Emerging Issues

This brief started by looking at the changing context for national and international healthcare systems, before reviewing the healthcare premises information, guidance and tools that underlie the approach in which sustainability is to be seen as integrated with evidence-based design rather than as divorced and separate themes. However, to understand the role these aspects play, it is also essential to consider both the historical context and, in particular, the organisational structures of the different healthcare systems whether these are national or international. This chapter discusses emerging issues from the approach that adopts design for sustainability integrated with evidence-based design. The aim is to help decision-making within the area of healthcare premises, planning and design whether this is nationally or globally. The crucial emerging issues start with the problem of definitions of ‘Evidence’ and ‘Sustainability’ but include the debates surrounding several themes: Centralisation versus Decentralisation, the nature of Public versus Private Sector Involvement, National versus International Standards to Prescription versus Performance Standards. Addressing these issues has an important bearing on the development of design for sustainability and evidence-based design as science.