Building to meet health needs in the community

Good design is all about the approach and the process. The focus should be on design quality and its impact on wellbeing. This need not mean extra cost, but does require inspiration and leadership. Capital investment is not simply about making buildings more comfortable or giving them a contemporary make-over.
    
It’s all about committing to a step change – making sure that the physical settings for health are fit to deliver care in the future. We acknowledge the urgent need for high performance environments that are affordable and adaptable whilst sustaining therapeutic design quality for all users. There needs to be a change in content and vision where projects aim to deliver health and social care in a more effective way, as part of a strategic plan.

Managing estates
The Department of Health owns extensive estates that require careful evaluation and management; delivering quality projects in an era of austerity requires very careful thought so that they can lead to improved outcomes. Rather like keyhole surgery, the process demands more precision and up-front preparation to deliver results.
    
Much of the existing estates and buildings are no longer fit for purpose and are tying up capital value and revenue cost. High performance premises in the right location that are ‘fit for purpose’ are essential for delivering high quality services fit for the 21st century. Doing nothing is no longer a viable option for survival; making any intervention, however small, has to deliver better outcomes, reduced costs, with greater satisfaction for staff: Design is central to this purpose.
    
Design review
An evaluation of the quality of space, environment and buildings should take place with a view to enhancing therapeutic impact. It is important to create strategies that are both robust and sustainable to improve clinical functionality, eliminate backlog maintenance, meet statutory compliance and environmental measures to achieve carbon reduction targets.
    
An example of where Design Review helped develop a masterplan and design strategy for a major hospital is Alder Hey Children’s Clinic in Liverpool. The Cabe team supported the NHS Trust during the bidding process and helped identify the preferred design team. Design Review improves the quality of design of major projects and often speeds up the planning process, leading to the quicker delivery of high quality places.
    
The proposal for Alder Hey promised to provide a new kind of hospital experience and to create an uplifting environment. There were a few elements that needed addressing in order for it to be fit for purpose in the round. For instance, we suggested simplifying the landscape design of the courtyards to create a fully usable, child-orientated environment that responds to the clear design rationale of the buildings. There was also an accessibility issue on one side of the development which we advised on and some comments on the elevational treatment of the buildings.
    
This resulted in better therapeutic ambience and a hospital that has the potential to become a truly exciting addition to this part of Liverpool. The NHS Academy stresses the importance of leadership. Our experience is that strong leadership is a key element in any successful project. It all starts with well informed clients who are able to develop a clear brief and demand high quality design solutions from experienced design professionals. Getting the brief for a project right is one of the main tasks of a client. It will be an essential guide for the delivery team throughout the project.

Newton Abbot
The Cabe team provided support in brief development for The Newton Abbot Community Hospital in Devon which is part of the Integrated Care Network. It was developed between Teignbridge Primary Care Trust and the local Acute Trust to deliver coordinated services to local communities. It had a challenging brief to write that combined a number of facilities from Stroke Patient Care to Minor Injuries and a Maternity Unit. We helped them through the procurement process by providing advice early on in order to define a successful brief and select an effective bid team. We also presented to stakeholders and critiqued the bid proposals.  
    
There is also guidance available for clients on the best way to assemble teams for healthcare projects, such as Future Health and Creating Excellent Buildings. Cabe helps health professionals unlock the potential of their projects through support, review and training and each process can be tailored to the clients’ needs. A network of 250 Built Environment Experts support the team’s work delivering high-quality designed places and provide the specialist knowledge needed for healthcare projects.  

A worthwhile challenge
It’s this independent expertise that is invaluable. Planning and procuring buildings and facilities that will meet a community’s long-term health needs is always a challenge. These are just a few examples but the general rule still applies – health estate commissioning is a challenge but injecting good design leadership into the process early on can save money, improve the quality and longevity of the building and have a positive therapeutic impact on patients.

Further information
www.designcouncil.org.uk/cabe

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