Creativity or collapse: The health infrastructure ultimatum
On a recent call, someone asked me ‘What does creativity have to do with infrastructure?’
This is not the first time I have been asked this question. I’m sure it won’t be the last.
While it sometimes gets unnecessary eye-rolls and/or raised eyebrows, I do actually think it’s a fair question.
After all, when we think infrastructure and estates, we tend to think of bricks-and-mortar, capital projects, space utilisation, net-zero, facilities management, etc. We don't tend to imagine bold visions, creative design, social intelligence, curiosity, or cognitive flexibility.
But here’s the thing - if we’re serious about building a future-ready health and care system, creativity isn’t a luxury. It’s a necessity.
So, what even is creativity?
We throw the word around a lot, but I’ve always landed on a very simple definition that I always end up returning to:
Creativity is turning imagination into reality
It’s not just having the idea. It’s finding a way to make it happen.
Yes, it’s also a lot about exercising original thinking, developing new ideas and making different connections. But it’s also deeply practical and ground in reality. It’s the true connection between vision and delivery.
Picasso once said that ‘Everything you can imagine is real.’
I personally don’t think that’s quite true. I’d suggest that everything you imagine has the potential to become real; IF you can figure out how to bring it to life.
Without creativity in action, the great works of art throughout history wouldn’t exist. We’d have only fading memories of people who once imagined paintings they never created.
Figuring out how to bring something you've imagined to life? That’s the space where creativity thrives.
Why does this matter to infrastructure?
The World Economic Forum’s Future of Jobs Report 2025 ranks creative thinking as the third most important skill we’ll need by 2030, just behind AI & big data, and tech literacy. It already ranks as the fourth most importance core skill today in 2025.
“AI and big data top the list as the fastest-growing skills, followed closely by networks and cybersecurity and technological literacy...Complementing these technological skills [are] creative thinking and two socio-emotional attitudes; resilience, flexibility, and agility; along with curiosity and lifelong learning, are also seen as rising in importance.”
WEF, Future of Jobs Report
These aren’t just ‘soft skills’ - they’re the mindset shifts we need to navigate complexity, work across boundaries, and imagine better futures.
So, where are they showing up in our approach to NHS estates and infrastructure? Are our strategies being led by people who holistically understand systems, ask sharper questions, and can turn bold ideas into reality?
Or are we still approaching infrastructure in isolation? Are we laying more bricks, patching holes, having the same conversations, working ever-harder doing a slightly better version of the things we have done before, and desperately hoping everything will just be okay?
The health system is already running on fumes. We’ve hit a crossroads where we can either innovate with creativity or collapse under the weight of inertia.
Creativity isn’t ‘fluffy’.
It’s not a ‘nice to have’.
It’s the critical lever we need.
It is arguably THE most critical skill in NHS infrastructure right now. Some people may prefer to think of it as the next step in problem solving. But whatever we call it, it is vital for strategists, estates teams, leaders and boards. It's essential. And everyone involved in building the future of health needs to get comfortable with it.
A new plan needs new thinking
There’s the fresh 10-year NHS plan on the table. Love it, loathe it, or land somewhere in between, the ask is the same - tackle today’s pressures while building the health infrastructure of the future.
That’s not a simple ask. And it won’t be delivered through technical excellence alone.
We need strategic creativity. The kind that blends ambition with action, grounds vision in reality, and puts people at the heart of every decision.
So how do we get there?
It starts with thinking differently. And with building (and flexing) a new set of creative muscles.