Define the right problem
Before you solve the wrong one with confidence.
Strategic clarity for health infrastructure and regeneration - before assumptions become expensive.
When we’re brought in
We usually step in when something important isn't moving, or when the people involved aren't aligned on what should happen next.
For NHS and public sector leads
A major programme has stalled, and nobody agrees why
You've spent months in meetings, but the underlying disagreement hasn't been resolved
The brief is changing because the organisation hasn't agreed what it actually needs
Investment decisions are becoming harder to defend, or governance is growing more complicated without creating more certainty
Everyone agrees something needs to change, but nobody agrees on what.
For developers, architects and delivery partners
Your client's brief keeps shifting and you're anticipating redesign
You're being asked to solve strategic problems that should have been resolved before design began
A bid needs a stronger health, place or strategic narrative
The technical solution is strong, but the client, partners or wider system aren't aligned
You're carrying the risk of someone else's uncertainty.
None of these are delivery problems. They're clarity problems.
What we do
The biggest opportunities in health infrastructure often sit between disciplines, organisations and places — not neatly inside them.
We're a front-end health infrastructure clarity practice.
We spatially translate health ambition into healthy infrastructure, working 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 work falls into two connected areas:
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 - turning health strategy into connected, deliverable infrastructure.
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.
We see the whole system.
Translate between worlds.
Make it real.
Create infrastructure confidence before delivery begins.
Independent - We aren't tied to a design solution, delivery model or commercial interest. We have no interest in defending an answer that already exists - we can say what others cannot.
Senior and focused - You work directly with our founders from day one. When a programme is stuck or a difficult decision needs to be made, our focused Clarity Diagnostic gets to the heart of what’s really going on in days, not months.
Creative pragmatism - We think laterally and challenge convention, but anchor every idea in what can actually get approved, funded and built.
Experienced - We've worked across NHS transformation, regeneration programmes, major infrastructure strategies and public-sector investment cases.
‘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 lab space for asking the awkward infrastructure questions.
We fund it ourselves.
We publish everything.
The hardest part isn't the build. It's knowing what to build.
Most of our clients start with a question: Something isn't working. Can you help us understand why?
That's what our Clarity Diagnostic is for.
All of our work starts with a conversation.
If you're responsible for a programme that matters and you're not sure it's ready to move forward, let's talk.