Planning with purpose: how joined-up thinking can transform NHS infrastructure

Tackling fragmentation, improving consistency and supporting more joined-up decision-making across the NHS in the planning and design of healthcare facilities is the focus of a recent Mott MacDonald digital innovation. Mott MacDonald health market lead Rhydian Morgan explains how the development of the Healthcare Configurator has been built on decades of experience.

Mott MacDonald launched the Healthcare Configurator earlier this year to bring a new and innovative digital toolkit to the market. Designed to create consistency, clarity and collaboration across the entire healthcare planning process, it enables smarter decisions, cost confidence, faster delivery and, ultimately, better outcomes for patients and communities.

Understanding the scale and widespread nature of the challenge across the sector has been critical to identifying the need for change. Although there has been great progress across the industry, more can and needs to be done to deliver an increased joined-up approach to healthcare planning and design.

Understanding the past to help create the future

After a quarter of a century in healthcare facility planning, design and construction, I’ve had the privilege of working on some of the sector’s most complex and ambitious projects. But over time, you quickly start to recognise a pattern where projects face the same challenges time and again.

While the sector has always been full of passionate and skilled professionals, the absence of the right tools to interpret complex datasets has often led to fragmented processes. This has driven our team to challenge itself and think: what if things were done differently? What if there was a more joined-up, data-informed and collaborative way to plan and design for healthcare?

One of the key issues we observed was that healthcare projects were frequently developed without considering their broader impact on the healthcare system. There was limited integration with master planning and no consistent way to assess how a new facility or service would affect regional flows, capacity or demand.

Access to timely, relevant data was another challenge. Many teams were relying on outdated benchmarks and disconnected datasets, which made it hard to forecast demand accurately or align designs with evolving models of care. That often led to projects that didn’t quite match actual service needs and investment decisions that missed the mark and failed to have the expected transformational effect.

It was apparent that varied approaches to developing briefs and early concepts meant there was no shared language or standardised process, and valuable lessons learned weren’t being carried forward. This presented a clear opportunity to reimagine the approach and build something better.

Building a better way to plan

The Healthcare Configurator platform brings together several tools, each playing a critical role in translating models of care into actionable infrastructure planning requirements.

Starting with an integrated demand and capacity toolkit, it has been designed to help forecast service needs using real population health data. It was important to move beyond assumptions and start grounding decisions in evidence. From there, a tool was developed that could automate room planning and link functional content to room sizes and standards, helping to reduce setup time and bring more consistency to early-stage design.

The team recognised the need for better cost intelligence too, so the Should Cost Toolkit was created, which gives planners a clearer view of affordability, factoring in location, inflation and design choices. It is not about chasing the lowest number but about understanding what’s realistic and sustainable.

To support spatial planning, massing and stacking analytics were developed. This generative design platform, driven by healthcare logic, allow teams to visualise how departments interact, how people move through spaces and how adjacencies affect efficiency and workflows.

All these come together as the Healthcare Configurator which is helping teams move from strategy to proof of concept with greater clarity. It doesn’t replace expertise; it supports it by making the process more transparent and collaborative.

The broader approach

One of the most important shifts that has been achieved is the move away from thinking about buildings in isolation. The Healthcare Configurator is designed to reflect the configuration of services across entire regions, understanding how patients move through the system and how future demographic changes might affect demand before thinking about how facilities need to connect and respond to this.

This broader perspective allows planning, not just for today’s needs, but for tomorrow’s challenges. It supports scenario planning, whether it’s for business-as-usual or reimagining care pathways. Then it ensures that decisions are both efficient and equitable. Perhaps even more importantly it fundamentally changes the timeline for scenario planning and solution development processes.

It is a game changer for the approach to early business cases with significantly increased confidence in deliverability and cost at every stage – essentially the Health Configurator is about seeing the whole system, not just the individual parts.

Further development

We’re continuing to evolve the Healthcare Configurator to make it even more responsive to the realities of modern healthcare. One area of focus on is the integration of social determinants of health – factors like future developments in housing, education and income that have a profound impact on people’s health and wellbeing. By bringing these into the planning process, their impact can be assessed so it is possible to design services and facilities that are better future-proofed and more aligned with the communities they serve.

Incorporating cross-sector service plans and geographic insights is also being worked on. This will aid understanding of how services interact across different areas and organisations, as well as how to better coordinate care across boundaries. It’s a natural next step in the journey, one that reflects the complexity of people’s lives and the systems that support them.

But this work isn’t just about developing tools, it’s about rethinking how healthcare is planned and delivered through collaboration. By embedding data, design and system thinking into every stage of the process, the Healthcare Configurator supports building a smarter, more resilient NHS.