NATIONAL ESTATE DEVELOPMENT
emphasised, ‘to learn significant lessons from the experiences they have had – whether contractual, scope, or spending- related’.
Setting out the ‘vision’
Her next slide set out the Programme’s ‘vision’ – ‘to build healthcare infrastructure that allows for world-leading experiences for patients and staff.’ She said: “We all know that, despite the medical and nursing care provided for patients across England being outstanding, the facilities we expect NHS staff to work in are not; this impacts both on their day-to-day life, and the patient experience.” Natalie Forrest explained that, against this backdrop, the New Hospital Programme had five key objectives. “The first,” she explained, “is to build capability within the system. We want to be able to develop an infrastructure ecosystem that owns and learns, and improves from, healthcare design. We want to reduce the time it takes to build a new hospital, and to look beyond the physical infrastructure, to understand what healthcare needs to be able to capitalise on some of the experiences of clinicians and patients during COVID around the virtual hospital – which I know Lance McCarthy can speak very eloquently about from frontline experience. We also,” she continued, “want to build trust in this national programme.” There was always, she believed, a degree of scepticism when a new national programme came into play, because it had ‘so many complexities and moving parts’. Her team was thus keen to be seen to be working hand in hand with Trusts ‘to build the positive relationship that means there is continual partnership and learning’.
Having discussed the Programme principles, Natalie Forrest handed over to Craig McWilliam, who she said would provide some of the detail on what was expected from it.
Looking beyond traditional boundaries
He began: “So, just as Natalie said, this programme has to look beyond what were once the traditional boundaries of a building project. The government is committed to a hospital building programme, has dedicated 10 years’ worth of funding, and, as part of this, wants to achieve significant transformational change – both in how hospitals are built, and how healthcare is delivered within them, but also within the broader construction industry; it wants a programme like this to drive forward other government agendas.” Among the Programme’s key objectives, Craig McWilliam explained, was to ensure that the NHS could become a sustainable operation; the Government wanted the hospitals built through it ‘to
22 Health Estate Journal September 2021
the Government and healthcare community could identify how clinical models could be made more efficient, how improvements could be incorporated, how new technologies can be taken advantage of, and how a new building could facilitate all of this. Craig McWilliam said: “So, it’s a chance to think about optimising patient flow, creating flexible spaces that support future changing operational models, and the learnings through the pandemic around infection control, as well as staff motivation and wellbeing.”
Craig McWilliam, Programme director, Hospital Building Programme, and Capacity Delivery director at NHSE/I, said: “We think that by standardising design, we can encourage new entrants into the healthcare building market.”
achieve fantastic standards of sustainability, reaching net zero carbon by 2040’. This would require not only an increased focus on the materials used by the supply chain, and how we build hospitals, but also on how those hospitals operate as buildings, and support a low carbon operation.
Opportunities for ‘transformation’ Significant technology was, he said, now available for use within hospitals, the last couple of years having shown ‘the kinds of changes that can be achieved.’ Craig McWilliam said: “So, again, transformation can take place when a new building is provided. We need to think how the programme is digitally enabled using BIM to very high levels, and about creating digital twins, but also about how the buildings themselves are ‘smart’ buildings incorporating technology to support the highly advanced operational healthcare technology the Trusts will employ. We therefore need to consider the value chain for technology within a hospital, and how the buildings we provide will help support the Trusts to be digitally enabled.” It was also important to consider how hospital design should change to reflect the impact and efficiencies emanating from technology. Equally, by working with the Trusts in the wider regions and systems,
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A period of change for the service With the NHS going through a period of structural change – just beginning as the Integrated Care Systems took hold – Craig McWilliam said it was also vital to ensure that the hospitals built in partnership with Trusts were ‘fully integrated into their regions and systems’. While hospitals were ‘an incredibly important part of the healthcare system’, there needed to be a focus too on ensuring that as much care as possible was delivered outside the hospital environment, and on the resulting imperative for investments in other facilities. Hospitals also needed to be built ‘in a modern way – a way that was simpler, less expensive, and quicker to build’. In this context, Craig McWilliam said it was important to recognise that hospital building ‘shouldn’t be a bespoke exercise’, with the opportunity for ‘significant commonalities’ across many hospitals within the Programme and countrywide. The New Hospital Programme was an opportunity to introduce more standardisation – not in terms of buildings that all looked the same, but rather that used ‘the same kits of parts, modules, and pieces’, with digital design ‘allowing us to drive this kit of parts approach that embraces Modern Methods of Construction from the outset’.
Encouraging new entrants to the market
“We think that by standardising design,” Craig McWilliam said, “we can encourage new entrants into the healthcare building market – new suppliers of kits of parts, whether M&E or structural elements.” As supply increased, the parts should get cheaper as an economy of scale for the NHS as new hospitals were built. Equally, client and contractor teams delivering hospitals would become more familiar with the designs and elements they were
It’s a chance to think about optimising patient flow, creating flexible spaces that support future changing operational models, and the learnings through the pandemic around infection control, as well as staff motivation and wellbeing
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