Creating a healthy service

Brandon Cheevers believes that the public health sector has been slow to recognise design’s potential, but new research proves it can make a difference

The private sector has long understood the potential of design to power a brand. But, despite a pool of world-class designers in the UK, the public sector has been slow to recognise the potential for design to improve services, particularly in our ailing hospitals.

The Government’s Budget pledge to pump an additional £40bn into the National Health Service over the next five years will help the suffering public health sector, but what of the role of design and its ability to enhance the patient experience? Can design help ensure the NHS is in a better position to offer the sort of worldclass service seen in other European countries?

Jane Priestman sits on The Design Brief Working Group, which works for NHS Estates, and is an advisor for Central Middlesex Hospital in her role as enabler for the Commission for Architecture & the Built Environment. She believes a shortage of cash does not need to equal a shortage of good design solutions.

‘I don’t think there is a cost issue. When a hospital is built it is designed. Whether it is a bad design or a good design is not dependent on money,’ she says.

John Sorrell argues cost is always an issue, but agrees a big budget is not a precursor to effective design.

‘Effective design does not cost any more and very often it saves money,’ he says. ‘I am talking about spending money wisely on effective design solutions to make things better.’

Sorrell is chairman of the NHS London Design Advisory Group, which was set up a year ago by the NHS London Executive and six design figures – John and Frances Sorrell, Michael Wolff, Jeremy Myerson, Keith Priest and Jane Priestman. It explores the way design can help the NHS in London improve the patient experience and hopes to extend those principles to the NHS as a whole.

The group is on the verge of agreeing a set of pilot projects that will be implemented in hospitals and primary care centres. The aim is to generate knowledge and evidence of the way in which design can impact on the health service and projects will centre around environmental, product and communications design.

Sorrell thinks there is a direct link between design and patients’ wellbeing.

‘Quite small design details can make all the difference. Design can have an impact on the patient both clinically and psychologically.

‘A drip stand or a bedside cabinet; a view out of a window and getting the lighting right; and good communication to ensure the patient is kept informed at all times. From effective signage to ensuring that information is relayed in different languages for different people, all this makes a difference to the patient’s experience,’ he says.

Architect and designer John Wells-Thorpe agrees. He is coming to the end of a three-year research programme into how the physical environment can improve a patient’s recovery time. The results of the research, conducted in collaboration with Sheffield University School of Architecture and two NHS Trusts, are striking.

The research involved treating one set of orthopaedic patients and one set of medium-secure mental health patients in old and rundown buildings and then moving them to brand new, specially-designed buildings where they received exactly the same treatment. The research team measured the patient’s responses, both clinically and scientifically.

‘We got authenticated results – improved recovery rates and less dependence on drugs. I used to believe, but now I know, that there is a direct link between a patient’s recovery time and their environment. Colour, light, texture, view, control of unwanted noises, all inter-relate with the four senses,’ says Wells-Thorpe.

However, he says that in order to effect change in the NHS, the argument should not be based on aesthetics.

‘If you can underwrite your argument by saying it is better for business or turnover rate you stand a better chance of convincing [the NHS].

‘We now know that it is better on balance to spend a little more [on a patient’s environment] in order to accelerate the rates of discharge and reduce dependence on drugs. Even if it costs more to improve the environment, this is offset by the increased turnover in patients,’ he says.

Sorrell and Priestman point out that design would be improved if the NHS were to employ people with a responsibility for overseeing the design process.

‘The NHS does not have enough people like me. Until it gets design directors it will get banal design. Every trust should have a design director on board. It is very important that a strong design brief is set for projects,’ says Priestman.

‘Why aren’t British designers working for the NHS?’ Sorrell asks. ‘It’s because there are no rules of engagement for them, like there are at most companies designers work with. Hospitals do not have the people to deal with design issues. [The NHS London Design Advisory Group] wants to look at the way the client group in the NHS can engage with designers and work with them in the future.’

Sorrell says effective design is about making life as good as possible for everyone. Let’s hope that this principle can be extended to the NHS and that design can help Britain build a health service to believe in and be proud of.

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