Reflection on the UKREiiF Roundtable: Evolving NHS infrastructure for the future
Founder Richard Darch recently attended a pivotal roundtable event at UKREiiF, where the future of NHS infrastructure was thoroughly examined.
In this article, he shares his expert insights on the NHS 10-year plan, emphasizing the crucial role of innovative approaches and collaboration to address the evolving demands of healthcare.
Last week at UKREiiF, there was an opportunity to debate and explore how the world of health infrastructure and the NHS more widely will need to respond to the three stated ambitions that will underpin the 10-year plan for the NHS. The roundtable discussion, hosted by NHS Estates and Facilities, was rich in insight and underscored the scale of transformation required - not just in infrastructure but in mindset, delivery models, and wider community and stakeholder engagement.
The landscape is evolving with these three transformative shifts on the horizon. But how can we prepare for them, and what implications do they have for our infrastructure?
The shift from hospital-centric care to community-based models is not just a policy ambition - it’s a necessity fuelled by the expectations of citizens.
As discussed in our session and echoed in the NHS Confederation’s 2025 vision, this transition demands more than rhetoric.
It requires investment in local infrastructure, workforce development, and a clear articulation of what “community care” truly means.
We must resist the temptation to oversimplify. Community care is a multifaceted ecosystem encompassing general practice, pharmacy, social care, rehabilitation, diagnostics and virtual acute care through virtual hospitals. Each plays a distinct role in creating a seamless, citizen-centred experience.
The real opportunity lies in designing digital and physical infrastructure that not only supports this diversity but also fosters integration, personal ownership, and control of care, as well as wider community regeneration.
From analogue to digital: Enabling a connected future
Digital transformation is no longer optional. Unified health records, virtual care, and patient-facing tools are essential to a responsive, efficient NHS. But digitalisation must be inclusive. It’s not just about technology- it’s about trust, accessibility, and ensuring no one is left behind.
As we discussed, the infrastructure must support this shift from broadband in community settings to training for frontline staff. The opportunity is vast, but so is the risk of fragmentation if we don’t get the foundations right.
From sickness to prevention: A cultural reorientation
Perhaps the most profound shift is the move from reactive to preventive care. This isn’t just about early diagnosis or screening - it’s about rethinking how we design services and embrace new technologies and preventative drug therapies. Early diagnosis through screening for risk factors has the ability to transform the preventative and public health agenda.
Prevention must be embedded across the system, from neighbourhood health services to national policy. This shift will require a cultural reorientation - one that values long-term outcomes over short-term metrics. It also demands a more sophisticated understanding of the social determinants of health and how infrastructure can support physical and mental wellbeing, not just treatment.
Transforming systems, inspiring belief
The roundtable reinforced a shared both a commitment and courage to change - but also a recognition that delivery will be complex and involve a multitude of stakeholders.
This is not just about buildings - it’s about systems, behaviours, and belief in a better way. We need bold leadership, sustained investment, and, above all, collaboration.
