Dementia-friendly environments

Transforming the £83 billion NHS built estate to deliver safe and dementia-friendly care

The NHS’s £83 billion building and estates portfolio is amassing critical maintenance backlogs - threatening users’ safety - but is expected to deliver radically new levels of service.

Dementia patient numbers are predicted to double by 2050. Radical changes to services for the elderly are needed – including the transformation of healthcare settings to ensure effective, patient-centric care delivery.

Our EPSRC and Department of Health-funded research in strategic asset management has demonstrated how to better design, fund and manage the NHS estate.

Our research has underpinned key changes to national healthcare policy and practice and provides innovative approaches to the design of health and social care environments that better suit the needs of patients.

Our impact

Our research into the strategic asset management of healthcare estates has

  • Transformed the NHS’s annual £3.7 billion capital funding and £9.5 billion estate management practices.
  • Improved quality of life and care for people living with dementia.
  • Delivered national guidance for designers to deliver dementia-friendly built environments.
  • Enhanced the safety, efficiency and efficacy of healthcare services in England.

Extensive dissemination

  • Pilot projects included 1,312 engagement activities with 409 stakeholder groups.
  • We have presented our findings at international conferences, including the International Federation of Hospital Engineering, IHEEM, Latin American Congress of Architecture and Hospital Engineering, EuHPN, HaCIRIC, King’s Fund and IADH.
  • Our work has received recognition via a range of awards including the Market Research Society Healthcare Research Award (2015), the MRS Grand Prix for Greatest Impact Award (shortlisted, 2015) and the RIBA President’s Awards for Research (shortlisted, 2015).

New national design guidance

  • Our research shaped the development of Health Building Note HBN08-02, Dementia-friendly Health and Social Care Environments.
  • It is the first HBN covering both health and social care and providing guidance to architects, designers and care providers to ensure all new or refurbished facilities are dementia-friendly.

Influencing Government policy

  • Our Strategic Asset Management (SAM) recommendations have changed the NHS’s capital funding and estate management practices – improving the safety, efficiency and efficacy of healthcare services.

The research

To support cost-effective provision, we have developed an evidence-based Strategic Asset Management approach to sustainably plan, manage, maintain and dispose of estate.

We have also demonstrated that the internal design of care settings can greatly influence elderly well-being.

For example, more needs to be done to increase the use of therapeutic lighting systems that positively impact physiology and behaviour, including the sleep-wake cycle. Similarly, high contrast fixtures and fittings – including handrails and toilet seats – are low-cost, but effective interventions.

In addition, we supported the development of appropriate guidance for dementia-friendly design of healthcare assets – including the Department of Health’s Dementia-friendly Health and Social Care Environments (HBN08-02) – as well as recommendations for reducing NHS backlog maintenance.

The key driver of this work was to improve quality of life for patients and staff.

We monitored and assessed the DHSC England’s National Dementia £50 million Capital Investment Programme’s 115 England-wide pilot projects. This involved an extensive knowledge exchange process and strong pathways created with project stakeholders – including design teams and end-users.

This delivered innovative dementia-friendly care environments, including the use of supportive technologies and dementia-friendly design details. In addition, it provided cost-effective benefits to about 100,000 patients, staff and carers.

Self-evaluation of the changes by the project teams and analysis by LU researchers determined that in acute, social and community settings, high and sustained impacts have been achieved over the past four years – and will continue for the foreseeable future.

What’s more, our research findings have now also been adopted by NHS Scotland and there is widespread international interest.

[HBN08-02] is a very important document for all health care and social care providers, it should be the foundation for all development and refurbishment decisions.

Professor Martin Green OBE Chief Executive - Care England
Foreword to HBN08-02

Research funders

  • Department of Health and Social Care
  • EIB
  • NHS Improvement

Meet the experts

Photograph of Andrew Price

Professor Andrew Price

Professor of Project Management (Retired)