A f HArchitects for Health Regional Event NW 25- 26 June 2014Hosted by Manchester Metropolitan University and Laing O’Rourke

BRIGHT FUTURE FREE THOUGHT

CANDACE IMISON Director of Policy The Kings Fund

DR ADRIAN CRELLINConsultant Clinical OncologistDH and NHS England National Clinical Lead for Proton Therapy

JOHN COOPER Director of John Cooper Architecture and former AfH Chair

DISCUSSION

A “cure” or “vaccine” for certain cancers.

An increase in the number of lifestyle drugs available

Devices that have the capacity to replace or integrate with human tissue

Biosensors that allow continuous monitoring of a patient

Pharmacogenetics support more effective treatments

In the longer term stem cells provide capacity to replace or repair organs

Increasing capacity to diagnose and treat

Continuing and rapid technological advance

Continuing growth in computing

power, intelligence and access

The world of Big Data

Shift towards smart phone/tablet

and apps from PC and web

Current digital divide presents

challenges

The hospital - part of a wider web of patient focused care

Home

Health and socialcare centresclose to home

Community care centresheart of the community

Specialist care centreson central city sites

Self careMonitoringAutomated treatmentInformation and adviceNHS Direct

Social carePrimary careOutreach care

Basic diagnostic servicesDay interventionsMinor injuriesNurse led inpatient careIntensive rehabilitationChronic care management

HomeNursing homes

PharmacyCyber café

Health kiosk

SurgeriesDrop in centresHealthy living

centres

Resourcecentres

Community hospitals

DTCsSecondary care

Tertiary care Planned interventionsEmergency careComplex diagnosticTreatment & inpatient care

Adapted from:Building a 2020 vision - The Nuffield Trust (2001)

More integrated community based models of care

High tech

Automated pathology, digital imaging, telemedicine, IT links

Bringing health care into the heart of the community:

A new relationship with the public:Welcoming, therapeutic environment, integrated with other public services

Mobility centre for intensive care

rehabilitation

ConsultingBasic diagnosticsDay interventions

Nurse ledinpatient care

Minor injuries

Child developmentcentre

Hospices and nursing homes

Mental healthresource centre

Education, leisure

Advice

Day centres forolder people

Alternative health care providers

A new relationship with the environmentSustainable systems: water,energy, recycling, waste,emissions, bio-diversity

Adapted from: Building a 2020 vision - Nuffield Trust (2001)

Technology could support service transformation

Reactive to proactive Help patients help

themselves and each other

Personalised services Care to health and

wellness But One size does not fit

all Caring still counts

Virtual visits – remove geographical barriers to access

Health care can be done at a distance with video conferencing and remote monitoring of blood sugar, blood pressure, heart rate, and other health data.

High resolution IGRT

Multileaf collimator

First Linac

Computerized 3D CT treatment planning

1960 1970 1980 1990 2000 2010

IMRTdose-painting

Standard collimator

Cerrobend blocks

Shaped electron fields

ImageFusion

Stereotactic Radiotherapy

ParticleTherapy

The Evolution of Radiation Therapy

Drive to increase conformal delivery to irregular tumour targets And reduce toxicity

EmbryonalRhabdomyosarcoma

IQ & FunctionGrowth2nd malignancy

Proton Radiotherapy

Proton equipment is primarily based on a standalone accelerator feeding multiple treatment gantries

AcceleratorUsing magnetic fields, the hydrogen protons are accelerated to two thirds the speed of light.

Gantry

Each of the three gantries is three-stories tall and weighs 200,000 Ibs

ElectromagnetsThe magnets focus and route the proton beams to the gantry

How can we do more with less?

In partnership with the European Health Property Network at the Royal College of Physicians

VIEWPOINTS FROM

Management

Policy research

Strategic planning

Developer

Architects

Response to Crisis

LOCAL HOSPITALS

Movement of out-patients diagnostics and treatments from acute towards community

Key issue is the movement of chronic disease management to the community preventing unnecessary hospitalisation

Movement of complex specialties or specialties benefiting from higher critical mass to Centres of Excellence

PULL

PULL

= LESS BEDS AND LESS HOSPITALS

Location of services

Developer’s approach

• Need for new types of infrastructure

• Extending care outside of Hospital

• Multi-occupiers of facilities

Focus is to move away from a ‘Building’ view to a ‘Property’ view

By design

The Capital Region of Denmark New Hospital and Mental Health Bispebjerg

Bispebjerg Hospital 1913 2013

Designing for people with dementia in hospitals

Collaborative practices

Artists and Architects in dialogue

UCLH tour

Little and Large Sue Ridge and Julia Dwyer

Sophie Twohig Hopkins and Guy Noble UCLH Arts coordinator

Jane Willis and Studio Weave recent projects in Bristol

When is an architect not an architect?

Jane Willis, Willis NewsonJe Ahn, Studio Weave

Stuart Haygarth

Designing for ImpairmentThe 2012 Paralympics changed public perception of disability. How much has it changed practice? What is the latest thinking about rehabilitation? What does it mean for design?

41

Glasgow Event

Policy context

Reference design schemes- little and large

Client perspective

Schemes in development for hospitals, primary and community care

Visits to range of buildings in use

IHEEM 2013Conference strand

How can we do more with lessDesigning environments for mental health and dementiaPanelExhibition of members projectsPresentation of design award

HOW CAN WE DO MORE WITH LESS?

John Cooper

Christopher Shaw

10 THINGS WRONG WITH THE NHS ESTATE

Why do we need change?

10 THINGS THAT MUST BE DONE

How do we need to change?

2 0 X 2

You either Love it or Hate it(But you have to try it)

Phil Gusack Essay Prize

Prize: £500 plus publish in RIBAJUp to 2000 wordsRegister your interest nowDeadline 1 September 2014

Fresh and provocative ideas

essayprize@architectsforhealth.com

AFH EVENTS 2014

SPRING Student Design Award

AGM Bright Future Free Thought & Phil Gusack Essay Prize

SUMMERDesign in Mental Health Conference

NW Regional Event and Visit 25-26 June

AUTUMNCollaborative practice Sept

IHEEM conference and Design Awards Oct 7-8

WINTER 20X2 Nov

CONTACT AfHwww.architectsforhealth.cominfo@architectsforhealth.commembers@architectsforhealth.comevents@architectsforhealth.comessayprize@architectsforhealth.comLinked In groupMembers Newsletter

OUR SPONSORS 2013-4Laing O’Rourke Brookfield MACE Guldmann Interserve Optima ARUP Teal Hewi Kier Trovex Hitch Mylius Altro With partnerships EUHPN A+D Scotland LSBU GSTT MARUMember supporters JCA NBBJ IBI Nightingales CODA P+HS Hopkins HLM CF Muller Stantec SBA Sheppard Robson

THANKS

EVENT CO-SPONSORSKier Tarkett Pineapple

WITH EVENT HOSTSManchester Metropolitan Universityand Laing O’Rourke