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In the UK healthcare sector, funding and provision of public care facilities has been primarily the responsibility of government through the National Health Service (NHS). After decades of under-investment and consequent effects on the quality of care, new procurement routes are currently being used to improve the standards of facilities to meet the requirements of modern care services. This paper critically reviews these new procurement routes in terms of concepts and suitable areas of application, and examines how the principal procurement methods have evolved into the forms used for UK healthcare facilities. The paper outlines recommendations for further research in assessing the suitability or otherwise of these new procurement methods, both for construction projects generally and specifically for healthcare facilities.

Recent climate change projections estimate that the average summertime temperature in the southern part of Great Britain may increase by up to 5.4°C by the end of the century. The general consensus is that projected increases in temperature will render British dwellings vulnerable to summer overheating and by the middle of this century it may become difficult to maintain a comfortable indoor environment, if adaptation measures are not well integrated in the design and operation of new dwellings, which are likely to remain in use beyond the 2050s. The challenge is to reduce overheating risks by integrating building and user adaptation measures, to avoid energy intensive mechanical cooling. Developing guidelines and updating building regulations for adaptation, therefore, requires an understanding of the baseline scenario; i.e. the performance of existing buildings in future climates.

This paper aims to investigate the performance of new-build multi-occupancy British dwellings for human thermal comfort in the present-day and projected future climates in four regional cities: Birmingham, Edinburgh, London and Manchester. Evaluations are carried out by a series of dynamic thermal simulations using widely adopted threshold temperature for overheating, as well as adaptive thermal comfort standards. This study thus offers a unique perspective on regional variations of performance and provides a clearer snapshot because of the use of more appropriate adaptive comfort standards in the evaluations. Finally, the paper sheds light on possible personal and building adaptation measures to alleviate overheating risks.

The purpose of this paper was to examine UK shale gas viability. The recent commitment to shale gas exploration in the UK through fracking has given rise to well-publicised economic benefits and environmental concerns. There is potential for shale gas exploration in different parts of the UK over the next couple of decades. As argued in this study, if it does, it would transform the energy market and provide long-term energy security at affordable cost.

Interviews with senior practitioners and local communities were recorded, transcribed and entered into qualitative research software Nvivo. Validity and reliability were achieved by first assessing the plausibility in terms of already existing knowledge on some of the economic and environmental issues raised by participants.

Findings from this study suggest that environmental, health and safety risks can be managed effectively provided operational best practices are implemented and monitored by the Health and Safety Executive; Department of Energy, Climate Change; and the Mineral Planning Authorities. Participants further suggested that the integration of shale gas technology will protect consumers against rising energy prices and ensure that government does not get exposed to long-term geopolitical risks.

The present study corroborates the position that environmental, health and safety risks can be managed effectively provided operational best practices are implemented and monitored by the Health and Safety Executive; Department of Energy, Climate Change; and the Mineral Planning Authorities.

The present study confirms that the government is committed to ensuring that the nation maximises the opportunity that cost-effective shale gas technology presents, not just investment, cheap energy bills and jobs but providing an energy mix that will underpin the UK long-term economic prosperity.

The present study corroborates the position that environmental, health and safety risks can be managed effectively provided operational best practices are implemented and monitored by the Health and Safety Executive; Department of Energy, Climate Change; and the Mineral Planning Authorities. As shown in this study, the UK has a very strong regulatory regime compared to USA; therefore, environmental, health and safety risks will be very well managed and unlikely to escalate into the crisis being envisioned.

Health and social care facilities are usually complex buildings that require continuous effort to provide resilient and sustainable responses to changes in demographics, technologies, diseases and models of care. Despite resilience and sustainability concepts being frequently used by practitioners and researchers, ambiguities in their definitions often result in a lack of operational solutions to record, monitor and improve the resilience and sustainability of health and social care facilities. Although the importance and complexity of the issues are widely acknowledged, there is little strategic guidance as to how they should be achieved. The purpose of this paper is to assess the suitability of developing a roadmap for improving the resilience and sustainability of UK health and social care facilities, and to identify the layers and processes needed to construct such a roadmap.

A qualitative approach was adopted, starting with a literature review of different types of roadmaps and their suitability to support the desired improvement objectives. Layers and processes were thus developed using the key issues identified in three recent research streams, and the roadmap was structured.

The major findings have been captured within a three-layer, four-step process generic roadmap for improving the resilience and sustainability of health and social care facilities that can be used to monitor performance, plans future actions and implement response to change.

This paper targets decision makers, especially estate managers, but the proposed layers and processes can be modified for other stakeholders.

This paper suggests an original approach for the development of a roadmap for resilience and sustainability of health and social care facilities, and specifically of how to structure layers and processes, envisioning a more integrated development of service provision and infrastructure asset management.

This paper aims to identify costs related to dementia care provision and explore how purpose-built environment investments can help control these costs and improve quality of life and clinical outcomes.

This research adopts a multi-method approach where the findings of a literature review drove the analysis of data obtained from the 115 pilot projects funded by the Department of Health England’s National Dementia Capital Investment Programme.

Under the UK Government’s new productivity challenge, it is fundamental to identify actions that provide value for money to prioritise policy and practice. This paper identifies healthcare spaces (e.g. bathroom) where the impact of the built environment on healthcare costs are most evident and building elements (e.g. lighting) to which these costs can be directly associated. The paper advocates the development of evidence and decision support tools capable of: linking built environment interventions to the healthcare costs; and helping the healthcare and social care sectors to develop effective and efficient capital investment strategies.

Further work needs to develop more systematic ways of rationalising proactive and timely built environment interventions capable of mitigating dementia (and older people) care cost escalation.

This research takes an innovative view on capital investment for care environments and suggests that appropriate built environment interventions can have a profound impact on costs associated with dementia care provision.

The re-use of good design solutions is a key source of evidence and knowledge in the design of healthcare buildings. However, due to the unique nature of healthcare built environments, the critical application of this evidence is of paramount importance. The purpose of this paper is to investigate the features of such critical application and identify the aspects that need to be considered during the re-use of good designs.

Data from three case studies of hospital designs in the UK were used to explore the processes behind the adaption and re-use of design solutions during the design of healthcare buildings. Data were thematically analysed to distinguish the aspects that should be carefully compared and contrasted during design re-use.

Existing designs of healthcare buildings should be captured and evaluated along with: patient demographics, care models of the hospital, other local departmental needs and facility operational aspects in order to ensure the effectiveness of re-use. In addition, properly introducing the design to the users is also a part of successful design re-use.

The findings of this research were integrated into a framework to support healthcare designers on the effective re-use of good designs. This data-driven framework could be validated further with design practitioners. Further, this research relied on memory recall of the interviewees and the accuracy and completeness of documentary records.

This research provides details of how healthcare built environment designs are embedded in project-unique circumstances. The results could therefore be used to develop meaningful and informative evaluation mechanisms for new and re-used healthcare building design features.

This research extends the understanding of the critical application of healthcare design evidence, by explaining how healthcare design solutions should be evaluated during the design process.

A substantial amount of research argues that built environmental interventions can improve the outcomes of patients and other users of healthcare facilities, supporting the concept of evidence-based design (EBD). However, the sources of such evidence and its flow into healthcare design are less well understood. This paper aims to provide insights to both the sources and flow of EBD used in three healthcare projects, to reveal practicalities of use and the relationships between them in practice.

Three healthcare case study projects provided empirical data on the design of a number of different elements. Inductive thematic analysis was used to identify the source and flow of evidence used in this design, which was subsequently quantised to reveal the dominant patterns therein.

Healthcare design teams use evidence from various sources, the knowledge and experience of the members of the design team being the most common due to both ease of access and thus flow. Practice-based research and peer-reviewed published research flow both directly and indirectly into the design process, whilst collaborations with researchers and research institutions nurture the credibility of the latter.

The findings can be used to enhance activities that aim to design, conduct and disseminate future EBD research to improve their flow to healthcare designers.

This research contributes to understandings of EBD by exploring the flow of research from various sources in conflation and within real-life environments.

According to architectural research, modifying environmental features has the potential to create an appropriate sensory environment for autistic children. Considering the design of public environments, it is difficult to accommodate the diverse requirements of each autistic child. The main objective of this paper is to find out the most prevalent architectural strategies and to prioritise them for the design of the public spaces addressing autistic children's needs.

This research is designed in two stages: (1) descriptive approach in which architectural strategies are extracted from theories on autism design to determine a theoretical test module; and (2) quantitative approach in which the frequency of gained strategies are studied in two groups of references: general references and key references (i.e. most cited and well-reputed researchers in autism architecture) while universal design strategies and the timeline of each strategy is considered for the conclusion.

The following strategies were highly significant: (1) acoustical control, (2) visual control, (3) legibility, (4) safety and security, (5) predictable spaces. Acoustic was frequently considered in both control and general groups while it was highlighted in timeline study and universal design strategies.

The main limitation is that these strategies have been prioritised according to their frequency in some limited articles and a control group including the pioneer of autism design researchers while verifying these strategies may not be strong enough. Likewise, the conclusion related to these data cannot be accurate enough. Establishing a case study survey that provides an opportunity to test all these strategies directly on a majority of autistic children and measure their prevalence is advised. Finally, it should be considered that although the five mentioned strategies are all the most prevalent strategies among autistic children, as each autistic child differs from others, generalising the conclusion for all the public area would be impossible, as though we need to study it for each group of them.

Seeking to improve the strategies' prioritisation as determined by previous researchers, this article aims to define the most essential strategies categories in this field to eliminate the confusion of researchers and designers.

Lord Carter’s (2015) “Review of Operational Productivity in NHS providers” stated that to improve National Health Service (NHS) England’s efficiency, operational productivity should be targeted in four main areas, one being estates management. NHS England’s estate includes a variety of buildings some of which are considered no longer fit-for-purpose, thus creating risk to patients and staff. These built assets require continuous maintenance, adding pressures to NHS England’s precarious financial situation. The purpose of this paper is to identify positive strategies and major constraints to achieving sustainable management of backlog maintenance (BM) across the NHS assets, and thus suggest balanced actions.

The research adopts a qualitative approach and combines: literature review of current BM methodologies; interviews with estates and facilities directors from seven NHS trusts on BM strategies; and a NHS trust detailed case study.

The major finding is that sustainable management of BM is achievable if there is a consistent, pro-active and long-term strategic approach where critical levels of BM are prioritised. Additional issues (i.e. appropriate methodology, performance metrics and links with clinical service delivery strategies) also need to be considered.

This study is relevant to the management of the NHS estate including development and adoption of sustainable strategies.

This paper offers original insights to the factors influencing healthcare estates’ BM at a time when the UK policy agenda is targeting infrastructure operational efficiency and organisations are seeking more comprehensive methodologies.