Evolving healthcare and education priorities could dramatically overhaul future hospitals schools. So what does this mean for building design.
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Digestible sensors that allow diagnosis and treatments to be dispensed at home. Hospital rooms that recreate the in-patient’s lounge and GP surgeries that could be mistaken for yoga studios.
It all sounds a touch sci-fi, but these are examples of seemingly radical changes to the way healthcare is administered that are actually based on today’s technology, according to Suzanne MacCormick, associate director for healthcare advisory at consultant WSP.
Applying the technology
“The technology is there, but actually getting it into the field is the hard thing,” she says.
Understanding the needs of an ageing population with a changing lifestyle means that making headway in adopting new technologies and new healthcare building design is vital.
One example of this principle being applied is in Hong Kong’s Kwong Wah hospital where the needs of the client are being addressed by multi-functional clinical rooms, MacCormick says. There, communicable diseases are of particular concern, so instead of building complex and single service isolation wards, 100 regular single inpatient rooms have been installed that “at the flick of a switch” can be converted into negative pressure isolation rooms suitable for treating those with contagious infections.
Yes there is an additional cost but the client’s priorities warrant it and engineers must be armed with the tools to respond, she warns.
The technology is there, but actually getting it into the field is the hard thing
In the UK, those that hold the purse strings need a little more persuading and guiding toward establishing the right priorities for healthcare facilities, so baby steps are what is needed.
The National Health Service (NHS) is “behind the curve” in terms of the global competition – notably from Sweden, Canada, the US and Germany, says MacCormick. This is understandable because it is a “very big machine to turn around”. Regardless, the engineering approach needs to be robust.
Instead of just “building buildings” because that constitutes “a total waste of money”, he says, the focus should be on what purpose the building serves.
Get the services right first
“Get the services right in the first instance and then wrap the building around them,” she advises.
“The technical [challenge] is in saying ‘we know we’re building a building that is not built for life but that will absolutely morph and change’,” she says and in most hospitals a change of use probably starts “the day you cut the ribbon”, she warns.
Flexible space provision in practice means building in adaptable steel structures, making the most of offsite and modular construction and looking at how hospital rooms are clustered together.
Altogether, design and construction must allow for internal changes, “much like a giant, robust Meccano set”, suggests MacCormick.
This is likely to mean higher design costs up front, she points out, but WSP has carried out work with quantity surveyors that suggests at the first significant change made in a more adaptable hospital building, the work has paid for itself in preventing loss of investment in a building that has begun to lose its usefulness.
The hope for is that further work to prove the cost efficiencies will start to encourage the Department of Health and Social Care to invest up front. But at the moment, the smaller scale services are where the case can be made more readily.
MacCormick illustrates this with an example from East London where a congested local GP practice has succeeded in easing the burden by shifting 70% of its consultations onto the telephone.
That, plus encouraging visits to surgeries that double up as wellbeing centres complete with educational and gym-style facilities – of which there is a trial in central Bedfordshire – means individuals should gradually become more proactive in treating and preventing illnesses associated with ageing, for example.
Robot-delivered medical care may still be some decades away, MacCormick suggests, but the buildings that house day to day healthcare could quite easily begin to look dramatically different very soon.
A fresh approach to public building design is evolving over in the educational sector too – and there can be few better examples of this working than at a multi-award winning school in central London.
People may forget that one of the UK’s wealthiest local authorities is also one where urban density and social infrastructure is critically important.
The Royal Borough of Kensington and Chelsea’s Marlborough Primary School was in desperate need of attention. It was a compact, overlooked Victorian school suffering from awkward sized classrooms, measly outside play areas and a pressing need to adapt to a wider range of pupils – including a growing number of autistic children.
Marlborough Primary School
After careful planning – and a vital funding boost – the new school is not only performing for the children but is a genuine provider of social amenities for the wider public.
The design is remarkable and has increased pupil capacity by 150% across a larger two-form entry school, a full-time nursery and an autism centre. A highly engaged headteacher helped the project team to keep focused on placing the pupils’ interests at the heart of the £22M scheme, and the result has won accolades including Social Infrastructure Project of the Year at the British Construction Industry Awards (BCIA), along with two prestigious gongs from the Royal Institute of British Architects.
BCIA judges said: “The constrained space from the perimeter has been carefully and impressively worked at to create imaginative, inclusive spaces internally and externally.”
A generous budget was handled “with great care and total focus on the needs of the staff and children”, they added.
Externally the multi-level rooftop landscaping brings nature into the heart of the city as well increasing exercise and sport facilities.
Beyond this, the use of the building beyond the working school day has established a lucrative funding stream for the school – not least because the imaginative inclusion of a dance studio is now in use as a local yoga studio and base for the Chelsea Ballet School.
Architect/lead consultant Dixon Jones
Structural engineer Waterman
M&E consultant Arup
Landscape architect Macgregor Smith
Main contractor Mace