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The Scottish Government have set out a program of infrastructure developments to help deliver their objectives for a Healthier Scotland. This includes the delivery of new hospital projects designed to reflect increasingly rapid changes in healthcare services and a range of community and primary care developments needed to shift the balance of care.
Many of these projects have come to fruition during the last 18 months. The first of the major projects is currently under construction in South Glasgow and will be followed by large developments in Edinburgh, North Ayrshire and Dumfries. These are complemented by over 30 primary and community scale projects in development across the country.
Design quality, innovation, and sustainability are major drivers in the delivery of these projects. Our event sought to contribute to and learn from the discussion in Scotland, aiding the creation of better healthcare environments through sharing ideas and experiences between clients and designers from across the UK.
AfH organised a seminar followed by a study tour of four recently completed health buildings. It was part of our annual programme of events specifically located outside London.
Opening the debate on a sunny Glasgow afternoon to a 70 strong audience at the Lighthouse Gallery, Mike Baxter, deputy director (Capital and Facilities) within the Scottish Government Health and Social Care Directorates, outlined the context for the procurement of health buildings in Scotland and explained how integrated care is to be delivered.
The Trust’s “20/20 Vision”, with its emphasis on quality and skills, reflects the shift from acute to community care aiming to support the population to live longer, healthier lives either at home or in a homely setting.
An astonishing set of statistics underlined the sheer scale of the Southern General Hospital – an £850m new build general and children’s hospital occupying a site area of some 80,000m2, creating a new hospital of some 170,000m2, comprising 1100 odd in-patient beds (100% single bed) and 32 operating theatres. The project is currently under construction and due for completion in January 2015.
Neil Murphy of IBI Nightingale and Paul Serkis of Brookfield Multiplex Construction Europe described the background to the scheme, the use of visual references from the area’s historic shipbuilding heritage, site constraints and opportunities to design the optimum layout for ease of orientation, wayfinding, navigation and drop off at the “front door”.
Dennis O’Keefe from NHS Dumfries introduced two projects, large and small. Firstly, Colin Carrie of Keppie Design, presented the larger scheme for the new 50,000m2 Dumfries and Galloway Acute Hospital. The smaller project, introduced by Graeme Armet from Richard Murphy Architects, was for a single storey, 18-bed mental health unit for Stratheden Mental Health Trust, which had been operational for two years. Dennis summed up with an interesting view of the importance of the social dimension of the briefing process in the evaluation of design quality. He stressed that the collaborative nature of the briefing process was the start of an evaluation approach which should continue through the design, construction and into the buildings use – coining the phrase “ontological primacy” to reflect the practice of being, doing and learning together.
At this point, questions from the floor probed the issue of change management and the impact on design and debate about Post Occupancy Evaluation. Heather Chapple inadvertently introduced her own talk by referring the audience to the Architecture & Design Scotland’s website “Pulse”, where case studies and lessons learnt are available.
Introducing a new publication entitled “Quality and Efficiency”, Heather then set out the lessons of a Reference Design project in which two design teams were asked to test and explore design responses to the new service context through engagement with stakeholders for a real project. Through clever design and the intelligent application of scarce resources into attractive and flexible spaces, it was estimated that the designs realised savings in construction terms of 22 times the design fee to stage C!
All Boards are required to prepare a Design Statement for projects of a certain scale, which is monitored by HFS and A&DS throughout the project approval process. Picking up this theme directly, Steve Shon of NHS Lothian, demonstrated how a specific Design Statement was being developed for a new Mental Health facility at the Royal Edinburgh Infirmary.
Clare Kemsley, from Gareth Hoskins Architects, one of two practices that carried out the Primary Care Reference Design Project, talked through the design iterations for their project. It came across as a sensitive and well thought out centre in planning terms with imaginative architectural interpretation.
Debate centred on the cultivation of “new blood” in the industry and particularly in the design professions: it was felt that events like this helped to raise awareness of the importance of healthcare design. AfH, through its annual Student Design Award, is specifically set up to foster new talent in health. Leslie Welch welcomed approaches from local practices interested in taking forward the debate in Scotland.
Our first visit on a somewhat grey and rainy day was to Barrhead Community Health Centre by Avanti Architects. Built as an integrated healthcare centre it accommodates many services including general practice and community health. Arranged around a light and spacious atrium, the centre felt welcoming and light.
As the coach approached the new Southern General site, the scale of this massive undertaking was clear. There are two conjoined hospitals under construction: the Southern General with state of the art Emergency, Acute Receiving, Critical Care, Theatres and Diagnostic Services and rooftop helipad, offering acute specialist inpatient care, medical day case services and also outpatient clinics servicing the local population; and the children’s hospital with separate identity and entrance, that will provide a large number of specialist services to the West of Scotland and the wider population of Scotland in addition to the full range of secondary care services to people of Greater Glasgow and Clyde. It’s too early in the construction to report on the success of this project. But it is one of the largest in the UK and clearly very important for the south west region of Glasgow and environs.
The new Stobhill Hospital designed By Reiach and Hall Architects, deserves its title of “the world’s best small hospital”. There is a feeling of calm and serenity in the atrium accessed from both ends with accommodation on either side. Although there were many people in this very attractive space it was not noticeably busy; visitors and patients were occupied with different activities in the café, at the reception desk, on the escalator or stairs and all was relatively quiet and ordered.
We concluded our tour with a visit to The West Centre designed By Alexander Bell Christie, a child and family centre in the community of Drumchapel. It was designed as a ‘one stop shop’ for medical and social support services for families and children with long term health issues. It has been accepted by all those involved, that it was the shared courage, motivation and ambition of the design team and the stakeholder groups that enabled the delivery of such a non-conventional but coherent building. An excellent example of a high quality, high design healthcare provision.