Allison Wagner, healthcare market leader at HOK Architects, reflects on the recent Budget announcement, which pledged £2.3billion over the next three years to transform diagnostic services, with at least 100 new community diagnostic centres across England. But, rather than new developments, Wagner sees the delivery of many of these facilities resulting from the repurposing of empty high street retail units and vacant offices
The Government recently pledged £2.3billion over the next three years to transform diagnostic services across the country, with plans to roll out at least 100 new community diagnostic centres (CDCs).
The need is obvious, with the NHS’s current diagnostic care backlog set to exceed six million people.
The question now is what the most-effective and viable delivery option is.
The first thought that often crosses the minds of government bodies and developers is where to build a new centre.
However, with land shortages, price growth in densely-populated areas, and competition with other use classes, namely residential, this isn’t the most-practical option.
Adaptive reuse is likely key to delivering many of these facilities.
For instance, repurposing the numerous retail units and offices that lie empty because of the pandemic, seems like the most-pragmatic route.
The past two years has accelerated the decline of bricks and mortar retail, particularly on high streets at the heart of local communities, which is exactly where there is a shortage of diagnostic centres
The past two years has accelerated the decline of bricks and mortar retail, particularly on high streets at the heart of local communities, which is exactly where there is a shortage of diagnostic centres. This can be expanded and include wellness centres and GP practices.
The pandemic taught us that everything in hospitals being in an acute setting meant that care procedures ground to a halt.
But taking facilities to a high street or office park would change that.
Apart from the convenient access, the adaptability of retail units is another factor that should encourage this form of reuse.
For example, the average units will have a 5m ceiling height, which is conducive for MRI and X-ray machines.
HOK is very aware that the delivery of world-class healthcare is changing constantly.
More patients are being seen in a primary care setting for day-to-day diagnostics and treatment instead of in the acute care setting facilitated by developments in testing, diagnostics, and wearable technology.
And this is changing the face of primary care.
HOK has developed a prototype for free-standing diagnostic and treatment centres for the private sector that the NHS can model their new clinics on.
The centres are very similar to primary care centres, but go one step further to provide imaging services.
Careful sizing and arrangement of clinical spaces increases adaptability and flexibility for use so rooms can flex between clinics on a daily basis, or can be adapted for alternative use more quickly
The onus of design is on flexibility so that the facility can respond quickly to changes in clinical need. This ultimately improves longevity of the building, increasing the utilisation and financial viability.
Ambulatory care centres: Learning from the private sector
In Chelsea, HCA Healthcare UK took up a former retail unit on the Kings Road, as well as a 1980s office building on Sydney Street, and repurposed both units to create outpatient and diagnostic centres.
Both centres are associated with the Lister Hospital to bring primary care services into the community surrounding the hospital.
We have become accustomed to receiving our jabs at a local office building, high street store, or shopping centre; so it makes sense to deliver the pledged CDCs within communities.
With the proximity and technological adoption, it could also solve that age-old issue of long waiting times, given that patients can be contacted and notified about their appointment at short notice.
HOK redeveloped the former Royal National Orthopaedic Hospital (RNOH) site in central London into a mixed-use, high-density urban development.
The onus of design is on flexibility so that the facility can respond quickly to changes in clinical need. This ultimately improves longevity of the building, increasing the utilisation and financial viability
Located near Regent’s Park, the project integrates a new ambulatory care department for the RNOH, luxury and affordable housing, and the adaptation of a formerly-listed waiting hall of the hospital into office space.
HOK led intensive consultations with clinicians throughout the design process.
Allison Wagner
And the result of consultation delivered patient-orientated accommodation that provides increased levels of privacy, dignity, and exemplar design in disability access.
More patients are being seen in a primary care setting for day-to-day diagnostics and treatment instead of in the acute care setting facilitated by developments in testing, diagnostics, and wearable technology
It has improved the quality of clinical care with rapid diagnostics, one-stop services, easy access, good patient information, and information technology; and it has provided a beneficial and stress-free working and learning environment for nursing, clinical and admin staff. As such, the trust reported absenteeism has reduced by 50%.
New ways of working
Flexibility is a key factor for any primary care facility.
Careful sizing and arrangement of clinical spaces increases adaptability and flexibility for use so rooms can flex between clinics on a daily basis, or can be adapted for alternative use more quickly.
Removing individual offices and sharing non-clinical spaces increases the clinical flexibility and enhances collaboration.
