eight therapy spaces across a medium-sized acute hospital (approximately 500 beds), making space efficiency a critical design consideration. The ideal location for these therapy spaces is within the ward core; a support area shared between two or three adjacent wards. The ward core provides accommodation for essential clinical and support functions that do not need to sit within individual wards. It features distinct zones for staff and patient-facing functions, and offers an ideal location for the therapy gym due to its proximity, shared access, and operational efficiency. Using the clinical design brief and room data sheets (RDS), a Revit model was developed to produce a 1:50 layout. This allowed for detailed testing with clinical teams, ensuring the space was both functional and flexible for real-world use.
Design intention The rehabilitation space is designed to replicate key features of a typical UK home, enabling patients to undergo realistic training and assessment before returning to their own environments. Core elements include a mock front door with step, a full-height staircase, and a functional kitchen with sink, tap, hob, and storage cupboards, all complemented by access to an outdoor garden space. Although these features may appear ordinary in daily life, for frail or older people, they can pose significant challenges for patients recovering from acute illness or surgery. Within this controlled and supportive environment, patients can practise essential activities safely, gradually rebuilding both their skills and their confidence to live independently after discharge.
Design features
n Flexible and adaptable The testing model is based on a structural grid of 8.4 m x 8.4 m, accommodating a 40 sqm gym space and a 10 sqm storage area within a single grid bay. This allows flexibility and adaptability if the gym needs to be reconfigured for changing rehabilitation practices or repurposed for inpatient accommodation.
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