How operating theatre design has changed, and the considerable differences in approach taken in the UK, mainland Europe, and North America in the past 5-10 years to enhancing the design of both the theatre itself, and the associated waiting, preparation and recovery facilities, were the subject of a fascinating presentation by Keith Millay, director--health sciences, at London-based Swanke Hayden Connell Architects, at the recent Healthcare Estates conference. Jonathan Baillie reports.