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A Considered Design for the NHS

In collaboration with Helen Kane, Access Included

Considered Design is a term which is often used when describing an architect or interior designer’s process. It would be strange after all to try and design something without first giving it some consideration. Last year I was fortunate enough to collaborate with the brilliant Helen Kane from Access Included on a project for the NHS. I have written a post about it below as I think it is a good example of what we mean when we tell people that at IAD we use a Considered Design approach to our projects.

An organisation such as the NHS needs to attract the world’s best talent. This puts it in direct competition with global giants such as Google, Facebook and all of the other worldwide behemoths. With approximately 40% of most organisation’s annual budget spent on wages, employee retention is a top priority.

With this in mind, we set out to produce an office design which would help to retain the office’s workforce, and in doing so help incentivise new employees over to the service.

To get an understanding of what the office’s residents did and did not like about the existing space we ran a series of neuro-diversity workshops, splitting the staff into groups of up to 8 to make sure that everybody had the chance to share their opinion. After initiating the discussion, we tried to guide the conversation with a light touch, allowing the group to explore the issues independently without pushing them in any direction.

During the workshops we gave information on neuro-diversity and design, looking at how individuals can be impacted by the same environment in different ways. Highlighting this to the groups from the outset helped them understand some of the design recommendations we would be putting forward later in the process.

One of the many benefits to working alongside Helen is her ability to touch type. This enabled us to keep a record of every word spoken in the workshops and create detailed notes of what issues and potential solutions were brought up, and what level of support each topic garnered from the rest of the group.

The workshops typically ran for around 90 minutes and attendees were given the chance to approach us by themselves at the end of the session if they were uncomfortable speaking out in front of the group.

As well as giving everybody the opportunity to express themselves, running a series of smaller workshops rather than one large workshop ensured that the results were not skewed by a few strong voices or being taken down a rabbit hole. The workshops did highlight a broad range of concerns but ultimately the same core issues were brought up again and again.

On completion of the workshops the notes were collated, analysed and then documented. The topics were broken down in to bullet points, and then prioritised based on how regularly they had been raised. Interestingly points 1, 2, 3 and 7 on the list all related to distractions and the solutions put forward to deal with distractions.

After the collected data had been studied the distractions were split in to three categories:

  • Walkways. Many distractions arose from a worker’s proximity to a thoroughfare within the office.

  • Doorways. As above, the closer a desk was located to a doorway the higher the level of distraction.

  • People. The data showed that a leading cause of distraction was interaction with or observation of interactions between other workers who inhabited nearby desks.

What the data also made clear was that the more social and interactive a work style was, the less impacted it would be by distractions. For example, when brain storming in a large group the individual members of that group are much less likely to be affected by other office workers walking past, or doors being opened and closed, than a solitary worker concentrating on a complex task.

Armed with the above conclusions we got to work designing the new office layout. Within the space we created three distinct styles of work area. Isolated individual work pods, generic desk work stations and collaborative meeting spaces.

The individual work pods were designed to allow those using them to tune out from all the noisy and visual distractions occurring in the larger office space. The pods are located as far away as possible from the pathways and doorways of the office and are fully close-able with acoustic properties to further insulate their inhabitants from the outside world. The pods were specifically targeted at users who had to tackle complex technical tasks and are allocated on a hotdesk basis to whomever has need of one.

The normal desk stations were moved away from doors and given visual protection from walkways using screens. The desks are not completely hidden from one another so as not to remove the social interaction or collaborative opportunities which an open plan office can offer.

Finally, the spaces most exposed to distraction were transformed in to collaborative meeting areas. With enclosed chairs and acoustically enhanced high walls each team space was still partially insulated from the general hub bub of the surrounding office. However, during the initial workshops it was highlighted that often when there were several teams brainstorming about different issues within ear shot of one another it was actually a member of an unrelated group that came forward with a solution. To avoid stifling this collaborative creativity some lines of sight were maintained between the adjacent meeting areas.

After addressing the feedback from the workshops we prepared our detailed design concept. Within our scheme we used Biophilic design to further promote wellbeing for the workers. It has been shown that Biophilic design in the workplace has an overwhelmingly positive impact on worker retention, productivity, stress and absenteeism. The effectiveness of Biophilic design can be measured in the number of leading tech firms adopting the practice as a way of attracting the most talented individuals to come and work for them.

At its core Biophilic design is the practice of bringing nature indoors. One of the ways we utilised Biophilic design in this project was with ‘living-panels’. The medium high partitions were 1.2m tall and were made up of dense green foliage. The living-panels were particularly effective as they not only improved access to nature within the office, they also helped with layout definition.

After completing the layout and furniture specification we returned to present our design to the department, doing so in two sittings with half of the department in attendance at each. There was very little actionable feedback form these presentations and so the overall design was kept almost entirely as it had been presented.

Following the presentations to the department the plans were shown to the group heads and directors, including the Director of Informatics Services and Chief Information Officer for Health for NHS Wales – Andrew Griffiths.

This presentation went well, and the scheme was quickly adopted and works green lighted.

The project has since been installed and has been in place now for approximately 9 months. I am due to return to the office in the next 6-8 weeks to conduct follow up surveys to assess what impact our design has had.

Once those surveys have been completed I will be publishing a review so that others may take away some of the lessons we have learned during this project and apply them to their own schemes elsewhere.

If you would like to see images from some of our other commercial projects, please click here. If you have a commercial project you would like our help with, please get in touch with us either via our Contact page or by sending an email to

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