Written by Will walkinton
The conversation around High-Risk Buildings has become more prominent over recent years. In healthcare, I don’t see that as a shift; I see it as a reinforcement of what good teams have always done.
Every hospital project I’m involved in is delivered within a live, operational estate. That context demands careful planning, disciplined coordination and clear leadership from the outset.
For me, the key in high-risk healthcare environments isn’t reacting to risk. It’s taking the time to properly understand what’s already there.
What is a High-Risk Building?
Under the Building Safety Act 2022 in England, a Higher-Risk Building (HRB) is generally defined as a building that is at least 18 metres in height or has seven or more storeys and contains at least two residential units.
While many hospitals may not fall neatly within that residential definition, they share many of the characteristics that sit behind the legislation: complex structures, high occupancy and life-safety-critical systems.
In practice, that means multi-storey acute healthcare environments should be approached with the same discipline and scrutiny expected of formal HRBs. In practice, that means healthcare projects, particularly in multi-storey acute environments, require the same level of discipline, scrutiny and coordination that formal HRBs demand.
Working Within Existing Estates
Hospitals evolve over decades. Services are adapted. Departments move. Layouts change. Drawings don’t always tell the full story.
That isn’t unusual; it’s how operational estates function. It does mean that in refurbishment projects, assumptions can creep in. Assumptions are unhelpful in complex environments.
What That Looks Like in Practice
In our healthcare projects, that typically means:
- Bringing fire, MEP and delivery expertise together early
- Validating compartmentation rather than relying solely on record information
- Being clear about design responsibility across disciplines
- Engaging with Building Control at the appropriate stage
- Planning works around live clinical operations
These steps don’t slow projects down. In my experience, they make delivery smoother and more predictable.
A Matter of Discipline
High-Risk Buildings in healthcare don’t require dramatic interventions.
They require coordination, transparency and open conversations at the beginning of a project. When that foundation is right, programme and compliance tend to follow.
In healthcare, certainty isn’t created by reacting to risk later. It’s created by taking ownership of it early, an approach my team and I apply consistently across our healthcare work.