Conclusions

To achieve success, providers, commissioners and regulators of the delivery of healthcare or more specifically the accommodation in which health and social care is provided need to proactively embrace the principles of design for sustainability integrated with evidence-based design. Also of importance is that the process involves users or occupants of the healthcare facilities. Otherwise, efforts to meet sustainability targets and aspirations for design quality improvement are futile without a meaningful engagement of users. This means that the imperative is for a cultural shift and raising awareness among the users and managers of healthcare facilities at both the local level of a clinic, the geographical health economy comprising hospitals, clinics and care homes, and the national healthcare system as well as globally. A culture change and increased awareness is also not enough but needs to be translated into actions by both individuals and organisations. Within the organisation, the support needs to emanate from the top down in order to be effective. Applying and implementing design for sustainability is perhaps the greatest challenge for any organisation that adopts and commits to this approach. The case studies in this brief highlight the different starting points and focus. In particular, the strategy in the UK has tended to be that of providing publicly sponsored and funded health care guidance and design tools to aid the design process compared with the US where the focus on practice has encouraged private firms to implement principles of sustainable evidence-based design.