Cancer care: Building for the future

Designing new cancer care centres by Richard Coe of Kajima Partnerships

The Gunma University Heavy Particle Beam Medical Center, Gunma, Japan, is an example of how cancer care facilities are being designed to be more patient-centred

Richard Coe, head of business development for healthcare at Kajima Partnerships, considers the design and build requirements of outstanding buildings for cancer care

There are now more people in the UK living with cancer than dying from it each year. Cancer treatments are rapidly advancing and, as they do, the facilities in which those treatments are delivered need to change.

In an age of personalised medicine and mounting pressure on NHS budgets, the challenge for the building design and construction industry is to deliver innovations which offer efficiencies to the NHS while enhancing the quality of service and care for every cancer patient.

This has led to the emergence of new integrative cancer service models in which facilities will provide end-to-end care for patients, addressing their clinical needs - from screening and diagnosis to therapy and monitoring - as well as their physical, emotional and spiritual needs.

In order to accomplish these critical objectives, we need to bring together medical and building best practice. This can only be achieved through a collaborative approach that starts in consultation with medical professionals and involves all stakeholders at every stage of the construction process from the client, architect and designer to the engineer and contractor.

BIM should be developed and co-ordinated to enhance the design, construction and operational aspects of the project. By harnessing the best of modelling technology and learning from innovative precedents worldwide, we can conceive and deliver spaces that provide exceptional one-stop patient facilities. This allows us to improve on historic practices, for example by integrating radiotherapy – traditionally relegated to windowless basement wings – with the rest of the hospital to humanise the patient experience.

In an age of personalised medicine and mounting pressure on NHS budgets, the challenge for the building design and construction industry is to deliver innovations which offer efficiencies to the NHS while enhancing the quality of service and care for every cancer patient

Given the evolving landscape of cancer care, facilities must be fit for purpose now and flexible for the future. As well as meeting stringent regulatory requirements e.g. Good Manufacturing Practice requirements in line with Eudralex and the Medical Health Regulatory Authority (MHRA); buildings need to anticipate future demand. Design excellence can deliver flexibility: planning for interstitial floors to act as maintenance zones, or integrating large, flexible spaces that can be sub-divided to suit evolving care needs can ensure that growing demand and evolving treatments can be accommodated. Building for sustainability can deliver operational cost efficiencies and prolong the life of the building.

Contractors should strive to achieve a BREEAM ‘Excellent’ rating for all cancer facilities, taking into consideration the building’s orientation, form and thermal performance in order to reduce demand for heating, cooling, lighting and water.

As well as accommodating patients’ clinical needs, facilities must also be able to support the coordination of complex, non-medical therapy: spaces which address their physical, emotional and spiritual needs, and those of their carers. High-quality, patient-centric environments can ease the patient journey, both literally - through improved accessibility, wayfinding and generous parking - and figuratively by developing spaces that are light and welcoming rather than sterile and imposing.

A balance must be struck between providing spaces that enhance patient privacy and dignity, for example the provision of individual rooms and separate inpatient/outpatient routes to treatment areas, while simultaneously limiting patients’ sense of isolation and loneliness by offering areas for easy social interaction such as landscaped gardens, family rooms and dining rooms. While physiotherapy suites can provide physical rehabilitation, dedicated spaces for contemplation, both religious and secular, can provide spiritual respite.

University College London (UCL) and King’s College London have predicted that cancer-related mortality in people aged under 80 will be eradicated in the course of the coming 20 to 30 years. Given that the typical lifespan of a clinical building is greater than this, the next generation of cancer care centres will need to be the theatre of this transformation and must set the tone for the scale of this medical achievement.

Nagoya Proton Therapy Center, Nagoya City, Japan

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