The high street is everchanging. Can it also adapt to integrate essential health and wellbeing facilities, to serve the local community, economy and place? Polly Barker of tp bennett reflects on our latest webinar.

NLA brought together four experts for its "Health on the High Street" webinar, where we discussed how this topic is being explored both in terms of research and policy, as well as in practice.

Chaired by Anisha Mayor, the UK Head of Healthcare at WSP, the session was well-timed, taking place less than a fortnight after the publication of the Hewitt Review – a comprehensive look at the state of our integrated care systems.

To kick it off, Lisa Finlay, Partner and Group Leader at Heatherwick Studio, presented the studio’s “Health Streets” concept, a vision for health creation on the local high street. She posited that the prevailing trend to build bigger and newer hospitals is not necessarily the right approach, proposing instead that health should be rooted in our communities – providing services that are more affordable and sustainable. 

She listed the essential ingredients for a Health Street: an underused high street that’s within a 15-minute walk to multiple residential communities, that is well connected via public transport and cycle routes, with a nearby public green space, a community diagnostic centre as well as local businesses and community champions. 

At Heatherwick Studio, Lisa has put this idea into practice at Lister Gate in Nottingham which had all the essential ingredients and conditions needed. They are now working with the city to refine the model, whilst also learning how it can be adapted to different locations.  

I continued the conversation by suggesting that there has always been healthcare on the high street in one form or another, and that it’s positive that we are now looking to expand it. At tp bennett, we’ve put modern health care provision into different types of existing buildings, including offices, shops, houses, and even in a decommissioned double-decker London bus – which we retrofitted to bring healthcare services directly to those who need it most. I touched on the nerdy, more technical aspects of doing this but also emphasised that we must also think about the needs of the people, both patients and providers, as well as the geography. Is it near the people who really need it, and how do they get to it? 

We could squeeze healthcare into almost any space if we wanted to, but it’s important that we focus on what’s actually important for the people who are using these services. The requirements of these spaces are also constantly changing as technology advances, often decreasing in size – making healthcare spaces more flexible as a result. We’ve done this in more typical high street projects such as at Dartford Town Centre, or for corporate businesses such as Goldman Sachs who want to provide amenities for their employees, as well as workspaces for remote GP services such as Push Doctor. 

Jaime Bishop, Founder of Fleet Architects, presented "The Well-Placed Hospital" manifesto, which advocates for wide-scale systematic health and social Care reform for the reintegration of hospitals into communities. The manifesto focused on market towns and looked at place based on data rather than political boundaries. Jaime reiterated the hospital’s journey that has seen it progress to the edges of cities and towns, largely driven by the need for more space when the trend for healthcare technology was to increase, rather than decrease, in size. Unfortunately, Jaime points out, we are still building hospitals based on these parameters even when the socioeconomic context has changed. 

The climate crisis is another key reason for rethinking how we design our healthcare infrastructure. Jaime points to huge opportunities to reuse existing buildings, particularly offices and shops, as the technical demands of healthcare can map onto these existing building forms. Jaime demonstrated this with “The Civic Supermarket” as a case study, where his practice proposed retrofitting a disused Haringey Sainsbury’s to provide community health services and GPs. 

To round it up, Jess Wilson, Director of Planning at Newsteer discussed the changing attitudes towards hospitals and health buildings, which may have been accelerated by the pandemic. She cited examples of health facilities being introduced into non-health buildings in emergency situations, such as vaccination centres in museums, leisure centres, libraries, and office buildings. Jess also discussed the potential of health facilities to anchor and regenerate declining high streets. However, Jess pointed out challenges in terms of navigating complex lease structures, access issues, and operating hours, alluding to the need for increased flexibility in planning policies in order to integrate health facilities into high streets more effectively.

Overall, the panel highlighted a range of innovative projects and initiatives that showcase how health can be integrated into the fabric of local communities, promoting accessibility, inclusivity, and sustainability. The event emphasized the need for collaborative efforts and holistic approaches to healthcare planning, and how policy changes can support these efforts at the local level.