“Everything is Design. Everything!” – Paul Rand

Everything is Design. Everything.
Architects for Health at the Design Council.
17th September 2015

As a writer, thinker, graphic designer and art director for some of the most memorable corporate organisations in the USA, Paul Rand (1914-1996) believed that design is embedded into every aspect of life – Everything is Design. Everything. Exploring this at the Design Council with five speakers from widely different backgrounds, Architects for Health was first given an insight into the design of the mind.

Dr Steven Allder, a consultant neurologist, declared unhesitatingly his interest in hysteria. Through his work as a clinician and subsequently leading change in his field, he explained how initial improvements to organisations at a small scale can be relatively successful but that upscaling is challenging. The larger the challenge, the more embedded are the entrenched positions – and we are all, he believes, programmed to exist and remain in a ‘tribe’ mentality, inhibiting creativity.

His analysis of the design of the mind explores three stages or loops, with the last achieving a creative mind. However, so often, this state is rarely achieved within large corporate structures, 99% of executive teams mess up at critical moments, entirely unconsciously.

On a more positive note, Dr Allder believes that design is a social process and should be fully embedded in any social system. To understand the design of the mind gives insight into our unconscious behaviour and a way forward beyond the analytical is the power of a lesson from ancient times – to connect with our hearts.
View Dr Steven Allder’s presentation on SlideShare

Shirley Cramer, Chief Executive of the Royal Society of Public Health, has a daunting agenda to challenge widespread health lifestyle issues – smoking, drinking, inactivity and obesity – and the associated costs to the NHS annually of around £14 billion. RSPH advocates parity between mental and physical health and has evaluated aspects of how deprivation skews lifestyles.

The RSPH study “Health on the High Street” began by attributing a score – a ‘Richter scale’ of health impact – to various types of outlet. Leisure centres scored best followed by health clubs, libraries and unexpectedly, pubs. The worst offenders were payday loan shops, closely followed by bookmakers, fast food outlets and tanning salons.

This methodology was then applied to various high streets across the country with a close correlation between the overall score of the outlets and the levels of health impact locally. Results were published widely leading to some local authorities asking RSPH for assistance in improvements. Several recommendations have been drawn from the study among which are changes to planning powers for local authorities, legislation to allow differential business rates for healthier outlets and clear nutrition and calorie information at fast food shops.
View Shirley Cramer’s presentation on SlideShare

Vivienne Parry works with Genomics England as Head of Engagement. Over the last few years, the cost and speed of genome sequencing has reduced dramatically and given rise to a government sponsored programme called the 100,000 Genomes Project.

Genomics England is owned by the Department of Health and is leading the world with the aspiration to source genomics information from about 75,000 people by 2017. The ethical and data security challenges are many but the study opens up an entirely innovative approach to treatment and prevention.

The possibility of personalised medicine is within reach as genomics aspires to allow individual targeted identification and diagnosis. Vivienne Parry cited five cases of neonatal diabetes, whose condition might have been treated with the same regime: genomic analysis allowed personal assessments leading to five different and individualised treatments.

The 100,000 genomes project has the potential to change the face of medicine and treatment with ever increasing sophistication and techniques: in the future, genomics information may be possible with hand-held technology, with the subject being asked to ‘spit in a box’ – with the amusing working title of ‘Min-ion’.
View Vivienne Parry’s presentation on SlideShare

John Cooper, former Chair of Architects for Health and seasoned healthcare architect, recalled earlier robust studies and conferences optimistically heralding design in healthcare as a vital thread. He then contrasted this with the reality of the present, where central guidance is under threat, design expertise within the NHS has all but disappeared, Trust finances appear out of control and Chief Executives have seeming the lifespan expectancy of a Lancaster bomber tail-gunner.

The NHS estate continues to carry a massive and unaddressed backlog maintenance burden while agency nurse costs and negligence claims apparently soar. It is broadly the case that clinical and nursing care is first class, but has become mechanistic; that the service perspective from staff is of over-management and fragmented. Investment and strategic decisions appear irrational.

John Cooper referred to work he is doing for London Trusts where reconfiguration is expected to achieve savings and rationalisation of services. However, his view is that these exercises are flawed and influenced unduly by historical and geographic baggage as well as egos and entrenched positions.

It is a sadness that NHS/DH has apparently mislaid the power of design and the value of an integrated strategy.

As an example of a more sympathetic system; through integrated thinking, Singapore has developed facilities which are well designed, not showy, give patients unexpected opportunities such as gardening, provide excellent green spaces with tropical fish and enhancing the integrity of a healthcare environment.

The Singapore experience may be influenced by their careful strategic approach to health developments and, potently, by the existence of design teams embedded within every hospital.
View John Cooper’s presentation on SlideShare

Claire Devine, who is a Director of DC CABE, referred to the studies which had been undertaken by the Design Council including the well-received research into reducing violence in A+E departments. The Knee High Design Challenge had engaged with children under 5 and work is under way on 5 Healthy New Towns which will focus on 250 homes per year for the next 5 years. DC’s programme also includes ongoing development of their Active by Design approach.

Claire Devine welcomed Architects for Health to DC CABE’s offices and expressed the view that the two organisations could work closely together as Design Advisory Panels are formed. There has already been initial dialogue between DC CABE and some NHS Trusts and the value of Architects for Health’s input was acknowledged.

The event was made possible by the generous sponsorship of Drager and of Scott Tallon Walker, to whom Architect for Health express their grateful thanks.
Draeger

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