Focusing on outcomes is key to improving health infrastructure

With the New Hospital Programme looking to build 40 new hospitals across England by 2030, Jacobs’ Cashfya Cazi explains why focussing on outcomes is key to improving health infrastructure.

Cashfya Cazi
30 August 2022

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Building Back Better

Health is personal and it’s in everyone’s interest to get right. We can’t afford to waste time or energy investing in health infrastructure without clear outcomes. By viewing it programmatically, we can drive benefits at a national scale. 

We now know that a well-educated, healthy and well-nourished workforce pays bigger dividends to the economy than simply investing in physical infrastructure. 

While obtaining returns from the latter are quicker, investing in health and wellness builds a labour force that is more productive and transmits gains over generations. 

Coming out of a pandemic that brought the global economy to a standstill, there is no time like the present to invest in equitable health opportunities for our people, building resilience in our workforce and our health care system. 

The New Hospital Programme (NHP) is looking to build 40 new hospitals across England by 2030. Together with funding that had been secured for eight existing schemes, this will mean 48 hospitals delivered by the end of the decade. 

This programme is a landmark in the history of the NHS and the most significant hospital building programme in a generation. 

What appears at first as an ambitious goal to transform the way we deliver health infrastructure for the NHS, is achievable over a carefully considered timescale. But only when we apply lessons learnt from successfully delivering programmes of this scale in other parts of the world and across different industries too.  

Using evidence-based research to identify best practice from international comparators and Jacobs’ post occupancy evaluation framework to inform future investment in healthcare design, there is an opportunity to build a programme based on continuous improvement to increase benefits and reduce costs.

Less haste and more speed.

Perhaps the biggest trend we have seen is the move to less haste and more speed, with the crucial importance in getting the planning right. Whether the planning reflects how the programme is delivered, structured, and governed or scoping the right solution, the importance of building a solid foundation for both the programme and the subsequent projects cannot be underestimated. 

Collaboration is key. 

Bringing all stakeholders together early can bring many benefits to large-scale health care developments, helping to solve the challenges of cost, workforce depletion, efficiency and sustainability, through standardisation of design and a programmatic approach to commercial, delivery and operational outcomes. 

Having a single arms-length body tasked with the delivery of hospital infrastructure strengthens the opportunity to apply standardisation principles from project inception through to delivery. 

The benefits range from integrated management systems, standardised contract template and specifications, and supply chain management to work staging and market capacity:

Funding assessment: a single body overseeing funding allocations can prioritise optimal distribution and support local NHS Trusts in presenting business cases.

Embedding policy: a central approach can better align with government policy and strategy providing more consistency, as opposed to singular Trusts interpreting policy differently. 

Standard guidelines: using a standard set of guidelines for terminology, tools, processes, practices and sizes helps clinical service delivery, patient safety, reduced project costs and improved timelines. 

Modern Methods of Construction: modular construction where standard units and kit of parts can be created at scale off-site, offers an opportunity to deliver significant time savings, better safety and sustainability outcomes, and drive productivity and quality efficiencies.

Digitisation: digital health is at the core of a more connected and integrated health care system. Integrating digital technology into hospitals in a standard way provides more efficient, consistent and aligned services, by improving communication, scheduling, medical care and accessibility within and across different facilities.

Asset management: a single asset manager with complete oversight of a centralised portfolio can help prioritise investment, focusing on preventative instead of reactive maintenance of the health facilities across the board. Post occupancy evaluation could be applied as a method of continuous improvement of outcomes.   

While infrastructure delivery is a key part of the programme, its success will be judged in how it supports equitable health outcomes for the community, whilst providing sustainable facilities that are responsive to changing clinical requirements and being efficient to maintain and operate. Future proofing is crucial. 

Adopting all the tools available at our disposal from digital technologies, better clinical treatment, new methods of construction and materials that create more sustainable buildings with lower emissions across the supply chain, will help deliver improved health outcomes for patients and a better environment for our clinical workforce. 

Cashfya Cazi is European market director, health, at Jacobs.