Abstract

Charles Darwin’s interpreted observation that it’s neither the most intellectual nor the strongest of the species that survives but the species that is able best to adapt and adjust to the changing environment in which it finds itself was the final message of Royal College of Physicians’ president Dr Andrew Goddard’s keynote talk during the opening plenary of the 7th European Healthcare Design Congress.

Speaking about some of the major challenges in healthcare today, Dr Goddard took inspiration from former US Secretary of Defence Donald Rumsfeld in structuring his talk around known knowns, known unknowns, and unknown unknowns, but all through the visor of Covid-19. He noted that it will be the ability to adapt, as Darwin suggests, that will be vital for the future of healthcare delivery not just because of the pandemic but the many other trends that have been exerting increasing pressure on the system in recent years.

One of the external pressures – the climate crisis and its effects – was the key focus of Prof Tony Capon’s keynote talk. As director of the Sustainable Development Institute at Monash University, Prof Capon explored how to deliver environmentally sustainable healthcare. The need to transition from a highly wasteful economic model to an economic model where focus is on repair, reuse and recycling presents a huge challenge and opportunity for healthcare around the world, argued Prof Capon. And it’s not enough to just focus on carbon emissions in relation to sustainable healthcare.

He ended his talk with a list of priority actions to make healthcare fully sustainable, including: leadership; measuring and monitoring key indicators of healthcare sustainability alongside economic and social indicators; integrating sustainability into health service planning and accreditation standards; documentation and sharing of best practice; and building capacity through in-service and pre-service training.

Sunand Prasad, principal of Penoyre & Prasad and chair of the UK Green Building Council (UKGBC), took up the baton on sustainable healthcare by exploring the notion of regenerative architecture, setting it in the context of the upcoming UN Climate Change Conference, COP26, in Glasgow in November.

Noting that temperatures last year were 1.2^oC above pre-industrial temperatures already and rising at about 0.2^oC per decade, Prasad said that the UKGBC had been thinking about what success would look like for the world, the UK, and the built environment industry, to best direct its efforts. Three issues, he concluded, were apparent. Firstly, nationally determined contributions that can give confidence in the world’s ability to keep global warming to under 2^oC; secondly, credibility that these pledges can be delivered; and thirdly, a wide and shared realisation that while action to resolve climate imbalance is about survival of species and civilization as we know it, we should frame it around human flourishing.

This keynote session was kindly supported by AECOM.