The healthcare sector is changing radically. Advances in medical science and technology, together with an ageing population, are having a dramatic effect on the building types required, says Jonathan Wilson
The healthcare sector is vast in its range of functions and building types. Many think of the sector as comprising essentially hospitals, health centres and surgeries, but the range is much wider and more nuanced. In fact the biggest changes are happening at a systemic and structural level, having a radical impact on investment decisions by providers. As a result, we will see new building types emerging, different emphases on the allocation of capital investment, and novel approaches to the building types we recognise as staples.
Advances in medical science and technology are perhaps the biggest driver for change. Over the last 20 years, advances in genetics, cell function and many other aspects of human biology, supported by progress in diagnostic imaging and interventional techniques, have profoundly influenced the nature of hospital-based care. Many conditions can now be treated out of hospital or within one day; the average length of stay in hospital has consequently reduced from weeks to days. It’s a staggering shift and it’s only just started. What does it mean?
There will be fewer general acute hospitals in the future and they will be smaller. We will continue to see major regional medical campuses with highly specialised centres of excellence in cancer, heart, trauma and so on, but the next tier down will shrink; replaced by local health centres that can deal with the majority of conditions. Within conventional hospitals there will be a continuing shift to daycare. There will be further large ambulatory care centres bringing together consultation, investigation, and treatment within highly efficient and pleasant environments. Think of them as the new healthcare shopping malls of the future.
Another axis of change is our changing demography. As we live longer, senior living is rapidly expanding worldwide – the UK is in fact somewhat lagging behind Scandinavia, the US and Australia. The concept is a specially adapted and configured living environment that supports older people in a full and normal life style. Imagine a sort of Center Parcs with discreetly provided facilities for mobility, nursing support and healthcare provision allowing ailing people and their relatives to live life to the fullest.
Also partly down to our ageing population, but also a result of advances in medical science, is a huge and multifaceted investment in cancer care. Major urban comprehensive cancer centres are being established at the same time as a national network of small local treatment centres offering radiotherapy and chemotherapy close to home.
A further cause of change is the health and wellness revolution. This is a paradigm shift from illness and disease focus (pathology) to life-affirming strategies, recognising the importance of healthy living and stress reduction to health. This new mindset has profoundly influenced the design of recent healthcare buildings of all types. It is especially evident in the new generation of cancer treatment centres, such as Hopkins Architects’ Macmillan Cancer Centre at University College Hospital (pictured) and RSHP and Stantec’s Cancer Centre at Guy’s. The Maggie’s Centre programme, a network of small homely centres to support people managing their lives with cancer, is perhaps the clearest expression of the wellness paradigm. There is no conventional treatment within these centres, but the heart mind and soul are nourished, and this is now established as an essential ingredient of excellent care.
Jonathan Wilson is principal and UK healthcare sector leader at Stantec
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