The move towards Decentralised healthcare | ISG

The move towards decentralised healthcare provision in a post-pandemic world

As we embrace the new normal and flexible working attitudes, the healthcare industry is doing the same as it decentralises its private and public facilities to bring more personalised healthcare to areas that need it most – and quickly.

As we embrace the new normal and flexible working attitudes, the healthcare industry is doing the same as it decentralises its private and public facilities to bring more personalised healthcare to areas that need it most – and quickly.

It’s no secret that the global pandemic uncovered core challenges facing our healthcare system, but it has also demonstrated how public/private partnerships and effective collaboration can deliver incredible results in unthinkable pre-pandemic timescales. The Nightingale Hospitals’; were an obvious example of agile planning, rapid mobilisation and highly focused and motivated delivery.

Post-pandemic, many commentators have suggested that decentralisation is seen as the future of the healthcare sector. With an increase in private healthcare provisions to mediate the overflowing hospitals, office and retail environments offering exciting investments and patient needs becoming more localised, it’s hard to argue with this logic.

With the large-scale health challenge requiring the urgent mobilisation of resources; there is an increasing need to adapt how care is delivered and to invest in technologies that digitalise health data and bring diagnostics and treatments into the community. The collection of data on patients and their outcomes is providing analysts with a rich dataset that reveals trends and patterns that can be used to better target facilities where they’re most needed.

The UK Government’s Construction Playbook brings immense opportunity for collaboration and innovation in the construction industry and at a time to recalibrate, data-driven decision making is adding rigour to asset planning. As this technology and interpretation matures, there is an increasing need to adapt how care is delivered and invest in technologies that digitalise health data and bring diagnostics and treatments into the home or community.

Our recent research report, ‘The power of place’, backs up this theory with 68% of people surveyed (UK average of 72%) believing the healthcare sector was technology and innovation-led in its response to the pandemic. Construction technologies offer a solution however and are opening up exciting possibilities to drive the decentralisation agenda in healthcare.

The ‘virtual operating theatre’ is an in-house developed, fully interactive and immersive environment that uses gaming technology to place stakeholders and decision-makers in the heart of the space before a single wall is constructed. The opportunity to virtually refine the design, layout and specification at an early stage in the process, means we build once, without changes and optimise efficiencies.

The VR medium is the best way we have yet found to successfully collaborate with a wide range of stakeholders that all bring valuable input into the design process. The VR environment is also ideal during the technical design phase to explore how we configure technical spaces, such as operating theatres, into buildings once thought too small or ill-suited for this type of use.

What about maintenance and operation of the facility – can VR help us here? It can and already is – using augmented reality (AR), a blending of VR and the real world - we can see through walls and ceilings to the services installation and carry out maintenance and repairs with greater precision. The pinnacle of this technology is the creation of a facility that heals itself through pre-emptive maintenance – self ordering components and scheduling installation. This technology is with us now, and we are currently delivering facilities that utilise this advanced automated facilities management (FM) capability.  

If we assume that we can now create a heat map of the UK showing demand for healthcare services – then we can use this data to asset and resource plan. This creates an exciting and necessary climate where we can tailor our healthcare provision with greater geographical accuracy than ever before, and also reimagine and develop existing property assets through the use of technology - this last point is crucial. Digital scanning technologies have improved massively over the last year to the point where we can create a digital twin of an existing building with millimetre precision. Couple this surveying accuracy with AI, our VR platform can now explore and visualise space planning in a way that was simply unavailable to us in the past.

Its moved away from just developing the facilities themselves but to run them for maximum efficiency well into the future. So, too is financial sustainability. The healthcare estate is no longer merely a ‘hospital’ but an advanced hub, servicing the end-to-end needs of a huge array of stakeholders. A healthy commercial model which ensures long-term sustainability should no longer be an afterthought.

This opens up a raft of opportunities within existing healthcare estates, buoyed by an increase in abandoned and redundant buildings perceived as no longer fit for purpose due to the pandemic, or spaces that appear too complex to convert. With a potential shift in the demand for retail and office space following the pandemic, we could see repurposing of some of these locations. With the logistical access these sites benefit from makes them prime candidates for the healthcare sector to utilise. The domino effect would mean that patients would be able to visit their GP in their local town or city centre, and in turn retail units would benefit due to the increase in footfall before or after their visit.  

It is also equally applicable across a host of building types that would seem initially to be entirely unsuitable for a healthcare conversion. Schoen Clinic, a good example, where ISG converted an existing commercial space building, which was stripped back to its shell and core, to create a new seven-storey, ‘five-star’ private medical facility on Wigmore Street, London’s Harley Street medical area.

As we slowly return to our deserted city centres, once thriving with people and productivity, we start to question how these spaces are used and transformed. There have been significant shifts in human behaviour, disrupting the landscape that businesses operate within, and presenting new challenges and opportunities that they must respond to. With the rapid introduction of the use of technology in healthcare, the patient experience has transformed, focusing on convenience and personalised experiences. Gone are the days where patients would travel far and wide to seek out specialised services.

The built environment also has a critical role to play. Pulling stats from our recent Sustainable Buildings Monitor, a quarter of all CO2 emissions come from buildings and collectively the global community needs to reduce building energy consumption by over 80% if we are to reach zero-carbon targets. The report also highlights that the healthcare sector represents roughly 5% of UK’s greenhouse gases, and hospitals accounting for 92% of total energy consumption in healthcare buildings – giving scope for change and opportunity. Removing traffic and flow away from where we live, cuts down on carbon emissions and enhances accessibility to treatment and consultation centres, and we help revitalise our high streets with a more sustainable mix of services and experiences.

Covid-19 has catapulted the healthcare sector into the future, forcing it to change, adapt and react at an unprecedented pace, breaking down a significant number of barriers to change. As the future of medicine moves towards greater personalisation of treatments, the healthcare estate must reflect this transformation. There will always be a future for central hubs of specialisation, drawing together resources and expertise to create world-class centres of excellence, however agility and responsiveness will punctuate the next generation of healthcare facilities.

I believe decentralisation is key to transforming the healthcare delivery model to improve patient care and reduce inefficiencies and costs. With 80% of the 2050’s buildings already built; healthcare providers are increasingly in demand for a delivery partner that can provide healthcare solutions across the project lifecycle. As those that will thrive will best demonstrate how existing spaces can be reimagined and digitalised to create the facilities of now and the future. 


Author: David Broderick

Operations Director

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