Sensing Spaces of Healthcare: Rethinking the NHS Hospital

Design is a pressing issue in healthcare. Poor hospital design impacts staff, patients and visitors, and critiques of hospitals are increasingly widespread. Such critiques often claim that we have lost 'holistic' design in healthcare and refer to historical examples to make their case, but draw repeatedly on the same few examples (Nightingale wards, sanatoria) and focus on their visual features (colour, light). This project offers a new way of approaching hospital history, for the benefit of hospital historians, designers and users. It focuses on more recent - and under-studied - hospitals of the National Health Service. It also rethinks the history of healthcare environments through the body and the senses, focusing on how places have felt rather than how they have looked.

Using a range of interdisciplinary methods, from archival research to site visits and participatory arts, the project will explore the recent history of the senses in hospitals. The project will consider how NHS hospital sensory environments (or 'sensescapes') changed as a result of new design trends, architecture, materials, technologies, nature and human behaviours. It will also consider how changing social, cultural, political, and economic factors affected people's experiences of the same 'sensescapes'. Overall, by taking the senses as productive sites of interaction between people, technologies, materials and nature, this project will rethink the history of hospitals and provide new approaches for scholars of medical humanities and sensory studies.

The project's findings will also feed into an imaginative rethinking of current and future hospital design, including the development of innovative multi-sensory design interventions for healthcare environments. In line with the UKRI strategy, the project will 'identify and tackle the complex societal challenges that matter most to people, in partnership with them ... with the aim of delivering maximum societal value'. It will work with Great Ormond Street Hospital (London), Southmead Hospital (Bristol) and Architects for Health to pinpoint issues or 'problems' for specific types of hospital user/worker or hospital spaces, which might range from sensory under-stimulation to sensory overload. In turn, these 'problems' will form the basis for sensory design solutions through a prototyping and development process in collaboration with artists, designers, charities and NHS Trusts. These outputs will be produced with and of value to all those who use hospitals, from patients to professionals. Overall, the project offers a novel approach to the history of healthcare spaces that helps us to rethink hospital histories and their relevance to current-day design challenges.

This project's research will be produced with and have a valuable impact on:
> users of hospitals (including staff, patients and visitors), by identifying ways of improving the sensory experiences of hospitals through design interventions.
> hospital arts/design organisations, by providing new ideas based on historical examples and new arts/humanities-based methods for identifying 'problems' that need solving.
> the NHS, by finding sensory design solutions that promote health and reduce unnecessary drains on resources.
It has 3 key partnerships - with GOSH Arts at Great Ormond Street Hospital (London), Fresh Arts at Southmead Hospital (Bristol) and Architects for Health - to ensure that its research findings are translated into practice in the most valuable and impactful form for the NHS. By working closely with these organisations, and with individuals who have a history of spending time (as staff, patients, or visitors) in London and Bristol hospitals, the project will involve its beneficiaries throughout.

Sensory design can both exacerbate and ameliorate problems in hospitals, such as worker stress, visitor anxiety and the boredom of long-term patients. These problems are significant resource drains and are detrimental to the holistic health of staff/visitors/patients. However, many healthcare environments pay insufficient attention to the importance of the multi-sensory, affective and emotional elements of design. This project will be the first long-term collaboration between arts/humanities academics, design professionals, artists, architects, hospitals, patients, staff, visitors and others to identify the most important 'sensory problems' in hospitals, which might range from sensory overload to sensory deprivation depending on the people/place. It will develop relevant guidance for architects and arts/health practitioners relating to these problems, and develop a multi-sensory prototype to tackle one. A key goal of the prototype (years 1-4), and ultimately a final scalable product (years 5-7), will be positively to impact the experiences of hospital users and the practice of hospital design. The prototype's exact form cannot yet be known, as it will be a result of co-production with people and organisations, which is an intentionally unpredictable process; it may be a new type of multi-sensory space (or space within a space), an object or an artwork. The prototype will have a number of organising principles to maximise its impact: (1) to bring the research conducted in years 1-3 into a 'design thinking' process, to 'empathise' through focusing on people's (hi)stories and to use this to 'define the problem' to be resolved through multi-sensory design; (2) to involve hospital staff, patients and families in its development; (3) to reflect the project's principles and methods, including its understandings of the relational and highly personal nature of sensory environments; (4) to find 'low resource' solutions that are easy for NHS hospitals to maintain and which are affordable/scalable

In terms of the UKRI's aim of 'societal value', this project will thus have a significant national and in the long term potentially international impact through such interventions. In relation to more specific council strategies, this research connects particularly to the AHRC strategy in relation to 'design research' and is likely to connect to specific sub-sections of this strategy such as 'healthy aging' as long-term hospital patients (in-patient or repeat visits) are often young or elderly. Finding design solutions for new kinds of hospital patient (such as the growing proportion of elderly patients) and new challenges (such as staff workload) requires innovative thinking and a long-term, co-production model of design which this project offers.