Health week 2006

An investigation into the relationship between health and the built environment, which focused on healthcare buildings and neighbourhood design.

Health Week 2006 looked at the relationship between health and the built environment. Healthcare buildings (and their impact on care and healing) and the design of neighbourhoods (with their impact on the health and wellbeing of communities) emerged as the two key themes.

Healthcare buildings

The immediate future for individual health buildings depends on the ongoing financial management issues in the health sector, and the progress of the many building projects currently in the pipeline.

The role of the hospital is gradually changing, with funding for a new generation of community hospitals and agendas such as care-closer-to-home influencing the way that hospital buildings will be seen and used in future.

Design of neighbourhoods

Healthy neighbourhoods have a successful, environmentally sustainable combination of individual buildings, public space and infrastructure, designed to enable healthy lifestyles and encourage mental and physical wellbeing.

We believe that four major points on the government's health agenda are related to the quality of the built environment and public space:

1. obesity
2. mental health
3. the needs of an aging population
4. child health.

Key points from Health Week 2006

Monday 15 May

Can we design healthy neighbourhoods?

• the NHS has huge potential to change society, and needs to invest in the places where its facilities are located to tackle illness before it happens
• hospitals are a strong force for regeneration, and need to use their influence to improve the health of their localities
• current professional priorities are focused on cure rather than prevention; this order of priority needs to be reversed

Naturally good for you

• physical activity must be placed higher on the agenda; it has the potential to play a part in achieving many important policy targets
• the Department of Health's 'Choosing Activity' initiative aims to increase demand for physical activity, and to help to halt the rise in childhood obesity. Other government departments have a role to play by creating opportunities for physical activity (eg safer roads, well-maintained public spaces, leisure facilities, marketing of opportunities)
• being outside can help to improve social cohesion, overcome isolation, promote mental well-being, build new skills, and can contribute to treatment for mental and physical health problems, and it's either free or very cheap

Learning from each other

• the process of design and delivery is influencing both the quality of buildings, and the achievements of those working within them
• a better design process is possible, as seen in a number of other countries
• skills capacity for future healthcare designers needs to be developed in the architecture schools

Tuesday 16 May

Sustainability and healthcare

• through activities such as commissioning buildings, procurement, employment and skills, transport, and community engagement, NHS organisations have the potential to help create strong local communities, social cohesion and a healthy environment
• delivery of the broader sustainable communities agenda relies on an NHS Trust's ability to build partnerships, and to overcome the barriers between institutions.
• the gap between the short-term funding of capital costs and long-term social benefits (and difficulty of costing benefits) is a barrier to achieving sustainable healthcare buildings. The PFI process, as it currently stands, is part of this problem

Does public health grow in public parks?

• activity programmes encourage people to use parks more. Increased use reduces crime and the perception of crime, again encouraging more people to use the space
• there is much evidence to suggest that provision of good quality green space can prevent bad health through increased physical activity, by increasing healing rates and by reducing mental stress levels. Better provision of green space could reduce the country's health bill
• more research is needed to produce evidence on the links between health outcomes and green space

How physical surroundings affect mental health

• there is surprisingly little work already in existence around the relationship between mental health and the built environment
• there is a need to subvert the historical principles for designing mental health care provision: generating social inclusion rather than social exclusion
• the links between mental health and different aspects of the built environment ie housing quality, public space and exercise, and so on, are very fertile areas for investigation

Wednesday 17 May

What's so special about hospitals?

• the horizon is changing for the health sector, driven by more treatment at a community level, shorter hospital stays, more day care services, advances in technology and prevention rather than treatment to name but a few
• we need to ensure that healthcare building provision is flexible and able to cope with these changes
• this is an important ongoing conversation, but it would appear that too few people are involved

Healthy buildings breakfast seminar

• we should be exploring how we can use incentives to embed good design in the procurement process
• the private sector and the client trusts hold differing views of what the obstacles to good design are, resulting in a lack of mutual understanding
• there are opposing views about the what the obstacles are to good design. These need to be diagnosed and agreed on before a cure can be found

History of healthcare buildings

• modern hospitals are undergoing continuous alteration and change, and need flexibility. We need better understanding of how to achieve this
• the contribution of designers is fundamentally restricted by a lack of consultation and contact between the design team and clinical staff
• we need to learn important lessons from the exemplary healthcare buildings of the past, such as space, light, and views, and a truly holistic approach to healthcare, rather than just a list of services

Thursday 18 May

Developing a healthy London

• over the next 10 years London's population will increase by 10 per cent; therefore, if we make the wrong decisions on public health now the consequences will be serious
• a great deal of relevant information and research exists, but its form, management and presentation to those who need it is inconsistent and inefficient
• many design problems can be traced back to lack of funding and resources at the early stages of a project. Though this is constantly raised as an issue, it has yet to be addressed in a practical and productive way

Designing homes for healthcare

• in future decades, the proportion of elderly in the UK will be the highest it has ever been, with a correspondingly different set of demands and values
• one quarter of the elderly live in 'unfit' housing, and the scale of the problem means that the NHS is struggling to tackle these issues
• new approaches to retirement housing involve making them an active part of the surrounding community

Friday 19 May

The benefit of hindsight

• evaluation is a continuous learning process. We do not want to fall into the cycle of forgetting what we know and again constructing buildings that do not work
• ‘research’ needs a broader definition, so that it is not restricted to large budget, long term projects
• a great deal of research is available to the health sector; it is a matter of gathering and managing that information to the most productive ends

Public consultation: help or hype?

• consultation is a valuable process, if well-managed and run properly. Despite the fact that contemporary consultation has a wide range of tools at its disposal, there is still a great deal of box-ticking masquerading as genuine consultation
• consultation needs to use inventive methods to continue reach its target audience
• case studies are needed to highlight good practice and examples of particularly effective consultation processes.