Five key challenges for the future of healthcare design

Oana Gavriliu, Principal and healthcare architect at Hassell’s London studio, outlines five key trends reshaping the future of healthcare and healthcare design in the UK and worldwide.

Healthcare systems worldwide are undergoing profound transformations, driven by the need to improve efficiency, sustainability and patient outcomes. While every country faces unique challenges, five key themes are emerging as universal trends: digitalisation, care in the community, predictive and preventative medicine, decarbonisation, and flexibility and adaptability.

These shifts are neither new nor occurring in isolation. Many healthcare systems have implemented aspects of these changes individually, with varying ranges of scope and degrees of success.

In the UK, the NHS, which is preparing to launch a 10-year transformation plan, holds a privileged position — it can implement these shifts in an integrated way, learning from global best practices while benefiting from a national strategy and structured programme.

This unique opportunity could allow for one of the most robust and comprehensive healthcare transformations globally.

Each of the following five topics is critical in shaping the future of healthcare. They are interconnected and provide a framework for creating more resilient, efficient and patient-centred systems.

1. DIGITALISATION: THE KEY TO A CONNECTED, INTELLIGENT HEALTHCARE NETWORK

Digitalisation is at the heart of healthcare transformation, shaping a future in which intelligent, data-driven and predictive systems enhance both patient care and operational efficiency.

Many countries have made strides in healthcare digitalisation, introducing electronic patient records (EPRs), AI-driven diagnostics, telemedicine and automated workflows. However, these advancements have often been implemented in isolation — on a regional or institutional level — without full integration or a cohesive national framework.

The NHS has the opportunity right now to scale digitalisation system-wide, creating an interconnected healthcare network that supports real-time data sharing, streamlines decision-making and enhances patient and staff experiences. This ambition extends beyond infrastructure upgrades; it involves building a digital-first culture that embeds AI-powered diagnostics, predictive analytics, remote monitoring and virtual care models into everyday healthcare delivery.

However, the journey to full-scale digital transformation is not without challenges. Legacy IT systems, cybersecurity risks, and the need for comprehensive staff training pose significant hurdles. Ensuring that digital solutions are inclusive, user-friendly and accessible across all levels of care will be crucial to their success. 

By leveraging international best practices, learning from past implementations, and investing in robust digital infrastructure, the NHS has the potential to establish a more cohesive, efficient, and scalable digital health ecosystem and set a global benchmark for digitally enabled healthcare.

2. CARE IN THE COMMUNITY: REDUCING PRESSURE ON ACUTE SETTINGS

Moving care closer to home has been a global directive for decades, with many health systems making significant strides in developing primary care, expanding step-down facilities, and integrating social services with medical care. However, in the UK, while the rhetoric around care in the community has been strong, investment and structural change have lagged behind other OECD countries in the past 10-15 years, hindered by fragmented and misaligned funding streams. 

A major priority for the NHS continues to be decompressing acute hospitals by shifting more patient care into community settings, ensuring that hospital resources remain focused on the most complex and acute cases. This transition has profound implications for how healthcare spaces are distributed. Rather than thinking of hospitals as the principal centres of care, the scope is widened to include a variety of integrated care facilities that blend healthcare with other community uses. 

These facilities could bring together public and private providers and co-locate GP services, step-down care, mental health support, aged and residential care, pharmacies and wellness initiatives, pooling resources, sharing data and fostering healthier communities and a sense of belonging.

This decentralisation of healthcare requires a rethink of funding models and care coordination, ensuring that community providers have the necessary settings, resources and digital infrastructure to deliver consistent, high-quality care. 

The shift also creates opportunities for rethinking hospital space, optimising acute care capacity, diversifying uses and developing new models of ambulatory and virtual care that bridge the gap between hospital and community services. As healthcare becomes more distributed, the need for flexible, multi-functional spaces that can adapt to evolving care needs will be critical in ensuring that both community and hospital environments remain fit for purpose.

3. PREDICTIVE AND PREVENTATIVE MEDICINE: DESIGNING FOR HEALTHIER LIVES 

A shift towards prevention is critical for the long-term sustainability of the NHS, as was highlighted in Lord Darzi’s report on the state of the National Health Service in England. At the same time, preventative and predictive medicine are becoming inseparable as AI and data analytics transform how we anticipate and manage disease. The ability to identify at-risk populations, track health trends and intervene earlier is advancing rapidly, shifting healthcare away from reactive treatment toward proactive health management.

Preventative healthcare focuses on early intervention, public health initiatives and lifestyle changes that reduce the need for costly hospital treatments down the line. For the NHS, this means incentivising GPs and other healthcare professionals to prioritise screening, education and wellness initiatives. From a design perspective, this approach extends beyond hospitals and healthcare facilities — it requires the creation of built environments that actively promote health and wellbeing across all building types, communities, and cities.

A healthy built environment, whether at the building or city scale, actively supports physical, mental and social wellbeing by integrating humanistic design, sustainability and accessibility. Healthy buildings provide ample daylight, strong connections to nature, clear wayfinding, high indoor air quality, thermal comfort, and thoughtful acoustics, creating spaces that enhance comfort and engagement.

At a broader scale, healthy communities prioritise walkability, green spaces, accessible healthcare, social cohesion and sustainable infrastructure, ensuring that urban environments encourage movement, interaction, and long-term resilience. 

The NLA agenda and similar initiatives advocate for responsible design, clarity in development processes and building trust among stakeholders, reinforcing the need for a holistic, human-centred approach to urban planning. Whether designing new developments or retrofitting existing spaces, the focus must be on creating environments that promote health, sustainability and inclusivity, allowing people not just to live, but to thrive.

4. DECARBONISING THE HEALTHCARE ESTATE 

The healthcare sector is a major contributor to global carbon emissions, accounting for around 5% of total greenhouse gas emissions worldwide. If it were a country, healthcare would rank among the largest emitters globally. 

Many nations are grappling with the challenge of decarbonising both new and existing healthcare infrastructure, and few have fully embedded sustainability into their national healthcare strategies. The UK is setting some of the world’s most ambitious carbon reduction targets, positioning the NHS at the forefront of this transformation — both as a leader and as an institution facing significant challenges in achieving net-zero goals.

Decarbonisation is, therefore, a critical priority, requiring both sustainably designed new-build hospitals that minimise embodied carbon and the retrofitting of existing NHS estates to enhance energy efficiency and reduce their carbon footprint. Cutting operational carbon is central to this effort, with new and upgraded facilities incorporating passive heating and cooling, smart energy systems, and renewable energy sources. Additionally, climate resilience must be a core consideration, ensuring that hospitals are built to withstand extreme weather events such as flooding and heat waves, which are becoming more frequent due to climate change.

Delivering new or upgraded facilities within an operational hospital campus presents a unique set of challenges, requiring a careful balance between infrastructure modernisation and the need to maintain uninterrupted patient care. Success depends on detailed planning, phased implementation and close collaboration between designers, contractors, executives, adminstrators and clinical teams. 

A holistic approach that integrates logistical efficiency, infection control and operational continuity while embracing circular economy principles, adaptive reuse strategies, modular solutions and Modern Methods of Construction (MMC) is essential to future-proofing healthcare facilities without compromising care delivery or efficiency.

By embedding sustainability across both new and existing infrastructure, the NHS has a pivotal opportunity to reduce carbon emissions, enhance resilience, and drive long-term environmental and operational sustainability. 

As one of the largest and most complex national health systems in the world, the NHS has both the challenge and the opportunity to lead the way by demonstrating how a national health system can be decarbonised at scale. 

5. EMBEDDING FLEXIBILITY AND ADAPTABILITY IN HEALTHCARE ENVIRONMENTS

Flexibility and adaptability in healthcare design have long been recognised as important, but as care models, technologies and treatment evolve at an accelerating pace, their role is becoming increasingly critical. Advances in medical science, digital health, genomics and AI-driven innovation are rapidly reshaping healthcare delivery, while staff and patient expectations continue to evolve. At the same time, the range of professionals involved in care is expanding in both acute and primary care settings. 

Healthcare is no longer centralised in specific locations and buildings; instead, it is transforming into a network of services distributed across acute hospitals, community settings and virtual care platforms. In this shifting landscape, designing spaces that can adapt, repurpose and evolve over time is no longer just beneficial — it’s essential.

Digitalisation has immense potential to enhance adaptability, enabling designers to think of space as multidimensional and multifunctional in terms of experience. 

By merging the physical and digital realms, healthcare environments can dynamically shift their uses, using smart infrastructure, AI-driven resource allocation and virtual care integration.

In this context, rigid standardisation risks creating outdated environments that cannot easily respond to future healthcare needs. While some level of standardisation is beneficial for cost efficiency, procurement and quality assurance, it must be applied to system-wide processes, core design principles, building strategies and modular components — not to entire departments or fixed building modules.

Instead, healthcare spaces should be organised into interchangeable typologies within high-tech, medium-tech, and low-tech zones, allowing for easier repurposing over time. This concept extends to the adaptive reuse of existing buildings, where legacy hospital estates and other urban assets can be repurposed for lower and medium-tech functions or further enhanced with additional service infrastructure and cores to achieve or maintain their suitability as high-tech spaces.

As health science, treatment models and patient needs continue to shift, how can we strike the right balance between efficiency, resilience and long-term adaptability? Perhaps the focus should not be on designing for certainty, but rather on designing for change itself — creating spaces that can flex and grow, just as healthcare itself does.

While all five of the above challenges are interconnected, digitalisation and adaptability stand out as the most transformative enablers of change, shaping the future of healthcare design.

Digitalisation provides the technological backbone that allows for greater efficiency, data integration, and new models of care delivery, while adaptability ensures that the healthcare estate and services can continuously evolve in response to changing demands.

As the NHS embarks on its 10-year transformation plan, embracing these two themes will be critical to ensuring the sustainability, resilience and effectiveness of healthcare in the UK. Designers, healthcare providers and policymakers must collaborate to create intelligent, adaptable healthcare environments that align with a digitally enabled, community-centred and patient-focused future.