Hassell has released a new foresight report arguing that cancer facilities are falling behind the realities of contemporary cancer care, identifying five design shifts the built environment industry must make to close the gap.

The Cancer Centre as the Caregiver, developed through Hassell’s Design Horizons foresight platform in partnership with engineering consultancy VA Sciences, examines how architecture and engineering can move from background systems to active agents in improving patient experience, clinical outcomes, environmental performance and the long-term adaptability of cancer facilities.

The report’s central argument is that the traditional model of the cancer centre has not kept pace with the changing nature of the disease and its treatment. Cancer incidence is rising and people are living longer with increasingly complex conditions that do not follow predictable pathways. Treatment is becoming more prolonged, higher-acuity care is increasing, and digital health is dissolving the boundary between hospital and home. Despite this, many cancer facilities continue to be designed around care models that assume patients move through a fixed treatment sequence in a defined timeframe.

Five critical design shifts

The report identifies five areas where cancer centre design must fundamentally change.

The first is designing for longer stays. As patients require extended periods in cancer facilities, inpatient spaces need to function as genuinely therapeutic, low-stimulus environments, designed to support the physiological and psychological demands of extended care rather than optimised around rapid patient turnover.

The second shift is the integration of digital health infrastructure. The report argues that digital systems must be treated as fundamental to the facility programme from the outset, embedded into the building rather than retrofitted. This approach allows the hospital to operate simultaneously as a physical place of care and as a platform for distributed, virtual care beyond its walls.

Third, the report calls for facilities designed to accommodate higher acuity. As cancer care becomes more complex and intensive, facilities need adaptable rooms with built-in spare capacity that can respond quickly to changing patient needs without major disruption to adjacent care environments.

The fourth shift is a move beyond siloed care models. Rather than facilities organised around single conditions or linear treatment sequences, the report advocates for integrated care ecosystems capable of accommodating different clinical conditions, functional abilities and durations of care within the same built environment.

The fifth shift addresses climate resilience. As extreme weather events become more frequent and severe, cancer centres need to be designed as high-performing, adaptable facilities capable of maintaining critical operations during events such as grid blackouts or periods of poor air quality caused by bushfire smoke.

Design as an active participant in clinical outcomes

Hassell Sustainable Design Leader Sian Willmott says cancer centres need to be designed around the realities of contemporary cancer care, rather than the assumptions of the past.

“Cancer care asks a lot of people — physically, emotionally and clinically,” says Willmott. “The next generation of cancer centres needs to give comfort, resilience and holistic support no matter the level of acuity.”

The report also stresses the importance of collaboration between architects, engineers, clinicians and health organisations in developing facilities capable of responding to uncertainty, rather than becoming locked into a single model of care.

“The collaboration between architects and engineers is paramount, so facilities can flex across different scenarios without compromising patient care,” adds Willmott.

The Cancer Centre as the Caregiver is the latest report from Hassell’s Design Horizons, a foresight platform exploring the macro trends that will influence the design of the built environment and the actions needed to prepare for them.

Images: Hassell / Supplied

Architecture & Design Team

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