In the face of unprecedented challenges, the NHS is taking bold steps toward shaping a sustainable and innovative future for healthcare in the UK. The creation of the NHS 10-Year Plan provides a unique opportunity to address long-standing issues within the system, from outdated infrastructure to rising demands for accessible patient care.
Darwin Group, the healthcare estates specialists, has positioned itself at the forefront of this transformation. Combining expertise in designing and delivering adaptable healthcare facilities with the expansive reach and resources available through UK factories, Darwin Group is advocating for a healthcare estate that is adaptable, resilient, and fit for the future.
In this exclusive interview, Hayley Smith, Strategy and Transformation Director, Darwin Group, shares insights into the company’s response to the NHS Change consultation, outlining their vision for an adaptable and future-proof healthcare estate. Here’s what Hayley had to say.
What does Darwin Group advocate for the NHS 10-Year Plan? Why is this vision important?
We [Darwin Group] see this as a chance to completely rethink healthcare estates. The NHS faces a rapidly evolving healthcare landscape - new care models, more complex needs, and growing care demands. However, its physical estate has struggled to evolve and keep pace. In some instances, they’re even deemed unsafe due to repair backlogs.
We believe adaptable infrastructure is essential for unlocking the NHS's potential. Outdated, rigid estates restrict the ability to meet growing patient needs and adapt to advancements in healthcare.
Our response calls for:
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Flexible and adaptable estates: Healthcare facilities that evolve with changing needs, providing scalable, patient-centred care.
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System-wide planning: Integration across all aspects of healthcare delivery to ensure a coordinated and holistic foundation.
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Sustainable investment: Quality facilities and experiences that align with the duration of need, supporting long-term cost-efficiency.
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Operational agility: Rapid deployment of On-Demand healthcare facilities to address urgent needs, such as elective backlogs, emergency care surges, or public health crises.
However, critical barriers to realising this vision remain. The annual approach to capital expenditure, including the Capital Department Expenditure Limit (CDEL), prevents long-term thinking and planning, meaning NHS Trusts are constricted in what development opportunities are available to them. Adopting a more flexible investment framework would enable the NHS to fully leverage dynamic solutions.
To help realise this vision, we have developed our On-Demand Healthcare Facilities, that are aligned to the duration of need, supporting organisations in managing current pressures and challenges, while also preparing them for the future of healthcare.
Our On-Demand facilities evolve with the needs of care, accommodating surges in demand, advancements in care complexities, and changing healthcare delivery models. They can assist in decanting services during repairs and refurbishments, or be relocated to support neighbouring communities or organisations, providing an adaptable solution that prioritises efficiency, staff experience, and improved patient pathways.
What do you see as the biggest barriers and solutions to moving care from hospitals to communities?
The lack of fit-for-purpose community healthcare facilities is a major barrier to transitioning care from hospitals. Many existing buildings were designed decades ago, making them unsuitable for modern healthcare needs. This outdated infrastructure often leaves hospitals overburdened as they compensate for insufficient community care options.
A critical issue is the speed of discharge while appropriate social care provisions are arranged. This delay often prevents patients who no longer require hospital-level care from leaving, resulting in bottlenecks in patient flow. Overcrowded hospitals, delayed admissions, and longer waiting lists are direct consequences of this inefficiency.
A practical solution is to establish interim accommodations using On-Demand Healthcare Facilities. This solution could provide recovery spaces or transitional care for patients awaiting social care support.
Additionally, On-Demand solutions can be used to create any clinical or non-clinical environment, from community diagnostic centres, urgent care clinics, or health hubs closer to where people live. These environments reduce reliance on hospitals and help identify illnesses earlier, reducing future admissions.
What role do On-Demand Healthcare Facilities play in tackling the causes of ill health and improving early diagnosis? 
Early diagnosis is critical to improving outcomes, and On-Demand Healthcare Facilities are vital to delivering it. Community Diagnostic Centres (CDCs) decentralise diagnostic services, bringing them closer to underserved populations. However, many CDCs are still confined to hospital grounds due to space constraints.
On-Demand solutions overcome this by placing diagnostic services within local communities, such as alongside GP practices or in health hubs. Unlike temporary mobile units, these durable and adaptable spaces evolve with community needs, offering superior experiences for both staff and patients.
By improving accessibility to diagnostic services, On-Demand Healthcare Facilities address health disparities, promote equity, and enable earlier interventions.
What policy changes do you think could support the NHS 10-Year Plan?
There are several quick wins. First, adopting a more flexible investment framework would enable the NHS to fully leverage dynamic solutions and long-term estate planning rather than annual, reactive budgeting.
In the medium term, we need nationally supported, locally led estate plans encouraging innovation and collaboration between trusts. Clear frameworks for On-Demand Healthcare Facilities will enable consistent delivery of agile solutions across the country.
Long-term, it’s essential that estates are seen as a core part of the NHS 10-Year Plan -not as an afterthought. This requires linking estate planning with outcomes like patient experience or outcomes, workforce wellbeing, and net-zero goals.
How is Darwin Group uniquely positioned to support this vision?
Combining Darwin Group’s healthcare expertise with the capacity and reach of Portakabin creates an unmatched collaboration. Together, we deliver modern construction solutions that meet the NHS’s most urgent needs while setting the foundation for future growth.
Our newly launched On-Demand Healthcare Facilities offer rapid, scalable solutions tailored to diverse healthcare needs. These facilities are designed to address challenges such as elective surgery backlogs, emergency care surges, and the growing demand for community diagnostic hubs. The ability to quickly deploy fully operational spaces aligned to the duration of need ensures we can respond to both immediate crises and long-term priorities.
Critically, we don’t see On-Demand Healthcare Facilities as stopgaps - they’re integral to creating a resilient and adaptable NHS estate. These solutions are built to evolve with patient and community needs, offering adaptability and sustainability. By aligning to the NHS’s future 10-year vision, Darwin Group is ensuring that healthcare estates not only meet today’s challenges but are ready for tomorrow’s opportunities.
Whether it's improving patient flow, supporting operational efficiency, or supporting workforce wellbeing, our focus remains clear: putting patients at the heart of every decision while delivering considered spaces that empower the NHS to thrive and evolve.
For more information on Darwin Group, please visit www.darwingroup.co.uk or email enquiries@darwingroup.co.uk