Introduction At the height of the Covid-19 pandemic, healthcare Trusts were stretched to capacity, utilising existing Intensive Care Units (ICU) and general wards to treat severely ill patients in respiratory distress. Current design guidance and healthcare infrastructure has had to accommodate these new needs, with little flexibility within the current system to cope. However, the facilities and clinical teams have confronted this challenge, doing a crucial job brilliantly whilst in difficult circumstances. Objectives The pandemic has raised three issues; why are ICU facilities inflexible, a major problem pre-pandemic but compounded by the last 18 months? How can medical advancements still be achieved while addressing the backlog of patient referrals and outpatient procedures? Finally, how fit-for-purpose is our current design guidance legislation? Concentrating on the ICU model, we will question how flexible it can be to meet future patient requirements, including personalised medicine, while maintaining effective isolation within intensive care. Methodology Current ICU designs will be evaluated, and hypothetical clinical models for care will be developed for testing and investigation. These are later analysed for suitability, effectiveness and versatility, at clinical and patient level. All findings will inform recommendations for changes to design guidance. Conclusion This paper seeks to examine what can be achieved while working outside the constraints of the current clinical model and design guidance. With flexibility at its core, can the current ICU clinical design be updated to allow for the needs of current and future requirements?