The document discusses trends in healthcare design over the past 20 years and a vision for healthcare environments over the next 20 years. It notes a shift towards more decentralized healthcare with mass migration, transient populations, and economic pressures straining integrated solutions. The patient and staff experience is described as mechanistic and fragmented rather than focused on care. The power of design, environment, and good working conditions to improve healthcare is cited as having been lost from the NHS vision. The document advocates for disruptive decentralization, regenerative design, and taking an integrated strategic approach.

1. Everything is design Everything

2. 2015
European Healthcare Design
Reinvent healthcare through design
Blair Sadler and Robin Guenther

3. 2020 vision:
our future healthcare
environments
A summary of the key findings of the 2020 vision research project
– a multi-disciplinary study to identify current social, economic
and technological trends and how they might influence the design
of healthcare environments over the next 20 years
20012001

4. 2003
The Fabled Hospital
Nuffield trust

5. 2004
The Hospital in the City
CABE

6. Civic buildings
City fabric
Extension of the city
Simulacra of the city

7. 13 Questions for engagement
ARS EXPERIENCE OF MANCHESTER
Do you think producing technical estates &
facilities guidance fits with the DH landscape
today (stewardship role for the NHS)
How could, or how should, the Department
maintain its current position with no technical
resource, fewer staff, lost expertise and
no/limited funding

8. 13 Questions for engagement
ARS EXPERIENCE OF MANCHESTER
Do you think producing technical estates &
facilities guidance fits with the DH landscape
today (stewardship role for the NHS)
How could, or how should, the Department
maintain its current position with no technical
resource, fewer staff, lost expertise and
no/limited funding

10. Addenbrooke’s Hospital chief executive Keith McNeill resigns
14 September 2015
The Chief Executive of a major
NHS hospital has resigned a
week before a care watchdog
report is published.
Dr Keith McNeil who was
appointed to the job at
Addenbrooke’s Hospital in
Cambridge in November 2012
said the faced “serious
challenges”.
Chief finance officer Paul
James has also resigned from
the hospital, which is running
a deficit of £1.2 million a
week.

11. IS YOUR HOSPITAL HERE?
A TOP 40 of Britain's healthiest hospitals was published yesterday following a survey of clinical targets such as waiting
times and mortality rates.
NHS trusts were assessed on a total of 13 clinical targets, which also included speed of access to surgery, availability of treatment to the elderly, and the
number of post-operative problems.
The list was compiled by a company which specialises in measuring health care performance.
The top 40 were selected from more than 100 NHS Trusts - about a third of the total in the UK - which employ the company to measure their
performances against one another.
Time taken to discharge hip operation and stroke patients, length of hospital stays, cost of procedures and the number of operations that resulted in
complications and readmissions were also examined.
Researchers also looked at wide- ranging Department of Health clinical indicators, published last year, which examined how trusts were managing
everything from complaints to waiting times.
Addenbrooke's NHS Trust, Cambridgeshire Altnagelvin Hospitals Health & Social Services Trust, Londonderry
Birmingham Heartlands & Solihull NHS Trust Brighton Healthcare NHS Trust Central Manchester and Manchester Children's University Hospitals NHS
Trust Ceredigion & Mid Wales NHS Trust Chelsea and Westminster Healthcare NHS Trust City Hospitals Sunderland NHS Trust Conwy & Denbighshire
NHS Trust Countess of Chester Hospital NHS Trust Doncaster & Bassetlaw Hospitals NHS Trust
16th September 2015

12. 13 YEARS EXPERIENCE OF MANCHESTERHeadhunters had struggled to find even one appointable
candidate in their last 10 NHS Trust Chief Executive
appointment processes.
The average length of tenure for an NHS Chief Executive these
days is 20 months and leadership turnover in some of the
more challenged Trusts is clearly a significant factor in poor
performance.
There were 20 NHS Trust Chief Executive vacancies at one
point last Summer.

13. NHS hit by £2.5bn agency staff bill
1 Nov 2014
NHS spending on agency nurses soars past £5.5bn
Government accused of ‘truly incompetent planning’ after years of
training cuts push cost of temporary staff way over budget

14. 13 Questions for engagement
ARS EXPERIENCE OF MANCHESTER
Do you think producing technical estates &
facilities guidance fits with the DH landscape
today (stewardship role for the NHS)
How could, or how should, the Department
maintain its current position with no technical
resource, fewer staff, lost expertise and
no/limited funding

15. Design matters
NHS Clinical Negligence budget
2011 £8.7 billion
2013/2014 £15.6 billion

16. £4.2 billion backlog maintenance

17. Design matters
Providers and commissioners of NHS services
There are currently in England:
209 clinical commissioning
155 acute trusts)
56 mental health trusts)
34 community providers
c.8,000 GP practices
853 for-profit and not-for-profit independent sector organisations

22. The Patient experience
• different journey, same outcome
• mechanistic processes
• treatment not care
The Staff experience
• the system dictates culture
• over managed
• a fragmented treatment conveyor belt
• an investment in capital, not revenue

23. The Patient experience
• different journey, same outcome
• mechanistic processes
• treatment not care
The Staff experience
• the system dictates culture
• over managed
• a fragmented treatment conveyor belt
• an investment in capital, not revenue

25. Northwick Park Hospital

26. Northwick Park Hospital 2015

27. Northwick Park Hospital Nursing Times 1966

28. Ealing Hospital

29. Central Middlesex Hospital

30. 2020 vision:
our future healthcare
environments
A summary of the key findings of the 2020 vision research project
– a multi-disciplinary study to identify current social, economic
and technological trends and how they might influence the design
of healthcare environments over the next 20 years
20012001

31. Disruptive decentralisation
requires informed intelligence

32. Shaping a healthier future 2012

33. Post 2008 economics
Post 2008 health economics
Mass migration
Fast growing population
Transient populations
Retardant effects of 2011 reforms
Denying any sense of integrated pan London solutions

34. The Fabled Hospital
The Hospital in the City
bilingual
disruptive decentralisation
regenerative design

35. 2004
The Hospital in the City
CABE
bilingual
disruptive decentralisation
regenerative design
The NHS has mislaid its belief in:
an integrated strategy
the power of design
the power of the environment to heal
The power of a good working environment

37. SWEETT GROUPWSP

40. concrete proof

41. 2013 Singapore

42. 1963 Singapore

43. 1963 Singapore
Khoo Teck Puat
Singapore

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58. 1963 Singapore
Phase 2
Community hospital