JULY 2025 | £8 A new era of holistic health care Reuben Young People’s Centre healthcaredm.co.uk healthcare design & management Toronto’s West Park Healthcare Centre Using nature as a tool for recovery Digital Twins Powering the virtual journey towards all-electric hospitals A breath of fresh air The promise of circular HVACR systems in healthcare 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. sales@healthcaredm.co.uk healthcaredm.co.uk Editor Helen Adkins Production Nicola Cann Design Gemma England Media Sales Manager Terry Stafford Managing Director Toby Filby Reuben Young People’s Centre at the Chelsea and Westminster Hospital, London 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 In March 2025, the Reuben Young People’s Centre opened its doors at Chelsea and Westminster Hospital, marking a significant shift in how we conceive and create healthcare spaces for children and adolescents. This centre, a cornerstone of the NHS’s Best For You programme, exemplifies the transformative power of involving stakeholders – particularly young people – in the design and management of healthcare facilities. When young people arrive at hospital in mental health crisis, the experience can be unsettling – for them, their families and staff. With few dedicated spaces in the NHS that cater to the complex mix of physical and mental health needs many of these patients face, they’ve often ended up in general wards that aren’t designed with their circumstances in mind. That’s why the centre was created – a purpose-built unit designed to meet young people where they are. Opened in February 2025 as part of the programme and supported by the Reuben Foundation, it offers 24 beds, including specialist rooms and flexible zones for different age groups. The design reflects what young people said they needed; calm, privacy and a space that doesn’t feel like a typical hospital ward. Crucially, this isn’t just about architecture. Staff on the unit receive specialist training to work confidently with both physical and mental health presentations, and young people were involved from the start through co-design sessions, youth boards and partnerships with local organisations. The result is an approach that feels different – and is already being looked at as a potential model for other trusts. But the Reuben Centre is only one part of a wider system. Best For You also includes a digital platform and The Ark, an out-of-hospital day unit for eating disorders. Together, these offer a more joined-up way to support young people in crisis – one that’s based on relationships, not just referrals. On page 11, I speak with Chris Chaney, chief executive of CW+ – the official charity of Chelsea and Westminster Hospital NHS Foundation Trust – who shares how the Best For You programme led to the creation of the centre. As mental health needs continue to grow, this integrated model offers a practical example of how hospitals can adapt – not by overhauling everything, but by listening to patients, and working across teams and building systems that fit real lives. Helen Adkins Editor Helen.Adkins@stable-media.co.uk Editor’s Letter July 2025 Creating holistic healthcare spaces for young people
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IN THIS ISSUE... July 2025 7 News Morgan Sindall completes the Newmarket Community Diagnostic Centre, RAAC replacement begins at the Royal Bolton Hospital Maternity Unit, and the £15m construction of a new Endoscopy Unit at the Cumberland Infirmary is finished 11 Reimagining youth care: The Reuben Young People’s Centre A look inside a ground-breaking new space offering holistic support for young people at the Chelsea and Westminster Hospital, led by CW+ in collaboration with the Play Team and renowned architects White Arkitekter. Helen Adkins speaks with the CW+ chief executive Chris Chaney about the inspiration behind the project 16 Procurement With NHS Trusts not knowing which way to turn and working with limited resources, tapping into readily available support is pivotal. Jonathan Oram, director of frameworks at procurement specialist Pagabo, leads the conversation on how this can be done effectively 20 West Park Healthcare Centre, Canada Opened in April 2024, West Park Healthcare Centre is an ambulatory care facility in Toronto. Jason Dobbin, principal at Montgomery Sisam Architects, discusses the principles behind the design – from accessibility and patient experience to the integration of nature as a tool for recovery 25 Air quality and HVACR systems In hospitals, clean air and temperature control are vital – but so is sustainability. Ulrik Vadstrup, regional Europe sales manager for HVACR at ABB Drive Products, explains why circular HVACR systems offer a longer-lasting, more energy-efficient alternative to EC fans, helping healthcare meet both environmental and patient care goals 28 Digital twin technology As healthcare estates strive to meet ambitious decarbonisation targets, digital twin technologies are emerging as a vital enabler of the transition to all-electric hospitals. Kas Mohammed, VP Digital Energy UK&I at Schneider Electric, explores how digital twins can support the NHS in modernising outdated infrastructure, optimising energy use and accelerating the journey to net zero 32 Comment With an ageing estate, intensifying space demands and an increasing maintenance backlog, the UK’s healthcare sector is under considerable pressure to find an innovative approach. Here, Laura McCormick, healthcare strategy lead at McAvoy, looks at how modular construction can meet the sector’s demands 25 11
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healthcaredm.co.uk 7 NEWS The construction of the new £15m endoscopy unit at the Cumberland Infirmary (CIC) is complete. The new unit will be able to treat more patients, helping to reduce waiting lists and improve timely diagnosis, particularly for cancers. It includes five clinical rooms and an outpatient area, enabling more patients to receive endoscopy procedures locally. Vendor neutral provider of Managed Equipment Services (MES), Ergéa UK, in collaboration with Actiform, utilised the latest Modern Methods of Construction (MMC) to ensure the building met high environmental standards and complied with national healthcare regulations. Some key benefits of the new unit include: • Patients will be able to access endoscopy faster – more patients will receive their diagnostic procedure within six weeks of referral in line with national standards. • The additional rooms will have capacity to provide more lists per week, avoiding unnecessary travel outside of the region. • It will also ensure the Cumberland Infirmary meets National Standards and future proofs the service to meet the need of patients across North Cumbria. Craig Farrow, commercial director at Ergéa UK, said: ‘We’re incredibly proud to be part of this project, which marks a significant milestone in our partnership with the Trust. Together, we have created a modern, state-of-the-art clinical facility that will play a critical role in transforming the patient experience and support positive outcomes. We’re excited for the official opening and to witness first-hand the positive impact this unit will have on the local community. ‘Our Managed Endoscopy Service collaborates with Actiform to deliver a comprehensive turnkey solution, utilising the latest Modern Methods of Construction (MMC). This project is designed to meet high environmental standards and comply with national healthcare regulations, achieving a BREEAM rating.’ ■ Bolton NHS Foundation Trust has officially broken ground on a major redevelopment of the Maternity and Women’s Health Unit at the Royal Bolton Hospital, in partnership with Robertson Construction North West. The project is part of a £38 million investment to replace Reinforced Autoclaved Aerated Concrete (RAAC) identified in the existing structure in 2023. The redevelopment will modernise maternity facilities for women, babies and families in Bolton and surrounding areas. Work is being delivered in phases to ensure all maternity services, including antenatal and postnatal care, remain fully operational during construction. Alongside the RAAC replacement, the project includes upgrades to theatres, mechanical ventilation systems and the installation of new rooftop plant. The new unit is expected to welcome its first families in early 2027. Robertson is delivering the project under Lot 2 of ProCure23, the Crown Commercial Service’s framework for NHS construction projects, with WeBuild Healthcare appointed as the main contractor. ProCure23 supports NHS England’s efforts to deliver safe and modern healthcare environments across the country. As part of its wider commitment, Robertson aims to provide local employment opportunities, apprenticeships and placements throughout the project’s duration. ■ RAAC replacement underway at Royal Bolton Hospital Maternity Unit New £15m state-of-the-art endoscopy unit now complete
8 healthcaredm.co.uk NEWS Morgan Sindall completes Newmarket Community Diagnostic Centre A new Community Diagnostic Centre (CDC) at Newmarket Community Hospital has been completed by Morgan Sindall Construction and handed over to West Suffolk NHS Foundation Trust (WSFT). Morgan Sindall’s Eastern Counties business was appointed to the WSFT’s project via the CWAS2/Procure 23 (P23) framework for the design and construction of NHS capital projects. The new facility will provide local communities with faster and more streamlined access to a wide range of tests, such as MRI, CT, X-ray, ultrasound, lung function and cardiology. This means waiting times will be reduced for patients, and that there will be a decrease in the length of time between being referred for tests, having appointments, getting results and beginning treatment. Since opening its doors in December last year, the CDC saw 2,800 patients and conducted at least 3,500 tests and scans in its first eight weeks. The tier one contractor employed its Intelligent Solutions approach during the design and construction of the 1,000 sq. m. facility. Morgan Sindall utilised modern building techniques, such as offsite manufacturing, to speed up the construction process and deliver a factory quality finish. To help the Trust meet the NHS 2040 net zero targets, the CDC has been created using low-carbon prefabricated materials and sustainable methods of construction. This included neutralising the water used in concrete production with specialist equipment, reducing the building energy use through modern design and building simulation techniques, and offsetting further energy use with renewable sources. In total, this has led to a reduction in carbon equivalent to heating almost 21 houses for one year. Air source heat pumps provide the CDC with an efficient source of heating and hot water and 123 photovoltaic (PV) panels have been installed as part of the scheme both on the CDC and across the Newmarket Community Hospital site. The building’s temperature is regulated through constant air volume (CAV) heating and cooling, with heat recovery units to ensure consistent and efficient temperature control. The combined green building features will generate at least 46% of the CDC’s energy, 36% above the original target, showcasing the Trust’s commitment to building for the future in a sustainable way. The Newmarket CDC forms part of a national programme to improve local access to diagnostic testing. Investing in the Newmarket Community Hospital site is a commitment of the WSFT and almost £15m of funding was secured from the national CDC programme to help reduce health inequalities in the region by providing patients with access to the care they need, closer to where they live. ■
healthcaredm.co.uk 9 NEWS A BRAND-NEW blood donation centre has completed in South London, boosting community engagement and playing a key role in combatting sickle cell disease. The first permanent NHS Blood and Transplant donor centre in Brixton, converted from an unused retail unit, has been completely refitted with nine donor beds and a purpose-built nursing station. Additionally, six consultation rooms, staff changing rooms and further amenities have been added. Brixton was identified as the ideal location due to it having the largest Black heritage population in England and Wales, with donations from this demographic set to significantly help combat the UK’s fastest-growing genetic disorder. Leading multi-disciplinary consultancy Pick Everard was behind the scheme, delivering project management and contract administration services through Perfect Circle via the SCAPE Consultancy Framework. Pick Everard was brought on board to assist the MEP strategy of the building, with the original design dating back to 1877. Community engagement and involvement also played a key role in the project, with bespoke artwork from local creatives, and a ‘hero wall’ showcasing inspiring stories of lives saved through donations, as well as a plaque dedicated to Dame Elizabeth Anionwu OM, the country’s first sickle cell nurse counsellor. ■ Patients across Coventry and Warwickshire are set to benefit from faster, safer and more joined-up care as Coventry and Warwickshire Partnership NHS Trust (CWPT) moves closer to implementing its new, Trust-wide Electronic Patient Record (EPR) system. Following a rigorous tender process, the Trust has confirmed The Phoenix Partnership as the supplier for its new EPR, with SystmOne being the new system that will be implemented. The new digital system will help ensure patients receive more personalised, timely and coordinated care by giving clinical teams instant access to up-to-date information. NHS England is providing £1.9 billion to NHS trusts to ensure they all meet a core level of digitisation and have electronic patient record systems in place. This investment in digitising the frontline will ensure that health and care staff have access to health-related information when and where it is needed, supporting them to deliver care efficiently, effectively and safely, reducing variation and improving outcomes. Over 90% of NHS Trusts now have an Electronic Patient Record (EPR) system and 100% of Trusts will have an EPR or the EPR will be in delivery by March 2026. Peter Newton, director of Digital & Informatic Services at CWPT, said: ‘This is a significant step toward improving the experience and safety of our patients. While this is a digital project, the true benefits will be felt at the point of care; where clinicians will have quicker, easier access to the information they need to make well-informed decisions, leading to better patient outcomes.’ Julie Frake-Harris, chief operating officer and senior responsible officer for the new EPR, added: ‘This investment will enable our staff to spend less time navigating systems and more time focused on patients. With real-time data at their fingertips, our teams will be able to act faster, reduce errors and tailor care more effectively to each individual accessing our services.’ The development of the EPR has been clinically led, with 62 clinical and operational staff being actively involved in its procurement. ■ Blood donation centre opens in South London New electronic patient record takes major step forward at CWPT
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healthcaredm.co.uk 11 PROJECT Youth-centred mental health care As the number of young people experiencing mental health crises continues to rise across the UK, an NHS programme called Best For You is taking action. Chris Chaney, chief executive of CW+, the official charity for Chelsea and Westminster Hospital NHS Foundation Trust, explains the story behind the programme and the creation of the Reuben Young People’s Centre All images © Damian Griffiths On 28 February 2025, the Reuben Young People’s Centre officially opened its doors at Chelsea and Westminster Hospital. Part of the Best For You programme and made possible with funding from the Reuben Foundation, the centre is the latest innovation in a growing movement to rethink how young people can be supported when facing mental health challenges. The centre was developed as part of the Best For You programme, which is run in partnership by Central and North West London NHS Foundation Trust, Chelsea and Westminster Hospital NHS Foundation Trust, West London NHS Trust and CW+, and is being evaluated by Imperial College. It is a dedicated, purpose-built space for children and adolescents that is designed to address both physical and mental health challenges – a first-of-its-kind in the NHS that aims to deliver holistic, joined-up care at a time when it’s needed most. Mental health crises among children and adolescents have been rising steadily >> Reuben Young People’s Centre
12 healthcaredm.co.uk PROJECT in the UK, a trend further accelerated by the pandemic. Acute hospital trusts across the country are seeing more young people presenting in distress, often with complex needs that do not fit neatly into traditional models of either physical or mental healthcare. Until now, many of these young people would have been admitted to general paediatric wards – clinical environments not designed to meet their psychological or emotional needs. The result was an experience that could feel confusing, overwhelming, and at times unsafe for patients, families and staff alike. With 24 beds, including two specialist rooms and several flexibly designed bays, the centre has been developed specifically to support children and young people with complex and often overlapping care needs (including those with significant mental health needs) during their stay in the acute hospital setting. Separate zones have been created for different age groups, with quiet spaces for reflection, dedicated areas for parents and carers, and therapeutic design features such as adjustable lighting, bespoke artwork and built-in seating nooks that encourage calm and connection. The design brief was to create a calm, therapeutic and clinically safe space. This was brought to life by the CW+ Arts in Health Team, in partnership with the Trust’s Play Team and architects White Arkitekter. Under the umbrella of West London Children’s Healthcare – a collaborative service uniting Imperial College Healthcare NHS Trust and Chelsea and Westminster NHS Foundation Trust ¬– the ward has been transformed into a space that is not only clinically sound but also welcoming, accessible and inclusive. Among its features are soft, adjustable lighting and sensory elements that can be tailored to each patient’s mood, artist-designed lightboxes to distract and soothe during treatment, and comfortable, hospital-safe furnishings that provide privacy and promote relaxation. Bespoke murals and locally inspired wayfinding artwork add to the sense of warmth and orientation, ensuring that the ward feels personal and not institutional. Importantly, the centre was not designed for young people in isolation, but with >>
healthcaredm.co.uk 13 PROJECT How did the Best For You programme come about? Chris Chaney: The programme began in 2019 after a conversation I had with Kasim Kutay, chief executive of Novo Holdings and chair of our development board. Kasim had personal experience of mental health issues and asked if Chelsea and Westminster Hospital – though not a specialist mental health facility – might work with him to improve care for young people in crisis. While we’re a district general hospital, we do have one of the few dedicated children’s A&Es in the NHS, as well as facilities for adolescents. That conversation led us to reflect on how ill-equipped we were – like many acute hospitals – to support children and teenagers presenting in mental health crisis. What was the vision from the start? Our goal wasn’t to reinvent the wheel but to better connect existing services. The system young people and families face is often fragmented and hard to navigate. We wanted to create a more integrated and compassionate model, centred on the individual and their family rather than what’s most convenient for the system. We started with digital, because when young people need help, the first place they look is their phone. This is a hub of resources informed by clinicians and young people, for young people. It includes an app library for mental health, with tools for anxiety, sleep, depression and eating disorders. It’s also location-tailored, signposting users to nearby support services. There’s advice written with peers and professionals, and a crisis text line in partnership with Mental Health Innovations UK. Users can text ‘NATTER’ to 85258 to exchange messages with a trained volunteer, and the system can escalate to emergency services if needed. Over 200,000 people have accessed the Best For You digital resources, and professionals are increasingly using it too. We’ve also developed a network of over 70 partners, ranging from Chelsea Football Club to small community organisations with strong local reach. These partners help deliver mentoring, volunteering and therapeutic activities. We provide training on our digital tools, so they can support young people in trusted, familiar settings. We set up Arc in October 2023 as a day unit located near, but not in, the hospital. During school hours, it provides an intensive programme for young people with eating disorders – an alternative to long inpatient stays and a first of its kind. Participants come in daily, often for four to six weeks, accompanied by a parent or carer. Outside school hours, it functions as a drop-in centre with group therapy, art and health activities, and peer support. We’ve trialled this model with volunteers and are now evaluating which approaches were most effective. How does the Reuben Young People’s Centre fit into the wider vision? This is the in-hospital element of the Best For You programme. Previously, young people experiencing a mental health crisis were admitted to general paediatric wards, often sharing space with much younger children recovering from surgery or illness. It wasn’t appropriate or safe. So we created the unit with specific provision for adolescents – it’s one of the first NHS units to properly integrate physical and mental health care for this age group. We work with co-design groups, including Word on the Curb and the Hammersmith & Fulham Youth Council, to get direct input on Best For You. For the Reuben Young People’s Centre, young people helped choose the lighting, contributed to the artist commissioning process, and advised on what would help create a calm and welcoming atmosphere. We ensured visual consistency between Arc and Reuben Young People’s Centre to promote familiarity. There are quiet spaces, seating nooks, a carers’ room, and adolescent and child-friendly zones. There are also QR codes linking patients back to the digital platform. What challenges did you face in making it happen? Introducing new ways of working in a busy clinical setting is always difficult. Some staff were initially concerned, thinking we were building a full-scale mental health unit in the hospital. We had to communicate that it was about delivering better care to the patients we already see. Finding the right space took time, as did managing post-pandemic delays. But once people understood the goal – improving outcomes for patients and staff – we gained momentum. Is there interest in replicating the model elsewhere? Yes, absolutely. Best For You was always designed to be scalable. It’s already been adapted in Denmark, where the Aalborg health region has launched a similar programme. We’re in conversations with NHS partners in Oxford, Manchester and Northamptonshire. Not everyone needs to build a new facility – even adopting our training and care model can make a difference. Over the next few years, we hope to support other trusts to take it forward. What has been the most rewarding part of your involvement? The day before the Reuben Young People’s Centre opened, I visited the unit and saw staff and families walking around, absolutely beaming. The nurses were proud and excited. Some families who had been through our hospital came to see the finished unit and could see how their input had shaped it. More broadly, I’m proud of how collaborative the programme has been. From donors and designers to clinicians, community partners and, most importantly, the young people and their families, it’s been a team effort. Now our focus is on growing that impact and reaching out to more young people. Chris Chaney, chief executive of CW+, discusses how the Best For You programme was formed
14 healthcaredm.co.uk PROJECT them. Co-design workshops ensured that young people’s voices shaped the look, feel and function of the space. Their feedback helped create a welcoming, non-clinical environment that feels safe, inclusive and empowering. The Reuben Young People’s Centre is also supported by a pioneering training model for staff, combining physical and mental health expertise. Nurses and clinicians working on the unit receive specific mental health training – a shift that reflects a more integrated view of healthcare and acknowledges the full spectrum of young people’s needs. This training not only enhances the care experience but also improves outcomes, de-escalation responses and staff wellbeing. Crucially, the Reuben Young People’s Centre does not stand alone. It is part of the Best For You ecosystem, a unique partnership of NHS Trusts, third sector, community and private organisations. Best For You has created a digital mental health platform and Arc, which is home to an out-of-hospital day programme for adolescents living with eating disorders. This approach also incorporates community partnerships and offers an unprecedented model for how youth mental health care might be reimagined and delivered across the NHS. ■
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16 healthcaredm.co.uk NEWS Estate management is a growing concern for the UK government, with a £49bn public estate maintenance backlog – £13.8bn from healthcare alone, more than double the 2015/16 figure. With limited resources, NHS trusts must seek support. Jonathan Oram, director of frameworks at Pagabo, explains how procurement solutions can help tackle the healthcare backlog crisis Tackling the estates maintenance crisis in healthcare The struggle to remain fit-forpurpose is at a tipping point, and the mounting backlog maintenance costs for public estates highlights the strain that continues to stretch an already overburdened NHS. A high priority for the government is improving healthcare infrastructure, but this is not limited to the New Hospitals Programme (NHP) alone, and the existing estate needs to be refurbished, reconfigured and revamped in many areas to continue to serve modern healthcare needs across society. However, this is no mean feat and will take a collaborative effort to deliver across client and project teams in a way that ensures top-quality clinical care, alongside overall value. THE COST OF A CRUMBLING ESTATE The National Audit Office’s recent report (NAO), spotlighting the staggering backlog in the UK’s estate maintenance, is not something that should come as a surprise. Across the Ministry of Defence, schools and NHS properties, there is more than £10bn in required maintenance alone, placing the healthcare sector especially at a critical turning point. The detrimental effect on patient safety from issues such as poorly maintained buildings and electrics are clear, but there are deeper cuts that continue to make the NHS bleed. This includes treatment delays, cancelled procedures and discharging delays outright, but also fosters an environment where inaccessibility and financial inefficiencies are also considerably common. As a construction sector, it can be easy for us to look at the buildings for what they are, but with the strain across NHS services continuing it’s important for us to remember the people those buildings support. Tackling this backlog is more than the structures that make up the NHS, but restoring the conditions necessary for timely, safe and dignified healthcare. Aligning with its report, the NAO has explored how the estate’s backlog as a whole can be bolstered. Standardisation is a top consideration, not only for ensuring compliance but in support of long-term viability – the NHS has to be a continued priority if we are to build a healthcare system fit for the future. WHY FRAMEWORKS WORK With the backlog increasingly impossible to ignore following the NAO’s scarily high deficit figures, we can no longer deny that action is needed. We instead must turn our attention to how tackling these COMMENT
healthcaredm.co.uk 17 COMMENT deficits can be done efficiently, safely and at pace. Public sector procurement and the framework routes available offer an effective route for this. These are pre-tendered and compliant routes that can provide trusts with flexible and fast access to specialist providers across estates and facilities management specialties. From limited internal resources to inconsistent delivery standards, these practical challenges that NHS teams are facing can be supported through framework intervention. Here, trusts can accelerate urgent maintenance works while also standardising quality and compliance, without the burden of complex contracts and procurement cycles. The benefits of this process are frequently seen in the work delivered through the frameworks Pagabo manages, including the Total Facilities Management Framework (TFM). This framework allows for more than just reactive maintenance, but also supports proactive lifecycle planning, monitoring and sustainability-focused upgrades, allowing us to shift from firefighting to forward thinking. NHS estates teams should be focused on supply chain management and project delivery, which is where the deep value of frameworks – including the TFM framework and other sectorspecific options – offer significant value. With many of the frameworks Pagabo manages being hosted by NHS trusts themselves, the design of them has healthcare in mind throughout. This close alignment with operational realities, alongside extensive engagement with healthcare professionals and ongoing dialogue with trusts, helps ensure procurement processes reflect current needs, not outdated models. Sector-specific framework offerings especially can offer unique respite to the challenges of the declining healthcare estate. Designed with the unique pressures of healthcare facilities in mind – from space constraints in areas like A&E to the risks of maintaining live sites throughout development – these frameworks offer more than just assistance; they provide a tailored, up-to-date solutions. This means trusts don’t have to start from scratch when tackling this uphill battle. They can access pre-vetted suppliers with a deep understanding of the healthcare environment, funding limitations and long-term planning needs – eliminating the need to start from scratch. The impact of poor maintenance on healthcare buildings is costly, and many issues – whether mechanical, electrical or safety-related – simply cannot wait for lengthy tender processes. Direct awards through a framework to approved suppliers can significantly reduce critical timescales, enabling urgent repairs and upgrades to be delivered quickly and effectively – still wrapped up in the all-important compliance required. SUSTAINABLE AND SOCIAL SOLUTIONS The continued stress on NHS services in recent years, from the pandemic to our ageing population, has left the foundations crumbling from the bottom up. What were once robust systems for planning and futureproofing have in many cases been sidelined. In this context, frameworks offer not only immediate delivery solutions but also a critical pathway to reintroduce resilience into estate management. Frameworks aimed at addressing the estates backlog should go beyond immediate fixes, helping to embed long-term goals that align with the NHS’s future vision. As we know, a prominent and pressing goal for the NHS is the move towards net zero goals. There is no doubt that facilities within the healthcare estate represent both major opportunity and challenge in reaching these goals. When utilising pre-approved suppliers that are already aligned with sustainability focuses and routes to realise goals, trusts can look to accelerate related efforts through elements such as retrofitting and energy-efficient systems – all without compromising day-to-day operations or patient safety. Effective social value is important across all sectors, and embedding this through framework options is an easy win to hitting those targets – but in a healthcare setting social value impacts can be far-reaching, impacting everything from quality of care and patient outcomes through to staff wellbeing. Using suppliers that work with local facilities management supply chains, for example, offers a great opportunity to give back, with apprenticeships and community engagement also being other top options. STRATEGIC CONSULTANCY AND GUIDING SMARTER DECISIONS The intrinsic makeup of a procurement offering is clear, offering powerful tools that can help our healthcare sector get back to a point where it can effectively withstand the blows of a tumultuous landscape. That being said, we can’t deny that there is also incredible value in understanding how to use them effectively. This topic has been a talking point >> ‘The continued stress on NHS services in recent years, from the pandemic to our ageing population, has left the foundations crumbling from the bottom up’
18 healthcaredm.co.uk NEWS well before the NAO’s report was published. To effectively tackle it, we need to understand the scale of support available and find the best collaborative routes. As a supplier on several frameworks managed by Pagabo, global engineering and professional services company AtkinsRéalis has reinforced the importance of effective strategic management consultancy within the procurement process. Anna Lewis, data and artificial intelligence lead at AtkinsRéalis, said: ‘The healthcare sector, along with most of the public sector, is under increasing pressure to drive productivity, improve performance and reduce costs – all while tackling constrained budgets. The consultancy approach operates to create structures, processes, technology and behaviours needed to turn vision into reality when it comes to a more streamlined operation. ‘As we adapt to the age of AI, we’re seeing technology take its place alongside human interaction - with its value becoming clearer when it comes to consultancy and project management. Across all sectors, many are erring on the side of caution with AI, unsure of what the future holds in terms of its ability, place and purpose alongside human-built structures. ‘Tackling the complicated structures of a national health system, AI use may become increasingly prominent, but it’s important to consider it as more than a tick-box exercise. As with effective procurement, AI utilisation for management needs to be considered, understood and utilised in the most efficient and compliant way, as a harmonisation of any framework process or procedure creation.’ TURNING INSIGHT INTO ACTION The NAO’s report at the start of this year presented some hard truths that end in an upward climb. With this comes a feeling of anticipatory anxiety that as a country and a sector we have to break through – doing so together. The effects of not doing so are too detrimental. Over the past two years alone, overall backlog maintenance has increased by £2bn. This rapid rise can be expected to continue if not tackled from multiple angles - from effective management consultancy, AI use and all-important stringent framework offerings that can offer solitude in the storm. With a framework approach, early engagement with framework providers is key, allowing for a holistic and collaborative approach. This approach must be embedded in all we do moving forward to tackle the crisis of our healthcare estate. Cross-sector collaboration – between client estate teams, contractors, consultants, procurement specialists and facilities management providers – is just one of the essentials needed to harness improvement. Alongside this, central government bodies must adopt this supportive and collaborative approach, working with frameworks as a delivery mechanism with significant positive benefits to the future of the UK’s healthcare system. For healthcare projects to succeed today and into the future, procurement can’t be an afterthought; it must be a foundational part of the project strategy from day one. By engaging early with those managing healthcare-specific frameworks, NHS leaders can better align procurement routes with clinical outcomes, sustainability goals and funding realities, all in aid of maintaining estates for the future. It’s not just about getting the job done; it’s about getting it done in a way that builds long-term resilience into the very fabric of the NHS estate. ■ www.pagabo.co.uk ‘For healthcare projects to succeed today and into the future, procurement can’t be an afterthought; it must be a foundational part of the project strategy from day one’ COMMENT Much of the exisitng NHS estate needs to be refurbished, reconfigured and revamped to serve modern healthcare needs
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20 healthcaredm.co.uk PROJECT West Park Healthcare Centre Toronto, Canada The new ambulatory care centre at West Park Healthcare Centre in Toronto was designed by CannonDesign + Montgomery Sisam Architects, and replaces aging hospital buildings on the historic 1904 West Park site with a 730,000 square foot centre focused on modern rehabilitative care. West Park has served patients with complex conditions like stroke, lung disease and traumatic injuries for over a century. The new design responds to evolving patient needs with a focus on functionality, natural light, accessibility, and integration with the surrounding landscape. Key features include operable windows in patient rooms, outdoor terraces and therapy spaces that prioritise both physical recovery and mental wellbeing. Principal at Montgomery Sisam, Jason Dobbin, played a central role in leading this project from concept to completion. In this conversation, he talks about the design process, the practical decisions behind key features and how architecture can support recovery in meaningful ways. Helen Adkins: What were the key design principles that guided the creation of the centre? Jason Dobbin: The design of West Park Healthcare Centre was guided by the principles of holistic healing, accessibility, sustainability and flexibility. From the outset, the goal was to create a facility that not only provided state-of-the-art rehabilitative and complex care but also fostered a sense of emotional and psychological wellbeing. Unlike conventional healthcare facilities where accessibility is often defined in limited terms dictated by codes and standards, the design of West Park took a broader, patient-centred approach that responded not only to patients’ physical abilities but also to their psychological, social and emotional needs. The facility brings together specialised rehabilitative and complex care services for lung disease, amputation, mental health, geriatrics, stroke and musculoskeletal injuries under one roof, ensuring a comprehensive and integrated care model. Pre-occupancy research played a critical role in shaping design decisions, ensuring that the built environment not only met the needs of its diverse patient population but also fostered confidence, motivation, and opportunities for physical and social interaction. The connection between indoor and outdoor spaces was another fundamental element of the design, reinforcing the role of nature in reducing stress, promoting recovery and improving overall patient outcomes. How did you balance the need for a functional medical facility with the goal of creating a healing environment? Balancing clinical functionality with a healing environment required a holistic and evidence-based approach that prioritised both efficient healthcare delivery and patient wellbeing. The design integrates natural materials, abundant daylight and extensive outdoor views to create a setting that reduces Opened in April 2024, West Park Healthcare Centre is an ambulatory care facility in Toronto. Jason Dobbin, principal at Montgomery Sisam Architects, discusses the principles behind the design – from accessibility and patient experience to the integration of nature as a tool for recovery – with hdm editor Helen Adkins
healthcaredm.co.uk 21 PROJECT stress and promotes recovery while ensuring the facility operates efficiently as a high-performing medical centre. To address known stressors in clinical environments, design solutions were implemented to remove physical and psychosocial barriers to patient recovery and reintegration. A core objective was to create an accessible and inclusive environment that encourages mobility, independence and social engagement. The inclusion of operable windows in patient rooms and terraces allows patients to connect with nature and experience fresh air at every stage of their recovery. At the same time, the spatial layout was carefully planned to support medical workflows, ensuring that therapeutic spaces, patient rooms and treatment areas were positioned to enhance accessibility, reduce unnecessary movement for staff and optimise clinical efficiency. By designing spaces that foster confidence and positive stimulation, the facility supports not only the physical recovery of patients but also their emotional and psychological wellbeing, reinforcing West Park’s mission to help patients ‘get their lives back’. Were there any specific patient or staff insights that influenced the architectural choices? Throughout the design process, extensive engagement with patients and staff informed many of the architectural decisions. One of the most significant insights was the need to create an environment that not only felt welcoming but also supported ease of movement for individuals with mobility challenges. As a result, operable windows were positioned at a low height in patient rooms, ensuring that even bedridden >> ‘Balancing clinical functionality with a healing environment required a holistic and evidence-based approach that prioritised both efficient healthcare delivery and patient wellbeing’
22 healthcaredm.co.uk PROJECT individuals could enjoy views of the outdoors. Outdoor terraces were incorporated on each floor to provide access to fresh air, recognising the importance of connecting to nature in the healing process. In the inpatient corridors, seating alcoves were placed at regular intervals, allowing patients to rest as they move through the space. Staff feedback also played a crucial role in shaping shared therapy areas and workspaces, ensuring that clinical efficiency was maintained while prioritising patient comfort. To ensure that the design met these needs, full-scale mock-ups of inpatient bedrooms, therapy spaces and staff areas were developed, allowing for hands-on input from both patients and staff. These mock-ups provided valuable opportunities to test, refine and evolve accessible design solutions in a way that directly responded to user feedback. The design emphasises nature as a healing element. What challenges did you face in incorporating natural elements both inside and outside the building? Incorporating natural elements into a healthcare setting presented several challenges, particularly in balancing access to outdoor spaces with the functional demands of a clinical facility. One of the primary considerations was ensuring that large windows and open spaces could be integrated without compromising infection control, privacy or energy efficiency. The Canadian climate posed another challenge, requiring careful material selection to ensure that outdoor spaces remained accessible year-round. Additionally, designing cascading outdoor therapy garden terraces (located on every inpatient level) and walking trails within an operational healthcare environment required a strategic approach to landscaping, accessibility and patient safety. Despite these complexities, the commitment to integrating nature into the healing process remained a priority, leading to innovative solutions that allow patients to experience the benefits of natural elements throughout their recovery journey. How did you determine the types of outdoor spaces (sensory gardens, fitness trails, meditation areas) that would best support patient recovery? The selection of outdoor spaces was based on research into the therapeutic benefits of nature, as well as input from rehabilitation specialists and patient care teams. Each space was designed to serve a specific function in the healing process, addressing both physical rehabilitation and mental wellbeing. The sensory gardens were developed to provide a ‘Meditation areas were designed to offer quiet spaces for reflection, recognising the role of emotional and psychological wellbeing in the recovery process’
healthcaredm.co.uk 23 PROJECT multi-sensory experience, incorporating textures, scents and sounds that promote cognitive stimulation and relaxation. Fitness trails were included to support patients undergoing mobility training and physical rehabilitation, allowing them to regain strength in a controlled outdoor setting. Meditation areas were designed to offer quiet spaces for reflection, recognising the role of emotional and psychological wellbeing in the recovery process. By incorporating a variety of outdoor spaces, the facility ensures that patients at different stages of rehabilitation can engage with nature in a way that supports their individual needs. Can you share more about the selection of natural materials and how they contribute to the therapeutic atmosphere? The selection of materials was heavily influenced by the goal of creating a warm, inviting environment that reinforces the connection to nature. Natural elements such as wood-like soffits, aluminium, copper-zinc alloy cladding, brick and stone were carefully chosen to reflect the surrounding landscape while ensuring durability in a healthcare setting. These materials contribute to a calming aesthetic, helping to reduce stress and anxiety among patients and visitors. The incorporation of nature-inspired textures and colours throughout the interior further enhances this effect, creating a cohesive design that supports the overall therapeutic atmosphere of the centre. The facility is designed to welcome the broader community. How did you ensure that the space remains both inclusive and functional for patients and visitors? Ensuring that the facility remains both inclusive and functional for patients and visitors required a comprehensive approach to accessibility – one that extends beyond physical requirements to also encompass social, emotional and psychological support. The design was guided by the principle that a truly accessible healthcare environment must not only be barrier-free but must also foster a sense of belonging, confidence and emotional wellbeing for all users. The hospital grounds are fully accessible to the neighbourhoods, with walking paths, exercise stations and quiet areas. The entry plaza will be used for neighbourhood events – such as the West Park Winterfest, outdoor market, community events etc. The auditorium can be reserved and used by the broader community. At the same time, careful attention was given to maintaining a balance between public accessibility and the specific needs of patients undergoing rehabilitation. Barrier-free design principles were applied throughout the facility, ensuring that all areas are easily navigable for individuals with mobility challenges. Thoughtfully placed wayfinding elements, natural lighting and open sightlines further enhance accessibility, ensuring that visitors and patients alike feel comfortable navigating the space. How does the therapeutic pool contribute to rehabilitation, and were there any specific design considerations for this space? The therapeutic pool plays an essential role in patient rehabilitation by providing environments that support physical and emotional healing. Located in the outpatient rehabilitation block, it was designed to facilitate aquatic therapy, allowing patients to improve mobility and strength in a low-impact environment. Accessibility was a key consideration in this space, ensuring that patients with varying levels of mobility could fully benefit from the therapeutic environment. What were the biggest challenges you encountered during the design and construction phases? One of the biggest challenges during the design and construction phases was integrating extensive green spaces within a high-functioning medical facility. The need to create a seamless connection between indoor and outdoor environments while maintaining operational efficiency required careful coordination between the design and healthcare teams. Another significant challenge was ensuring that the facility’s sustainability goals, including achieving LEED Silver certification, were met without compromising patient comfort or clinical functionality. The construction process also required meticulous planning to minimise disruption to ongoing healthcare services, as the facility was replacing aging hospital buildings within an active healthcare campus. If you were to design another healthcare facility in the future, is there anything you would do differently based on this experience? This project has reinforced the importance of flexibility in healthcare design, and if given the opportunity to design another facility, an even greater emphasis would be placed on modular, adaptable spaces that can evolve with changing healthcare needs. Additionally, while the integration of outdoor environments has been a significant success, future projects could explore even more extensive indoor naturebased therapy areas, ensuring that patients have year-round access to the healing benefits of nature regardless of seasonal limitations. Finally, the lessons learned in sustainable design and energy efficiency would continue to be refined, allowing for even greater environmental performance in future healthcare developments. ■ www.montgomerysisam.com www.cannondesign.com
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