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COMMENT
Cavell Community Health and Wellbeing Hub © Pillar Visuals
The Cavell Centre programme, named after Edith Cavell, a British nurse during World War I, is one such initiative that looks to the future. The programme began after Medical Architecture, with John Cooper Architects, proposed the development of a blueprint for the transformation of primary and community care facilities in England. Developed with NHS England and NHS Improvement (NHSE/I), the aim was to optimise and standardise the briefi ng, planning and design process to allow the business case process to be streamlined, increasing quality and reducing design costs at each project stage. The proposed Cavell Centres that emerged pioneered an approach to standardised yet adaptable planning, with a specifi c approach to MMC, net zero carbon design, and high quality, wellbeing-focused environments. Following on from this work, we were commissioned alongside Passivhaus design specialists Architype to co-design one of six pilot schemes for the programme – the only one to be designed to Passivhaus standards.
Social prescribing as a route to health & wellbeing Like The Jean Bishop Integrated Care Centre, the strategic vision for the Cavell Centres recognises that social factors in health are as signifi cant as clinical factors, and therefore combines both models to proactively address the barriers to improved community health and wellbeing. This formed a central feature of the pilot scheme design.
Setting a new standard for community health facilities, the building hosts a varied health and wellbeing offering, including multiple GP practices, community diagnostics, therapy services, outpatient services, third sector social prescribing organisations, and a health-centred commercial offer. The building is designed to be highly fl exible to allow this mix of services and tenants to adapt over time. Strong internal connections to quality external
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landscaping with lawns, planting, and water features; and inviting, non-institutional internal spaces; enable a variety of wellbeing activities. This, combined with access to local authority support, links patients with opportunities for social prescribing, integrating health and wellness into the community.
Competing priorities for limited funding Currently, NHSE has paused the development of the project business cases to focus on developing the programme business case ahead of a bid for capital funding for the programme at upcoming spending reviews. We are hopeful that initiatives such as the Cavell Centre programme will be able to demonstrate the benefi t of a long term investment in a preventative approach to healthcare, in relieving pressure on an already overstretched system. In their report, The King’s Fund describes ‘hierarchies of care’ – urgent problems taking priority over longer-term issues – as a reason for underinvestment in community healthcare. For example, treatments for urgent medical problems taking priority over services that prevent the development of problems. It recommends that leaders need to be clear about why a change in focus is needed: “which is to deliver improved care and improved outcomes, and to ensure the health and care system is sustainable for the future, rather than to deliver cost savings in the short term.” Clearly, the challenges the health service faces are complex and multifaceted, and no quick solution exists, however successful pioneering projects like The Jean Bishop Integrated Care Centre, demonstrate the value of a person-focused, preventative approach, which the Cavell Centre programme is well placed to continue – if funded as a priority.
Bob Wills is director at Medical Architecture ADF MAY 2024
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