Everything is design Everything

2015European Healthcare Design

Reinvent healthcare through design

Blair Sadler and Robin Guenther

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, economicand technological trends and how they might influence the designof healthcare environments over the next 20 years

20012001

2003The Fabled Hospital

Nuffield trust

2004The Hospital in the City

CABE

Civic buildings

City fabric

Extension of the city

Simulacra of the city

13 Questions for engagementARS 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

13 Questions for engagementARS 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

Addenbrooke’s Hospital chief executive Keith McNeill resigns14 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.

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

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.

NHS hit by £2.5bn agency staff bill

1 Nov 2014NHS spending on agency nurses soars past £5.5bnGovernment accused of ‘truly incompetent planning’ after years of training cuts push cost of temporary staff way over budget

13 Questions for engagementARS 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

Design matters

NHS Clinical Negligence budget

2011 £8.7 billion

2013/2014 £15.6 billion

£4.2 billion backlog maintenance

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

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

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

Northwick Park Hospital

Northwick Park Hospital 2015

Northwick Park Hospital Nursing Times 1966

Ealing Hospital

Central Middlesex Hospital

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, economicand technological trends and how they might influence the designof healthcare environments over the next 20 years

20012001

Disruptive decentralisation requires informed intelligence

Shaping a healthier future 2012

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

The Fabled HospitalThe Hospital in the City

bilingual disruptive decentralisation regenerative design

2004The Hospital in the CityCABEbilingual disruptive decentralisation regenerative design

The NHS has mislaid its belief in:an integrated strategythe power of designthe power of the environment to heal The power of a good working environment

SWEETT GROUPWSP

concrete proof

2013 Singapore

1963 Singapore

1963 Singapore

Khoo Teck Puat

Singapore

1963 Singapore

1963 Singapore

1963 Singapore

1963 Singapore

1963 Singapore

1963 Singapore

1963 Singapore

1963 Singapore

1963 Singapore

1963 Singapore

1963 Singapore

1963 Singapore

1963 Singapore

Phase 2

Community hospital