Guide to the Finalists and Awards WOLFSON ECONOMICS PRIZE ...

WOLFSON ECONOMICS PRIZE 2021 | 1

Guide to the Finalists and Awards


Table of Contents

About the Wolfson Economics Prize 3

Our Five Finalists Creating Complete Hospitals 4Living Systems 5Starfish Hospitals: A Design for Life 6The Smart ED 7The Well-Placed Hospital 8

Highly Commended EntriesThe Caring Collective presents ‘The Future of Health and Wellbeing’ 9Hospital of the Future 10Rethink NHS 11

Light Bulb Award WinnersThe High Street Hospital Model 12Healthcare reimagined 13


About the Wolfson Economics PrizeThe Wolfson Economics Prize is in cash terms the second-biggest economics prize in the world. Previous editions of the Prize have sought policy solutions on rethinking roadbuilding (2017), delivering more homes via Garden Cities (2014), and reforming currency unions (2012).

The 2021 Prize question is: 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?

Entrants were asked to explore this year’s question in detail in a primary submission of up to 10,000 words, to be submitted by Friday 18th June. There were 98 entries from more than 15 countries. This year’s set of Five Finalists were chosen by a panel of world-renowned experts, Chaired by Lord Kakkar, Professor of Surgery at University College London, crossbench peer in the House of Lords and Chair of the King’s Fund. The panel also includes Professor Brian Donley MD, CEO of Cleveland Clinic, London; Dame Elaine Inglesby-Burke CBE, former Chief Nurse at Salford Royal; Dame Laura Lee, CEO of the Cancer charity Maggie’s; Robert A.M. Stern, Founding Partner of Robert A.M. Stern Architects and Nigel Wilson, CEO of Legal & General. The Prize was founded by Lord (Simon) Wolfson, Chief Executive of Next Plc.

Finalists will now have until Friday 29th October to work on a secondary submission of up to 25,000 words. These will be assessed by our Judges in November, with the winner of the £250,000 cash prize to be announced in the same month.

“The entries to this year’s Wolfson Economics Prize have been remarkably impressive. They represent examples of brilliant thinking, the world over, about how better to serve patients and support staff in hospitals. Out of an exceptionally strong field, the shortlisted entries demonstrate particularly ingenious approaches. With a renewed focus on hospital building in the UK, these finalists have a really exciting opportunity to shape how NHS hospitals look, feel and function.”

Lord Kakkar, Chair of the Judging Panel


Our planet’s, and our own, health and wellbeing are influenced by an infinitely more complex array of factors than once we realised. Neuroscience is teaching us that fully flourishing humans need connectedness, beauty, greenery and a sense of purpose just as much as they need clean air and sufficient food.

This submission to the Wolfson Prize is written in the spirit of moving hospital design from the twentieth century to the twenty first, from ‘factories for fixing’ to ‘places for healing’. It builds on our team’s deliberately diverse backgrounds in clinical care and hospital management, in real world hospital design and academic research into the correlations between design and wellbeing. It is based on practical experience of building and running hospitals and it is informed by the best available research into one of the most profound of all questions: what types of places make us whole, healthy and happy?

What is the big idea? We have identified seven key components essential to the creation of hospitals for humans which are more completely able to improve patient experiences, clinical outcomes and staff wellbeing whilst also integrating with wider civic society and health and social care. These seven components will also help deliver new hospitals more sustainably by suggesting the right approach on the critical (but too often overlooked) issues of embodied carbon and longevity and how staff and patients arrive at and interact with hospitals. We have called this framework our Complete Hospitals Framework.

Hospitals should be:• Green with gardens;• Enclosed and secure;• Naturally lit and ventilated;• Beautiful places to be proud of;• Built with variety in a pattern;• Adaptable and resilient; and• Interwoven with neighbourhoods

What problem is it solving in current hospital planning and design?Too much twentieth century science, design, management and medicine treated problems as simplistic time and motion studies, as machines where inputs could be directly related to outputs and where efficiency was about size and avoiding extraneous distractions. This approach had many strengths: hospitals got cleaner, food got cheaper, lives got longer. But at the same time, it failed to understand how complex and interlinked were the ecosystems which keep us alive. It created environments, which are mechanistic and ultimately bad for us. One simple illustration was the description given by a father visiting a major new children’s hospital as “harsh, confusing and intimidating”.

What is the potential impact?The Complete Hospitals Framework is devised to provide guidance for the design of places for healing where the human spirit can thrive and where patients and staff can feel nourished and supported on their journey.

The much-improved hospital environment should result in better patient experiences, clinical outcomes, staff wellbeing and effectiveness as well as integration with wider health and social care.

John Simpson Architects LtdRuggles Mabe Studio Architecture + InteriorsCreate Streets and Create Streets FoundationDr Hervey WilcoxNatalie Ricci

Creating Complete Hospitals From Factories For Fixing To Places For Healing


Living SystemsWhat is the big idea?‘Architecture should defend man at his weakest.’ – Alvar Aalto

Our vision for the hospital of the future is a celebration of health; it nurtures body and mind and cares for the sick, the well and everyone in between. Inspired by the adaptive qualities of living systems, it is a connected and forward-looking institution that grows and changes in response to its environment and the needs of its users.

We use the notion of design as the third carer to create human-centred architecture that actively works alongside health professionals, ensuring they are able to deliver the art of care as well the science of treatment. The hospital is sited on a levitated park that floats above the bustling city, driven by a democratic, sustainable plan that delivers natural light and views out for all. Fuelled by a thriving marketplace of local produce and alternative health practices on street level, our hospital of the future opens its arms to the community and restores our faith in the hospital’s ability to give love and care.

What problem is it solving in current hospital planning and design?In current healthcare, design is perceived as a luxury rather than a necessity, a cosmetic fix that only serves to improve appearances.

The hospital of today is:

Detached: Turns its back on the community it serves and is alienating to its users.

Inhumane: it is so determined to eradicate disease and cure sickness that it has forgotten to take care of the humans that use it, both patients and staff alike.

Inflexible: through its utilitarian approach and cost engineering, it becomes obsolete before it is complete.

What is the potential impact?Our proposal embraces design as the third carer and places the human at the centre.

The hospital of the future is:

Integrated: it is embedded into the community, welcoming the people it serves and bringing together staff and patients in an environment that both cares for and inspires care.

Empowering: it educates as well as cures, encouraging users to be proactive in taking ownership of their mental and physical health.

Adaptive: it anticipates change by investing in flexibility and sustainability remaining fit for purpose in an ever-changing world.

Ab Rogers Design

Advisory GroupMando WatsonHelen StarrLaura BenjaminAsh RanpuraKhan HammadJames KinrossCarol BlackJohn Gilsenan

Designers Paul NultySergio LuzziBlue FarrierMarina Willer Dan Pearson

EngineersChris WiseGary Eliott


Starfish Hospitals: A design for lifeWhat is the big idea?Our big idea is ‘Starfish’ – a hospital designed to enhance and save lives, with a philosophy partly inspired by my experiences in hospital as a patient and by the tale of a young boy throwing starfish back into the ocean to save their lives, who when told there were millions of stranded starfish and that he could never make a difference replied, “Well, I just made a difference to that one,” and continued with his work.Starfish hospitals will make a difference.

Our adaptable hospital design is a Starfish modern hub with connected rays and satellite centres of excellence located in a ring of buildings around the campus or within local community cities and towns.

The whole ethos of Starfish is to create a calm environment, with a ‘front stage/back stage’ design element; pioneering clinical services; staff empowered to deliver the best care; and an atmosphere enhancing the wellbeing of patients and staff. By improving community health, facilitating positive health behaviour, R&D, and prioritising comfort for all in healthcare settings, we have a design for life.

What problem is it solving in current hospital planning and design?Generally, the hospital experience can be confusing, impersonal, and unwelcoming for patients. For those that work there and look after us from cradle to grave it can be impractical, inefficient, and unattractive. It is rare to walk into a hospital and feel the sense of welcome you would in a five-star hotel. You should.

Too many patients arrive at A&E when ideally they should be treated elsewhere.

Experiences throughout the Covid-19 pandemic have highlighted our current outdated hospital buildings, facilities and technology.

With ever-increasing health demands and an ageing population, our design strikes a balance between services that are critical to hospital provision, those that are not, and those that could be provided in a ‘virtual’ hospital without compromising the safety or well-being of patients. The overall experience is enhanced for all.

What is the potential impact?Surveys indicate that people want hospitals to be:• Welcoming and spacious, homely, modern & bright • Connected with the outside, close to nature and fresh air • Sustainable with green buildings fit for the future • Contributing an important role in the community

Our design encapsulates all these qualities with patient and staff co- creation alongside the levelling up of healthcare. Like the boy throwing back the starfish, we have a design that will make a difference with optimal health outcomes for all, creating a healthier population.

Starfish hospitals – a design for life – will make a difference

Deirdre King, with contributor David Leonard of Leonard Design Architects


The Smart ED What is the big idea? Attending an Emergency Department (ED) can be a frightening and overwhelming experience. It frequently represents a major life event for both patient and family. Their experience is often poor. The high-tempo decision making and care provided by staff is critical to safety. The efficiency of the ED typically reflects the performance of the wider healthcare system it supports. Our big idea is to combine the experience of staff and patients with a range of state-of-the-art technologies and design principles to radically improve access and experience whilst optimising efficiency of staff and sustainability. The focus is on designing spaces and processes specifically aimed at improving patient and staff experience as well as clinical outcomes. The Smart ED has been designed to permit it to test new processes, technology and design for the wider NHS. We describe a novel sustainability framework and suggest how it’s surplus energy can supply local homes and generate additional income. What problems will it solve in current hospital planning and design? Multiple factors have resulted in the worst ED crowding seen for some time. From the patient’s perspective this means very long waits, but the invisible consequences are physical and psychological harm for patients and staff. Arrival at a conventional ED is often chaotic, the layout is confusing and the environment is noisy. Our solutions provide an orderly, calm and efficient environment for those arriving at the Smart ED. It has an easy-to-understand layout and offers amenities not found in current NHS EDs. There is a dedicated, quiet staff workspace at its core and the layout releases staff time for more patient care. Within the NHS there is an absence of a facility capable of testing innovative design or new processes whilst the challenge of a getting to a zero carbon NHS by 2040 is significant. The Smart ED designs in a testing capability for the wider NHS and re-imagines the use of water, energy and consumables and waste, offsetting the carbon footprint and contributing to the 2040 objective. What is its potential impact? Our design has the potential to deliver higher levels of patient care, safety and satisfaction at a lower cost relative to current standards within an environment that can manage an unexpected inflow of patients. The Smart ED supports staff in their daily activities in an inclusive working environment, whilst enhancing their physical and mental well-being. Additional financial flows are created by providing sustainable heating solutions for local communities, as well as experimentation space for companies whilst reducing carbon emissions from operational activities, transforming the NHS into a net positive contributor to climate change. This design is based on tested technology and processes and could be implemented immediately.

Dr Susan M Robinson FRCP FRCEM Mr James Lennon MS AIA Mr Ciaran Rymer MSc Dr Roderick Mackenzie PhD FRCP FIMC Ed Wilson PhD


The Well-Placed HospitalWhat is the big idea?Well 3 ideas combine. To move NHS hospitals back into the centre of their towns (away from edge of town campus sites). To link the acute hospital and the local residential nursing home facilities to operate as a single pool of places and staff with social care services. To position for the future formation of a ‘unified clinical faculty’ which would transcend the traditional division of hospital medicine and general practice.

What problem is it solving?NHS capital investment has increased NHS operating costs and has not driven integration. Peverse. The migration of the hospital from the town centre to a large self- contained campus on the edge of town may have made sense in the car-culture and planning frameworks of the last century - but that period may now be over? The local acute hospital is usually big-budget and big carbon footprint. Yet this economic power does not invigorate the local economy as much as it might. We see an opportunity for a new approach to capital investment bringing the hospital back into the centre of civic life in a (much) more convivial formation for both staff and patients.

We address head-on the operational confusion between health and social care, particularly the relationship between residential nursing home care and hospital care for elderly citizens. We propose moving a substantial element of elderly care that is currently taking place in the acute hospital into reformed residential nursing care and housing-for-life units. NHS revenue and staff would follow these patients and inject much needed liquidity into the care sector and bring closer joint working.

The organisational and financial boundary between hospital medicine and general practice has long roots back to a time when the longitudinal care in the local community gave real advantages. The GP would be a long serving member of the community and would know the family circumstances and medical histories of their patients. Acute hospital care was a smaller and rarer part of the picture. Medical careers and family patterns are very different now.

What is the potential impact?Financially speaking, the current health and social care economy is broken. Squirting more cash down the same tubes will not do it? It has been tried. Many times. Organisational change without intelligent investment and staffing reforms leads to cosmetic change?

There are over 250 NHS hospitals. Perhaps 30 are integrated with their host towns. A preliminary sweep identifies a number of towns with pending NHS investment.We have focussed on one - Barnstaple, North Devon - and developed an illustrative case study to show how the hospital could be moved back into the town. A better hospital and an anchor for urban prosperity.

Andy Black – healthcare planning & managementAnthony Farnsworth – social care planning & management Mungo Smith – MAAP ArchitectsJaime Bishop – Fleet Architects


Highly Commended The Caring Collective presents ‘The Future of Health and Wellbeing’

Description

The LDN Collective, a group of 50 built environment experts and creatives, collaborated with Siemens, JLL, Therme Group, Dar and Perkins & Will to create a vision for the hospital of the future. As a team, we delight in making beautiful, efficient, and human-centric places. We see the hospital as a micro and a macro place, with a myriad of complexities which are site-specific, all working within an overarching framework.

We envisage hospitals not just embedded in the community but being the community. A hybrid and agile network able to seamlessly integrate the physical and virtual worlds of wellness. We formed six guiding principles to underpin this vision, with hospitals becoming people-centric; adaptable; sustainable; technologically smart; value for money; civic and community beacons.

To communicate the diversity of our creative thinking, we wrote a play in four Acts called The Caring Collective. The characters, ranging from a child patient to a psychiatric nurse, are all real and were interviewed by our team. The play weaves together a mass of opinions, experiences, expertise, and creativity collected through interviews, conversations, design workshops and research. We are looking forward to putting these ideas into practice on some exciting projects we are working on.

LDN CollectiveSiemensJLLTherme GroupDarPerkins & Will


Hospital of the Future

Description

Hospitals need to be fundamentally re-conceptualised to take advantage of rapidly advancing technology. Increasing patient ownership over health, personalised medicine and digitised health platforms changes how communities interact with hospitals. Our hospital adapts to this by existing as virtual space with physical outposts rather than a physical space struggling to integrate novel technologies.

Flexibility to meet the needs of society is fundamental to the longevity of hospitals. Our hospital achieves this by minimising uniquely clinical high-tech areas, with multi-functional modular areas distributed around the hospital campus and wider community. These spaces communicate via the virtual hospital platform rather than relying on co-location. Acute care is coordinated remotely, with the central hub providing intensive care, specialist treatment and social care to a small group of patients that have specific needs. Harnessing technology to ensure the best use of resources will allow us to meet increasingly complex geriatric needs.

With the majority of healthcare coordinated in a virtual setting, the physical hospital environment is re-imagined to maximise the benefits of co-location. Encouraging collaboration and meaningful human interaction underpins the hospital design, facilitated by new technologies. The hospital is established as an anchor institution, with a community space that supports local economies and promotes health.

Co-AuthorsSamantha FieldNick Culley

Additional ContributorJenya Andersson


Rethink NHS

Description

Recent technological and architectural advancements provide an opportunity to develop hospital design that enhances the NHS’ core values in line with its outstanding heritage. Our proposal is a hybrid physical and digital ecosystem that is self-learning/ever-evolving, focussing on providing instant, individualised and empowering, physical, mental and emotional wellness, care and treatment encompassing prevention, diagnosis, treatment, recovery, community and home care.

At the proposal’s core is HEAL: Healthcare Ecosystem Architecture Leadership. HEAL provides blockchain-enabled information, collaboration, support, and incentives for healthcare providers, practitioners, designers and patients and the public. The ESSENCE design framework at the heart of HEAL encourages collaborative, human-centric, biophilic and sustainable design that enhances patient, staff and environmental wellbeing via: Engagement between all aspects of the healthcare community; Sensation of all senses; Synergy connecting providers, practitioners, patients & public; Empowerment of all; Navigation to optimise patient and practitioners journeys; Climate sustainability and carbon neutrality; Evolution offering flexibility, modularity, and self-learning AI systems.

Key components of HEAL include: Academy offering training, guidance and innovation; Certification motivating and rewarding design excellence; Accelerator of health infrastructure innovation; Helper empowering patients’ access to resources and services; Rewards creating wellness gamification and incentives; Together building networks of knowledge, experience and emotional support.

Zaha Hadid ArchitectsPatrik Schumacher, PrincipalManuela Gatto, DirectorShajay Bhooshan, Senior AssociateYevgeniya Pozigun, AssociateShao-wei Huang, Senior AssociateUli Blum, ConsultantLorena Espaillat Bencosme, Strate-gic Space PlannerArjun Kaicker, External Consultant

desMJohn Marsh, Director

AtelierTenMeredith Davey, Director

WT PartnershipDavid Hudson, Director

Rubicon Health ConsultingAndy Whiting, Director

Design Computation Ltd.Abel Maciel, Principal


Light Bulb Award WinnersThe High Street Hospital Model

Description

In the future, healthcare facilities will be better connected and more strategically located in cities, with a stronger identity and links to the community.

Our concept is to repurpose vacant major retail stores in cities and towns as outpatient and diagnostic hubs – using Sheffield and its former Debenhams store as a test case.

Our vision puts healthcare at the heart of cities, to improve patient outcomes and revitalise urban centres as they recover from losing major retailers. This simple idea could deliver a range of benefits:

• Delivering more accessible and higher quality healthcare by bringing together diagnostic and outpatient services with good transport links;

• Increased wellbeing of patients and staff through active travel, green spaces and healthy eating options;

• Reconceiving the hospital as a new kind of anchor institution for the city, promoting preventative healthcare and healthy lifestyles as well as encouraging entrepreneurship and supporting retail, cultural and leisure activities;

• and saving embodied carbon by using repurposing existing buildings.

This concept will free up capacity in existing hospitals to help them maintain services while also embracing change, adopting new technology and responding to future shocks.

Authors Jim Bell – ArupEdith Blennerhassett – ArupRebecca Chau – ArupChris Green – ArupSteve Haake - Sheffield Hallam University Agostino Nickl – ArupHelena Parsons - Sheffield Teaching HospitalsDerek Roberts – ArupAndrew Rolf – ArupAnna Sutherland – Arup

Contributors Arup Foresight Team Tom Bridges – ArupGreg Fell - Sheffield Director of Public HealthJonathan Guest - Sheffield City RegionEdward Highfield - Sheffield City CouncilKathryn Thomas – QMCVarious conversations with Staff at Sheffield Teaching Hospitals


Healthcare reimagined: How a hospital can drive a rethought model of medical care

Description

Dr Wade and his team propose a hospital design that promotes better integration of the biomedical and psychosocial models of medical care. Whilst strengthening of social and community services is undoubtedly essential, they warn that excessively pushing care out of hospitals into the community risks fragmentation of these services. Their concept of a community hub provides an area within the hospital where community, charity, and social care services are brought together into a collaborative space which dissolves siloes and enhances the efficiency of care they provide to their patients. The inter-digitation of community and hospital services promotes a rethought model of medicine which values taking a whole-patient and personalised approach to delivering quality and appropriate care to patients. The hub also offers opportunities for health education and public engagement that empower the wider community to improve their own health and prevent or mitigate disease. The community hub signals the transition of the hospital from being mainly a place of cure, to a centre of prevention and health improvement within society.

Dr Cian Wade, Academy of Medical Royal CollegesDr Harrison Carter, NHS England and NHS ImprovementMr Thibault Quinn, Department of Architecture & Civil Engineering, Bath University


Date post:	03-Apr-2022
Category:	Documents
Upload:	others
View:	2 times
Download:	0 times

Guide to the Finalists and Awards WOLFSON ECONOMICS PRIZE ...

Documents