As the NHS continues to face an uncertain political landscape, coupled with the lasting legacy of austerity, and a decline in capital investment, there remain a number of tough questions, particularly around how it can provide modern, world class healthcare in the future.
Along with concerns about future funding and staff, the NHS is also stretched by an ageing population. Improvements in medical care, lifestyle and diet mean more people are living for longer – a fact borne out by research by the Office for National Statistics. The ageing population is having a direct impact on the healthcare sector; 18 per cent of the UK are now aged over 65 and 2.4 per cent are aged over 85. This places a significant strain on an already under resourced service.
Of course, construction doesn’t have all the answers to resolve these complex, societal issues. However, as an industry, we possess the expertise to collaboratively implement solutions which can make a meaningful contribution. The ability to harness innovative technology will be key to this.
MAXIMISING PERFORMANCE OF EXISTING ASSETS
Across the healthcare sector, we are seeing a new trend emerging that has important implications for the delivery of health services across the UK. A greater number of NHS trusts are focusing on lower cost refurbishment and expansion projects – with a focus on improving sustainability and reducing carbon footprints.
This change is happening in the context of a wider shift towards integrated primary care hubs. Investment is flowing away from acute care and hospital infrastructure to projects that deliver primary and community care facilities outside the acute hospital system. An approach that can accelerate the delivery of services to the public.
Integrated care hubs demonstrate the positive impact that innovative design can have in significantly enhancing the delivery of social care. Considered design in retrofit and expansion projects can create spaces where GP practices, pharmacies and inpatient beds are all provided in one development – in turn helping to reduce bed blocking in hospitals. There is also a significant opportunity to embrace the adoption of standardised design and component solutions driving efficiency in both Capital and revenue costs for projects.
Digital construction has an important role to play in delivering these first class integrated primary care facilities. Both by helping deliver new build facilities for an estate, and by creating a data-rich model of existing assets that provides a basis for an effective facilities management system. As the construction industry looks to achieve the goals set out in the Government’s ‘Construction 2025’ strategy paper, including construction costs reduction of 33 per cent and project delivery acceleration of 50 per cent in the next six years, BIM will have a key role to play.
Technology, such as BIM 360 field, is crucial to future-proofing the NHS’ built environment. BIM is well known for its ability to create fly-through models, which can play an important role in stakeholder engagement ahead of a project delivery date. However, it’s most crucial attribute is its ability to create a data-rich model of an estate, which can be accessed and edited remotely in real time.
The creation of a central point of information for all data relating to a healthcare estate is invaluable. From a construction perspective, it can greatly increase the efficiency of the snagging process, with details on the condition of a unit recorded in real time. From a FM perspective, it means that manual records can be replaced with a single authoritative point of information that is continually updated. The ability to access such a resource allows estates teams to make more informed decisions about refurbishment and renovation work beyond the initial construction phase. It also allows these teams to analyse data to better understand the maintenance costs across an estate, and effectively identify where efficiencies can be realised.
For existing healthcare assets where a digital model does not already exist, laser scanning technology – sometimes referred to as scan-to-BIM – can be used to create one. Again, this process can deliver vast efficiencies, with spatial data collected on healthcare assets in a matter of hours rather than days or even weeks. It can also be used to understand the spatial dimensions of areas that would otherwise be difficult to measure, such as lift shafts. In cases such as this, the use of laser scanning can also deliver considerable health and safety benefits.
Ensuring the consistent digitisation of healthcare estates is even more crucial as we move into the era of smart buildings, where everything from lighting, heating and security, to cleaning and catering is integrated across a single network. Features such as temperature and lighting that adjust intelligently to individual preferences will become the norm. These advancements will shape the future of the NHS and provide an improved experience for staff and patients. They will also benefit estate and facilities management teams, who will be able to access more meaningful information on their healthcare estate than ever before.
Equally, the speed of technological advances in areas such as robotics, machine learning and automation means buildings designed with anything up to a 60-year lifespan must be future-proofed. This means they need to be flexible and easily adapted to accommodate the future requirements of clinicians, other staff and patients. For buildings that need to be updated to adapt to these technological advances, the ability to plan expansion or renovation work with the aid of BIM data will be crucial to minimise project risk and maximise efficiency.
A FUTURE-PROOF NHS
Delivering a future-proof NHS is crucial if we are to meet the requirements of an ageing population and continue to deliver world class healthcare. In relation to the built environment, this means collecting data on healthcare estates through BIM, so that informed decisions can be made. It also means healthcare estate planning needs to take into consideration the disruptive technologies that will shape healthcare provision in the next 50 to 60 years.
As NHS trusts move towards an integrated model of primary healthcare provision, renovation and refurbishment work will have a crucial role to play. Here, the importance of BIM should not be underestimated. Its use is essential to providing a firm foundation on which the future of healthcare can be built.