What is the first word that comes to mind when you think of your local hospital? It could be any number of things, but “welcoming” or “calming” is unlikely to be one. The reality is that too many of our current NHS hospitals are suboptimal environments for the type of healthcare we want to be delivering in 2021. They’re challenging for patients and for visitors, but also for staff, who must resort to making their own modifications to buildings designed for a different era.
At Maggie’s we have tried to redefine what healthcare buildings should look and feel like through our network of 24 cancer centres in the UK and three overseas. We give all our architects the same, simple design brief. It is then up to the architect to incorporate the same key requirements, while tailoring these needs to the local population of people with cancer. The result is spectacularly contrasting, but universally effective and beautiful buildings.
This year’s Wolfson Economics Prize, hosted in partnership with the thinktank Policy Exchange, was based around a similar concept. It asked every entrant to respond to the same question: “how would you design and plan new hospitals to radically improve patient experiences, clinical outcomes, staff wellbeing, and integration with wider health and social care?” Anyone, from anywhere in the world, could enter. I was honoured to be asked to sit on the judging panel, which was a multidisciplinary group composed of clinicians, architects, and those who run and invest in hospitals.
Much like our Maggie’s buildings, the responses to the prize reflected the diverse ideas that can come forward when you take people away from their day job and ask them to think creatively. Entries came from 15 countries and more than 250 organisations, including 11 NHS trusts. Ideas were submitted by architecture students in the Philippines and Canada, retired NHS nurses, A&E doctors, and former patients. Some were wacky and wonderful—such as the proposal to build a flotilla of floating hospitals. Others were grounded in responding to the immediate challenges facing the NHS—including a specialist elective centre for the Midlands to work through the care backlog at pace.
Whittling them down was not easy, but we have now selected five entries to go through to a second stage, where they will be asked to expand on their ideas before an eventual winner of the £250 000 prize is announced in November. It is a diverse group of finalists. One is a plan to “bring the hospital back into the town” to better serve the community. Another is a proposal to transform the emergency department to boost patient safety and dignity. Then there is a plan for an innovative multisensory hospital inspired by the adaptive qualities of living systems, and a hospital masterplan inspired by starfish. Finally, there is a proposal with a seven point plan to create the “complete hospital,” so that they are transformed from “factories for fixing” to “places for healing.”
We are hopeful that the best thinking which has come forward can inform the hospital refurbishments and new constructions being kicked off by the government in England. Making a great idea into a reality is challenging, especially when you are faced with a tight capital envelope, and political pressure to deliver at speed. It will be important that we collectively learn the lessons from the last time we embarked upon a major round of hospital building.
But in the debate over business cases and feasibility, we must allow space for emotion too. I passionately believe that great design and architecture can help people feel better. It was the originating concept of Maggie’s, and with the assistance of the great ideas generated from the Wolfson Economics Prize, I would love to see it adopted more widely across the NHS.
Laura Lee is chief executive of Maggie’s.
Competing interests: none declared.
More information about the Wolfson Economics Prize and this year’s finalists and award winners can be found at www.policyexchange.org.uk/WolfsonPrize