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Report urges urgent design reforms to combat rising threat of AMR

New BEIPI report reveals how better hospital design will save lives - and millions in NHS costs.

A report published today reveals that antimicrobial resistance poses a mounting threat to patient safety and NHS budgets alike. Infections caused by resistant bacteria already cost the NHS an estimated £180 million per year - many linked to preventable design issues such as unsafe drainage systems and poor ventilation.

The report, published by the Healthcare Infection Society (HIS) through its Built Environment Infection Prevention Initiative (BEIPI), calls for urgent action to embed infection prevention principles into every stage of hospital buildings, to combat the growing threat of antimicrobial resistance (AMR), reduce deaths and ease avoidable financial strain on the NHS. 

BEIPI was established in 2025 following a workshop, which for the first time brought together infection prevention specialists, architects, engineers and construction professionals to address the challenges of building hospitals that are safe from infection.

“The very first requirement in a hospital is that it should do the sick no harm,” said BEIPI Chair Ron Finlay, echoing Florence Nightingale’s words. “With over £45 billion being invested in new NHS hospitals over the next 15 years, we have an unprecedented opportunity to ensure these buildings help prevent, not spread, infection. Getting this wrong would be a costly and potentially deadly mistake.”

Endorsed by the New Hospitals Programme (NHP) and Institute of Engineering and Estate Management (IHEEM), the prospectus sets out a shared vision to eliminate deaths from avoidable infections caused by poor design, minimise costly remediation and ensure every new UK healthcare facility advances the global fight against AMR, the 'silent pandemic'.

BEIPI’s expert group, which includes Arup, Currie & Brown, Frimley NHS Trust, Laing O’Rourke, P+HS Architects, UCLH and others, is now calling for infection prevention to be “built in from day one” of all future hospital projects.

Dr Manjula Meda, HIS Chair and BEIPI member, said: “Antimicrobial resistance is not just a microbiological issue, it’s a design issue. Hospitals built without infection-safe principles can end up costing more to fix and manage. The right design decisions can prevent deaths and save the NHS millions.”

The initiative will work closely with the NHS New Hospitals Programme (NHP) to deliver two key areas of support: ‘Expert advice’ and ‘Research and knowledge exchange’. BEIPI will also convene a Policy Workshop on 22 January 2026 to begin developing new tools and frameworks to support this goal.

Read Building Infection Prevention into Hospital Design: Prospectus and find out how to get involved by clicking here.

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