This year’s Regional Event took place in the North West of England where we reviewed new proposals and buildings under construction for acute hospital, cancer and mental health services.
The three themes that stood out in all the presentations were:
- The relationship of health buildings to their immediate and neighbourhood context
- Quality of design for all the people who use the health buildings
- The relationship of the designer both to those who will use and also those who build the hospital
Liverpool Royal is exemplary for the consideration given to the design in terms of its historical and urban context that underpin not only the overall layout of the site, but also the massing and materials. The current scheme works within a robust masterplan that will be realised over time: so the development of the whole site – not just the hospital – has been taken into consideration from the start. Access and entrances to the hospital, connections to the immediate surroundings, making a landmark on the approach to the city, have all been considered. Additionally, the potential to make landscaped gardens as amenities to be enjoyed both as views from the hospital and by pedestrians walking through, has been thoughtfully explored. Internally the hospital design has taken the challenge of arranging the single bedrooms in wards that cluster suites of rooms, provide interstitial bathrooms to enhance views into and out of the bedrooms, with a cranked plan to enhance circulation and place making.
We were privileged to walk round the Alder Hey Childrens’ Hospital site immediately prior to their ‘topping out’ ceremony – all very organised and ship-shape as you would expect! Whilst still in skeletal form, the build was sufficiently advanced for us to see the overall layout of the design and to have a fair sense of the scale. We were also able to appreciate the size of the components – for example the glu-lam ‘whalebone’ beams transported from Germany and ready to be installed in the main atrium space. The commitment to ‘design for manufacture’ demonstrated through the project by the contractors is impressive. Using off site fabrication for the bedroom ensuite – as a single product, to improve both speed and quality of build. The design and manufacturing of the external panel materials is equally compelling. Inspired by the sandstone strata on entry to Lime Street Station, the concrete panels resemble the geological formation and by careful manipulation retain a sense of individuality even though they have been reduced to 9 types. The use of CAD, BIM and CAM to transfer the designs into manufacturing is remarkable.
The proposed designs for cancer services ranged from full treatment centre for Clatterbridge on the Royal Liverpool site to the informal and holistic care and information centre for Maggie’s for the Christies in Manchester. Dealing with large scale kit and intrusive drug treatments, the former, demonstrated the designers intention to create a supportive and quality environment in the face of potentially frightening care. For the Maggie’s, the intention was clearly to make a domestic space that resemble “my best friends mum’s kitchen”. The extent to which that holds true for both genders and across generations may be questioned, but the idea behind it is clear. Again, in both cases, attention was given to the quality of the spaces, the experience of the space by the users and the relationship to the immediate context.
Junction 17, whilst designing for a very different care group, in mental health services, bore remarkable similarities of design purpose to the ‘Maggies’. Making a place that Young Adults could feel comfortable and have a sense of belonging, whilst maintaining security and safety is no mean feat. Clearly the close relationships of the designers to the clients was very much part of the success of the project.
Clock View was impressive for the way that it defined intentionally the separate nature of private bedroom spaces from the daily live – work activities, for the attention to detail in the specification of materials, detailed design and finishes, but also for shifting the reference from custodial care settings to cloisters – an almost monastic template for contemplation and renewal – as the model environment for acute mental health services.
The relationship of healthcare settings to the urban fabric was seen not only in the layout of the major sites: the walk around the Manchester Metropolitan University campus made clear the parallels with hospital settings – and the potential to explore further these ideas – making healthcare part of, not separate from, city life. The design of the new Art and Design building at MMU and the new Education and Research building for Alder Hey, served to underline the potential to introduce, albeit for now in non-clinical areas, innovative thinking about spaces that help to foster teamwork and interaction in major institutions.
A recurring theme over the 2 days was the importance of the relationship between the client and designers at every stage of the project. The dialogue between informed clients and imaginative designers is at the core of this and clearly helps to foster good quality design. Yet it is so often overlooked or subsumed in the drive for effective, efficient and productive processes. That’s not to say that these are mutually exclusive.
It was inspiring to see such a strong commitment to good design and is certainly worth keeping a watch on developments in the NW. But perhaps the most intriguing idea was that of using technology to create a virtual buddy for patients at Alder Hey – that can exist inside and outside the hospital setting – as a way to help patients feel more comfortable about their stay.