1. The future of
healthcare and the
implications for the
built environment
Candace Imison
March 2014

2. Rising life expectancy

3. Rising numbers of older people

4. % Increase last 20 years
0-64
65-84
85+
1989/90-2009/10
An ageing and more demanding
population
NHS
Spend
Source: DH - Departmental Report
2006
133% by 2035

5. Population lifestyles present
significant risks to their health
5

6. Behaviour change is not easy

7. Growing numbers of people with long term
conditions and multiple conditions

8. Rising care needs

9. Significant growth in need for
informal care

10. But - more people living on their own

11. ! A cure or vaccine for certain cancers.
! An increase in the number of lifestyle
drugs available
! Devices that have the capacity to replace
or integrate with human tissue
! Biosensors that allow continuous
monitoring of a patient
! Pharmacogenetics support more effective
treatments
! In the longer term stem cells provide
capacity to replace or repair organs
Increasing capacity to
diagnose and treat

12. Continuing and rapid
technological advance
! Continuing growth in
computing power,
intelligence and access
! The world of Big Data
! Shift towards smart phone/
tablet and apps from PC
and web
! Current digital divide
presents challenges

13. Ubiquitous access to the internet

14. Technology could support service
transformation
! Reactive to proactive
! Help patients help
themselves and each
other
! Personalised services
! Care to health and
wellness
! But
! One size does not fit
all
! Caring still counts

15. Virtual visits – remove
geographical barriers to access
Health care can be
done at a distance
with video
conferencing and
remote monitoring
of blood sugar,
blood pressure,
heart rate, and other
health data.

16. !"#$%&%'%"(%')*"+"&,+-)#$%../$%.)

17. 0%+-(1)2/,-(),"(3)(1%)%"4,$3"5%"()
!"#$%&'()*+,(-(+#./0.12(3#4#$&5(6(!./7&$(8.1.125(

18. The home as the locus of care

19. 65+$()13/.%)37)(1%)7/(/$%)8)3$)9:;<=)
!"#$%&'(91.7&$5.4:(";(*"<=(>?@'AA=BC.D#."<=D&0#A(

20. Hospital of the future?

21. The hospital - part of a wider web of
patient focused care
Home
Health and social
care centres
close to home
Community care
centres
heart of the
community
Specialist care centres
on central city sites
Self care
Monitoring
Automated treatment
Information and advice
NHS Direct
Social care
Primary care
Outreach care
Basic diagnostic services
Day interventions
Minor injuries
Nurse led inpatient care
Intensive rehabilitation
Chronic care management
Home
Nursing homes
Pharmacy
Cyber café
Health kiosk
Surgeries
Drop in centres
Healthy living
centres
Resource
centres
Community
hospitals
DTCs
Secondary care
Tertiary care
Planned interventions
Emergency care
Complex diagnostic
Treatment & inpatient care
Adapted from:Building a 2020 vision - The Nuffield Trust (2001)

22. Bromley by Bow Health Centre

23. More integrated community based
models of care
High tech
Automated
pathology, digital
imaging,
telemedicine, IT
links
Bringing health care into the
heart of the community:
A new relationship with the
public:
Welcoming, therapeutic
environment, integrated with other
public services
Mobility centre
for intensive care
rehabilitation
Consulting
Basic diagnostics
Day interventions
Nurse led
inpatient care
Minor injuries
Child development
centre
Hospices and
nursing homes
Mental health
resource centre
Education,
leisure
Advice
Day centres for
older people
Alternative
health care providers
A new relationship
with the environment
Sustainable systems:
water,
energy, recycling,
waste,
emissions, bio-diversity
Adapted from: Building a 2020 vision - Nuffield Trust (2001)

24. Older people’s
vision
› Connection
› Control
› Personal
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7.5."16;"$6%=$&6;#//D@0;((

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