High street integrated care hub

High-streetIntegratedCareHub Arupresearch:PrototypestudyMay2023 Introduction DefiningthecontextDefiningthedesignDefiningthecostsClosingstatement ForewordExecutivesummaryBackground Scope IntroductionHealthchallenges HealthestatechallengesLocalcontext Sitecontext HICHprototypeCommunityandsocialcareHealthcare Primarycare DiagnosticsandresearchHomeandthehigh-StreetDefiningthescheduleofareasDesignconcept DescriptionofarrangementHICH:KeydesignconsiderationsPatientjourney CostofanageingpopulationReferencesAcknowledgementsAbbreviations Foreword Wehearalotaboutthedamagecausedbyoverpopulation, buttheyearof“peakchild”hasalreadyoccurred.Thepopulationgrowthfortherestofthiscenturyisfuelledmorebyincreasinglongevitythanitisbyfertilityrates. TristramCarfrae ArupDeputyChair|ArupFellowFRSA,FREng,FTSE,RDI Inmanycountries,weareactuallyseeingfertilityratesdecliningbelowthereplacementrate,thisnotonlydrivesanoveralldeclineinpopulationbutfurtherskewsthedemographicsoftheexistingpopulationtowardsagreaterproportionofelderlypeople. OurcurrentUKhealthcareapproachappearstohavethreeaxes:careinthehome,incarehomes,orinhospitals,andallarebeingincreasinglyimpactedbycaringfortheelderly.Thisintelligentstudylooks atthebenefitsofaddingdrop-inurbancarecentrestocosteffectivelyassistmorepeople,particularlyourincreasingelderlypopulation,byprovidingappropriatedaytimecarewhilestilllivingathome. Thestudyalsocleverlyproposesthere-purposingunderutilisedhighstreetretailspace,whichkeepsexistingbuildingsinuse,whilerevitalisinghighstreetsandimprovingurbanliveability. FRCGPThisstudyleadscurrenthealthandsocialcarethinking.Thephysicalco-locationofteamscurrentlystruggling tointegratewillmakeabigdifferenceandthefactthatthehubsarelikelytobeinthe centreoftownswillenablethecommunitytobebroughtinmuchmoreeasily. DrLindsayHadley SussexICSDementiaClinicalLead ThenewreportbytheRoyalCollegeofGPs‘FitFortheFuture’‘supportsthisvisionwithanemphasisonprovidingspaceformorecliniciansandprovidersofcareandgreaterintegrationwithsecondarycare.Ifyouknowtherheumatologistisjustdownthecorridor,itiseasytoaskforadvice.Thisinturnavoidslengthywaitsandunnecessaryappointmentsforpatients. Buildingslikethiswillmakeadifferencetoefficiency,staffwellbeing,retentionandrecruitmentfurtherdowntheline. 23 Introduction DefiningthecontextDefiningthedesign ForewordExecutivesummaryBackground Scope IntroductionHealthchallenges HealthestatechallengesLocalcontext Sitecontext HICHprototypeCommunityandsocialcareHealthcare Primarycare DiagnosticsandresearchHomeandthehigh-StreetDefiningthescheduleofareasDesignconcept DescriptionofarrangementHICH:KeydesignconsiderationsPatientjourney o - e c o n o m i c e n S o c Executivesummary S E v i r o n V Integrationcanbebestachievedthroughtheconsolidationofexistingservices,re-useofexistingbuildings,andleveragingofexistingnetworks. TheHigh-streetIntegratedCareHub(HICH) TheUKpopulationisageing,withthelatestprojectionsindicatingthatin50years’time,therewillbeanadditional8.6millionpeopleaged65andover,equivalenttothepopulationsizeofLondon.ThistrendisnotuniquetotheUK,butisbeingfeltglobally. WhentheNHSwasestablished,itwasdesignedtocatertotheacutehealthneedsofyoungerpatients.However,aspeopleage,thelikelihoodofdevelopingmultiplechronicillness,suchaslong-termconditions,dementia,andfrailty,increases. Thisshiftinneedsiscurrentlybeingfeltacrossthehealthandsocialcaresystem,resultinginrisingcosts,unmetcareneeds,staffburnout,and,mostimportantly,asignificantdeclineinthequalityoflifeforthoselivingwiththeseconditions. Inresponse,thegovernmenthasrecentlyrestructuredtheUK’shealthandsocialcaresystemsbyformingIntegratedCareSystems(ICSs)that aimtointegratethepresentlyfragmentedhealthandsocialservices. Healthcaredesignershavesoughttosupportthisshifttowardsintegrationthroughthedesignofnewformsofhealthandcareprovision.Althoughstillintheirinfancy,theseprototypeshaveexploredthebenefitsofprogrammaticintegration(combiningelementsfromacrossthehealthandsocialcaresectors),contextualintegration(provisionof healthcentreswithintowncentres),andsystemicintegration(consideringhealthandcareprovisionaspartofawiderbuiltecosystem). - H o m e c a m r e e n t a l s u s t a i n a b i l i t y S o c i a l c a r e Thisstudytakestheseconsiderationsasitspointofdepartureandexploresanddefinesanewtypologyofhealthandcareprovisionthatcombinesthemeritsofprogrammatic,contextual,andsystemicintegration,henceforthreferredtoastheHigh-streetIntegratedCareHub(HICH). v e F Respite r o n t Staff a g e Roomto Grow Roomto Grow r y A c t Dissimilartootherconceptualstudies,theHICHprototypeisgroundedinarealsite,calibratedandtestedagainstthechallengesofHasting’s P ri M m a u r l y t i - D i s A s s e s s m e n t R e s p i t e + R e c o v e Treatment Therapy publicservices,place,andpeople.Indoingso,thestudybringstogetheradiverserangeofstrategic,spatialandhealthdata,analysedthroughamultidisciplinarylens. e r a c h t l a e H c a r e Roomto Grow Roomto Grow h TheresultingHICHprototypeaccommodatesa2,700sqmhealthandcarefacilitylocatedwit