Shaping Future Hospital Delivery: Digital Infrastructure Lessons from the Future HealthSpaces Round-Table.

Digital Hospital Strategy and Vision 

Delivering a “digital hospital” is not a matter of layering new technology onto existing structures. As Future HealthSpaces’ Forum 20 made clear, it requires infrastructure designed to sustain clinical, operational, and workforce needs for decades to come. 

The New Hospital Programme (NHP) has identified forty-nine core technology components spanning building-integrated systems, connectivity, and operational support. But as participants noted, intelligence lies less in any single deployment than in how these systems integrate. Prioritising integrated digital infrastructure and systems from the outset to support clinical workflows rather than retrofitting piecemeal was seen as essential for operational viability. 

Implementation Challenges and Lessons Learned 

Several contributions underscored the risks of delaying digital strategy. International projects have shown how difficult it is to “backfit” vision mid-construction, while UK Trusts risk insufficient digital budget if not built into capital business cases. 

Space emerged as a foundational requirement. The challenge extends beyond individual buildings to the flows between them, particularly how legacy estates might be adapted to better integrate with new sites, easing staff transitions. As Abhi Shekar raised: “How do we bridge that divide across existing sites and new build sites, especially when patient and staff movement cuts across both?”  The question highlights the need to consider what can be done within legacy estates to align layouts, equipment, and processes with the new hospital, smoothing the transition and reducing the learning curve. 

Katie Wood emphasised the point from a design perspective, noting that “decisions [such as] what kind of fibre network [we are having] need to be taken at a certain point because they have huge spatial implications.”  These early calls shape the physical fabric of hospitals long before a piece of equipment is installed. 

POLAN: Network Infrastructure 

The shift from copper to Passive Optical LAN (POLAN) was a topic which garnered considerable debate. Unlike copper, POLAN connects endpoints directly to the core via passive splitters, eliminating intermediate active equipment. With XGS-PON already offering 10-gigabit symmetrical bandwidth — and newer generations pushing further — the long-term case is compelling. “The evolution is going to go beyond copper… copper has stopped evolving and it will not keep up. It will hit a saturation point and no longer be able to handle [data transfer speed demands]."

Participants pointed to significant savings in capital and operational expenditure, alongside lower energy use, longer infrastructure life, and space efficiencies. Fibre’s immunity to electromagnetic interference and capacity to span hospital campuses without disruption added further weight. Kevin Robinson emphasised the strategic importance of this shift: “I don't think this is just a practical approach… I think it's going to be essential. Fibre is the way forward.” 

Whilst POLAN is now being actively piloted within a UK NHS trust — with extensive testing completed and live deployment awaiting equipment installation — adoption remains limited. Transition would also require new skillsets for network teams and introduce a distinct management platform, raising concerns about complexity and the risk of dual systems during phased adoption. 

Skills and Workforce Transformation 

Digital success depends as much on people as on technology. The forum identified expertise in system integration as a weak point across the supply chain. Unless roles are clearly defined from briefing stage and procurement ensures coordination, technology risks being underutilised or fragmented. 

Katie Wood reflected on this challenge, emphasising the importance of prioritising clinical and workforce strategy over capital or digital solutions, and the need to map decision points across all workstreams:  “if capital's running it, then it's kind of the wrong way around in a way. It should be the clinical, it should be the transformation, the clinical and the workforce, and then the, you know, the capital and the digital should be supporting that. And you need to map the decision points between all of those.” 

Governance, Funding, and Procurement 

A systems-based approach to governance, funding, and procurement was strongly emphasised. The Target Operating Model was described as a backbone for aligning estates, workforce, operations, and technology. 

Delivery models differ — from bundled Main Works contracts to dedicated digital services agreements — but all require clarity of roles and effective integration mechanisms. Phased implementation was recommended: start with the foundations, pilot advanced capabilities, and prioritise high-return systems. Kevin Robinson reminded the group that the patient voice must not be overlooked: “We should want to have a patient advocate role because that's an important element to keep in mind. It's all about patients and so the patient experience has to be folded into this as well.” 

Risk Management and Resilience 

Resilience — digital and physical — was a recurring theme. Recent disruptions in pathology services underscored the reality of cyber risk. Network segregation, VLANs, access controls, and continuity planning were cited as baseline safeguards. 

Physical resilience was framed in equally urgent terms. The need for hospitals to sustain 24-hour island capability, supported by generator and UPS systems was mentioned. Much of the discussion stemmed from questions such as “what happens if it all fails?”, with reference to an incident where surgeons were plunged into darkness mid-operation. As was noted, critical spaces like operating theatres should already be protected by UPS — which by definition relies on batteries to provide an uninterrupted supply — rather than depending solely on mains and generators. The real shift, therefore, is not in using batteries for resilience, but in extending UPS availability across the entire hospital. This hospital-wide “battery-first” approach marks the step change envisioned in Hospital 2.0. 

In this context, Kevin Robinson observed: “We are risk averse because we are dealing with people whose lives are on the line.” This was widely interpreted as underlining the importance of clinical trials and reference sites to validate digital solutions before widescale deployment. 

Innovation and Knowledge Sharing 

Despite an active innovation pipeline, adoption remains slow. It was noted that innovation can take two decades to move from proof-of-concept to NHS-wide implementation.

Accelerating this requires closer cross-organisational collaboration, open documentation, forward-looking awareness of emerging technologies, and deeper engagement with educational bodies and research organisations. 

Reflection 

Forum 20 reinforced that digital foundations are no longer an optional layer — they are the core of the hospital of the future. From estates design to clinical workflow, patient experience to resilience, integration will define adaptability for decades to come. 

The message was clear: only by aligning digital, clinical, workforce, and estates strategies — rather than treating them in isolation — can we design hospitals that are fit for today and ready for the challenges and innovations of the next 50–60 years. 

Future HealthSpaces will continue to provide a neutral forum for these conversations, ensuring lessons are shared and momentum maintained. We look forward to continuing the digital dialogue at upcoming events — explore the programme here. 

Note: This publication is intended as a synopsis of open discussion between industry peers. It does not represent definitive guidance or policy, nor should it be taken as the official position of any participating organisation. Future HealthSpaces remains an independent, third-party organisation, distinct from political or governmental bodies, while maintaining a close understanding of — and ongoing collaboration with — such stakeholders.