How can we do more with less?
From within the inspiring modernist setting of the Royal College of Physicians’ library endowed with ancient books on subjects as diverse as mathematics and the universe, AfH together with the European Health Property Network explored how to sustain the quality of healthcare design with less money and importantly, less political will to spend freely. Speakers and delegates from across the UK and mainland Europe shared ideas, plans, built examples and visions. The event generated a challenging and provocative discussion with the sense that significant changes will need to happen to make this possible over the next decade.
Jeni Bremner, Director of the European Health Management Association (EHMA) outlined three ways to introduce structural change: keep calm and carry on, rearrange the deck chairs and head for the lifeboats. Policy makers and manager each react differently to these scenarios. Moreover, an ageing workforce and inadequate working conditions are significant barriers to change: happy staff positively impact patient outcomes. The ways things are currently happening leaves many people feeling that they are ‘changing the wheels while the car is moving’.
Andy Black, Director of Durrow Consulting, outlined the parts of the NHS services that are delivered well: eg General Practice and Accident and emergency, pointing out that the bit in the middle is poor –that is, care of frail older people and those with long term care illnesses in the community. He criticized the NHS for having no sense of civic purpose- in social and architectural terms- calling for great civic engagement. ‘We have forgotten how to be radical in our thinking. And it holds us back.’
Steve Wright from the European Centre for Heathcare Assets and Architecture ECHAA, gave an Olympian overview of the literature on European health systems emphasising that complex systems are intrinsically hazardous. There is inconclusive and insubstantial evidence on the scale and scope of healthcare networks, hospitals and general services. Leadership and vision need to prevail otherwise we are in ‘danger of sleepwalking into a disaster of our own making’.
The experience of the Danish speakers, Claes Brylle Hallqvist and Henrik Scholts, was almost from an equal and opposite vantage point, with five super hospitals underway in Denmark. They both expressed great optimism for achieving the best planning in relation to location, public engagement, effective productivity and intelligent use of technology.
Richard Darch of Healthcare Partnering, showed how commercial prudence, good sense and good design can be combined to achieve sound investment into property development in the NHS. Making this happen on the ground requires vision and the ability for co-working between public and private sectors.
Petra Woener of Woenerundpartners, and Duncan Finch of Avanti Architects, each described small scale schemes of great delight in Germany and the UK respectively. They both beautifully demonstrated the potential for achieving good design with intelligent designers and informed clients.
John Cole and Richard Murphy exemplified this relationship and illustrated it with examples of designs for mental health services in hospital and community settings. Richard articulated his ‘Crusade against the corridor’, making rooms feel like individual homes, celebrating the views that connect with the place, and generating a sense of security without the presence of oppressive boundaries.
Alex Kafetz, Editor of a recent report on hospitals by Dr Foster’s, joined John Cooper and Chris Shaw from Architects for Health, to lead the final session: a review of the ideas that had surfaced over the day and recommendations for the way forward. These included: for health services and systems to engage in a wider civic responsibility; for the workplace to value staff and the immense importance of caring they bring; for a more prudent use of resources for development; for recognising that in those parts of the UK/ EU with high land values, the renewal of the health estate might be funded through shrewd property development without the need for major public investment; for better planning of services for improvement across the system knowing there are no metrics for certainty; and for the direct engagement of designers and clients in an intelligent process of renewal and revitalisation.
View event’s presentations at Architects for Health Presentations