Hospital design to be based on 'next practice', not 'best practice'

New report calls for improvements to procurement and design

The design of healthcare buildings over the coming years will be based on 'next practice' rather than 'best practice' as an ageing population and struggling economy force a shift in priorities.

Six months after the merger of The Design Council and the Commission for Architecture and the Built Environment (CABE), a new report has been published which explores the future of infrastructure design in the UK.

Few people would willingly choose be treated in a poorly-designed hospital. But, while the importance of good design is increasingly recognised by consumers making individual choices on the products they buy, the case for good design in the physical environment still needs to be reinforced

The Bishop Review warns that, with a struggling economy and the Government’s plans to shift healthcare closer to home, the traditional approach to building design will come under increasing scrutiny. And it says the NHS reforms and the need to deliver economic growth are an opportunity to continue to champion the role of good design, stating: “Design has never been more necessary, particularly in relation to the built environment.”

Written by Peter Bishop, the report for the newly-named Design Council Cabe explores how good urban design, architecture and landscaping can be achieved within a national agenda that is, seemingly in contrast, devolving power to local communities.

We have learned from past experience that short-term savings on poor-quality design merely place a burden on the future as scarce resources have to be diverted to resolve the mistakes of the past

Bishop said of his review: “Few people would willingly choose to live in a badly-designed house, be treated in a poorly-designed hospital, or send their children to a drab or uninspiring school. But, while the importance of good design is increasingly recognised by consumers making individual choices on the products they buy, the case for good design in the physical environment still needs to be reinforced. At a time of scarce resources, design costs are in effect social costs, borne by all and requiring careful justification.”

The report goes on to say: “Good design, when embedded in an effective planning system, binds individual buildings and spaces into functional and sustainable neighbourhoods.”

One of the key issues moving forward will be procurement, with value for money the buzzword for future developments, particularly in the NHS, where PFI has recently come in for widespread criticism.

The report states: “The experience of procuring design services is generally poor. It is expensive, bureaucratic and time-consuming, is generally driven by process rather than outcome and is too rarely placed under the control of operational staff who have a real stake in the final product. From the practitioner’s point of view, procurement of design services is a costly overhead which detracts from provision of an effective end result. In short, the present system is costly, slow and often delivers a product that is second best.”

Major issues will lead the design debate away from best practice into ‘next practice’, focusing on innovation in the design of housing, workplaces, public spaces and transport

At the same time as making financial efficiencies, the NHS also faces a change in population and the Government’s localism agenda, which will see care delivered closer to home. This, too, will also have an impact on how the estate is developed in the future.

The report says: “Changes in the age profile and composition of the population should have a significant impact on how we design the built environment today. Similarly, climate change will impact on the ways in which buildings, spaces and landscapes are designed. The concept of sustainable development will need to be translated into real and tangible design solutions if our towns and cities are to avoid serious problems and costs in the future. These and other major issues will lead the design debate away from best practice into ‘next practice’, focusing on innovation in the design of housing, workplaces, public spaces and transport.”

Procuring design services is expensive, bureaucratic and time-consuming, is generally driven by process rather than outcome and is too rarely placed under the control of operational staff who have a real stake in the final product

Driving these improvements will be Design Council Cabe, which has drawn up a four-point plan to change the focus of infrastructure design. Firstly, it aims to assist and advise government to help fashion a national design agenda. Secondly, the organisation will act as a debate forum for industry, and it will influence the overall quality of what is built using design reviews and helping with procurement. Finally, the group will assist in pulling together effective methodologies and expertise to embed good design at a local level.

Good design often flourishes in difficult economic conditions, as plans and proposals have to be sophisticated and robust in order to be implemented ”

The report states: “Good design often flourishes in difficult economic conditions, as plans and proposals have to be sophisticated and robust in order to be implemented. However, doing what we do well will no longer suffice. The design agenda is set to shift into areas where we will need to experiment, learn and disseminate new and emerging techniques and approaches.

“We are living through a period of great change. It is important that the quality of what we build is not sacrificed for short-term gain.”

Click here for the Bishop Review

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