Space planning
Flexible ‘zoning’ aids adaptability
Simon Corben, business development director at Capita Symonds’ Health team, examines how ‘clever use of zoning’ when planning new healthcare facilities could improve hospital design, increase inherent flexibility, and reduce lifetime costs, and argues that a ‘loose-fit, non-bespoke approach’ to space planning will lead to ‘more flexible buildings that are suitable for conversion to alternative uses’.
W
e live in interesting times, as the saying goes, and the challenges we need to meet in healthcare
design are exactly the same as those for most capital projects these days – more for less; in other words, more sustainable, more innovative, more future-proofed solutions, delivered in double-quick time, with a minimum spend. For all sectors, when the focus is on
minimum spatial requirements to meet current best practice standards, there is a clear pressure on commissioners to deliver what is needed today, and worry about tomorrow when it comes. In the long term, though, this may lead to the polar opposite of the ideal solution: adequate space capable of flexing to the needs of users throughout the lifetime of the facility. As we all know, in relative terms, initial capital outlay is far outstripped by lifetime costs, and estate strategies should be developed that produce the maximum income for each square metre.
frontline care For healthcare, any cost efficiencies made can be ploughed back into frontline care. Every £30,000 saved can fund an extra nurse. As the cost to occupy buildings in the NHS is typically between £250 and £400 per square metre, a correctly sized estate can make a significant contribution to meeting required efficiencies. NHS QIPP is a large-scale
Ploughed back into
transformational programme for the NHS to improve the quality of care the NHS delivers, while making up to £20 billion of efficiency savings by 2014-15, which will be reinvested in frontline care. (The NHS estate comprises 25 million m2
A consulting corridor; Capita Symonds says healthcare facility ‘zoning’ can also be used to control the movement of users and equipment to segregate ‘clean’ and ‘dirty’ traffic (and therefore create restricted zones accessed by staff only).
aims for all new non-domestic public sector buildings to be zero carbon by 2018. The QIPP ambition is for an NHS that delivers high quality and financially sustainable services, to make savings, while maintaining quality and productivity, and, above all, ensure a safe and secure environment for patients, staff, and visitors, alike. A key enabler in delivering ‘better for less’ is the scope, use, and application, of the healthcare estate. The NHS Operating Framework
of occupied
floor area, and has a value of £36 billion for buildings and equipment). The Government
emphasises this when it says: “As well as truly clinically led commissioning, and a robust and diverse provider sector, service change requires the right environment at local level. Responding to the current
economic climate, and a national focus on asset management, healthcare providers can simultaneously deliver better outcomes, secure significant cash-releasing savings, and define the irreducible level of fixed assets required to meet healthcare needs, both now and in the future.”
Patient-centric design Layout and size have been subject to many changes over the centuries, as concepts for healthcare facilities have evolved. In the early 20th century, acute hospitals tended to be places for the very sick, and to be designed largely on a task-oriented basis. Victorian premises, for instance –
Health Estate Journal September 2013
27
Courtesy of the NHS Photo Library
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