Architect Alan Short and social scientist Mary Dixon-Woods reflect with Chris Smith on the hospitals of the future...
Mary - There are lots of design issues to be resolved. As you say, many of these priorities for patients are evident, but how you resolve them is not as straightforward as it might appear. Also important to patients are fundamental processes of care. We know, for example, about 20 to 30% of patients admitted to hospital develop delirium, which is a very upsetting and frightening condition for patients where they become acutely confused. We know that it can be managed or prevented to some extent by processes of care, like good hydration, good diet, pain control, avoiding constipation. To deliver all of those processes, to make sure people reliably get the care that they need, you need to have enough staff and that's absolutely key. And you need to have processes that enable staff to do what they need to do.
Chris - Alan short, is this all feasible given the constraints of the building architecture that we have within the NHS already? Because the NHS is a huge landowner, isn't it? And has a huge number of assets that effectively all would need to be retrofitted and updated to meet some of these expectations.
Alan - Yes, well, we measured 627 buildings across England. And the bill we came up with was about £17 billion. It's entirely possible to rescue these buildings. I think the challenge for designers is how to achieve the dignity and humanity in the spaces that your previous speaker spoke to. And I think that's about designing very characterised and specific places and buildings. Not huge gridded slabs, contemporary prototype for a hospital.
Chris - I'm surprised it's actually so low. £17 billion. I know that that is about six times bigger than what they're currently planning to spend. But given that that is the whole lot. That's not that much.
Alan - It's not that much because the backlog maintenance bill in the NHS is between four and a half and 5 billion a year. Yes, it's about five years, you know, normal maintenance cost. It's entirely possible.
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