Addressing adaptability

Addressing adaptability

Moss, Ray

Ray Moss explains the reasoning behind launching a far-reaching study into an often-advocated aspect of NHS building design. See HD for future updates.

PERHAPS you may recall the death of Howard Goodman in April 1999. Howard had been chief architect at the Department of Health from 1971-1988 and while in post presided over dramatic changes in the shape and size of hospital buildings, from high-rise, highenergy to low-rise, low-energy, and from one off, fragmented designs to more compact standardised models.

In fact the stock of hospitals we now have was largely shaped during these years. However, different pressures are now at work, pressures which not only require a fresh perspective on the whole subject of hospital design, but also look again at the methods by which such hospitals are procured.

Perhaps the greatest culture change underlying all this is that the NHS is no longer providing buildings for itself at ‘nil’ cost, but is using extremely expensive facilities, provided by others, who over time will take back the building from its hospital tenant, and very likely use it again, but for something quite different.

Bearing this in mind and adding to it what is already well-known, namely that medical science develops rapidly along unpredictable lines, it rolls off the tongue so easily to say: “Adaptability is what we need”. But what is adaptability? How much do we need, and how much does it cost?

A number of large and seriously intentioned REtD projects have been built in an attempt to address the problem. In this country there were hospitals at Northwick Park and Greenwich and later, standardised hospitals, but unfortunately these significant buildings were never followed up with a systematic study, nor has there been a serious attempt to understand the problem as we now perceive it. By this is meant both NHS and private sector together, looking seriously at the question of adaptability in modern buildings – one as building user, the other as building owner — and asking questions such as: “How can modern structures become more multifunctional and cost effective? What kind of buildings should we be looking at which will be able to absorb the pressures for growth and change, without themselves becoming non productive during the change process? Or, to put the question another way: “What sort of adaptability is it that allows building systems to be used equally effectively by different client groups?”

From such investigations, planned carefully and conducted at an international level, minimum risk structures could be identified for future buildings. In the case of hospitals for example, this could take account of the need to design to reduce the operating costs, by allowing for better management – a requirement almost totally absent from hospital planning briefs currently.

As it is clear that the NHS will never be able to fully fund its activities from central Government, and as it is clear also that the emphasis is changing constantly in the provision of healthcare, the challenge is considerable – as is the scope of the study, which will require funding both by the Government and the private sector. As Howard Goodman had a considerable influence in the shaping of our building stock to date – at the ‘laboratory’ for future work so to speak, we thought that using his name would be appropriate for the fund.

This study should in no way be aimed at the same target as previous studies in this area, but should learn from them and move forward to produce a general ‘tool-kit’ for designers and constructors. It will take account of all the old concerns of functionality, but add to them current and future concerns in a guide for ‘investors’ — concerns such as risk, speed, pay back time and so on.

The whole idea is to forge ahead with a thoughtful study, representative of the whole industry, carried out at a highly regarded academic establishment, and most important, feeding back its findings as the work proceeds against strict timetables.

Copyright Wilmington Publishing Ltd. Oct 2001

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