Large hospitals are complex organisations that cannot be designed successfully without close collaboration between the design team and a myriad of users: to satisfy users' needs, yet allow for future change.
Design does demand specialist skills (AJ 10.4.03), but almost any competent architect can acquire these on the job by talking to users of comparable rooms, departments, routes, mechanical services, etc, and particularly learning from failures more than from successes.
It is nonsense that current procurement allows designs to be frozen before discussion with users can take place; rather like converting existing buildings.
With a few exceptions, it is the failure of clients to develop briefs from aspirations to operational policies, and to test these against explorations of options for planning, space, movement and mechanical services, and search for compromises between competing demands.
If there is no such detail to the brief, how can the end product be assessed for compliance?
The public purse appears unwilling to stretch to 'planning to minimise future regret': it will surely pay later.
Michael Pearson, London WC2