Environmental aspects of health care in the Grampian NHS region and the place of telehealth

Detailed information about the composition of the carbon footprint of the NHS in the Grampian health region, and in Scotland generally, is not available at present. Based on the limited information available, our best guess is that travel emissions in Grampian are substantial, perhaps 49,000 tonnes CO2 per year. This is equivalent to 233 million km of car travel per year. A well-established telemedicine network in the Grampian region, which saves over 2000 patient journeys a year from community hospitals, avoids about 260,000 km travel per year, or about 59 tonnes CO2 per year. Therefore using telehealth as it has been used historically (primarily to facilitate hospital-to-hospital interactions) seems unlikely to have a major environmental impact – although of course there may be other good reasons for persevering with conventional telehealth. On the other hand, telehealth might be useful in reducing staff travel and to a lesser extent, visitor travel. It looks particularly promising for reducing outpatient travel, where substantial carbon savings might be made by reconfiguring the way that certain services are provided

Decreasing spatial disorientation in care-home settings: How psychology can guide the development of dementia friendly design guidelines

Alzheimer’s disease results in marked declines in navigation skills that are particularly pronounced in unfamiliar environments. However, many people with Alzheimer’s disease eventually face the challenge of having to learn their way around unfamiliar environments when moving into assisted living or care-homes. People with Alzheimer’s disease would have an easier transition moving to new residences if these larger, and often more institutional, environments were designed to compensate for decreasing orientation skills. However, few existing dementia friendly design guidelines specifically address orientation and wayfinding. Those that do are often based on custom, practice or intuition and not well integrated with psychological and neuroscientific knowledge or navigation research, therefore often remaining unspecific. This paper discusses current dementia friendly design guidelines, reports findings from psychological and neuropsychological experiments on navigation and evaluates their potential for informing design guidelines that decrease spatial disorientation for people with dementia

“Essentially It’s Just a Lot of Bedrooms”: Architectural Design, Prescribed Personalization and the Construction of Care ‘Beds’ for Later Life

This paper draws on ethnographic data from a UK ESRC funded study called Buildings in the Making. The project aims to open up the black box of architectural work to explore what happens between the commissioning of architectural projects through to the construction of buildings and seeks to understand how ideas about care for later life are operationalized into designs. Drawing on recent scholarship on ‘materialities of care’ and ‘practising architectures’, which emphasize the salience of material objects for understanding the politics and practices of care, we focus on ‘beds.’ References to ‘beds’ were ubiquitous throughout our data, and we analyse their varied uses and imaginaries as a way in to understanding the embedded nature of architectural work. Four themes emerged: ‘commissioning architectures and the commodification of beds’; ‘adjusting architectures and socio-spatial inequalities of beds’; ‘prescribing architectures and person-centred care beds’; and ‘phenomenological architectures and inhabiting beds’. We offer the concept prescribed personalization to capture how practising architectures come to reconcile the multiple tensions of commodification and the codification of person centred care, in ways that might mitigate phenomenological and serendipitous qualities of life and living in care settings during later life

Resilience of 'Nightingale' hospital wards in a changing climate

The National Health Service (NHS) Estate in England comprises more than 30?Mm2 with 18.83?Mm2 of acute hospital accommodation on 330 sites. There is concern about the resilience of these buildings in a changing climate, informed by the experience of recent heatwaves. However, the widespread installation of air conditioning would disrupt the achievement of ambitious energy reduction targets. The research project ‘Design and Delivery of Robust Hospital Environments in a Changing Climate’ is attempting to estimate the resilience of the NHS Estate on the basis of current and projected performance, using an adaptive comfort model. This paper presents results relating to a 1920s traditionally built block with open ‘Nightingale’ wards, a representative type. The paper demonstrates the relative resilience of the type, and illustrates a series of light-touch measures that may increase resilience while saving energy