Lightbulb moments: bringing estates and digital together at Westmorland General Hospital

Nobody said that designing the hospitals of the future would be a small task.

We face a multi-layered challenge, in which we must consider patient welfare alongside cost reduction requirements imposed on the health service, and pressing climate concerns which touch everything from building materials, to energy expenditure, and everyday operations.

On a more fundamental level, however, we face an organisational challenge. We need estates and digital to be working in concert, and — when thinking about how our hospitals will be used in the future — we need to consider future workforce planning.

All of this takes place in the unique environment that is the NHS estate. This is millions of square metres stretching across eras and geographies — and currently carrying an £11.6 billion backlog on maintenance.

We know that our vast challenge will only be solved with a meticulous, evidence-based approach. Which is why running proof of concepts is so vitally important.

Currently, at University Hospitals of Morecambe Bay NHS Foundation Trust’s Westmorland General Hospital in Kendal, we’re testing new solutions in 20 or so rooms — in order to prove not just the concept but the value it brings. The hope is that this will allow us to scale up quickly: from tens of rooms to hundreds, and, ultimately, whole new hospitals.

The ideal situation is that, by the time new hospitals are being built, our test runs will have contributed to a new set of building standards for digital solutions in a healthcare setting. As well as benefiting patients and staff, these standardised designs will help to shorten the length of time taken to develop and build hospitals, and bring the associated costs down through economies of scale.

There is still some way to go, however.

There are currently no Health Technical Memoranda governing the application of digital in our hospitals. We hope our work will contribute to the national policy group that’s responsible for writing these standards.

The Royal Institute of British Architects (or RIBA) published its Smart Building Overlay in February of this year, to provide guidance on how to include smart tech in future buildings.

For those of us pushing for greater digital adoption in building standards, this has been a welcome arrival — but is simultaneously symbolic of how far behind the construction industry is when it comes to folding in digital (despite a widely held desire to transform).

Many of our trials at Westmorland General Hospital involve using old, proven technology in new ways and contexts.

Consider the lightbulb. Electric bulbs have been around since the early 1800s (Humphry Davy beat Edison by a good seven-plus decades in the race for electric light).

But by combining the humble bulb with smart building management controls and area mapping, we’re able to expand the possibilities of what lighting can do: improving patient care, and climate care too, while delivering cost savings and a new data source for estate mapping.

Smarter control over lighting systems — alongside heating, air conditioning, and other environmental factors — can have myriad positive benefits for patients. At the very least, a well-lit space is a more inviting one. But more complex controls can encourage healthy sleeping and waking cycles too, or make spaces easier to navigate for those with partial vision, for example.

Knowing how and where lighting is used in a building can also provide a clearer idea of a space’s utilisation and occupancy; it’s another means of gaining more valuable, granular data on the NHS estate.

And, of course, having closer control over when, where, and why lighting is in use provides opportunities for greater energy efficiency too — with both cost reduction and minimised climate impact following in step.

These are all things that are possible today. Our job is to figure out how to optimise their use across a vast and complex estate.

Digital and estates have traditionally been seen as quite separate entities within the NHS. Our trials at Westmorland General Hospital aim to bridge this gap.

We’re building digital twins of the hospital’s core estate functions, offering a means of not just mapping our capabilities and potential, but testing possible solutions and ways of working for the future. It means we can test and tweak new ideas without risking disruption to the smooth running of the hospital.

With these digital models of the physical world, we’re able to run scenarios — from energy usage, to building utilisation, to people flow and mass movement — and begin this convergence of estates and digital

Digital twins allow us to trial not just how the tech works, but how the people steering the ship can best work together too.

Westmorland General Hospital, where practically-minded people are keen to see results, is proving to be an ideal testing ground. Our findings will, in due course, be reported and presented on, before a decision is made about which aspects will go forward into the Lancashire and South Cumbria New Hospitals Programme, with Government investment in new hospitals on new sites to replace both Royal Lancaster Infirmary (with investment in Furness General Hospital) and Lancashire Teaching Hospitals NHS Foundation Trust’s Royal Preston Hospital.

We’ve had every support from Trust colleagues, which only helps when it comes to delivering the maximum benefit — to patients, yes, but to pockets and the planet too. We don’t, if you’ll excuse the pun, take any of this lightly.