Milestone for £85m maternity hospital development in Belfast Spotlight on best practice for dementia-inclusive design
Framework agreements provide support for next-generation healthcare buildings
During my 31-year reporting career I have written about many subjects, but, since the very beginning, when I was working on a local newspaper, I have had a particular interest in the built environment.
This passion began when attending council planning meetings, one of the few political gatherings which attracted the attention, and provoked the wrath, of members of the public, who came out in force to protest against the development, or demise, of local landmarks and buildings.
So, when 15 years ago I was given the opportunity to work on a B2B magazine focusing solely on the design and construction of health and care buildings, I jumped at the chance.
Fast forward to 2024 and I am now a very-vocal advocate of the importance of good building design on changing and enhancing people’s lives.
And nowhere is this more important than in healthcare.
Over the years I have reported on a wealth of research which is providing a much-needed evidence base to inform the future design of supportive medical and social care facilities.
For example, research by Roger Ulrich revealed that, compared to hospital patients whose beds faced brick walls, those whose beds had views of natural scenery had shorter post-operative hospital stays, fewer negative evaluative comments from nurses, took fewer moderately-strong and strong medications, and had slightly-lower scores for minor post-surgical complications.
And these outcomes are just about the placement of windows and the presence of outdoor spaces!
Since this study in the 1980s, the impact of the physical environment of hospitals and care homes on
About Jo: Jo is the editor of Healthcare Property, having joined Nexus Media in November.
She has been specialising in design and construction best practice within the health and care sector for the past 15 years, working on the Building Better Healthcare
the wellbeing and health of patients and residents has received extensive academic attention, resulting in buildings that promote and aid recovery and support those who work within them.
A particular focus for me over the past decade has been on dementia care facilities, and I’ve decided to focus on this veryspecialist area in this edition of Healthcare Property
In a special report (p22), I have interviewed the brains behind the world-renowned Hogeweyk dementia village in the Netherlands.
I have also spoken to an expert from the University of Stirling’s Dementia Services Design Centre, who provides an insight into how even small design interventions can have a lasting positive impact on people living with this disease.
It is crucial, as we deal with a rising prevalence in dementia diagnoses, that we continue to rethink the way we provide homes and medical and support facilities for this cohort of patients, and Healthcare Property will be at the forefront of this drive moving forward, reporting on the latest thinking and showcasing some of the mostforward-thinking projects.
Also in this edition, you can read about the latest property and finance news, find out more about how the sector is addressing the carbon net zero challenge, and discover the winners of our first Healthcare Design Awards.
In the next edition, among other topics, we will be looking at healthcare window design, the evolution of ‘smart’ hospitals, and the impact of planning laws on property development. If you can help, please contact joanne.makosinski@nexusgroup.co.uk
Jo Makosinski Editor, Healthcare PropertyAwards and editing both Building Better Healthcare and Healthcare Design & Management magazines.
She has a special interest in the design of mental health and dementia care settings and in modern methods of construction and energy efficiency.
Why fire doors are critical to safety in healthcare settings; plus new guidance supports a long-term
Exploring the health sector’s net zero carbon challenge and the support available, including the increased use of heat pump technologies, EV charging, and a the launch of new fund to
Paul Yeomans, director at Medical Architecture, talks about his career at the forefront of healthcare design and his predictions for the future
Staffing and people news, including the latest industry appointments
The total cost of running the NHS estate was £12.4bn during the 2022/23 financial year, according to the results of the latest Estates Return Information Collection (ERIC) survey.
The annual data set comprises information relating to the costs of providing and maintaining the NHS estate, including buildings, maintaining and equipping hospitals, the provision of services such as laundry and food, and the costs and consumption of utilities.
And is has revealed that the cost of running the estate — at £12.4bn — was 12% up on the previous year.
Total energy usage from all energy sources was 11.2 billion kWh — down by 1.65% on 2021/22 figures.
Backlog maintenance continues to plague NHS organisations, according to the data, with the total estimated cost to eradicate works currently standing at £11.6bn — an increase of 13.5% on the previous 12 months.
Of these works, it is estimated that £2.3bn is needed to address high-risk issues, £3.8bn for significant-risk works, £3.9bn
for moderate risk, and £1.3bn for low-risk works.
Other data revealed includes:
• There are now 223 combined heat and power (CHP) units — an increase of 4% on 2021/22
• The total cost for cleaning services was £1.3bn — a 10% increase
• The total cost of providing inpatient food was £800m — up 13.7%
• The cost of waste services was £164.7m — up 8%
The data covered 9,713 trusts in England with a gross internal floorspace of 27.2 million sq m.
The figures also revealed that currently 167.6 million sq m of internal floorspace is unoccupied.
Commenting on the report, Siva Anandaciva, chief analyst at The King’s Fund health think tank, said: “The cost and severity of maintenance issues with NHS buildings and equipment is still growing, with a maintenance backlog that has now risen to £11.6bn.
“Promises to build new hospitals have not been realised, which has left parts of the NHS estate in such a poor condition they
Planners at The London Borough of Newham have given the green light for a ground-breaking new health campus at the University of East London (UEL).
The facility, in Water Lane, Stratford, will be a centre for learning and advanced research and a visionary cornerstone for community health, preventive care, and overall wellbeing.
Set to boost the local economy, it will also generate job opportunities, attract investment, and stimulate business growth.
Professor Amanda Broderick, vicechancellor and president of the university, said: “Together, we are not just building a campus; we are nurturing the roots of a community that will flourish for generations to come.
“This Stratford development project is more than a physical expansion; it is a promise to our students and the community we serve.
“It encapsulates our commitment to nurturing local talent, advancing ecological stewardship, and promoting public wellbeing
connected, healthy, and thriving community for everyone involved with the University of East London.”
Designed as a cutting-edge hub for innovation and learning, the campus will seamlessly integrate the latest health technology and teaching methodologies.
And it will be dedicated to equipping future healthcare professionals with the skills needed to excel in their fields.
pose serious risks to staff and patients.
“The repeated raiding of long-term investment budgets to cover day-to-day spending is illustrative of the short-term thinking that has plagued NHS finances in recent years.
“The consequences of the Government’s earlier decisions to put off dealing with long-term problems are now being realised.
“Recent increases in the number of hospital staff have not yet translated into increased hospital activity, and outdated tech and dilapidated buildings are likely to be one factor limiting progress.
“The deteriorating state of NHS buildings and equipment is a shaky foundation that could undermine the Government’s productivity drive.”
And he added: “To get the sector back on track in the coming years and break the cycle of ‘worst-ever’ winters, bolder action and longer-term thinking by government will be necessary.
“This includes action to make working in the NHS and social care a more-attractive career, bolstering out-of-hospital care such as primary, community, and social care services, and helping people live healthier lives.”
plans consisting of 40% green space and including a net increase of 50 trees.
A new academic building will house lecture theatres and teaching rooms, and there will be improved lighting and safety features which will benefit the surrounding area.
Construction is scheduled to begin this summer.
Cannock town centre is to benefit from significant investment with the opening of a new nursing home for adults living with complex needs.
Midlands-based Deeley Group, a family-owned business headquartered in Coventry, has partnered with leading national provider, Exemplar Health Care, to transform Cannock Chase Council’s former Avon Road Car Park, opposite the Asda supermarket, into a new 33-bedroom care home.
The provider, which will own and operate the home once built, is funding the £6m investment to bring this muchneeded complex care service to the local community.
Work on the new threestorey building, which includes communal living space, sensory bathrooms, a therapy room, car park, and gardens, is expected to
Centre Development Prospectus and planning permission was granted to Deeley Group earlier this year, securing much-needed new care facilities for the local community.
Leader of the council, Councillor Tony Johnson, said: “This is a very-welcome investment into our town centre and fulfils a real need within the Cannock community for complex nursing care that allows people to be
close to amenities.
“We are delighted that Deeley Group and Exemplar Health Care have shown confidence in Cannock and decided to invest in our town centre, attracted by Avon Road Car Park’s inclusion in our prospectus launched a few years ago.
“The prospectus outlines land in the town centre available for development and complements work underway to create an exciting new leisure hub around
the theatre and nearby Church Street as part of the £20m Levelling Up Fund support from the Government announced in 2021.”
Eleanor Deeley, joint managing director of the Deeley Group, added: “This development will transform a redundant brownfield site into an important nursing home which will provide vital care for people living with complex needs in Cannock.
“This will be the fourth development we have worked on in partnership with Exemplar Health Care and we are proud to be creating this new care home, which will also contribute to the wider regeneration of Cannock town centre.”
Exemplar Health Care expects to commence construction of the new home in November, with the first residents moving in by January 2025.
Northwood and Pinner Cottage Hospital is set to be redeveloped after achieving full planning permission.
Approximately £11m will be injected into the project to cement better health outcomes for the 20,000 patients who access the facility.
Hillingdon Council’s planning committee recently voted unanimously in favour of the refurbishment scheme, where 100% of the available space will be utilised.
NHS Property Services (NHSPS) and North West London Integrated Care Board will work closely to deliver the scope of works, expected to start later this year.
Once completed, two GP practices, Carepoint and Acre, will be relocated into the refurbished building from nearby Northwood Health Centre to deliver primary care services.
And new mental health services will be facilitated by Central and North West London NHS Foundation Trust.
Following the work, the existing Northwood Health Centre building will be sold through NHSPS’s disposal policy to generate the necessary capital to fund parts of the project and to promote a streamlined delivery of patient care under one roof.
Under the approved proposal, 70 new
housing units will also be erected in accordance with Hillingdon Council’s local plan.
And NHSPS has committed to preserving the war memorial that commemorates soldiers who served during World War 1 and World War 2.
With sustainability at its core, further proposals include attaining a BREEAM ‘Excellent’ rating through eco-friendly technology such as green roofs and reducing overall carbon emissions by 80%. 100 new trees will also be planted to increase biodiversity, and 15 electric vehicle charging points and water-efficient flow restrictors will be installed.
Additionally, heat pumps, LED lighting, and thermal-efficient building fabric will be used.
Once all sustainable measures are in place, the centre’s EPC rating will raise from an ‘F’
Adrian Powell, director of investment and development management for NHSPS, said: “Northwood and Pinner is a key hub that is used by thousands across the locality.
“We are committed to breathing new life into the building and achieving full planning permission means we are able to move forward with the project and we are excited to get started.”
Dr Manish Patel, practice manager at Carepoint Practice, added: “This relocation is a welcome opportunity for us to enhance patient care and expand the services we currently deliver.
“We are thrilled to be able to provide patients with a state-of-the-art, accessible facility that we hope will improve longterm health outcomes for our residents in Hillingdon.”
A new state-of-the-art facility which will train the next generation of dentists has officially opened in east London.
The Kenworthy Road Dental Clinic was opened by the Chief Dental Officer for England, Jason Wong, and representatives from Community Health Partnerships (CHP), Barts Health NHS Trust, and Queen Mary University of London, alongside clinicians and NHS colleagues.
The £3.2m reconfiguration, which was capital funded by CHP, will provide a modern and fit-for-purpose training ground for dental students from the university, while providing residents in north-east London with quicker and easier access to free dental care within a primary care setting.
The project was made possible through collaboration with CHP LIFTCo partner, Infracare East London, and Coleman Consult, which played a pivotal role in the delivery of the project.
The clinic will provide capacity for 20 chairs, accommodating 300 dental students who will be overseen by trained dentists, with the ability to deliver 7,000 patient appointments per year.
And it will vastly improve access to dental services for local communities in Homerton, an area known for high prevalence of dental decay and reduced access compared to national averages across England.
Christopher Tredwin, dean and director of the Institute of Dentistry, Queen Mary University of London, said: “This new clinic will provide care to patients that need it the
most, all while training the next generation of the UK’s dentists.
“Thanks to the high-tech equipment and opportunity for students to treat patients, this clinic will ensure undergraduates have the best opportunities to meet their clinical requirements while providing dental care to the community.”
The variation at Kenworthy Road Health Centre was made possible through initial scoping and collaboration with North East London ICB and local trusts by identifying the areas of significant health needs and high backlog, some of these caused by the COVID-19 pandemic.
Kenworthy Road Health Centre was identified as Homerton is an area with high dental needs and the health centre itself is centrally positioned, with strong transport links, making it accessible for patients.
In addition, there are existing primary care services being delivered from the health centre which will provide a sustainable opportunity for joined-up working.
With constraints on capital funding, optimising the use of high-quality estate is essential to support key priorities such as recovery of elective and primary care services and delivery of place-based care.
And, across the CHP portfolio, there are a number of dental variation opportunities, some with the ability to convert to dental services at pace.
“The variation at Kenworthy Road is a prime example of what can be achieved through collaboration with the local NHS system, leading to a solution that will meet the needs of the local population for years to come,” said a spokesman for CHP.
Belfast Health and Social Care Trust has celebrated a significant milestone after work was completed on Phase B1 of the Belfast Maternity Unit at the Royal Victoria Hospital.
Constructed by GRAHAM-BAM Healthcare Partnership (GBHP), the facility marks a significant advancement in healthcare infrastructure, enhancing the birthing experience for over 5,000 women every year.
The £85m development has been a collaborative effort aimed at meeting the evolving needs of expectant mothers and their families.
Peter Reavey, director at GBHP, said: “This new maternity hospital represents the future of maternity care for Belfast and we are proud to deliver a facility that not only meets the highest standards of safety and comfort, but also fosters an environment of support and empowerment for mothers and their newborns.”
Built adjacent to the existing maternity hospital, the new five-storey unit boasts modern amenities and innovative design features aimed at providing a welcoming and uplifting environment.
With en-suite rooms equipped with birthing pools, delivery suites, obstetric
— all conveniently located on one floor — the facility ensures comprehensive care for mothers and babies, from routine deliveries to those requiring specialised care.
But the project’s success was not without its challenges as construction work took place within a busy acute hospital environment surrounded by existing live hospital buildings.
However, through close collaboration with the trust’s management and stakeholders, GBHP implemented rigorous logistical co-ordination and infection prevention measures to minimise disruptions and
Galliford Try’s Building Southern business has handed over the £12.2m Edenbridge Memorial Health Centre (EMHC) development in Four Elms Road, Edenbridge, Kent. Developed on behalf of GB Partnerships in conjunction with Kent Community Health NHS Foundation Trust, Edenbridge Medical Practice, and Kent and Medway Clinical Commissioning Group, the facility was designed by LSI Architects.
The part-two-storey building has public services on the ground floor and staff amenities on the first floor.
Health services include a GP practice, outpatient services, a minor injuries unit, X-ray services, phlebotomy, therapies, and social prescribing, with around 2000sq m of clinical and community space, along with vehicle parking and landscaping.
In addition to incorporating a memorial garden area for conservation, and an emphasis on health, wellbeing, and lifestyle services; the centre has been designed to be sustainable and in keeping with the local environment.
Replacing existing provision at both Edenbridge Medical Practice and Edenbridge Memorial Hospital, the clinic will serve up to 15,000 NHS patients — allowing for a 20% increase in local population growth.
The low-rise building uses a simple palette of materials and components to create a non-institutional feel.
And the form generates a familiar association with Kentish vernacular building forms through a series of alternating gable roofs.
Maureen Edwards, the trust’s director of finance, estates and capital development, said: “Belfast Health and Social Care Trust is delighted that the handover of the new maternity hospital from contractor, GRAHAM-BAM, has taken place.
“This is a significant step forward in delivering a new modern facility which will provide a high standard of care for our mothers and their new babies.”
In addition to the maternity hospital, GBHP also previously completed the £30m Acute Mental Health Inpatient Centre at Belfast City Hospital.
The result is a centre that is vibrant and inviting and provides a strong emphasis on the promotion of wellbeing.
Spaces have been designed in accordance with HNB11-01 to be generic, flexible, and multifunctional to support effective utilisation and futureproofing.
The project also includes a section 278 agreement for a new entrance and associated bus stop reconfiguration.
Jesse Putzel, director of ESG at Primary Health Properties (PHP), discusses the importance of Environmental Social Governance for the health sector
Environmental Social Governance (ESG) or sustainability in business is increasingly important for companies in all sectors. But, for those operating in the built environment, including the healthcare property space, there is mounting pressure to address a range of issues, from climate impact and nature to the social impact of operations and investments.
Despite some economic pressures, ESG and sustainability remain priorities for investors, in part driven by new standards, regulations and incentives, particularly in Europe and the United States.
The International Sustainability Standards Board (ISSB) reporting guidelines for business have harmonised reporting standards, aligning reporting internationally and are being adopted or mandated by governments worldwide, the UK included.
The EU Corporate Sustainability Reporting Directive (CSRD) imposes challenging requirements for companies operating in Europe, extending to their global operations.
And these regulatory trends and investor demand for ESG, mean companies are having to step out of their comfort zones.
In the past, the healthcare space, as it relates to buildings, was perhaps behind others on sustainability.
There was rarely talk of measuring carbon, let alone net zero, likely given other pressures and priorities that are unique to healthcare.
However, the dial is moving and companies operating in healthcare property have either already been changing their approach, or will need to do so.
ESG encompasses a wide spectrum of issues. Which are most relevant, or material, will differ from company to company.
Each business should assess what the
…the dial is moving and companies operating in healthcare property have either already been changing their approach, or will need to do so
most-material issues are for its operations and its stakeholders.
Identifying the key impacts, but also opportunities, is key. Then, depending on the level of control and influence a company has, different strategies will be needed.
There are issues which will apply to any company, albeit with different implications depending on the business model.
Outlined below are three areas of particular and growing importance now.
Healthcare property has obvious social benefits and is rightly seen as a sociallypositive area to invest. However, just being in the space doesn’t tick all the boxes anymore.
Companies must be conscious of the impact on their own employees, that they create a culture of equality, diversity, and inclusion and that they offer support and development opportunities to attract the best talent.
There can also be potential negative social impacts to deal with, especially in the value chain.
Ethics in supply chains is coming under increasing scrutiny, with growing awareness of forced labour and modern slavery risks.
An example which is relevant to many in healthcare property is solar PV, a positive technology that can have a dark side.
In recent years there has been increasing awareness of human rights abuses in the manufacture of polysilicon (a key ingredient of solar panels).
Therefore, identifying higher-risk products and either engaging with suppliers or using different ones will be important going forward.
Beyond avoiding negative impacts, there is a growing focus on creating a wider positive social impact.
The rise of concepts like social value and social return in investment, put a focus on companies understanding their real impact on society and backing this up with data.
The social aspects of ESG or social value can include all the ways a company interacts with employees, suppliers, customers, and their local communities.
In the built environment, we create added social value when buildings, places, or infrastructure support environmental, economic, and social wellbeing. This may be through the way construction projects are procured (creating new employment), or in the way buildings are designed and operated (enhancing people’s wellbeing).
A recent example is the ‘Designing for Everyone toolkit’ , developed to help GP practices and health centres improve the physical environment in buildings for people with learning disabilities, autism, anxiety, and those who are neurodiverse.
There is going to be a growing focus on the measurement and disclosure of social
impact, which can be challenging to do.
Starting now will benefit companies ahead of any stronger requirements or regulation.
Those in healthcare property need to be aware of what net zero carbon means and what is expected.
Where widely-different approaches were used in the past, the industry is converging around shared and accepted definitions and frameworks. These include the UK Green Building Council’s Framework Definition for Net Zero Carbon Buildings, the Climate Risk Real Estate Monitor (CRREM) transition pathways for energy and carbon intensity (which include UK Healthcare targets), the London Energy Transformation Initiative (LETI) operational and embodied carbon benchmarks, and the RICS whole life carbon assessment standard .
Together these outline a set of standards and practices which should be followed to achieve net zero carbon buildings.
Linked with these standards, but specific to healthcare buildings, is the NHS Net Zero Carbon Building Standard, which is setting a benchmark for healthcare buildings.
Anyone not already aware of these definitions, metrics, and targets should get up to speed and begin to assess how they can be incorporated into projects and future building improvements
While these standards are detailed, and differ in some aspects; the core of what a net zero carbon building should encompass is largely agreed, namely where:
• Energy use intensity (kWh/m2), covering all the energy used by a building, is minimised, ideally aiming for minimum performance thresholds e.g. CRREM UK Healthcare or more-ambitious NHS net zero targets
• There are no fossil fuels on site (where not possible, there should be a plan to remove them entirely in future, with interim hybrid approaches where possible)
• Onsite renewable energy generation is maximised where possible
• Embodied carbon of materials (in new constructions or refurbishments) is measured and minimised, with residual emissions offset. Ideally targets are set to limit ‘upfront embodied carbon’ in line with industry benchmarks e.g. LETI
• Performance in use will be monitored to prove targets are met or, where not, to intervene to optimise performance
Getting consistency across industry here is key. If energy use is not minimised, it will be difficult to decarbonise the grid.
This also benefits end users who can operate buildings with less cost.
Getting a handle on embodied carbon is also vital as buildings move to operating with net zero emissions.
This approach will soon be required for any companies seeking to have an approved science-based target, with the upcoming launch of their building’s guidance. It will also become part of the updated BREEAM v7, both due to land later in 2024, as well as a Net Zero Buildings certification standard.
Anyone not already aware of these definitions, metrics, and targets, should get up to speed and begin to assess how they can be incorporated into projects and future building improvements.
The link between nature, biodiversity, and health and wellbeing is increasingly clear. And healthcare property can have a part to play.
Nature, and how companies interact with it (directly and indirectly), is the next hot topic.
In September 2023, the Taskforce on Nature-related Financial Disclosures (TNFD) published its final recommendations for nature-related risk management and disclosure.
A growing number of companies have become early adopters of TNFD, including financial institutions and asset managers involved in the property sector, and the number is set to grow.
The recommendations are based on the work and framework of TNFD and, if they follow the same trajectory, may become mandatory for many.
In addition, from April 2024 most construction work in the UK requiring planning permission will need to comply with biodiversity net gain.
While not all projects will need to achieve a 10% net gain in biodiversity, additional assessments may still be required.
At the sharper end, projects will need to plan to deliver biodiversity net gain on site or budget for purchase of offsite biodiversity credits.
But the opportunity for healthcare property shouldn’t be ignored.
Nature is good for health and can also help to safeguard and futureproof buildings, not least in helping to adapt to inevitable climate changes. n
Launched in 2022, the ProCure23 (P23) framework agreement is the fourth generation of NHS England’s route to market for the provision of design and construction services for NHS capital projects.
NHS England has collaborated with Crown Commercial Service (CCS) to deliver P23 as part of the Construction Works and Associated Services 2 (CWAS2) procurement framework to ensure that NHS capital works adopt the principles of the Government’s Construction Playbook, modern construction delivery, and have a focus on sustainability and social value.
And, through this route to market, NHS trusts and Integrated Care Systems (ICSs) can quickly access experienced and proficient partners to support excellence in all aspects of NHS capital project delivery, including business case development, sustainability, design, construction, disruption mitigation, benefit realisation, and optimised occupation.
To run over four years to October 2026, P23 has an expected cumulative spend of £9bn and builds on the successes of three previous iterations, which together delivered over £10bn worth of infrastructure projects for the NHS.
P23 operates under three ‘Lots’ covering different values ranging from under £20m to over £70m.
And, for the first time as part of the ProCure structure, the lower-value lot (under £20m) has been split into the seven NHS England and NHS Improvement geographical regions. This is intended to open the framework to suitable regional contractors, enhance capacity, and increase
local backing for projects. There are 12 national suppliers and 21 regional suppliers available via the framework, including Balfour Beatty Construction, BAM Building & Infrastructure, Kier Construction, McLaughlin & Harvey, Galliford Try, Integrated Health Projects, ISG Construction, GRAHAM Construction, and Laing O’Rourke.
And, to date — halfway through the framework’s intended lifespan — there have been 95 NHS clients, collectively spending £5.8bn on delivering more than 50 projects.
P23 offers a number of key benefits to NHS clients, including:
• Confidence that all suppliers are proficient with health/complex project design and construction
• Increased supplier capacity, including access to regional suppliers
• Use of modern methods of construction, including a range of standardised, project share, and repeatable rooms options to provide reliable, evidence-based designs and to reduce capital cost
• Call-off options to suit differing project needs, values, and complexities while ensuring clients’ post-construction review (PCR) compliance
• A fast-track process without the need to open tender, making the approvals process more efficient and reducing associated costs
• The ability to set the quality/price ratio for call-offs according to project needs
• Free-of-charge training for all project team members to enhance project proficiency
(more than 25 hours each)
• All projects will use tried-and-tested NEC contract processes, enabling collaboration and collective risk sharing between partners
• Implementation of advisor support, offered in a neutral capacity, free of charge
A spokesman for the NHS Estates and Facilities division at NHS England, said: “As of January 2024, the committed value of P23 stands at £2.58bn, with 54 procurements completed and a further six currently live.
“The framework’s ability to expedite projects while maintaining fiscal responsibility has garnered attention within the construction industry.
“This achievement not only highlights the efficiency of the procurement process, but also reflects the trust that clients and stakeholders have placed in ProCure23.”
He added: “ProCure23’s success extends beyond individual projects to its impact on the overall construction landscape.
“The framework has become a catalyst for positive change, fostering collaboration and innovation within the industry.
“And its ability to adapt to evolving challenges has positioned it as a dynamic force that continues to redefine procurement norms.
“As ProCure23 looks towards the future, its success is setting the benchmark for other frameworks and industry players.
“The framework’s achievements in surpassing financial targets, winning prestigious awards, and delivering exceptional projects highlight the transformative power of effective procurement practices in the construction sector.” n
Similar to the approach in England, the Welsh Government also has a procurement framework to deliver the next generation of health and care facilities. Jo Makosinski finds out more
Replacing the Designed for Life 2 & 3 frameworks in 2018, the NHS Building for Wales frameworks continue to drive forward improvements in the delivery of major capital construction projects for NHS Wales, working closely
fifth generation due to be launched this spring — the current procurement model is the preferred approach for major NHS capital projects with construction costs in excess of £4m.
The framework is based on the
money and helping to develop best practice and sustainability and other core objectives on behalf of the Welsh Government.
For schemes with a capital value of less than £4m, each health board or trust is responsible for making its own
continual improvement. delivering value for
To date, the 4th framework agreement has tendered in excess of £520m worth of healthcare infrastructure, with 33 projects in development or completed during its extended six-year duration.
It is particularly appealing to health boards and trusts as the framework pre-approves principal supply chain partners — fronted by a management contractor with an established team of building services installers, architects, and engineers already on board.
This means the project teams are used to working together and have the capacity and capability to meet the specific requirements of project delivery within the healthcare sector.
Contractors on the current NHS Building for Wales framework include BAM Construction, Interserve, Willmott Dixon, Kier, and IHP.
Speaking to Healthcare Property, Andrew Waddington, head of NHS Building for Wales at NHS Wales Shared Services Partnership’s Specialist Estates Services division, explains: “Over the past six years the framework has developed a variety of schemes, with a particular focus on the Welsh Government’s pipeline of health and wellbeing hubs (HWBs) to enhance provision of primary care services across Wales.
“This investment is quite significant — with projects worth between £7m-£100m delivering a variety of clinical services, also including mental health, radiology, and operating theatres.”
And he said the current framework has been one of the busiest.
“Health boards like the framework because it offers a one-stop shop where they can appoint a contractor and these companies already have their designers and installers on board,” he adds.
“It allows for a single point of contact, and this drives efficiencies.
“They also recognise the broader benefits of the framework, through shared best practice and lessons learnt.”
NHS Wales Shared Services Partnership has also established supporting frameworks for project and cost management services, allowing health boards to deliver projects in a timely manner.
Through the management of the frameworks, NHS Wales Shared Services Partnership is leading on the creation of best-practice guidelines and standardised models, including a drive to increase the use of modern methods of construction (MMC).
Projects completed under the current framework include the All-Wales Medical Genomics Services, a £15.3m state-of-the-art genomics facility in Cardiff delivered by Tilbury Douglas; Kier’s Phase 1 work on the Aneurin Bevan Health and Wellbeing Centre, a £19m primary care facility in Tredegar; and the Maelfa Health and Wellbeing Centre, a £14m facility in Cardiff, built by Willmott Dixon, which brings a range of health and social services together under one roof. n
Demand for specialist healthcare property continues to increase, with Civitas Investment Management, the UK’s largest provider of community facilities, investing £113m worth of equity in the second half of 2023.
With £3.5bn of assets under advisory, the company has announced that, following £73m of acquisitions in December, it deployed £113m of equity in the second half of 2023, acquiring or forward funding 22 UK specialist healthcare assets across 14 transactions.
transactions on behalf of Civitas’ Forward Funding
Representing a continuation on the first half of 2023, the activity furthered Civitas’ commitment to the high growth and specialist sector with strong social impact credentials and which offers secure, long-income real estate or infrastructure characteristics.
The proceeds from the disposals will enable a mix of capital recycling into new development, business growth, and reduction of indebtedness.
The rental income is 100% government backed and benefits from annual indexation.
The investments included:
• Specialist supported multioccupancy properties leased to a mix of existing and new operators. Acquired in separate
Supported Housing strategy, the assets are located in Coventry, Margate, Newark, Worthing, Dunstable, and Nottingham. The purposebuilt properties were all constructed since 2020 with a minimum EPC B rating, and provide around 100 adults with significant physical and mental health conditions with safe, lifelong accommodation
• Supported living properties, acquired on behalf of Civitas’ Social Healthcare Properties strategy from a mix of existing and new operators, two of which are located in Leicester, as well as Stoke-on-Trent, Arlesey, and Colchester. The properties have been specially adapted for use as supported living homes for adults with specific care needs
• Special Educational Needs (SEN) schools, acquired via sale and leaseback, providing special education support for children between the ages of five and 18
• Neuro rehab homes located in Northampton. These highlyspecialised properties provide accommodation for adults with diseases, injury, or disorders of the nervous system, where they can undertake doctorsupervised programmes
• A learning disability care home in Wales provides accommodation for 15 adults over two storeys, spread across three wings with an EPC rating B. Each resident benefits from ensuite facilities and access to external gardens. There is also staff accommodation and dedicated medicine rooms onsite
Civitas currently manages a
£3.5bn portfolio of over 1,285 specialist healthcare and education assets in the UK and Sweden, with the capacity to provide community-based living and specialist education to over 9,360 individuals.
Andrew Dawber, group director, said: “Against a backdrop of generally-volatile markets and low transaction volumes across most real estate classes, Civitas has continued to drive forward its investment programmes on behalf of institutional clients, in an asset class that demonstrates strong social and environmental credentials, and which benefits from indexation and visible longterm income.
“Working closely with specialist local developers and with local authority commissioners, we seek to deliver designated properties that meet specific identified needs within each local authority area.
“And our pipeline of projects remains strong in 2024 and this reflects the evidence on the ground of increasing need for high-quality, community-based facilities with an emphasis on working closely with local commissioning services and with leading care providers, housing managers, and specialist developers.”
In a bid to optimise its investments in the UK, real estate company, Aedifica, has gained real estate investment trust (REIT) status.
The company has transferred its real estate activities in the UK, Jersey, and the Isle of Man to the recently-incorporated AED UK Holdings Ltd.
This wholly-owned, non-listed entity now holds the shares of all UK subsidiaries within the Aedifica group, which has acquired and developed a portfolio of over 110 healthcare properties in the UK, Channel Islands, and the Isle of Man with a total value of more than £900m and generating £58m in annual
contractual rent.
Under the REIT legislation, which was introduced in 2007, companies are exempt from UK corporation tax on UK property investment income and gains on UK property.
However, REITs must distribute 90% of underlying tax-exempt property income (not gains) to shareholders within 12 months. These distributions are subject to a 20% withholding tax.
Introducing our growing family of companies, each a testament to our dedication and passion for creating care home interiors that are not just functional, but also a source of pride.
Winners of the Healthcare Design Awards (formerly Pinders) 2016, 2020, 2022 and 2023.
info@carehome-interiors.co.uk
+44 (0)1420 550000
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Craigard Care Group — a portfolio of three established care homes in Aberdeen City, Aberdeenshire, and Moray — has been sold by Christie & Co on behalf of the joint administrators, Graham Smith and Tom MacLennan of FRP Advisory.
Founded in 1996, the three homes — Wakefield House Care Home in Buckie, Weston View Care Home in Keith, and Riverside Nursing Home in Aberdeen — comprise 111 private rooms with ensuite facilities across two modern homes and a period villa with purpose-built extensions.
They provided a complete range of care services including the provision of specialist nursing, dementia, respite, and palliative care.
Following a confidential sales process with Martin Daw from Christie & Co, Weston View Care Home in Keith and Wakefield House Care Home in Cullen have been sold to Parklands Care, which operates 10 care homes across Moray and the Highlands.
And Riverside Care Home in Aberdeen has been sold to Renaissance Care, which operates a further 16 care homes across Scotland, four of
mobility, create a new sunroom extension to deliver a larger communal space, upgrade laundry facilities, create a new hairdressing salon, and improve staff changing facilities.
At Weston View, there are plans to introduce a new café, doubling as an event space; create a more-welcoming entrance area; expand the home’s four day rooms; and add balconies on the first floor to provide residents with access to
including upgrading the electrics to ensure safety, and initiating a redecoration programme to modernise the interior aesthetics of the home.
And it is working closely with architects to develop layout plans that will maximise the use of space and create additional day rooms and communal areas, adding extra shower rooms and increasing storage throughout. Ron Taylor, managing director at Parklands, said: “Since March we have been working with the
administrators to secure the long-term future of these homes and I am delighted they have now been incorporated into the Parklands group.”
Commenting on the current demand for high-quality care homes, Daw, senior director at Christie & Co, said: “Having worked for many years with the vendor prior to the administration process, it was evident that the group was one of the many that has, and will, succumb to the ongoing operational pressures that the social care sector is facing.
“Despite high occupancy, the challenges of recruiting staff meant the business was crippled under the weight of agency costs and, with utility and food costs also increasing, the business could not survive.
“Working closely with FRP, we approached the situation differently from traditional administration disposals and agreed management contracts and exchanged contracts so that on the day of administration the new providers were able to attend the homes and begin operating immediately while awaiting re-registration with the Care Inspectorate.”
The homes were sold for an undisclosed price.
Sidmouth Residential Nursing Home in Devon has been sold to a local operator for an undisclosed sum.
Owned by Sam Bevan for over 20 years, the property, which occupies a corner site in a predominantly-residential area on the outskirts of Sidmouth, has been significantly modified and improved over the years and now provides accommodation for up to 29 residents.
After Bevan’s decision to retire overseas a few years ago, the home was taken over by Julie Casely, who recently put it up for sale.
Following a confidential process with
now been purchased by an existing care home operator in Devon which identified it as an opportunity to add to its other care business in Devon — Palm Court in Dawlish
— which was acquired through Christie & Co in 2016.
Harvey said: “This home attracted a lot of interest, with multiple bids being received; its location, reputation, and asset quality combined to make it an attractive proposition.
“Homes of this nature are still well sought after and this sale, along with the completions earlier this year of Bymead House in Charmouth and The Old Vicarage in Otterton, really demonstrates the appetite that exists for this style of care home in these popular South West locations.”
Specialist health law firm, Hill Dickinson, and chartered surveyors, Sanderson Weatherall, have advised Mid Cheshire Hospitals NHS Foundation Trust on a deal to purchase land immediately adjacent to the Leighton Hospital near Crewe in Cheshire.
The purchase of four parcels of land surrounding Leighton Hospital — one of three acute healthcare sites managed by the trust — marks a significant milestone in its plans for the development of a new Leighton Hospital campus as part of the Government’s New Hospitals Programme (NHP).
The campus will be developed in line with the Government’s standardised ‘Hospital 2.0’ model, providing a world-class health and care campus that aims to address health inequalities and transform health outcomes in the local population.
It is expected to be completed by 2030.
Rebecca Wakefield, senior associate in Hill Dickinson’s health real estate team, led on the provision of advice to the trust throughout the process, from assessing potential options for acquiring the land and assisting with the full business case to the NHP, to undertaking the conveyancing of the land to the trust.
She was supported by the wider health real estate team, including partner, James
Shawbrook
Atkins, and senior associate, Rachel Jones. Commenting on the deal, Wakefield said: “We are delighted to have supported Mid Cheshire Hospitals NHS Foundation Trust through negotiation of the land purchase and to have secured this land for it to move forward with its exciting NHP plans.
“We worked closely with the trust’s internal project team and its surveyor, John Goodchild of Sanderson Weatherall, taking a collaborative approach to advising the trust on the terms of the deal and guiding it to completion of the acquisition.”
Goodchild added: “The importance of this
‘resilient and flexible’ market
Shawbrook’s development finance business has provided more than £2bn in funding for property developers in the UK, including financing a number of care home schemes.
The specialist team has been able to support a wide range of significant and often-complex projects through its structured funding solutions. These include the facilitation of a five-year funding arrangement for the construction of three state-of-the-art 66-bed care homes.
Its core development finance loans are further bolstered by complementary finance solutions that suit developers’ often urgent and complicated needs. This includes the imminent launch of its Planning Assistance
Loan, a short-term loan to help developers improve the planning they already have for a site, which can then switch to a tailored development finance loan to construct the project.
Terry Woodley, managing director for development finance at Shawbrook, said: “Despite facing significant hurdles in recent years, more than a third of developers in the UK (34%) have been able to expand their business in the last 12 months, demonstrating that the sector has remained resilient and flexible in the face of a volatile market.
“We’re proud to be at the forefront of lenders who are willing to support established developers across the country,
land purchase cannot be understated as it has propelled the trust into the vanguard of new hospitals to delivered under the NHS’s New Hospitals Programme and Hospital 2.0.
“The new hospital will be complemented by a network of new roads and the delivery of more than 1,600 new homes in adjacent development plots.
“This really opens up the prospect to see transformational change in this part of Crewe, with the benefits of significant public and private sector investment likely to be felt across Cheshire.”
providing not just the knowledgeable service they deserve, but also the flexibility and certainty they need from their funder.”
Matt Lowe, chief executive of LNT Care Developments, which has built over 200 new homes, with 20 schemes currently in progress, added: “The team at Shawbrook was able to offer a bespoke facility to enable us to drive forward our commitment to building the country’s leading care home portfolio.
“It was important for us that they provided a facility which not only enabled the construction of three new homes, but also supported the operational side of the business once construction of the care home is complete.”
FJennifer Lewis of Mills & Reeve reveals the importance of a carefully-crafted lease agreement for primary care facilities
or those renting in the primary care setting, having a robust lease is important.
But having a sector-specific lease could be crucial for two reasons.
Firstly, it ensures there is certainty over the terms agreed. And, secondly, it ensures the terms take account of the unique circumstances and rules for primary care contractors, whether under their core contracts, the Premises Costs Directions, or otherwise.
Lease heads of terms are a standard way to capture agreement on key commercial terms before getting into the detail of a full draft lease.
While heads of terms are not binding, and steps should be taken to ensure that they are flagged as being non-binding; it can be difficult to make a case to change key commercial terms once agreed.
In addition, some terms included in heads of terms can seem innocuous, but they can have a big impact if not considered carefully.
In this article, we identify five key areas to consider when negotiating lease heads of terms for primary care premises.
1. DEFINING YOUR PROPERTY
A lease can be for the whole, or part, of the property and may include the structure or be internal only, so you need to be clear what is, and is not, included to know:
• What your costs will be
• What areas you can access and use
• What you should expect the landlord to be responsible for
Exclusion of security of tenure under the Landlord and Tenant Act 1954 do not automatically have the right to a new lease at the end of the term.
This might be acceptable in some circumstances, but you shouldn’t agree this without taking advice.
Alienation clauses determine how flexible the lease is in terms of transfer, underletting, and sharing.
In particular, most GP practices will share with other service providers, and it is key to ensure this is permitted.
Ensure it is clear who is responsible for what when it comes to repairs and maintenance, what (if any) services will be provided by or on behalf of the landlord, and the extent to which those costs are recoverable from you as a tenant.
This point is particularly important when we consider that the costs of repairs/ services are not reimbursed under the Premises Cost Directions
As part of this you should consider what the current state of the property is.
And, before agreeing heads of terms,
that the landlord is under an obligation to address items of disrepair.
That is all down to the terms you agree. Only by knowing the current state of the property can you negotiate terms, particularly around repairs and maintenance, that are fair and financially viable.
Integrated Care Board (ICB) consent is required for new leases, including renewals or new leases of existing premises.
Failure to obtain this could impact your reimbursement and leave you in a situation where the level of rent payable under the lease does not align to your level of rent reimbursement.
While this isn’t an exhaustive list, hopefully it gives an idea of the core elements that need to be discussed when agreeing a lease.
It is important that you seek advice at an early stage to avoid revisiting these key commercial terms later in the transaction. n
“We are not our illness” — a fresh approach to dementia-friendly design
Editor, Jo Makosinski, speaks to Jannette Spiering, the brains behind The Hogeweyk, a game-changing development which is helping to redefine the way dementia care facilities are designed worldwide
According to the World Health Organization (WHO) there are currently more than 55 million people living with dementia worldwide — costing $1.3trillion a year.
And, with a recent Global Burden of Disease study predicting that, by 2050, 153 million people will be impacted, there is no time to waste in tackling the issue and providing support for those affected.
And this will mean a step change in the way we deliver care homes.
Leading this charge is the team behind The Hogeweyk, a pioneering purpose-built dementia village in the Netherlands, which is helping to change the perception of care facilities worldwide.
Developed by Vivium Care Group and designed by BuroKade, the facility opened in 2009 as the world’sfirst dedicated dementia village.
Architects and care providers do things with the right intentions, but we are talking about making a real difference
Focusing on the power of architecture to evoke strong memories, The Hogeweyk provides a comfortable, safe, and even healing environment for those suffering from the memory loss, personality changes, and impaired reasoning often associated with advanced dementia and/or Alzheimer’s Disease.
Located on a 3.7-acre site just south east of Amsterdam, it has 27 houses with six or seven residents in each property — 188 people in all — supported day and night by professional care and support staff.
To reflect wider society, there are also streets, courtyards, alleyways, and squares, as well as facilities such as a restaurant, café, supermarket, theatre, office, and club rooms.
And all these facilities are fully functional, not ‘mock’ shopfronts as seen in some traditional care homes.
Inside the houses, residents share a living room and have their own kitchen, private bedroom, bathroom, storage area, and laundry room, as well as access to private outside space.
This means they are encouraged to continue with everyday activities, rather than have their meals provided for them at a schedule which may not fit in with their previous daily routine.
Speaking to Healthcare Property, Jannette Spiering, co-founder of the vision ‘normal life for people with dementia’ and the brains behind The Hogeweyk, said: “Our initial aim was to create a new design for people living with dementia.
“Architects and care providers do things with the right intentions, but we are talking about making a real difference.
“We wanted to do something very different to the traditional care home approach because our vision, besides care, is
about life and wellbeing.
“More-traditional nursing home models focus on treating patients, treating dementia, and creating safe and secure environments.
“In our opinion if you want to support someone with severe dementia, of course you have to look at medical system, but also how someone wants to live and how we can support that and create as close to a home life environment and a social environment as possible, where people can thrive using the abilities they still have.
“After all, people living with dementia are still human beings with the same needs and they want to enjoy their lives and socialise with people from outside and have a daily life.
“We need a more-holistic view, particularly of the built environment, making it as recognisable as possible so people can live the life they lived before they had dementia.
“We are not our illness!”
And it is an approach which Spiering says is finally gaining traction around the globe.
She said: “We support care organisations, architects, and governments in making change and we have identified around 50 projects all around the world where they represent the care model that we have to some degree.
“We are not saying ‘copy us’, but the principles are transferable to different countries and their specific financial and health systems.
“We see The Hogeweyk as the first step away from the traditional dementia care facility.”
But, in order to effectively create similar environments, there needs to be a culture change.
Spiering said: “Architects can’t do wrong. It is those who commission care facilities who have the responsibility to think about what their vision is, what outputs they need, and to be very specific about what they
want in terms of an environment to support that vision and the possible outcomes.
“Architects are professionals and they come from a world where they assume a nursing home is a particular thing because they have built them that way for 30 or 40 years.
“They have not been required to be doing something different, or to have a different vision, so you will get the same design, and it’s not up to the architect to try to change healthcare.
“They are very important in the pathway, but it has to come from the care provider and that requires a culture change.
“You can change the built environment, but you can’t create a household or household model without adapting your organisation to reflect that.”
It also requires designers to rethink their approach to risk.
Spiering said: “Traditional nursing homes are all about keeping residents safe and taking all the risks away.
“But it’s not what it’s about.
“For example, falls are a part of life, whatever your age and if you have dementia or not.
“Risk is one of things we really have to rethink and which we must accept as part of life for the elderly and for people with dementia.”
At The Hogeweyk, residents are encouraged to get out an about and to use the facilities.
Spiering said: “If you were not aware it was a nursing home, you would not recognise it as such.
“Interiors are normalised, not fancy in design, and the outdoor spaces are designed to enhance wayfinding, with diverse landscapes.
“Wayfinding, in particular, can be challenging for people with dementia, and we use less-obvious methods, such as a bench or a statue.
“It’s about making things as recognisable as possible.
“If you achieve this then people living with severe dementia are less confused, less stressed, and less anxious, compared to a clinical ward or care home where everything is the same and you have long corridors with the same doors on either side so you don’t know where to go.
“We can influence all these things with the built environment.
If we continue to keep people ‘locked up’ they will soon become aggressive, and that’s nothing to do with dementia
disease, but these can be influenced by the environment and the staff.”
• The vision started in 1993 and the development was completed in 2009
• 188 residents
• 27 houses with six or seven residents per house
• Professional care and support is available night and day, including home supporters, individual healthcare professionals, nurses, practice nurses, doctors, psychologists, physiotherapists and social coaches
• The Hogeweyk has streets, courtyards, alleyways, and squares in the ‘Randstad’ style appropriate to the surroundings
• Facilities include a restaurant, café, supermarket, theatre, office, various club rooms, a physiotherapist, and a hair and beauty salon
• There are four lifestyles: traditional, urban, formal, and cosmopolitan
• The houses have a living room (70-100sq m), kitchen, private bedrooms (17-20sq m), bathrooms, a storage, and laundry room including a tumble dryer and washing machine, and a private outdoor space (terrace/balcony)
• The Hogeweyk is financed by the Longterm Care Act (Wet Langdurige Zorg, WLZ) n
For more information visit
bethecareconcept.com/en/hogeweykdementia-village-hogeweyk-netherlands/
In this article we look at how even the smallest design interventions can help to enhance the lives of those living with dementia
Another world leader for knowledge exchange and research impact dedicated to improving the lives of people with dementia is Stirling University’s Dementia Services Development Centre (DSDC).
Established in 1989, the centre uses research to inform practice, and practice to inform research, providing comprehensive resources for anyone supporting someone living with dementia, both personally and professionally.
And it has led the way in creating tools
and guidance for health and care providers, working with medical architects, care home operators, and health organisations to make all environments inclusive and supportive of people with dementia.
Speaking to Healthcare Property, Lynsey Hutchinson, the DSDC’s senior interior designer, said: “There is a need to better understand the realities of the disease and to create environments that are truly supportive.
“Dementia is not a normal condition of ageing, but ageing is a key risk factor in
To create truly dementia-inclusive environments, we need to involve people with lived experience and care professionals in the design phase, not just the care operator, the developer, or the architect
developing dementia.
“Older people may have sight and hearing problems, mobility issues, and breathing difficulties, and we need to consider all of these when designing buildings.”
She added: “To create truly dementiainclusive environments, we need to involve people with lived experience and care professionals in the design phase, not just the care operator, the developer, or the architect.”
Here, she shares some of the key design interventions which help to create optimal environments for people with dementia.
Hutchinson is calling for the creation of more single-story care environments.
“A lot of care operators are building dementia wings, which tend to be on the upper floors of multi-storey buildings, but it should be about making the whole interior of the building dementia inclusive, rather than just a specific area,” she adds.
“We want to see designs which mean that people can stay in a familiar environment, rather than be moved as the disease progresses, so all areas should be designed
with dementia principles in mind.
“This doesn’t mean spaces have to look like they are ‘dementia friendly’. Wellconsidered design can make spaces more accessible without looking infantile.”
Double-loaded corridors should also be avoided.
“Often in these long corridors bedroom doors face each other,” said Hutchinson.
“It’s very difficult to change this in existing buildings, but in new builds we would suggest staggering doors so when someone comes out of their room into a long corridor space there is a point of hesitation and they have time to adjust and decide where to go.
“In double-loaded corridors a person might come out of their room and go straight forward into someone else’s room, which probably looks very similar, and this can cause confusion and anxiety.”
Another modern design trend is to ‘futureproof’ buildings by creating multipurpose spaces.
But Hutchinson warns: “Multifunctional spaces are a real issue in many new builds.
“It’s about creating spaces which can be used as a dining area one minute and maybe an arts and crafts space the next, but this can be very confusing for people with dementia.
“It is hard to remove all associated furniture and fixtures and this creates clutter and makes it hard for someone with dementia to properly understand the
function of a room.
“A dining room, for example, should be very easily identified, with glazing showing someone what the purpose of the room is
before they have entered it.
“Good dementia design is about creating smaller spaces with specific and clear functions.”
We want to see designs which mean that people can stay in a familiar environment, rather than be moved as the disease progresses, so all areas should be designed with dementia principles in mind
In particular, the typical care home lounge layout where chairs are positioned in a circle against the walls should be avoided.
“Sitting everyone around the perimeter of the room with the TV, which is blaring and often unwatched, as the focal point is not good design,” said Hutchinson.
“It is better to provide a choice of spaces and zones, both social and quieter areas.”
Research has shown that access to outdoor space is crucial to the wellbeing of people with dementia.
However, with many dementia care wings on upper floors, the opportunity for access to nature is often lost.
Hutchinson said: “Residents and staff might be reluctant to go outside as it takes a degree of planning and more staff time.
“Roof terraces are often provided, but this is not the same as being on the ground.
“Having single-storey buildings means that people with dementia are able to access outdoor areas and research tells us this is absolutely vital.
“It’s about creating environments that encourage people to take part in aspects of daily life.
“This might involve a small amount of positive risk taking, but every day we are all making decisions about risk and it can help people living with dementia to maintain their self identity, particularly for somebody who has always worked outside.”
Also key is creating spaces which reduce confusion and anxiety.
“We often find in hospitals and care homes there are confusing layouts and poor wayfinding and signage,” Hutchinson said.
“These big buildings have lots of long corridors with low light and no rest points.
“Lighting is absolutely critical as the ageing eye needs three times as much light and it takes the ageing eye a lot longer to adjust to changes in light levels when moving from a brighter communal living area to a low-lit corridor, for example.
“Research has shown that it is on these thresholds and within corridors that many slips, trips, and falls occur and often this is because of poor lighting.
“Consistency of lighting is therefore key when designing for people living with dementia, and for older people in general.”
“Tonal contrast is something we will always advocate for,” said Hutchinson.
“It makes it easier to see an object or plane against a background and to navigate around a building.
“Designers should consider the contrast between the walls and the floor, the floor and the furniture, and things like ironmongery and doors.
“Ensuring these can be more easily seen improves safety and helps people to maintain their independence.
“The only place we do not want to see high colour contrast is on flooring, where ideally surfaces should be continuous or they can be perceived as a level change or an obstacle. This will make people hesitate, refuse to continue, and can cause high stepping, all of which can lead to falls and increased anxiety.”
Toilet seats, for example, cause considerable issues for people with dementia.
A white toilet seat against a white bowl and a white wall cannot be seen and this has been found to lead to incontinence issues among older people and in particular those with dementia.
“Sometimes we are misdiagnosing people as having incontinence when it is just because they cannot see where to sit,” said Hutchinson.
“A colour-contrasting toilet seat, toilet roll holder, and flush are easy and low cost, but could make a massive difference to somebody’s life.”
In terms of colour, while there is little research on the impact of colour of people with dementia, it is reported that the blue to violet end of the spectrum is lost first, so more-saturated blues and purples are often recommended.
Another bugbear for the researchers is clutter.
Hutchinson said: “In many care settings there is overstimulation from nick nacks and confusing message boards and clutter — lots of information that people living with dementia do not need.
“We need to pare this back. Maybe certificates and staff notices can be put in staff-only areas. After all, designers often create these lovely areas for memory boards and things which will help people with dementia and they end up being repurposed.
“And we need to minimise patterns and visual stimulus by focusing on smaller items like scatter cushions and artwork or providing reversible duvets so people can choose to have something patterned or plain.
“Small interventions often have the biggest impact on people with dementia.”
With care homes, in particular, operators are primarily targeting families of older people who will often be choosing, or paying for, their relatives’ care in later life.
But this has resulted in a tendency to create interiors designed to mimic upmarket hotels.
And Hutchinson warns: “We need to think less about attracting the family and more about creating environments that are more homely for people living with dementia.
“We need to go back to interiors which are more domestic and familiar.”
To offer further best-practice guidance, the DSDC has launched created The Environments for Ageing and Dementia Design Assessment Tool (EADDAT),
which supports families, businesses, and professionals to make homes, premises, and public places more accessible to an ageing population and those living with dementia.
It replaces the centre’s earlier Dementia Design Audit Tool, which was first developed in 2008 and has influenced the design of dementia care buildings worldwide.
Following successful trials by Transport for London and Kirklees Council, EADDAT is now available to those seeking to make their buildings more accessible.
Lesley Palmer, chief architect at the DSDC, said: “Two thirds of people with dementia in the UK live at home in their community and it is a requirement that supermarkets, pharmacies, and other public places make reasonable adjustments to enable everyone to use their facilities.
“This ground-breaking new tool is designed to be more accessible and covers an array of building types. Whether you are a person living with dementia, a small business owner, or commissioning a new care home, there is a version of EADDAT available to support you.”
The tool provides practical solutions and
and spaces.
And it is made up of three tiers, with each reflecting the scale of intervention required.
Each supplies a complete user guide, assessment checklist, case studies, and bestpractice examples. There is also the option to receive an official audit and accreditation from the DSDC.
Kirklees Council was the first local authority to adopt the guidance, using it to develop its own dementia design guide.
Councillor Musarrat Khan, cabinet member for health and social care at the council, said: “I have seen first-hand how DSDC’s design work can very positively impact on the experience of people living in a care home environment that is built using their design research.
“But, of course, most people live in their own homes in local communities.
“It is really important, therefore, that we apply the same attention to design to public spaces and buildings and to enable people to make simple changes to their own homes that will enable them to continue to live
Exploring plans for a new Health Innovation Hub in Glasgow, which will forge partnerships between academia, industry, clinicians, and the community in order to better tackle healthcare challenges
Academia and specialist commercial leaders are coming together as work gets underway on a flagship new Health Innovation Hub in Glasgow, due for completion in autumn 2025.
Kadans Science Partner has recently started construction work on the precision medicine facility in Govan, in partnership with the University of Glasgow, and supported by Scottish Enterprise.
It follows recent research from Savills which revealed a huge amount of investment in the life science sector, with £5.6bn of venture capital being ploughed into life science-related companies headquartered in the UK — a 120% increase between 2020-2021 and 500% since 2017.
Key cities across the UK, and the rest of the world, are seeing emerging clusters of activity, and it is hoped that such a focus on life sciences in Glasgow will bring huge rewards for wider prosperity and education.
With research links to the Queen Elizabeth University Hospital, the new Health Innovation Hub, designed by Hawkins\Brown, will set the stage for a thriving life sciences cluster in the area.
It will offer laboratory and office accommodation, attract new and innovative businesses to the area, and deliver local benefits to the wider community.
The flexible nature of the design also means tenants can grow and evolve within the building over time, making the Health Innovation Hub their long-term home.
The project is targeting a BREEAM ‘Excellent’ sustainability rating.
Speaking to Healthcare Property, James Dawson, development manager at Kadans Science Partner, said: “Developments of this kind are increasingly being delivered to drive collaboration between hospitals and world-leading universities to better tackle global healthcare challenges.
“Traditionally located around centres of excellence; they provide environments where university spin-out businesses can grow and innovate with close collaborations with hospitals offering new advanced treatments.”
The state-of-the-art building, which is being built by Morrison Construction, has been designed to create opportunities for collaboration between commercial
Dawson said: “Kadans supports the growth of businesses through flexible design and commercials along with soft support such as our ecosystem services.”
Lead architect, Shirley Wong, of Hawkins\Brown, adds: “The groundfloor space will include a Digital Health Validation Laboratory, operated by the university, which will support the testing and development of new technologies, such as contactless stethoscopes.
“This space will enable clinicians to work with participants to trial new medical technologies and drive improvements in clinical interventions and treatments.
“On the upper levels of the building there
laboratories. These have been designed to be flexible so that companies can tailor them to their specific needs.
And Dawson said: “Collaboration and flexibility has remained at the heart of the design, providing space that fosters innovation and community among the clinician and academic occupiers.”
Externally, the building will have a rustred façade, representing the area’s heavily industrial past — while windows are spaced at varying intervals, inspired by the DNA Helix.
To reduce energy use, there will be 300sq m of solar panels fitted on the roof and EV chargers will be available in the carpark. n
Collaboration and flexibility has remained at the heart of the design, providing space that fosters innovation and community among the clinician and academic occupiers
ASteve McSorely, director at Perega, highlights the pressing need to retrofit and build more futureproofed care homes, the effect that updated building regulations around sustainability are having on developers, and gives advice on key considerations during the design phase of assistant living developments
new report from AGE UK, The State of Health and Care of Older People in England, highlights that a joined-up, collaborative approach is needed when it comes to social care for pensioners.
By 2045 the number of senior citizens is set to hit 3.1 million in the UK – double the current population – so the race is on to provide adequate services to deal with this massive surge.
Beyond suitable healthcare provision,
accommodation is also an important factor, offering appropriate dwellings for a morevulnerable demographic.
And this is a complex issue, far removed from the construction of traditional homes.
There is so much more to consider when designing these types of facilities and much of it goes unseen, especially the important role structural and civil engineers play in the process.
This encompasses not only the integrity
of the building itself, but also the landscaping around it; aiming to meet strict standards and regulations, while delivering safe, secure, and comfortable ‘homes for life’.
With this in mind, I’d like to seize this opportunity to offer my perspective on how our work contributes to the ultimate success of these developments and, as a result, the overall wellbeing of the individuals living in them.
With available greenfield land becoming increasingly scarce, maybe it’s time to shift the focus towards these former commercial and industrial sites, which present an opportunity for later living developers looking for plots close to public amenities while also meeting their sustainability targets
In any later living project, understanding the parameters and constraints of the site at the start of the project is essential.
You need to take the location’s topography into account, conducting a thorough survey and investigation to identify potential restrictions or limitations around the area’s existing infrastructure.
This is particularly important in brownfield locations, where unseen contaminants can lie beneath the site surface and cause major problems down the line if not found and addressed in the design phase before building starts.
Careful consideration must also be given to landscaping around the building, minimising inclines to create a safe and accessible environment.
This means designing thoroughfares which offer plenty of room to manoeuvre for mobility scooters to pass, also making provisions for installing ramps and stairlifts at a later stage if not needed from the outset.
A steep slope can pose a serious hazard to elderly residents who may have limited mobility.
When working on Retirement Villages’ award-winning project, Charters Village in East Grinstead, we were acutely aware of the audience and the specific criteria which needed to be considered as manoeuvring around such terrain can be challenging, and the risk of accidents therefore increases.
The healthcare and care system in England carries a significant environmental responsibility, accounting for approximately 4-5% of the nation’s carbon footprint.
It’s here we return to brownfield.
With available greenfield land becoming increasingly scarce, maybe it’s time to shift the focus towards these former commercial and industrial sites, which present an opportunity for later living developers looking for plots close to public amenities while also meeting their sustainability targets.
Just to highlight this potential, the CPRE reports dormant brownfield sites in the UK offer space for 1.2 million homes.
However, as above, these sites need to be approached cautiously.
If it’s categorised as brownfield, there is a specific set of regulatory restrictions that have to be considered. For example, to achieve planning permission, the land’s quality and composition must be thoroughly assessed and, where necessary, reinforced with any identified contamination removed before construction can begin.
approach care home developments with an empathetic mindset, prioritising resident independence wherever possible
The overall location needs to be suitable and appropriate for a more-vulnerable client group.
When working on care homes, preserving the personal dignity of those in care is of paramount importance, so engineers should approach care home developments with an empathetic mindset, prioritising resident independence wherever possible.
This equally applies to independent later living in many ways, it’s just the emphasis that is different as with independent or later living, the residents are just that, independent, so their needs are different to those requiring a high degree of care.
The development should, in both cases, seamlessly integrate with, and become an integral part of, the broader community.
Achieving this integration becomes feasible when the development aligns with the local authority’s long-term planning strategy.
Civil engineers can also play an active part here, designing transport links that neatly connect with existing road and rail
links, facilitating easy access for visiting friends and family as well as residents’ attendance at medical appointments.
The close proximity to urban areas also provides residents with the opportunity for group outings and interactions beyond their living enviroment.
Civil engineers also come into play when designing the infrastructure layout, which includes utility links and connections to the grid.
They consider factors such as the location of the development, the local terrain, and the existing utility infrastructure, while planning the layout to ensure optimal efficiency and reliability.
Ultimately, engineers play a crucial role across the entire development, from the big picture to the finer details.
With AGE UK advising on an increase in ‘home first’ developments to alleviate pressure on the NHS, engineers can provide design advice and assist with planning, all while keeping a holistic view of the audience they are catering to.
Their contributions are the building blocks that pave the way for better-quality later living and care facilities. n
Powerful intelligence tool helps construction professionals harness actionable data insights to drive business growth
Glenigan, one of the UK’s leading providers of construction market intelligence, has launched ‘Analytix’, a self-serve business intelligence platform empowering construction professionals with data-driven insights to optimise decision-making and strategic planning.
A new platform within Glenigan’s suite of intelligence solutions, the innovative tool bridges the gap between data availability and actionable insights, helping contractors and suppliers make informed decisions that drive business growth.
And, for the first time, Glenigan Analytix addresses the persistent challenges faced by construction professionals currently making strategic decisions based on fragmented or insufficient data.
Customer-driven, intuitive, and user defined, it provides subscribers with prebuilt analytics and dashboards to gain valuable knowledge relating to historic planning applications, main contract
awards, and starts on site.
Crucially, Glenigan Analytix also empowers construction leaders to gain a real-time understanding of market trends throughout all regions and sectors of the industry.
Key benefits include:
• Access to comprehensive construction market data: Glenigan Analytix provides users with access to a comprehensive database of construction market data, including planning
applications, contract awards, and project starts
• Pre-built analytics and dashboards: It comes with a suite of pre-built analytics and dashboards that allow users to quickly and easily visualise and analyse construction market data
• Self-service platform: Glenigan Analytix is a self-service platform that doesn’t require any technical expertise to use. This makes it an ideal solution for construction professionals who do not have the time or resources to learn complex data analysis tools
• Real-time insights: It provides users with real-time insights into construction market trends. This allows users to make informed decisions about their businesses and stay ahead of the competition
Commenting on the launch, Russell Haworth, Glenigan’s chief executive, said: “Construction has a long-standing data problem.
“Traditionally, this has meant many sales and commercial teams have had to rely on siloed market data to inform business planning and decisions.
“Not only this, but organisations need the tools to adapt to today’s rapidly-changing and increasingly-fraught economy.
“Glenigan Analytix is the solution, providing access to the UK’s mostcomprehensive and up-to-date sector data, creating a more-efficient and insightful way to navigate the market.
“It streamlines workflows, breaks down data barriers, and speeds up the decisionmaking process.”
He added: “Glenigan Analytix is set to undergo rapid development throughout 2024, expanding its capabilities to include forecasting and future trend identification.
“This enhanced functionality will meet our clients’ needs and more, empowering them to make better, more-informed decisions based on real-time data-driven insights, helping them stay a step ahead of the competition in an ever-evolving market.” n
Glenigan Analytix is the solution, providing access to the UK’s most-comprehensive and up-to-date sector data, creating a more-efficient and insightful way to navigate the market
Following news that there are four fires daily across NHS hospitals, Helen Hewitt, chief executive of the British Woodworking Federation, speaks to Healthcare Property about the essential role of fire doors in protecting people and assets
Recent data from NHS Digital has revealed an alarming 18% increase in fire incidents, equivalent to nearly four fires daily across the NHS.
And this surge highlights the pivotal importance of robust fire safety protocols, particularly concerning fire doors, thirdparty certification, and inspection regimes, which are essential to effectively manage fire risks in hospital buildings.
Educating building owners and hospital staff about fire safety is also paramount. They must be equipped to recognise potential fire hazards and take responsibility for reporting issues.
“Fire doors play a pivotal role in the event of a fire, acting as a barrier to prevent the spread of fire and smoke. Additionally, they ensure that escape routes, such as corridors, remain clear — a vital consideration in a busy hospital setting,” explains Helen Hewitt, chief executive of the British Woodworking Federation.
“This gives patients and staff more time to evacuate safely and provides better access for firefighting efforts.
adequately trained to identify and report faulty fire doors is therefore imperative for
Third-party certification entails a rigorous audit by an independent party to validate that the fire door manufacturer or processor has conducted appropriate testing and consistently adheres to set standards.
Be Certain, Be Certified campaign run by the British Woodworking Federation (BWF) Fire Door Alliance, highlights the importance of third-party certification of fire doors in improving fire
And last year’s campaign found an increased understanding of the benefits of third-party certification, with 52% of respondents looking to thirdparty certification to provide proof of performance of a fire door.
This marked a seven-point increase from the 46% recorded in 2022 when surveying the same audience.
However, despite the increased understanding of the benefits associated with third-party certification, many still rely on alternative methods for fire door testing which lack crucial traceability and performance assurance. And this poses significant risks as these methods often fall short of the comprehensive assessment provided by third-party certification.
“While opting for third-party certified doors offers numerous advantages, their performance hinges on correct installation practices alongside vigorous inspection procedures,” said Hewitt.
“When it comes to fire doors, particularly for large buildings like hospitals where there can be hundreds of fire doors, a quality inspection of fire door installation can be time-consuming. For this reason, there are steps and preparations that site inspectors
should undertake to ensure a quality and safe installation.
“Beyond installation, there needs to be a robust regime of inspection and maintenance of the door on an ongoing basis.”
Regulation 38 is a requirement under the Building Regulations to provide fire safety information to the ‘Responsible Person’ to allow them to inspect and manage that product throughout its lifespan.
For fire doors, this includes care and maintenance instructions, as well as traceability back to the original fire door certificate.
This is crucial so that the original installation can be inspected against this certificated specification and ensure that any components that need to be changed during its lifespan are compatible.
Hewitt advises following these five easy steps to check that fire doors are fit for purpose.
• Certification — Is there a label or plug on top (or occasionally on the side) of the door to show it is a certificated fire door? You can use your mobile phone camera or a mirror to check. If there is, that’s good news. Otherwise, report it to whoever is in charge of your building
• Apertures — Altering the door for glazing apertures and air transfer grilles will make certification void
• Gaps and seals — Check the gap around the door frame is constant and around 3mm-4mm and CE-Marked hinges are firmly fixed with no missing screws. Ensure seals are fitted at the top and sides of the door
• Closers — Check that the closer shuts the door onto the latch from any position — check from 75mm from the closed position
• Operation — Ensure the door closes correctly around all parts of the frame n For more information visit: http://firedoors. bwf.org.uk/be-certain-be-certified/
Guidance has been issued to help NHS estates and facilities managers create and manage long-term infrastructure strategies.
NHS England has published guidance and templates aimed at helping Integrated Care Systems (ICSs) craft five to 10-year plans for the NHS estate, which currently occupies more than 29 million sq m.
It states: “Healthcare infrastructure is critical to the delivery of safe, high-quality clinical services and is a key enabler for transformational change and quality improvement.
“A fit-for-purpose estate means we can deliver the kind of modern, digitallyenabled patient care pathways that we know result in significant improvements for patients, staff, and anyone involved with the NHS.”
It adds: “If the NHS is to deliver its own plan for change, it must invest in the infrastructure and buildings it needs to underpin clinical service provision and demonstrate to government how, and where, capital investment is required.
“The need is therefore clear for each integrated care system (ICS) to have a clear and well-planned strategy for its infrastructure.
“This practical guidance, based on learning from pilots and best practice across government, supports ICSs to develop a
10-year strategy.”
To enable this, ICSs are advised to focus on several key areas, including:
• How the estate, digital, equipment, and workforce models contribute to delivery of the overarching system strategy, related clinical pathways, and national priorities
A fit-for-purpose estate means we can deliver the kind of modern, digitally-enabled patient care pathways that we know result in significant improvements for patients, staff, and anyone involved with the NHS
• What estate sits in a system, the condition of that estate, and how it can best be used
• What the required additional investment is in the short and long term
• What the options and plans are for property or land that is no longer required, or needs repurposing or acquiring
• What needs to be done to deliver against sustainability and net zero ambitions
• How the estate’s cost effectiveness, productivity, and efficiency can be increased and long-term running costs reduced
• What resources are required at the system level and within partners, and how the system collaborates with nonhealth bodies such as the local authority and voluntary, community, and social enterprise (VCSE) sector
The proposed 10-year infrastructure strategies will help to build on the work instigated by the Government’s response to Sir Robert Naylor’s independent review of NHS property and estates, which was published in 2017.
This response accepted recommendations that local systems should develop affordable estates and infrastructure plans and that those which fail to develop sufficientlystretching plans should not be granted access to capital funding.
In 2018/19 NHS England mandated the completion of sustainability and transformation partnership (STPs) estate strategies to inform ‘STP Wave 4 and Wave 4b’ capital funding.
Those strategies included a prioritised capital pipeline, which now needs to be reviewed and updated, says the guidance.
It also highlights Dr Claire Fuller’s stocktake report, Next steps for integrating primary care, which was published in 2022 and called for a detailed review of the space available in each system, service by service, to inform future ICS-level infrastructure planning.
And it identified the need for a significant increase in the number of healthcare practitioners locally and said space and increased capacity for them to deliver healthcare would more than likely be needed.
The new guidance states: “While the main focus of these strategies is the physical resource we have at our disposal, ICSs must
consider their estates workforce.
“The NHS People Plan 2020/21: Action for us all and NHS Estates and Facilities Workforce Action Plan focus on how we need more people, working differently, in a compassionate and inclusive culture to deliver patient care.
“Including an estate workforce plan within the ICS infrastructure strategy will identify how the ICS will contribute to these national objectives and ensure it has the capacity and capability in place to deliver complex ICS infrastructure requirements and ambitions.”
And the guidance calls for ICSs to embed infrastructure and estates leadership within their governance and risk assurance from an early stage, prioritise effective partnership building across and within systems, and establish a clear capital pipeline as a baseline.
They will also need to demonstrate increasing estate productivity and efficiency, including a plan for reducing long-term running costs; and establish baseline data for both demand and supply.
To further support EFM professionals and ICSs, additional resources are being made available, including templates, data packs, case studies, and examples of best practice.
And the national NHS England Estates Strategy and Planning team will run regular webinars over the coming months to support strategy development.
n
Heat pumps are becoming the go-to option for healthcare organisations looking to improve the efficiency of heating systems and drive a reduction in carbon emissions
All four UK health services have united to commit to achieving net-zero carbon emissions by 2045 at the latest.
And, with emissions from the NHS estate responsible for over 60% of the total NHS carbon footprint, there are significant opportunities to improve efficiency and make savings.
One of the technologies being widely adopted within the sector is heat pumps.
Unlike traditional gas boilers, heat pumps do not burn fuel to create heat.
Instead, they use refrigerants to transfer heat, which is similar to the technology used in refrigerators.
There are two main types of heat pump most commonly used within the health sector — ground source and air source.
The air-source heat pump works by transferring heat between the outdoor and indoor air; while ground-source heat pumps, also known as geothermal heat pumps, are used to transfer heat from the ground to a building.
considered for sites where there is less outdoor space, and they are also typically easier to install.
When operating, the refrigerant within the pump takes in heat from the outside air or ground and the temperature is then raised by compressing it.
Both offer viable solutions for healthcare estates, but air source heat pumps require less space and are likely to fit within existing plant rooms and space more readily.
And, while ground-source options offer a slightly-more-stable performance
This hot gas is passed through a heat exchanger to heat up the water in the central heating system.
And this process means the pump uses less energy.
Dr Samira Saravi, hydronics product
manager for Mitsubishi Electric, explains: “As the NHS looks to decarbonise its estate, heating becomes an obvious area to start as it consumes so much energy.
“NHS trusts are actively looking at ways of removing gas systems, and modern heat pumps are available right now that can meet the demand of a large hospital and deliver hot water up to 90°C.
“Heat pumps contribute to much-lower whole-life carbon compared to fossil fuel-based heating system. Also, they offer consistent heating, which is crucial for maintaining optimal temperatures in hospitals.
“For instance, air source heat pumps can provide 90°C sanitary hot water when the outdoor temperature is -5°C. In addition, most need only two water pipe connections and they have lower maintenance costs. This helps to make the long-term operational cost and maintenance financially attractive for NHS trusts.
“And heat pumps can not only help in terms of carbon emission reduction, but also provide precise temperature control.
NHS trusts are actively looking at ways of removing gas systems, and modern heat pumps are available right now that can meet the demand of a large hospital and deliver hot water up to 90°C
“As they are powered by electricity, how you source and use that electricity can help adapt operations to save even more money. That may be thermodynamically — by charging storage/buffer vessels with hot water during off-peak and lowdemand periods; or electronically — with integration of onsite photovoltaic power generation.”
pump for their estate, she adds: “Both have a place in the hospital sector where they can be applied most effectively, so a key aspect, always, is to understand the individual needs of the site and its operation, including both current uses and future uses.
“Each system will be different as each building and hospital is unique.
“We would advise trusts to consider the feasibility of installing heat pumps based on the characteristics of their particular hospital
site, taking into account space availability, requirements, noise considerations, etc.
“The important thing though is to talk to the manufacturer as early in the planning process as possible.”
Mitsubishi has worked with a number of NHS trusts across the country to upgrade and replace outdated heating systems, including Devon Partnership NHS Trust (pictured above), where its team replaced a heating and cooling system with three modular heat pumps and two modular chillers.
E.ON Energy has also embarked on a 15-year energy efficiency partnership with Nottingham’s Queen’s Medical Centre (QMC), one of the largest NHS hospitals in the UK.
And the trust’s new energy centre will use four high-efficiency heat pumps to extract heat from the air and 64 boreholes up to 250m deep to draw natural warmth from the earth.
Excess heat can be piped down into these boreholes and stored or preserved for use at a later date.
Any leftover heat can be recycled by the heat pumps, lowering the demand for fossil fuels and in turn reducing energy costs.
Nottingham University Hospitals NHS Trust said the project would cut the hospital’s carbon emissions by 30% a year initially, which would increase to about 43% after its current gas-fired heating system is decommissioned.
Anthony May, chief executive of NUH, said: “This partnership demonstrates our significant commitment to environmental sustainability and offers a creative solution to meeting our energy needs and tackling
climate change, while at the same time improving patient and staff comfort by allowing us to better manage temperatures within our buildings.
“Innovative projects like these will play a hugely-important role in helping us meet our ambitious goal of achieving a net zero carbon operation for heating and cooling system emissions by 2040.”
We would advise trusts to consider the feasibility of installing heat pumps based on the characteristics of their particular hospital site, taking into account space availability, requirements, noise considerations, etc
The critical care unit at St Mary’s Hospital in London has also installed a ground source heat pump system to provide heating and cooling.
As a result, the hospital’s carbon emissions have dropped by over 40%, and it expects annual energy savings of around £1m.
And the University Hospital of South Manchester has installed air source heat
pumps to provide heating and cooling to the hospital’s outpatient building, reducing emissions by over 30%.
Funding for NHS heat pump technology is primarily coming from the Public Sector Decarbonisation Scheme (PSDS) or via Energy Performance Contracts with manufacturers and suppliers.
Veolia secured £22m from the PSDS to help decarbonise two acute hospitals for the University Hospitals Birmingham NHS
Elizabeth Hospital Birmingham will lower its carbon footprint by 2,086 tonnes per year through conversion from the use of steam for heating to a hot water system backed by the integration of a 1MW multistage heat pump system. And upgrades at the Good Hope Hospital in Sutton Coldfield will see the installation of a 650kW multi-stage heat pump system. n
On 17 April, the Public Sector Low Carbon Skill Fund (LCSF) Phase 5 opened to applications, providing £16m of grant funding to enable public sector organisations, including NHS trusts, to hire expert consultants to help create heat decarbonisation plans.
Created by the Department of Energy Security and Net Zero, the fund is delivered by Salix Finance, with organisations having just 14 days to submit their application. And, for the first time, this phase leaves the old ‘first come first served’ system behind, introducing a new randomised assessment protocol.
The available funding will be divided across three grant value ranges to mitigate the risk that a small number of high-value
projects exhaust a large proportion of the available budget, and to ensure the available funding is distributed across a range of grant values.
• 34% of the total Phase 5 Low Carbon Skills Fund funding will be allocated to applications with a value of £100,000 and below
• 38% of the total funding will be allocated to applications with a value between £100,001-£500,000
• 28% of the total will be allocated to applications with a value between £500,001-£1m
A spokesman for Salix Finance said:
“One of the greatest challenges today in meeting the UK’s 2050 net zero target is decarbonising the way buildings are
heated.
“Most of the buildings in the public sector still rely on fossil fuel-based heating and expert skills are required to identify and plan how these heating systems can be replaced, ideally at the end of their working lives.
“Having a robust heat decarbonisation plan will put organisations in a strong position to take the next steps in decarbonising, including by enabling them to develop detailed project proposals that will help them to apply for any future grant funding for capital decarbonisation measures, or alternative sources of finance.
“This means organisations can think more strategically and be better prepared for future decarbonisation opportunities.”
A first-of-its-kind solar car park and EV charging hub has opened at Raigmore Hospital in Inverness.
The innovative facility provides hospital users with access to 12 electric vehicle charging points boosted by renewable energy.
With a fleet of EVs already in operation at the hospital, Papilio3 — developed by 3ti — will support destination and workplace EV charging, while addressing the growing demand for accessible and convenient charging in an area where long dwell times are common.
A spokesman for 3ti said: “The rapidly-installed unit has helped Raigmore Hospital quickly boost its EV charging infrastructure and will encourage EV adoption in the area by providing affordable, low-carbon charging for everyone, regardless of access to off-street parking or geographic location.”
The Papilio3 is built around a
The spokesman said: “It can be easily transported and set up almost anywhere in the world and, today, Papilio3 is already in operation at several facilities across the UK, designed to solve many of the challenges facing transport, energy, and infrastructure sectors.”
Papilio3 is pre-fitted with a back-office billing system and a range of technology and user features.
automatically operate the lights when a customer approaches.
Fully-operational CCTV also provides additional safety and security for staff and members of the public.
Making it particularly suitable for healthcare operators, the unit can be rented, therefore requiring no upfront capital investment.
And, with a solar capacity of 19.32 kWp, it will generate on
average 18MWh of electricity annually — which equates to over 63,000 miles of EV range — and can fast charge up to 12 EVs simultaneously at seven, 11, or 22kW.
Brian Johnstone, head of energy, environment and sustainability at NHS Highland, said: “As part of our commitment to supporting the delivery of healthcare in the future, we understand that our environmental responsibilities go beyond our own services.
“As an organisation, we are looking to develop innovative ways to harness electricity and utilise renewable energy onsite, which Papilio3 is a great example of.
“With the introduction of Papilio3, NHS Highland is now in better positioned to support patients, staff, and visitors with EVs at Raigmore and we hope this investment helps convince others to make the switch over to zero-emission vehicles.”
A new hand sanitiser refill and reuse scheme has been launched which cuts plastic waste, supports employment, and saves money for Scotland’s NHS.
The Institute of Neurological Sciences at the Queen Elizabeth University Hospital in Glasgow is the first hospital-based site to pilot the initiative, developed by NHS National Services Scotland (NSS) and Redeem Exchange.
Zero Waste Scotland has supported the initiative with £38,000 from the Circular Economy Investment Fund, supported by the Scottish Government and the European Regional Development Fund.
NSS partnered with Redeem Exchange, a Greenock-based social enterprise, and NHS Greater Glasgow and Clyde to establish and run an initial pilot in 25 community locations, including health centres, hospitals, and social care facilities across the region.
Under the scheme, empty hand sanitiser bottles are collected from participating
locations and then washed, refilled with medically-approved hand sanitiser, and returned back into circulation by the Redeem Exchange team.
The scheme is continuing in the original pilot locations and is now up and running at the Institute of Neurological Sciences (INS).
Sam Atkinson, operational manager at the INS, said: “Since COP26, INS & Spinal Injuries have been exploring new ways to improve our record on sustainability.
“Redeem Exchange is the first pilot we have launched that aims to reduce plastic waste, in this instance of empty hand sanitiser bottles.
“The first collection was successful, with
boxes filled to the brim with empty hand sanitiser bottles, all ready to be reused up to 50
“Working closely with the sustainability team, Redeem Exchange is one of a number of projects that INS & Spinal Injuries seeks to implement over the coming months.”
Trev Gregory, chief executive of Trade Right International CiC, added: “What began as a throw-away idea during the pandemic when there was a global shortage of plastic bottles for hand sanitiser, has developed and grown into the Redeem Exchange.
“Partnering with NHS Scotland we have been able to shape a venture which is good for people and for the planet.
“Single-use bottles can be reused multiple times while also providing meaningful employment skills and experience to people living in areas of deprivation.”
The winners of the 2024 Healthcare Design Awards have been announced
Achildren’s mental health unit, a dementia care home, and a primary care clinic were among the winners
which were first launched in 1991, have been taken over by Nexus Media Group, which also owns the Healthcare Property website and magazine.
The competition recognises innovation and excellence in the design of health and
care facilities across the UK.
And this year, there were six winners, announced by celebrity host, Wayne Hemmingway, at a ceremony at the Royal Lancaster Hotel in central London. They were:
For information on next year’s awards visit www.healthcaredesignawards.co.uk
Project team: Cullinan Studio, Alder Hey NHS Foundation Trust, 10Architect, Galliford
The Catkin Centre and Sunflower House project for Alder Hey NHS Foundation Trust in Liverpool was designed by Cullinan Studio and delivered
RIBA competition, it brings a range of specialist mental health facilities that were previously scattered across the hospital site and the city of Liverpool together in two connected buildings.
Project team: Vestar Architectural and Design, Evermore Care, Teal Furniture, Ashton Manor is built on the site of a former 20-bed care facility as is designed to provide quality care in a setting deserving of the best environmental standards.
Key features include mature landscaped grounds, rooms with patio or balcony access, a feature courtyard, and community facilities such as a tearoom, cinema, sunrooms, and hair salon.
As the first purpose-built care home in the local area since the 1990s, the project team overcame challenges to create a market-
Project team: Loveday & Co, Realm Landscapes, ReardonSmith Architects, Iconic Build Loveday Abbey Road is a new care home within the St John’s Wood Conservation Area in London.
The brief for the new property was for the building and landscape to work seamlessly together, to create a refined and welcoming home-from-home experience to complement the interior spaces and afford a garden space that would be an integral part of the care experience.
The judges were impressed with the level of thought that went into a small space, making use of it in the best way they can and offering individual spaces for residents.
The judges praised the ‘well-thought-out floorplan, therapeutic interiors, and good use of natural materials and natural light’, adding: “This is a great example of thinking outside the box, delivering mental health services in an environment which maximises views to the outdoors.”
The judges thought a focus on resident comfort, wellbeing, and choice was evidenced by a range of attractive and interesting social spaces, with close attention paid to accessibility and wayfinding, indoors and outside.
They also praised the Loveday team for ‘demonstrating a real passion, commitment, and meticulous attention to detail to ensuring the sensory garden fully caters to the needs of the people living with dementia.’
Project team: Cinnamon Luxury Care, The Cinnamon Care Collection, Edmund Williams Architects, Catalyst Interiors
This state-of-the art ‘boutique’ care home boasts 47 spacious en-suite bedrooms and four luxury care suites.
It offers residential care tailored to each individual person and also provides expert dementia care within a dedicated community.
The development stood out for its person-centred design, from attractive privacy screens in bathrooms to intelligent interactive cues positioned throughout the home, allowing residents to navigate with ease.
Project team: Primary Health Properties, Simpson Hilder Associates, Westridge
The judges felt the thought behind each design choice was evident, with practicality combining with style and homeliness. And staff areas are not seen as a ‘back of house’ after thought, but promote a sense of pride and belonging.
The Victoria Medical Centre development and associated GP practice mergers and service changes have enabled Sussex ICS’s realisation of the delivery of primary care at scale for a
The new premises and associated service model wholly align with the strategic direction for the delivery of primary care and set a precedent for modern, flexible, integrated care.
This was a standout entry as it brings together multiple services
Arbour Walk’s design has been carefully curated to support a holistic approach to caring for adults over the age of 40.
Each bedroom has its own en-suite fitted with light sensors and large feature windows. Wide corridors throughout the home provide ample ‘break-out’ space and there is a pub, restaurant, community café, and garden restaurant on site.
The judges were impressed by how thoroughly the environment
in a modern, fit-forpurpose, and very-wellthought-out building with a logical floorplan and interiors which make the most of natural daylight and provides a supportive and less-clinical environment for patients, staff, and visitors.
The judges were particularly impressed by the range of services offered and the way the team had thought about the needs of all users.
They also liked its ‘simple, elegant design with a no-nonsense approach to understanding their patients’.
supported people with a wide range of care needs from mental health to nursing and complex dementia.
They were also impressed by the wide variety of environments that provided a calming and stimulating environment for people living with dementia.
Jo Makosinski speaks to Paul Yeomans, director at Medical Architecture, about his experience designing healthcare buildings and how approaches have changed over the past two decades to create more-supportive facilities
Q. When and how did you first become involved in the design of healthcare buildings?
A. I had been working at a well-known Newcastle practice for six years, delivering some lovely projects in the museum, education, and residential sectors. So, when I got a call from now-retired Chris Shaw, I was at a little bit of a crossroads.
I’d been headhunted and MAAP (as the practice was know at the time and later rebranded to Medical Architecture) was looking to establish an office in Newcastle on the back of significant work it had started delivering for Northumberland, Tyne and Wear NHS Trust and Laing O’Rourke under the NHS ProCure21 framework.
Over a pizza, Chris told me all about the company’s philosophy and opportunities, saying: “I’m looking for somebody who can run our new studio. I don’t know how it’ll go, but the prospects seem good, and the opportunity is there if you are interested.”
Looking back, it was quite a leap of faith.
The company’s sole focus was the health sector and I’d never designed any healthcare
buildings before, but Chris and the other directors were clear that first and foremost you should be a really-good designer, the nuances of healthcare design could be learnt.
In September 2006 I took that jump and set to work on my first healthcare project and building a team to support it.
I’ve never looked back!
Q. In your opinion why is building design so important in the overall delivery of healthcare services?
A. So much of our work is incredibly rewarding, not just in creating good buildings, but also genuinely-worthwhile design that enables clinicians to treat patients, and people to recover better.
I recognised this on my very-first healthcare project. It was a significant reconfiguration/extension of a Victorian mental health inpatient ward to create a modern, fit-for-purpose psychiatric inpatient care unit — often the patients with the most-challenging behaviours.
They arrive at the building at the peak of crisis, and for the first time in my career I witnessed that the architecture and building design was having a measurable impact on its users, rather than it being subjective and anecdotal, which is what I had been used to in other sectors.
Post-occupancy studies with this building revealed that there had been a 60% reduction in violent incidents and that prescription drug use had also dropped significantly.
This had a lasting impact on me.
Although this evidence was related to mental health design, our continued use of post-occupancy and benefit realisation studies in all sectors of healthcare design all point to the same findings — high-quality buildings improve the patient experience and the quality of care provided.
Q. What has changed in terms of design approaches/interventions since your first project?
A. Throughout our history we have challenged the field of healthcare architecture to focus on improving the patient experience, supporting recovery through therapeutic design.
In an acute setting, the human experience makes a huge difference to wellbeing, recovery, and the perception of care quality. Careful consideration of circulation spaces, wayfinding systems, artwork, lighting, and interior design can raise a mundane experience to a dignified and positive event.
I think the one fundamental aspect that has changed is the scale of healthcare infrastructure spend and ambition.
We are used to the cycle of government spending, the peaks and troughs, but in the last few years our clients are having to do more with less money and our designs have to be even more effective.
Q. What are the key things you have learned in your career designing healthcare facilities?
A. Architectural design is fundamentally about the way space, structure, and environmental conditions are modulated, and the way that a place is used.
The architect needs to deploy and orchestrate physics, social sciences, economics, and aesthetics.
I really love that in architecture you can join the dots in so many interesting and creative ways.
Specifically in healthcare, we’re in this brilliant position where you’ve got architecture at the crossroads of medicine, two great professions where you’re really making a difference.
Q. Did COVID change the way we approach the design of healthcare facilities?
A. I don’t think there were any fundamental changes as to how we design, but I think there was a change of mindset with healthcare organisations.
More importance was placed on looking after staff — providing much-better spaces for rest and wellbeing.
Also, there was clearly a heightened importance for control of infection and making sure that flows of patients/staff/ visitors/FM worked well.
Our general approach to planning design is to ensure spaces are flexible and adapt to a wide range of situations and use — and the importance of this came to the fore during COVID.
Q. How do you think design approaches will continue to evolve in the future?
A. The legacy of past and current underinvestment tells us that continuing with managed decline is an undesirable, risky, and expensive option.
Despite the poor state of public finances, good custodianship of our healthcare infrastructure goes hand in hand with providing what the public expect: modern and effective health services in buildings that are safe, attractive, and a great place to work.
This needs strong leadership, skill, and a concerted effort to secure short-term improvements while nurturing a long-term positive vision for our healthcare estates.
This dual strategy entails building a pipeline of rapid, revenue-driven, highimpact improvements alongside strategic plans that will underpin a robust and appealing forward vision.
New NHS facilities will integrate sustainable design, modern methods of construction, logistical automation, and digital technologies to ensure our healthcare infrastructure is fit for the future. n
Paul is a director of Medical Architecture, with over 17 years of experience in healthcare design. In 2022, he was awarded a Fellowship of the Royal Society of Arts for his leadership in healthcare design. He is also an associate for the Design in Mental Health Network and member of their Conference Advisory Group and Design Awards jury. Through this role, he contributes to best practice guidance in mental health facility design to raise standards across the sector and improve the experience of patients and staff across the UK and internationally. Paul is a regular speaker at conferences and uses this platform to promote good-quality healthcare design. His project portfolio has received awards from the RIBA, Building Better Healthcare, Design in Mental Health, and European Healthcare Design.
George Morris has become a director, architect technician, and shareholder at architectural practice and care home specialist, Carless + Adams, working alongside Melissa Magee, company director and architect.
Growth in the business has demanded specialist technical skill sets and Morris has been instrumental in driving the team with this.
His appointment comes after Neil Rutland, associate, left the business in January to take
early retirement and Stewart Anderson joined as associate director.
Morris has been with Carless + Adams since early 2018 when he joined from Nottingham Trent University with a BSc (Hons) in architectural technology.
As part of the management team, he has been instrumental in developing and driving the direction of the business, maintaining and enhancing client relationships, formulating sales strategies, and instigating and leading projects.
Commenting on his new role, he said:
“Being part of a business that enables change and positively impacts people’s lives though architecture is something I feel privileged to be part of.
“The UK has an ageing population with insufficient suitable accommodation available, so to be able to support the business in growth though designing homes that enable people to pro-actively right size and enhance their lives through their home environment is something I feel very passionate about.”
NHS Property Services (NHSPS) has recently promoted Sally Tombs to the role of managing director for the London region.
Taking up her new position from this month, Tombs’s role will include working with, and supporting, NHSPS customers in addition to ensuring that all London-based properties under its portfolio are safe and compliant.
She joined the health and property organisation in 2020 as its principal operations manager, progressing to become an estates delivery partner.
Prior to joining NHSPS, she held positions in facilities management and property services at Telereal Trillium, Cofely UK, and Metropolitan Thames Valley Housing.
Over the past 20 years, Tombs has acquired a diverse skill set and vast experience in the property and facilities sectors, and latterly, the health sector.
She has also developed many key relationships with NHSPS’ customers and stakeholders.
“I am delighted to be taking this next step in my career. I have thoroughly enjoyed working at NHSPS for the past four years and I can’t wait to continue to support our customers,”
HKS, an architectural firm which specialises in healthcare design, has appointed Dan Noble as chief executive and chairman of the board and Sam Mudro as president and chief financial officer.
For 10 years, Noble has served as president and chief executive, a joint role traditionally held by one individual.
During this time he has guided HKS to a period of growth in staff and revenue, leading to its recent ranking as the world’s secondlargest architecture and design firm.
Recognising a need to evolve the firm’s executive leadership structure, Noble and the board recently divided the chief executive and president roles.
This move will enable HKS to capitalise on market
she said of the new role.
“To ensure we can enable excellent patient care, I will continue to work with our London teams to guarantee that our portfolio remains compliant, clean, safe, and welcoming for all patients across the capital who are accessing necessitated healthcare. I’m excited to get started.”
Trish Stephenson, NHSPS chief operating officer, added: “I know Sally will continue to do amazing work and support our customers, in addition to our internal teams and colleagues. “She is a great example of our get, grow, keep talent culture and I am thrilled to see her progress in her career with us.”
opportunities and drive an even higher level of design excellence and innovation for its global clients.
As chief executive and chairman, Noble will lead and shape HKS’s vision, strategy, and organisational culture. He will also lead and advise the Board, maintaining ultimate decisionmaking authority for high-level business changes.
“HKS leadership has long
understood that the best way for us to leverage our talent is to give agency to others,” Noble said.
“This transition will give us latitude within our organisation to do more and continue to lead the industry through limitless thinking.
He added: “Sam is an incredible sounding board and a trusted advisor. Together, he and I will continue to work together, influencing the future of HKS
alongside our colleagues around the world.”
Mudro ascends to the role of president and retains his position of CFO, which he has held since joining HKS in 2015.
He now oversees overall business strategy implementation and is responsible for operational and financial performance, reporting to Noble and the Board.
He said: “The new leadership structure will help us unlock our ability to achieve our vision at a deeper level.
“It will create clarity and focus around two essential elements of our business: our strategic vision and our execution, and we will be able to innovate and create at a much-faster speed, ultimately delivering greater value to our clients.”
GRE Finance, a specialist lender to the UK real estate market, has hired two associate directors from Octopus Real Estate and Hilltop Credit Partners to capitalise on the surge of opportunities in the real estate finance market.
Clare Grimes has joined as an associate director from leading UK specialist real estate investor, Octopus Real Estate, where she specialised in the origination and execution of primarily commercial real estate debt transactions.
Grimes has gained extensive knowledge and experience through working with a range of clients, including funds, to deliver financing on a variety of assets across the UK.
And she is chairman of the Association of Real Estate Funds’ Future Generation Committee, a member of AREF’s management committee, a chartered surveyor, and holds a master’s degree in Real Estate, Investment and Finance from Henley Business School.
Archie Dickinsonalongside high street lenders, challenger banks, institutional funds, and HNWIs.
He began his career at Proseed Capital, a mezzanine development finance lender before moving to specialist development finance provider, Hilltop Credit Partners.
underwriting, and execution, past roles have seen him structuring and executing both senior and mezzanine development loans, working
During his career he has underwritten and completed on over £750m of real estate
Founded in 2020 by Michael Mirelman and Daniel Benton, GRE Finance is a specialist lender to the UK real estate market and currently holds a loan book of £110m against residential and commercial
Remaining active through the economic turbulence of 2023, it agreed several loans over the course of the year, including a £6m acquisition loan against a student building in Portsmouth; a £4m loan to MACC Care, a Midlands-based care home developer to acquire two sites with planning for new care homes; a £6m loan to the UK’s
NHS Property Services’ (NHSPS) chairman, Jane Hamilton, is to step down following the end of her three-
Having joined the board in March 2021, she has decided that, after 15 years working in the UK, now is the right time to return to her native Australia to be with her family.
She has overseen the successful transformation of the organisation and with the end of her original three-year term as chairman, she now feels this is the right time to allow someone new to oversee the next exciting chapter for NHSPS.
“When I reflect on the last three years at NHSPS, I am filled with real pride in what we have achieved,” she said.
“We have truly transformed the organisation, continuing to embed a culture that puts the customer at the heart of everything we do.
“A year on from that transformation programme, we now have an organisation that is ready and confident of taking the next exciting step in its journey, with the brilliant expertise of its people and a newlydeveloped five-year business strategy.
“I know that I will be leaving behind a strong team in place with an exciting future, which I will continue to watch from afar.”
Ellie Mason, shareholder representative director on the board for the Department of Health and Social Care, added: “I would
leading retirement developer, Lifestory Group; and a £17m loan for a development finish and exit facility secured against residential development of 89 homes in Surrey.
Daniel Benton, director at GRE Finance, said: “The opportunities in the UK’s real estate debt markets today are vast, and the appointments of Clare and Archie to kick off this year put us in prime position to seize what could be a once-ina-decade opportunity.
“We remained active through 2023, focusing on strategic asset management in the first half of the year before identifying market opportunities in the latter half and agreeing more than £30m in real estate financing.
“Our opportunistic and value-add approach, depth of expertise in property development and management as well as financing, and willingness to take on projects involving planning risk, means that we are very well placed to support a range of transactions taking place in the market.”
like to thank Jane for the last three years of help and support she has brought to NHSPS.
“She has shown true passion and commitment to everything we are trying to achieve.”
And Martin Steele, chief executive, said: “Jane has guided the business through a period of extraordinary change, with a fundamental pivot to a customer-centric operating model, a transformational organisational redesign, and the creation of a new business strategy.
“Her 30 years of experience in property and the government sector have also helped ensure focus on sustaining high levels of operational performance.”
Hamilton will remain in post until the end of July 2024 while the recruitment for her replacement takes place.