An Architects for Health Event – Thursday 27 November 2003 at The Jerwood Space, London.
AfH Annual General Meeting
Alistair Cory introduces the Event Sponsor: Build for Health
Build for Health
Welcome: Ann Noble
Event Chair: John Cole
Evelina Children’s Hospital, Michael Hopkins Architects – Speaker: Pamela Bate
Evelina Children’s Hospital, a specialist unit of St Thomas’ Hospital opposite the Houses of Parliament on London’s South Bank, suggests a new approach to health care design.
The project demonstrates how ideas pioneered in workplace design can be applied to hospital design. Like offices, hospitals demand efficient operations and flexible layouts, but casual social interaction is also important. So at Evelina, we broke with the typical layout of long corridors and bland wards, proposing a simple section of two long blocks flanking a central concourse which rises the full height of the building. The closely linked lower three levels have the most intensively serviced functions; operating theatres, imaging equipment and outpatient departments. Above, the northerly block has three floors of wards, while the southerly block transforms into a spacious and airy four storey conservatory under a giant curving roof.
The conservatory is the social heart of the building. Wall climber lifts rise through it to connect each floor, and all the wards have open plan social and day areas overlooking this space, with private rooms facing north on the other side of a strip of nurses stations and service areas. The conservatory is high enough for views into Lambeth Palace garden, and large enough for a café and waiting area, as well as providing space for activities, such as play sessions, lessons, exhibitions and even informal performances. A solar collector in winter, and naturally ventilated by stack effect in summer, the conservatory aids the servicing strategy of the building as well as offering relief from hospital routine and treatment. Throughout, structure and services are flexible. Using pre-fabricated components, as much as possible, gives maximum space for future changes.
Client: Guys and St Thomas’ Hospital NHS Trust
Dublin Dental Hospitals: Ahrends Burton & Koralek – Speaker: Paul Koralek
Dublin Dental Hospital, which was founded in 1895, contains the School of Dental Science, one of the constituents of the Faculty of Health Sciences at the University of Dublin, Trinity College. It currently serves 2,500 patients per week and trains 265 students. The completed building provides a total area of 5,800 m2 including 3,500 m2 of new building and 2,300 m2 of existing, which has been totally refurbished and integrated into the new complex.
The facade of the original Victorian building on Lincoln Place has for a long time been identified with the Dental Hospital and also, being in a conservation area, needed to be retained. For reasons of tradition, therefore, as well as economy, it was decided to retain the existing buildings on Lincoln Place, to refurbish these buildings so that they form part of the new hospital complex and to enter the new hospital from Lincoln Place through, or more precisely under, the old building – again, retaining the traditional location of the entrance and maintaining the historic presence of the hospital on Lincoln Place. The new building occupies the site at the rear of the hospital within the Trinity College campus.
We were therefore faced with the need to preserve the old buildings and to keep them operational as a hospital while building a new building on the site behind them – ‘behind’ seen from Lincoln Place, ‘in front’ seen from the College.
It was decided to accommodate the clinical functions of the hospital within the new building, which could be designed with appropriate spaces, clear of structure, appropriate ceiling heights and suitable service distribution systems.
On completion of the new building, the hospital moved from the old to the new, vacating the old building so that refurbishment could be carried out. This building now accommodates teaching areas for the dental school so that the whole of the hospital and school are accommodated within a single complex of buildings.
Our main concerns and objectives in the design of the hospital have been:
- To provide a humane and attractive environment for dental treatment and education
- To unify the old and new buildings so as to avoid any sense of two separate buildings
- To provide the buildings with a heart or core which will give them a sense of identity and also unity – the central atrium space fulfils this purpose
- To design a building which reflects its dual role – clinical and educational
- A building which addresses both the City and the College and helps to establish links between them
- A building which fulfils its urban design role in its location – the tower marking the Lincoln Place entrance to College – and which addresses the proposed new square which will be formed in College
The central atrium provides the first impression of the building. A full height space enclosed between the old and new buildings with a fully glazed roof, it contains the main stairs and lift as well as reception and waiting areas and bridge links between the two buildings at all levels. It is the circulation hub of the building.
The atrium may indeed be the heart of the building, but arguably the most important spaces in the building are the clinics. They are to a large degree the raison d’être for the building.
The clinics are located in the new building where provision can be made for the necessarily complex and sophisticated services installations. The clinics are designed to be light and friendly in character, to have a balance of openness and privacy, order and informality. The irregular form of the cubicles avoids a sense of regimentation while the clear circulation pattern establishes an order. The large, north-facing glass walls allow the maximum possible daylight and give a sense of openness tempered by the semi-transparent black fabric external screens which give a degree of privacy. Environmental control is by means of a displacement ventilation system which provides a very low velocity air movement which is both energy efficient and comfortable for the occupants. The detailing and finishes are designed for cleanliness and ease of maintenance although for reasons of economy we have had to rely on paint finishes to a large extent. The elegant and efficient dental chairs by Planmeca in Finland perfectly complement the design of the clinics.
I don’t know whether it is more difficult to build a new building around and amongst a working dental hospital, or to run a hospital virtually on a building site. Neither is easy and the exercise has not been without its problems from either point of view. The fact that it has been completed successfully is testimony to the goodwill and cooperation of all those involved.
Mater Hospital: Todd Architects – Speaker: Barrie Todd
The original Victorian Hospital was unsuitable for adaption to accommodate modern healthcare practices.
Spatial opportunities for expansion and redevelopment were few, on this densely built Belfast urban site.
The old building and the 1980’s tower block are sited very close to the busy Crumlin Road also effectively restricting visiting traffic movement, presenting a negative sense of place and making pedestrian movement uncomfortable and in cases perilous.
To solve these problems a location for the new £14.0m development was sought to the rear of the old Hospital.
After presentation of compelling social and medical arguments, permission for the demolition of a listed redundant convent was given thereby making space for the new facility.
This enabled, all traffic, pedestrian and vehicular to retreat from the road frontage, and the creation of safe drop off and maneuvering area.
Tightly enclosed by boundary walls, the proximity of a redundant Victorian prison and the rear of the old Hospital buildings, a need to form a space which would create a sense of place and arrival became an obvious design requirement.
This combined with the functional need to provide a confluential circulation space led to the creation of a new generous atrium and courtyard garden.
These core elements not only created the much desired sense of place, but a place of calm respite away from the urban bustle and an atmosphere which is conducive to the promotion of healing.
As well as providing a new entrance to all buildings, old and new, the new facilities accommodate, wards, a day surgery unit other ancillary medical accommodation and a modern coffee dock.
As a consequence of the good environment provided, an increase in applications of nursing jobs has increased considerably, and there is a notable reduction in abuse or vandalism of the fabric of the common areas.
Glasgow Homeopathic Hospital: Macmon Architects – Speaker: Dr David Reilly
Please see Glasgow Homeopathic Hospital’s online presentation at their website: http://www.ghh.info/
Coronary Care Unit at Charing Cross Hospital: Tangram Architects – Speakers: Paul Mercer, Susan Wainwright and Femi Santos
Sir Michael Sobell House Hospice, Oxford: Nightingale Associates – Speaker: Mike Nightingale
Three healthcare projects – Mike Nightingale Associates: Introduction
- West Middlesex University Hospital, West London (£53m PFI)
- Sir Michael Sobell House Hospice, Oxford
- Meadowfield Adult Acute Unit, West Sussex Health & Social Care NHS Trust
West Middlesex University Hospital, West London (£53m PFI)
The West Middlesex Hospital sits near the banks of the Thames in a belt of parkland that stretches from Kew Gardens to the Old Deer Park. Nightingales adopted shallow plan forms and used them to great effect, helping to promote the non-institutional feel within a major new build and significant refurbishment project.
A key feature of the design-led successful bid was the provision of new patient-focused critical care and inpatient accommodation, which enabled a 1960’s ward block to be utilized more appropriately for support services – a radical change from the public sector comparitor.
The design impact on added value lifecycle was significant, as well as providing a wonderful patient and staff environment. A linear atrium assists way-finding and orientation whilst providing amenity spaces and retail outlets with a café and a dedicated landscaped courtyard. The atrium and associated courtyards allow the building to be naturally ventilated with a feeling and experience of spaciousness and natural light.
The external materials have been chosen carefully to complement its form. Contrasting metal, glass, cedar cladding, terracotta and render finishes have been used to provide a welcoming, bright and optimistic feel to the building. The design is the first major NHS hospital to use natural cedar wood cladding.
Client: West Middx University Hospital NHS Trust
PFI Consortium: Bouygues UK
Architect: Nightingale Associates, London
Contractor: Bouygues UK
Cost: £53m (£35m new build; £18m refurbishment)
Floor area: 26,000m2
Completion: April 2003
Opened: June 2003
Phase 2 completion: May 2004
Sir Michael Sobell House Hospice, Oxford (£3.3m D&B)
The hospice is located on the Churchill Hospital site in Oxford, with glorious views across the adjoining golf course and countryside.
Nightingales imaginative design added value by diverting a road to increase the site area and enable retention of the original hospice building until the completion of the new facility, and therefore avoiding costly and disruptive decanting.
The wonderful curved plan of the new hospice is home to a variety of spaces, many of which are bathed in sunlight in the summer months from the top-lit corridors and roofing. Noteworthy features are the sensitive use of colours, fresh and subtle, matched carefully with the delicately patterned flooring and high quality joinery. The integration of artwork (a key feature of Nightingales work) is colourful and imaginative within sensitive settings, and the chapel retains a stained glass window from the original hospice.
Another key feature of the design is the therapeutic garden and the relationship the building has with its new landscaped spaces.
The hospice design is recognized for its sensitivity and light touch and has been awarded an “Oxfordshire Preservation Trust Award for Architecture and Design”, and is also submitted for the RIBA Awards.
Client: Sobell Hospice Charity
Architect: Nightingale Associates, Oxford
Contractor: Leadbitter construction
Floor area: 1,500m2
Completion: August 2003
Opened: September 2003
Meadowfield Adult Acute Unit, West Sussex Health & Social Care NHS Trust
The award winning Nightingale designed Meadowfield Adult Acute Unit is situated on the edge of the South Downs near Worthing, and was originally commissioned by the then “Worthing Priority Care NHS Trust”, which has since been renamed.
The excellent design was driven by three main considerations. The first was the functionality required for a 48 single bed mental health facility suitable for effective delivery of the Trusts services. The second was to exceed the Trust’s aspirations in terms of the building’s environment, particularly within the context of the considerations highlighted in the report “Not Just Bricks & Mortar”, published by the Royal College of Psychiatrists. The third was the context and landscape within which the building would rest, an undulating topography in a semi-rural setting on the edge of the Downs.
The high quality therapeutic environment was achieved by designing unconventional layouts and circulation spaces, with shallow plan, maximum daylight, clerestory windows and roof glazing. Substantial access to glazing, views and fresh air achieve a feeling of lightness and airiness. Traditional materials used in an imaginative manner achieve a welcoming and attractive building at home in its leafy setting.
Client: Worthing Priority Care NHS Trust (West Sussex HSC NHS Trust)
Architect: Nightingale Associates, London
Floor area: 3732m2
Completion: July 2001