There is a fundamental need to recognise and address the whole-life implications of the design and management of all buildings. This is due for most buildings to the dominant impact which running costs have on overall expenditure. With hospital buildings, though, the range of criteria which must be considered are increasingly complex, and relate to patient care, building fabric, infection control, and maintenance procedures. This paper reports on work undertaken for a study funded by the Department of Health. The project undertook a detailed analysis of existing criteria and guidance on the selection of finishes, and developed a fully integrated system for use by the design team. Of particular interest is the balance to be struck between the incorporation of easily objectified criteria, and the implications of more qualitative and subjective variables. The paper includes a discussion of those criteria, and illustrates the manner in which design practice could benefit from the availability of such an integrated system. The paper concludes with a discussion of the manner in which the system could be used in practice, and suggests routes for further research and development.