Abstract

Craig McWilliam, programme director for the New Hospital Programme (NHP) – a joint venture between the Department of Health and Social Care (DHSC), and NHS England and NHS Improvement – emphasised the integrated team approach and collaborative spirit built into the project. The programme approach also intends to facilitate continual improvement and adapt in response to lessons learned from earlier schemes.

A key aim of the programme is to build nationwide capability for both planning and delivering healthcare infrastructure in the private and public sectors. “We think it’s important to create an infrastructure and ecosystem that owns, learns from, and improves healthcare design iteratively,” McWilliam said. “It’s really important that the NHS rediscovers and rebuilds its capacity to deliver new assets – to be a better client.

There was recognition, too, that the programme needs to look beyond just physical infrastructure and consider the operations that take place inside hospitals, as well as the clinical strategies, the way technology can be used, how the workforce is employed, how a hospital integrates with its regions and systems, and the sustainability of the NHS.

Natalie Forrest, senior responsible officer for the NHP at the DHSC, detailed some of the challenges of the programme, first pointing out that flexible space, which can be adaptable, will be hugely important in creating hospitals that are fit for the future, as Covid has shown.

As well as stressing the need to deliver value for money, Forrest noted that innovation and inspiring design principles will be required to help deal with the net-zero challenge, while the use of technology in hospitals is an issue where the UK is still playing catch-up. Forrest also set the programme in the context of the Government’s wider agenda to “build back better”.

Nigel Edwards, chief executive of the Nuffield Trust, followed up by reflecting on how the new models of care might impact on the designs under consideration for the New Hospital Programme. And he emphasised that the whole initiative should be seen as a cultural exercise, as much as a service redesign and building exercise.

Considering some of the new models and how they might impact on the design of healthcare buildings, Edwards noted the shift to more consultations via phone and video but warned that patients who do come into hospital will likely need a different type of facility than those who just have a face-to-face conversation. A shift towards more multidisciplinary assessment, more examinations, and more procedures may also require “a looser fit in designing the consultation rooms”. And for the hospital staff, they will need offices and rooms where they can hold confidential meetings for telemedicine patients, which are easy to use, have multiple screens, and which are well set up ergonomically, Edwards added.

Summing up, Edwards reiterated the need to consider the hospital building programme through the lens of broader lifecycle costs, not just in relation to the physical infrastructure and maintenance but also in how these new models of care impact on workforce productivity and the ways that staff work, as well as a wider calculation of the economic benefit.

This keynote session was kindly supported by AECOM.