Whole-life costs

摘要

The design of hospitals is currently in a state of flux. For a start, the design of health buildings, fuelled by debate over the first PFI hospitals, has revealed a tension between economy of plan and operational flexibility for the healthcare provider, against quality of environment for all users of the building, particularly patients. In terms of building design this is characterised as a choice between shallow and deep-plan hospitals. There has also been the introduction by the government of minimum standards of service in hospitals, which have been reinforced by evidence of causal links between indicators such as recovery times, cross-infection rates and re-admission rates. This impacts on hospital design - for example, the preponderance of single bedrooms. The challenge for hospital design is that the lessons of emerging research are recognised but the funding for the capital and operational on-costs of these lessons isn't yet available. Meanwhile, those responsible for capital investment decisions increasingly see the need to meet anticipated future change without major capital penalty. Because of the impact these factors can have on building form choices need to be made early on, during the option appraisal stage of the capital planning process.