The strategic importance of car parks in healthcare development

7th February 2024

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The strategic importance of car parks in healthcare development
  • Hospital car parking creates significant challenges for health and care leaders, impacting the patient experience, staff satisfaction and obstructing estate development. It is the first and last point of contact that users have with the hospital and often a bad parking ‘experience’ is what they remember.
  • The development of new car park infrastructure can positively impact sustainability and social value goals for the NHS via environmentally sympathetic design and construction.
  • Car park infrastructure must be considered as part of broader estate challenges and address the current needs of patients, visitors, and staff today, as well as considering future growth and demand.

As demand for hospital services rises, every square metre of hospital estate becomes an increasingly precious resource, leaving trusts facing complex estate challenges. But what if the key to unlocking estates lay within the most unremarkable part of hospital infrastructure?

In this article, we explore the strategic importance of car parks and transportation in shaping the future of hospital estates.

Car parking is often contentious on hospital sites, particularly in densely populated urban areas. From the rising costs of parking and a lack of availability for staff and visitors to frustrated hospital neighbours bearing the brunt of car park overspills on residential roads.

A scarcity of easily accessible parking can add additional and unnecessary stress to both hospital visitors and staff in an already pressurised environment. Additionally, for hospitals struggling with recruitment and retention challenges, the availability and affordability of parking can have a significant impact on both staff satisfaction and the attractiveness of that trust as an employer. Having to park in residential streets close to hospital sites can not only add a significant amount of time to an employee’s journey to work but also create safety concerns for those staff finishing shifts at unsociable hours.

As demographics change and the population grows, pressure is mounting on hospital trusts. They are often being asked to deliver more within the confines of limited space and resources. As a result, many trusts have turned to ad hoc, patchwork and temporary solutions to car parking challenges. However, to solve the long-term challenges trusts face, healthcare leaders must now embrace a more strategic approach to their estate challenges.

Unlocking space and efficiency

From an outside perspective, car parking might not appear to be the most exciting or cutting-edge of development projects. However, car park and transportation projects can be the enablers of transformational change, empowering trusts to achieve their strategic vision and alleviate complex challenges.

Parking structures, such as multi-storey or undercroft parking, can help hospitals maximise their estate footprints and better meet the needs of patients, visitors and staff with well-designed and modern parking facilities. Prime’s development of a 650-space multi-storey car park (MSCP) at Yeovil District Hospital shows just how pivotal these schemes can be in freeing up development space for new clinical facilities while also dramatically improving the staff and patient experience.

Before the development of the new MSCP at Yeovil District Hospital, only 8 per cent of patients and visitors found it easy to park, while only 42 per cent of staff said they felt safe walking from their parking place to the hospital. However, after the completion of the scheme, these figures improved dramatically; 78 per cent of patients and visitors reported finding it easy to park, while almost three-quarters of staff (72 per cent) said they now felt safe walking from the new car park to the hospital.

At hospital sites where on-site car park development just isn’t a viable option, such as at University Hospital Southampton (UHS), Prime has devised park and ride solutions. As well as helping UHS to progress its strategic estate plan, the park and ride facility is freeing up more patient parking space at the main site, reducing traffic in the city, and helping to boost the morale and retention of hospital staff who benefit from a reliable, affordable and safe transport system.

A strategic approach to accessibility may also lead to revised access routes that help alleviate bottlenecks and streamline traffic flow in and around hospital sites — as demonstrated at Prime’s car parking scheme at University Hospital Coventry. It’s an outcome that not only improves user experiences and encourages more active forms of travel, such as cycling and walking, but can also help reduce harmful emissions from cars that contribute to air pollution.

Across all parking projects, Prime’s approach puts car park users at the centre of all design decisions. The starting point is to consider the differing needs of all users, making sure that the facility is easy to access by all modes of travel and that the wayfinding into the hospital is logical and convenient.  Our design, from parking bay size to strategically placed lifts and staircases, reflects market-leading guidance and best practices, shaping an efficient and user-friendly facility.

Empowering NHS sustainability ambitions

Travel and transport account for 14% of the NHS carbon footprint [1]

The NHS has bold ambitions to achieve net zero carbon emissions by 2040, and to help lower its carbon output, NHS Shared Business Service (NHS SBS) has developed a new Sustainable Transport and Infrastructure framework agreement. This procurement framework enables trusts to source and appoint pre-approved providers who comply with NHS sustainability ambitions at pace.

The investment to upgrade and improve existing NHS infrastructure will be a considerable step towards achieving this goal. As well as encouraging more sustainable modes of transport and the electrification of the NHS transport fleet, redesigned car park infrastructure can positively impact a trust’s sustainability and social value KPIs.

When it comes to car park construction, using a high proportion of reusable or recyclable materials, such as steel frames or metal cladding, ensures more efficient use of materials and protects the environment against unnecessary future waste. Modern construction methods also enable components to be created off-site, reducing the dependence on energy-heavy machinery and shortening construction times.

From a design perspective, new technologies offer long-term sustainability gains. Low energy lifts, LED lights with smart sensors, and natural ventilation all help to minimise consumption. The inclusion of photovoltaic (PV) panels enables on-site energy creation, while the installation of EV chargers supports the adoption of electric and hybrid vehicles.

Guy Kippen, Development Manager at Prime explains why considering both current and future needs is vital when designing for a sustainable future:

“When it comes to testing the viability of a project, analysing the future demand for EV charging points is an essential step – as we’ve shown at Dorset County Hospital.

“As well as providing a proportionate amount of EV parking spaces to be used now, we’ve also calculated and built-in passive provision, enabling the Trust to expand their infrastructure at ease when required.”

Carefully considering the natural environment in development projects is very important. New parking facilities can contribute to biodiversity net gain by providing dedicated housing for birds, bees, bats and hedgehogs. Surrounding green spaces can also be significantly landscaped, and off-site woodland creation can be implemented. These efforts aim to improve the natural environment, leaving it in a better state than it was before the project commenced.

A 15% biodiversity net gain was created at Dorset County Hospital after Prime’s MSCP development.

At what cost? Funding future possibilities

National headlines continue to take aim at the cost of hospital parking, with the latest figures revealing that hospital car parking costs have risen 50 per cent in a year. Patients and visitors paid £146m for parking in 2022/23, triple the cost from just two years ago. Meanwhile, staff have seen their parking fees soar eight-fold compared to the previous year, rising from £5.6m in 2021/2022 to £46.7m in 2022/23.[2]

While such headlines position hospitals as profiteering from parking and exploiting the vulnerable, the issue is far less black and white. Car park ownership varies greatly across the country. While some trusts directly manage their parking facilities and generate an income stream that enables profits to be reinvested back into frontline services, other trusts hand over the day-to-day operation to a professional car park operator.

Prime has a proven track record of helping trusts develop both models. With design, build and finance (DBF) schemes, trusts lease their new car park infrastructure from an institutional investor, utilising the revenue they collect from parking to pay back the cost of the build, over 30 years for example. With design, build, finance and operate (DBFO) schemes, Prime still helps source affordable funding solutions and efficient construction costs to deliver infrastructure for the best value, but will also find a suitable car park operating partner to lease and manage the car park on the trust’s behalf. Institutional investor funding is a key enabler to the development of any hospital car park project, ensuring that money and resources are not diverted away from patient care.

While DBFO structures reduce or eliminate potential revenue for trusts, they can also alleviate the additional challenges that come with successfully managing a car park facility, and allow trusts to focus on what they do best. Iain Saunders, Group Commercial and Legal Director for Prime, explains why despite the loss of revenue, the DBFO structure is often a more appealing route to trusts:

By using a DBFO contract structure, Prime is able to deliver solutions that are off-balance sheet and do not impact a trust’s CDEL.

“For some trusts, the challenges that new parking facilities unlock are more critical than the income stream that a car park can generate. And in these cases, a DBFO route is a great enabler for change, delivering more car parking spaces, increasing staff and patient satisfaction, and unlocking vital space for development.”

Whatever route trusts choose, one of the most vital steps in project development is ensuring that current needs and future demands are strategically analysed. Planning for future capacity is essential to prevent site congestion, accommodate the anticipated growth in healthcare services, and avoid unnecessary economic and environmental costs associated with overbuilding infrastructure.

Engagement matters

As well as extracting the most functionality from every square metre of an estate and delivering the best value for money from every project, Prime also understands the additional pressures NHS leaders face from stakeholders. The size, scale and cost of MSCPs mean that any new project will draw considerable stakeholder attention. Carefully balancing the needs of car park users with local resident concerns and council planning requirements requires experience.

From the design and planning phases through to construction and operation, Prime ensures that stakeholders are engaged at every stage of a project. On the MSCP project at Dorset County Hospital stakeholder engagement impacted everything from the facilities that were delivered, such as a dedicated motorcycle shelter and new cycle lanes, through to the art chosen for the building facades, which included a public vote to decide upon three local landmarks.

A future worth building

Despite their utilitarian functionality, car parks have an incredibly pivotal role to play in the day-to-day running of a busy NHS hospital. Understanding the impact that parking plays in the lives of staff, patients, visitors and hospital neighbours is vitally important when it comes to addressing some of the challenges facing healthcare leaders today.

New infrastructure doesn’t simply make parking easier — it has far longer-reaching impacts; from the ability to recruit staff and reduce stress for patients and families when they are most vulnerable, to freeing up development for vital hospital resources. That’s why Prime urges leaders to not overlook or underestimate the importance of car parks as an enabler for transformational change.

Explore more of Prime’s car park and transportation projects:

[1] Delivering a ‘Net Zero’ National Health Service, NHS, 2022

[2] Price of car parking at hospitals in England soars by 50% in a year, data shows, Sky News, 2023

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