I’ve had a front-row seat to how digital innovation is reshaping healthcare estates management. Monklands is set to be the UK’s first digital-first hospital, and we are pioneering the use of digital twin technology to revolutionise how the facility is planned, built and operated.
Our role in the project has given us unique insights into how early integration of building services with digital twin technology can unlock significant efficiencies and support operational excellence in a complex healthcare environment.
Digital twins are not simply detailed 3D models. They are dynamic, data-integrated digital mirrors of real buildings and systems, updated in real-time. In the context of Monklands, a digital twin will allow estates teams to monitor infrastructure performance, simulate decisions before acting, and identify opportunities to optimise operations. This means staff will be able to track energy consumption, monitor maintainable assets, and predict the impact of operational choices before committing resources. In a hospital setting, where safety, cost control and efficiency are all paramount, this capability is critical.
Delivering value
The adoption of digital twins in healthcare estates is still emerging, but the sector is ripe for the application of this technology. This is largely driven by the inherent complexity and critical nature of hospital environments. In these settings, optimising energy use and asset maintenance directly supports patient care and staff effectiveness. Crucially, hospitals cannot afford downtime. Systems must operate seamlessly around the clock which makes predictive maintenance and real-time monitoring especially valuable.
While initial setup costs remain high, particularly on large projects, the potential for long-term operational savings makes a compelling commercial case for the use of digital twins.
Over time, as technology matures and becomes more cost effective, digital twins are likely to follow a similar path to building information modelling (BIM). Once considered cutting edge, BIM is now standard across the industry, and the use of digital twins will likely follow the same trajectory.
A key lesson from Monklands is the importance of involving MEP engineers early in the development of the digital twin. At Wallace Whittle, our role as lead MEP engineers meant we were engaged from the outset. This means that the digital twin will reflect the systems that matter most, such as lighting, heating, ventilation, and cooling.
These are the systems which generate the live data that gives the twins value. Early MEP integration avoids the need for costly retrofits and reduces the risk of data gaps, ensuring the twin delivers relevant, usable insights from day one. It also ensures that the twin is aligned with the building’s actual operational requirements.
It’s important to acknowledge the collaborative environment needed to make this happen. From the earliest design phases, engineers, architects, facilities managers, and digital consultants have been working together to define how the twins will function. The success of a digital twin hinges on the structure and quality of the data it uses. Therefore, defining data parameters and formats early has also been essential to maintaining consistency and ensuring future usability.
Digital twins in action
Creating a digital twin is not about collecting as much data as possible. In fact, often it’s quite the opposite. Sensors, monitoring systems, and modelling platforms all come at a cost, and while this technology means that now, nearly everything can be monitored and tracked, that doesn’t mean it should be. Indiscriminate data collection can lead to systems that are bloated, difficult to manage, and ultimately useless.
The process at Monklands has involved extensive workshops with the client, estates teams, digital consultants, architects, and sustainability experts. These sessions have focused on carefully defining what data should be monitored and why. Identifying meaningful key performance indicators has been central to the process.
The approach involves developing a single digital twin that incorporates multiple functional aspects, including patient interface and energy performance capabilities.
Within this unified digital twin, patient interface functionalities will manage how the hospital environment responds to individual patient needs. For example, lighting, temperature, and ventilation can be adjusted automatically in a room ahead of a patient’s arrival, or sensors may be able to see which bays are vacant or occupied in real-time. This offers both operational and experiential benefits.
Similarly, energy performance monitoring will enable real-time consumption data analysis to identify inefficiencies and optimise energy use. This will enable the estates team to simulate operational changes and forecast outcomes, reducing waste and supporting sustainability targets.
The digital twin will provide real-time insights via digital dashboards. These tools will allow estates teams to test scenarios and make informed decisions without disruption.
In this way, the digital twin will become a practical decision-making support tool, not just a future-gazing innovation.
Managing complexity
Hospitals are among the most complex developments in the built environment. They contain tens of thousands of elements, from major plant systems and lifesaving medical equipment to structural components and internal finishes.
Different stakeholders have different requirements for the data they use and manage. Coordinating this information and ensuring consistency across all parties is a major undertaking.
At Monklands, this has been addressed through strict data structure protocols and adherence to the ‘golden thread’ principle. This means maintaining a continuous flow of accurate, verifiable information throughout the project lifecycle. It will ensure that once the hospital is operational, the digital twin will remain a reliable source of information for years to come.
Data compliance is checked rigorously. BIM models are populated not just with geometry, but with operational data — such as product specifications, maintenance timelines, key contacts, and warranty information. This will enhance the value of the digital twin during the operational phase, enabling seamless integration with facilities management systems.
Another challenge is managing volume and communication. With so many systems and stakeholders involved, aligning terminology and expectations is no small task. For instance, an engineer might define an asset differently to how a digital consultant or architect would. Establishing shared naming conventions and responsibilities across the board has been crucial to avoiding silos and ensuring smooth operation between systems.
The success of a digital twin depends not only on how it is built, but on how it is used. A well-designed twin must present data in ways that are understandable and usable for the people who rely on it day to day.
User-friendly dashboards are essential. Rather than displaying raw sensor readings, a digital twin must visualise key metrics, such as energy trends or asset performance, clearly and concisely. Alerts must highlight issues before they escalate. The aim is to provide useful, actionable information, rather than overwhelming users with unnecessary detail.
Training and education are equally important. Many healthcare estates teams are used to managing facilities with manual processes or legacy systems. A digital twin represents a significant shift in how buildings are operated and maintained. Supporting teams through this transition is vital.
Cultural change is also required. Teams need to understand how to interpret the twin’s outputs and how those insights translate into real-world actions. When this is done well, the twin becomes a tool that empowers staff to improve building performance proactively.
Digital twins are also playing a key role in enhancing patient experience. At Monklands, the digital twin will personalise the environment to meet specific needs. Something as simple as automated temperature or lighting adjustments can reduce anxiety, particularly for patients with sensory sensitivities or long-term conditions. The result is a more human-centred healthcare environment, powered by data.
Sustainability at scale
Sustainability is a key driving force behind the adoption of digital twin technology in healthcare. Hospitals are under pressure to reduce carbon emissions and energy use while maintaining round-the-clock operations.
A digital twin offers real-time visibility into system performance. This enables facilities managers to identify areas of waste, fine-tune performance, and test sustainability interventions virtually. Instead of installing a new control strategy and waiting to see if it works, the impact can be modelled in advance and implemented only once the outcome is clear.
This not only reduces emissions and energy bills but also supports compliance with sustainability frameworks such as NABERS and BREEAM. These frameworks increasingly require performance to be verified in operation, not just at design stage. A digital twin provides the data to meet those requirements.
Sustainability teams benefit from being engaged early in the process too. Their input helps determine what data should be collected and how performance should be benchmarked. At Monklands, this early collaboration is helping to ensure the twin supports both regulatory compliance and environmental performance targets.
Digital twins also support long-term carbon strategies. By gathering performance data from day one, estates teams can establish robust baselines and measure progress over time. This makes it easier to justify future investments, track ROI, and ensure targets are grounded in real operational data.
When it comes to ESG reporting, one of the more complex and evolving aspects of building performance, the insights generated by digital twins can be hugely valuable. At Wallace Whittle, we support clients across sectors through our sustainability reporting platform PathWWay, which helps bring clarity and consistency to ESG data. By connecting digital twin insights with structured reporting tools, clients are better equipped to track progress, meet regulatory demands and drive continuous improvement across their estates.
Challenges and opportunities
Delivering a digital twin at Monklands has not been without its challenges.
One of the biggest issues has been defining the right scope. It has taken months of engagement with stakeholders to agree on what should be monitored and why. However, getting this right at the outset has been crucial. Without that clarity, there is a risk of either missing critical data or collecting more than is needed, driving up cost and complexity.
Another challenge is scale. The volume of data involved in a large hospital project is enormous. Each discipline has its own terminology and data structure, which must be unified into a single, coherent system. This is essential to ensure the twin is consistent, compliant and usable.
Despite these challenges, the opportunities are significant. Our digital twin will give estates teams the ability to manage buildings in real-time, to act before issues become failures, and to continuously improve building performance. They will support better patient experiences, more efficient use of resources, and meaningful carbon reductions.
The patient interface twin will also represent a step-change in how hospitals respond to individual needs. These are not theoretical benefits. They are practical tools that will support the day-to-day running of the UK’s first digital-first hospital.
Monklands is a great live example of how a digital twin can shift from concept to operational reality within healthcare estates. By focusing on early engagement, targeted data capture, and close coordination across disciplines, the project is showing what it takes to deliver a digital twin that adds lasting value.
As the industry continues to evolve, the lessons from Monklands will help shape how digital twins are applied across the sector. From improving the performance of critical systems, to supporting more efficient maintenance, and creating better patient environments, the potential is clear.
Digital twins are not a one-size-fits-all solution. Their success depends on clear scope, structured data collection, and committed collaboration throughout design and delivery. Monklands is helping define what excellence looks like in this space, not just for today, but for the digitally connected hospitals of tomorrow.