Do keep up

The focus of healthcare delivery is moving from a service to treat illness to encouraging more personal responsibility for health. The change will be enabled by new clinical diagnostic and treatment services, new community-based health services and the use of digital communications to support effective use of clinical resources. As a consequence of this shift in emphasis, healthcare buildings will have to accommodate significant changes in use over their lifetime.

Improved awareness and understanding of new and emerging technologies should lead to an enhancement in the quality of the UK’s healthcare estate. But this will only be possible if clients can link with organisations and individuals to develop and supply the innovative technologies and processes required in the sector.

To help encourage organisations and individuals to share knowledge and processes, the DTI has set up a healthcare group as part of the Modern Built Environment Knowledge Transfer Network (MBE KTN). The network is run by BRE, BSRIA, CIRIA and Arup.

The mission of the Healthcare KTN is to accelerate the transfer and uptake of technology and process innovation to facilitate delivery of improved clinical outcomes and cost-effectiveness.

The aim of the network is to bring together the suppliers of technological and process innovations, including universities and research organisations, with those directly involved in making use of innovation, such as clients, suppliers, contractors or component manufacturers involved in the provision and use of the built estate.

Working with key healthcare organisations, including the Department of Health, the KTN has identified the following important themes in addressing strategic sector issues: energy and sustainability; flexibility in use of the built environment; application of digital communications to support effective use of healthcare resources; and clinical infection.

Energy efficiency

The NHS’s annual energy bill is set to reach £400 - £500 million this year following recent price increases. A primary objective of the Healthcare KTN is to improve energy efficiency and reduce energy costs. Innovative processes to help achieve significant reductions in energy consumption in new and existing stock will be promoted through the KTN along with developments from industry and academe. In addition, the Department of Health recently launched a £100 million energy reduction grant scheme and the lessons from this will be communicated through the KTN.

Flexibility of healthcare buildings

Health services in the UK and much of the developed world are being forced to deal with unparalleled levels of innovation, new technologies and new clinical and diagnostic procedures, along with changes in the form and location of service delivery.

The buildings in which health services are delivered need to be designed, constructed and managed in such a way that they can respond flexibly. For example, large institutional buildings are unlikely to be able to meet the needs of a health sector where there is an expansion of community-based services and a shift towards service delivery in the home.

Achieving this flexibility is a priority for the Department of Health and therefore a priority theme for the Knowledge Transfer Network.

In practice this will require not just the identification, exchange and promotion of both existing and new knowledge relating to appropriate design and construction methods, but also a change on the part of clients and decision-takers to ensure, as far as possible, that project specifications and supporting technical guidance have regard to future patterns of use and service delivery.

Digital communications

Widespread availability of the internet has produced a revolution in communications, affecting economies and societies. Public services are moving towards delivery of services through the internet, and this includes healthcare.

Internet-based technologies have the potential for a substantial impact on the delivery of healthcare. A number of internet-based initiatives are under way in the UK, including NHS Direct and Connecting for Health, which is responsible for co-ordinating the roll-out of a range of internet and IT-based initiatives. The systems and technologies can be used to support existing practices, such as providing online prescription or appointment booking services for acute and primary care. Potentially, though, the greater impact is in offering a framework for new models of healthcare provision.

Healthcare delivery supported by digital communications systems is consistent with the shift in focus to delivery in the community, satisfying patient preferences to be at home, supplying services locally and saving the expense of supporting patients in acute care facilities.

Clinical infection

If healthcare-associated infection is to be reduced, it is essential to design infection control into buildings. To achieve this designers, architects, engineers, facilities managers and planners need to work in collaborative partnership with infection control teams.