NHS: Service model co-design for a health and wellness centre

NHS Mid and South Essex ICB needed to replace two outdated GP facilities in Shoebury with a new health and wellness centre. But with multiple organisations and stakeholders involved, plus numerous ideas for ways the space might work, how do you unite people behind a shared vision?

The ICB appointed us to lead a co-design process to define a service model for the space. We explored which services should be included, ways they could work and be accessed. The piece built on our previous NHS research exploring ways to improve the digital primary care journey.

We worked at stage zero of the Royal Institute of British Architects (RIBA) Plan of Work - the strategic definition of a project prior to preparation and full brief.

The findings and decisions made throughout the process have informed the business case for constructing the new centre.
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Approach

Our approach centred on understanding the evolving needs of Shoebury's diverse population. We collaborated with local residents, staff and GPs to define the centre's services, their integration, room and resource needs, and ways to measure the new building's impact.

Unlike traditional projects focusing primarily on the building, this project offered a chance to innovate beyond the limitations of existing structures, aligning with the community's values and future needs. Through a series of inclusive research and co-design activities, we gathered insight from across the community, building a shared vision for the future.

We observed patient engagement and process flow in primary care settings, conducted interviews, and facilitated co-design workshops with various groups. We reached out to diverse voices, including those from local charity-run groups, ensuring a broad range of perspectives.
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Findings

From the ideas shared by Shoebury residents and staff, we identified key service moments and space requirements. Here are a few examples:

• Flexible Space: For events, clinics, and courses, accommodating various care models and proactive wellbeing initiatives.
• Garden Zones: Designed for outdoor waiting and appointments, enhancing patient experience and community engagement.
• Patient Education Space: A private area for patients to access health information, away from distractions. The strong local volunteering sector's involvement was evident, emphasising the need to leverage existing community strengths.
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Staying realistic

We balanced creative ideas with practical considerations, regularly consulting with the ICB Finance Director and a Service Design Group. A demand and capacity model from York Health Economics Consortium and consultancy from Ingleton Wood Architects helped us understand the new building's size and cost implications.
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Impact

Our work fostered deeper connections and collaboration among stakeholders. We successfully integrated diverse needs into a coherent set of recommendations, shaping the vision for the new health centre. The evidence uncovered through the work is being used as a foundation for the business case for the full design and build phase of the work.

Sarah Mills, Transformation and Engagement Lead, Mid and South Essex Integrated Care System, said: “Choosing Healthia for the co-design foundations of the Shoebury project has been transformative. The team has already changed the perceptions of the project amongst our NHS stakeholders and increased engagement. Our joint work is going to underpin our business case to take the project forward with confidence and effective evidence.”

Peter Lovett, Head of Shoebury Residents Association, told us: “This has been the most positive process we have been involved in the last twenty years. We couldn’t have asked for a better team to work with on the co-design than Healthia. It’s been so nice to have the community come together. We have felt clearly listened to by the NHS, all questions have been open, and everything has been approached in a transparent fashion.”

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