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A new centre of excellence for short stay elective care

National Treatment Centre, Lothian

National Treatment Centre Lothian1


NHS Lothian





This design enables a complete system of care that equally addresses complex replacement surgery with the ability to aid recovery within hours of procedure.

The background

As part of our broader master plan for St Johns Hospital, phase one of the Elective Care Centre project saw the refurbishment of Ward 20 within the existing building. This gateway project created a day surgery elective unit for orthopaedics and ophthalmology. The unit includes two new theatres for eye and hand surgery patients to support pre and post-operative care. 

National Treatment Centre Lothian

The design approach

Our team developed a site wide masterplan to inform the overall strategy for this National Treatment Centre. This included an internal review of the hospital and an external site rationalisation plan to identify future phases and opportunities for development. These opportunities can respond to and strengthen the campus strategy as the site develops in the future.

Phase two will see the creation of a short-stay elective facility, located at the southern end of the St. Johns Hospital site and linking back to the existing building. The new National Treatment Centre will provide care for residents of the Lothians and act as an enabler to release elective capacity on acute sites across local NHS estates. 

National Treatment Centre Lothian 1
National Treatment Centre Lothian4

The Centre will deliver a high volume of low complex routine surgeries across Orthopaedics, General Surgery, Colorectal Surgery, Urology and Gynaecology. Accommodation will include an MRI suite, imaging suite, consulting rooms, forty-eight inpatient beds, thirty-eight single person rooms and eleven theatres plus welfare facilities and office accommodation.

The building whilst complex is centred around a simple and direct patient journey. Surgery of any scale can be daunting and the additional stress of arriving at a new centre must be limited. The design and layout focuses on arrival and recovery. An internal courtyard guides patients from outside into the heart of the building where two short journeys to day case or inpatients are simple and direct. Beyond arrival and the clinical process of patient surgery the design focuses on recovery. Departments ensure all post-surgery bed spaces have activation areas close by to developed destination points to record progression towards the journey of full recovery.

National Treatment Centre Lothian3

The impact

The Elective Care Centre is one of a network of six elective and diagnostic centres being developed across Scotland to reduce waiting times for planned surgeries. Included in these wider plans is the National Treatment Centre, Highland, also delivered by our healthcare team for NHS Highland in 2023. The Highland facility is successfully reducing waiting times and improving patient care as an exemplar of the power of stakeholder led healthcare design.

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Paul Gilligan Partner Sector Lead

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