FEATURE ARTICLES

Laura Carrara-Cagni RIBA, director and co-founder of Cagni Williams Associates and Cagni Williams Energy, explores how architects can assist NHS Trusts and other healthcare providers in developing and implementing Net Zero Carbon strategies, how their expertise can drive cost reductions, and the role of external partnerships.

Dr Scott Brown, managing director and lead consultant for Health Tech Solutions, and Simon Everett, Senior Lecturer in the Built Environment and Programme leader at Wrexham University, discuss the importance of senior healthcare estate management and capital finance managers having in place a risk-based strategic replacement plan for the HVAC systems within their hospitals. They highlight the risk factors which influence the decision-making process.

A look at the ‘advantages and challenges’ of central dosing systems, and some of the innovations and emerging technologies shaping the future of dosing in medical decontamination facilities – with a view to reducing waste and energy consumption, and safeguarding the health and wellbeing of employees within such units – by Alan Abbatt, a director at Dr Weigert UK.

Now approaching 200 days since the post- ‘go-live’ marker of the Procurement Act 2023 (the ‘Act’), Chris Robinson, associate director, and Fleur Summers, senior consultant at Turner and Townsend, provide their insights into some of the major developments and key ‘takeaways’ since its launch, particularly when it comes to healthcare estate provisions.

David Navarrete, director of Research Initiatives and Professional Education at Sky Factory – a fine arts and digital technology studio that leverages Neuroaesthetics in its design framework, discusses some of the interesting research on the positive impact of dynamic lighting systems in reducing stress and burnout among healthcare staff and improving patient outcomes. Among the areas studied have been ‘the unique patterns of brain activation’ associated with exposure to photographic sky compositions (representing nature stimuli) compared with other positive, negative, and neutral images.

At the Institute of Decontamination Sciences’ annual scientific conference at the Birmingham Metropole Hotel, decontamination scientists from across the UK discussed issues including common reprocessing challenges experienced by decontamination staff, the need for clear IFUs for medical devices, whether the time is right to review the Spaulding Classification, and some of the risks posed by biofilms in flexible endoscopes. Louise Frampton, the editor of HEJ’s sister publication, The Clinical Services Journal, reports.

Giving the opening keynote speech remotely at the 2025 IHEEM Wales Regional Conference at the ICC Wales in May, Judith Paget CBE, Director General for Health and Social Services and NHS Wales Chief Executive, reflected on some of the key challenges for the NHS estate in Wales – including an ageing estate, a significant maintenance backlog, and the need to prioritise where limited capital funding is invested. With avoidable safety incidents still occurring across the NHS, it was also vital – she said – that compliance risks were managed and mitigated against.

IHEEM-registered Authorising Engineer (Water), Karina Jones, of Eta Projects, discusses some of the risks to patients in hospitals and other healthcare facilities from contaminated wastewater, and suggests a number of often simple-to-implement measures that can be taken to mitigate these risks.

A new £110 m health and care complex at Catterick Garrison (HEJ – April 2023) – a joint project between the Ministry of Defence (MOD) and the NHS – is under construction and due to open next year, and will provide a range of health services for military personnel and the local community, including general practice, physiotherapy, rehabilitation, mental health services, X-rays, and ultrasound. As Karina Dare, Primary Care Estates Strategy lead at NHS Property Services (NHSPS) reports, supporting Humber and North Yorkshire ICB and working with DIO (Defence Infrastructure Organisation) and the Defence Medical Services on this joint project was a first for NHSPS.

Dr James Soothill MBBS, MD, FRCPath, a Consultant Microbiologist at London’s Great Ormond Street Hospital for Children, discusses his invention and development of what he dubs ‘a cost-effective, robust, low-maintenance approach to prevent the ascent of antibiotic-resistant bacteria from drains into hospital sinks’ – the ‘so-called’ Tuba Drain.

Professor John Sandham CEng, FIHEEM, discusses the potential positive impact of the new role of IHEEM Authorising Engineer (Medical Devices) – which ‘became official’ on 2 June – drawing on the insights gained from a case study conducted within an NHS Trust, which explored what he dubs ‘the transformative potential of a collaborative, expert-led, intervention in medical device management policy’.

Sarah Walter, managing director of Charleston, South Carolina-based architecture and engineering firm, Page Southerland Page, and Nora Colman, an Assistant Professor in Paediatrics in the division of Paediatric Critical Care Medicine at Children’s Healthcare of Atlanta, discuss some of the most important elements in the quest to balance an open and welcoming space with sufficient security when designing children’s healthcare facilities.

Amy Krause, Architectural Design manager at private healthcare company, Mediclinic Southern Africa, takes a look at what she describes as ‘the seven flows’ of healthcare, what each contributes to a hospital or other healthcare facility, and the challenges in aligning them with stringent regulations and end-user expectations.

Tom Davies, Sales manager for Energy Control at fortop Automation & Energy Control (fortop UK), explores how improving power quality and energy management is essential for healthcare estates teams in the quest to achieve Net Zero carbon goals.

Paul Chivers of PCC Sustainable Solutions – an independent SME and Programme / Project manager for innovation and sustainability across PPE, medical devices, and facilities, discusses recent work to examine, and then verify, the effectiveness of novel ways to reprocess reuseable anaesthetic masks, other PPE, and medical devices, using technologies such as UVC, in the process considerably reducing energy and water consumption across the NHS.

Anil Madan, Non-Residential Marketing manager at Ideal Standard UK and Armitage Shanks, looks at some of the advantages of pressure-balancing valves (PBVs) in healthcare water systems. He says PBVs can offer ‘a simpler, more cost-effective, and lower maintenance alternative’ to the ‘traditional’ TMV for suitably risk-assessed environments such as non-critical care settings.

Sharon Cook, Healthcare lead at P+HS Architects, reflects on how the 10 WELL Concept areas were embedded into the design of the Northumbria Health and Care Academy, the UK’s first healthcare building to achieve WELL Gold certification, creating a workplace that the practice says ‘champions wellbeing, connection, and clinical excellence’.

The NHS estate is under increasing strain due to underinvestment, rising demand, and a £13.8 bn maintenance backlog. While high-quality estate is available, much of it remains underutilised, and optimising these assets is essential as the NHS shifts towards out-of-hospital care. Here, Baxendale Senior consultant, Kelsey Price, and head of Healthcare Estate Planning, Jim Brooks, and Abintra director, Tony Booty, argue that by combining sensor data with local knowledge, organisations can ‘uncover hidden capacity, optimise space, and reduce reliance on outdated buildings’. They explain how the two businesses are ‘helping healthcare organisations make smarter estate decisions’.

David Hemming, a highly experienced Chartered Civil Engineer who heads the Estate and Major Programme area within the NHS Shared Business Services Consulting team, argues that the so-called ‘Golden Thread’ – a complete digital record of information about a building, from its design and construction, to its ongoing maintenance and use – ‘represents a fundamental cultural shift in how buildings are designed, constructed, and maintained’. He warns that failure to maintain an accurate, accessible, and up-to-date Golden Thread ‘is no longer merely poor practice – it represents serious corporate risk’.

Alan Wilson, managing director of ModuleCo Healthcare (MCH), a provider of modular healthcare buildings in the UK, explains how – with budgets especially tight – modular construction, utilising a usage-based revenue agreement solution, enables NHS Trusts to ‘access state-of-the-art healthcare facilities without the huge capital investments typically required’.