
Clinic 20XX: Designing for an Ever-Changing Present—The United Kingdom Patient Survey
- Upali Nanda, PhD
- Jane Ho
- Melissa Hoelting
What is the Aim
Challenge
It is evident that there is a shift to outpatient care and preventive health. In the UK, strategies to deal with the increasing demand on public health and social services are being deployed to combat the lack of funding. There is a mismatch between the physical facilities’ infrastructure and the types and volumes of services to be carried out. There is an urgent need to investigate patient expectations for clinics as they move to provide more patient choice, convenience and access, and state-of-the-art facilities and how facilities can be change-ready, and as health care rapidly changes.
Aim
To understand if perceptions and expectations around outpatient primary care are universal. To do this, we investigated whether boomers and millennials in the United Kingdom, a distinctly different health system, felt similarly about the choices they make compared to those in the U.S., by repeating the patient poll from the original Clinic 20XX study in the UK.
What We Did
Approach
To answer these questions, we deployed the patient survey from the original Clinic 20XX study in the UK.
Method
A total of 230 respondents—109 millennials (born within 1981-2000) and 121 baby boomers (born within 1946-1964)—had visited a clinic for the first time in the last six months. Survey findings from the UK and U.S. studies were then compared to identify key differences in patient perception and expectations.

What We Found
Results
To summarize this poll, attracting patients is more a factor of convenience, quality of care and the environment, along with the reputation and referral of the clinic and its providers. Retaining patients, however, is about quality of service in the clinic and outside of the patient visit.
Findings from this poll of patients in the UK support the facility implications from the original Clinic 20XX study.
- We found that contrary to expectation, respondents thought of themselves as patients needing health services more than consumers buying health services. This trend stayed surprisingly true for millennials as well as boomers, though with the youngest millennials (born after 1995), we started seeing an upward trend. Interestingly, this is very similar to what we found in our U.S. survey as well.

- Patients are ready for telehealth, but do not want to lose face-to-face interactions with their care team. This desire for human interaction reinforces the need for clinic facilities. It also highlights its key role as a physical access point connecting the cloud and the community.

- While boomers in the UK are less concerned about experience as long as their health issues are addressed, millennials are moving toward experience being as important. Enhancing the experience in the clinic and beyond the physical visit by streamlining the entire process is crucial.
Deliverable
Findings from the UK patient survey and the international comparison between the U.S. and UK can be found in the CADRE published report. The international comparison was also featured in LaingBuisson’s Healthcare Markets.
What the Findings Mean
Application
Activities in the clinic are now happening in the physical (footprint) and virtual (cloudprint). Consideration of a clinic’s cloudprint and footprint creates implications for facilities centering around data integration and tech-ready spaces. Physical space in the UK is at a premium, making planning for the amount of space a facility needs a crucial part of the design process.
We believe that going forward, facilities will have to plan for both their footprint and their cloudprint. Flexibility can help minimize the amount of space needed by accommodating a shift between the two as well as provide affordances for technological advances, staff role changes and resource needs. This flexibility, along with connectivity and a strong sense of place, creates a change-ready facility.

Future
This document is our first step toward making 20XX a living report. Information will be regularly updated to capture a snapshot of where the industry is today. We will also continue to add to this body of knowledge by continuing studies in other countries or benchmarking hospitals against the nationwide polls.
If you would like to do a survey in your country—or benchmark your hospital against the nationwide poll—let us know. The more we learn, and the more we share, the better equipped we are to move the needle in our industry—together.
Acknowledgments
Team Members:
Dr. Upali Nanda
Melissa Hoelting
Jane Ho
Dr. Giyoung Park
Funding:
CADRE