Changes to hospital designs could reduce NHS costs

Involve the public and patients in design, says Prof Derek Bell. Picture: PA

Professor Derek Bell, the new president of the Royal College of Physicians of Edinburgh, said the area of hospital design had not been well explored in healthcare, but could be used to help drive efficiency and reduce costs.

The college has now set up a working group to investigate the issue of building design.

Prof Bell, speaking in his first interview since taking up his new post, said design played an important role in how hospitals ran.

“It relates to how we ensure patients move quickly and seamlessly through the system and at the same time get a good experience,” he said. “It is also about creating an environment which is conducive to staff working and so that the building meets purpose.

“While in healthcare we do an element of that, I don’t think we often do that as well as we can.

“There is an increasing need for us to have the patients and public involved in design concepts.”

Prof Bell, who has spent his career working for the NHS in both Scotland and England, said making alterations to older buildings may prove more difficult, but changes were important.

Making sure new hospitals were designed to be fit for purpose was also vital, he said.

This could, for example, involve making sure that emergency departments are close to acute medical units and also imaging and radiology areas, with easy access to critical care.

“What we want to avoid is long delays between patients moving from one department to another or having a long distance to be transferred to the next place of care or for investigation,” Prof Bell said.

“That disrupts care and also utilises a lot of staff time. If we can get the co-location of the important facilities together we can make it better for patients and staff.”

Prof Bell said design should also take into account the large numbers of older people using hospitals, as well as the needs of younger patients.

But he said more effort put into design now would reduce costs for the health service in the long-term.

“It may save them money in a whole series of ways by reducing the amount of time staff spend doing tasks that are not related to care,” he said.

“That is the really important part in the healthcare environment because we are doing things relatively quickly.

“We need staff to be able to do clinical things quickly and do less administrative or portering and transport tasks. So that would be one way of releasing efficiency because we could get staff gains.

“But it is not just about making the staff work harder. It’s about creating an environment that is much more conducive to delivering high quality care.”

Prof Bell said healthcare systems around the world were facing growing pressures in meeting demand.

Margaret Watt, chair of the Scotland Patients Association, said: “Doctors and nurses know best about how hospitals should be run and designed.

“We now have to make sure that people listen to what they are saying and act upon it.”

Prof Bell’s predecessor, Dr Neil Dewhurst, was outspoken on the subject of NHS pressures.

Last month he warned that doctors and nurses were facing “almost intolerable pressure” as a result of cuts in the number of hospital beds, the increasing number of admissions and workforce shortages.