Sidara Voices & Visions
A Conversation with Andrew Castle, Director of Healthcare at Currie & Brown
Andrew Castle shares his perspective on the evolving challenges shaping the healthcare sector across the UK and worldwide. As a Director in Currie & Brown’s Healthcare Advisory team, Andrew Castle works closely with clients to navigate the complexities of healthcare estates and long-term infrastructure planning. In this edition of Voices & Visions, he discusses the importance of systems thinking in shaping a more sustainable healthcare estate.
Andrew Castle Director of Healthcare at Currie & Brown
What drivers are reshaping demand on healthcare estates globally?
"Around the world, the pressures are broadly the same – aging populations, rising levels of chronic illness, limited capital and infrastructure that’s increasingly not fit for purpose. At the same time, digital transformation and new models of care are reshaping what healthcare delivery actually looks like.
Meeting that challenge requires a more joined-up, systems-led approach, where advisory, design and delivery expertise can help shape estates that are genuinely future-ready."
“We’re using some of the most expensive assets in the world for services that could be delivered in community or even virtual settings.”
Where are current healthcare estates most misaligned, and where are the biggest pressures emerging?
"The biggest issue is that healthcare remains heavily hospital‑centric. We’re using some of the most expensive assets in the world for services that could be delivered in community or even virtual settings. The challenge now is rebalancing that model, rethinking where care happens and supporting that shift through integrated planning across strategy, design and cost disciplines. On this topic, Sidara companies, Currie & Brown and Portland Design, are contributing to, is the Health on the High Street Commission, helping to explore how this transition can move from theory into practical delivery across the UK."
How is the shift toward community-based and preventative care influencing estate planning?
"There’s a clear push to move activity out of hospitals into neighborhood settings or virtual care all around the world, but the funding and delivery models are still catching up. The direction of travel is right, but unless funding follows that activity, providers are naturally cautious about making the shift.
Where it does come together – through coordinated planning and delivery – it creates a much more accessible and efficient system, with care delivered closer to where people live."
“A lot of existing buildings simply weren’t designed for the way healthcare is now delivered.”
What are the biggest challenges in adapting existing estates rather than building new ones?
"A lot of existing buildings simply weren’t designed for the way healthcare is now delivered, particularly when it comes to new technologies. Their physical constraints make it difficult to adapt without compromising efficiency or experience.
In reality, you’re often trying to fit modern models of care into legacy environments. That’s always going to be less effective than starting with the right, or adaptable foundations."
How important is early, integrated collaboration in shaping future-ready estates?
"It’s absolutely critical. Without a clear view of how healthcare is likely to evolve, there’s a real risk of designing buildings that are out of date before they even open.
Bringing healthcare planning and advisory, cost, architecture, engineering and digital expertise together early – something Sidara companies regularly collaborate on across major projects worldwide – helps ensure the right trade-offs are made between upfront investment and long-term performance."
How are sustainability and net zero targets changing the conversation?
"They’re fundamentally shifting the starting point. It’s no longer just about how a building is designed, but whether it needs to be built at all – through greater use of virtual care, prevention, and better use of existing assets.
At the same time, where new build is required, sustainability targets are now shaping key decisions around materials, energy use and operational performance from day one. The critical point is to set those ambitions early and stick to them, rather than diluting them through value engineering later, ensuring that both design intent and long-term outcomes remain aligned."
What does a successful, resilient healthcare estate look like in 10–15 years?
"Ultimately, it’s about adaptability. The most successful estates will be those designed to evolve, where spaces can be reconfigured easily as healthcare changes.
Delivering that requires a genuinely integrated approach, combining strategy, design and delivery expertise to create environments that can keep pace with the needs of the populations they serve. With so much change happening in our society, it’s absolutely critical that the healthcare estate keeps pace too."
To explore Andrew’s insights on creating more connected, resilient, and future-ready healthcare environments, connect with him on LinkedIn and join the conversation.
Director of Healthcare at Currie & Brown
