Beyond scoring: advancing a new approach to the design evaluation of NHS buildings

The engagement of project stakeholders in the design evaluation of National Health Service (NHS) buildings is critiqued to evaluate the current effectiveness of NHS policy which prescribes the use of quantitative, positivist survey instruments to capture stakeholder views. An alternative conceptual framework for design evaluation is presented that privileges the practice of design evaluation as the social interaction of project stakeholders. Empirical evidence from two longitudinal case studies of newly-constructed mental health facilities illustrate the success of this innovative approach in improving patient healthcare outcomes and reducing operating costs. It elucidates and enhances both the praxis and practices stimulated by current approaches to design evaluation. It raises important implications for the future development of UK Government policy to substantively improve the design quality of NHS healthcare buildings and, in turn, improve patient healthcare outcomes.