The demands put on the new facility will change over time. Thought should be given from the outset on how the building can be made flexible to accommodate these changes.
Change will be largely unpredictable, but could occur over the short, medium and long term. The project team should identify where change is most likely to occur and establish some strategies for accommodating it, while minimising disruption and cost. This information will become an important part of the brief and will inform fundamental issues such as site selection and building height and form, layout, and materials.
The demand placed on the new building will change over time. A strategy for managing this change should be considered from the outset.
Change can occur over different time cycles. It is useful to consider these separately when establishing how flexibility will be achieved:
The project team should formally consider each scenario, recording the outcome of the discussion in notes, which should be shared with the design team or architect as part of the briefing process.
This can be achieved by using spaces for different functions at different times of the day, week or month. This philosophy is enshrined in the notion that ‘space is a resource, not territory’. Managing space efficiently requires comprehensive timetabling by a designated person. To maximise opportunities for shared use of space, rooms should where possible be generic and selected from a limited palette of room sizes. Clustering similar rooms together maximises opportunities for flexible use, provided they are supported where necessary by utility spaces, stores (for specialist equipment) and near to waiting areas.
This is reliant on flexible use of space but it may require a greater degree of physical change to the room such as changing furniture or finishes, or the addition or the removal of a hand wash basin. Rooms should be, where possible, generic and selected from a limited palette of room sizes. Using modular room sizes will facilitate the easy addition or removal of walls to extend the numbers of each available room type. Internal partition walls should be of demountable plasterboard containing suitable levels of sound insulation quilt. Such buildings usually have a steel or timber frame, rather than load-bearing walls. In the initial design, if practical, service outlets on ‘cross’ partition walls (those running from the corridor to the outside wall) should be minimised, and service tails (hot & cold water pipes and waste) could be left in strategic locations. Clustering like-rooms together also maximises opportunities for medium-term flexible use, provided they are supported by necessary utility spaces and close to waiting areas. Consideration should be given how administration accommodation could be changed to clinical use in the future, as offices are relatively east to decant and replace without interrupting the main functions of the building. For example, the project team may decide that the shape (including position of WC etc) of the adminstration cluster should match that of a clinical area to make a future change as simple as possible. It is likely that the use of electronic patient records will release archive and patient records storage space, although this will be offset by the need for server rooms and data-entry workspaces.
There may be a need to extend the building after completion of the project, to accommodate new services or to extend those that it already contains. The project team should identify the services that are most likely to develop in the future (for example IM&T and diagnostic imaging). Checks should be made to ensure that the selected site is large enough to accommodate an extension, if appropriate, and that planning consent would be permitted. The building should be positioned on the site to enable extension in the future if possible, with space left adjacent to the service most likely to grow. Consideration should also be given to how ancillary areas (such as waiting and WCs) could expand under such a scenario (possibly by displacing another service adjacent to existing waiting, and replacing it elsewhere). If the site is restricted in size, designing the foundations and structure to accommodate additional storeys should be considered. This does involve expense, however, and the amount of disruption that such an operation would involve in the future should not be underestimated if such a decision is made. Planner’s views on such a possibility should be sought from the outset. If the building is likely to be extended, its form should be simple and the material used should be commonly available, to ensure that the extension sits comfortably with the original building.