ABSTRACT

KEY POINTS: x The focus of health design is beginning to shift from an obsession

with cost and functionality to one of quality, potential flexibility of use and whole life costs

x Primary health buildings closely reflect policy and guidance – as guidance changes, so do the buildings

x Patient choice will increasingly become a factor which drives the design of, and provision within, primary health buildings

Contents 1 Executive summary 2 International background 3 A short history 4 Current position 5 Political framework and government policy 6 Approach to briefing and design 7 Key relationships 8 Engineering and IT services 9 Art in health

10 Holistic care 11 Conclusion 12 Case studies 13 References

1 EXECUTIVE SUMMARY Primary care premises are generally complex small-scale buildings (when compared to hospitals) with many functional requirements to accommodate. They tend to be busy places with many people entering and leaving the building during the course of the day including patients, doctors, nurses and other service personnel. So it is understandable that the NHS has focused on issues of functionality and cost to evaluate the design of this building type. However, in the last few years there has been a fundamental shift in this approach and there is now much greater emphasis placed on the evaluation of the quality of design. Hence, this section attempts to set out that the ethos of the place is of paramount importance and the organisation of spaces within the building should flow from this overarching principle. The new wave of publications from the Department of Health recognise the importance of creating a high-quality working environment. These notes seek to guide the designer to establish qualitative factors through discussion with the users of the building and then refer to the detailed guidance on the ergonomic requirements for ensuring that room data sheets accommodate the functional requirements of a room. Current thinking is to assume that the use of rooms may change over time and, therefore, flexibility for change is also important.