In the early 2000s, the largest healthcare building programme for a generation was underway, aiming to build over 100 new hospitals by 2010. CABE estimated that one in four nurses and one in four patients would be affected by the time the hospital building programme was complete.
As well as this investment in buildings, there was a massive increase in NHS staff, especially nurses. From 1997, the number of qualified nurses working in hospitals and the community increased on average by 10,704 a year, with a range of new responsibilities and skills.
In November 2003 CABE, with partners Royal College of Nursing, King’s Fund, The Nuffield Trust, Design Council, NHS Estates Centre for Healthcare Architecture and Design and Future Healthcare Network launched the Healthy Hospitals campaign, calling for radical improvements in the design of hospitals.
At the heart of the campaign was an ideas competition in which four teams were asked to create hospital environments that embraced principles of well-designed therapeutic environments. The public were asked to vote for their preferred proposal, to offer the reasons for their selection, and to comment on their experience of healthcare buildings to date.
The design teams were muf architecture/art with Rosetta Life; McDowell + Benedetti; Fat Ltd with DEMOS; and Jane Darbyshire and David Kendall Limited. Schemes looked at internal and external environments, issues of privacy and dignity, welcoming and waiting, and the role of the garden and outdoor space in creating therapeutic environments. Technical guidance was provided by NHS Estates Centre for Healthcare Architecture and Design.
The winning images was designed by Jane Darbyshire & David Kendall Ltd who received 53% of the votes. Their ideas were dominated by space and light, two factors that were prioritised by more than half of the voters. Of the 700 people who voted, 42% worked in healthcare, and 83% of voters indicated that they had had a negative experience of hospital environments.
Complementary material was gathered through a poll of nurses conducted for CABE by ICM, and the combination of material formed the basis for the on-going campaign. A bespoke website was created, and a report, ‘Radical Improvements in Hospital Design’, was published setting out the key findings and messages.
The Healthy Hospitals campaign complemented and supported CABE’s work in health across the board, as well as CABE’s own strategic thinking around health and wellbeing. A set of key projects continued the work of the campaign.
‘The role of hospital design in the recruitment, retention and performance of NHS nurses in England’ (2004) provided evidence that well-designed hospitals have a significant influence on the performance of nurses in their work and have a positive impact on their recruitment and retention - much of the information about design in hospitals until that time was focused on patients. The material formed part of CABE’s on-going work in healthcare, and the findings were published as a summary, full report and appendices.
In parallel, the health agenda was moving care away from hospitals and closer to home. ‘Designed with Care: Design and neighbourhood healthcare buildings’ (February 2006) reviewed 15 case studies of new healthcare buildings that challenged existing ways of working.
This work was extended as the health agenda continued to evolve, from a preoccupation with buildings for healthcare to embrace the notion of health and wellbeing. Health Week in May 2006 brought together a comprehensive range of organisations and individuals engaged at some level in health and wellbeing in relation to the built environment to debate issues during a week-long series of events. The debate and discussions were published on-line, adding to the material gathered for the Healthy Hospitals campaign.