IT WAS HEALTH SECRETARY JOHN REID, WAY BACK IN JULY 2004, WHO GAVE THE 'GREEN LIGHT' FOR 15 NEW NHS HOSPITAL DEVELOPMENTS WORTH OVER £4BN
It’s interesting that less than 6 months before that announcement, helpful CABE published the results of its Healthy Hospitals campaign carried out in partnership with the Royal College of Nursing to call for radical improvements in the design of new hospitals. This was an interesting experiment which showed that 83% of people who voted have had negative experiences of hospital environments – cold, depressing, dehumanising, impersonal, confusing, no privacy etc etc. After CABE asked four teams of architects to come up with their visions for the hospitals of the future, the designs were put to the public vote via the internet at www.healthyhospitals.org.uk. Other public priorities included fresh air (16%), warm friendly atmosphere inside (12%), gardens/outdoor space (12%), privacy (9%) and a calm environment (8%).
Studying this year’s Healthcare Design Awards would be a good way to find out to if these sentiments have been taken on board and lessons learnt. Each of the shortlisted entrants has met tough criteria set by the panel of expert judges to make it through to the final stage of judging, fighting off competition from a record 141 entries.
The worrying fact is that some new hospitals have been already been criticised because of their factoryprocessing type design and their lack of consideration for the experience of the patient or for the environmental issues. It is worrying that CABE and other organisations are still having to advise designers about the very simplest things – such as recommending a single reception point on entering in order to offer an early welcome and easy orientation. Or has to point out areas of design weakness which are obvious to the layman, let alone the professional – eg the prioritisng of maintenance over quality of patient environment often in the use of materials which can create an overt institutional atmosphere rather than welcoming and reassuring spaces.
CABE has also been calling for an improvement in the design of primary healthcare buildings procured by LIFT (Local Improvement Finance Trust) companies. However, there are some blessed schemes out there; the Heart of Hounslow and the Plowright Surgery in Norfolk are great examples.
HEALTHCARE IN PRACTICE
Certainly the UK programme building healthy hospitals and other healthcare facilities is alive and well. At the present time, over the next three years, over £15 billion is being spent on healthcare projects in varying amounts. This covers straightforward hospital building to related infrastructure matters, such as training and IT programmes. There are also 25 PFI projects currently under construction and about £4biillion will be spent. Of course, it's not all for the big stuff because the NHS is improving GP practices and providing what are called Polyclinics. Procurement is a problem but shortcuts have been introduced.
Designing for healthcare means designing large and complex buildings. These have 24/7 heavy traffic and exceptional high movement rates of people and equipment. Designers have a tough job specifying materials and components that have to withstand wear, tear and accidental damage and meet standards for fire, noise, health and safety and accessibility. Building products also have to meet NHS agendas of sustainability, improving patients experience, reduction of infection and waste reduction.
The clever designer needs to identify and specify the very best products and make the right choices in terms of capital and in use costs - a building envelope which combines aesthetics and energy efficiency with long life performance and minimum maintenance, surfaces (floors, walls and built-in furniture) that do the same, doors and architectural ironmongery than never fail and so on.
Of course, the central drive for all this is PFI which, sadly, many people think is often just an accounting trick to keep the public sector balance as low as possible and off the books. Clearly too, there is some abuse of the objectives of PFI, particularly the responsibility for lifecycle performance. Some PFI contracts have been awarded where the contractor’s responsibility merely embraces a mere dozen or so years when 25 to 30 or even more should be the norm.
And the conclusion of all this? Soon you may actually look forward to being ill in order to experience the multiple new goodies which will soon be coming your way!
