JANUARY 2025 | £8 healthcaredm.co.uk healthcare design & management Also in this issue: Health on the high street Supporting a struggling NHS, while boosting the nation’s ailing high streets Five tech trends for 2025 How artificial intelligence and machine learning can reshape everyday practices within healthcare Lithium-ion batteries A look at how to mitigate fire safety risks associated with lithium-ion batteries Designing the future of cancer care Canada’s Arthur J.E. Child Comprehensive Cancer Centre opens
We would like to introduce the Integrated Theatre of Things (ITOT). Revolutionary technology designed to turbocharge the environmental sustainability of integrated operating room systems has launched in the UK.The eco-friendly and money-saving game-changer is set to slash CO2 emissions and hefty costs facing Britain’s National Health Service (NHS). Visit Us Online At: greener.surgery INTEGRATED THEATRE OF THINGS Medical Systems INVEST IN GREENER INTEGRATED OPERATING THEATRE SYSTEMS AND HELP SAVE THE PLANET
healthcaredm.co.uk 3 Publishers Stable Publishing Limited SBC House, Restmor Way Wallington, Surrey SM6 7AH, England. t. 020 8288 1080 f. 020 8288 1099 e. [email protected] healthcaredm.co.uk Editor Helen Adkins Sales Director Julian Walter Media Sales Manager Barnaby Goodman-Smith Production Nicola Cann Design Gemma England Managing Director Toby Filby The inner courtyard within the Arthur J.E. Child Comprehensive Cancer Centre in Calgary, Canada The publishers do not necessarily agree with views expressed by contributors and cannot accept responsibility for claims made by manufacturers and authors, nor do they accept any responsibility for any errors in the subject matter of this publication. healthcare design & management The British high street, long suffering from the double whammy of online shopping and economic malaise, might finally have found a cure. With retail spaces sitting empty and the NHS bursting at the seams, a new vision has been steadily emerging: turn these oncebustling shops into healthcare hubs. Where you once browsed for novelty phone cases, you could soon be getting your blood pressure checked. It’s an idea that ticks all the boxes. Bringing healthcare to the heart of communities would cut travel times for patients, offer accessibility to specialist departments such as ophthalmology, and ease the pressure on overstretched hospitals. Meanwhile, empty properties gain a new lease of life, helping to revive the high street. Whilst repurposing high street retail properties into healthcare facilities presents a promising opportunity to address healthcare demands, transforming these spaces requires a thoughtful approach to design. This isn’t as simple as plonking a GP surgery where the perfume counter used to be. Healthcare spaces demand rigorous standards. Adapting former retail units structurally can pose challenges. Spaces must accommodate consultation rooms, waiting areas and specialised treatment zones, sometimes requiring reinforced floors or modified ceilings for medical equipment. Yet, these challenges also open doors to creative solutions that enhance patient experiences. On page 18, Pick Everard’s Mark Dando discusses how the resurgence of the Health on the High Street (HOTHS) trend could be key for boosting the nation’s ailing high streets, while supporting a struggling NHS, while Jim Hart, director at Corstorphine & Wright architects, explores the practical considerations involved with repurposing retail spaces into healthcare hubs. They argue that the success of these conversions hinges on patient-centric design. Spaces should be intuitive and welcoming, with clear signage and calming aesthetics to reduce anxiety. Privacy is crucial, with soundproof consultation rooms and secure layouts protecting patient confidentiality. Technology integration further modernises these facilities, from telemedicine-ready rooms to advanced IT infrastructure for electronic health records. Combined with energyefficient systems and sustainable materials, these features ensure long-term functionality and environmental responsibility. Lastly, the external appearance of these new healthcare hubs must harmonise with the high street’s character, preserving its visual appeal while signalling the availability of essential services. Adding green spaces or community-friendly features can further enhance the neighbourhood’s vitality. With careful planning and innovative design, the UK can turn vacant high street properties into thriving healthcare centres that support both health and community regeneration. It’s a blueprint for transformation that merges practicality with vision, promising a healthier and more vibrant future for all. . Helen Adkins Editor [email protected] Editor’s Letter January 2025 A prescription for the high street
23 25 7 12 31 18
IN THIS ISSUE... January 2025 7 News All the latest news in the sector, from achieving a net zero future for Royal Shrewsbury Hospital and DNV Imatis’ new Digital Patient Journey Experience Centre to the merging of two leading health estates consultancies 9 Five machine learning trends for 2025 As artificial intelligence (AI) and machine learning (ML) dominate headlines and reshape everyday practices within healthcare, we look at the five machine learning trends of 2025 12 Arthur J.E. Child Comprehensive Cancer Centre The Arthur J.E. Child Comprehensive Cancer Centre is the largest of its kind in Canada and will offer both state-of the-art cancer care and world-class research. Helen Adkins speaks to the people behind the project 18 Health on the high street The resurgence of the Health on the High Street trend could be key for boosting the nation’s ailing high streets, while supporting a struggling NHS. We hear from two experts on how the concept may work and the practical considerations involved 23 Winter excavation To help avoid potential accidents while excavating during the colder months, experts at Integrated Fencing explain what extra considerations need to be taken into account when carrying out work 25 Lithium-ion batteries in healthcare facilities Daniel Robins, projects director at CheckFire, explores the strategies healthcare facilities can implement to mitigate fire safety risks associated with lithium-ion batteries 31 Water conservation Water usage in healthcare environments is often wasteful. Richard Braid, managing director at Cistermiser and Keraflo, explains how an effective conservation strategy can help to save this precious resource 9
CONSULT CONSTRUCT MAINTAIN After your facility is up and running, the same team remains your first point of contact for ongoing training and maintenance. We understand that construction projects can be complex, and that's why we're dedicated to offering a reliable, approachable and friendly aftercare service. We're not just building healthcare facilities; we're building relationships. And we’re committed to our clients every step of the way. Our end-to-end construction solution brings together development, design, construction and funding expertise for healthcare projects throughout the UK. We offer a full-service package from project conception to completion - and our commitment to you doesn't just end when construction does. East Suffolk and North Essex NHS Foundation Trust University Hospitals Plymouth NHS Trust
healthcaredm.co.uk 7 NEWS Multidisciplinary built environment consultancy Edge has been reappointed to the Procure Partnerships (PPF) Professional Services Framework, with the firm set to deliver project management, quantity surveying and building surveying services across all nine available subregional lots. The company’s inclusion in the secondgeneration framework streamlines the procurement process for public sector organisations. This will enable Edge to provide long-term support to public sector clients across the North East, Yorkshire, North West, West Midlands, East Midlands, as well as East of England, London, South East and South West. The PPF framework will provide flexibility for clients to procure projects via two Edge reappointed to Procure Partnerships Professional Services Framework complex dormitory eradication works for Derbyshire Healthcare NHS Foundation Trust, Sheffield Health & Social Care NHS Foundation Trust, Bradford District Care Trust NHS Foundation Trust, Manchester Metropolitan University, University of Sheffield and Chesterfield College. ■ www.edgeps.co.uk stage, single stage, or direct award routes, while promoting a long-term partnership over the next four years. This marks a significant milestone for the consultancy, which has continued to exponentially grow in its portfolio of public sector projects since its allocation on the first-generation framework. It has delivered ten major projects including Wandsworth Healthcare, UK provider of advanced nurse call solutions, has opened a new Digital Patient Journey Experience Centre which aligns with the Government's Hospital 2.0 initiative. The state-ofthe-art facility showcases the latest integrated digital solutions designed to streamline healthcare operations and enhance the patient journey – from the point of arrival through to discharge. Located at Wandsworth’s headquarters in Woking, Surrey, the new centre combines the company’s own advanced nurse call solutions with a comprehensive range of innovative digital healthcare solutions from DNV Imatis, a leading Scandinavian digital healthcare solutions provider, with whom Wandsworth announced a collaboration earlier this year. The centre incorporates a range of integrated digital solutions designed to address the fundamental challenges NHS trusts face, including task management, bed capacity management, alarm management and patient engagement. These solutions can manage patient flow, optimise operational efficiency, enhance staff productivity and improve patient safety and the overall patient experience. However, the new centre brings them all together under one roof for the first time, along with smart tech such as switches and sockets, thermostats and control systems from Wandsworth’s parent company, German building technology specialist Gira. All of the centre’s digital solutions are interconnected using KNX technology from Gira. KNX, an open standard for commercial building automation, enables the control of heating, lighting and ventilation in a single platform. By enabling patients to control their environment, this solution not only reduces energy consumption but also enhances patient experience by supporting their circadian rhythm through personalised lighting and blind adjustments. ■ To find out more, visit www.wandsworthhealthcare.com/ digital-patient-journey-experiencecentre Wandsworth Healthcare and DNV Imatis unveil new Digital Patient Journey Experience Centre
8 healthcaredm.co.uk NEWS Two UK estates consultancies have announced their plan to merge, creating a significant new health estates advisory business which will operate nationwide. East Yorkshire-based Shared Agenda and Leeds-headquartered Community Ventures will merge in January 2025, creating a larger estates consultancy Sewell Advisory. The new business will employ more than 60 people and will operate across the UK. The two businesses have already been working together on projects for some time, with both being part of the wider Sewell Group of companies. The decision to formalise the merger was made to help grow the company and ensure all clients could benefit from the strength and depth of expertise available across both businesses. As part of the wider Sewell Group, both companies are part employee-owned, and were named in the Sunday Times Best Places to Work list in 2024. Current Community Ventures chief executive Emma Bolton will become CEO of new company Sewell Advisory, with Shared Agenda chief executive Tim Wigglesworth moving to a role as director of Partnerships across the wider Sewell Group, and also continuing as chief executive of Hull Citycare. Emma has previously worked across local authorities and the NHS, including at NHS Property Services and NHS England, and as director of Estates and Fleet at Yorkshire Ambulance Service. Sewell Advisory will specialise in strategy, development and management of public sector estates, particularly in the health, social care and education sectors. The new company will bring together professionals to offer strategic advice, project and programme management, health planning and operational estate management, and will Two leading health estates consultancies to merge also have a dedicated team of digital and data experts. Shared Agenda and Community Ventures are both estates consultancy firms, with a team of multi-disciplinary consultants who work to solve estates challenges in the health, education, public and commercial sectors. The company manages an estate portfolio of around 150 properties, with a combined value of over £250 million. They are also involved in managing a third of the country’s NHS Local Improvement Finance Trust (LIFT) buildings, including over 80 health centres across the north of England and East Midlands. ■ sewell-advisory.co.uk Left to right: Claire Harrison, Emma Bolton, Jonathan Turner, Nikola Idle and Peter Jones Heat pumps, solar panels and energy efficiency measures will be introduced at Royal Shrewsbury Hospital (RSH) as part of a £16.2m decarbonisation project which will reduce the site’s carbon footprint by over 3,000 tonnes a year. The Shrewsbury and Telford Hospital NHS Trust, which runs RSH, secured funding through the Public Sector Decarbonisation Scheme, and have partnered with Vital Energi, who have developed the scheme. Vital Energi will install a 1.6MW air and water source heat pump system, which will provide low carbon heating, hot water and chilled water to buildings across the hospital site. This will enable the Trust to remove the old steam boilers and associated gas-fired equipment. The £16.2m grant will also fund a range of energy conservation measures such as 675kWp solar panels, the upgrade and optimisation of the building energy management systems, upgrades of roof and pipework insultation, and the replacement of air handling unit fans units with low-energy fan systems. As part of the project, the development of a Digital Twin of the heating and cooling systems will form part of the decarbonisation works. This will be used to gather insights of the existing system in order to optimise the design, while ironing out any inefficiencies, thereby maximising the performance of the heat pump system, as well as the reliability. When the work is complete, the investment could save the Trust an estimated £1m a year in energy costs, and will support the Trust’s Estates Decarbonisation Strategies, Green Plan and national NHS ambitions of reaching net zero by 2040. The project is being delivered through the Carbon and Energy Fund Framework, which has been specifically created to fund complex energy infrastructure upgrades for public sector organisations. It has also received grant funding from the Public Sector Decarbonisation Scheme (PSDS), which is administered by Salix on behalf of the Government’s Department for Energy Security and Net Zero (DESNZ). ■ New zero future for Royal Shrewsbury Hospital
healthcaredm.co.uk 9 NEWS Five machine learning trends for 2025 As artificial intelligence (AI) and machine learning (ML) dominate headlines and reshape everyday practices within healthcare, Dr Russell Hunter, AI and Data Science academic lead at Cambridge University, outlines the five machine learning trends of 2025 Following critical concerns raised in the Darzi report and Sir Keir Starmer’s pledge to digitise the NHS, there is now widespread interest in how ML could transform the healthcare sector. Questions about how the healthcare industry applies ML are frequently searched, with common queries including ‘How is machine learning used in healthcare? and ‘Does the NHS use machine learning?’. IBM’s latest global AI adoption index found that 42% of enterprise-scale companies now claim to be actively deploying AI in their business. Here are the five machine learning trends for healthcare providers to look out for in 2025. EXPLAINABLE AI (XAI) XAI aims to make AI decisions understandable to humans, enhancing trust and regulatory compliance. When you build a model to solve a particular problem, it is often more difficult to persuade stakeholders to come on board. In fact, in many cases they would prefer a less optimal model that can be visualised and understood more easily than jumping on board with some kind of mysterious model that works for unknown reasons. This is especially important when it comes to healthcare or finance. In healthcare, XAI provides explanations for diagnostic decisions or treatment recommendations made by AI systems. These explanations are crucial for doctors and patients to trust and act on AI-driven insights, ultimately improving patient outcomes. AI models used for predicting patient risks, such as the likelihood of developing a certain disease, need to be clear and understandable to ensure that healthcare providers can grasp the underlying factors behind the risk assessment. AUTONOMOUS DECISION-MAKING These advanced systems are transforming healthcare by accelerating the speed and precision of decision-making, driving greater efficiency and enhancing customer experiences. By automating manual processes, ML technologies can increase businesses’ abilities to analyse vast amounts of data quickly, while uncovering patterns and making informed decisions. These autonomous systems can be applied to the healthcare industry. Sophisticated multimodal AI can >> TECHNOLOGY
10 healthcaredm.co.uk NEWS analyse genetic data and patient histories to recommend personalised treatment plans. This leads to more effective and individualised health care. Similarly, by leveraging data from electronic health records, these systems can predict patient outcomes or complications, which allows for proactive intervention. AGENETIC AI Agentic AI represents a significant advancement beyond classical reactive AI by being designed to proactively set its own goals and take autonomous actions to achieve them. These proactive systems not only enhance patient care but also have the potential to alleviate the burden on healthcare professionals by automating routine monitoring and treatment adjustments. In the realm of personalised healthcare, agentic AI can revolutionise patient care by continuously monitoring patient health metrics and autonomously administering medication as needed. For example, an agentic AI system could monitor a diabetic patient’s blood sugar levels in real-time and administer insulin precisely when required, thus maintaining optimal glucose levels and reducing the risk of complications. Another application is in personalised treatment plans for chronic diseases. Agentic AI can analyse vast amounts of patient data to predict disease progression and suggest tailored treatment plans. For instance, in oncology, agentic AI can process data from medical records, genetic profiles and treatment responses to recommend personalised chemotherapy protocols, potentially improving outcomes and minimising side effects. EDGE AI Another cutting-edge development, Edge AI, brings an immediate processing capability which is crucial for applications in healthcare monitoring, where time-sensitive tasks require prompt responses. This is achieved by processing data locally on the device, Dr Russell Hunter works within the Department of Engineering at the University of Cambridge and leads Cambridge Advance Online’s Leveraging Big Data for Business Intelligence course. For an in-depth look at these insights and additional trends across industries, read Dr Hunter’s machine learning trend analysis on www.advanceonline.cam.ac.uk/blog reducing latency, enabling real-time decision-making and minimising the amount of data that needs to be transmitted to central servers. By processing sensitive information locally, this also enhances privacy and security, reducing the risk of data breaches during transmission, something specifically important with healthcare data. However, challenges such as hardware limitations, integration complexity, and the need for efficient management and maintenance of numerous edge devices, curtail the full effectiveness of edge AI. AUGMENTED WORKFORCES While there are concerns that AI will replace humans in the workplace, the latest AI developments can augment ‘Rather than eliminating jobs, AI reshapes them, leading to the creation of new roles that require managing, programming and collaborating with AI systems’ rather than undermine human contributions. AI can assist doctors by analysing medical images and patient data, identifying patterns that might be missed by the human eye. This allows doctors to make more accurate diagnoses and develop personalised treatment plans, thereby improving patient outcomes and operational efficiency. This collaboration between humans and AI combines the strengths of both, allowing AI to handle repetitive, dataintensive tasks while humans focus on strategic, creative and interpersonal activities that require emotional intelligence and critical thinking. Rather than eliminating jobs, AI reshapes them, leading to the creation of new roles that require managing, programming and collaborating with AI systems. It is crucial to keep an eye on these developments as a healthcare leader, to ensure your organisation is fully equipped to gain an edge by leveraging AI and ML. ■ TECHNOLOGY
BATH-OVER-BATH SHOWER-OVER-SHOWER Hospitality Health Multi-unit Cruise ships Student Accommodation Military Assisted living Council housing CONTACT US FOR MORE INFORMATION 020452 52255 BATHFITTER.CO.UK +353 01 592 1717 BATHFITTER.IE A BETTER WAY TO RENOVATE For 40 years, Bath Fitter has revolutionized bath renovation. Our process puts a new bath or shower in place in as little as one day, with no messy demolition. Best of all, our product is built to last for a lifetime. INDUSTRIES SERVED
12 healthcaredm.co.uk PROJECT Bringing biophilia to cancer care Opened in 2024, the Arthur J.E. Child Comprehensive Cancer Centre in Calgary is the largest cancer care facility in Canada and second-largest in North America, and has been designed to elicit positive psychological responses among patients, fostering feelings of trust, comfort and hope to promote healing. Helen Adkins talked to architect Diego Morettin The Arthur J.E. Child Comprehensive Cancer Centre in Calgary, Canada, is a monumental achievement in healthcare infrastructure. With a $1.4 billion CAD budget and an expansive 127,000 m² footprint (approximately 1.4 million square feet), the centre is designed to deliver advanced, integrated cancer care to Albertans. Its goal is to improve outcomes and expand access to cutting-edge treatment for a large and diverse population through an interdisciplinary approach that unites research, education and patient- and family-focused care. The centre offers a comprehensive range of services and facilities, integrating treatment, education and research, which includes 100 exam rooms, 100 chemotherapy chairs, 160 beds and 15 radiation vaults, plus an MRI Linac suite. The hospital also offers specialist surgery with a brachytherapy MRI suite, plus medical research laboratories, diagnostic imaging services and a robust support programme for patients, both pre- and post-treatment. Catherine Zeliotis, clinical lead at engineering services company Stantec, explains: ‘Key to the model of care is the emphasis on outpatient services, interdisciplinary care integrating research and teaching, and innovative diagnosis and treatment, all supported by psychosocial, physical and supportive care throughout the cancer journey.’ The importance of education, teaching and research is also exemplified by the inclusion of the Knowledge Centre and the direct link to the adjacent University of Albert via the skybridge connector. At the heart of the hospital’s design is a seven-story podium and a five-storey tower, forming two curving L-shaped structures that surround an all-season exterior garden and courtyard. This design reflects a critical shift in modern healthcare facilities in the country, enhancing both the patient experience and the healing process through design innovation and biophilia. DIALOG, in collaboration with Stantec, played a key role in shaping the centre’s design. Together, they were responsible for architectural and interior design, as well as structural, mechanical and electrical engineering. Their work extended to landscape architecture, planning and urban design, ensuring a holistic approach to the centre’s development. BIOPHILIC PRINCIPALS Diego Morettin, partner and architect at DIALOG, shares his overarching vision for the centre, which emphasised biophilic principles and an holistic approach to patient care. By integrating treatment, Location: Calgary, AB Client: Alberta Health Services Completion: 2024 Collaborators DIALOG Stantec Smith + Andersen PCL Construction Management Inc.
healthcaredm.co.uk 13 PROJECT diagnostics, support and research within a single location, the centre provides patients with a holistic and comprehensive care experience. A key aspect of this project was the significant influence of the patient voice, which shaped the design brief. Patients shared their experiences of cancer treatment, highlighting their spatial needs and specific requirements for the facility. Morettin explains: ‘One of the things that was very clear from the beginning was that the design should support the patients and give them a sense of hope. They spoke about a place that was connected to nature, that was filled with daylight and that would allow them to connect this to their care experience through their entire journey. They talked about their previous hospital experiences – of walking into spaces that had no windows or natural light, and of disorienting corridors and waiting areas, and not being able to see any of the physicians or nurses who were going to ‘When we spoke to the patients, they said, think of us as people that have this range of emotions – we want to be in a space that is uplifting and celebrating our strength, but we may also need moments of respite and quiet’ be treating them. They often felt isolated and alone. At no time does that happen in this facility.’ Zeliotis adds: ‘The patient voice underlays the key design decisions. The Patient Advisory group was embedded throughout the design participating fully in all our design workshops, a truly remarkable collaboration and representing over 4,000 of patient hours.’ A HOSPITAL WITH A HEART The surrounding geography – characterised by grasslands, Aspen trees, the quality of light and rolling hills – is unique to the area and heavily informed the design of the building. ‘I’m very passionate about the light,’ Morettin enthuses. ‘I live in Toronto, but I have spent a lot of time in the mountains in this region, and the light quality in the foothills is amazing – crisp, clean and radiant. We really wanted to make sure that this light and surrounding nature influenced the design in some way.’ To achieve a harmonious partnership between nature and the hospital, the building is composed of two L-shaped forms that wrap around the courtyard, creating an embrace-like gesture open to the sky, flooding the area with daylight. This landscaped courtyard serves as the heart of the facility, offering spaces for gathering, a family learning area and a spiritual space for >>
14 healthcaredm.co.uk PROJECT intimate moments of reflection. Morettin says: ‘The notion of an embrace was very powerful for us because it gives help and nurturing, but also strength. When we spoke to the patients, they said, think of us as people that have this range of emotions – we want to be in a space that is uplifting and celebrating our strength, but we may also need moments of respite and quiet.’ The building is organised by five interdisciplinary communities of care that bring caregivers together with their patients and families to create like-minded care services that are part of the patient’s journey. They are: the Radiation Therapy community of care, the Welcome community of care, the Outpatient community of care, the Research community of care and the Inpatient community of care. The Radiation Therapy, Welcome and Outpatient communities are organised around the courtyard, at the podium levels. The main entrance – known as the town square – is immediately connected to the courtyard, with direct physical and visual connection to the learning centre, spiritual care spaces and research areas. Morettin explains: ‘It was designed this way to support and promote interdisciplinary care and teamwork, and for the patients to feel connected to their care environment, as well as to the research, caregivers, world class treatment programmes and nature. All of these elements are visible and there is power in that.’ The building itself is set back along 29th Avenue, with an extensive community garden featuring indigenous plant species, grasslands, trees and welldefined pedestrian pathways. Rooftop gardens on the top floor of the podium are both visible and accessible from the inpatient rooms. Additionally, an intimate series of courtyards adjacent to each radiotherapy waiting area provides a natural connection for approximately ten patients, ensuring they also remain connected to nature. The main podium is primarily oriented inward toward the courtyard on the lower levels. The tower above the podium is designed to have unobstructed views from every patient room of the city skyline to the east and the Rocky mountains to the west. Morettin emphasises the importance of familiarity with one’s environment and access to views for patients. ‘We thought it was important for patients with longer stays to be reconnected with things very familiar in terms of your city and surroundings,’ he says. ‘This is important because the mountains have a majestic beauty – which is probably why you live in Calgary – and then there’s the Downtown skyline. Skylines have always really captivated me, whether it’s the New York skyline, my own Toronto skyline or the London skyline, because they automatically connect you with your relationship to a place – it is familiar and it gives you strength. BALANCING TECH WITH NATURE So, how were the technical requirements of this hospital balanced with the goal of enhancing patient experience? Morettin says consistency was the key, >>
Specialising in modular construction for 90 years CONTACT US TODAY 0800 18 18 22 | www.wernick.co.uk [email protected] Find out more Scan the QR code 50+YEARS DESIGN LIFE SUSTAINABLE CONSTRUCTION FULL PROJECT MANAGEMENT MINIMUM ON-SITE TIME FLEXIBLE RELOCATABLE WERNICK MODULAR BUILDINGS DELIVER... WINNER! Project of the Year for Commercial/Retail/Offices MMC AWARDS 2024 Project: Southmead Hospital executive offices 1
16 healthcaredm.co.uk PROJECT DNA of each floor plate. That allowed us to have a consistent approach where, on every floor, the patient’s journey follows the organisation of the building, from inward to outward, from public spaces to treatment spaces. ‘Staff retention is also of huge importance, especially in a cancer centre where the emotional care aspects are so heightened. Careful consideration was given to providing places of respite connected to daylight with outside access. They were carefully placed in between care areas to foster collaboration between clinicians and researchers.’ He admits, however, that creating meaningful natural spaces in an urban site was a huge challenge. The original plot consisted of an asphalt parking lot surrounded by a major highway on one side, a major road on the other and an existing hospital campus, with no significant natural features. especially in the initial stages when trying to meet the challenge of creating a journey of hope and support for the patient, while meeting the technical and service requirements of a large hospital. He says: ‘First of all, putting a courtyard at the very centre is a unique concept, certainly here in Canada. We carefully studied the size and scale of programme elements and balanced the scale of the courtyard with the programme needs on each floor. ‘We were able to separate public circulation from service and patient flows by consistently organising public circulation around the courtyard on all floors. The service and patient flows are offset along the perimeter of the building with dedicated back-of-house access to service elevators. We didn’t have to sacrifice any part of the patient journey. In fact, we thought of those requirements first and built it into the ‘To create natural spaces was a challenge, and then to do that as well as accommodate complex programme elements such as linear accelerators is even more so. These have to be installed into big vaults and are difficult to build ‘First of all, putting a courtyard at the very centre is a unique concept, certainly here in Canada’ around. That we were able to achieve such an amazing public patient amenity and landscape space within an urban environment is very unique.’ FUTURE PROOFING As far as the future lies, the robust structural framework of the centre has been designed to accommodate change over time. While the building features curvilinear forms and cantilevers, the designers maintained a rigorous grid spacing and structural system throughout. The radiotherapy vaults were built outside the main building footprint to allow for an optimum structural design and easy replacement of the complex medical equipment. Additionally, the mechanical and electrical building systems have been designed to support adaptability as needs evolve. That said, Morettin doesn’t envisage this site significantly increasing in size within the next 10 or 15 years. As for future projects, he hopes the principles of biophilic design showcased in this project will remain central to his work going forward: ‘This project is special because we have achieved so many of those things we set out to do with respect to creating healing environments that have meaningful connection to place, nature and daylight. It makes me evermore optimistic that we can continue to achieve these goals on all our projects.’ Reflecting on the centre’s impact on patients and staff, Morettin shares: ‘I got an amazing email from one of the doctors, describing how special it was to see the centre come alive and embrace over a thousand patients on the first day.’ Yet, despite its scale, Morettin highlights the project’s sense of intimacy: ‘This is a project that actually feels very intimate. The continuous circulation around a central space, in an interesting way, creates a smaller footprint because it’s a much more vertical building. The strong physical and visual presence to gardens and the outdoors, on all levels, makes you feel like everyone is connected. Even though it’s a large building, I never feel overwhelmed by it. I think it’s exceptional.’ ■
EXPERT DESIGN Refurbishments, upgrades and new builds MAINTENANCE Nationwide coverage INSTALLATION All sizes of projects BIM 3D Modelling [email protected] 01494 782168 www.shj.co.uk DELIVERING LEADING INNOVATIONS TO THE HEALTHCARE AND LABORATORY SECTORS FOR OVER 50 YEARS MEDICAL & LAB GAS SYSTEM DESIGN INSTALLATION AND MAINTENANCE DesignSafeCover For guaranteed confidence in your medical gas pipeline system (MGPS) Office: 01246 474 242 | E-mail: [email protected] www.beaconmedaes.com/en-uk | www.mymedgas.com/en-uk •Our unique new DesignSafeCover takes compliance risk away from consultants and customers •Come to us for MGPS designs and installation, and we’ll guarantee that design is completed in line with HTM 02-01 guidelines and will work as specified for the life of the system •BIM modelling ensures accuracy - we know the designs are right, so we can be absolutely confident that as long as it is follows our design and install standards, the installation will be too BeaconMedaes is the global leader in end-to-end medical gas pipeline solutions (MGPS). Our expertise encompasses manufacturing, design, drawing services, site surveys, installation, preventative maintenance and equipment servicing. That’s a huge weight off your shoulders
18 healthcaredm.co.uk HEALTHCARE ESTATES The drive towards health on the high street There are many lasting impacts of the Covid-19 pandemic, not least the changes to the way the UK approaches its healthcare. While many of the initiatives may have been reactive responses to a crisis, when it comes to adapting and increasing health services for communities, it is certainly still a major priority. The resurgence of the Health on the High Street trend could be key for boosting the nation’s ailing high streets, while supporting a struggling NHS. Pick Everard director of cost management, Mark Dando, outlines the concept, while Jim Hart, director at Corstorphine & Wright architects, explores the practical considerations involved with repurposing retail spaces into healthcare hubs Over the past few years, the Health on the High Street (HOTHS) movement has taken shape in various ways. HOTHS was first mentioned in an NHS Confederation report in 2020, with a concept of ‘reimaging the connection between the NHS and the high street’, and the role health could play in supporting economic and social recovery. More broadly, it was proposed as a way for the NHS to get directly involved in high street policy, supporting communities through the reshaping of vacant high street units into integrated health centres, thereby revitalising footfall into our town centres. But while the idea has been explored in recent years, its implementation has been gradual, with local authorities tackling a significant £6.2 billion national funding gap which has the potential to affect the adoption and redevelopment. The concept is, however, gaining momentum, helping to improve healthcare accessibility in a more sustainable way, with a green building, retrofit and redevelopment rhetoric now firmly established in national and industry consciousness. An example of this was the Sands Centre in Carlisle, which commenced in 2017 to support an aging infrastructure. NHS trust operators saw this as a good opportunity to improve resources within a community hub, with the new sports centre strategically located with NHS physiotherapy services nearby to support rehab patients. The practice more overtly Defunct shops and shopping centres can be repurposed for the 21st century
healthcaredm.co.uk 19 HEALTHCARE ESTATES shows the health benefits of having sport, fitness and wellbeing so closely integrated together, as well as making a great deal of sense from an accessibility view. We are also seeing commercial spaces, including retail units both small and large, undergoing refurbishment across the country. One project we are currently working on is transforming a vacant unit within a busy shopping centre into a space for an ophthalmology department for an NHS trust. This will enable the specialist healthcare department to relocate into a bigger space in a central location with high footfall, making it easily accessible and convenient to the public, while removing the fear factor many people face when entering a hospital environment. This is a good example of how our defunct shopping centres can be repurposed for the 21st century and help build healthier, more resilient cities. This change will also ease pressure on departments in overcrowded hospital sites that are much need of extensive refurbishment. BENEFIT BY INTEGRATION HOTHS initiatives make healthcare services more accessible to residents, especially in rural areas where travel distances can be significant. And when it comes to those residents needing to make a journey, it makes sense to use this as a way to bring people back into town centres and really revitalise our high streets. As much as it is about bringing healthcare provisions into ‘The successful implementation of HOTHS requires careful planning and consideration of logistical factors, such as location and accessibility.’ centralised areas, HOTHS also has the potential to contribute to economic growth and support local businesses by increasing footfall in surrounding areas. Overall, there is also the potential for improved health outcomes and enhanced wellbeing, with these convenient and accessible services promoting preventive care and early intervention. This is particularly the case when we consider what makes people reluctant to visit their GP – if it feels like a difficult trip to make, it can be simplified by bringing services into more familiar locations, or we can strip away pressure from NHS hospitals by integrating some of the most >> Busy shopping centres can offer space for specialist healthcare departments Horizon Leisure’s Wellbeing Hub, in the Meridian Shopping Centre and supported by Havant Borough Council, serves as a hub for health services and fitness
20 healthcaredm.co.uk HEALTHCARE ESTATES High street retail units, particularly those in larger buildings or shopping centres, offer several practical advantages when repurposed for healthcare use. One of the key benefits is the typically generous floor-to-floor heights found in such spaces. These high ceilings facilitate the installation of vital mechanical and electrical (M&E) systems, such as ventilation and climate control, which are essential for clinical environments where air quality and temperature regulation are paramount. Additionally, converting retail units into healthcare centres contributes to the UK’s Net Zero Carbon targets. By repurposing existing buildings, the process reduces embodied carbon, which refers to the carbon footprint associated with the extraction, production and assembly of building materials. This approach aligns with sustainability goals, ensuring that the development of healthcare infrastructure minimises its environmental impact. TURNING DEEP FLOOR PLANS INTO A DESIGN ADVANTAGE Many high street retail units were originally designed with deep floor plans, which often limit natural light. While this may seem like a drawback, innovative design strategies can turn these spaces into environments that enhance patient wellbeing. Historically, healthcare facilities have been designed with an emphasis on access to natural light in clinical rooms. However, modern technology and design innovations are shifting the focus toward inward-facing layouts that reimagine how space and light are used. Instead of relying on external windows, healthcare spaces can be designed around central biophilic areas, which integrate nature-inspired elements into the built environment. These features – such as plant installations, sky-mimicking LED lighting, and natural materials – create soothing, nature-like spaces that promote wellbeing, even in windowless environments. Imagine a central waiting area surrounded by clinical rooms, with views of a lush indoor garden. This design not only offers a calming environment but also ensures privacy for patients and staff. In healthcare settings, privacy and dignity are crucial. Smart glass and fin walls can be used to create flexible spaces that maintain visual connections without compromising patient confidentiality. This balance between openness and privacy is key to delivering a positive patient experience. We know this model works because Corstorphine & Wright are in the process of delivering the conversion of a former Co-op superstore in Gloucestershire into a modern healthcare facility. The project has received ICB Business Case approval with a design centred around a windowless area transformed into a large community space, intended for various wellbeing activities linked to social prescribing. By seamlessly connecting the central activity space with the waiting area, the facility blends clinical and community functions. Natural materials, including preserved moss and rocks, along with LED lighting mimicking the sky, create a calming, outdoor-like environment, while the space also supports flexible community-led activities aimed at improving public health. ENVIRONMENTAL AND ECONOMIC BENEFITS OF REPURPOSING Repurposing retail spaces for healthcare centres offers significant environmental Jim Hart, director at Corstorphine & Wright architects, explores the practical considerations, design innovations and environmental benefits involved with repurposing retail spaces into healthcare hubs Design from retail to healthcare widely used services, such as X-ray and ultrasound facilities, into local community settings. HOTHS initiatives can also foster a sense of community and support the overall wellbeing of residents. SCALING THE OPPORTUNITIES The successful implementation of HOTHS requires careful planning and consideration of logistical factors, such as location and accessibility. This is why repurposing premises has been seen as an effective way for NHS to deliver more for communities, especially in smaller towns. This could be seen in the way it was utilised during the recent pandemic, when accessible hubs were important for rolling out the mass vaccination programme. This was a prime example
healthcaredm.co.uk 21 HEALTHCARE ESTATES benefits, particularly in reducing the carbon footprint of construction. By reusing existing structures, the process cuts down on the embodied carbon that would have been produced through new construction. Additionally, many retail buildings have reduced solar gain due to their deep floor plans, meaning they require less cooling. This translates into greater energy efficiency and lower operational costs, which is crucial for long-term sustainability. For the NHS and other healthcare providers, these efficiencies contribute to broader sustainability targets. Creating facilities that use less energy not only aligns with the UK's Net Zero Carbon goals but also helps to ensure that healthcare services remain financially viable. This dual focus on sustainability and cost-effectiveness is a smart, forward-thinking approach to healthcare infrastructure. PROMOTING PREVENTIVE CARE: A COMMUNITY-CENTRED APPROACH One of the most exciting opportunities in repurposing retail spaces for healthcare is the potential to make healthcare more accessible and to promote preventive care. A high street healthcare hub could host regular health events such as workshops on managing chronic conditions, cooking demonstrations that promote healthy eating, or exercise classes. By incorporating these activities into the design and flow of the space, healthcare centres could make preventive care a seamless part of daily life. This experiential approach to health education helps normalise healthy behaviours and makes preventive care more accessible to the public. In addition, high street healthcare hubs could form partnerships with local businesses – such as fitness centres, cafes, and pharmacies – creating a more holistic approach to public wellbeing. This model could ultimately foster stronger ties between healthcare providers and the communities they serve. REVITALISING THE HIGH STREET The integration of healthcare centres into high street spaces not only addresses healthcare needs but also supports the wider revitalisation of town centres. According to research from Legal & General, nearly half (48%) of patients who visit healthcare centres located in town centres go on to shop in nearby retail outlets. This creates a symbiotic relationship between healthcare and retail, where healthcare services draw people into town centres, boosting footfall for local businesses. Through thoughtful design – such as the use of biophilic elements, inward-facing layouts and energy-efficient systems – these spaces can enhance patient experience while minimising environmental impact. Moreover, by integrating preventive care and community health activities into these centres, we can make healthcare more accessible and foster healthier, more connected communities. ■ of not always needing traditional healthcare settings to deliver services, demonstrating how effectively it could be done. Our industry has also been completely au fait with retrofit and offsite construction methods that can mitigate operational disruption and shorten project timelines, ensuring that we can deliver opportunities for placement of services elsewhere, quicker and more efficiently. When it comes to external parties, stakeholder engagement has also shown to be an essential part of making HOTHS successful. Only through effective collaboration between local authorities, healthcare providers and community organisations can we begin to make these solutions happen. With the new Labour government, regeneration has been high on the agenda along with a huge push for new housing. As more inner-city populations expand, we are seeing schemes where developers are becoming landlords, and in partnership with local authorities, NHS hubs can be integrated into their sites. With hospitals so saturated, the private market will play an important role in this movement, as well as securing adequate funding and resources that can see these projects through. ADDRESSING FUTURE CHALLENGES The resurgence of HOTHS represents a promising approach to improving healthcare accessibility and revitalising town centres. By providing convenient and accessible healthcare services, these initiatives can contribute to the overall health and wellbeing of communities across the UK. As local authorities and healthcare providers continue to explore this concept, it is hoped we will continue to see innovative ideas to address the challenges, regenerate our high streets, and make our communities more resilient and sustainable for the future. ■ Central locations with high footfall offer accessible and convenient spaces for healthcare hubs Concept designs for high street healthcare facilities by Corstorphine & Wright
Totally Cordless and Maintenance Free. Ideal for Hospitals, Clinics and Surgeries With a choice of magnetically operated or motorised blinds, our double glazed integral blind systems are suitable for both internal and external use. t. 020 8500 2200 www.betweenglassblinds.co.uk Introducing the BGB Blackout – an integral magnetic blind designed to block out all light. A solution to the challenges of nitrous oxide Exhaled or leaked nitrous oxide is a dangerous risk for all hospital staff. A long-lived, potent greenhouse gas, it’s also bad news for the environment. But now you can breathe easy. Our full Sustainability Nitrous Oxide Solution is a game-changing approach to this challenging issue, achieving outstanding results without any reduction in the level of pain relief provided through gas and air. Three key elements unite to provide a safer healthcare environment and support hospital net zero targets: 1. Central Destruction Unit (CDU) - processes 99% of captured exhaled nitrous oxide and releases it harmlessly to the atmosphere. Can be used in 12-14 active treatment rooms at any one time 2. Personal and room monitors - ensure staff exposure levels are accurately recorded 3. MedGasScan acoustic camera - detects leaks on gas pipelines The solution is easy to implement and works seamlessly within existing work practices. Protect your staff, protect the planet – the Sustainability Nitrous Oxide Solution from BeaconMedaes is available now ng-lived, o this challenging issue Greaves Close, Markham Vale, Derbyshire S44 5FB 3ƾGI 01246 474 242 | ) QEMP [email protected] www.beaconmedaes.com/en-uk | www.mymedgas.com/en-uk
RkJQdWJsaXNoZXIy MjQ0NzM=