Innovation in Hospital Design

Caroline Dinenage Excerpts

Tuesday 4th February 2020 Westminster Hall

[The Minister for Care (Caroline Dinenage)]

It is a huge pleasure to serve under your chairmanship for the first time, Ms Nokes.

I congratulate my right hon. Friend the Member for Basingstoke (Mrs Miller) on securing this incredibly important debate about innovation in hospital design, which I know is an important subject for her. She has worked tirelessly to secure a new and better hospital to serve her constituents in Basingstoke, who I know are grateful for the enormous amount of work that she done. I also know that she will continue to hold our feet to the fire in the Department of Health and Social Care, to ensure that the new hospital is the very best that it can be.

As my right hon. Friend said, the Department has invested heavily in the NHS, providing large amounts of capital investment to hospitals, as announced last year by the Prime Minister and the Secretary of State for Health and Social Care. Ensuring that this investment delivers innovation in health infrastructure is absolutely vital, as we move forward towards a health estate that is fit and able to face the challenges of the future.

We announced a new health infrastructure plan, or HIP, to deliver a long-term programme of investment in our NHS estate, buildings and equipment. This will be the biggest and boldest hospital-building programme in a generation, supporting our health service so that dedicated NHS staff, who are quite marvellous, can give patients world-class care in world-class facilities.

Under the new HIP, we have made a long-term commitment to build 40 new hospitals over the next decade, including to the Hampshire Hospitals NHS Foundation Trust in my right hon. Friend’s constituency. As she knows, the trust will receive £5 million in seed funding to develop plans to renew the ageing estate and better align services at the hospitals in Basingstoke and Winchester.

The 20 hospital upgrades that we previously announced are already under way. That is on top of a capital commitment, amounting to around £3.3 billion, provisionally awarded to over 170 sustainability and transformation plans since July 2017. That capital investment is going into a wide variety of programmes right across the country, including new urgent care centres and integrated care hubs—which bring together primary and community services—and, of course, new mental health facilities.

This investment programme will totally transform the health infrastructure in this country. It presents a unique and exciting opportunity to implement the latest innovation in healthcare design, with all the benefits and advances of modern methods of construction. Getting this right will ensure that patients receive the right treatment—treatment that speeds up their recovery and makes the most of the working environment, ensuring that our wonderful NHS staff can work in facilities that support them to deliver the very best in patient care.

The impact of the built environment on patient outcomes and staff satisfaction is increasingly clear. My right hon. Friend has already referred to it, but academic research conducted by the University of Sheffield shows that patients make significantly better progress in new, purpose-built and designed buildings than in old ones. There are a range of impacts, including reductions in pain medication needs and shortening hospital stays. In the mental health sector, treatment times were reduced by 14%, and in the general medical sector, non-operative patient treatment times were reduced by a staggering 21%. That is the prize here.

There is also growing evidence that access to and visibility of green space is vital to promoting therapeutic environments that aid recovery, with positive health outcomes including reductions in stress and anxiety, increased social interaction and, of course, an improved healthcare experience.

There has been some really interesting recent work in this space, which the Department welcomes. For instance, the Royal Horticultural Society donated its feel-good garden from the 2018 RHS Chelsea Flower Show to Camden and Islington NHS Foundation Trust. Its permanent home is now at Highgate mental health centre, one of the trust’s two in-patient psychiatric sites, and it is dedicated to improving the care of older adults with acute mental illness.

As my right hon. Friend said, there is nothing new about that approach. Florence Nightingale—who I know is deeply ingrained in your constituency, Ms Nokes—had it right from the beginning. My constituency of Gosport houses Haslar, a military hospital built in 1756 that has long, well-lit buildings, beautifully landscaped gardens overlooking the Solent and, critically, many out-buildings—smaller structures where the war-wounded would be wheeled out to take the air and look at the beautiful views of the Solent that we still enjoy today. Buildings designed to maximise natural light and views of green space, with increased natural ventilation and reduced noise levels, make for a much more pleasant environment, not only for the patients, to aid recovery, but for the staff going about their work.

As my right hon. Friend said, there is mounting evidence that there are strong links between the design or layout of buildings and the job satisfaction of staff, thereby improving staff retention. Buildings should be designed in a way that makes it easier for staff to do their job. For instance, designing the layout of a health building in a way that aligns with patient flow and clinical pathways also contributes to increased staff satisfaction, which makes sense. Staff can dedicate more time to patients because the time spent walking between linked wards and clinical services is reduced.

Naturally, we want to ensure that the modern clinical design of buildings is also cutting-edge in the way it supports environmental sustainability. The large hospital projects selected for phases 1 and 2 of the Department’s health infrastructure programme have been instructed to ensure that they combine and contribute to the reduction in the NHS carbon footprint by following the framework developed by the UK Green Building Council on net zero carbon buildings.

As well as seeing innovation in hospital buildings, we want to see environmentally conscious design. The NHS has led a new-for-old programme, which improves delivery of local community-based infrastructure as well, so these things are not only for the big new acute hospitals. The new-for-old programme is adopting a variety of sustainability measures, including something called BREEAM, which stands for the Building Research Establishment environmental assessment method—that slips off the tongue. It will be incorporated as standard, as independent third-party verification of sustainability performance in infrastructure.

The design of estate has a massive part to play in achieving net zero carbon targets, and carbon efficiency measures can have a positive effect on both patients and staff. For example, installing energy-efficient LED lighting in every hospital will produce average energy cost savings of up to £33 million and, importantly, improve the clinical environment for patients and staff. Adopting renewable energy solutions in the design of clinical facilities also contributes to cleaner air for our communities and better health outcomes.

Our building programme will take advantage of innovative design and innovative construction methods, and we are encouraging the NHS to take advantage of a range of modern construction approaches, including off-site manufacturing and standardisation, such as repeatable room design. Such methods can enable new and better buildings to be built quicker than otherwise would be possible. They can open their doors to patients sooner.

[Mrs Miller]

The Minister rightly talks about new and innovative methods to build buildings quicker, and that is very important, but my concern about getting these things finished is not about the building; it is about the approvals processes. Given the benefits that she so eloquently outlines in having the additional 40 new hospitals—benefits to patients, but also to the taxpayer—what space is there for the NHS to speed up the programme? It is clearly long overdue and to the benefit of all our constituents.

[Caroline Dinenage]

My right hon. Friend is absolutely right to raise that point, and I will come to it later in my speech. The key thing is to ensure that all the relevant stakeholders and partners are brought to the table very early so that everybody understands exactly what the plan is and has a feeling that they have bought into and invested in how that plan unfolds.

Earlier, I mentioned the importance of innovation, repeatable room design and standardised components, which very much lead to the flexibility that my right hon. Friend talked about. That means that the NHS can adapt to future advances in delivering modern patient care, and it delivers time, cost and efficiency benefits. For example, the Wrightington Hospital orthopaedic centre uses repeatable rooms, and that is already delivering benefits to patients and staff, but it also means that the rooms can be changed in future as modern innovation delivers changes. It is also critical that innovative building design integrates the benefits of technology and infrastructure to make full use of its transformative potential for service delivery and patient care.

As my right hon. Friend says, it is important to ensure that the designs are delivered fast. The schemes must be built in a way that works with the local community. The buildings must be easily accessible, sustainable and integrated with the local planning infrastructure, and scheme proposals and business cases developed in partnership and in alignment with sustainability and transformation plans, integrated care systems and clinical and estate strategies. They need written commissioner support, alongside evidence of engagement with local stakeholders and their support for the plans. We hope that will speed up delivery of the buildings.

I hope that goes some way towards reassuring my right hon. Friend that the Government are absolutely committed to maximising innovation in the high-quality hospitals that we are delivering. We are going to seize this once-in-a-generation opportunity, and we will work tirelessly to ensure that the people of this country are receiving the care they deserve in buildings that are modern, functional and beautiful. I thank her for securing this debate, because it has given me an opportunity to outline how we intend to do that, but I am sure she will continue to hold us to account when it comes to delivering on that commitment.

Question put and agreed to.