Healthcare Property Issue 03 May-June 2024

05/2024
MAY-JUNE 2024
Milestone for £85m maternity
hospital development in Belfast
Spotlight on best practice for
dementia-inclusive design
Framework agreements provide
support for next-generation
healthcare buildings
HEALTHCARE-PROPERTY.COM

Comment
W E L C O M E
Design matters!
During my 31-year reporting
career I have written about many
subjects, but, since the very
beginning, when I was working
on a local newspaper, I have had
a particular interest in the built
environment.
This passion began when
attending council planning
meetings, one of the few political
gatherings which attracted the
attention, and provoked the wrath,
of members of the public, who
came out in force to protest against
the development, or demise, of
local landmarks and buildings.
So, when 15 years ago I was given
the opportunity to work on a B2B
magazine focusing solely on the
design and construction of health
and care buildings, I jumped at the chance.
Fast forward to 2024 and I am now a very-vocal
advocate of the importance of good building design on
changing and enhancing people’s lives.
And nowhere is this more important than in
healthcare.
Over the years I have reported on a wealth of research
which is providing a much-needed evidence base to
inform the future design of supportive medical and
social care facilities.
For example, research by Roger Ulrich revealed
that, compared to hospital patients whose beds faced
brick walls, those whose beds had views of natural
scenery had shorter post-operative hospital stays,
fewer negative evaluative comments from nurses, took
fewer moderately-strong and strong medications,
and had slightly-lower scores for minor post-surgical
complications.
And these outcomes are just about the placement of
windows and the presence of outdoor spaces!
Since this study in the 1980s, the impact of the
physical environment of hospitals and care homes on
the wellbeing and health of patients
and residents has received extensive
academic attention, resulting in
buildings that promote and aid
recovery and support those who
work within them.
A particular focus for me over
the past decade has been on
dementia care facilities, and I’ve
decided to focus on this veryspecialist
area in this edition of
Healthcare Property.
In a special report (p22), I
have interviewed the brains
behind the world-renowned
Hogeweyk dementia village in the
Netherlands.
I have also spoken to an expert
from the University of Stirling’s
Dementia Services Design Centre,
who provides an insight into how even small design
interventions can have a lasting positive impact on
people living with this disease.
It is crucial, as we deal with a rising prevalence in
dementia diagnoses, that we continue to rethink the way
we provide homes and medical and support facilities for
this cohort of patients, and Healthcare Property will be
at the forefront of this drive moving forward, reporting
on the latest thinking and showcasing some of the mostforward-thinking
projects.
Also in this edition, you can read about the latest
property and finance news, find out more about how
the sector is addressing the carbon net zero challenge,
and discover the winners of our first Healthcare Design
Awards.
In the next edition, among other topics, we will be
looking at healthcare window design, the evolution of
‘smart’ hospitals, and the impact of planning laws on
property development. If you can help, please contact
joanne.makosinski@nexusgroup.co.uk
Jo Makosinski
Editor, Healthcare Property
About Jo: Jo is the editor of Healthcare Property, having
joined Nexus Media in November.
She has been specialising in design and construction
best practice within the health and care sector for the
past 15 years, working on the Building Better Healthcare
Awards and editing both Building Better Healthcare and
Healthcare Design & Management magazines.
She has a special interest in the design of mental
health and dementia care settings and in modern
methods of construction and energy efficiency.
HEALTHCARE-PROPERTY.COM MAY-JUNE 2024 | 3

Contents
Chief executive officer
Alex Dampier
Chief operating officer
Sarah Hyman
Chief marketing officer
Julia Payne
Editor
Joanne Makosinski
joanne.makosinski@nexusgroup.co.uk
Reporter and subeditor
Charles Wheeldon
Business development director
Mike Griffin
Advertising & event sales director
Caroline Bowern
Business development executive
Kirsty Parks
Sales manager
Luke Crist
Publisher
Harry Hyman
Investor Publishing Ltd, 5th Floor, Greener House,
66-68 Haymarket, London, SW1Y 4RF
Tel: 020 7104 2000
Website: www.healthcare-property.com
Healthcare Property is published six times a year
by Investor Publishing Ltd.
ISSN 3029-0627
© Investor Publishing Limited 2024
The views expressed in Healthcare Property
are not necessarily those of the editor or publishers.
@HCprop
linkedin.com/company/healthcare-property/
6-9 News
We round up the latest big
stories, including the soaring
cost of running the NHS estate;
plans for a ground-breaking new
health campus at the University
of East London; the proposed
redevelopment of a cottage
hospital in north west London; and
the completion of a new stateof-the-art
dental treatment and
training facility
10-11 Policy
The growing importance of
Environmental and Social
Governance (ESG) in the health
sector
15
13-20 Finance and Property
Deals
An overview of the key trends in
real estate financing for the health
sector, including how procurement
frameworks are helping to deliver
healthcare infrastructure projects
at pace; the importance of drawing
up property lease agreements for
primary care facilities; and the
latest property acquisitions and
disposals across the sector
22
22-32 Building Design and
Construction
Special report on the design of
dementia-inclusive health and
care environments. We also
profile a new collaborative Health
Innovation Hub in Glasgow, and
look at the role of engineering in
delivering later living developments
33-35 Estates and Facilities
Management
Why fire doors are critical to safety
in healthcare settings; plus new
guidance supports a long-term
approach to infrastructure planning
36
34
36-40 Environmental
Exploring the health sector’s
net zero carbon challenge and
the support available, including
the increased use of heat pump
technologies, EV charging, and
a the launch of new fund to
support the creation of NHS heat
decarbonisation plans
42
42-44 Awards
We reveal the winners of the 2024
Healthcare Design Awards
46-47 Interview
Paul Yeomans, director at Medical
Architecture, talks about his career
at the forefront of healthcare design
and his predictions for the future
48-50 People
Staffing and people news, including
the latest industry appointments
HEALTHCARE-PROPERTY.COM MAY-JUNE 2024 | 5

News
Cost of running the
NHS estate soars
The total cost of running the NHS
estate was £12.4bn during the 2022/23
financial year, according to the results
of the latest Estates Return Information
Collection (ERIC) survey.
The annual data set comprises
information relating to the costs of
providing and maintaining the NHS
estate, including buildings, maintaining
and equipping hospitals, the provision of
services such as laundry and food, and the
costs and consumption of utilities.
And is has revealed that the cost of
running the estate — at £12.4bn — was 12%
up on the previous year.
Total energy usage from all energy
sources was 11.2 billion kWh — down by
1.65% on 2021/22 figures.
ADDRESSING THE BACKLOG
Backlog maintenance continues to plague
NHS organisations, according to the data,
with the total estimated cost to eradicate
works currently standing at £11.6bn — an
increase of 13.5% on the previous 12
months.
Of these works, it is estimated that £2.3bn
is needed to address high-risk issues,
£3.8bn for significant-risk works, £3.9bn
for moderate risk, and £1.3bn for low-risk
works.
Other data revealed includes:
• There are now 223 combined heat and
power (CHP) units — an increase of 4%
on 2021/22
• The total cost for cleaning services was
£1.3bn — a 10% increase
• The total cost of providing inpatient food
was £800m — up 13.7%
• The cost of waste services was £164.7m
— up 8%
The data covered 9,713 trusts in England with
a gross internal floorspace of 27.2 million sq m.
The figures also revealed that currently
167.6 million sq m of internal floorspace is
unoccupied.
A GROWING PROBLEM
Commenting on the report, Siva
Anandaciva, chief analyst at The King’s
Fund health think tank, said: “The cost and
severity of maintenance issues with NHS
buildings and equipment is still growing,
with a maintenance backlog that has now
risen to £11.6bn.
“Promises to build new hospitals have not
been realised, which has left parts of the
NHS estate in such a poor condition they
pose serious risks to staff and patients.
“The repeated raiding of long-term
investment budgets to cover day-to-day
spending is illustrative of the short-term
thinking that has plagued NHS finances in
recent years.
“The consequences of the Government’s
earlier decisions to put off dealing with
long-term problems are now being realised.
“Recent increases in the number of
hospital staff have not yet translated into
increased hospital activity, and outdated
tech and dilapidated buildings are likely to
be one factor limiting progress.
“The deteriorating state of NHS buildings
and equipment is a shaky foundation
that could undermine the Government’s
productivity drive.”
And he added: “To get the sector back
on track in the coming years and break the
cycle of ‘worst-ever’ winters, bolder action
and longer-term thinking by government
will be necessary.
“This includes action to make working in
the NHS and social care a more-attractive
career, bolstering out-of-hospital care such
as primary, community, and social care
services, and helping people live healthier
lives.”
The cusp of a new chapter
Planners at The London Borough of
Newham have given the green light for a
ground-breaking new health campus at
the University of East London (UEL).
The facility, in Water Lane, Stratford, will be
a centre for learning and advanced research
and a visionary cornerstone for community
health, preventive care, and overall wellbeing.
Set to boost the local economy, it will
also generate job opportunities, attract
investment, and stimulate business growth.
Professor Amanda Broderick, vicechancellor
and president of the university,
said: “Together, we are not just building a
campus; we are nurturing the roots of a
community that will flourish for generations
to come.
“This Stratford development project is more
than a physical expansion; it is a promise to
our students and the community we serve.
“It encapsulates our commitment to
nurturing local talent, advancing ecological
stewardship, and promoting public wellbeing
and it embodies our vision of creating a
connected, healthy, and thriving community
for everyone involved with the University of
East London.”
Designed as a cutting-edge hub for
innovation and learning, the campus will
seamlessly integrate the latest health
technology and teaching methodologies.
And it will be dedicated to equipping future
healthcare professionals with the skills
needed to excel in their fields.
Sustainability has also been central to the
design of the building, with the approved
plans consisting of 40% green space and
including a net increase of 50 trees.
A new academic building will house
lecture theatres and teaching rooms, and
there will be improved lighting and safety
features which will benefit the surrounding
area.
Construction is scheduled to begin this
summer.
6 | MAY-JUNE 2024 HEALTHCARE-PROPERTY.COM

News
Care home plan unveiled
Cannock town centre is
to benefit from significant
investment with the opening of
a new nursing home for adults
living with complex needs.
Midlands-based Deeley
Group, a family-owned business
headquartered in Coventry, has
partnered with leading national
provider, Exemplar Health
Care, to transform Cannock
Chase Council’s former Avon
Road Car Park, opposite the
Asda supermarket, into a new
33-bedroom care home.
The provider, which will
own and operate the home
once built, is funding the £6m
investment to bring this muchneeded
complex care service to
the local community.
Work on the new threestorey
building, which includes
communal living space, sensory
bathrooms, a therapy room, car
park, and gardens, is expected to
start shortly.
The land had been earmarked
for sale in the Cannock Town
Centre Development Prospectus
and planning permission was
granted to Deeley Group earlier
this year, securing much-needed
new care facilities for the local
community.
Leader of the council,
Councillor Tony Johnson,
said: “This is a very-welcome
investment into our town
centre and fulfils a real need
within the Cannock community
for complex nursing care
that allows people to be
independent, yet have their
complex healthcare needs well
supported and in a location
close to amenities.
“We are delighted that Deeley
Group and Exemplar Health
Care have shown confidence in
Cannock and decided to invest
in our town centre, attracted by
Avon Road Car Park’s inclusion
in our prospectus launched a
few years ago.
“The prospectus outlines land
in the town centre available for
development and complements
work underway to create an
exciting new leisure hub around
the theatre and nearby Church
Street as part of the £20m
Levelling Up Fund support from
the Government announced in
2021.”
Eleanor Deeley, joint managing
director of the Deeley Group,
added: “This development
will transform a redundant
brownfield site into an important
nursing home which will provide
vital care for people living with
complex needs in Cannock.
“This will be the fourth
development we have worked
on in partnership with Exemplar
Health Care and we are proud to
be creating this new care home,
which will also contribute to the
wider regeneration of Cannock
town centre.”
Exemplar Health Care expects
to commence construction of
the new home in November,
with the first residents moving in
by January 2025.
Thumbs up for £11m health centre revamp
Northwood and Pinner Cottage Hospital
is set to be redeveloped after achieving
full planning permission.
Approximately £11m will be injected into the
project to cement better health outcomes for
the 20,000 patients who access the facility.
Hillingdon Council’s planning committee
recently voted unanimously in favour of the
refurbishment scheme, where 100% of the
available space will be utilised.
NHS Property Services (NHSPS) and
North West London Integrated Care Board
will work closely to deliver the scope of
works, expected to start later this year.
Once completed, two GP practices,
Carepoint and Acre, will be relocated
into the refurbished building from nearby
Northwood Health Centre to deliver primary
care services.
And new mental health services will
be facilitated by Central and North West
London NHS Foundation Trust.
Following the work, the existing
Northwood Health Centre building will be
sold through NHSPS’s disposal policy to
generate the necessary capital to fund parts
of the project and to promote a streamlined
delivery of patient care under one roof.
Under the approved proposal, 70 new
housing units will also be erected in
accordance with Hillingdon Council’s local
plan.
And NHSPS has committed to preserving
the war memorial that commemorates
soldiers who served during World War 1 and
World War 2.
With sustainability at its core, further
proposals include attaining a BREEAM
‘Excellent’ rating through eco-friendly
technology such as green roofs and
reducing overall carbon emissions by
80%. 100 new trees will also be planted to
increase biodiversity, and 15 electric vehicle
charging points and water-efficient flow
restrictors will be installed.
Additionally, heat pumps, LED lighting, and
thermal-efficient building fabric will be used.
Once all sustainable measures are in place,
the centre’s EPC rating will raise from an ‘F’
to a ‘B’.
Adrian Powell, director of investment and
development management for NHSPS, said:
“Northwood and Pinner is a key hub that is
used by thousands across the locality.
“We are committed to breathing new life
into the building and achieving full planning
permission means we are able to move
forward with the project and we are excited
to get started.”
Dr Manish Patel, practice manager at
Carepoint Practice, added: “This relocation
is a welcome opportunity for us to enhance
patient care and expand the services we
currently deliver.
“We are thrilled to be able to provide
patients with a state-of-the-art, accessible
facility that we hope will improve longterm
health outcomes for our residents in
Hillingdon.”
HEALTHCARE-PROPERTY.COM MAY-JUNE 2024 | 7

News
£3.2m dental clinic opens
A new state-of-the-art facility which will
train the next generation of dentists has
officially opened in east London.
The Kenworthy Road Dental Clinic was
opened by the Chief Dental Officer for
England, Jason Wong, and representatives
from Community Health Partnerships
(CHP), Barts Health NHS Trust, and Queen
Mary University of London, alongside
clinicians and NHS colleagues.
The £3.2m reconfiguration, which was
capital funded by CHP, will provide a
modern and fit-for-purpose training ground
for dental students from the university, while
providing residents in north-east London
with quicker and easier access to free dental
care within a primary care setting.
The project was made possible through
collaboration with CHP LIFTCo partner,
Infracare East London, and Coleman
Consult, which played a pivotal role in the
delivery of the project.
THE NEXT GENERATION
The clinic will provide capacity for 20 chairs,
accommodating 300 dental students who
will be overseen by trained dentists, with the
ability to deliver 7,000 patient appointments
per year.
And it will vastly improve access to dental
services for local communities in Homerton,
an area known for high prevalence of dental
decay and reduced access compared to
national averages across England.
Christopher Tredwin, dean and director
of the Institute of Dentistry, Queen Mary
University of London, said: “This new clinic
will provide care to patients that need it the
most, all while training the next generation
of the UK’s dentists.
“Thanks to the high-tech equipment and
opportunity for students to treat patients,
this clinic will ensure undergraduates have
the best opportunities to meet their clinical
requirements while providing dental care to
the community.”
The variation at Kenworthy Road Health
Centre was made possible through initial
scoping and collaboration with North East
London ICB and local trusts by identifying
the areas of significant health needs and
high backlog, some of these caused by the
COVID-19 pandemic.
ACCESSIBLE TO ALL
Kenworthy Road Health Centre was
identified as Homerton is an area with high
dental needs and the health centre itself is
centrally positioned, with strong transport
links, making it accessible for patients.
In addition, there are existing primary care
services being delivered from the health
centre which will provide a sustainable
opportunity for joined-up working.
With constraints on capital funding,
optimising the use of high-quality estate
is essential to support key priorities such
as recovery of elective and primary care
services and delivery of place-based care.
And, across the CHP portfolio, there are
a number of dental variation opportunities,
some with the ability to convert to dental
services at pace.
“The variation at Kenworthy Road is a
prime example of what can be achieved
through collaboration with the local NHS
system, leading to a solution that will meet
the needs of the local population for years to
come,” said a spokesman for CHP.
8 | MAY-JUNE 2024 HEALTHCARE-PROPERTY.COM

News
The future of maternity care
Belfast Health and Social Care Trust
has celebrated a significant milestone
after work was completed on Phase B1
of the Belfast Maternity Unit at the Royal
Victoria Hospital.
Constructed by GRAHAM-BAM
Healthcare Partnership (GBHP), the
facility marks a significant advancement
in healthcare infrastructure, enhancing the
birthing experience for over 5,000 women
every year.
The £85m development has been a
collaborative effort aimed at meeting the
evolving needs of expectant mothers and
their families.
Peter Reavey, director at GBHP, said:
“This new maternity hospital represents the
future of maternity care for Belfast and we
are proud to deliver a facility that not only
meets the highest standards of safety and
comfort, but also fosters an environment of
support and empowerment for mothers and
their newborns.”
Built adjacent to the existing maternity
hospital, the new five-storey unit boasts
modern amenities and innovative design
features aimed at providing a welcoming
and uplifting environment.
With en-suite rooms equipped with
birthing pools, delivery suites, obstetric
theatres, and a neonatal intensive care unit
— all conveniently located on one floor —
the facility ensures comprehensive care for
mothers and babies, from routine deliveries
to those requiring specialised care.
But the project’s success was not without
its challenges as construction work
took place within a busy acute hospital
environment surrounded by existing live
hospital buildings.
However, through close collaboration with
the trust’s management and stakeholders,
GBHP implemented rigorous logistical
co-ordination and infection prevention
measures to minimise disruptions and
ensure the safety of patients and staff.
Maureen Edwards, the trust’s director of
finance, estates and capital development,
said: “Belfast Health and Social Care
Trust is delighted that the handover of the
new maternity hospital from contractor,
GRAHAM-BAM, has taken place.
“This is a significant step forward in
delivering a new modern facility which
will provide a high standard of care for our
mothers and their new babies.”
In addition to the maternity hospital,
GBHP also previously completed the £30m
Acute Mental Health Inpatient Centre at
Belfast City Hospital.
Health centre is handed over
Galliford Try’s Building Southern business has handed over
the £12.2m Edenbridge Memorial Health Centre (EMHC)
development in Four Elms Road, Edenbridge, Kent.
Developed on behalf of GB Partnerships in conjunction with Kent
Community Health NHS Foundation Trust, Edenbridge Medical
Practice, and Kent and Medway Clinical Commissioning Group, the
facility was designed by LSI Architects.
The part-two-storey building has public services on the ground floor
and staff amenities on the first floor.
Health services include a GP practice, outpatient services, a
minor injuries unit, X-ray services, phlebotomy, therapies, and social
prescribing, with around 2000sq m of clinical and community space,
along with vehicle parking and landscaping.
In addition to incorporating a memorial garden area for conservation,
and an emphasis on health, wellbeing, and lifestyle services; the
centre has been designed to be sustainable and in keeping with the
local environment.
Replacing existing provision at both Edenbridge Medical Practice
and Edenbridge Memorial Hospital, the clinic will serve up to 15,000
NHS patients — allowing for a 20% increase in local population
growth.
The low-rise building uses a simple palette of materials and
components to create a non-institutional feel.
And the form generates a familiar association with Kentish
vernacular building forms through a series of alternating gable roofs.
The result is a centre that is vibrant and inviting and provides a
strong emphasis on the promotion of wellbeing.
Spaces have been designed in accordance with HNB11-01 to be
generic, flexible, and multifunctional to support effective utilisation
and futureproofing.
The project also includes a section 278 agreement for a new
entrance and associated bus stop reconfiguration.
HEALTHCARE-PROPERTY.COM MAY-JUNE 2024 | 9

Policy
Sustainability and ESG
in healthcare property
Jesse Putzel, director of ESG at Primary Health
Properties (PHP), discusses the importance of
Environmental Social Governance for the health sector
Environmental Social Governance
(ESG) or sustainability in business is
increasingly important for companies
in all sectors. But, for those operating in the
built environment, including the healthcare
property space, there is mounting pressure
to address a range of issues, from climate
impact and nature to the social impact of
operations and investments.
Despite some economic pressures, ESG
and sustainability remain priorities for
investors, in part driven by new standards,
regulations and incentives, particularly in
Europe and the United States.
The International Sustainability
Standards Board (ISSB) reporting
guidelines for business have harmonised
reporting standards, aligning reporting
internationally and are being adopted or
mandated by governments worldwide, the
UK included.
The EU Corporate Sustainability
Reporting Directive (CSRD) imposes
challenging requirements for companies
operating in Europe, extending to their
global operations.
And these regulatory trends and investor
demand for ESG, mean companies are
having to step out of their comfort zones.
In the past, the healthcare space, as it
relates to buildings, was perhaps behind
others on sustainability.
There was rarely talk of measuring
carbon, let alone net zero, likely given other
pressures and priorities that are unique to
healthcare.
However, the dial is moving and
companies operating in healthcare property
have either already been changing their
approach, or will need to do so.
WHAT ISSUES TO FOCUS ON
ESG encompasses a wide spectrum of
issues. Which are most relevant, or material,
will differ from company to company.
Each business should assess what the
…the dial is moving and companies operating
in healthcare property have either already been
changing their approach, or will need to do so
most-material issues are for its operations
and its stakeholders.
Identifying the key impacts, but also
opportunities, is key. Then, depending
on the level of control and influence a
company has, different strategies will be
needed.
There are issues which will apply to any
company, albeit with different implications
depending on the business model.
Outlined below are three areas of
particular and growing importance now.
SOCIAL IMPACT,
BEYOND THE OBVIOUS
Healthcare property has obvious social
benefits and is rightly seen as a sociallypositive
area to invest. However, just being
in the space doesn’t tick all the boxes
anymore.
Companies must be conscious of the
impact on their own employees, that they
create a culture of equality, diversity, and
inclusion and that they offer support and
development opportunities to attract the
best talent.
There can also be potential negative social
impacts to deal with, especially in the value
chain.
Ethics in supply chains is coming under
increasing scrutiny, with growing awareness
of forced labour and modern slavery risks.
An example which is relevant to many in
healthcare property is solar PV, a positive
technology that can have a dark side.
In recent years there has been increasing
awareness of human rights abuses in
the manufacture of polysilicon (a key
ingredient of solar panels).
Therefore, identifying higher-risk
products and either engaging with suppliers
or using different ones will be important
going forward.
Beyond avoiding negative impacts, there
is a growing focus on creating a wider
positive social impact.
The rise of concepts like social value and
social return in investment, put a focus on
companies understanding their real impact
on society and backing this up with data.
The social aspects of ESG or social value
can include all the ways a company interacts
with employees, suppliers, customers, and
their local communities.
In the built environment, we create
added social value when buildings, places,
or infrastructure support environmental,
economic, and social wellbeing. This may
be through the way construction projects
are procured (creating new employment),
or in the way buildings are designed and
operated (enhancing people’s wellbeing).
A recent example is the ‘Designing for
Everyone toolkit’ , developed to help GP
practices and health centres improve the
physical environment in buildings for
people with learning disabilities, autism,
anxiety, and those who are neurodiverse.
There is going to be a growing focus on
the measurement and disclosure of social
10 | MAY-JUNE 2024 HEALTHCARE-PROPERTY.COM

Policy
impact, which can be challenging to do.
Starting now will benefit companies ahead of any
stronger requirements or regulation.
TARGETING NET ZERO
Those in healthcare property need to be aware of what
net zero carbon means and what is expected.
Where widely-different approaches were used in
the past, the industry is converging around shared
and accepted definitions and frameworks. These
include the UK Green Building Council’s Framework
Definition for Net Zero Carbon Buildings, the Climate
Risk Real Estate Monitor (CRREM) transition
pathways for energy and carbon intensity (which
include UK Healthcare targets), the London Energy
Transformation Initiative (LETI) operational and
embodied carbon benchmarks, and the RICS whole life
carbon assessment standard .
Together these outline a set of standards and practices
which should be followed to achieve net zero carbon
buildings.
Linked with these standards, but specific to
healthcare buildings, is the NHS Net Zero Carbon
Building Standard, which is setting a benchmark for
healthcare buildings.
Anyone not already aware of these
definitions, metrics, and targets should
get up to speed and begin to assess how
they can be incorporated into projects
and future building improvements
5 yrs
Low energy use
Measurement and verifcation
kWh/m 2 /yr
Embodied carbon
Low carbon supply
Net Zero
Operational
Carbon
Zero carbon balance
ukgbc.org
While these standards are detailed, and differ in some
aspects; the core of what a net zero carbon building
should encompass is largely agreed, namely where:
• Energy use intensity (kWh/m2), covering all the
energy used by a building, is minimised, ideally
aiming for minimum performance thresholds e.g.
CRREM UK Healthcare or more-ambitious NHS
net zero targets
• There are no fossil fuels on site (where not possible,
there should be a plan to remove them entirely in
future, with interim hybrid approaches where possible)
• Onsite renewable energy generation is maximised
where possible
• Embodied carbon of materials (in new constructions
or refurbishments) is measured and minimised,
with residual emissions offset. Ideally targets are
set to limit ‘upfront embodied carbon’ in line with
industry benchmarks e.g. LETI
• Performance in use will be monitored to prove
targets are met or, where not, to intervene to
optimise performance
Getting consistency across industry here is key. If energy use is not
minimised, it will be difficult to decarbonise the grid.
This also benefits end users who can operate buildings with less cost.
Getting a handle on embodied carbon is also vital as buildings move to
operating with net zero emissions.
This approach will soon be required for any companies seeking to have an
approved science-based target, with the upcoming launch of their building’s
guidance. It will also become part of the updated BREEAM v7, both due to
land later in 2024, as well as a Net Zero Buildings certification standard.
Anyone not already aware of these definitions, metrics, and targets, should
get up to speed and begin to assess how they can be incorporated into projects
and future building improvements.
NATURE AND BIODIVERSITY
The link between nature, biodiversity, and health and wellbeing is increasingly
clear. And healthcare property can have a part to play.
Nature, and how companies interact with it (directly and indirectly), is the
next hot topic.
In September 2023, the Taskforce on Nature-related Financial Disclosures
(TNFD) published its final recommendations for nature-related risk
management and disclosure.
A growing number of companies have become early adopters of TNFD,
including financial institutions and asset managers involved in the property
sector, and the number is set to grow.
The recommendations are based on the work and framework of TNFD and,
if they follow the same trajectory, may become mandatory for many.
In addition, from April 2024 most construction work in the UK requiring
planning permission will need to comply with biodiversity net gain.
While not all projects will need to achieve a 10% net gain in biodiversity,
additional assessments may still be required.
At the sharper end, projects will need to plan to deliver biodiversity net gain
on site or budget for purchase of offsite biodiversity credits.
But the opportunity for healthcare property shouldn’t be ignored.
Nature is good for health and can also help to safeguard and futureproof
buildings, not least in helping to adapt to inevitable climate changes. n
HEALTHCARE-PROPERTY.COM MAY-JUNE 2024 | 11

Finance and Property
A framework for the future
This article looks at how the ProCure23 framework agreement is being used to support the delivery
of capital projects across the NHS in England
Earlier this year, Integrated Health Projects (IHP), a joint venture between VINCI
Building and Sir Robert McAlpine, was appointed by The Shrewsbury and
Telford Hospital NHS Trust (SaTH) under the P23 framework as its design and
construction partner to progress the Hospitals Transformation Programme (HTP)
A new daycase surgical unit at Hereford County Hospital,
designed by ADP Architects and built by Speller Metcalfe, was
the first project procured under the P23 framework
Launched in 2022, the ProCure23
(P23) framework agreement is the
fourth generation of NHS England’s
route to market for the provision of design
and construction services for NHS capital
projects.
NHS England has collaborated with
Crown Commercial Service (CCS) to
deliver P23 as part of the Construction
Works and Associated Services 2 (CWAS2)
procurement framework to ensure that
NHS capital works adopt the principles of
the Government’s Construction Playbook,
modern construction delivery, and have a
focus on sustainability and social value.
And, through this route to market, NHS
trusts and Integrated Care Systems (ICSs)
can quickly access experienced and proficient
partners to support excellence in all aspects
of NHS capital project delivery, including
business case development, sustainability,
design, construction, disruption mitigation,
benefit realisation, and optimised
occupation.
To run over four years to October 2026,
P23 has an expected cumulative spend of
£9bn and builds on the successes of three
previous iterations, which together delivered
over £10bn worth of infrastructure projects
for the NHS.
P23 operates under three ‘Lots’ covering
different values ranging from under £20m to
over £70m.
And, for the first time as part of the
ProCure structure, the lower-value lot
(under £20m) has been split into the seven
NHS England and NHS Improvement
geographical regions. This is intended to
open the framework to suitable regional
contractors, enhance capacity, and increase
local backing for projects.
There are 12 national suppliers
and 21 regional suppliers available
via the framework, including Balfour
Beatty Construction, BAM Building
& Infrastructure, Kier Construction,
McLaughlin & Harvey, Galliford
Try, Integrated Health Projects, ISG
Construction, GRAHAM Construction,
and Laing O’Rourke.
And, to date — halfway through the
framework’s intended lifespan — there have
been 95 NHS clients, collectively spending
£5.8bn on delivering more than 50 projects.
THE BENEFITS
P23 offers a number of key benefits to NHS
clients, including:
• Confidence that all suppliers are proficient
with health/complex project design and
construction
• Increased supplier capacity, including
access to regional suppliers
• Use of modern methods of construction,
including a range of standardised, project
share, and repeatable rooms options to
provide reliable, evidence-based designs
and to reduce capital cost
• Call-off options to suit differing project
needs, values, and complexities while
ensuring clients’ post-construction review
(PCR) compliance
• A fast-track process without the need to
open tender, making the approvals process
more efficient and reducing associated
costs
• The ability to set the quality/price ratio for
call-offs according to project needs
• Free-of-charge training for all project team
members to enhance project proficiency
(more than 25 hours each)
• All projects will use tried-and-tested NEC
contract processes, enabling collaboration
and collective risk sharing between
partners
• Implementation of advisor support,
offered in a neutral capacity, free of charge
A spokesman for the NHS Estates and
Facilities division at NHS England, said: “As
of January 2024, the committed value of P23
stands at £2.58bn, with 54 procurements
completed and a further six currently live.
“The framework’s ability to expedite
projects while maintaining fiscal
responsibility has garnered attention within
the construction industry.
“This achievement not only highlights
the efficiency of the procurement process,
but also reflects the trust that clients and
stakeholders have placed in ProCure23.”
He added: “ProCure23’s success extends
beyond individual projects to its impact on
the overall construction landscape.
“The framework has become a catalyst for
positive change, fostering collaboration and
innovation within the industry.
“And its ability to adapt to evolving
challenges has positioned it as a dynamic
force that continues to redefine procurement
norms.
“As ProCure23 looks towards the future,
its success is setting the benchmark for other
frameworks and industry players.
“The framework’s achievements in
surpassing financial targets, winning
prestigious awards, and delivering exceptional
projects highlight the transformative power
of effective procurement practices in the
construction sector.” n
HEALTHCARE-PROPERTY.COM MAY-JUNE 2024 | 13

Finance and Property
Building for Wales — creating
the next generation of
healthcare infrastructure
Recent developments completed under the framework include the Maelfa Health and Wellbeing Centre, a £14m facility in Cardiff
Similar to the approach in England, the Welsh Government also has a procurement framework to
deliver the next generation of health and care facilities. Jo Makosinski finds out more
Replacing the Designed for Life 2 &
3 frameworks in 2018, the NHS
Building for Wales frameworks
continue to drive forward improvements in
the delivery of major capital construction
projects for NHS Wales, working closely
with health boards and trusts to deliver
high-quality healthcare facilities.
Now in its fourth iteration — with the
fifth generation due to be launched this
spring — the current procurement model
is the preferred approach for major NHS
capital projects with construction costs in
excess of £4m.
The framework is based on the
fundamental principles of collaborative
working, integrated supply chains, and
continual improvement. delivering value for
money and helping to develop best practice
and sustainability and other core objectives
on behalf of the Welsh Government.
For schemes with a capital value of
less than £4m, each health board or
trust is responsible for making its own
arrangements to procure works and each
will have either traditional tendering or
framework arrangements in place.
14 | MAY-JUNE 2024 HEALTHCARE-PROPERTY.COM

Finance and Property
Willmott Dixon delivered the £19m Aneurin Bevan Health
and Wellbeing Centre in Tredegar through the framework
To date, the 4th framework agreement has tendered
in excess of £520m worth of healthcare infrastructure,
with 33 projects in development or completed during
its extended six-year duration.
It is particularly appealing to health boards and
trusts as the framework pre-approves principal supply
chain partners — fronted by a management contractor
with an established team of building services installers,
architects, and engineers already on board.
This means the project teams are used to working
together and have the capacity and capability to meet
the specific requirements of project delivery within the
healthcare sector.
Contractors on the current NHS Building for Wales
framework include BAM Construction, Interserve,
Willmott Dixon, Kier, and IHP.
Speaking to Healthcare Property, Andrew
Waddington, head of NHS Building for Wales at NHS
Wales Shared Services Partnership’s Specialist Estates
Services division, explains: “Over the past six years the
framework has developed a variety of schemes, with a
particular focus on the Welsh Government’s pipeline
of health and wellbeing hubs (HWBs) to enhance
provision of primary care services across Wales.
“This investment is quite significant — with projects worth between
£7m-£100m delivering a variety of clinical services, also including mental
health, radiology, and operating theatres.”
And he said the current framework has been one of the busiest.
“Health boards like the framework because it offers a one-stop shop where
they can appoint a contractor and these companies already have their designers
and installers on board,” he adds.
“It allows for a single point of contact, and this drives efficiencies.
“They also recognise the broader benefits of the framework, through shared
best practice and lessons learnt.”
NHS Wales Shared Services Partnership has also established supporting
frameworks for project and cost management services, allowing health boards
to deliver projects in a timely manner.
Through the management of the frameworks, NHS Wales Shared Services
Partnership is leading on the creation of best-practice guidelines and
standardised models, including a drive to increase the use of modern methods
of construction (MMC).
Projects completed under the current framework include the All-Wales
Medical Genomics Services, a £15.3m state-of-the-art genomics facility in
Cardiff delivered by Tilbury Douglas; Kier’s Phase 1 work on the Aneurin
Bevan Health and Wellbeing Centre, a £19m primary care facility in Tredegar;
and the Maelfa Health and Wellbeing Centre, a £14m facility in Cardiff, built
by Willmott Dixon, which brings a range of health and social services together
under one roof. n
HEALTHCARE-PROPERTY.COM MAY-JUNE 2024 | 15

Finance and Property
Civitas deploys £113m into social
infrastructure
Demand for specialist
healthcare property continues
to increase, with Civitas
Investment Management,
the UK’s largest provider of
community facilities, investing
£113m worth of equity in the
second half of 2023.
With £3.5bn of assets under
advisory, the company has
announced that, following £73m
of acquisitions in December, it
deployed £113m of equity in the
second half of 2023, acquiring or
forward funding 22 UK specialist
healthcare assets across 14
transactions.
Representing a continuation on
the first half of 2023, the activity
furthered Civitas’ commitment
to the high growth and specialist
sector with strong social impact
credentials and which offers
secure, long-income real estate
or infrastructure characteristics.
The proceeds from the
disposals will enable a mix
of capital recycling into new
development, business growth,
and reduction of indebtedness.
The rental income is 100%
government backed and benefits
from annual indexation.
The investments included:
• Specialist supported multioccupancy
properties leased
to a mix of existing and new
operators. Acquired in separate
In a bid to optimise its investments in the
UK, real estate company, Aedifica, has
gained real estate investment trust (REIT)
status.
The company has transferred its real estate
activities in the UK, Jersey, and the Isle of
Man to the recently-incorporated AED UK
Holdings Ltd.
This wholly-owned, non-listed entity now
holds the shares of all UK subsidiaries within
the Aedifica group, which has acquired and
developed a portfolio of over 110 healthcare
properties in the UK, Channel Islands, and
the Isle of Man with a total value of more
than £900m and generating £58m in annual
Hill House, one of the properties acquired by Civitas
transactions on behalf of
Civitas’ Forward Funding
Supported Housing strategy,
the assets are located in
Coventry, Margate, Newark,
Worthing, Dunstable, and
Nottingham. The purposebuilt
properties were all
constructed since 2020 with
a minimum EPC B rating, and
provide around 100 adults with
significant physical and mental
health conditions with safe,
lifelong accommodation
• Supported living properties,
acquired on behalf of Civitas’
Social Healthcare Properties
strategy from a mix of existing
and new operators, two of
which are located in Leicester,
as well as Stoke-on-Trent,
Arlesey, and Colchester. The
properties have been specially
adapted for use as supported
living homes for adults with
specific care needs
• Special Educational Needs
(SEN) schools, acquired via
sale and leaseback, providing
special education support for
children between the ages of
five and 18
• Neuro rehab homes located in
Northampton. These highlyspecialised
properties provide
accommodation for adults with
diseases, injury, or disorders
of the nervous system, where
they can undertake doctorsupervised
programmes
• A learning disability care
home in Wales provides
accommodation for 15 adults
over two storeys, spread across
three wings with an EPC rating
B. Each resident benefits from
ensuite facilities and access
to external gardens. There is
also staff accommodation and
dedicated medicine rooms
onsite
Civitas currently manages a
contractual rent.
Under the REIT legislation, which was
introduced in 2007, companies are exempt
from UK corporation tax on UK property
investment income and gains on UK property.
£3.5bn portfolio of over 1,285
specialist healthcare and
education assets in the UK and
Sweden, with the capacity to
provide community-based living
and specialist education to over
9,360 individuals.
Andrew Dawber, group director,
said: “Against a backdrop of
generally-volatile markets and
low transaction volumes across
most real estate classes, Civitas
has continued to drive forward
its investment programmes on
behalf of institutional clients, in
an asset class that demonstrates
strong social and environmental
credentials, and which benefits
from indexation and visible longterm
income.
“Working closely with specialist
local developers and with local
authority commissioners, we
seek to deliver designated
properties that meet specific
identified needs within each local
authority area.
“And our pipeline of projects
remains strong in 2024 and this
reflects the evidence on the
ground of increasing need for
high-quality, community-based
facilities with an emphasis
on working closely with local
commissioning services and
with leading care providers,
housing managers, and specialist
developers.”
Optimising UK investment through REIT status
Ashfield Road in Sleaford let to
Torwood Care Home in November
Chartwell Manor in Aylesbury, let to MMCG
However, REITs must distribute 90% of
underlying tax-exempt property income (not
gains) to shareholders within 12 months.
These distributions are subject to a 20%
withholding tax.
16 | MAY-JUNE 2024 HEALTHCARE-PROPERTY.COM

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creating outstanding spaces through
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Precious photos and beloved memories,
forever encapsulated on personalised
furnishings transforming personal rooms
into sanctuaries of comfort.
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Refurbishing residential care environments
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Finance and Property Deals
Sale addresses
operational pressures
Craigard Care Group — a
portfolio of three established
care homes in Aberdeen City,
Aberdeenshire, and Moray
— has been sold by Christie
& Co on behalf of the joint
administrators, Graham Smith
and Tom MacLennan of FRP
Advisory.
Founded in 1996, the three
homes — Wakefield House
Care Home in Buckie, Weston
View Care Home in Keith, and
Riverside Nursing Home in
Aberdeen — comprise 111 private
rooms with ensuite facilities
across two modern homes and
a period villa with purpose-built
extensions.
They provided a complete
range of care services including
the provision of specialist
nursing, dementia, respite, and
palliative care.
Following a confidential
sales process with Martin Daw
from Christie & Co, Weston
View Care Home in Keith and
Wakefield House Care Home
in Cullen have been sold to
Parklands Care, which operates
10 care homes across Moray
and the Highlands.
And Riverside Care Home
in Aberdeen has been sold
to Renaissance Care, which
operates a further 16 care
homes across Scotland, four of
Wakefield House
Weston View
which are in Aberdeen.
At Wakefield House, Parklands
plans to widen the pathway and
entrance to the home to improve
access for people with reduced
mobility, create a new sunroom
extension to deliver a larger
communal space, upgrade
laundry facilities, create a new
hairdressing salon, and improve
staff changing facilities.
At Weston View, there are
plans to introduce a new café,
doubling as an event space;
create a more-welcoming
entrance area; expand the
home’s four day rooms; and add
balconies on the first floor to
provide residents with access to
outdoor space.
At Riverside, Renaissance
Care has already undertaken
a number of improvements,
including upgrading the electrics
to ensure safety, and initiating
a redecoration programme to
modernise the interior aesthetics
of the home.
And it is working closely with
architects to develop layout
plans that will maximise the use
of space and create additional
day rooms and communal areas,
adding extra shower rooms and
increasing storage throughout.
Ron Taylor, managing director
at Parklands, said: “Since March
we have been working with the
administrators to secure the
long-term future of these homes
and I am delighted they have
now been incorporated into the
Parklands group.”
Commenting on the current
demand for high-quality care
homes, Daw, senior director
at Christie & Co, said: “Having
worked for many years
with the vendor prior to the
administration process, it was
evident that the group was
one of the many that has, and
will, succumb to the ongoing
operational pressures that the
social care sector is facing.
“Despite high occupancy,
the challenges of recruiting
staff meant the business was
crippled under the weight of
agency costs and, with utility
and food costs also increasing,
the business could not survive.
“Working closely with FRP,
we approached the situation
differently from traditional
administration disposals and
agreed management contracts
and exchanged contracts so
that on the day of administration
the new providers were able
to attend the homes and begin
operating immediately while
awaiting re-registration with the
Care Inspectorate.”
The homes were sold for an
undisclosed price.
Nursing home attracts widespread interest
Sidmouth Residential Nursing Home in
Devon has been sold to a local operator
for an undisclosed sum.
Owned by Sam Bevan for over 20 years,
the property, which occupies a corner site
in a predominantly-residential area on the
outskirts of Sidmouth, has been significantly
modified and improved over the years and
now provides accommodation for up to 29
residents.
After Bevan’s decision to retire overseas a
few years ago, the home was taken over by
Julie Casely, who recently put it up for sale.
Following a confidential process with
Sidmouth Residential Nursing Home
Simon Harvey from Christie & Co, it has
now been purchased by an existing care
home operator in Devon which identified
it as an opportunity to add to its other care
business in Devon — Palm Court in Dawlish
— which was acquired through Christie &
Co in 2016.
Harvey said: “This home attracted a
lot of interest, with multiple bids being
received; its location, reputation, and asset
quality combined to make it an attractive
proposition.
“Homes of this nature are still well
sought after and this sale, along with the
completions earlier this year of Bymead
House in Charmouth and The Old Vicarage
in Otterton, really demonstrates the appetite
that exists for this style of care home in
these popular South West locations.”
18 | MAY-JUNE 2024 HEALTHCARE-PROPERTY.COM

Land deal drives forward
hospital project
Finance and Property Deals
Specialist health law firm, Hill Dickinson,
and chartered surveyors, Sanderson
Weatherall, have advised Mid Cheshire
Hospitals NHS Foundation Trust on
a deal to purchase land immediately
adjacent to the Leighton Hospital near
Crewe in Cheshire.
The purchase of four parcels of land
surrounding Leighton Hospital — one of
three acute healthcare sites managed by
the trust — marks a significant milestone
in its plans for the development of a new
Leighton Hospital campus as part of the
Government’s New Hospitals Programme
(NHP).
The campus will be developed in line with
the Government’s standardised ‘Hospital
2.0’ model, providing a world-class health
and care campus that aims to address
health inequalities and transform health
outcomes in the local population.
It is expected to be completed by 2030.
Rebecca Wakefield, senior associate in
Hill Dickinson’s health real estate team,
led on the provision of advice to the trust
throughout the process, from assessing
potential options for acquiring the land and
assisting with the full business case to the
NHP, to undertaking the conveyancing of
the land to the trust.
She was supported by the wider health
real estate team, including partner, James
Atkins, and senior associate, Rachel Jones.
Commenting on the deal, Wakefield said:
“We are delighted to have supported Mid
Cheshire Hospitals NHS Foundation Trust
through negotiation of the land purchase
and to have secured this land for it to move
forward with its exciting NHP plans.
“We worked closely with the trust’s
internal project team and its surveyor, John
Goodchild of Sanderson Weatherall, taking
a collaborative approach to advising the
trust on the terms of the deal and guiding it
to completion of the acquisition.”
Goodchild added: “The importance of this
Shawbrook funding reflects
‘resilient and flexible’ market
Shawbrook’s development finance
business has provided more than £2bn
in funding for property developers in the
UK, including financing a number of care
home schemes.
The specialist team has been able
to support a wide range of significant
and often-complex projects through its
structured funding solutions. These include
the facilitation of a five-year funding
arrangement for the construction of three
state-of-the-art 66-bed care homes.
Its core development finance loans are
further bolstered by complementary finance
solutions that suit developers’ often urgent
and complicated needs. This includes the
imminent launch of its Planning Assistance
Loan, a short-term loan to help developers
improve the planning they already have for
a site, which can then switch to a tailored
development finance loan to construct the
project.
Terry Woodley, managing director for
development finance at Shawbrook, said:
“Despite facing significant hurdles in recent
years, more than a third of developers in
the UK (34%) have been able to expand
their business in the last 12 months,
demonstrating that the sector has remained
resilient and flexible in the face of a volatile
market.
“We’re proud to be at the forefront
of lenders who are willing to support
established developers across the country,
land purchase cannot be understated as
it has propelled the trust into the vanguard
of new hospitals to delivered under the
NHS’s New Hospitals Programme and
Hospital 2.0.
“The new hospital will be complemented
by a network of new roads and the delivery
of more than 1,600 new homes in adjacent
development plots.
“This really opens up the prospect to
see transformational change in this part
of Crewe, with the benefits of significant
public and private sector investment likely
to be felt across Cheshire.”
providing not just the knowledgeable service
they deserve, but also the flexibility and
certainty they need from their funder.”
Matt Lowe, chief executive of LNT Care
Developments, which has built over 200
new homes, with 20 schemes currently in
progress, added: “The team at Shawbrook
was able to offer a bespoke facility to enable
us to drive forward our commitment to
building the country’s leading care home
portfolio.
“It was important for us that they provided
a facility which not only enabled the
construction of three new homes, but
also supported the operational side of the
business once construction of the care
home is complete.”
HEALTHCARE-PROPERTY.COM MAY-JUNE 2024 | 19

Finance and Property Deals
Negotiating lease heads of
terms in primary care settings
Jennifer Lewis of Mills & Reeve reveals the
importance of a carefully-crafted lease agreement
for primary care facilities
For those renting in the primary
care setting, having a robust lease is
important.
But having a sector-specific lease could be
crucial for two reasons.
Firstly, it ensures there is certainty over
the terms agreed. And, secondly, it ensures
the terms take account of the unique
circumstances and rules for primary care
contractors, whether under their core
contracts, the Premises Costs Directions, or
otherwise.
WHAT DO WE MEAN BY LEASE
HEADS OF TERMS?
Lease heads of terms are a standard way
to capture agreement on key commercial
terms before getting into the detail of a full
draft lease.
While heads of terms are not binding,
and steps should be taken to ensure that
they are flagged as being non-binding; it
can be difficult to make a case to change key
commercial terms once agreed.
In addition, some terms included in
heads of terms can seem innocuous, but
they can have a big impact if not considered
carefully.
In this article, we identify five key areas
to consider when negotiating lease heads of
terms for primary care premises.
1. DEFINING YOUR PROPERTY
A lease can be for the whole, or part, of the
property and may include the structure or
be internal only, so you need to be clear
what is, and is not, included to know:
• What your costs will be
• What areas you can access and use
• What you should expect the landlord to
be responsible for
2. BE CLEAR ON THE TERMS
Exclusion of security of tenure under the
Landlord and Tenant Act 1954 means you
do not automatically have the right to a new
lease at the end of the term.
This might be acceptable in some
circumstances, but you shouldn’t agree this
without taking advice.
3. THE LEVEL OF FLEXIBILITY
Alienation clauses determine how flexible
the lease is in terms of transfer, underletting,
and sharing.
In particular, most GP practices will share
with other service providers, and it is key to
ensure this is permitted.
4. REPAIRS, MAINTENANCE,
AND SERVICE CHARGES
Ensure it is clear who is responsible for what
when it comes to repairs and maintenance,
what (if any) services will be provided by or
on behalf of the landlord, and the extent to
which those costs are recoverable from you
as a tenant.
This point is particularly important
when we consider that the costs of repairs/
services are not reimbursed under the
Premises Cost Directions.
As part of this you should consider what
the current state of the property is.
And, before agreeing heads of terms,
you should inspect the property and it
may be appropriate to carry out surveys or
request more-detailed information from the
landlord.
You must not assume that because the
property is in poor repair that you only have
to maintain it to the same standard and/or
that the landlord is under an obligation to
address items of disrepair.
That is all down to the terms you agree.
Only by knowing the current state
of the property can you negotiate
terms, particularly around repairs and
maintenance, that are fair and financially
viable.
5. SECURING NHS
INTEGRATED CARE BOARD
APPROVAL
Integrated Care Board (ICB) consent is
required for new leases, including renewals
or new leases of existing premises.
Failure to obtain this could impact your
reimbursement and leave you in a situation
where the level of rent payable under the
lease does not align to your level of rent
reimbursement.
While this isn’t an exhaustive list, hopefully
it gives an idea of the core elements that
need to be discussed when agreeing a lease.
It is important that you seek advice at
an early stage to avoid revisiting these key
commercial terms later in the transaction. n
20 | MAY-JUNE 2024 HEALTHCARE-PROPERTY.COM

Building Design
To reflect wider society, The Hogeweyk has a series of streets,
courtyards, alleyways, and squares, including the Theatre Square
“We are not our illness” —
a fresh approach to
dementia-friendly design
Editor, Jo Makosinski, speaks to Jannette Spiering, the brains behind The Hogeweyk, a
game-changing development which is helping to redefine the way dementia care facilities
are designed worldwide
According to the World Health Organization (WHO) there are
currently more than 55 million people living with dementia worldwide
— costing $1.3trillion a year.
And, with a recent Global Burden of Disease study predicting that, by 2050,
153 million people will be impacted, there is no time to waste in tackling the
issue and providing support for those affected.
And this will mean a step change in the way we
deliver care homes.
Leading this charge is the team behind The
Hogeweyk, a pioneering purpose-built dementia village
in the Netherlands, which is helping to change the
perception of care facilities worldwide.
Developed by Vivium Care Group and designed by
BuroKade, the facility opened in 2009 as the world’sfirst
dedicated dementia village.
The development reflects normal life, with
residents able to enjoy pastimes such as gardening
Architects and care
providers do things with
the right intentions, but we
are talking about making a
real difference
22 | MAY-JUNE 2024 HEALTHCARE-PROPERTY.COM

Building Design
Residents, staff, and visitors can sit by the fountain in one of the squares
Streets are designed to reflect wider
society and aid with wayfinding
THE POWER OF DESIGN
Focusing on the power of architecture to
evoke strong memories, The Hogeweyk
provides a comfortable, safe, and even
healing environment for those suffering
from the memory loss, personality
changes, and impaired reasoning often
associated with advanced dementia and/or
Alzheimer’s Disease.
Located on a 3.7-acre site just south east
of Amsterdam, it has 27 houses with six
or seven residents in each property — 188
people in all — supported day and night by
professional care and support staff.
To reflect wider society, there are also
streets, courtyards, alleyways, and squares,
as well as facilities such as a restaurant,
café, supermarket, theatre, office, and club
rooms.
And all these facilities are fully
functional, not ‘mock’ shopfronts as seen in
some traditional care homes.
Inside the houses, residents share a living
room and have their own kitchen, private
bedroom, bathroom, storage area, and
laundry room, as well as access to private
outside space.
This means they are encouraged to
continue with everyday activities, rather
than have their meals provided for them at
a schedule which may not fit in with their
previous daily routine.
MAKING A DIFFERENCE
Speaking to Healthcare Property, Jannette
Spiering, co-founder of the vision ‘normal
life for people with dementia’ and the
brains behind The Hogeweyk, said: “Our
initial aim was to create a new design for
people living with dementia.
“Architects and care providers do things
with the right intentions, but we are talking
about making a real difference.
“We wanted to do something very
different to the traditional care home
approach because our vision, besides care, is
A fully-functioning supermarket enables residents to go shopping
about life and wellbeing.
“More-traditional nursing home
models focus on treating patients, treating
dementia, and creating safe and secure
environments.
“In our opinion if you want to support
someone with severe dementia, of course
you have to look at medical system, but also
how someone wants to live and how we can
support that and create as close to a home
life environment and a social environment
as possible, where people can thrive using
the abilities they still have.
“After all, people living with dementia are
still human beings with the same needs and
they want to enjoy their lives and socialise
with people from outside and have a daily
life.
“We need a more-holistic view,
particularly of the built environment,
making it as recognisable as possible so
people can live the life they lived before
they had dementia.
“We are not our illness!”
A CULTURE CHANGE
And it is an approach which Spiering says is
finally gaining traction around the globe.
She said: “We support care organisations,
architects, and governments in making
change and we have identified around 50
projects all around the world where they
represent the care model that we have to
some degree.
“We are not saying ‘copy us’, but the
principles are transferable to different
countries and their specific financial and
health systems.
“We see The Hogeweyk as the first step
away from the traditional dementia care
facility.”
But, in order to effectively create similar
environments, there needs to be a culture
change.
Spiering said: “Architects can’t do wrong.
It is those who commission care facilities
who have the responsibility to think about
what their vision is, what outputs they need,
and to be very specific about what they
HEALTHCARE-PROPERTY.COM MAY-JUNE 2024 | 23

Building Design
Residents can take part in activities, such as the baking club
Homes are traditionally designed,
with familiar furniture and fixtures
Inside the houses, residents share a living room and have their own kitchen, private bedroom, bathroom, storage
area, and laundry room, as well as access to private outside space, enabling them to continue with everyday activities
want in terms of an environment to support
that vision and the possible outcomes.
“Architects are professionals and they come
from a world where they assume a nursing
home is a particular thing because they have
built them that way for 30 or 40 years.
“They have not been required to be doing
something different, or to have a different
vision, so you will get the same design, and
it’s not up to the architect to try to change
healthcare.
“They are very important in the pathway,
but it has to come from the care provider
and that requires a culture change.
“You can change the built environment,
but you can’t create a household or
household model without adapting your
organisation to reflect that.”
RISKY BUSINESS
It also requires designers to rethink their
approach to risk.
Spiering said: “Traditional nursing homes
are all about keeping residents safe and
taking all the risks away.
“But it’s not what it’s about.
“For example, falls are a part of life,
whatever your age and if you have dementia
or not.
“Risk is one of things we really have to
rethink and which we must accept as part
of life for the elderly and for people with
dementia.”
At The Hogeweyk, residents are
encouraged to get out an about and to use
the facilities.
Spiering said: “If you were not aware
it was a nursing home, you would not
recognise it as such.
“Interiors are normalised, not fancy in
design, and the outdoor spaces are designed
to enhance wayfinding, with diverse
landscapes.
“Wayfinding, in particular, can be
challenging for people with dementia, and
we use less-obvious methods, such as a
bench or a statue.
“It’s about making things as recognisable
as possible.
“If you achieve this then people living
with severe dementia are less confused,
less stressed, and less anxious, compared
to a clinical ward or care home where
everything is the same and you have long
corridors with the same doors on either side
so you don’t know where to go.
“We can influence all these things with
the built environment.
If we continue to keep people ‘locked up’
they will soon become aggressive, and that’s
nothing to do with dementia
“If we continue to keep people ‘locked up’
they will soon become aggressive, and that’s
nothing to do with dementia.
“We link certain behaviours to the
disease, but these can be influenced by the
environment and the staff.”
THE HOGEWEYK FACTFILE
• The vision started in 1993 and the
development was completed in 2009
• 188 residents
• 27 houses with six or seven residents per
house
• Professional care and support is
available night and day, including
home supporters, individual healthcare
professionals, nurses, practice nurses,
doctors, psychologists, physiotherapists
and social coaches
• The Hogeweyk has streets, courtyards,
alleyways, and squares in the ‘Randstad’
style appropriate to the surroundings
• Facilities include a restaurant, café,
supermarket, theatre, office, various club
rooms, a physiotherapist, and a hair and
beauty salon
• There are four lifestyles: traditional,
urban, formal, and cosmopolitan
• The houses have a living room
(70-100sq m), kitchen, private bedrooms
(17-20sq m), bathrooms, a storage, and
laundry room including a tumble dryer
and washing machine, and a private
outdoor space (terrace/balcony)
• The Hogeweyk is financed by the Longterm
Care Act (Wet Langdurige Zorg,
WLZ) n
For more information visit
bethecareconcept.com/en/hogeweykdementia-village-hogeweyk-netherlands/
24 | MAY-JUNE 2024 HEALTHCARE-PROPERTY.COM

Building Design
Low cost, high impact
In this article we look at how even the smallest design
interventions can help to enhance the lives of those living
with dementia
Another world leader for knowledge
exchange and research impact
dedicated to improving the lives of
people with dementia is Stirling University’s
Dementia Services Development Centre
(DSDC).
Established in 1989, the centre uses
research to inform practice, and practice to
inform research, providing comprehensive
resources for anyone supporting someone
living with dementia, both personally and
professionally.
And it has led the way in creating tools
and guidance for health and care providers,
working with medical architects, care home
operators, and health organisations to make
all environments inclusive and supportive
of people with dementia.
Speaking to Healthcare Property, Lynsey
Hutchinson, the DSDC’s senior interior
designer, said: “There is a need to better
understand the realities of the disease
and to create environments that are truly
supportive.
“Dementia is not a normal condition
of ageing, but ageing is a key risk factor in
To create truly dementia-inclusive
environments, we need to involve people with
lived experience and care professionals in the
design phase, not just the care operator, the
developer, or the architect
developing dementia.
“Older people may have sight and hearing
problems, mobility issues, and breathing
difficulties, and we need to consider all of
these when designing buildings.”
She added: “To create truly dementiainclusive
environments, we need to involve
people with lived experience and care
professionals in the design phase, not just
the care operator, the developer, or the
architect.”
Here, she shares some of the key design
interventions which help to create optimal
environments for people with dementia.
LAYOUT AND SPACE
Hutchinson is calling for the creation of
more single-story care environments.
“A lot of care operators are building
dementia wings, which tend to be on the
upper floors of multi-storey buildings,
but it should be about making the whole
interior of the building dementia inclusive,
rather than just a specific area,” she adds.
“We want to see designs which mean that
people can stay in a familiar environment,
rather than be moved as the disease
progresses, so all areas should be designed
HEALTHCARE-PROPERTY.COM MAY-JUNE 2024 | 25

Building Design
The EADDAT tool supports the design of more
dementia-inclusive public and private spaces
with dementia principles in mind.
“This doesn’t mean spaces have to look
like they are ‘dementia friendly’. Wellconsidered
design can make spaces more
accessible without looking infantile.”
Double-loaded corridors should also be
avoided.
“Often in these long corridors bedroom
doors face each other,” said Hutchinson.
“It’s very difficult to change this in
existing buildings, but in new builds we
would suggest staggering doors so when
someone comes out of their room into
a long corridor space there is a point of
hesitation and they have time to adjust and
decide where to go.
“In double-loaded corridors a person
might come out of their room and go
straight forward into someone else’s room,
which probably looks very similar, and this
can cause confusion and anxiety.”
CREATING PURPOSE
Another modern design trend is to
‘futureproof ’ buildings by creating multipurpose
spaces.
But Hutchinson warns: “Multifunctional
spaces are a real issue in many
new builds.
“It’s about creating spaces which can be
used as a dining area one minute and maybe
an arts and crafts space the next, but this can
be very confusing for people with dementia.
“It is hard to remove all associated
furniture and fixtures and this creates
clutter and makes it hard for someone
with dementia to properly understand the
function of a room.
“A dining room, for example, should be
very easily identified, with glazing showing
someone what the purpose of the room is
before they have entered it.
“Good dementia design is about creating
smaller spaces with specific and clear
functions.”
We want to see designs which mean that
people can stay in a familiar environment,
rather than be moved as the disease progresses,
so all areas should be designed with dementia
principles in mind
26 | MAY-JUNE 2024 HEALTHCARE-PROPERTY.COM

Building Design
In particular, the typical care home
lounge layout where chairs are positioned in
a circle against the walls should be avoided.
“Sitting everyone around the perimeter of
the room with the TV, which is blaring and
often unwatched, as the focal point is not
good design,” said Hutchinson.
“It is better to provide a choice of spaces
and zones, both social and quieter areas.”
OUTDOOR SPACE
Research has shown that access to outdoor
space is crucial to the wellbeing of people
with dementia.
However, with many dementia care wings
on upper floors, the opportunity for access
to nature is often lost.
Hutchinson said: “Residents and staff
might be reluctant to go outside as it takes a
degree of planning and more staff time.
“Roof terraces are often provided, but
this is not the same as being on the ground.
“Having single-storey buildings means
that people with dementia are able to access
outdoor areas and research tells us this is
absolutely vital.
“It’s about creating environments that
encourage people to take part in aspects of
daily life.
“This might involve a small amount of
positive risk taking, but every day we are all
making decisions about risk and it can help
people living with dementia to maintain
their self identity, particularly for somebody
who has always worked outside.”
LET THERE BE LIGHT
Also key is creating spaces which reduce
confusion and anxiety.
“We often find in hospitals and care
homes there are confusing layouts and poor
wayfinding and signage,” Hutchinson said.
“These big buildings have lots of long
corridors with low light and no rest points.
“Lighting is absolutely critical as the
ageing eye needs three times as much light
and it takes the ageing eye a lot longer
to adjust to changes in light levels when
moving from a brighter communal living
area to a low-lit corridor, for example.
“Research has shown that it is on these
thresholds and within corridors that many
slips, trips, and falls occur and often this is
because of poor lighting.
“Consistency of lighting is therefore
key when designing for people living with
dementia, and for older people in general.”
COLOUR AND CONTRAST
“Tonal contrast is something we will always
advocate for,” said Hutchinson.
“It makes it easier to see an object or
plane against a background and to navigate
around a building.
“Designers should consider the contrast
between the walls and the floor, the
floor and the furniture, and things like
ironmongery and doors.
“Ensuring these can be more easily
seen improves safety and helps people to
maintain their independence.
“The only place we do not want to see
high colour contrast is on flooring, where
ideally surfaces should be continuous or
they can be perceived as a level change or
an obstacle. This will make people hesitate,
refuse to continue, and can cause high
stepping, all of which can lead to falls and
increased anxiety.”
HEALTHCARE-PROPERTY.COM MAY-JUNE 2024 | 27

Building Design
Toilet seats, for example, cause
considerable issues for people with dementia.
A white toilet seat against a white bowl
and a white wall cannot be seen and this has
been found to lead to incontinence issues
among older people and in particular those
with dementia.
“Sometimes we are misdiagnosing people
as having incontinence when it is just
because they cannot see where to sit,” said
Hutchinson.
“A colour-contrasting toilet seat, toilet
roll holder, and flush are easy and low cost,
but could make a massive difference to
somebody’s life.”
In terms of colour, while there is little
research on the impact of colour of people
with dementia, it is reported that the blue
to violet end of the spectrum is lost first, so
more-saturated blues and purples are often
recommended.
CLUTTER
Another bugbear for the researchers is clutter.
Hutchinson said: “In many care settings
there is overstimulation from nick nacks
and confusing message boards and clutter
— lots of information that people living
with dementia do not need.
“We need to pare this back. Maybe
certificates and staff notices can be put
in staff-only areas. After all, designers
often create these lovely areas for memory
boards and things which will help people
with dementia and they end up being
repurposed.
“And we need to minimise patterns
and visual stimulus by focusing on smaller
items like scatter cushions and artwork or
providing reversible duvets so people can
choose to have something patterned or plain.
“Small interventions often have the
biggest impact on people with dementia.”
INTERIORS
With care homes, in particular, operators
are primarily targeting families of older
people who will often be choosing, or
paying for, their relatives’ care in later life.
But this has resulted in a tendency
to create interiors designed to mimic
upmarket hotels.
And Hutchinson warns: “We need to
think less about attracting the family and
more about creating environments that are
more homely for people living with dementia.
“We need to go back to interiors which
are more domestic and familiar.”
HELP AT HAND
To offer further best-practice guidance,
the DSDC has launched created The
Environments for Ageing and Dementia
Design Assessment Tool (EADDAT),
which supports families, businesses, and
professionals to make homes, premises, and
public places more accessible to an ageing
population and those living with dementia.
It replaces the centre’s earlier Dementia
Design Audit Tool, which was first
developed in 2008 and has influenced
the design of dementia care buildings
worldwide.
Following successful trials by Transport
for London and Kirklees Council,
EADDAT is now available to those seeking
to make their buildings more accessible.
Lesley Palmer, chief architect at the
DSDC, said: “Two thirds of people with
dementia in the UK live at home in their
community and it is a requirement that
supermarkets, pharmacies, and other public
places make reasonable adjustments to
enable everyone to use their facilities.
“This ground-breaking new tool is
designed to be more accessible and covers
an array of building types. Whether you
are a person living with dementia, a small
business owner, or commissioning a new
care home, there is a version of EADDAT
available to support you.”
The tool provides practical solutions and
guidance on how the design, layout, and
The DSDC is based in the Iris Murdoch Building at the University of Stirling
furnishing of buildings and environments
can make it easier for older people and
people living with dementia to use places
and spaces.
And it is made up of three tiers, with each
reflecting the scale of intervention required.
Each supplies a complete user guide,
assessment checklist, case studies, and bestpractice
examples. There is also the option
to receive an official audit and accreditation
from the DSDC.
Kirklees Council was the first local
authority to adopt the guidance, using it to
develop its own dementia design guide.
Councillor Musarrat Khan, cabinet
member for health and social care at the
council, said: “I have seen first-hand how
DSDC’s design work can very positively
impact on the experience of people living in
a care home environment that is built using
their design research.
“But, of course, most people live in their
own homes in local communities.
“It is really important, therefore, that we
apply the same attention to design to public
spaces and buildings and to enable people
to make simple changes to their own homes
that will enable them to continue to live
well.” n
28 | MAY-JUNE 2024 HEALTHCARE-PROPERTY.COM

Building Design
Coming together!
Exploring plans for a new Health Innovation Hub in Glasgow, which will forge partnerships between
academia, industry, clinicians, and the community in order to better tackle healthcare challenges
Academia and specialist commercial
leaders are coming together as work
gets underway on a flagship new
Health Innovation Hub in Glasgow, due for
completion in autumn 2025.
Kadans Science Partner has recently
started construction work on the precision
medicine facility in Govan, in partnership
with the University of Glasgow, and
supported by Scottish Enterprise.
It follows recent research from Savills
which revealed a huge amount of
investment in the life science sector, with
£5.6bn of venture capital being ploughed
into life science-related companies
headquartered in the UK — a 120%
increase between 2020-2021 and 500%
since 2017.
Key cities across the UK, and the rest of
the world, are seeing emerging clusters of
activity, and it is hoped that such a focus
on life sciences in Glasgow will bring huge
rewards for wider prosperity and education.
With research links to the Queen
Elizabeth University Hospital, the new
Health Innovation Hub, designed by
Hawkins\Brown, will set the stage for a
thriving life sciences cluster in the area.
It will offer laboratory and office
accommodation, attract new and innovative
businesses to the area, and deliver local
benefits to the wider community.
The flexible nature of the design also
means tenants can grow and evolve within
the building over time, making the Health
Innovation Hub their long-term home.
The project is targeting a BREEAM
‘Excellent’ sustainability rating.
Speaking to Healthcare Property, James
Dawson, development manager at Kadans
Science Partner, said: “Developments of
this kind are increasingly being delivered to
drive collaboration between hospitals and
world-leading universities to better tackle
global healthcare challenges.
“Traditionally located around centres
of excellence; they provide environments
where university spin-out businesses can
grow and innovate with close collaborations
with hospitals offering new advanced
treatments.”
The state-of-the-art building, which is
being built by Morrison Construction,
has been designed to create opportunities
for collaboration between commercial
entrepreneurs, clinicians, and academics.
Dawson said: “Kadans supports the
growth of businesses through flexible design
and commercials along with soft support
such as our ecosystem services.”
Lead architect, Shirley Wong, of
Hawkins\Brown, adds: “The groundfloor
space will include a Digital Health
Validation Laboratory, operated by the
university, which will support the testing
and development of new technologies, such
as contactless stethoscopes.
“This space will enable clinicians to work
with participants to trial new medical
technologies and drive improvements in
clinical interventions and treatments.
“On the upper levels of the building there
are a variety of sizes of workspaces and
laboratories. These have been designed to be
flexible so that companies can tailor them
to their specific needs.
And Dawson said: “Collaboration and
flexibility has remained at the heart of
the design, providing space that fosters
innovation and community among the
clinician and academic occupiers.”
Externally, the building will have a rustred
façade, representing the area’s heavily
industrial past — while windows are spaced
at varying intervals, inspired by the DNA
Helix.
To reduce energy use, there will be 300sq
m of solar panels fitted on the roof and EV
chargers will be available in the carpark. n
Collaboration and flexibility has remained at
the heart of the design, providing space that
fosters innovation and community among the
clinician and academic occupiers
HEALTHCARE-PROPERTY.COM MAY-JUNE 2024 | 29

Construction
Engineering the Golden Years
Image: Christopher Burns, unsplash
Steve McSorely, director at Perega, highlights the pressing need to retrofit and build
more futureproofed care homes, the effect that updated building regulations around
sustainability are having on developers, and gives advice on key considerations during the
design phase of assistant living developments
A
new report from AGE UK, The
State of Health and Care of Older
People in England, highlights that a
joined-up, collaborative approach is needed
when it comes to social care for pensioners.
By 2045 the number of senior citizens is
set to hit 3.1 million in the UK – double
the current population – so the race is on to
provide adequate services to deal with this
massive surge.
Beyond suitable healthcare provision,
accommodation is also an important factor,
offering appropriate dwellings for a morevulnerable
demographic.
And this is a complex issue, far removed
from the construction of traditional homes.
There is so much more to consider when
designing these types of facilities and much
of it goes unseen, especially the important
role structural and civil engineers play in
the process.
This encompasses not only the integrity
of the building itself, but also the
landscaping around it; aiming to meet
strict standards and regulations, while
delivering safe, secure, and comfortable
‘homes for life’.
With this in mind, I’d like to seize this
opportunity to offer my perspective on
how our work contributes to the ultimate
success of these developments and, as
a result, the overall wellbeing of the
individuals living in them.
With available greenfield land becoming increasingly scarce, maybe
it’s time to shift the focus towards these former commercial and
industrial sites, which present an opportunity for later living developers
looking for plots close to public amenities while also meeting their
sustainability targets
30 | MAY-JUNE 2024 HEALTHCARE-PROPERTY.COM

Construction
SAFETY IN STRUCTURE
In any later living project, understanding
the parameters and constraints of the site at
the start of the project is essential.
You need to take the location’s
topography into account, conducting
a thorough survey and investigation to
identify potential restrictions or limitations
around the area’s existing infrastructure.
This is particularly important in
brownfield locations, where unseen
contaminants can lie beneath the site
surface and cause major problems down
the line if not found and addressed in the
design phase before building starts.
Careful consideration must also be
given to landscaping around the building,
minimising inclines to create a safe and
accessible environment.
This means designing thoroughfares
which offer plenty of room to manoeuvre
for mobility scooters to pass, also making
provisions for installing ramps and stairlifts
at a later stage if not needed from the
outset.
A steep slope can pose a serious hazard
to elderly residents who may have limited
mobility.
When working on Retirement Villages’
award-winning project, Charters Village in
East Grinstead, we were acutely aware of
the audience and the specific criteria which
needed to be considered as manoeuvring
around such terrain can be challenging, and
the risk of accidents therefore increases.
Image: Saad Salim, unsplash
When working on care homes, preserving
the personal dignity of those in care is of
paramount importance, so engineers should
approach care home developments with an
empathetic mindset, prioritising resident
independence wherever possible
CARING FOR THE FUTURE
The healthcare and care system in England
carries a significant environmental
responsibility, accounting for approximately
4-5% of the nation’s carbon footprint.
It’s here we return to brownfield.
With available greenfield land becoming
increasingly scarce, maybe it’s time to shift
the focus towards these former commercial
and industrial sites, which present an
opportunity for later living developers
looking for plots close to public amenities
while also meeting their sustainability
targets.
Just to highlight this potential, the CPRE
reports dormant brownfield sites in the UK
offer space for 1.2 million homes.
However, as above, these sites need to be
approached cautiously.
If it’s categorised as brownfield, there
is a specific set of regulatory restrictions
that have to be considered. For example,
to achieve planning permission, the
land’s quality and composition must
be thoroughly assessed and, where
necessary, reinforced with any identified
contamination removed before
construction can begin.
The overall location needs to be suitable
and appropriate for a more-vulnerable
client group.
UNDERSTAND YOUR
AUDIENCE
When working on care homes, preserving
the personal dignity of those in care is of
paramount importance, so engineers should
approach care home developments with an
empathetic mindset, prioritising resident
independence wherever possible.
This equally applies to independent later
living in many ways, it’s just the emphasis
that is different as with independent or
later living, the residents are just that,
independent, so their needs are different to
those requiring a high degree of care.
The development should, in both cases,
seamlessly integrate with, and become an
integral part of, the broader community.
Achieving this integration becomes
feasible when the development aligns with
the local authority’s long-term planning
strategy.
Civil engineers can also play an active
part here, designing transport links that
neatly connect with existing road and rail
links, facilitating easy access for visiting
friends and family as well as residents’
attendance at medical appointments.
The close proximity to urban areas also
provides residents with the opportunity
for group outings and interactions beyond
their living enviroment.
Civil engineers also come into play when
designing the infrastructure layout, which
includes utility links and connections to the
grid.
They consider factors such as the location
of the development, the local terrain, and
the existing utility infrastructure, while
planning the layout to ensure optimal
efficiency and reliability.
Ultimately, engineers play a crucial role
across the entire development, from the big
picture to the finer details.
With AGE UK advising on an increase
in ‘home first’ developments to alleviate
pressure on the NHS, engineers can provide
design advice and assist with planning,
all while keeping a holistic view of the
audience they are catering to.
Their contributions are the building
blocks that pave the way for better-quality
later living and care facilities. n
HEALTHCARE-PROPERTY.COM MAY-JUNE 2024 | 31

Construction
BI platform turns
market trends into
opportunities
Powerful intelligence tool helps construction professionals
harness actionable data insights to drive business growth
Glenigan, one of the UK’s leading
providers of construction market
intelligence, has launched ‘Analytix’,
a self-serve business intelligence platform
empowering construction professionals
with data-driven insights to optimise
decision-making and strategic planning.
A new platform within Glenigan’s suite
of intelligence solutions, the innovative tool
bridges the gap between data availability
and actionable insights, helping contractors
and suppliers make informed decisions that
drive business growth.
And, for the first time, Glenigan Analytix
addresses the persistent challenges faced by
construction professionals currently making
strategic decisions based on fragmented or
insufficient data.
KNOWLEDGE EXCHANGE
Customer-driven, intuitive, and user
defined, it provides subscribers with prebuilt
analytics and dashboards to gain
valuable knowledge relating to historic
planning applications, main contract
awards, and starts on site.
Crucially, Glenigan Analytix also
empowers construction leaders to gain a
real-time understanding of market trends
throughout all regions and sectors of the
industry.
Key benefits include:
• Access to comprehensive construction
market data: Glenigan Analytix
provides users with access to a
comprehensive database of construction
market data, including planning
applications, contract awards, and project
starts
• Pre-built analytics and dashboards: It
comes with a suite of pre-built analytics
and dashboards that allow users to
quickly and easily visualise and analyse
construction market data
• Self-service platform: Glenigan
Analytix is a self-service platform that
doesn’t require any technical expertise
to use. This makes it an ideal solution
for construction professionals who do
not have the time or resources to learn
complex data analysis tools
• Real-time insights: It provides users
with real-time insights into construction
market trends. This allows users to make
informed decisions about their businesses
and stay ahead of the competition
Commenting on the launch, Russell
Haworth, Glenigan’s chief executive, said:
“Construction has a long-standing data
problem.
“Traditionally, this has meant many sales
and commercial teams have had to rely
on siloed market data to inform business
planning and decisions.
NAVIGATING THE MARKET
“Not only this, but organisations need the
tools to adapt to today’s rapidly-changing
and increasingly-fraught economy.
“Glenigan Analytix is the solution,
providing access to the UK’s mostcomprehensive
and up-to-date sector data,
creating a more-efficient and insightful way
to navigate the market.
“It streamlines workflows, breaks down
data barriers, and speeds up the decisionmaking
process.”
He added: “Glenigan Analytix is set to
undergo rapid development throughout
2024, expanding its capabilities to include
forecasting and future trend identification.
“This enhanced functionality will meet
our clients’ needs and more, empowering
them to make better, more-informed
decisions based on real-time data-driven
insights, helping them stay a step ahead
of the competition in an ever-evolving
market.” n
Glenigan Analytix is the solution, providing
access to the UK’s most-comprehensive and
up-to-date sector data, creating a more-efficient
and insightful way to navigate the market
32 | MAY-JUNE 2024 HEALTHCARE-PROPERTY.COM

Estates and Facilities Management
Ensuring fire safety
competence in hospitals
Following news that there are four fires daily across NHS hospitals, Helen Hewitt, chief
executive of the British Woodworking Federation, speaks to Healthcare Property about the
essential role of fire doors in protecting people and assets
Recent data from NHS Digital has
revealed an alarming 18% increase
in fire incidents, equivalent to nearly
four fires daily across the NHS.
And this surge highlights the pivotal
importance of robust fire safety protocols,
particularly concerning fire doors, thirdparty
certification, and inspection regimes,
which are essential to effectively manage fire
risks in hospital buildings.
Educating building owners and
hospital staff about fire safety is also
paramount. They must be equipped to
recognise potential fire hazards and take
responsibility for reporting issues.
THE ESSENTIAL ROLE OF
FIRE DOORS
“Fire doors play a pivotal role in the event
of a fire, acting as a barrier to prevent the
spread of fire and smoke. Additionally, they
ensure that escape routes, such as corridors,
remain clear — a vital consideration in
a busy hospital setting,” explains Helen
Hewitt, chief executive of the British
Woodworking Federation.
“This gives patients and staff more time
to evacuate safely and provides better access
for firefighting efforts.
“Ensuring that hospital staff are
adequately trained to identify and report
faulty fire doors is therefore imperative for
ensuring patient safety.”
CHOOSING THIRD-PARTY
CERTIFIED DOORS
Third-party certification entails a rigorous
audit by an independent party to validate
that the fire door manufacturer or processor
has conducted appropriate testing and
consistently adheres to set standards.
The ongoing Be Certain, Be Certified
campaign run by the British Woodworking
Federation (BWF) Fire Door Alliance,
highlights the importance of third-party
certification of fire doors in improving fire
safety standards across the UK.
And last year’s campaign found an
increased understanding of the benefits
of third-party certification, with
52% of respondents looking to thirdparty
certification to provide proof of
performance of a fire door.
This marked a seven-point increase from
the 46% recorded in 2022 when surveying
the same audience.
However, despite the increased
understanding of the benefits associated
with third-party certification, many still
rely on alternative methods for fire door
testing which lack crucial traceability and
performance assurance. And this poses
significant risks as these methods often
fall short of the comprehensive assessment
provided by third-party certification.
“While opting for third-party certified
doors offers numerous advantages, their
performance hinges on correct installation
practices alongside vigorous inspection
procedures,” said Hewitt.
FIRE DOOR INSPECTION
REGIMES
“When it comes to fire doors, particularly
for large buildings like hospitals where there
can be hundreds of fire doors, a quality
inspection of fire door installation can be
time-consuming. For this reason, there are
steps and preparations that site inspectors
should undertake to ensure a quality and
safe installation.
“Beyond installation, there needs to
be a robust regime of inspection and
maintenance of the door on an ongoing
basis.”
Regulation 38 is a requirement under the
Building Regulations to provide fire safety
information to the ‘Responsible Person’
to allow them to inspect and manage that
product throughout its lifespan.
For fire doors, this includes care and
maintenance instructions, as well as
traceability back to the original fire door
certificate.
This is crucial so that the original
installation can be inspected against this
certificated specification and ensure that
any components that need to be changed
during its lifespan are compatible.
CHECKING A FIRE DOOR’S
CONDITION
Hewitt advises following these five easy
steps to check that fire doors are fit for
purpose.
• Certification — Is there a label or plug
on top (or occasionally on the side) of
the door to show it is a certificated fire
door? You can use your mobile phone
camera or a mirror to check. If there is,
that’s good news. Otherwise, report it to
whoever is in charge of your building
• Apertures — Altering the door for
glazing apertures and air transfer grilles
will make certification void
• Gaps and seals — Check the gap around
the door frame is constant and around
3mm-4mm and CE-Marked hinges are
firmly fixed with no missing screws.
Ensure seals are fitted at the top and sides
of the door
• Closers — Check that the closer shuts
the door onto the latch from any
position — check from 75mm from the
closed position
• Operation — Ensure the door closes
correctly around all parts of the frame n
For more information visit: http://firedoors.
bwf.org.uk/be-certain-be-certified/
HEALTHCARE-PROPERTY.COM MAY-JUNE 2024 | 33

Estates and Facilities Management
Image: Vilius Kukanauskas from Pixabay
A long-term approach
to estates management
Guidance has been issued to help NHS estates and facilities
managers create and manage long-term infrastructure strategies.
NHS England has published
guidance and templates aimed at
helping Integrated Care Systems
(ICSs) craft five to 10-year plans for the
NHS estate, which currently occupies more
than 29 million sq m.
It states: “Healthcare infrastructure is
critical to the delivery of safe, high-quality
clinical services and is a key enabler for
transformational change and quality
improvement.
“A fit-for-purpose estate means we can
deliver the kind of modern, digitallyenabled
patient care pathways that we
know result in significant improvements for
patients, staff, and anyone involved with the
NHS.”
It adds: “If the NHS is to deliver its
own plan for change, it must invest in the
infrastructure and buildings it needs to
underpin clinical service provision and
demonstrate to government how, and
where, capital investment is required.
PLANNING AHEAD
“The need is therefore clear for each
integrated care system (ICS) to have a
clear and well-planned strategy for its
infrastructure.
“This practical guidance, based on
learning from pilots and best practice across
government, supports ICSs to develop a
10-year strategy.”
To enable this, ICSs are advised to focus
on several key areas, including:
• How the estate, digital, equipment, and
workforce models contribute to delivery
of the overarching system strategy,
related clinical pathways, and national
priorities
A fit-for-purpose estate means we can deliver
the kind of modern, digitally-enabled
patient care pathways that we know result in
significant improvements for patients, staff,
and anyone involved with the NHS
34 | MAY-JUNE 2024 HEALTHCARE-PROPERTY.COM

Estates and Facilities Management
• What estate sits in a system, the
condition of that estate, and how it can
best be used
• What the required additional investment
is in the short and long term
• What the options and plans are for
property or land that is no longer
required, or needs repurposing or
acquiring
• What needs to be done to deliver against
sustainability and net zero ambitions
• How the estate’s cost effectiveness,
productivity, and efficiency can be
increased and long-term running costs
reduced
• What resources are required at the
system level and within partners, and
how the system collaborates with nonhealth
bodies such as the local authority
and voluntary, community, and social
enterprise (VCSE) sector
The proposed 10-year infrastructure
strategies will help to build on the work
instigated by the Government’s response
to Sir Robert Naylor’s independent review
of NHS property and estates, which was
published in 2017.
SERVICE-LEVEL DATA
This response accepted recommendations
that local systems should develop affordable
estates and infrastructure plans and that
those which fail to develop sufficientlystretching
plans should not be granted
access to capital funding.
In 2018/19 NHS England mandated
the completion of sustainability and
transformation partnership (STPs) estate
strategies to inform ‘STP Wave 4 and Wave
4b’ capital funding.
Those strategies included a prioritised
capital pipeline, which now needs to be
reviewed and updated, says the guidance.
It also highlights Dr Claire Fuller’s
stocktake report, Next steps for integrating
primary care, which was published in 2022
and called for a detailed review of the space
available in each system, service by service,
to inform future ICS-level infrastructure
planning.
And it identified the need for a
significant increase in the number of
healthcare practitioners locally and said
space and increased capacity for them to
deliver healthcare would more than likely
be needed.
The new guidance states: “While the
main focus of these strategies is the physical
resource we have at our disposal, ICSs must
Image: ElasticComputeFarm from Pixabay
Image: Alfred Derks from Pixabay
consider their estates workforce.
“The NHS People Plan 2020/21: Action
for us all and NHS Estates and Facilities
Workforce Action Plan focus on how we
need more people, working differently, in
a compassionate and inclusive culture to
deliver patient care.
“Including an estate workforce plan
within the ICS infrastructure strategy
will identify how the ICS will contribute
to these national objectives and ensure it
has the capacity and capability in place
to deliver complex ICS infrastructure
requirements and ambitions.”
HELP AT HAND
And the guidance calls for ICSs to embed
infrastructure and estates leadership within
their governance and risk assurance from an
early stage, prioritise effective partnership
building across and within systems, and
establish a clear capital pipeline as a
baseline.
They will also need to demonstrate
increasing estate productivity and efficiency,
including a plan for reducing long-term
running costs; and establish baseline data
for both demand and supply.
To further support EFM professionals
and ICSs, additional resources are being
made available, including templates, data
packs, case studies, and examples of best
practice.
And the national NHS England Estates
Strategy and Planning team will run regular
webinars over the coming months to
support strategy development. n
HEALTHCARE-PROPERTY.COM MAY-JUNE 2024 | 35

Environmental
Turning up the heat
Heat pumps are becoming the go-to option for healthcare
organisations looking to improve the efficiency of heating systems
and drive a reduction in carbon emissions
All four UK health services have
united to commit to achieving
net-zero carbon emissions by 2045
at the latest.
And, with emissions from the NHS
estate responsible for over 60% of the total
NHS carbon footprint, there are significant
opportunities to improve efficiency and
make savings.
One of the technologies being widely
adopted within the sector is heat pumps.
Unlike traditional gas boilers, heat pumps
do not burn fuel to create heat.
Instead, they use refrigerants to transfer
heat, which is similar to the technology
used in refrigerators.
CHOOSE WISELY
There are two main types of heat pump
most commonly used within the health
sector — ground source and air source.
The air-source heat pump works by
transferring heat between the outdoor
and indoor air; while ground-source heat
pumps, also known as geothermal heat
pumps, are used to transfer heat from the
ground to a building.
Both offer viable solutions for healthcare
estates, but air source heat pumps require
less space and are likely to fit within existing
plant rooms and space more readily.
And, while ground-source options
offer a slightly-more-stable performance
Dr Samira Saravi, hydronics product
manager for Mitsubishi Electric
throughout the year, air source can be
considered for sites where there is less
outdoor space, and they are also typically
easier to install.
ENERGY EFFICIENT
When operating, the refrigerant within the
pump takes in heat from the outside air or
ground and the temperature is then raised
by compressing it.
This hot gas is passed through a heat
exchanger to heat up the water in the
central heating system.
And this process means the pump uses
less energy.
Dr Samira Saravi, hydronics product
36 | MAY-JUNE 2024 HEALTHCARE-PROPERTY.COM

Environmental
manager for Mitsubishi Electric, explains:
“As the NHS looks to decarbonise its estate,
heating becomes an obvious area to start as
it consumes so much energy.
“NHS trusts are actively looking at ways
of removing gas systems, and modern heat
pumps are available right now that can meet
the demand of a large hospital and deliver
hot water up to 90°C.
“Heat pumps contribute to much-lower
whole-life carbon compared to fossil
fuel-based heating system. Also, they
offer consistent heating, which is crucial
for maintaining optimal temperatures in
hospitals.
“For instance, air source heat pumps can
provide 90°C sanitary hot water when the
outdoor temperature is -5°C. In addition,
most need only two water pipe connections
and they have lower maintenance costs. This
helps to make the long-term operational
cost and maintenance financially attractive
for NHS trusts.
NHS trusts are actively looking at ways of
removing gas systems, and modern heat
pumps are available right now that can meet
the demand of a large hospital and deliver hot
water up to 90°C
TEMPERATURE CONTROL
“And heat pumps can not only help in terms
of carbon emission reduction, but also
provide precise temperature control.
“As they are powered by electricity, how
you source and use that electricity can
help adapt operations to save even more
money. That may be thermodynamically
— by charging storage/buffer vessels
with hot water during off-peak and lowdemand
periods; or electronically — with
integration of onsite photovoltaic power
generation.”
Advising trusts on choosing the right
pump for their estate, she adds: “Both have
a place in the hospital sector where they can
be applied most effectively, so a key aspect,
always, is to understand the individual needs
of the site and its operation, including both
current uses and future uses.
“Each system will be different as each
building and hospital is unique.
“We would advise trusts to consider the
feasibility of installing heat pumps based on
the characteristics of their particular hospital
site, taking into account space availability,
requirements, noise considerations, etc.
“The important thing though is to talk
to the manufacturer as early in the planning
process as possible.”
Mitsubishi has worked with a number of
NHS trusts across the country to upgrade and
replace outdated heating systems, including
Devon Partnership NHS Trust (pictured
above), where its team replaced a heating
and cooling system with three modular heat
pumps and two modular chillers.
HEALTHCARE-PROPERTY.COM MAY-JUNE 2024 | 37

Environmental
E.ON Energy installed heat pumps at Queen’s Medical Centre in Nottingham Photo: Harry Mitchell
WORKING WITH INDUSTRY
E.ON Energy has also embarked on a
15-year energy efficiency partnership with
Nottingham’s Queen’s Medical Centre
(QMC), one of the largest NHS hospitals
in the UK.
And the trust’s new energy centre will use
four high-efficiency heat pumps to extract
heat from the air and 64 boreholes up to
250m deep to draw natural warmth from
the earth.
Excess heat can be piped down into these
boreholes and stored or preserved for use at
a later date.
Any leftover heat can be recycled by the
heat pumps, lowering the demand for fossil
fuels and in turn reducing energy costs.
Nottingham University Hospitals
NHS Trust said the project would cut the
hospital’s carbon emissions by 30% a year
initially, which would increase to about
43% after its current gas-fired heating
system is decommissioned.
Anthony May, chief executive of NUH,
said: “This partnership demonstrates our
significant commitment to environmental
sustainability and offers a creative solution
to meeting our energy needs and tackling
climate change, while at the same time
improving patient and staff comfort by
allowing us to better manage temperatures
within our buildings.
“Innovative projects like these will play
a hugely-important role in helping us meet
our ambitious goal of achieving a net zero
carbon operation for heating and cooling
system emissions by 2040.”
We would advise
trusts to consider
the feasibility of
installing heat
pumps based on
the characteristics
of their particular
hospital site,
taking into account
space availability,
requirements, noise
considerations, etc
38 | MAY-JUNE 2024 HEALTHCARE-PROPERTY.COM

Environmental
St. Mary’s Hospital London
MAKING SAVINGS
The critical care unit at St Mary’s Hospital
in London has also installed a ground
source heat pump system to provide heating
and cooling.
As a result, the hospital’s carbon
emissions have dropped by over 40%,
and it expects annual energy savings of
around £1m.
And the University Hospital of South
Manchester has installed air source heat
University Hospital of South Manchester
pumps to provide heating and cooling to
the hospital’s outpatient building, reducing
emissions by over 30%.
Funding for NHS heat pump technology
is primarily coming from the Public Sector
Decarbonisation Scheme (PSDS) or
via Energy Performance Contracts with
manufacturers and suppliers.
Veolia secured £22m from the PSDS to
help decarbonise two acute hospitals for the
University Hospitals Birmingham NHS
Foundation Trust.
Located in Edgbaston, the Queen
Elizabeth Hospital Birmingham will lower
its carbon footprint by 2,086 tonnes per
year through conversion from the use of
steam for heating to a hot water system
backed by the integration of a 1MW multistage
heat pump system. And upgrades
at the Good Hope Hospital in Sutton
Coldfield will see the installation of a
650kW multi-stage heat pump system. n
Veolia is installing heat pumps at the Queen Elizabeth Hospital Birmingham and the Good Hope Hospital in Sutton Coldfield
£16m fund supports decarbonisation efforts
On 17 April, the Public Sector Low
Carbon Skill Fund (LCSF) Phase 5
opened to applications, providing £16m
of grant funding to enable public sector
organisations, including NHS trusts, to
hire expert consultants to help create
heat decarbonisation plans.
Created by the Department of Energy
Security and Net Zero, the fund is delivered
by Salix Finance, with organisations having
just 14 days to submit their application.
And, for the first time, this phase leaves
the old ‘first come first served’ system
behind, introducing a new randomised
assessment protocol.
The available funding will be divided
across three grant value ranges to mitigate
the risk that a small number of high-value
projects exhaust a large proportion of
the available budget, and to ensure the
available funding is distributed across a
range of grant values.
• 34% of the total Phase 5 Low Carbon
Skills Fund funding will be allocated to
applications with a value of £100,000
and below
• 38% of the total funding will be
allocated to applications with a value
between £100,001-£500,000
• 28% of the total will be allocated to
applications with a value between
£500,001-£1m
A spokesman for Salix Finance said:
“One of the greatest challenges today in
meeting the UK’s 2050 net zero target
is decarbonising the way buildings are
heated.
“Most of the buildings in the public sector
still rely on fossil fuel-based heating and
expert skills are required to identify and
plan how these heating systems can be
replaced, ideally at the end of their working
lives.
“Having a robust heat decarbonisation
plan will put organisations in a strong
position to take the next steps in
decarbonising, including by enabling them
to develop detailed project proposals
that will help them to apply for any future
grant funding for capital decarbonisation
measures, or alternative sources of finance.
“This means organisations can think more
strategically and be better prepared for
future decarbonisation opportunities.”
HEALTHCARE-PROPERTY.COM MAY-JUNE 2024 | 39

Environmental
First pop-up solar car park and
EV charging hub launched
A first-of-its-kind solar car
park and EV charging hub has
opened at Raigmore Hospital
in Inverness.
The innovative facility provides
hospital users with access to 12
electric vehicle charging points
boosted by renewable energy.
With a fleet of EVs already
in operation at the hospital,
Papilio3 — developed by
3ti — will support destination
and workplace EV charging,
while addressing the growing
demand for accessible and
convenient charging in an area
where long dwell times are
common.
A spokesman for 3ti said: “The
rapidly-installed unit has helped
Raigmore Hospital quickly boost
its EV charging infrastructure
and will encourage EV adoption
in the area by providing
affordable, low-carbon charging
for everyone, regardless of
access to off-street parking or
geographic location.”
The Papilio3 is built around a
recycled shipping container and
can be installed in under eight
hours.
The spokesman said: “It can
be easily transported and set up
almost anywhere in the world
and, today, Papilio3 is already
in operation at several facilities
across the UK, designed to
solve many of the challenges
facing transport, energy, and
infrastructure sectors.”
Papilio3 is pre-fitted with a
back-office billing system and
a range of technology and user
features.
The watertight canopy
keeps EV drivers dry, while
energy-saving motion sensors
automatically operate the lights
when a customer approaches.
Fully-operational CCTV also
provides additional safety and
security for staff and members
of the public.
Making it particularly suitable
for healthcare operators, the
unit can be rented, therefore
requiring no upfront capital
investment.
And, with a solar capacity of
19.32 kWp, it will generate on
average 18MWh of electricity
annually — which equates to
over 63,000 miles of EV range
— and can fast charge up to 12
EVs simultaneously at seven, 11,
or 22kW.
Brian Johnstone, head
of energy, environment
and sustainability at NHS
Highland, said: “As part of our
commitment to supporting the
delivery of healthcare in the
future, we understand that our
environmental responsibilities
go beyond our own services.
“As an organisation, we are
looking to develop innovative
ways to harness electricity
and utilise renewable energy
onsite, which Papilio3 is a great
example of.
“With the introduction of
Papilio3, NHS Highland is now
in better positioned to support
patients, staff, and visitors with
EVs at Raigmore and we hope
this investment helps convince
others to make the switch over
to zero-emission vehicles.”
Sustainable hand sanitiser refill scheme launched
A new hand sanitiser refill and reuse
scheme has been launched which cuts
plastic waste, supports employment, and
saves money for Scotland’s NHS.
The Institute of Neurological Sciences at
the Queen Elizabeth University Hospital
in Glasgow is the first hospital-based site
to pilot the initiative, developed by NHS
National Services Scotland (NSS) and
Redeem Exchange.
Zero Waste Scotland has supported the
initiative with £38,000 from the Circular
Economy Investment Fund, supported by
the Scottish Government and the European
Regional Development Fund.
NSS partnered with Redeem Exchange, a
Greenock-based social enterprise, and NHS
Greater Glasgow and Clyde to establish and
run an initial pilot in 25 community locations,
including health centres, hospitals, and
social care facilities across the region.
Under the scheme, empty hand sanitiser
bottles are collected from participating
locations and then washed, refilled
with medically-approved hand sanitiser,
and returned back into circulation by the
Redeem Exchange team.
The scheme is continuing in the original
pilot locations and is now up and running at
the Institute of Neurological Sciences (INS).
Sam Atkinson, operational manager at
the INS, said: “Since COP26, INS & Spinal
Injuries have been exploring new ways to
improve our record on sustainability.
“Redeem Exchange is the first pilot we
have launched that aims to reduce plastic
waste, in this instance of empty hand
sanitiser bottles.
“The first collection was successful, with
boxes filled to the brim with
empty hand sanitiser bottles,
all ready to be reused up to 50
times.
“Working closely with the
sustainability team, Redeem
Exchange is one of a number of
projects that INS & Spinal Injuries
seeks to implement over the coming months.”
Trev Gregory, chief executive of Trade
Right International CiC, added: “What
began as a throw-away idea during
the pandemic when there was a global
shortage of plastic bottles for hand sanitiser,
has developed and grown into the Redeem
Exchange.
“Partnering with NHS Scotland we have
been able to shape a venture which is good
for people and for the planet.
“Single-use bottles can be reused multiple
times while also providing meaningful
employment skills and experience to people
living in areas of deprivation.”
40 | MAY-JUNE 2024 HEALTHCARE-PROPERTY.COM

Healthcare Design Awards
The cream of the crop!
The winners of the 2024 Healthcare Design Awards have been announced
A
children’s mental health unit, a
dementia care home, and a primary
care clinic were among the winners
at the 2024 Healthcare Design Awards, held
recently in London.
Previously run by Pinders, the awards,
which were first launched in 1991, have
been taken over by Nexus Media Group,
which also owns the Healthcare Property
website and magazine.
The competition recognises innovation
and excellence in the design of health and
care facilities across the UK.
And this year, there were six winners,
announced by celebrity host, Wayne
Hemmingway, at a ceremony at the
Royal Lancaster Hotel in central London.
They were:
For information on next year’s awards visit www.healthcaredesignawards.co.uk
42 | MAY-JUNE 2024 HEALTHCARE-PROPERTY.COM

Healthcare Design Awards
BEST ACUTE CARE DESIGN
THE CATKIN CENTRE AND SUNFLOWER
CHILDREN’S HOSPITAL, ALDER HEY
CHILDREN’S HOSPITAL
Project team: Cullinan Studio, Alder Hey NHS Foundation Trust, 10Architect, Galliford
Try, Turkington Martin Landscape Architect, Buro Happold, Gleeds, Cundall
The Catkin Centre
and Sunflower House
project for Alder Hey
NHS Foundation
Trust in Liverpool was
designed by Cullinan
Studio and delivered
by 10architect.
Won through a
RIBA competition,
it brings a range of
specialist mental health facilities that were previously scattered
across the hospital site and the city of Liverpool together in two
connected buildings.
© Paul Raftery
The judges praised the ‘well-thought-out floorplan, therapeutic
interiors, and good use of natural materials and natural light’,
adding: “This is a great example of thinking outside the box,
delivering mental health services in an environment which
maximises views to the outdoors.”
BEST ARCHITECTURAL DESIGN
ASHTON MANOR, LANCASTER
Project team: Vestar Architectural and Design, Evermore Care, Teal Furniture,
Stubbs Construction, Ashden, AWP, Active Pathways
Ashton Manor is
built on the site of a
former 20-bed care
facility as is designed
to provide quality
care in a setting
deserving of the
best environmental
standards.
Key features include mature landscaped grounds, rooms with
patio or balcony access, a feature courtyard, and community
facilities such as a tearoom, cinema, sunrooms, and hair salon.
As the first purpose-built care home in the local area since the
1990s, the project team overcame challenges to create a marketleading
environment focusing on resident and staff wellbeing that
sets the standard for the region.
The judges thought a focus on resident comfort, wellbeing, and
choice was evidenced by a range of attractive and interesting
social spaces, with close attention paid to accessibility and
wayfinding, indoors and outside.
BEST EXTERIOR SPACE
LOVEDAY ABBEY ROAD, LONDON
Project team: Loveday & Co, Realm Landscapes, ReardonSmith Architects, Iconic Build
Loveday Abbey Road is
a new care home within
the St John’s Wood
Conservation Area in
London.
The brief for the new
property was for the
building and landscape to
work seamlessly together,
to create a refined and welcoming home-from-home experience
to complement the interior spaces and afford a garden space that
would be an integral part of the care experience.
The judges were impressed with the level of thought that went
into a small space, making use of it in the best way they can and
offering individual spaces for residents.
They also praised the Loveday team for ‘demonstrating a real
passion, commitment, and meticulous attention to detail to
ensuring the sensory garden fully caters to the needs of the people
living with dementia.’
HEALTHCARE-PROPERTY.COM MAY-JUNE 2024 | 43

Healthcare Design Awards
BEST INTERIOR DESIGN
LAKEVIEW GRANGE, CHICHESTER
Project team: Cinnamon Luxury Care, The Cinnamon Care Collection, Edmund Williams
Architects, Catalyst Interiors
This state-of-the art
‘boutique’ care home
boasts 47 spacious
en-suite bedrooms
and four luxury care
suites.
It offers residential
care tailored to each
individual person and
also provides expert
dementia care within
a dedicated community.
The development stood out for its person-centred design, from
attractive privacy screens in bathrooms to intelligent interactive
cues positioned throughout the home, allowing residents to
navigate with ease.
The judges felt the thought behind each design choice was
evident, with practicality combining with style and homeliness.
And staff areas are not seen as a ‘back of house’ after thought, but
promote a sense of pride and belonging.
BEST PRIMARY CARE DESIGN
VICTORIA MEDICAL CENTRE, EASTBOURNE
Project team: Primary Health Properties, Simpson Hilder Associates, Westridge
Construction, Sussex ICS
The Victoria Medical
Centre development
and associated GP
practice mergers
and service changes
have enabled Sussex
ICS’s realisation of the
delivery of primary
care at scale for a
significant proportion of patients in Eastbourne.
The new premises and associated service model wholly align
with the strategic direction for the delivery of primary care and set
a precedent for modern, flexible, integrated care.
This was a standout entry as it brings together multiple services
in a modern, fit-forpurpose,
and very-wellthought-out
building with
a logical floorplan and
interiors which make the
most of natural daylight
and provides a supportive
and less-clinical
environment for patients,
staff, and visitors.
The judges were
particularly impressed by
the range of services offered
and the way the team had
thought about the needs of
all users.
They also liked its ‘simple, elegant design with a no-nonsense
approach to understanding their patients’.
BEST SPECIALIST OR
DEMENTIA CARE DESIGN
ARBOUR WALK, BRISTOL
Project team: Cedar Care Homes, Minal Desai
Arbour Walk’s design
has been carefully
curated to support a
holistic approach to
caring for adults over
the age of 40.
Each bedroom has
its own en-suite fitted
with light sensors and
large feature windows.
Wide corridors throughout the home provide ample ‘break-out’
space and there is a pub, restaurant, community café, and garden
restaurant on site.
The judges were impressed by how thoroughly the environment
supported people with a wide range of care needs from mental
health to nursing and complex dementia.
They were also impressed by the wide variety of environments
that provided a calming and stimulating environment for people
living with dementia.
44 | MAY-JUNE 2024 HEALTHCARE-PROPERTY.COM

People: Interview
A leap of faith
Jo Makosinski speaks to Paul Yeomans, director at Medical
Architecture, about his experience designing healthcare buildings
and how approaches have changed over the past two decades to
create more-supportive facilities
Q. When and how did you first become
involved in the design of healthcare
buildings?
A. I had been working at a well-known
Newcastle practice for six years, delivering
some lovely projects in the museum,
education, and residential sectors. So, when
I got a call from now-retired Chris Shaw, I
was at a little bit of a crossroads.
I’d been headhunted and MAAP (as the
practice was know at the time and later
rebranded to Medical Architecture) was
looking to establish an office in Newcastle
on the back of significant work it had
started delivering for Northumberland,
Tyne and Wear NHS Trust and Laing
O’Rourke under the NHS ProCure21
framework.
Over a pizza, Chris told me all about the
company’s philosophy and opportunities,
saying: “I’m looking for somebody who can
run our new studio. I don’t know how it’ll
go, but the prospects seem good, and the
opportunity is there if you are interested.”
Looking back, it was quite a leap of faith.
The company’s sole focus was the health
sector and I’d never designed any healthcare
buildings before, but Chris and the other
directors were clear that first and foremost
you should be a really-good designer, the
nuances of healthcare design could be
learnt.
Paul Yeomans. Image, Medical Architecture
Cavell Passivhaus Community Health and Wellbeing Hub. Image, Pillar Visuals
46 | MAY-JUNE 2024 HEALTHCARE-PROPERTY.COM

People: Interview
In September 2006 I took that jump and
set to work on my first healthcare project
and building a team to support it.
I’ve never looked back!
Q. In your opinion why is building design
so important in the overall delivery of
healthcare services?
A. So much of our work is incredibly
rewarding, not just in creating good
buildings, but also genuinely-worthwhile
design that enables clinicians to treat
patients, and people to recover better.
I recognised this on my very-first
healthcare project. It was a significant
reconfiguration/extension of a Victorian
mental health inpatient ward to create
a modern, fit-for-purpose psychiatric
inpatient care unit — often the patients
with the most-challenging behaviours.
They arrive at the building at the peak of
crisis, and for the first time in my career I
witnessed that the architecture and building
design was having a measurable impact on
its users, rather than it being subjective and
anecdotal, which is what I had been used to
in other sectors.
Post-occupancy studies with this
building revealed that there had been a
60% reduction in violent incidents and
that prescription drug use had also dropped
significantly.
This had a lasting impact on me.
Although this evidence was related to
mental health design, our continued use
of post-occupancy and benefit realisation
studies in all sectors of healthcare design all
point to the same findings — high-quality
buildings improve the patient experience
and the quality of care provided.
Q. What has changed in terms of design
approaches/interventions since your first
project?
A. Throughout our history we have
challenged the field of healthcare
architecture to focus on improving the
patient experience, supporting recovery
through therapeutic design.
In an acute setting, the human experience
makes a huge difference to wellbeing,
recovery, and the perception of care quality.
Careful consideration of circulation
spaces, wayfinding systems, artwork, lighting,
and interior design can raise a mundane
experience to a dignified and positive event.
I think the one fundamental aspect
that has changed is the scale of healthcare
infrastructure spend and ambition.
We are used to the cycle of government
spending, the peaks and troughs, but in the
last few years our clients are having to do
more with less money and our designs have
to be even more effective.
Dorset Hospital Critical Care Unit. Image: Renderloft
Q. What are the key things you have
learned in your career designing
healthcare facilities?
A. Architectural design is fundamentally
about the way space, structure, and
environmental conditions are modulated,
and the way that a place is used.
The architect needs to deploy and
orchestrate physics, social sciences,
economics, and aesthetics.
I really love that in architecture you can
join the dots in so many interesting and
creative ways.
Specifically in healthcare, we’re in
this brilliant position where you’ve got
architecture at the crossroads of medicine,
two great professions where you’re really
making a difference.
Q. Did COVID change the way we
approach the design of healthcare
facilities?
A. I don’t think there were any fundamental
changes as to how we design, but I think
there was a change of mindset with
healthcare organisations.
More importance was placed on looking
after staff — providing much-better spaces
for rest and wellbeing.
Also, there was clearly a heightened
importance for control of infection and
making sure that flows of patients/staff/
visitors/FM worked well.
Our general approach to planning design
is to ensure spaces are flexible and adapt to a
wide range of situations and use — and the
importance of this came to the fore during
COVID.
Q. How do you think design approaches
will continue to evolve in the future?
A. The legacy of past and current
underinvestment tells us that continuing
with managed decline is an undesirable,
risky, and expensive option.
Despite the poor state of public finances,
good custodianship of our healthcare
infrastructure goes hand in hand with
providing what the public expect: modern
and effective health services in buildings
that are safe, attractive, and a great place to
work.
This needs strong leadership, skill, and
a concerted effort to secure short-term
improvements while nurturing a long-term
positive vision for our healthcare estates.
This dual strategy entails building a
pipeline of rapid, revenue-driven, highimpact
improvements alongside strategic
plans that will underpin a robust and
appealing forward vision.
New NHS facilities will integrate
sustainable design, modern methods of
construction, logistical automation, and
digital technologies to ensure our healthcare
infrastructure is fit for the future. n
Paul is a director of Medical Architecture,
with over 17 years of experience in
healthcare design. In 2022, he was
awarded a Fellowship of the Royal
Society of Arts for his leadership in
healthcare design. He is also an associate
for the Design in Mental Health Network
and member of their Conference
Advisory Group and Design Awards
jury. Through this role, he contributes to
best practice guidance in mental health
facility design to raise standards across
the sector and improve the experience
of patients and staff across the UK and
internationally. Paul is a regular speaker
at conferences and uses this platform
to promote good-quality healthcare
design. His project portfolio has received
awards from the RIBA, Building Better
Healthcare, Design in Mental Health, and
European Healthcare Design.
HEALTHCARE-PROPERTY.COM MAY-JUNE 2024 | 47

People
New director at Carless + Adams
George Morris has become a director,
architect technician, and shareholder
at architectural practice and care home
specialist, Carless + Adams, working
alongside Melissa Magee, company
director and architect.
Growth in the business has demanded
specialist technical skill sets and Morris has
been instrumental in driving the team with
this.
His appointment comes after Neil Rutland,
associate, left the business in January to take
early retirement and Stewart Anderson joined
as associate director.
Morris has been with Carless + Adams
since early 2018 when he joined from
Nottingham Trent University with a BSc
(Hons) in architectural technology.
As part of the management team, he has
been instrumental in developing and driving
the direction of the business, maintaining and
enhancing client relationships, formulating
sales strategies, and instigating and leading
projects.
Commenting on his new role, he said:
“Being part of a business that enables change
and positively impacts people’s lives though
architecture is something I feel privileged to
be part of.
“The UK has an ageing population with
insufficient suitable accommodation available,
so to be able to support the business in
growth though designing homes that enable
people to pro-actively right size and enhance
their lives through their home environment is
something I feel very passionate about.”
NHS Property Services appoints London lead
NHS Property Services
(NHSPS) has recently
promoted Sally Tombs to the
role of managing director for
the London region.
Taking up her new position
from this month, Tombs’s role
will include working with, and supporting,
NHSPS customers in addition to ensuring
that all London-based properties under its
portfolio are safe and compliant.
She joined the health and property
organisation in 2020 as its principal
operations manager, progressing to become
an estates delivery partner.
Prior to joining NHSPS, she held positions
in facilities management and property
services at Telereal Trillium, Cofely UK, and
Metropolitan Thames Valley Housing.
Over the past 20 years, Tombs has acquired
a diverse skill set and vast experience in the
property and facilities sectors, and latterly, the
health sector.
She has also developed many key
relationships with NHSPS’ customers and
stakeholders.
“I am delighted to be taking this next step in
my career. I have thoroughly enjoyed working
at NHSPS for the past four years and I can’t
wait to continue to support our customers,”
ARCHITECTURAL FIRM SECURES GROWTH
HKS, an architectural firm
which specialises in healthcare
design, has appointed Dan
Noble as chief executive and
chairman of the board and
Sam Mudro as president and
chief financial officer.
For 10 years, Noble has served
as president and chief executive,
a joint role traditionally held by
one individual.
During this time he has guided
HKS to a period of growth in staff
and revenue, leading to its recent
ranking as the world’s secondlargest
architecture and design
firm.
Recognising a need to evolve
the firm’s executive leadership
structure, Noble and the board
recently divided the chief
executive and president roles.
This move will enable
HKS to capitalise on market
opportunities and drive an even
higher level of design excellence
and innovation for its global
clients.
As chief executive and
chairman, Noble will lead and
shape HKS’s vision, strategy, and
organisational culture. He will
also lead and advise the Board,
maintaining ultimate decisionmaking
authority for high-level
business changes.
“HKS leadership has long
understood that the best way for
us to leverage our talent is to give
agency to others,” Noble said.
“This transition will give us
latitude within our organisation
to do more and continue to lead
the industry through limitless
thinking.
He added: “Sam is an
incredible sounding board and a
trusted advisor. Together, he and
I will continue to work together,
influencing the future of HKS
she said of the new role.
“To ensure we can enable excellent patient
care, I will continue to work with our London
teams to guarantee that our portfolio remains
compliant, clean, safe, and welcoming for all
patients across the capital who are accessing
necessitated healthcare. I’m excited to get
started.”
Trish Stephenson, NHSPS chief operating
officer, added: “I know Sally will continue to do
amazing work and support our customers, in
addition to our internal teams and colleagues.
“She is a great example of our get, grow,
keep talent culture and I am thrilled to see her
progress in her career with us.”
alongside our colleagues around
the world.”
Mudro ascends to the role of
president and retains his position
of CFO, which he has held since
joining HKS in 2015.
He now oversees
overall business strategy
implementation and is
responsible for operational and
financial performance, reporting
to Noble and the Board.
He said: “The new leadership
structure will help us unlock our
ability to achieve our vision at a
deeper level.
“It will create clarity and focus
around two essential elements of
our business: our strategic vision
and our execution, and we will
be able to innovate and create at
a much-faster speed, ultimately
delivering greater value to our
clients.”
48 | MAY-JUNE 2024 HEALTHCARE-PROPERTY.COM

People
Private equity firm takes
on healthcare advisor
GRE Finance, a specialist
lender to the UK real estate
market, has hired two
associate directors from
Octopus Real Estate and
Hilltop Credit Partners to
capitalise on the surge of
opportunities in the real estate
finance market.
Clare Grimes has joined as an
associate director from leading
UK specialist real estate investor,
Octopus Real Estate, where she
specialised in the origination
and execution of primarily
commercial real estate debt
transactions.
Grimes has gained extensive
knowledge and experience
through working with a range
of clients, including funds, to
deliver financing on a variety of
assets across the UK.
And she is chairman of the
Association of Real Estate
Funds’ Future Generation
Committee, a member of AREF’s
management committee, a
chartered surveyor, and holds a
master’s degree in Real Estate,
Investment and Finance from
Henley Business School.
Clare Grimes
Archie Dickinson
Archie Dickinson, who also
joins as an associate director,
has more than 10 years of
experience in real estate finance.
Specialising in origination,
underwriting, and execution,
past roles have seen him
structuring and executing
both senior and mezzanine
development loans, working
alongside high street lenders,
challenger banks, institutional
funds, and HNWIs.
He began his career at
Proseed Capital, a mezzanine
development finance lender
before moving to specialist
development finance provider,
Hilltop Credit Partners.
During his career he has
underwritten and completed
on over £750m of real estate
finance.
Founded in 2020 by Michael
Mirelman and Daniel Benton,
GRE Finance is a specialist
lender to the UK real estate
market and currently holds a
loan book of £110m against
residential and commercial
property.
Remaining active through the
economic turbulence of 2023,
it agreed several loans over the
course of the year, including a
£6m acquisition loan against a
student building in Portsmouth;
a £4m loan to MACC Care, a
Midlands-based care home
developer to acquire two sites
with planning for new care
homes; a £6m loan to the UK’s
Health estates chair steps down
NHS Property
Services’ (NHSPS)
chairman, Jane
Hamilton, is to step
down following the
end of her threeyear
term.
Having joined the
board in March 2021,
she has decided
that, after 15 years
working in the UK, now is the right time to
return to her native Australia to be with her
family.
She has overseen the successful
transformation of the organisation and with
the end of her original three-year term as
chairman, she now feels this is the right
time to allow someone new to oversee the
next exciting chapter for NHSPS.
“When I reflect on the last three years at
NHSPS, I am filled with real pride in what
we have achieved,” she said.
“We have truly transformed the
organisation, continuing to embed a culture
that puts the customer at the heart of
everything we do.
“A year on from that transformation
programme, we now have an organisation
that is ready and confident of taking the
next exciting step in its journey, with the
brilliant expertise of its people and a newlydeveloped
five-year business strategy.
“I know that I will be leaving behind
a strong team in place with an exciting
future, which I will continue to watch from
afar.”
Ellie Mason, shareholder representative
director on the board for the Department
of Health and Social Care, added: “I would
leading retirement developer,
Lifestory Group; and a £17m
loan for a development finish
and exit facility secured against
residential development of 89
homes in Surrey.
Daniel Benton, director
at GRE Finance, said: “The
opportunities in the UK’s real
estate debt markets today are
vast, and the appointments of
Clare and Archie to kick off this
year put us in prime position to
seize what could be a once-ina-decade
opportunity.
“We remained active through
2023, focusing on strategic asset
management in the first half
of the year before identifying
market opportunities in the latter
half and agreeing more than
£30m in real estate financing.
“Our opportunistic and
value-add approach, depth
of expertise in property
development and management
as well as financing, and
willingness to take on projects
involving planning risk, means
that we are very well placed to
support a range of transactions
taking place in the market.”
like to thank Jane for the last three years
of help and support she has brought to
NHSPS.
“She has shown true passion and
commitment to everything we are trying to
achieve.”
And Martin Steele, chief executive, said:
“Jane has guided the business through
a period of extraordinary change, with a
fundamental pivot to a customer-centric
operating model, a transformational
organisational redesign, and the creation of
a new business strategy.
“Her 30 years of experience in property
and the government sector have also
helped ensure focus on sustaining high
levels of operational performance.”
Hamilton will remain in post until the end
of July 2024 while the recruitment for her
replacement takes place.
50 | MAY-JUNE 2024 HEALTHCARE-PROPERTY.COM