'Modernization of Our Hospital System': The National Health Service, the Hospital Plan, and the 'Harness' Programme, 1962-77.

This article augments the literature on the British experience of planning by examining attempts to plan the hospital system between 1962 and 1977. The Hospital Plan for England and Wales of 1962 proposed the construction of a suite of new 'District General Hospitals'. Underpinning this proposal was a belief in the value of standardized designs and construction methods, both of which were subsequently investigated in detail by the Ministry of Health and the Department of Health and Social Security (DHSS). The history of this project reveals the challenges of putting centralized planning into practice. Yet while the standardization programme was scaled back in 1975, the article suggests that the drive to 'plan' modern Britain perhaps lasted longer than might initially be thought, into the 1980s, with implications for the way that the broader history of this period is framed.

Impact of extreme weather events and climate change for health and social care systems.

This review, commissioned by the Research Councils UK Living With Environmental Change (LWEC) programme, concerns research on the impacts on health and social care systems in the United Kingdom of extreme weather events, under conditions of climate change. Extreme weather events considered include heatwaves, coldwaves and flooding. Using a structured review method, we consider evidence regarding the currently observed and anticipated future impacts of extreme weather on health and social care systems and the potential of preparedness and adaptation measures that may enhance resilience. We highlight a number of general conclusions which are likely to be of international relevance, although the review focussed on the situation in the UK. Extreme weather events impact the operation of health services through the effects on built, social and institutional infrastructures which support health and health care, and also because of changes in service demand as extreme weather impacts on human health. Strategic planning for extreme weather and impacts on the care system should be sensitive to within country variations. Adaptation will require changes to built infrastructure systems (including transport and utilities as well as individual care facilities) and also to institutional and social infrastructure supporting the health care system. Care sector organisations, communities and individuals need to adapt their practices to improve resilience of health and health care to extreme weather. Preparedness and emergency response strategies call for action extending beyond the emergency response services, to include health and social care providers more generally.