St James Health Centre, located in the heart of Walthamstow, is in need of significant modernisation. Primary and community health services will continue to be provided from St James, at least until its lease expires, and there will be a need for local health services in that locality long after. The project business case evaluated a number of options to modernise or replace the premises. These ranged from the lowest cost refurbishment to considerable internal reconstruction and a scheme for demolition and rebuild. The preferred option is the demolition of the existing centre and the building of a new facility on the same site. This presents an opportunity to bring together a number of complementary community resources under one roof, and to provide a number of community based outpatient services as an alternative to hospital based planned care.

At the DQI Briefing workshop, stakeholders debated and agreed their aspirations for the project. It was agreed the design should facilitate patient care model, space should be designed to be practicable and flexible for different user requirements, layout of the building should be easy to understand and signage should be clear. The team agreed that patient flows and travel distances should be optimised by the layout. There were concerns that this was not being achieved by the sketch proposals presented at the workshop and this issue needed to be addressed.

At the DQI Concept design workshop, stakeholder participants received a presentation of the current design proposals at a level of detail appropriate to the stage reached. It was felt that the current design proposal had gone a long way to address these requirements. Participants agreed the design has been developed in line with the patient care model, and accommodation has been carefully separated to ensure there is good circulation for clinicians, patients and administrative staff. There were some concerns about the capacity of the waiting area and its ability to manage large numbers of patients attending phlebotomy clinics, also the design of building should reflect the needs of patients and allow for appropriate levels of privacy, dignity and confidentiality.