The physical fabric of estates acts as an enabler for so many other things – how patient records are being delivered, how services are delivered, where and how people are physically working – there are so many considerations to take into account when designing spaces.

But crucially, it’s the simplest considerations that can often have the biggest impact not only on how people use a space, but how they feel within it.

A great example of this was our work to transform the Manchester Central Conference Centre into a Nightingale Hospital during the pandemic, where we created five distinct breakout areas for our colleagues.

We were able to create some impactful interventions while we were setting up those temporary spaces. Initially, areas like the changing rooms, the toilets and the shower facilities were designed with a 50/50 split. But when we really sat down and thought about it, we realised that our workforce was 80/20, with a much higher proportion of female staff. We knew then that those spaces should reflect the makeup of our workforce.

It was all very baseline, practical stuff but it made a massive difference. Female staff were no longer having to queue up to use the toilets, there was more locker space and bigger changing rooms which meant there was more space to put scrubs on. They were all things that once we’d thought about, were a real no brainer.

And it’s some of those inequities that we see playing out that can really help to inform how we design a space. The NHS can be hierarchical but that gives us the opportunity to do some social engineering around how people meet and interconnect with each other, especially when we’re talking about impact, wellbeing and sustaining ourselves. But that can’t happen if we have nurses in one area and health care assistants in another for instance.

We can delve even deeper into this when we consider the legacy divide between those who are substantive in their post and staff who may be bank or agency staff. Historically our healthcare spaces may have been fit for purpose for all the different workforce groups, but when we’ve got medics, clinicians and staff who are actively making decisions to have more of a portfolio career, perhaps not wanting to work in one place, or wanting more work/life balance, the spaces we work in are really important to foster that one culture approach.

It’s all about curating the value that people feel when they are in spaces that are considered, that are designed. I don’t mean designed to look beautiful, but designed with the user experience in mind in terms of what a space feels like practicality, so that it does all the things you need it to. It also needs to be comfortable – if you’re on your feet all day you want to have a comfy seat for example.

Even the understanding that someone in an administrative or office based role will be sitting at a desk for the majority of the day so they’ll often make a conscious effort to get up, go for a walk throughout the day. For clinical colleagues, it’s the other way around – when they get their break, they don’t want to go for a walk because they’ve already done 40,000 steps, and actually want to be still and be comfortable and have good lumbar support. So, we’re thinking about the ergonomics as much as what things look like.

We spend a huge amount of time talking about patient care and while we all have an understanding, we perhaps don’t spend enough time how we support our workforce to give the best care. It’s about more than just a duty of care, but how we make people feel looked after.

For most of us, it isn’t in our gift to pay people more money. We can’t change IT systems overnight, no matter how much we may want to. But what we can do is make people feel looked after, ensure they feel seen and heard, especially when they’re tired and frustrated. So that means making sure we have discrete places where people can take 5 minutes to let off some steam or proper refreshment stations – and that means decent food that doesn’t come out of a vending machine. All of that is really important.

But what we also need to remember is that particularly in older buildings, we may not have the infrastructure in place. A great example of this is that we lots notice boards with information and notices that get pinned onto it. Occasionally we’ll get a digital screen now but it’s not dynamic, it’s not as interactive as it could be.

This is where we should be thinking more about the fabric of new buildings and the possibilities they can bring – they should be steeped in technology. The lack of technology can sometimes be as simple as not having enough electricity points in our public spaces and that’s where we need to be thinking more about the practicalities of that when we’re approaching a project. So being able to go up and scan a QR code and get all the information you need about a particular thing for instance or being able to see of the right information that’s relevant to you – there’s loads of brilliant ways to engage a busy workforce out there.

– Sheni Ravji-Smith, Assistant Director of Organisational Development and Good Employment at NHS Greater Manchester