Assura : What would the NHS’s buildings tell us?

2022 will mark five years since Sir Robert Naylor published his national review of the NHS's estate, which made a series of recommendations for improving the buildings and places where NHS care is delivered, how we fund them and how we can plan more effectively for the space the NHS will need in the future. It's fair to say there hasn't been as much progress as Sir Robert had called for, but with that milestone approaching, it feels like a good time to think about the 2022 resolutions that NHS buildings might make (if they could!):

Start using us premises as a tool for the future of care, rather than seeing us as a barrier to progress and change. When the opportunity is there to improve or replace us, don't take what's gone before as the blueprint. Explore what different premises, locations or design approaches could do to help local care deliver a mix of remote and face to face services, move diagnostics away from hospital, create a base for social prescribing activities and links to other health and care professionals and support. It might achieve far more than you imagine. Stop us premises from failing the many patients with disabilities and neurodiversity who struggle to use us, because we aren't always designed for their needs. Over the course of research with organisations such as the Patients Association, Dementia UK and Dimensions, many people have talked about the challenges of accessing and spending time in some primary care environments because of their personal health needs or those of family members they support. For some, it's historic design aspects which mean they can't access a building in the same way as other patients: there may not be a lift, or corridors might be too narrow, or the toilet area might be too small for someone needing a changing places space.

For others, it's about other environmental factors which can make it difficult, distressing or unpleasant to spend time in that space - and can be the difference between someone accessing the face to face care they might need or not.

The NHS is for everyone, so its places must be designed in the same way - and this could be one of the levelling up challenges with huge power to reduce health inequalities, through better access to care.

Continue to keep the NHS estate in the spotlight. Technology is helping the health service to do many things differently, which is a fantastic positive to come out of the darkest of times. But it doesn't take away the need for caring, fit-for-purpose places for face to face treatments and conversations with professionals. Technology cannot make up for dingy waiting areas, buildings with no way for families to get small children or less mobile elderly parents upstairs, sites with intimidating corridors and no view of the outside world.

Let's make 2022 the year when we focus on the NHS's physical infrastructure for the future - and give it the time it deserves.

Rob James is our Development Team Lead