Enhancing the resilience of cancer services in terms of hospital built environment reconfiguration in case of pandemics

The provision of cancer care is complex due to its heavy reliance on hospital-intertwined departments and services. However, with hospital care severely disrupted during COVID-19, cancer services were affected. This research aims to extract lessons from the experience of COVID-19 at the cancer service delivered across three hospitals in an NHS Trust in England and provide recommendations to enhance the resilience of the built environment for cancer service in future pandemics. The study employed a qualitative approach, including a literature review on the impact of COVID-19 on cancer services and their built environment. Seven staff interviews were conducted to gather insights, followed by a focus group with eight participants to discuss findings and potential environmental reconfigurations. In evaluating the cancer service infrastructure pre- and peri-COVID-19, the research found a correlation between the pre- and peri-pandemic challenges and strategies to cope with them during the pandemic. The complexity of the cancer service and its hospital location posed risks for staff moving between offices and departments, increasing their chances of contracting the virus. While hospital zoning was implemented, it resulted in longer travel times for staff and failed to ease patients' fears about visiting hospitals. Local makeshift solutions also proved ineffective. Findings established the need for ‘ lasting solutions ’ to improve the resilience of the cancer service to future pandemics, such as developing independent, purpose-built buildings for cancer services, integrated with remote consultation and work to enhance staff and patient safety and needs. • The study assessed the cancer service infrastructure within an NHS Trust in England, showing a link between challenges before and during COVID-19. • The hospital's layout of cancer services hindered efficiency during the pandemic. • The cancer service's complexity and location within the hospitals increased the risk of staff contracting the virus. • The hospital's zoning aimed at minimising COVID-19's impact increased staff travel time and did little to alleviate patients' fears. • Remote consultations and teleworking helped support the workforce during the pandemic. • This research emphasises the need for “ lasting solutions ” in hospital environments for patients with cancer. • Relocating cancer services to specialized facilities that enable remote consultations can enhance resilience during pandemics.