Hospital Redesign

The NHS is facing unprecedented demand. The UK population is expanding rapidly, people are living for longer and conditions associated with old age and modern lifestyles, such as Diabetes and COPD are skyrocketing. For London, home to a vast and diverse population, these challenges are even more pronounced with a growing gap between the resources available within the NHS and the needs and expectations of 21st Century patients. With fewer resources to draw from, hospitals, as we know them, must change in order to deliver better outcomes to patients.

The 'Shaping a healthier future programme' was conceived in 2012, and aims to address these challenges in North West London by developing a vision for how health services can be improved in eight boroughs, serving a population of over 2 million people. Within this programme, different hospitals are changing their functions and purpose. We formed an alliance with PriceWaterhouseCoopers and Penoyre & Prasad Architects to craft a vision for two Local Hospitals in Ealing and Charing Cross that were capable of supporting 21st century populations and conditions.

Our vision for the 21st century local hospital:

Ultimately, the aim of the new model is to bring as much medical care and treatment as possible out of hospital settings, which are often expensive and not conducive to recovery, into homes and communities. In other words, it aims to localise care where possible, and centralise it where necessary to achieve economies of scale that can support world-class excellence.

The local hospital serves as a bridge between acute care in specialist hospitals, and primary care delivered in the community, by building the conditions for integrated, patient- centred local services to be safer and more effective than the current model. For example, this means doing things differently to build the confidence and skills of patients and carers to manage their own health and the health of other people.

This will be delivered through a training and learning function in which patients can attend classes about self management and care, access peer support and mentoring. This will be a chance for carers, clinicians and patients to orientate themselves around expert care that is also closer to home.

There will also be a special community zone within the hospital- which will form a hub of information and support open to health trainers, volunteers or anybody interested in healthcare, in which they can learn about wellbeing and care in an informal setting.

The hospital will also feature a 24 hour Local Emergency Care Centre for minor injuries and non specialist treatment, a primary care centre with GPs, and a specialist unit for people transitioning out of specialist care, in particular, older people with long term conditions.

Our role in crafting the business plan:

The alliance was commissioned to produce a business case and  a visionary model of care that illustrates what a local hospital could be in order to deliver the best care for people in the 21st century, and therefore how much would it cost to deliver. This was a complex and challenging task due to the number of stakeholders and competing interests, and since there are no successful models of  local hospitals in the UK upon which to base our vision.

An effective plan for a local hospital needed to be shaped by the needs, challenges and concerns of the communities it serves, so our role included extensive research with clinicians, patients and GPs. This included:

  • Ethnographic research with high need patients, such as those with long term conditions, older people, and carers, to better understand their experiences with health services and identify the opportunities for change.

  • Co-design workshops with general public and specialist groups ,such as homeless people and groups for learning disabled people, in their homes and out in the community.

  • Drop-in community events in Southall Market and Hammersmith, where citizens could come and share their views about their care in hospital.

  • Four major events facilitated by us, with clinicians and in both boroughs.

All of this research fed into new model of care and the business case. The journey continues as the business cases and implementation plans get approval in local and national bodies, with the expected completion of Ealing and Charing Cross Local Hospitals due in 2017.