An anxious wait is an unavoidable part of many hospital visits. Moreover, departments are often located deep within buildings or acute services blocks, where enclosed corridors and limited natural daylight can negatively impact how patients feel while waiting for appointments.
With millions of people waiting for NHS treatment, and more than 25 million diagnostic tests carried out each year in England, the cumulative time spent in hospital waiting areas before diagnosis, procedures, or consultations is significant.
According to the National Arts in Hospitals Network (NAHN), the ambience of healthcare surroundings can influence stress levels and patients’ overall perception of care. For NHS estates managers, this makes lighting design an important consideration, particularly within waiting areas.
Refurbishment works
Milton Keynes University Hospital NHS Foundation Trust (MKUH) is a medium-sized general hospital, delivering a range of acute and specialist services to Milton Keynes and the surrounding areas.
As the population of Milton Keynes continues to grow, demand for treatment is increasing. This puts pressure on the hospital to balance operational efficiency with the need to create environments that support patient comfort and wellbeing during visits.
As part of ongoing refurbishment works at MKUH, we carried out work to improve the cardiology department waiting area. The project was part of C&B’s local community giving and social value programme, and involved installing illuminated ceiling panels depicting open sky scenes, with the aim to introduce a more calming visual environment while maintaining suitable lighting conditions for a clinical setting.
Although modest in scale, the project offers wider lessons for estates professionals considering wellbeing-focused environmental interventions within NHS facilities.
Environmental context and
patient perception
The ceiling lighting installation follows the guidance published by NAHN, which highlights how hospital environmental conditions can influence comfort, stress, and behaviour, particularly in spaces without access to natural daylight. The guidance draws together research examining how lighting, imagery, and visual complexity shape the experience of healthcare environments.
Organisations such as Arts Council England have also acknowledged the relationship between creative health interventions and health outcomes.
Some might not automatically see lighting in the same terms as art, but the two are closely connected, and these findings demonstrate how environmental cues can contribute to emotional responses, particularly in clinical environments where patients may already feel uncertain.
The impact of daylight
on patient wellbeing
Studies have also explored the relationship between daylight exposure and clinical recovery. Access to natural daylight supports circadian rhythms, which influence sleep patterns, mood, and hormonal balance. In healthcare environments, these factors can affect how patients rest, recover and respond to treatment.
A study by University College London (UCL) found that patients exposed to better daylight conditions experienced hospital stays between 16 per cent and 41 per cent shorter than those with lower levels of daylight exposure.
In practice, however, clinical departments such as radiology, cardiology, imaging suites, and specialist treatment areas are frequently positioned within the internal footprint of hospital buildings to accommodate complex equipment and shielding requirements.
These environments are typically designed primarily around clinical function and operational efficiency. As a result, access to windows and external views is often limited.
In the absence of natural light, healthcare designers are increasingly looking for lighting systems that replicate the visual qualities of natural daylight.
Simulated skylights, backlit ceiling panels, and daylight-mimicking lighting installations are now used in clinical environments to introduce visual cues associated with open sky and outdoor environments.
While these systems do not replace the physiological benefits of natural sunlight, they can help reduce the sense of enclosure often experienced in internal hospital spaces. One example of a successful installation is at the Gloucestershire Hospitals NHS Foundation Trust’s oncology unit. To support cancer patients having radiotherapy or chemotherapy, the Trust’s Big Plus Fund arranged for sky ceilings (panels) to be installed to enhance patient experience.
Meanwhile, at Lincoln County Hospital’s maternity ward, it was reported that some midwives were suffering from Seasonal Affective Disorder, and the lack of natural light made their symptoms worse. After exploring several options, the United Lincolnshire Hospitals Charity paid for ceiling panels to help staff morale and improve patient experience.
Within the cardiology department at MKUH, the imagery selected for the installation was intentionally neutral and familiar rather than stylised. The aim was to create a subtle sense of openness without distracting from clinical processes. Luminance levels were considered with existing lighting systems to avoid glare and excessive contrast.
Supporting staff wellbeing
Environmental design can also affect healthcare staff working within these spaces. The NHS is one of the largest employers in the world, with around 1.3 million full-time equivalent staff working across the health service in England. Studies published in The Journal of Emergency Medicine (via NAHN) suggest that visual art, colour, and nature elements in healthcare environments may promote job satisfaction and help reduce staff stress in high-pressure clinical settings.
When clinical environments prioritise visual comfort and environmental quality, the benefits can therefore extend beyond patients to the professionals delivering care.
Governance and technical approval
In NHS environments, environmental enhancements are subject to established governance and technical approval processes.
At the most basic level, the NHS’s Patient-Led Assessments of the Care Environment (PLACE) requirements say of lighting:
Natural light should be available wherever possible. Where artificial lighting is used, this should be adequate to maintain normal daily activity and provide enough light to make areas bright and easy to walk through.
Lighting should be suitable for the area and be even, for example without pools of light and/or dark areas, stripes or shadows. Energy-saving/motion- activated lighting is acceptable, but should be designed to respond quickly and to light the area well, particularly in long corridors, lifts or areas where there is no natural light. Bulbs should be working.
The Society of Light and Lighting’s (SLL) updated LG02 Lighting for healthcare premises guidance published in 2019 also gives very detailed guidance on lighting for each and every part of a hospital setting — even for helicopter pads and car parks.
While the SLL acknowledges the limited scientific evidence around issues such as ‘circadian lighting’ and does not really touch on current interest around lighting for health and productivity, its guidance aims to ensure work is up to date with modern lighting practice and it illustrates varying ways of lighting the modern hospital environment.
Looking at the broader issues of healthcare estates, Health Building Notes (HBNs) published by the Department for Health also give best practice guidance on the design and planning of new healthcare buildings and on the adaptation/extension of existing facilities.
HBN 00-10 Part B covers walls and ceilings, including integration with lighting. It allows choice in the materials and methods of construction — provided they satisfy the specified performance requirements — but also requires healthcare providers and their contractors to improve quality whilst achieving value for money. Key drivers include the standardisation and pre-assembly of components, flexibility, adaptability, and sustainability, including low energy design.
Guidance from NAHN reflects similar wider estates practice by emphasising compliance with fire safety, infection prevention, and structural integrity requirements
For the illuminated ceiling panels in MKUH, compliance included verifying fire performance certification, demonstrating compatibility with suspended ceiling grids and building services, and using materials suitable for healthcare cleaning regimes.
In addition, infection prevention and control teams must confirm that finishes tolerate approved disinfectants and do not introduce contamination risks. Provision for safe maintenance access had to be demonstrated.
Lifecycle considerations are also important when gaining estate approval. Lighting features that appear decorative are unlikely to be approved unless there is clear evidence showing they are durable, resilient, and suitable for long-term operation.
Delivering work in live
healthcare settings
Installation work within cardiology departments does have its own complications, as patient services often run continuously and there may be very limited opportunities for lighting professionals to get the job done. Detailed planning, structured communication, and formal risk assessment processes are therefore essential.
NAHN’s guidance highlights the need for documented design approvals, risk assessments, and method statements (RAMS), alongside close coordination with estates and clinical representatives before work begins. These conform with NHS project governance frameworks and are fundamental to safeguarding patients, staff, and contractors.
Practical delivery considerations include sequencing works to minimise disruption, managing dust and noise, coordinating access routes, and integrating safely with existing mechanical and electrical systems.
Lighting in internal clinical environments should be evaluated with the same diligence applied to any building services element, with defined performance criteria and documented assurance. For NHS estates teams, this means balancing strict requirements with the need to create a welcoming and supportive space for patients.
Where natural daylight is unavailable, carefully specified artificial solutions may help reduce the challenges of enclosed hospital spaces. Features such as simulated skylights, biophilic imagery, and well-considered lighting design can introduce visual cues that make clinical environments feel more open and less institutional. When integrated carefully with existing infrastructure, these enhancements can support a resilient and patient-conscious healthcare estate.
While major capital projects often focus on expanding clinical capacity or upgrading medical technology, smaller design enhancements can play an important role in shaping how hospital spaces are experienced by both patients and staff.
Projects such as the installation at Milton Keynes University Hospital demonstrate how relatively modest environmental interventions can complement wider healthcare infrastructure improvements.
A calmer atmosphere
The hospital environment is one of the most demanding operational settings, where departments operate under constant pressure and every decision must support both patient care and clinical efficiency.
Waiting areas and diagnostic departments can feel overwhelming, particularly for patients facing uncertainty about their health. Lighting plays an important role in shaping that experience and can influence how comfortable people feel while they wait.
At Milton Keynes University Hospital, the installation of simulated ceiling lights within the cardiology department was designed to recreate the visual qualities of natural daylight in an internal space. By introducing a sense of openness overhead, the lighting helps create a calmer atmosphere within a busy clinical environment.
Projects like this demonstrate how carefully considered lighting design can support wellbeing in healthcare settings within a modern hospital estate.