| In recent years the value of good design has been increasingly recognised and a wealth of evidence based findings has demonstrated that good design adds value, not only from an economic perspective but also in terms of a range of social and environmental benefits. This capacity to add value is particularly important for healthcare environments, where the physical and psychological well-being of patients, staff and visitors is of paramount consideration.
In October 2000, the Prime Minister established a UK-wide ‘Better Public Buildings’ initiative to achieve a step change in the design quality of publicly procured buildings. Over the last decade, Scottish Ministers have in parallel, through their policies, sought to achieve a culture of quality in the procurement of publicly-funded buildings that embraces good design as a means of achieving value for money and sustainable development. The Scottish Government has five strategic objectives; it is committed to creating a Scotland that is:
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wealthier and fairer
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stronger and safer
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healthier
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greener
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smarter
It is clear that the design quality of our built environment must, by necessity, play a vital part in our ability to meet all of these strategic objectives. Government, thus, continues to promote and to encourage investment in well-designed buildings and places in both the public and private sectors.
In response to and, in support of the Scottish Government's quality objectives The Scottish Government Health and Social Care Directorates has revised its Policy on Design Quality for NHSScotland. The revised policy articulates the Scottish Government Health and Social Care Directorates ambition for NHSScotland's asset base and, to embed the need for well-designed, sustainable healthcare environments as an integral part of high quality service delivery.
Policy on Design Quality for NHSScotland - 2010 Revision
Partnership working
In September 2006, to support the implementation of the original Policy on Design Quality for NHSScotland, the then Scottish Executive Health Department (SEHD) entered into a three-year Framework Agreement with Architecture and Design Scotland (A+DS), which has been established by Scottish Ministers as the National Champion for good architecture, design and planning in the built environment with the aim of operating within the Scottish Government's policy framework on architecture and design, as well as in partnership with a range of bodies in the private and public sector to help turn the aspirations of policy into reality.
This Framework Agreement has now ended and in its place support for the implementation of the design agenda will be provided by means of a coordinated, tripartite working arrangement between Scottish Government Health and Social Care Directorates (SGHSC), Health Facilities Scotland (HFS) and Architecture and Design Scotland (A+DS) to facilitate the procurement of well-designed, sustainable, healing environments which support the policies and objectives of NHS Boards and the Scottish Government Health and Social Care Directorates.
Through this new partnership arrangment, SGHSC, A+DS and HFS have developed a range of initiatives to assist NHSScotland in addressing design quality issues in the procurement of healthcare building projects, the summary objectives of which are to:
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raise the level of design quality achieved through infrastructure investment;
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increase the capacity of health boards and central agencies in respect of the above; and
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assist in sharing good practices.
Healthier Places website
To assist in sharing good practice, Architecture and Design Scotland and Health Facilities Scotland have developed a website Healthier Places, which has been designed to house information on good healthcare design to assist NHS Boards in the development of the project brief and to raise awareness of the good practice being developed and delivered across NHSScotland and elsewhere. In addition to providing guidance on the development of ‘Design Statements’ and, articles on healthcare design topics, the website holds a project resource - Pulse - a database of projects and examples of good practice.
Healthier Places website
Circulation in multi-service facilities
Architecture and Design Scotland have produced a quick reference guide to the implications of different organisational diagrams on the utility, amenity and cost of shared facilities. Increasingly public services both within healthcare and other local services (such as housing, social work, police, leisure) are working closer together and being housed in the same facility. If well designed, an integrated services building can provide space for all the services in a smaller total area than had the services been located separately, thus reducing the environmental and economic impact of the development. This study aims to explore the opportunities and challenges of different organisational forms to help those involved in briefing, budgeting and early design make informed decisions about the building and its performance as a whole.
Circulation in multi-service facilities - quick reference guide
Dementia-friendly design
An aging population and the social and economic effects of dementia are key challenges for the NHS. Dementia friendly design is essential for all new health and social care buildings particularly primary care premises and those used mainly by older people.
Dementia Services Development Centre at Stirling University
Article on Healthier Places website
Design Assessment and the Business Case process
An assessment of design quality is now part of the SGHSC Business Case process. All projects submitted to the SGHSC Capital Investment Group for approval are now subject to an assessment of design quality and functionality, including technical and sustainability standards. This Design Assessment will take during latter stages of development of the Initial Agreement, Outline Business Case and Full Business Case; the assessment to be carried out prior to formal consideration by the Health Board and before the business case is submitted to CIG. Guidance on the Design Assessment process has been added to the Scottish Capital Investment Manual.
The Scottish Government Health and Social Care Directorates’ purpose in developing and implementing this process is to ensure that the outcomes of development projects meet the Government’s objectives and expectations for public investment. The aim of mapping design into the Business Case process is to support the implementation of the Policy on Design Quality for NHSScotland by improving the level of design quality achieved across NHSScotland and, ultimately, the outcomes achieved by doing so.
To assist NHS Boards in utilising good design to achieve the best outcomes from their development projects, Boards are required to develop and produce a Design Statement prior to the submission of their Initial Agreement. The Design Statement is the first control document produced for a project and should be consistent with the Board’s overall vision contained within the strategic Design Action Plan.
Additional guidance on Design Assessment and the Business Case process has been added to the Scottish Capital Investment Manual. The guidance also includes advice on the preparation of the Design Statement.
Design Champions - (username + password required)
List of appointed NHSScotland Design Champions (as at 1 September 2009)
NHSScotland Design Champions can use the menu link on the left to access the Design Champions page. Please note a username and password is required.
A+DS has appointed its Board Member Gareth Hoskins as Scottish Healthcare Design Champion. This important role will see Gareth providing an overarching vision for work carried out under the design quality initiative.
Design Action Plan Guidance
SGHSC and A+DS have developed a template setting a framework within which each NHSBoard may develop their own Design Action Plan.
Design Action Plan Template
A Design Action Plan Template has been developed in association with representatives of NHSScotland Boards and is a suggested format and methodology for the development of a Design Action Plan. The template is in Word format to facilitate easy editing. The template should be viewed alongside the above Design Action Plan Guidance on the purpose and content of Design Action Plans.
A Vision of Health - launch by Cabinet Secretary for Health and Wellbeing
On 27 August 2009 at the Beatson Institute for Cancer Research, Nicola Sturgeon MSP, Deputy First Minister and Cabinet Secretary for Health and Wellbeing, launched the final publication produced under the 3-year Framework Agreement between the Scottish Government Health and Social Care Directorates and Architecture and Design Scotland. "A Vision of Health" sets out the vision of some of Scotland's healthcare leaders and sets out the practical measures being put in place to assist NHSScotland in guiding projects to successful outcomes and is a pre-cursor to the new tripartite arrangement between the Health and Social Care Directorates, A+DS and Health Facilities Scotland to take forward the design agenda.
A Vision of Health - links to A+DS website
Design Champions - Visit to Northern Ireland
The European Health Property Network held its 3 day conference in Belfast on 28-30 April and NHSScotland Design Champions were been invited to join them join the event from midday on 29th to hear John Cole talk about what they’re doing in Northern Ireland and visit 3 exemplar buildings. A+DS have collated images of the buildings visited
Design Champions Belfast visit images (5MB)
Healthcare Design Champion presentation to NHS Board Chief Executives
At the NHSScotland Chief Executives Business Meeting on 21 May 2008, Gareth Hoskins, Healthcare Design Champion and A+DS Board member, gave a presentation on the support A+DS is providing to NHSScotland within the Framework Agreement between the Scottish Government Health and Social Care Directorates and A+DS.
A+DS presentation to NHSS Chief Executives (PDF, 3MB)
Masterplanning health
On 30 April 2008 , at the annual workshop of the European Health Property Network in Belfast, A+DS launched its first publication designed specifically to support better healthcare development - Masterplanning Health. The publication addresses an area that is frequently underdeveloped in hospital schemes across the UK and is thought to be the first publication in Europe looking at masterplanning healthcare developments.
Download a copy of Masterplanning Health from the A+DS website
Masterplanning - what and why
At the Design Champions Network meeting which took place on 11 June 2007, Karen Esslemont delivered a presentation on Masterplanning, describing the purpose, scope and detail of a masterplan and the benefits, how to commission one, skills resources, consultation both before and during the development and the processes for revising and amending in light of change.
NHSS Project Design Assessments
SGHSC notified NHSScotland of the requirement to submit completed Design Assessment Proforma's with their Initial Agreement and Outline Business Case submissions to assist in the Design Assessment process being undertaken by Architecture and Design Scotland within the Framework Agreement announced in 2006.
Letter of notification and attached Design Assessment proforma
Design Assessment guidance
Sustainable construction
In 2004 SEDA (The Scottish Ecological Design Association) was awarded a Sustainable Action Grant from the Sustainable Development Directorate of the then Scottish Executive - now the Scottish Government Greener Scotland Directorate - to undertake three ground-breaking Design Guides on design and detailing for more sustainable construction. The three documents cover Design and Detailing for Deconstruction; Design and Detailing for Airtightness and; Design and Detailing for Toxic Chemical Reduction in Buildings.
These are available as a free download from the SEDA website
CABE publication - Good Design: the fundamentals
This publication resents an essay from the Chief Executive of CABE on why design matters and how best to achieve good design. It discusses why architecture and urban design are important cultural assets, explores the myths and reasons that are used to excuse poor design and explains how CABE attempts to create the conditions for good design to prosper.
Download a copy of the document
Evidence linking design and health
Evidence linking design and health, both in the health estate and more broadly, can be found at the following link:
http://www.hiaconnect.edu.au/evidence_summaries.htm
Of all the research given there, perhaps the most relevant is a review of hospital design which updates the work done previously by NHS Estates in England:
http://www.hiaconnect.edu.au/files/Hospital_Design_Review.pdf
Case Notes: Client Leadership
As part of the support provided by A+DS through the Framework Agreement with SGHSC, A+DS agreed to prepare a document to assist those professionals involved in the procurement, planning and development of our new healthcare facilities. The document provides examples of how some of the most successful clients of recent healthcare buildings in the UK have delivered uplifting healthcare environments.
Download a copy of Case Notes: Client Leadership from the A+DS website
NHS Greater Glasgow and Clyde New South Glasgow Hospitals - Design Workshops
NHS GG&C prepared a report in April 2009 for the Project and Design Teams of the New South Glasgow Hospitals Project. The report presents the ideas, hopes and aspitarions of patients, carers and famuilies for their new hospitals, gathered through a series of 16 design workshops and contains user recommendations for the design of 12 key areas of the new facilities.
New South Glasgow Hospitals - Design Workshops Report
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