APRIL 2025 | £8 healthcaredm.co.uk healthcare design & management Building to Passivhaus standards We talk to the architects behind the Shrewsbury Cavell Health and Wellbeing Hub The Silent Hospital project Harnessing innovative technology to enhance both patient experience and staff efficiency Military healthcare As the NHS grapples with unprecedented challenges, solutions may come from an unexpected source A biophilic award-winning design for elective care Heatherwood Hospital Also in this issue:
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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 Heatherwood Hospital was rated the best elective care centre in England by patients 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 Welcome to the latest issue of Healthcare Design & Management, where we explore the ideas, projects and innovations shaping the future of healthcare environments across the UK and beyond. In this edition, we focus on the intersection of design excellence, environmental performance and operational resilience – showcasing how the built environment can support both clinical outcomes and patient experience. Leading the issue is an in-depth look at the new Shrewsbury Health and Wellbeing Centre, a landmark project aiming to meet Passivhaus standards. As the NHS strives toward more sustainable and energy-efficient infrastructure, this scheme sets a new benchmark for future development. On page 10, we talk to the architects who offer valuable insights into what it means to deliver a low-carbon, high-comfort healthcare facility that aligns with the wider goals of the NHS Net Zero agenda. We also feature a detailed conversation with the architects behind Heatherwood Hospital in Ascot (p 16), recently rated the best elective care centre in England by patients. Their approach reveals how thoughtful design can significantly enhance the patient journey, support staff wellbeing and contribute to exceptional clinical outcomes. Elsewhere in this issue (p 21), we examine how technology is being deployed to create quieter, calmer hospitals, with new approaches helping to reduce stress, improve recovery times and create more efficient environments. We also consider what the NHS might learn from beyond its own walls. On page 32, Mark Gostock, VP of Health and Wellbeing at Ploughshare, explores how design and logistical solutions developed by the military could help the health service respond more effectively to complex challenges. Together, these stories highlight the breadth of innovation at play across healthcare design and management today. As the sector continues to adapt to rising demand, sustainability imperatives and shifting models of care, the need for agile, intelligent design has never been greater. . Helen Adkins Editor [email protected] Editor’s Letter April 2025 Designing for better care: Innovation, sustainability and the future of healthcare spaces
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IN THIS ISSUE... April 2025 7 News UK healthcare leaders are revising their strategic plans, driven by mounting global economic pressures and cybersecurity threats, while the Government has approved funding for the modernisation of James Paget University Hospital (JPUH) in Great Yarmouth 10 Passivhaus at the Shrewsbury Health and Wellbeing Centre The NHS England initiative to pilot six super health hubs – dubbed Cavell Centres – aims to revolutionise healthcare delivery, with one being designed to adhere to Passivhaus standards. We talk to the architects involved 16 Best elective care at Heatherwood Hospital Designed by multidisciplinary design practice BDP, the Heatherwood Hospital in Ascot has been named the best elective care centre in England by patients. Helen Adkins spoke to Sean Woodhead, associate architect at BDP, about the project 21 Achieving the silent hospital The Royal Cornwall Hospital’s NHS Trust, with the help of DNV Imatis and Wandsworth Healthcare, is transforming the postnatal ward experience, creating a calmer, more efficient space for patients and staff 25 Project: The Child Development Centre at Crawley Hospital A look at Sussex Community NHS Foundation Trust’s new state-of-the-art facility, dedicated to supporting children with developmental needs, that has not only revitalised the physical environment but enhanced the quality of care 29 Watercoolers in healthcare With summer around the corner, the need for adequate hydration in healthcare environments is crucial, yet steps must be taken to avoid problems with bacterial growth. Peter Gunn, senior consultant at the Water Hygiene Centre, explains 32 Comment: Miliary healthcare As the NHS grapples with unprecedented challenges, solutions may come from an unexpected source: the military. Mark Gostock, VP of Health and Wellbeing at Ploughshare discusses how frontline innovations could transform the NHS 21 16
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healthcaredm.co.uk 7 NEWS Morgan Sindall Construction’s Northern Home Counties business has handed over a state-of-the-art Radiotherapy Centre to Milton Keynes University Hospital (MKUH) NHS Foundation Trust. The Radiotherapy Centre is one of three projects Morgan Sindall has been working on at MKUH. The tier one contractor is also in the process of constructing a brand-new imaging centre and expanding the hospital’s bed capacity with a new ward facility, Oak Wards. All three projects were procured through the PAGABO framework and have a combined value of £53.6m. The £17.6m two-storey radiotherapy centre includes two state-of-the-art medical LINAC bunkers, as well as a main reception, consultation rooms and a CT scanner area, all connected to the hospital’s recently opened cancer centre via a link corridor. The services in the radiotherapy centre will be run by Oxford University Hospitals with the aim to improve access to radiotherapy for patients who must currently travel to other hospitals to receive treatment. A 43-bay car park has also been built, providing a purposebuilt space for a mobile PET-CT Scanner. The £18.1m Oak Wards facility is set to be completed by early 2026 and will increase MKUH’s ward capacity by providing two 24-bed wards. The £17m imaging centre is due to be completed in March 2026. ■ Morgan Sindall completes first project of Milton Keynes healthcare trifecta The Government has approved funding for the expansion and modernisation of James Paget University Hospital (JPUH) in Great Yarmouth, according to a master plan and design by Perkins&Will. One of the seven hospitals originally constructed with reinforced autoclaved aerated concrete (RAAC) included in Wave 1 of the Government’s New Hospital Programme (NHP), the project is scheduled to be delivered by 2032. Health Secretary, Wes Streeting, recently reconfirmed the Government’s commitment to the NHP, the flagship scheme designed to deliver an upgraded NHS. JPUH provides general acute and specialist services for around 300,000 residents in East Anglia, plus a significant number of tourists who visit the area. Perkins&Will developed the proposal in alignment with the NHP’s Hospital 2.0 guidelines. The design team is currently working with the NHP to fine tune the concept. The master plan creates a framework for future development, expansion of the main acute hospital, and provision of ambulatory care, staff training and administration. Extensive clinical and stakeholder consultation informed a rigorous optioneering exercise, at both the master plan and building scale, to ensure the preferred option met the Trust’s vision. JPUH will be one of the largest construction projects in the area for decades and can serve as a catalyst for economic growth and employment opportunities. Perkins&Will is working closely with stakeholders, the local authority and the wider community to ensure thorough and effective consultation and engagement is carried out. Contractor procurement for the enabling works is currently in train, and outline planning is due to be submitted in July 2025. ■ Government greenlights James Paget University Hospital
8 healthcaredm.co.uk NEWS Veolia is set to deliver wide-ranging energy projects to further decarbonise the heat supply at the University Hospital of Hartlepool. Designed to de-steam the current heating system, and deliver guaranteed carbon savings of 2,179 tonnes per year, it will use a ground source heat pump and thermal store, combined with solar arrays to maximise energy efficiency. The innovative new scheme is the first healthcare site where Veolia has implemented this type of design in the UK, and will help the hospital meet the NHS carbon reduction targets for 2030. Since 2003, Veolia has been managing combined heat and power at the hospital that provides a wide range of diagnostic services, outpatient clinics and low risk surgery. The new upgrades will use a combination of technologies to optimise efficiency and balance the electrical and thermal requirements. The new scheme combines a 1,400kW ground source heat pump system with a 70,000 litre thermal store to optimise the efficiency of the system by operating the heat pump at a higher load, when it is most efficient, to charge the store and deplete it over several hours. To maximise efficiency and give N+1 redundancy, the heat pump will use the supply from two boreholes, and will be supported by 1MWp of renewable electricity supplied from ground and roof mounted solar PV arrays. To balance the power generated by the solar PV system and the CHP, and the thermal output of the heat pump and CHP, Veolia’s specialist energy team has developed a bespoke management solution which will manage the electrical and thermal balancing of the system using smart controls. The smart control strategy will optimise the overall system efficiency, and provide additional resilience to the site through carbon balancing of the energy delivered using the combination of the heat pump, CHP heat recovery, hot water boilers and thermal store. The scheme includes high voltage and low voltage electrical infrastructure upgrades to support the new plant and equipment with an extension of the site’s existing HV ring main. Energy efficiency will also be extended through the wide ranging installation of LED light fittings across the buildings, and upgraded air handling units. ■ Veolia to decarbonise energy at University Hospital of Hartlepool More than two-thirds (68%) of UK healthcare leaders are revising their strategic plans every three months or more frequently, driven by mounting global economic pressures and cybersecurity threats, according to research by the Association for Project Management (APM), the chartered membership organisation for the project profession. The study, conducted among senior managers in public and private healthcare and pharmaceutical organisations, reveals a notable shift from traditional long-term planning to more frequent, agile strategy updates. This shift reflects an urgent need to adapt rapidly to emerging challenges and trends in an increasingly complex and fast-changing environment. The research, carried out by Censuswide, found that nearly one in four (24%) healthcare leaders update their strategies more often than quarterly, while 44% do so quarterly. Fewer respondents reported revising strategies bi-annually (16%), annually (8%) or every two to three years (8%), highlighting the growing trend toward short-term planning. This accelerated pace of strategic decision-making is largely driven by the need to address pressing global challenges. Respondents identified cybersecurity and economic shifts threats as top concerns (each cited by 50%) followed closely by sustainability and environmental regulations (46%). ■ www.apm.org.uk Over 68% of healthcare leaders revise strategies amid cybersecurity pressures
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10 healthcaredm.co.uk PROJECT The Cavell Centres aim to revolutionise healthcare delivery by bringing together multiple health and social care services under one roof. What sets the Shrewsbury Health and Wellbeing Hub apart is its potential Passivhaus accreditation. We spoke to the architects to find out more Shrewsbury’s Passivhaus health hub The NHS England initiative to pilot six super health hubs – dubbed Cavell Centres (named in honour of World War I nurse Edith Cavell) – aims to revolutionise healthcare delivery by bringing multiple health and social care services under one roof. In 2021, plans were drawn up for hubs in Sleaford, Staines, Hucknall, Plymouth, Derby and Shrewsbury. These hubs were intended to transform primary care infrastructure by accommodating up to 80,000 patients each, supporting multidisciplinary working and replacing aging GP premises with carbon-neutral, fit-forpurpose facilities. They aligned with NHS England’s Long Term Plan and Integrated Care Systems (ICS) goals to improve population health management in community settings. Then, in January 2023, the initiative was put on hold due to a lack of capital funding. THE SHREWSBURY HEALTH AND WELLBEING HUB One of these centres in Shrewsbury, Shropshire, was set to be a flagship integrated health hub. NHS Shropshire, Telford and Wrekin had earmarked the town for a new community campus – the Shrewsbury Health and Wellbeing Hub – consolidating six GP surgeries serving over 40,000 patients. Each practice would retain its identity while sharing state-of-the-art facilities. The new centre promised expanded services, space for more staff and a welcoming, community-focused environment. By early 2023, the project had evaluated sites, selected a preferred location, developed a project initiation document and commissioned Medical Architecture, collaborating with Architype, to lead the design work. The hub aimed to open by 2025. The design of the centre prioritises a human-centred, therapeutic environment. Instead of a maze of corridors and waiting rooms, the building is conceived as a series of interconnected spaces that blend healthcare with community life. At its heart is a ‘wellbeing hub’ atrium – envisioned as a kind of indoor public square – with an open café, seating areas and library for visitors. Around this central hub, a network of green courtyards and gardens bring daylight and nature into the building, giving patients pleasant views and places to relax. Large glass facades and skylights invite in natural light, while interior finishes and plantings continue the outdoor feel within the halls. Crucially, the design aims to serve both the community and clinical functions without compromising either, with a clear wayfinding strategy separating the public zone from the private clinical areas. The hub’s design also accounted for future adaptability. In line with Cavell Centre principles, the building was
healthcaredm.co.uk 11 PROJECT planned with a standardised modular layout for consultation rooms and offices, so that spaces could be reconfigured as needs evolve. REACHING PASSIVHAUS STANDARDS Perhaps the most ground-breaking aspect of the centre was its sustainability ambition. From the outset, the project team set a goal for the building to achieve full Passivhaus certification – making it one of the first healthcare facilities in the UK to do so. Mark Barry, director from the architectural firm Architype, and Bob Wills, director at Medical Architecture, are among the specialists who worked on the project, which was designed to be an exemplar primary care healthcare building that could set a new replicable Passivhaus benchmark. Applying Passivhaus to healthcare is rare. While some areas, such as consultation rooms and waiting areas, are relatively easy to adapt to Passivhaus principles, others, such as imaging suites and operating rooms, present greater challenges due to their high energy consumption. ‘One of the primary concerns in designing a healthcare building to Passivhaus standards is ensuring that energy efficiency measures do not interfere with its operational functionality,’ Wills explains. ‘You have to stand back and look at both practices having to work holistically with the entire brief without being dogmatic about what we do.’ Barry notes that ‘a huge proportion of the healthcare estate should be low demand in terms of its servicing need and can readily be designed to Passivhaus standards’. One of the primary challenges in applying Passivhaus standards to healthcare facilities is providing sufficient ventilation without increasing energy consumption. Traditionally, hospitals and clinics rely on mechanical ventilation with high air-change rates to control infections. However, a Passivhaus building optimises ventilation through highly efficient heat-recovery systems, ensuring a continuous supply of fresh air without the need for excessive heating or cooling. Thick, high-performance insulation and the elimination of thermal bridges work together with heat-recovery ventilation to keep the interior warm in winter and cool in summer with minimal mechanical input to provide a healthy and comfortable internal environment. The architects also coordinated the building’s structural grid and façade with modern methods of construction (MMC), allowing the use of prefabricated components to reduce waste and embodied carbon. The design team further introduced a ventilation ‘boost’ mode for multi-purpose rooms so that high air flow rates are only used when necessary. As Barry notes: ‘We worked with the client to ensure that multi-purpose spaces, like consultation rooms that could be used for minor procedures, have a boost function on the ventilation system. This way, they don’t operate at high ventilation rates all the time – only when needed.’ Managing solar heat gain is another crucial consideration. Large glazed façades, common in many modern healthcare buildings, can cause high levels of overheating — a serious risk in a healthcare facility. Barry explains: ‘Many UK buildings are over-glazed, and then shading is added to counteract heat gain, so even larger areas of glazing are required for daylighting purposes, creating a cycle that ultimately increases energy demand. Instead, we optimised glazing ratios and used recessed windows to balance daylighting with heat control.’ >> ‘A huge proportion of the healthcare estate should be low demand in terms of its servicing need and can readily be designed to Passivhaus standards’
12 healthcaredm.co.uk PROJECT THE FINANCIAL BENEFITS OF PASSIVHAUS One of the most common arguments against Passivhaus construction is its higher initial cost. The Shrewsbury Cavell Centre, for instance, was estimated to have a 4.66% capital cost uplift compared to conventional designs. However, the long-term savings in operational costs make a compelling case for investment. Barry outlines the financial benefits: ‘The annual energy savings for Shrewsbury were calculated to be £291,000 per annum. While the additional upfront cost was £1.8 million, this investment would be recovered in just over six years. Over the building’s 60-year lifespan, that translates to over £15 million in savings.’ Globally, only a few healthcare facilities have achieved full Passivhaus certification. The Frankfurt Klinikum in Germany is one of the only acute hospitals to meet these stringent standards. Barry acknowledges that ‘designing an acute hospital to Passivhaus is more challenging due to high energy environmental demands from specialist services such as operating theatres and imaging suites. However, we successfully developed compliant solutions for the diagnostics centre element of our Shrewsbury project.’ The success of the Shrewsbury project could serve as a model for future NHS buildings, Barry believes: ‘We truly believe this approach has tremendous benefits and will have a significant impact on the NHS moving forward. Scotland has already mandated high energy performance standards for public buildings, and we see a similar trend emerging in England.’ A FUTURE MANDATE FOR HEALTHCARE SUSTAINABILITY? While the momentum for Passivhaus in healthcare appears to be growing, the Government’s recent announcement to abolish NHS England, as well as looming budget cuts of up to 50% for Integrated Care Systems (ICSs), casts doubt over the future of the Cavell Centre initiative. Despite this, planning guidance for 2025/26 still emphasises the importance of locally-led systems and a renewed focus on improving outcomes for communities, in addition to a focus on sustainable design practices such as Passivhaus. ‘The hope is that, in time, genuine sustainability will become the rule rather than the exception,’ says Barry. ‘We are trying to make this not the exception but the standard.’ For the people of Shrewsbury and the five other pilot communities, the wait goes on. In the meantime, the bold vision of the Cavell Centres, and the Shrewsbury hub in particular, remains a tantalising glimpse of what’s possible. ■ medicalarchitecture.com architype.co.uk ‘We truly believe this approach has tremendous benefits and will have a significant impact on the NHS moving forward’
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14 healthcaredm.co.uk The healthcare buildings forum 2025 takes place at a time of exceptional transition for the NHS and its partners. With the abolition of NHS England and the mandated restructuring of Integrated Care Boards (ICBs) to deliver 50% cost reductions in corporate services, the sector is being reshaped at pace. These structural reforms are unfolding alongside major challenges around ageing estates, capital delivery constraints, reinforced concrete risks (RAAC) and the urgent need to meet the NHS’s 2040 net-zero target. This year’s forum offers a space to reflect, respond and reimagine. Across two days of curated discussion, speaker sessions and peer-to-peer engagement, we’ll explore how healthcare infrastructure can adapt to this evolving landscape — balancing near-term pressures with long-term strategic goals. As the NHS navigates organisational upheaval, funding pressures and increasing localism through ICSs, it’s more important than ever to rethink how we plan, procure and deliver healthcare spaces. Key topics include: • Creative procurement approaches • Decarbonising the estate and designing for long-term sustainability • Risk mitigation and resilience in the face of RAAC and structural safety issues • Optimising the interface between national policy and local delivery • Futureproofing infrastructure in a time of digital transformation and evolving models of care With a unique cross-section of leaders from estates, design and construction, the forum is an essential opportunity to align thinking and drive forward collective solutions. In a system where capital must work harder and faster — and where every project must deliver environmental, financial and social value — the healthcare buildings forum 2025 will be a vital space for strategy, innovation and action. WHAT’S ON OFFER As a supplier, you’ll benefit from a tailored schedule of one-to-one meetings with your chosen project delegates, in addition to the architects, contractors, project managers and consultants delivering projects in the UK. This is a real opportunity to do business, and includes: • 1-2-1 scheduled meetings and planner • An abundance of networking opportunities • An all-inclusive package accommodation and meals • An exclusive event directory • Limited competition • Access to informative speaker sessions Stable Events presents its annual healthcare buildings forum 2025, which unites NHS Trusts and private healthcare providers, together with architects, contractors, service and product suppliers, and other stakeholders Theme: Rethinking the NHS: Infrastructure for a resilient future 2025 Healthcare buildings forum PREVIEW
healthcaredm.co.uk 15 PREVIEW 10-11 July 2025 The Belfry Sutton Coldfield hb-forum.co.uk For more information about the event, or to register for your place, visit www.hb-forum.co.uk or email [email protected] (speaker and project delegates) or [email protected] (supplier delegates) As a complimentary project delegate, you will join us as our guest at the forum and learn about the latest thinking and debate taking place across the rapidly evolving environment. The event comprises of thought-provoking seminars, and the opportunity to meet manufacturers and suppliers to find out about the latest innovations, products and services. Above all, you will get the opportunity to network and do business with your peers. Additionally, we will provide one to two nights’ accommodation, as well as all meals and refreshments, a drinks reception and a gala dinner. This unique format means supplier delegates are guaranteed quality time with commissioners and can demonstrate how their products or services can help to transform a new generation of buildings. Helen Adkins, editor of healthcare, design and management, said ‘This is a pivotal time for everyone involved in delivering healthcare infrastructure. While there are significant pressures and challenges, there are also valuable opportunities – all of which will be explored at this year’s forum. ‘Our speaker sessions and networking events are designed to help delegates understand their role in this evolving landscape, and explore how healthcare infrastructure can adapt in these challenging times.’
16 healthcaredm.co.uk INTERVIEW Designed as a dedicated elective care hub, Heatherwood Hospital, part of Frimley Health Foundation Trust, focusses on planned procedures – particularly orthopaedics – allowing it to optimise both patient flow and clinical efficiency. Its design prioritises natural light, clear wayfinding and a connection to nature, all contributing to the positive experience reported by patients. HELEN ADKINS: As part of NHS care delivery, Heatherwood has emerged as a leader in patient experience. Can you talk about your role in shaping the vision for the hospital? SEAN WOODHEAD: The original Heatherwood Hospital was a TB sanatorium built in 1922, with a major expansion constructed in the 1960s, which featured in Carry On Matron. It was a well-loved hospital but the buildings were definitely coming to the end of their lifespan. Initially we were looking at the existing estate and trying to find out how to fit a piece in here and adapt a bit there, and then we realised that there was a beautiful site at the back of the campus, which was the location of the kitchen garden originally serving the sanatorium. We came to the conclusion that a much better idea would be to site the new hospital on this land to the south of the existing hospital, taking advantage of the beautiful woodland setting. That would also mean the existing hospital could continue to operate without interruption whilst we built the new facility. The Trust had a clear clinical vision, to separate planned care from acute and Heatherwood Hospital in Ascot, designed by multidisciplinary design practice BDP, has been named the best elective care centre in England by patients, following the latest National NHS Adult Inpatient Survey. Helen Adkins spoke to Sean Woodhead, associate architect at BDP, about the project Heatherwood Hospital Best elective care in England
healthcaredm.co.uk 17 INTERVIEW provide a calming environment for both patients and staff. These objectives, the scale of the building and the woodland context provided a wonderful opportunity to deliver a fantastic building aligned with the principles of biophilia. Crucial to the approach was ensuring access to the surrounding landscape, both visually and physically. We would provide trails through the adjacent woodland and plenty of opportunities to enjoy the views of nature. How did the biophilic theme influence the layout? The biophilic theme was woven throughout the whole design. We wanted to maximise the views out into the landscape, but also keep the hospital compact which has many advantages in terms of wayfinding and the legibility of the building, but also reduces the amount of woodland we were impacting. This approach also gave us an efficient ‘form factor’ with a low external wall to floor area ratio, which benefits building performance. We were strategic with the use of large areas of glazing, ensuring that public areas where you enter the building felt very much amongst the woods, whilst not negatively impacting the thermal performance of the building fabric elsewhere. Where possible, we used natural materials internally. The curtain walling has timber back boxes, and we used hybrid timber /aluminium window systems throughout. In terms of materials and how you experience the building, it very much feels like you’re amongst the trees. It’s quite a steeply sloping site, so we have positioned the building in such a way that it reduces the scale on the approach to the front door. On the southern side, if you look out the windows, it almost feels like you could touch the trees. The Trust has called the upper floor the Treetops Ward, which probably gives you an idea of how successful that has been. >> ‘As a practice, we like to focus on people as part of our design, keeping that very much at the baseline of everything we’re doing — not just for patients, but staff as well’
18 healthcaredm.co.uk INTERVIEW How did you incorporate the needs of patients, staff and visitors in the early design? We went through an extensive engagement process during design development. The stakeholders were quite keen to incorporate some of the old parts of the hospital because of its history. Sculptural works and stainedglass windows from the old hospital buildings have been preserved and repurposed as artworks in the landscape, and a mural in the main entrance illustrates the history of the hospital from 1922 to the current day. As a practice, BDP likes to focus on people as part of our design, keeping that very much at the baseline of everything we do — not just for patients but staff as well. For example, we incorporated external terraces behind staff bases so they could get outside. In a big hospital, staff are often an afterthought, but because of the scale of this project, we wanted to make sure that wasn’t the case. We prioritised their wellbeing as well as the patients. It looks like the hospital succeeded in reducing waiting times and patient stay. How do you think the design contributed towards that? First and foremost the credit needs to go to the team at the hospital and the Trust for having the vision to make this strategic decision to separate acute from planned care. The design of course plays a role too and the team have very much embraced it. An innovative outpatient ‘one stop shop’ approach on the ground floor reduces and can even eliminate the need for return visits, and hence greatly improves efficiency. A patient can have a consultation and follow-up imaging appointment and treatment all on the same day. The layout and arrangement of different departments facilitate this approach, while the design of central waiting and café facilities with views to the landscape makes the day a pleasant and calming experience. There is increasing evidence that natural light and views to nature can improve recovery time, and we have very much embraced this idea at Heatherwood. All patient rooms have large, openable windows with low sills so that the surrounding trees and wildlife can be seen from the patient’s bed.
healthcaredm.co.uk 19 INTERVIEW I visited Heatherwood recently with my family on our way back from visiting friends, and when you walk around, it’s a very friendly building, full of natural light. We set out to create a very inclusive design with the wellbeing of all users at its heart, and that vison seems to have been realised. Can you talk about the sustainable aspects of the design? It’s a very high-performing building in terms of energy efficiency. The envelope is highly insulated and the form factor (wall to floor area) is efficient. We’ve avoided extensive areas of glazing which are thermally inefficient, and where we have large areas, they have been placed strategically to optimise the benefit. The energy systems are highly efficient. It does still run on fossil fuels — it’s not fully electric — but we do have four-pipe chillers and very large air-source heat pumps, not the little domestic fan units. There are full heat recovery systems in place. The drainage strategy uses the site’s topography. Instead of sending stormwater into the sewer, we use a balancing pond in the adjacent woodland. There’s actually a fantastic photo of a deer swimming in it, which was great to see. How do you see the role of design evolving in elective care hospitals in the future? Are there any trends, and is Passivhaus something healthcare architects are looking at? Sustainability is definitely coming to the fore. Passivhaus is increasingly being discussed in healthcare, but it’s not a standard we usually aim for. In Wales, there are other standards being considered. The NHS Net Zero Carbon standard (NSSC) is a big focus for us Heatherwood Hospital was named the best elective care centre in England by patients who took part in the latest National NHS Adult Inpatient Survey, giving the Ascot hospital the highest average score in the country for overall patient experience. The annual NHS survey, published by the Care Quality Commission (CQC) as part of a national programme to improve patients’ experiences while in hospital, looked at the experience of 63,573 patients across 131 NHS trusts who stayed at least one night in hospital during November 2023. Between January and April last year, 1,250 patients at each Trust were invited to take part. They were asked 55 questions about hospital admission and discharge, the hospital ward and environment, care and treatment, communication with staff, involvement in decisions and being treated with respect and dignity. The results were published in the full national benchmarking report last autumn, with the data shown at both NHS trust and individual hospital site level. The average score of Heatherwood patients asked to rate their overall experience was 9.7 out of 10, the best of any individual hospital included in the survey. now — across all projects, not just elective care. We’re looking at operational carbon and embodied carbon from the very start, including structural weight and materials. Elective care itself is increasingly important. Separating planned care from acute care is a big part of the future of healthcare delivery. When acute and planned care share facilities, winter pressures often lead to acute patients taking planned care beds, which then leads to delays and longer waiting lists. Frimley Health was thinking strategically about this separation back in 2015-16, which was ahead of its time. Now, it’s much more widely discussed. Were there any particular challenges on this project, and would you do anything differently in the future? Planning was a key challenge. It was important to bring the borough along with us, helping them understand the significance of the project and its contribution to the community. Planning took a little longer than normal as a result. On larger projects, there’s now more focus on standardisation, but for this project I think we did pretty well. It’s lovely to go back after three years and see that the building is weathering nicely and settling into its context. I like to think we did a good job. Better healthcare is fundamental to creating a ‘Good City’. A human-centric design approach can create healthy, inclusive, sustainable buildings with the flexibility to meet constantly changing needs, a topic explored in practice’s The Good City initiative, which aims to address some of the most pressing urban challenges by bringing together experts from across the world. ■ thegoodcity.bdp.com
WE CARE BECAUSE YOU CARE Courtney Thorne, Nurse Call Technology you can rely on Call for a free demonstration www.c-t.co.uk 0800 068 7419
healthcaredm.co.uk 21 TECHNOLOGY The silent hospital Creating a calmer, more restorative hospital environment By harnessing innovative technology, the Royal Cornwall Hospital’s NHS Trust, with the help of DNV Imatis and Wandsworth Healthcare, is transforming the postnatal ward experience — creating a calmer, quieter space that enhances both patient experience and staff efficiency How can we create a more peaceful and restorative environment for patients in healthcare environments? Royal Cornwall Hospitals NHS Trust’s (RCHT) ‘Silent Hospital’ project provides a compelling answer. By leveraging technology to silence patient call bells and route alerts directly to staff smartphones, the hospital is transforming its Wheal Fortune postnatal and transitional care ward experience. RCHT has partnered with DNV Imatis, a leading Norwegian provider of digital healthcare solutions, to bring this project to life. Rather than developing a system in-house, RCHT leveraged DNV Imatis’ proven Fundamentum platform and integrated it with the existing Wandsworth Healthcare nurse call system. This strategic decision allowed RCHT to benefit from an established and reliable platform, ensuring a smoother implementation process and enabling the trust to focus on achieving key improvements – all without the complexities of developing new technology from the ground up. HOW IT WORKS The technological backbone of the project is the Fundamentum platform, an enterprise-level intelligent platform which, when deployed, becomes integral to the overall IT architecture of a hospital. Fundamentum digitalises and automates work processes using data from both existing and new systems. At RCHT, the platform has been tailored to meet the specific needs of the site and is integrated with the hospital’s wider infrastructure. Patient call bells on the postnatal ward’s shared and private rooms are silenced, with the alerts quietly and directly routed to standard smartphones carried by midwives and nursing staff. Real-time monitoring allows staff to monitor patient needs and respond to alerts promptly. Staff can customise alerts to their specific needs and to the appropriate health professional, reducing alarm fatigue and information overload. If an alert remains unacknowledged or unresolved within a specific timeframe, it escalates to a higher level of urgency. This automated escalation process ensures proper and timely attention to critical situations. Staff can also easily switch to audio alerts if necessary, using a dedicated key switch, allowing for greater flexibility and control. This fallback option can be managed directly by staff within the ward using a tailormade key switch solution, ensuring flexibility and control. The Fundamentum platform collects data on patient alerts and staff response >> ‘By sending alerts directly to staff mobile devices, the system has streamlined communication, minimised noise disruptions and reduced alarm fatigue’
22 healthcaredm.co.uk TECHNOLOGY times from the existing Wandsworth Healthcare nurse call system, which enables data-driven improvements in care delivery. The platform integrates seamlessly with various electronic patient record (EPR) systems and, along with DMV Imatis’ other digital health solutions, is helping to improve operational efficiency for over 50,000 healthcare professionals across 52 hospitals in Europe, Australia and Canada. To ensure a smooth rollout, RCHT and DNV Imatis conducted stakeholder workshops to customise workflows and system functionality. A comprehensive training program was delivered using a ‘train-the-trainer’ model, equipping key staff as ‘super users’ to guide colleagues. Staff and patient engagement played a crucial role. Patient information leaflets, on-ward digital signage and ongoing communication kept everyone informed and involved. Additionally, a Patient Leader and RCHT’s Accessibility Advisory Group ensured the system was userfriendly and inclusive. MEASURABLE RESULTS Throughout the initial six-month project, RCHT tested and measured – both quantitatively and qualitatively – the impact of silencing call bells and routing nurse call signals directly to staff smartphones. Since its launch in April 2024, the project has demonstrated remarkable benefits, including: • Pre and post decibel (dB) measurements revealed a 3dB reduction, equating to a 50% decrease in noise on the ward • 0.5-day reduction in average length of stay (ALOS) per patient, generating an estimated £74,942 in annual bed-day savings for the 25 bedded ward • 12% improvement in patient-reported sleep quality, directly addressing the issue of noise disruption • 57% of patients who previously struggled to sleep during their stay reported that they experienced improvement in the length and quality of sleep The ward’s staff are also reaping the benefits. By sending alerts directly to staff mobile devices, the system has streamlined communication, minimised noise disruptions and reduced alarm fatigue. This has resulted in a calmer, less stressful work environment, allowing staff to respond more efficiently to patient needs. Additionally, reduced distractions have improved situational awareness, enhancing patient and staff safety. Post implementation staff surveys have confirmed a positive impact on wellbeing and performance. In particular, the innovative ‘silent handover’ process has streamlined shift transitions, making them more efficient and less disruptive by providing structured, easily accessible patient information. The ability to track data for call bell responses has enhanced accountability and provided valuable insights into staff performance. This data-driven approach has enabled the optimisation of patient care delivery and identified areas for improvement. GAINING MOMENTUM While RCHT is the first NHS trust to implement the silent hospital technology, this new approach has been generating interest among other NHS trusts, particularly over the past year. Roberta Fuller, programme manager for the Women and Children’s Hospital at RCHT, has been instrumental in raising awareness and garnering support from the Cornwall and Isles of Scilly ICB (Integrated Care Board), as well as regional and national NHS trusts. This heightened interest indicates that the technology is likely to be adopted more widely within the NHS in the future. To gain first-hand insights into the benefits, a number of NHS organisations ‘To gain first-hand insights into the benefits, a number of NHS organisations have visited hospitals in Norway where DNV Imatis’ solutions have been successfully implemented for several years’
healthcaredm.co.uk 23 TECHNOLOGY have visited hospitals in Norway where DNV Imatis’ solutions have been successfully implemented for several years. Østfold Hospital Trust in southeastern Norway, for example, was one of the first in Norway to create a quiet working environment by turning off audio signals from patient alerts. The Trust is the only hospital in Norway that has achieved HIMSS EMRAM level 6 certification. Like RCHT’s project, the DNV Imatis Fundamentum platform played a crucial role in Østfold Hospital Trust’s success thanks to its scalability and adaptability. By providing full integration and messaging across over 50 areas, including clinical and administrative systems such as the Electronic Patient Record (EPR) system, lab systems and telemetry, the platform facilitated a seamless and efficient workflow. Wandsworth Healthcare has opened a new Digital Patient Journey Experience Centre which aligns with the Government's Hospital 2.0 initiative. The state-of-the-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. 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 are already helping healthcare providers worldwide to manage patient flow, optimise operational efficiency, enhance staff productivity and improve patient safety and the overall patient experience. Digital Patient Journey Experience Centre Moving forward, RCHT plans to expand the project to drive broader digital transformation. The goal is to implement a pipeline of ‘smart hospital’ projects – including integration with the new EPR system – ahead of the Women and Children’s Hospital opening which is expected to be within the next five years. By extending this technology to other areas of the hospital and exploring additional digital solutions, RCHT plans to optimise efficiency and patient care on the postnatal ward and beyond. ■ www.wandsworthhealthcare.com www.dnvimatis.com
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healthcaredm.co.uk 25 PROJECT The Child Development Centre at Crawley Hospital Last year, Sussex Community NHS Foundation Trust celebrated the official opening of the new Child Development Centre (CDC) at Crawley Hospital. We look at the results The CDC was designed by Jefferson Sheard Architects, who transformed the existing space into a state-of-theart facility dedicated to supporting children from 0-19 with developmental needs. The project not only revitalised the physical environment but also enhanced the quality of care provided to young patients. The centre brings together community paediatricians, physiotherapists, occupational therapists, and speech and language therapists under one roof, offering a secure and self-contained environment dedicated to the health and wellbeing of young patients. This milestone project was part of an extensive redevelopment led by LST Projects, commissioned by West Sussex Estates Partnership on behalf of NHS Property Services. The initiative involved relocating the Child Development Centre from its previously overcrowded space in the Green Wing to a purpose-built area in the Yellow Wing. TRANSFORMING THE SPACE The transformation saw the demolition of an outdated second-floor layout and the construction of new, acoustically optimised room configurations – including a specialised audiology suite featuring an innovative ‘box in box’ design. Throughout the works, LST Projects managed a full spectrum of refurbishment tasks, from stripping out old fittings to installing new mechanical and electrical infrastructure, ceilings, flooring and doors, all while redecorating the space to a high standard. To ensure continuous hospital operations, a temporary outpatients department was established, and strict infection control protocols were rigorously enforced to protect patients, staff and service providers. Environmental considerations were also paramount, with a robust waste management plan in place to recycle or >>
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