Heather Chapple A+D Scotland

  • 109 views
Uploaded on

Primary Care Reference Design

Primary Care Reference Design

More in: Technology , Business
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Be the first to comment
    Be the first to like this
No Downloads

Views

Total Views
109
On Slideshare
0
From Embeds
0
Number of Embeds
0

Actions

Shares
Downloads
0
Comments
0
Likes
0

Embeds 0

No embeds

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
    No notes for slide

Transcript

  • 1. Heather Chapple A+D Scotland Primary Care Reference Design
  • 2. Reference Design Multi-agency project through SFT & Hub 1 real project 2 design teams 3 half day sessions 30+ stakeholders £2.5m savings Lessons on design, on process and on affordability
  • 3. Design Lessons  Wayfinding for those less familiar with the facility  Bookable rooms and central spaces to be used flexibly over an extended day  The ’visibility’ of such services in the experience of all users  GP areas be calmer, with less through traffic, and more readily ‘shut down’ while other areas remain open  Increase privacy in GP consulting areas  Brings GP areas closer to staff offices, increasing the viability of shared staff resources and opportunities for developing shared experience and ethos. The New ‘Front Door’
  • 4. Design Lessons  Ease of access, especially for people with impaired mobility  Minimise transfer time from waiting to consulting, reducing down-time between appointments and increasing opportunities for staff to collect patients in person, which is valued by patients  Minimise patient use of corridors, and the monotonous experience  The quality of environment when waiting, with good visual connection to receptions to feel secure and not forgotten, and greater opportunities for personal choice and visual interest Efficient Patient Circulation
  • 5.  Give flexibility to accommodate new and more mobile work patterns  Provide good quality spaces for collaboration and retreat spaces for quick/sensitive conversations  Offer choice in location, and a range of space types for personal preferences  Ensure resources are put into providing a positive working environment for staff, rather than an under-used one  Increase social/impromptu discussions helping build a shared ethos  Provide opportunities to allow GP’s etc to learn/work away from consulting rooms, freeing up additional consulting sessions Design Lessons Changing Working Modes
  • 6. Design Lessons  Layout which minimises provision of dedicated "departments"  Rooms for general sessional use grouped and served by a shared reception with a mix of clinical and interview rooms and operable in a range of clinic sizes  Shared GP waiting areas which allow peak numbers of patients to sit near to their practice  Shared receptions resisted but adjacent location of receptions was thought beneficial, making sharing of resources viable, and also helping long term flexibility Flexibility and Space Efficiency
  • 7. Design Lessons  Electronic records  Physio, if co-located with consult X Public spaces; no longer overheads but venues for health promotion, the social aspects of well-being, and integration of the third sector, • seating groupings within larger space and smaller more discrete areas. • public areas with venues for accessing information through IT etc • public areas with space for 3rd sector stalls and flexibility for out of hours use • external areas designed to provide additional service opportunities for physio/children’s services/3rd sector and promotion events Room for Reduction?
  • 8. Process Lessons  Concentrating the Program  Stakeholder Engagement Mixing up the groups: • helped the cross fertilisation of ideas and practices, encouraging people to reach beyond their own experience and braking down preconceptions of what is possible; when a colleague describes how they work in one way it becomes difficult to say it is not possible. • started to build the relationships that’ll be needed in the new place.  Quality Based Selection Process Construction Unitary charge
  • 9. www.scottishfuturestrust.org.uk Area Efficiency Measurement
  • 10. www.scottishfuturestrust.org.uk Area Efficiency Measurement
  • 11. www.scottishfuturestrust.org.uk Funding Metric Summary Metric includes all costs with the exception of the following: • Land purchase • VAT • Group 2 supply and group 3 & 4 supply and install furniture. • IT hardware £1,385/m2 £1,395/m2
  • 12. www.scottishfuturestrust.org.uk VFM Summary VFM Summary Sheet • Submitted by Health Board to SGHD • Summaries cost drivers & performance • Simple to use. Eastwood Assessment 0% 20% 40% 60% 80% 100% 120% Area Per GP Ratio Support Space Capex Life Cycle Metric Actual
  • 13. Design Context in Scotland “Work is in hand to consider how design quality can be embedded within the Scottish Government Health Directorates business case approval processes through the further development of the Scottish Capital Investment Manual for NHSScotland and the involvement of appropriate design experts within the business case approvals process.” Nicola Sturgeon: 24 February 2009 Design Quality Policy for NHSScotland Business cases seen by Government Design Assessment in the Business Case
  • 14. Design Assessment in SCIM  Applies in full to all projects, over delegated limit, which were pre-IA on 1st July 2010.  Discretionary use on those pre-OBC on that date.  Considered good practice in all other projects.  Process supported by HFS and A+DS, who have role advising Boards & CIG.  Formal assessments needed in lead up to business case points, but recommend engagement sought earlier : ‘no surprises’ principle.  Assessments are made of developing project against standards established in Healthcare Design Guidance and project specific Design Statement - produced, assessed and agreed pre-IA. Capital Investment Group Consider Business Case including level of support from NDAP PROJECT TEAM Develop business case and Design Proposals PROJECT BOARD ensure standards are established and self assessment is carried out HEALTH BOARD Consider Business Case, including assessment of NDAP, and, when ready, submit to CIG Design Assessment Process HFS/A+DS Consider draft business case and comment prior to consideration of completed business case by Health Board. Outcome verified to CIG on submission of business case.
  • 15. Map this into YOUR processes Walk through a ‘day in the life’ Capture short statements on key attributes increase ‘bang for the buck’ find views of what success might look like Pull out key Business Objectives Design Statement
  • 16. Map this into YOUR processes Walk through a ‘day in the life’ Capture short statements on key attributes increase ‘bang for the buck’ find views of what success might look like Pull out key Business Objectives Design Statement • Platform for integrated service delivery at a neighbourhood level. • Facilitate safe and easy access. • Support clinical effectiveness and result in improved treatment outcomes for patients. • Tackling health inequalities and maximise social and economic benefits for the area . • Improve service efficiency by achieving a better joint use of valuable resources and flexibility to meet the health care needs arising from demographic change . • Sustainability - optimise the efficient use of energy, water, waste management and in so doing reduce lifetime costs whilst also reducing the carbon footprint by minimising pollution generation. • Suitable working environment including promoting patient and staff wellbeing and confidence .
  • 17. Map this into YOUR processes Walk through a ‘day in the life’ Capture short statements on key attributes increase ‘bang for the buck’ find views of what success might look like Pull out key Business Objectives Design Statement Service Users “Arriving must feel pleasant and safe in daylight and darkness... The routes and any parking spaces used should allow and encourage use of other amenities (shops, library etc) whilst in the area, not separate the use of health services from the normal experience of the area.” Staff “The layout of the facility, and the inclusion of IT services to support communication, must promote and enable joint working and efficiency.” Visitors “the design of the communal areas must communicate the range of services available, support for carers , and health promotion messages to those visiting with others”
  • 18. Map this into YOUR processes Walk through a ‘day in the life’ Capture short statements on key attributes increase ‘bang for the buck’ find views of what success might look like Pull out key Business Objectives Design Statement “Arriving must feel pleasant and safe in daylight and darkness... The routes and any parking spaces used should allow and encourage use of other amenities (shops, library etc) whilst in the area, not separate the use of health services from the normal experience of the area.”
  • 19. Map this into YOUR processes Walk through a ‘day in the life’ Capture short statements on key attributes increase ‘bang for the buck’ find views of what success might look like Pull out key Business Objectives Design Statement Staff - “The layout of the facility, and the inclusion of IT services to support communication, must promote and enable joint working and efficiency.” -Shared resources (meeting and rest spaces) close enough to other working areas to facilitate use (2 mins walk) and attractive enough to encourage use. Designed flexibly to allow range of uses over an extended day. -Staff circulation routes shared by all services, not separated by discipline. -Informal spaces at natural meeting points such as circulation nodes and commonly used facilities (photocopier/printer) to enable impromptu discussions.
  • 20. Map this into YOUR processes Walk through a ‘day in the life’ Capture short statements on key attributes increase ‘bang for the buck’ find views of what success might look like Pull out key Business Objectives Design Statement Visitors “the design of the communal areas must communicate the range of services available, support for carers , and health promotion messages to those visiting with others”
  • 21. Map this into YOUR processes Walk through a ‘day in the life’ Capture short statements on key attributes increase ‘bang for the buck’ find views of what success might look like Pull out key Business Objectives Design Statement “the project must make the most of the opportunity to improve the appearance and experience of an area of multiple deprivation to aid community perception and regeneration” “the layout must allow for additional services to be added to the development as an ‘extension’ without compromising the ‘non- negotiables’ above”
  • 22. Map this into YOUR processes Walk through a ‘day in the life’ Capture short statements on key attributes increase ‘bang for the buck’ find views of what success might look like Pull out key Business Objectives Design Statement What are the key decision points in progressing the project? Then for each: •Who will decide if it’s looking on track to deliver? •Do you need to bring in any additional perspectives to inform that decision, and if so who? •How will you assess you’re on track in terms of the statements and benchmarks (in getting the right skills on board and checking the developing proposition) and how can you ‘value’ that aspect in the decision amongst the other criteria that would figure in that? •What specific/additional information will you need to make that evaluation?
  • 23. What are we looking for? Clear link between business objectives and design objectives through: •the key experiences on the patient journey •supporting behaviours, connections and wellbeing in staff .....and which address key areas such as: •benefits of any co-location •flexibility in use and adaptability over time .....and that tricky aspects are tackled and direction of travel established. Benchmarks that are: •humane. •learning from other’s successes •a clear ‘basis’ for assessment Objectives and benchmarks that aren't so specific as to be problematic. Broad basis of support - “agreed non-negotiables”. Design Statement
  • 24. ...an estate designed with ‘a level of care and thought that conveys respect’; buildings that grow from the local history and landscape, that are developed in partnership with the local community - a work of joint learning and joint responsibility that is particular to that community and that place; ‘Not off the shelf shoe boxes’... from an interview with Dr Harry Burns CMO Vision of Health
  • 25. ` © Architecture and Design Scotland June 2012 You can find out more about Architecture and Design Scotland on our website www.ads.org.uk or follow us on Twitter @ArcDesSco Thank you. Edinburgh office Bakehouse Close 146 Canongate Edinburgh EH8 8DD Glasgow office 11 Mitchell Lane Glasgow G1 3NU Tel +44 (0) 131 556 6699 Fax +44 (0) 131 556 6633 www.ads.org.uk www.healthierplaces.org