Define the right problem
Before you solve the wrong one with confidence.
Strategic clarity for health infrastructure and regeneration.
Helping NHS leaders, designers and delivery partners define the right problem before investment decisions become expensive.
When we’re brought in
We usually step in when ambition has stalled, or when something simply doesn't feel right.
For NHS and public sector leads
A programme has stalled, or nobody knows how to start it
Stakeholders nod in meetings, but disagree behind closed doors
Investment confidence is weakening, or governance is becoming overly complicated
Everyone agrees something needs to change, but nobody agrees on what
For commercial partners
A client brief keeps shifting, and you’re anticipating multiple redesigns.
A bid needs a stronger health and place narrative
The technical solution is strong, but the strategic story is weak and partners are misaligned
You're being asked to solve problems that should have been resolved before design began
None of these are delivery problems. They're clarity problems.
What we do
We're a front-end health infrastructure clarity practice.
We work in the space before certainty - where patterns are forming, but the wrong assumptions can still be challenged.
We don’t design, build, or manage assets. We make sure the people who do are working from the right brief.
We solve the problems that exist before architects, project managers and contractors can solve theirs.
Our two core specialisms:
Building delivery confidence
STRATEGIC INFRASTRUCTURE CLARITY & DELIVERY READINESS
For infrastructure programmes that are stuck, contested or losing momentum.
We help leaders align stakeholders, test assumptions, develop narratives and create a clear route to delivery. We usually join projects before design begins, giving project teams the strategic clarity that makes good design possible.
Typical work: Strategic options appraisals, masterplan briefs, visioning, stakeholder alignment, delivery roadmaps, narrative development and Green Book alignment for SOC/OBC/FBC, early-stage risk identification.
For: NHS Trusts, ICBs, local authorities, architects and development partners working on complex infrastructure programmes.
EXAMPLE PROJECT
NHS Masterplan
Taking a 100+ acre health-led masterplan through visioning, governance, and stakeholder complexity into outline planning.
Moving beyond the NHS estate
NEIGHBOURHOOD INFRASTRUCTURE & HEALTH-LED REGENERATION
For organisations aligning health, development, and place - connecting fragmented systems.
Because health outcomes are shaped by systems, not buildings.
Typical work: Place-based infrastructure frameworks, health-led regeneration, partnership alignment, cross-sector governance, neighbourhood infrastructure strategies.
For: ICBs, place leads, local authorities, housing associations, purpose-led developers, PCNs
EXAMPLE PROJECT
Newcastle Health Innovation Neighbourhood
identifying how health could create long-term value across housing, learning, leisure and public realm, not simply healthcare facilities.
They invested time to deeply understand our aspirations and challenges, creating a strategy that was both innovative and grounded in practical insights.
— EXECUTIVE DIRECTOR, NHS Trust
Why Loxie.
Independent - No links to NHS property companies, system organisations, or developers. Our only interest is your local outcome
Senior - You work directly with our founders from start to finish
Frictionless - Our Clarity Diagnostic delivers rapid clarity without months of delay
Commercial - We challenge ideas, but we understand what gets approved, funded and delivered. Our role isn't to create uncertainty; it's to expose the right questions early enough to protect the outcome.
Experienced - We've led NHS transformation, regeneration programmes, major infrastructure strategies and public-sector investment cases
Our role is simple: Create infrastructure confidence before delivery begins.
‘I am never the most technically qualified person in the room. But I’m often the most useful - because I am the one looking at the bigger picture.’
Emma Ingham, Co-founder
And the bit that isn’t for sale?
Some infrastructure questions are too important to leave inside commercial briefs.
Unbuilt is our ideas platform — an internal department of awkward infrastructure questions.
We fund it ourselves.
We publish everything.
The hardest part isn't the build. It's knowing what to build.
Most clients start with our Clarity Diagnostic - a fixed-fee intervention that maps your system and identifies what’s actually blocking delivery before you commit further budget.
All of our work starts with a conversation.