Unparalleled changes require new approach.

How healthcare estates and facilities teams can best respond to the challenge of maintaining a safe, clean, and secure patient and staff environment at a time when not only are capital budgets being severely squeezed, but, in one headline speaker's words, "the NHS is facing some of the most far-reaching changes in its history", was the major focus of both the presidential address, and the two keynote speeches--one of which also considered the case for "evidence-based" design-- at this year's Healthcare Estates conference and exhibition in Manchester.