ARCHITECTURE AND DESIGN
What’s different about the way NHP is approaching hospital delivery compared to the past? Traditionally, hospital projects were very linear. You’d start with a clinical design, then you’d try to match that with the budget, then you’d go back and forth until the client signed off. Only then would you try and work out how to actually build it. Because every hospital was unique – with its own specific briefing requirements – there were no two hospitals the same. That meant the construction response was always bespoke. Structure, services, engineering – everything had to be adapted each time. What’s unique about this programme
is that we’re bringing all those elements together earlier, at a truly collaborative level. The building must deliver clinically and be best in class for patients, but now we can weave in construction efficiencies and commercial efficiencies much sooner. That makes the outcome more straightforward to build, more repeatable, and less risky. Repeatability reduces risk, and that’s critical in construction. The risk profile of hospitals is so high that only a handful of contractors are willing to take them on. What we’re trying to do is change that, by creating a delivery model that contractors want to be part of. We’re using the same ‘kit of parts’ across projects. We can adjust and change things, but the building blocks are the same. That increases repeatability, efficiency, and reduces risk. In construction, we work on small margins, so if a project is too risky, contractors just won’t touch it. By standardising the approach and reducing risk, we’re opening the door to more contractors engaging with these large hospital projects.
Let’s talk about the single-bedroom prototype. Why was this chosen as the first space to develop and test? The reason we focused on a single bedroom is that it’s the most repeatable room in any hospital. The brief is clear: 100% single bedrooms. We’re not doing multi-bed wards anymore. Every patient will have their own room, their own space for privacy and dignity, for better infection prevention and control, and for patient care. The benefits are massive. Outcomes improve when people are in their own bedrooms. So, 100% single bedrooms was the drive. In a standard district general hospital of around 400–500 beds, you’re looking at around 3,500 single rooms across the first wave of hospitals alone. If we can get this room right now and test it thoroughly in a prototype before construction starts, it’s massively important. We’re delivering multiple projects in parallel, so this is our one chance to learn those lessons in a safe environment before the hospitals are built.
What exactly are you testing through the prototype? Initially, it was a low-fidelity prototype to test industrialised elements. We wanted to see how mechanical and electrical services could be standardised and manufactured off-site – things like the bedhead services, the doors, and especially the corridor-to-bedroom-to- bathroom interface, which is a classic problem area in hospitals. Where different services interface with each other, or
different parts of the building meet, is where problems usually arise. If we can solve those now and provide a repeatable solution, it reduces risk and means contractors can deliver efficiently. But this prototype evolved beyond just technical testing – working with Reds10, we realised
we could take it up to a much higher level of fidelity. Rather than just rough walls and no ceiling, we built a more complete space. That allowed us to bring in multiple disciplines – clinical, estates, digital, patient representatives – to test workflows, technology, and patient experience. It also makes construction safer. By having a controlled, mock-up environment to understand exactly how the room will come together we can solve problems early which is obviously much better than doing so on a live site, where mistakes can be costly and dangerous.
What’s the biggest benefit of prototyping at this stage? The biggest benefit is confidence. Once we get the interfaces and industrialised elements right, we can give contractors a proven solution and say, ‘Do it like this - we know it works’. That allows them to deliver at scale and with fewer risks. It makes it safer for those working on the hospitals as well because fewer problems on a live site makes it a safer one, with fewer accidents. This is so important and supports the safety case required by the Building Safety Regulator. Health and Safety Executive (HSE) – the UK’s national regulator for workplace health, safety and welfare – statistics show that 51 people per year are killed on site in the construction industry.1 Based on the working hours projected for the NHP
that would mean we could anticipate three deaths on our first wave of sites. This is simply unacceptable, and we must work with the industry to change it. Modularisation of products and systems has been proven to reduce the likelihood of serious incidents, and for that reason we need to advance it, making construction safer and therefore a sector where people want to build long and rewarding careers. This would also further support Building Safety Regulator’s drive toward all a wider audit of all construction products.
Finally, what does the prototype tell you about the future of hospital construction? It tells us that building hospitals in a programmatic, repeatable way is possible. You can balance clinical outcomes, construction efficiency, and operational flexibility. You can industrialise where it makes sense, standardise the complex interfaces, and reduce risk. Crucially, you can do all of that before construction
starts. That’s what makes this programme different. It’s exciting, and it gives me real confidence that the first wave of H2.0 hospitals will deliver what patients and staff need – efficiently, safely, and at scale.
References 1 HSE. (2025). Work-related fatal injuries in Great Britain.
https://www.hse.gov.uk/statistics/fatals-overview.htm.
The prototype has evolved beyond just technical testing – a complete space has been built to test workflows, technology, and patient experience.
Stuart Thatcher
Stuart Thatcher is a senior leader with more than 25 years’ experience in healthcare construction, spanning the UK, Sweden, and Australia. He is currently part of the New Hospital Programme, helping to shape and deliver the next generation of NHS hospitals. Stuart has previously held senior roles including Healthcare Sector lead at John Sisk & Son, and Capital Delivery director at Guy’s and St Thomas’ NHS Foundation Trust, where he oversaw a team of 85 delivering more than 100 new-build and refurbishment projects during the height of the COVID-19 pandemic. He is frequently called upon to lead complex healthcare projects and is recognised for his expertise in managing the full project lifecycle as well as resolving mid- project challenges.
October 2025 Health Estate Journal 55
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
