News & Media

The common denominator is flexible, modern capacity in primary care.


Jonathan’s blog was first published by the British Property Federation – read the full post on the BPF website.

“Today’s funding is an important step, but is only the first of many. In planning the next, we cannot forget the sometimes forgotten infrastructure in primary care which underpins the Long Term Plan – infrastructure which could be truly transformational for the NHS.”

I wrote those words as the Health Infrastructure Plan was launched last year, ushered into being with the pledge of £850m for hospital maintenance and upgrades to acute facilities. Since then, the operating environment for all of the NHS’s buildings has changed dramatically. Where last year, Trusts and primary care teams were battling to stay on top of the maintenance backlog and capacity challenges of an estate which – in some places – pre-dates the health service itself, the NHS’s premises have now become crucial tools in the ongoing management of the pandemic. More than £4bn has been pledged for immediate hospital facilities improvements and maintenance, and for preparations to cope with a second wave of coronavirus cases. But in the big thinking about ‘building back better’ and investment in social infrastructure, are we thinking enough about the transformative power of the NHS’s local places and spaces in primary care?

For a number of years now, we’ve been working on what we see as the medical centre design of the future – exploring how the physical design and layout will work with primary care’s growing use of digital technology, remote consultation and diagnostics. The last three months have shown us just how important this work is. Working with YouGov, we asked doctors, nurses and other healthcare professionals for their reflections on the healthcare premises they’ve worked at or visited since March.

While just over half (55%) said sites they’ve used were fit for purpose during the pandemic so far, 27% said premises had not worked that well or at all well for the services provided within.

Concerns about lack of space to implement social distancing in both clinical and staff areas, infection risk in older buildings and inflexible layouts were among the challenges flagged by workers across organisations such as hospitals, health centres and mental health sites. We also asked what they would want to see in community medical centre buildings of the future, based on their experiences of care during the pandemic so far. The most called-for features were:

  • More flexible space which can be adapted quickly when needed (70%)
  • The ability to divide the building or isolate specific areas (64%)
  • Both face-to-face consulting rooms and smaller remote consulting spaces (52%)
  • External spaces for both patients and staff (49%)
  • Intercom systems for communicating with patients outside the building or in different zones (42%)
  • Room for more on-site diagnostic options away from hospital (42%)
  • Room for more on-site treatments away from hospital (41%)

With the NHS Long Term Plan and experiences of the pandemic to guide us, the common denominator is flexible, modern capacity in primary care. Hospital upgrades are desperately needed, but as the NHS attempts to address care backlogs and as GPs look ahead to a future where clicks and consultations combine, the most transformative infrastructure investment would be in creating the right space for consultation (both digital and traditional), diagnostics and treatment close to home. Clearly, we all hope we’ll never experience a situation like this again – but there is so much we can learn from it to create the health spaces of the future.