The Design and Delivery of Robust Hospital Environments in a Changing Climate

sash_windows17:21 Wednesday 9th July 2014
BBC Radio Cambridgeshire

[C]HRIS MANN: Ninety per cent of hospital wards are prone to overheating, with staff unable to open windows wide due to health and safety fears. That’s a finding of a study led by Cambridge University Professor of Architecture Alan Short. It also showed things could get much hotter with climate change. The research looked at ways to cool hospital wards without costing air condition systems. We’ll be talking to Professor Short in just a second, but first of all these visitors to Addenbrookes Hospital in Cambridge today gave their views on temperatures in the wards.
CHRIS MANN: Patients and relatives there at Addenbrookes Hospital in Cambridge talking to Jozef Hall today. Well the man behind the report, the Professor of Architecture Alan Short is with me now. Hello. Hello Alan.
ALAN SHORT: Hello. Yes, hello Chris.
CHRIS MANN: What did you make of what people had to say?
ALAN SHORT: Oh. They were incredibly interesting. You’ve advanced our research a bit there. But I suspect that they were in the eleven storey ward tower, and we spent three years looking at that building. And certainly .. I’m looking at all the temperature traces in front of me .. it does get up to twenty eight degrees centigrade just about without much difficulty.
CHRIS MANN: Just explain why they can’t open windows wide.

ALAN SHORT: Well this is interesting. In the late nineteen nineties the NHS issued guidance that all windows in NHS buildings should be restricted to four inches opening. There’d obviously been an awful spate of people trying to throw themselves out of windows. So it’s a fantastic example of an unintended consequence of what was probably a very sensible thing to do in health and safety terms, but they completely dismantled the ventilation really of all NHS buildings, all twenty eight million square metres of them.
CHRIS MANN: Now have you done this report off your own back, or are you trying to help the NHS and Addenbrookes?
ALAN SHORT: Well this comes out of a big research project that my department’s been doing with the Engineering Department, our colleagues at Loughborough and Leeds and the Open University. The project is called “Design and delivery of robust hospitals in a changing climate.” It was funded by the Engineering and Physical Sciences Research Council and the Department of Health, and it’s part of the Government’s Living with Environmental Change programme that Lord Krebbs’ report relates to, the Climate Change Committee.
CHRIS MANN: My mum was a nurse, not quite in the Florence Nightingale days. But the recipe was big windows, high ceilings, wasn’t it? And (UNCLEAR) then?
ALAN SHORT: Well, one of the extraordinary findings is that we took a lot of temperature data and made computer models of Nightingale, pre-nineteen thirty nine Nightingale wards, in fact the nineteen twenties’ buildings at the Bradford Royal Infirmary, and they are fantastically resilient to high temperatures. And our modelling shows even in twenty eight it’s incredibly difficult to get them to overheat theoretically. You just need to tweak them a little bit. And they’re very resilient buildings. Of course they’re all condemned by default really in the NHS. They’re thought not to deliver, these old-fashioned wards, not to deliver the privacy and dignity model that the NHS rus on. But we just published another paper today that shows you can reconfigure them to give people a measure of privacy and dignity. And those sort of communal wards, rather good for the elderly. One of your interviewees was talking about elderly people enjoying warmer conditions, and of course this is a bigger proportion of our hospital population at the moment.
CHRIS MANN: So going forward, are things going to get hotter in hospitals? Is that the real concern? Or can they do something about it to fix this problem?
ALAN SHORT: Well I think both things are very likely. I think we have in the NHS a huge number of nineteen sixties and nineteen seventies buildings that are very lightweight, very overglazed, no insulation, did have lots of opening windows but as you said that’s been dismantled. And they’re filling up with medical equipment. Nobody knows how much heat is chucked out by those. And the throughput of patients has been forced up of course for all kinds of sensible reasons. So if you can keep the temperature inside a lightweight building the same as the temperature outside in the summer you’re doing very very well indeed. So you’re looking at a temperature uplift inside these buildings some degrees above the peak external temperature. So yes, in the future there’s a whopping problem. Probably by the mid-twenty forties in the south of England the NHS will have a huge air-conditioning bill, unless it does some very simple adaptation schemes to its existing buildings.
CHRIS MANN: Fascinating stuff. Thank you so much for joining us. Appreciate that. Cambridge University Professor of Architecture Alan Short there.