The neighbourhood health service, designed around you — that’s the vision outlined in Fit for the future: 10 Year Health Plan for England. As you might expect, there are some big promises in there, and making good on those pledges is going to hinge on having the infrastructure to support the exceptional service provided by our healthcare professionals.
Putting patients first is more than a sympathetic bedside manner — it boils down to everything from how an environment puts a patient at ease to how well served a location is by public transport. As last year’s IHEEM Healthcare Estates conference focused on the role that architecture, engineering and estate management play in promoting ‘prevention rather than cure’, the case for revisiting the idea of health on the high street seems stronger than ever.
Anchoring healthcare
Health on the High Street was first mentioned in an NHS Confederation report in 2020, with a concept of ‘reimaging the connection between the NHS and the high street’, and the role health could play in supporting economic and social recovery. More broadly, it was proposed as a way for the NHS to get directly involved in high street policy, supporting communities through the reshaping of vacant high street units into integrated health centres, thereby revitalising footfall in town centres.
This idea is not new, and had been explored in recent years. However, the implementation has been gradual, mainly because of what happened with the Covid-19 pandemic. But what the Coronavirus experience did teach us all — patients, healthcare professionals and building services experts — was that healthcare services can be provided in diverse ways, and in different locations, that may have not really been considered before.
Transforming community centres into vaccination hubs, using modular buildings as temporary hospitals, turning dormant sports halls, and leisure centres into testing clinics. The NHS response to the pandemic showed that bringing healthcare into the heart of the community could increase footfall, reach thousands of patients and prove to the public that traditional hospitals or surgery buildings are not necessary for the delivery of excellent care.
Imagine what can be done now with the added benefit of forward planning, advances in sustainable energy technology and medical equipment, such as scanning facilities, accommodated in finely tuned retrofit solutions and units created through modern methods of construction, providing access for all.
Systems to stay well
While one of the perceived benefits of relocating healthcare services to town and city centres is an increase in people visiting the high street, the real win is the potential for improved health outcomes among the community.
Convenient and accessible services promote preventive care and early intervention. This is particularly the case when we consider what makes people reluctant to visit their GP — if it feels like a difficult trip to make then patients may be more likely to delay making an appointment. Humans are wired to choose the path of least resistance.
Moving services into more familiar locations fosters a sense of comfort, and feelings of wellbeing are fundamental to our state of physical and mental health. Taking some departments out of hospitals can reduce pressure on already busy sites, such as X-ray and ultrasound facilities, and help patients to feel like they are receiving more tailored, individual care rather than being just the next person on a conveyor belt.
This approach works both ways, supporting healthcare teams to engage with target groups and stakeholders. In Brixton for example, an ageing retail unit was transformed into a modern clinical facility for the NHS Blood and Transplant service. Delivering an inclusive and welcoming environment was crucial to the project, which was designed to encourage more donors to come forward in the area. Artwork by local creatives, a dedicated community space and a ‘hero wall’ helped the NHS to achieve its goals.
Bringing healthcare provision into centralised areas can also contribute to economic growth and support local businesses. From offices to shopping centres, across the country we can see examples of redundant buildings taking on a new, useful purpose. Another example is the development of a retail unit into a space for an ophthalmology department. This will enable the specialist healthcare department to relocate into a bigger space in a central location with high footfall, making it easily accessible and convenient to the public, while removing the fear factor many people face when entering a hospital environment.
Meanwhile at the Sands Centre in Carlisle, the redevelopment of the sports centre provided an opportunity to strategically locate NHS physiotherapy services nearby to support rehab patients. The practice more overtly shows the health benefits of having sport, fitness and wellbeing closely integrated, as well as making a great deal of sense from an accessibility view.
Repurposing premises is widely seen as an effective and efficient way for the NHS to deliver more for communities, especially in smaller towns. Speed of delivery is essential. With the right engineering, architecture and building services support, operational disruption can be minimised and project timelines condensed, ensuring opportunities for relocating services are quickly and efficiently delivered.
When it comes to external parties, stakeholder engagement has also shown to be an essential part of making Health on the High Street successful. Only through effective collaboration between local authorities, healthcare providers and community organisations can we begin to make these solutions happen. As more inner-city populations expand, we are seeing schemes where developers are becoming landlords, and in partnership with local authorities, NHS hubs can be integrated into their sites. With hospitals so saturated, the private market will play an important role in this movement as well as securing adequate funding and resources that can see these projects through.
Addressing future challenges
As the ageing population continues to grow, and the demand for healthcare services increases, initiatives to move services into our neighbourhoods are likely to become even more important.
Contributing to the overall health and wellbeing of communities by encouraging a proactive approach to self-care and removing the barriers to support and intervention, moving health to the high street is a key step towards a more resilient and sustainable future. It is time for a new era when care comes to the patient, not the other way around.
Mark Dando
As director of Cost Management at Pick Everard, Mark Dando has more than 35 years of consultancy experience and has spent more than 12 years specialising in healthcare projects. His background includes delivering integrated healthcare facilities within large-scale masterplans, applying industry best practice to deliver costeffective outcomes.
Mark oversees cost planning and life cycle costings, managing budgets and providing ongoing cost advice to ensure project success. He is committed to delivering high-quality, tailored solutions that add real value to every programme.