As the world recovers from the impact of the Covid pandemic, Arcadis health sector specialists Smriti Singh and Chris Waine share their initial thoughts on designing future post-Covid hospitals.
The impact of the Covid-19 pandemic is enormous and still playing out. It has forced us to think about airborne infections for the first time in decades. Any new hospital design must now take account of airborne infections as well as addressing the longer-standing strategic challenges of aging and lifestyle factors.
We have considered these challenges and set out our initial thinking on how to design a post-Covid hospital: in terms of its purpose, what services it should provide, layout, staff spaces and technology.
Our starting point for hospital design is clarity of purpose. Addressing modern healthcare challenges requires cultural as well as practical changes. We therefore recommend directly addressing this from the start, in the design principles. Traditional hospitals require – for reasons valid at the time – people to behave as passive recipients of treatment and care. Modern hospital design should seek to harness people’s own motivations and resources and integrate them into the way we manage health.
The modern hospital needs to be more than a hospital. We believe it should be a hub for the local community, housing a range of organisations, some of which directly support people’s health and care, and others which will do this indirectly supporting the health of the local population.
We propose that new hospitals must be designed to include a broader range of services, most importantly mental health provision. Including mental health services in hospital design could be through additional dedicated space for mental health practitioners but also the inclusion of mental health expertise in ‘mainstream’ service areas such as Emergency Departments.
Hospitals can be difficult to navigate and feel disempowering to patients and families. This is often because they have developed incrementally, with departments and services set out in ways which feel illogical to users, with signage that uses the language of professionals and not ordinary people.
One simple idea is that services should be organised around parts of the body with all signage in simple English; an area for the ‘heart’, an area for the ‘brain’. Whilst this may not always be possible, having plain, non-medical, language as a design principle is a cheap and effective way of making the hospital easier to navigate.
The layout must also now be designed to minimise infection control. Even if we don’t have a full-blown pandemic for decades, the reality is we are likely to see mutations and consequently infectious outbreaks. For most of the hospital, this means single rooms by default.
As hospitals have evolved, and healthcare costs increased, staff spaces within hospitals have become eroded. We now need to think seriously about great facilities for hospital staff. If nothing else, the pandemic has brought home the value of the hospital workforce and the urgent need to address the longer-term issue of the NHS’ workforce crisis. When thinking about staff spaces, we want to achieve three outcomes: enabling relaxation and decompression, support co-working and driving a safety culture.
Digital tech is a game-changer. Whilst the NHS is right to focus on electronic patient records, we can do much with cheaper solutions which deliver benefits quicker. Digitising patient pathways, to introduce more self-monitoring, means we can provide more with the same workforce, increase visibility and extend the hospital’s reach beyond its walls. Benefits can also include a reduction in ‘routine’ follow-up appointments and patients getting faster, timely and direct access to specialists.
The ideas set out here represent a starting point. They require further development, and this should be done ‘bottom-up’, with those who will use it and those who will work there.
Smriti Singh is UK health transformation advisory lead at Arcadis, and Chris Waine is UK health sector lead at Arcadis.