Example Acute Care Design Statement
Example Inpatient Design Statement
Example Primary Care Design Statement
Guidance on workshopping the non-negotiables
Download a copy of this guidance
The development of a Design Statement is intended to assist NHSScotland Boards in using good design to get the most out of their development projects.
The Design Statement sets out the approach to the project and how it will be delivered. The Design Statement should have three basic elements:
The benchmarks should not require a pre-determined design outcome, but provide the parameters for what success might look like, and how they will inform key decisions throughout the project (including the development and consideration of the business case), and allow the evaluation of the project’s success
It is proposed that the Design Statement should be the first design control document produced for the project which can, and ideally should, also be used as:
Three example design statements have been worked up based on real NHSScotland projects. They act both as an illustration of the likely form and content of such statements, but also as a demonstration of the standard of benchmark that is ‘deemed to satisfy’ policy. Projects submitted to the NDAP that set benchmarks below these standards will be unsupported by the Process.
A Design Statement is built around the needs of the people who the facility will directly impact upon and whole life value for money. It is then expanded to consider the elements needed to deliver on the broader responsibilities of using public money – that of addressing local and national needs – for the public purse to achieve economies of benefit (getting the most benefit from the money that has to be spent).
These are incorporated into the Design Statement by establishing, early in the project’s development, agreed statements that give the core objectives of the project : non-negotiables that all key stakeholders can sign up to that derive from and articulate the Investment Objectives. These are the fundamental aspects that define the success of the scheme – the criteria that if you cannot achieve them will seriously call into doubt the viability of the project.
It is anticipated that the non-negotiables will be established and agreed by the Project Board to encapsulate a consensus from a range of points of view, from strategic planners to those with a more intimate and ongoing relationship with the proposed facility, rather than be written by one person. The downloadable document “workshop the non-negotiables” suggests a series of questions that might be helpful in debating these with key stakeholders. Once established, the non –negotiables encapsulate an agreed direction and as such can help resist incremental change in the brief due to external pressures or subjective opinions.
One of the strategies that could bring real change, but which the public sector generally under-utilises, is benchmarking developments. Benchmarking against the best and most relevant projects that NHSScotland and its sister bodies have delivered, and learning from the work of others, is a critically helpful tool to improve both the standard of care environment and the image of the NHS in the community.
There are three basic ways of benchmarking, each with benefits and pitfalls;
It is important to bear in mind that the purpose of choosing comparators is not to choose a predetermined design solution; it is to provide an example (or better still a range of examples) of ‘what success might look like’.
The setting of benchmarks requires an understanding of what has gone before, and this is likely to require the project team to do some research and carry out site visits to learn from what others have done. As an initial step into this there are a number of web resources that can be used for scoping and as a source of reference projects or criteria. The most likely to be relevant are:
This website has been commissioned by SGHD, HFS and A+DS to house information on good healthcare design to assist boards in brief development and to raise awareness of the good practice being developed and delivered across NHSScotland and elsewhere. In addition to providing guidance on the development of ‘design statements’, and articles on healthcare design topics, the website holds a project resource called ‘Pulse' that can be used in two main ways:
Developed by NHSEstates in England this site describes design challenges of particular built elements (such as bedrooms or consulting rooms) and numerous examples of completed buildings that respond to these challenges.
This self assessment toolkit establishes aims for cancer care environments and views of what success might look like. Though designed particularly with cancer patients in mind may of the objectives have a much wider applicability. Case studies of environments that have been awarded the mark may be added to the site over time.
Benchmarks can be refined, as the project develops and more information is understood, or if better benchmarks become available. It is anticipated that the benchmarks set at IA may be revisited in advance of the OBC and FBC to check that they are still the most relevant and useful means of checking that the project is achieving real value. The benchmarks should also be used in the Post Occupancy and Post Project Evaluation processes.
This section establishes the key design milestones for the project; and set out for each milestone the methodology and authority of the assessment, and the information and skills needed to carry it out. There are three areas to cover, when, who and how:
The business case process is designed to seek approval at key financial milestones, however these do not always coincide with key design milestones. Therefore the client team must consider and set out the key milestones that are most appropriate to their particular project. These may move relative to each other and relative to the business case milestones, dependant on the procurement route chosen, but are likely to include the following key milestones:
This is likely to be different depending on the milestone reached, the decision being made, and the risk associated with that decision. The first thing to be decided therefore is the position of the particular assessment within the project governance – i.e. does the assessment sit within the project team (a matter that the project manager handles and reports to the project board on), or is the Project Board looking to undertake this function either itself or by seeking an opinion that is independent from the reporting being given by the project manager and forms part of the Project Board’s assurance process.
Thereafter the skills set of the people, process or advisor assessing the options or proposals must be established. It is likely that specific design training and/or expertise would be of value in assessing the information being given and in differentiating between alternatives.
For example: A common issue in design team selection is that many people do not feel they have the competence or confidence to differentiate strongly between the ability of different designers to design. This can result in them assessing the ‘quality’ aspect of the scoring in terms of the clarity and coverage of the written information submitted - their essay writing skill – rather than their potential to design a facility of lasting value.
Firstly, and most importantly, the decision making process for these key points must allow you to ascribe a value to the elements needed to achieve the benchmarks you have set yourself.
Secondly, set out how you will approach the assessment. This includes both the tools you might use (such as an AEDET or ASPECT workshop) and the information you will need to inform the decision: i.e. the shortlist of sites for selection are likely to require some level of design feasibility study to provide reliable information on whether the ‘Non-Negotiables’ can be delivered on the site and the implications of doing so.
For example, a site that is ideal in terms of transport connections and immediate availability may be very close to a busy road and therefore building on that site will require significant investment in the building envelope to attenuate sound, and a sophisticated building form may be needed to allow the use of natural ventilation to meet sustainability criteria. This knowledge may either prompt the choice of a different site, where all of these factors are more easily achieved, or if this site is still the preferred option will allow the proper planning and budgeting of a project on this site.
The information required to make good and informed decisions at these key points needs to be allowed for in the project programme and budget and therefore the process of self assessment must be understood early in the project.