Salus journal

Healthy Planet. Healthy People.

Healthcare / New models of care

European Healthcare Design 2019

Design of place-based health systems – lessons from Scotland

By Susan Grant 19 Aug 2019 0

This talk considers the Scottish Government’s 20:20 Vision for NHS Scotland, which established a strategy for safe, sustainable, place-based, person-centred care close to home.

Download the slides for this video presentation


Implementation required bringing regional health boards and local authorities together to work in community health and care partnerships, to develop services that support populations across urban and rural areas.

Objectives: Central to achieving the strategy is the provision of suitable NHS facilities to support systemic change. Objectives include:

  • a clear line of sight from the policy ‘vision’ to places and services that deliver it;
  • local decision-makers and experts working together to enable change; and
  • continuous sharing of knowledge, best practice from relevant projects, and emerging trends.

Methodology: In 2010, NHS Scotland Design Assessment Process (NDAP) became part of our business case approvals mechanism for all health facility investment (circa >£2m). NHS Health Facilities Scotland (HFS) and Architecture and Design Scotland (A&DS) work in partnership to support NHS boards and their communities to create healing places. We do this through early stakeholder workshops, capturing briefing in plain English with images, then reviewing proposals at key stages of design development, with expert advice ensuring lessons are incorporated.

NDAP independently reports on key project risks, with recommendations for further development where required. This assessment looks at the whole project, not solely the design, to best enable delivery of a sustainable, quality service to suit each place. It can also be used in the planning process as evidence of national agency (A&DS) consultation and their opinion of quality.

Results: This decade has seen a sea change in the quality of developments delivered, and NHS Scotland punches consistently above its weight. Our biggest change is the capacity and ambition of the people involved, who take the learning from project to project so that improvement continues.

Conclusions: Focus on the value of what each project will deliver (not solely time and budget) shifts attention for all involved. Bringing users with different perspectives together at an early stage helps challenge preconceptions and aids the change process. It also establishes a shared language, enables better engagement and encourages continuous improvement.

Organisations involved