AfH Wales Trip 2012

STUDY TOUR

YSBYTY YSTRAD FAWR

10 July 2012

Leaving Cardiff by coach, the Architects for Health study group wound their way through the spectacular Welsh countryside to the new local general hospital, Ysbyty Ystrad Fawr, located in the former mining town of Ystrad Mynach, five miles north of Caerphilly.

Officially opened in November 2011, the new hospital provides replacement services for three former hospitals in the borough of Caerphilly, co-locating all services under one roof.  In addition the hospital provides a range of services previously only available from the major acute centres.

The hospital provides 226 beds (26 of which are located in the elderly mental health unit), being one of the first to provide 100% single en-suite bedrooms (more of that to follow).  Services available at the hospital include a 24 hour local emergency centre (together with GP out of hours services), integrated mental health unit, day surgery, diagnostic, outpatient, therapies and a midwife led birthing unit.

The hospital was designed by Nightingale Associates and built by BAM under the ‘Designed for Life’ framework which was set up by the Welsh Assembly in 2006 to provide strategic partnering to support the aspiration to provide world class healthcare services in Wales by 2015.

Arranged over three principal levels, the main entrance is located at one end of the hospital street announced by an elegant glazed prow featuring coloureds glazed panels atop a terracotta entrance vestibule at the northern end of the site, creating a four storey galleried void within.  The main clinical accommodation is raised up one level to acknowledge the hospital’s location within a flood plain adjacent to the River Rhymney, allowing some 600 car parking spaces to be provided beneath the building ( very popular with the staff ) .  Visitors drop off and emergency accesses are both provided at the upper level.

Moving from the main entrance, the clinical accommodation is arranged on either side of the hospital street, a long naturally lit artery with wards formed in V-shaped blocks creating triangular courtyards one side and trapezoidal blocks on the other.  Landscaped courtyards help to articulate the journey along the street and also provide welcome visual interest.  The courtyard elevations are clad with silver grey composite metal cladding (possibly the result of value engineering?) which is relieved by large glazed screens to the street articulated with multi-coloured aluminium fins attached to the curtain wall. Internally, the circulation spaces adopt a simple muted palette of white walls, grey floors and full height oak doors set in glazed screens collectively providing a blank canvass for future artwork.

An unfortunate consequence of the move to raise the building up one level is the visual dominance of the car parking at the lower level and the physical disconnect of the courtyards from the clinical accommodation which seemed to be a missed opportunity given the hospital’s dramatic location.

Public spaces within the building, however, are particularly well handled with the use of the building section to create a selection of double height spaces in the restaurant and other waiting areas, naturally lit from a variety of sources, although the selection of standard furniture disappointingly did not match the aspirations of the architecture.

Each 30 bedded V-shaped ward is accessed from a single shared reception at the junction of the street and the V form, from where the single bedrooms are simply arranged either side of the corridor, with the en-suite bathrooms placed back to back between bedrooms.  Full height glazed screens to each bedroom allow natural light to filter into the corridor and allow patients to control privacy through the use of integral blinds.

Each bedroom is identical in layout, with vertical bedhead trunking always located to the left of the bed and in between the bed and en-suite bathroom.  The plan form allows each room to benefit from a large window divided into three horizontal panels, providing a choice of ventilation at low or high level, although the height of the cill in the typical bedroom visited was a little high to benefit views of the landscaping at the lower levels from the bed.  Anecdotal patient feedback was generally good, although some had felt ‘a little isolated’ despite day rooms being provided within each ward.

The long tapered shape of the site clearly informed the overall parti, and whilst there remained nagging doubts about the resolution of the flood plain, parking and entrance arrangements, the success of the project must be judged on the key ambitions of the scheme- namely, the bringing together of disparate clinical services under one roof combined with the decision to provide 100% single rooms.

YSBYTY ANEURIN BEVAN

10 July 2012

Following lunch at Ystrad Fawr, the AfH contingent travelled to Ebbw Vale, to visit Ysbyty Aneurin Bevan, the new local general hospital for Blaenau Gwent, some 35 miles north of Caerphilly which opened in October 2010.

Located on the site of the former Ebbw Vale steelworks which closed in 2004, the hospital was one of the first projects on the site intended to regenerate the area.  Other developments on site recently completed or under construction include some pilot eco-homes, a post 16 college and a new primary school.

Delivered under the same ‘Designed for Life’ procurement as Ystrad Fawr, the hospital forms part of the wider national strategy to reconfigure and improve the provision of healthcare services throughout Wales.  Services previously provided at two hospitals are now brought together in one facility to serve the whole catchment area of Blaenau Gwent.

These include 96 in-patient bedrooms – the first to provide 100% single en-suite accommodation incorporating an adult mental health unit with out-patient, day care and an 11 bedded in-patient facility.  Other services include an out-patients department, an urgent care centre, a birthing unit, diagnostic support and a large therapies unit.

Unlike Ystrad Fawr, the site for the hospital was not affected by flood plain issues and here all accommodation is readily accessed from ground level, with the entrance located more centrally within the plan, minimising travel distances to the main wards which are all located at first floor level.  Visitors are greeted with a pleasant entrance and cafe area with views out to a landscaped courtyard.

In plan, the building features similar V-shaped ward design to the Ystrad Fawr creating triangular shaped courtyards, with the therapies and mental health unit forming extended legs at ground level.  Here the courtyards are far more successful by virtue of their location at ground level, with access afforded from the perimeter and the bright, white  render treatment to the internal courtyard elevations creates a cheerier finish than the silver grey cladding panels at Ystrad Fawr.

The therapies unit makes particularly good use of the site by using the external spaces as part of the rehabilitation ‘garden’, where patients are able to use pathways etc. to aid movement and recovery.

Establishing a similar colour and finishes palette of white walls, grey floors and oak doors, the interiors are complimented by well-designed joinery details to the main stair and principal reception desks.  Externally the elevations are comprised of a collage of materials including stone faced block, fibre cement panels and splashes of copper cladding, referencing the former industrial nature of the site. The indented entrance façade creates a vehicular drop off point, and all car parking is located a short distance from the main entrance.

The design of the single bedrooms is identical to the Ystrad Fawr, but here grouped into 32 bed wards, accessed at the centre of the ward on  the point of the ‘V’, thereby creating an ‘L’ shaped ward.  Each ward benefits from a day room (some complete with a terrace), to provide social space for in-patients, however these were not being used as intended apparently due to the short stay of patients and their preference to remain in their rooms – perhaps a reflection to their success.  As an unintended consequence, staff have apparently ‘adopted’ these unofficially!!

Whilst a year separated the opening of the two hospitals visited, it is evident they were born from the same design approach, evolving from the detail resolution of the single bedroom, the design of the V-shaped wards enclosing landscaped courtyards through to the adoption of similar interior detailing and colour palette.

This design approach represents a move to a more patient focussed healthcare system, reinforced by the co-location of a range of sub-acute clinical services under one roof and taken together, the hospitals can be seen as physical evidence of a step change in the provision of healthcare in Wales in the twenty first century.

Teenage Cancer Trust at University Hospital for Wales

Opened in July 2009, the ‘Skypod’ at University Hospital of Wales follows the same guiding principles promoted by the Teenage Cancer Trust in all their centres nationwide. Essentially the charity’s mission is to provide inpatient and day care services to cancer patients between 13 to 24 years in age appropriate settings. Applauded for the charity’s trademark for design inspired interiors, this unit shown to us by nurse consultant Laura Clark and lead nurse Jenny Labaton was no exception. Whilst making a bold design statement the ‘Skypod’ was sensitively articulated to communicate to a very specialist patient user.

On a difficult infill site, the unit is appropriately located between the paediatric and adult oncology departments. ORMS designed the first and second floor extension on stilts to sit over existing ground level accommodation. Architecturally the extension is a gallant eye catching insertion into a nondescript backdrop of concrete and pebble dash.

Arrival to the unit via a dedicated lift delivered us to the first floor of the extension, where the bedrooms, 2 singles and 2 three-bed bays are located around a central nurse station/ reception area. For patients requiring a higher level of care such as post surgical and transplant, one of the single bedrooms has an accessible en-suite bathroom fitted with ceiling hoist and is HEPA filtered. This single bedroom is otherwise identical to the adjacent one, fully presented as a teenage friendly space with desk/ dressing table, computer games console and feature lighting.

In the three-bed bays specifically, visual privacy is afforded by the design of the cubicle curtains which were formed by multiple layers of textiles, each giving differing degrees of transparency. As well as providing full visual privacy as and when needs dictate, the layers also offer a subtle and useful communication tool for the patients to indicate their reservation/ desire for social engagement at the bed side. Should some social interaction be sought beyond the bed space, a sliding screen at the end of the room reveals a discrete den shared between the 2 no. three-bed bays. The living area located on the second floor, occupies the majority of the floor plate and has open views over the hospital site offered by the full height glazed balcony doors. The space is open plan and multi-functional other than for a curved timber cladded structure which encapsulates the ‘chill-out zone’. Darkly lit and softly furnished, this space provides a cocoon-like hideaway for those wishing to retreat. The attention paid to privacy, dignity and social issues shown in the living areas and the bed bays is a key demonstration of the response to patient-focussed needs.

Significantly, around the time this project was launched, a study was commissioned by the charity and undertaken by The Futures Company. With the aim to address the real needs of patients, their friends, families and staff, ‘control, comfort, stimulation, personalisation and connectivity’ were reported as “benefit platforms”. It was clear from our visit that the design of this unit works hand in hand with the model of care to deliver on these “benefit platforms” in responding sensitively to the physical and emotional needs of young people whilst also championing the relationship between the built environment and health outcomes.

Cynon Valley Hospital

The final visit on the AfH tour took us to the Cynon Valley, where the new £60m Ysbyty Cwm Cynon sits in the centre of the flood plain. Designed by HLM Architects and completed in Spring 2012, the hospital is based on an unusual radial design and spread, over 2 storeys. Patients and visitors arrive at the centre of the circle, giving the impression that the building is welcoming the community as its wings embrace the main entrance approach.

With a floor area of 18,500sqm, the building provides primary care support for the neighbourhood including outpatient care, minor injuries, therapies suite, diagnostic facilities on the ground level. On the first floor, we find four flexible 25 bed medical wards as well as ancillary administration and plant rooms. A midwife led birthing unit was also planned for this area but it was not completed

The accommodation is arranged in two concentric curved wings punctuated by a string of planted courtyards around which the departments wrap. The hospital street between the two forms follows a gentle arc that reduces it’s perceived length and links to the entrance atrium part way along in the form of a wedge providing views through to the hills beyond.

Although this building was completed after the Aneurin bevan and Ystrad Fawr hospitals, the design work started as far back as 2001 before the advent of Designed for Life Procurement Frameworks and the 100% single bed ward agenda. Arguably the flexible wards are more appropriate to accommodate rehab inpatients in any case. The fact that the project was procured traditionally is reflected in the quality of internal finishes. For example, the solid surface acrylic forming the booths in the dental suite were particularly well detailed – subtle in design and finely finished.

Flexibility were built into the wards by a common template, but what distinguishes them from standard ward designs is the generous floor to ceiling height of 3.3m which in combination with exposed concrete soffits offer a sense of spaciousness, comfort and a clutter-free aesthetic.

The art strategy themed around nature followed consultations with staff and art consultants. These were presented as sculpture, murals, photography and paintings. One memorable installation assembled from large carved stone panels draws the eye along the atrium on entry to the building.

Whilst this hospital is less striking in it’s architectural execution than Ystrad Fawr and Aneurin Bevan in terms of material palette and form, it’s real success lies in the attention given to the design of the interior and it’s attempt to enhance the user experience by features such as the colour-themed canopies to each department threshold, generous restaurant terrace overlooking the hills and the well presented courtyards.

 

Better cities, better lives (student competition)

Deadline: 07 September

Global architecture competition for students – Better cities, better lives

Open to: All architecture students (undergraduates/architects in training)

The brief: The UIA theme for World Architecture Day 2012: London is Architects are city changers. As global populations rise, architects will be responsible for shaping the urban fabric and developing the necessary tools to accommodate the citizens of the 21st century. This theme embraces the United Nations’ Human World Urban Campaign initiative established to promote business practices, models and technologies that provide viable solutions to the challenges of urbanisation.

You are invited to submit your ideas/concepts of how you could forward the aim of Better cities, better lives. The jury will be looking for ideas/innovation/notated sketches rather than detailed drawings. You may select a specific city/challenge or a generic solution.

Format: 1 A2 PDF (portrait)

Deadline: Friday 07 September 2012

Cost: Entry is free

Judging: A panel of WAN AWARD judges will assess the submissions and draw up six shortlisted entries. The winner will be announced at World Architecture Day 2012: London on Monday 01 October.

The winner will receive an iPad and their submission will be published in WAN’s News Review to our 230,000 global readership.

Send entries to caroline.stephens@wantoday.com

http://www.worldarchitecturenews.com/index.php?fuseaction=wanappln.showbriefdetail&newsid=1651

HACIRIC RESEARCH – Flexible space design for healthcare built environments

Are you willing to share your experience about designing flexibility ?

A new study will explore effective practices for selecting either a standardised or innovative approach to flexible design

What do you have to do?

You will simply agree to take part in an detailed discussion that will help to identify components or building systems/processes

Why participate?

·       This would be a great opportunity for a robust discussion about their project and learn things out of it.

·       This would also be a great opportunity explore possible flexibility solutions.

·       Contributions will be used to improve current flexibility strategies.

More information

See PDF Participant information sheet 1

What next?

Simply email researcher

Ahmad Mohammad Ahmad

(A.M.Ahmad@lboro.ac.uk)

School of Civil and Building Engineering, Loughborough University

HaCIRIC International Conference, 19-21 September 2012, Cardiff

The conference will include more than 25 new research presentations plus top level speakers looking at the UK, European and Welsh perspectives of how infrastructural and service innovation can deliver higher quality, more cost-effective healthcare in this age of austerity.

More information can be found here: http://us5.campaign-archive1.com/?u=43dc0544fb6732990588a55f8&id=28b5962526&e=93627956c8

Health Secretary’s annual report on the NHS and public health published

The Secretary of State’s annual report has been published today, a year earlier than is required by law, in order to enable Parliament and the public to see the direction the NHS is heading. From 1 April 2013, the Secretary of State for Health will be under a new duty to produce the annual report relating to the performance of the health service in England, which will be laid before Parliament. The Health Secretary’s annual report will be the principal method by which Parliament will hold the Health Secretary to account for the performance of the health service in England.

http://www.dh.gov.uk/health/2012/07/annual-report/

Collaborative practices: artists and architects 20th June 2012

Another full-house for the Architects for Health’s collaborative practices showcase on the 20th June, the first event to be hosted within the new Great Ormond Street Hospital’s Morgan Stanley Clinical Building “Lagoon staff space”, part of the Mittal Children’s Medical Centre.

Over 70 attendees, participated in this special event, as part of London Arts for Health Forum’s “Creativity and Well-being week”. AfH hosted an energising evening of presentations and discussions focussing on collaborative partnerships.

Following brief guided tours for over 50  AfH members and guests, thanks goes to Great Ormond Street and Lewellyn Davies Yeang representatives, for successfully herding the four troupes around the first phase of this impressive facility.

The evening started with a “word from our sponsors”, Hitch Mylius. It was great to hear from an award winning British manufacturer, striving to create beautiful contemporary upholstered furniture for use within healthcare settings. Guests were invited to test out their healthcare range of chairs, showcased within many familiar schemes including ACAD and the Evelina.

Robert Etchell and Mark Gage, of Llewelyn Davies Yeang, provided an overview of the design and delivery of the Mittal Children’s Medical Centre, first phase. This “deep green” medical building sets a new benchmark in Children’s Hospital design. Successful collaboration, staying power, commitment and talent, were all evident and became the recurring themes of the evening.

Artist Kate Blee’s and Claudia Bloom’s (Avanti Architects), “from earth to sky” presentation on the Learning Resource Centre and Pathology Building at Southmead Hospital, demonstrated the benefits of architect and artist collaborative working. The sheer depth and detail of the work which goes into generating unique and location specific artwork was humbling. The introduction of a single red tile amongst the work titled “one in a million” was an act of genius, as the conclusion to the journey and understanding of the work within, which was described as “a hive of activity”. It really was a tale of “where two worlds collide”, the determined artist and architect, focussed on specific elements, working alongside an equally determined contractor constructing the building, culminating in “joyful” partnership working sealed with a mars bar.

Artist Julia Ridge and Architect Julia Dwyer, “little and large” presentation showcasing the “large” as North Middlesex PFI with the “little” as Homerton Hospital’s Mother and Baby unit. They seemed to understand the “very fast or very slow” PFI culture instantly, when delivering the media wall and lift lobby storyboards at North Middlesex Hospital new build PFI. Story’s/Stories/Storeys of “shed man public engagement”, “social wall-paper” and an injection of humour, underpinned the delivery of some very engaging pieces, which were all about communication and localism. For me the line of “120 languages, 120 ways to say hello” captured the spirit of their approach and collaboration. My one disappointment was in hearing of the oldest tree on the Homerton Hospital site that the line “we saved it from chipping” was expanded to “we saved it from chipping, by having it milled on site”. Having said that it was unclear whether it was standing in the way of the development, but it’s timber was used to create a unique and very relevant piece of artwork based on measurement. Little and Large Presentation.

Artist Heather Barnett and Poet Will Holloway, saved the best to last with their presentation simply titled “flow”, telling the story of the art within the new Chemotherapy unit in the Guy’s Hospital tower working with Greenhill Jenner. I took the title to be advice i.e., to go with the flow and see what develops when engaging in consultation and artistic endeavour, be playful “let it flow”. The opening line of “95% of art in architecture is about beauty but Will and Heather have moved away from that”, caught our attention and desire to hear more. Once again the depth of thought, the introduction of a sense of daring, humour and of pushing boundaries pervaded their work. The “repeat viewing appeal” reference to their “atlas of journeys” was an understatement, it was fascinating, clever, though-provoking and “beauty may be in the eye of the beholder” but I thought it was beautiful for all those reasons. http://prezi.com/mx01r8o0b0i7/cdu-lahf-talk/

To be treated to the level of detail and hear about “the journey”, “the process” as well as admire the end product, made for a truly inspirational evening

Susan Francis summarised the evening’s presentations and discussions “as a bringing together of art in it’s widest sense and architecture, hosting a creative process within technical necessities. It was an inspiration to see such imagination and creativity impacting on spaces and ultimately on us. ”

Lastly we would like to thank our hosts, Jo Trussler (GOSH clinical planner) and Victoria Jones (GOSH Head of GO create), for supporting the event and making us all feel so welcome.

 

Exhibition Displays – Call for entries

Exhibition Displays – Call for entries

“Healthcare Design Best Practice”

AfH will be exhibiting at a number of upcoming health design events, including ‘IHEEM’ in Manchester on the 9th and 10th October 2012.

This year we are going ‘paper-light’, so we are inviting you to submit up to three illustrations from your practice, reflecting your projects from this year (2011-12) in pictures. With this change in format we would like the exhibition to be both visually stimulating and also informative, so we are asking for the submissions to be made in the form outlined below, focussing on Healthcare Design Best Practice.

We will display these submissions electronically on a large LCD screen, in the form of printed banners and, on our website gallery.  These banners will be launched at IHEEM 2012, then displayed at future Architects for Health events and conferences supported by AfH.

In this our Olympic host year, we will be awarding gold, silver and bronze AfH medals, for those entries judged to be the most informative and innovative.

Format of submissions

Each illustration submitted should be in the form of a single image (A3 size landscape format, minimum resolution 200pixels/inch, in high-quality compressed jpg or tiff format). In true “Twitter” style, each illustration should be supported by a 140-character explanation of the particular scheme’s contribution to “Healthcare Design Best Practice”, for use within the power-point slide show.

Please limit each submission to no more than 3MB. (allows for 1MB per illustration when the maximum of three are submitted)

For uniformity of the banners and slide show the entries will be formatted by AfH. No company logos will be used. Practice names and project names should be clearly stated, these will be added by AfH to each illustration to the same size, style and format for all.

Please email your submission in a single message containing clearly identified illustrations, your practice name and text descriptions, to: events@architectsforhealth.com

Entry fee

An entry fee of £100 will be charged per practice submission of up to three entries. (See payment details below)

Deadline

Deadline for all entries and payments is 25th August.

Payment

For payment instructions please email events@architectsforhealth.com

International Meeting Australia 10th May 2012

A full-house for the Architects for Health’s International meeting on the 10th May at the RIBA.

With over 80 attendees, including 18 guests from the Antipodean Health study tour, AfH hosted an enlightening evening of presentations and lively debate focussing on Healthcare planning and design in Australia.

The evening started with a “word from our sponsors”, the Copper Development Association. They provided an update and some extremely encouraging evidence, through clinical trials, of the beneficial effects of copper in relation to infection control. Any product which can boast a 75% reduction in HAI through the introduction of just 6 copper components has got to be worthy of further research. Interestingly, with no examples of this in practice within the UK or Australia, there’s a real opportunity for learning from this global best practice and being one of the first to use copper “touch surfaces” components within the UK and Australia. http://www.antimicrobialcopper.com/media/320507/afh-antimicrobial-copper-10may2012.pdf

Andy Black (Andy Black CV), of Durrow Consulting, provided an illuminating overview of the Royal Adelaide Hospital briefing process, comparing the two approaches of ‘centralised’ and ‘distributed’, to designing a University Hospital for the future. Andy emphasised the importance of the civic status and presence of a University Hospital, as one which could re-invigorate and re-generate it’s host city. Andy Black presentation.

Dr Keith Joe, (Keith Joe CV) of the Australian Centre for Health Innovation, presented a fresh perspective of healthcare design, through the eyes of a practising Health professional specialising in Trauma medicine. Keith shared his experience and his ideas for his ED, which reflected his vision of using “the most advanced IT systems and best recent thinking”, resulting in the Royal Melbourne Hospital ED being totally electronic. Keith shared his view on the latest IT systems and technologies, challenging all of us present to “design for mission control in all your Hospitals”. Dr Keith Joe presentation.

Jane Carthey, (Jane Carthey CV) of the Australian Health Design Council, shared with us her work at Rice Daubney Architecture, including the inspirational Chris O’Brien Lifehouse Cancer Centre at the Royal Prince Albert Hospital in Sydney. Jane told the story of Chris O’Brien’s experience, similar to that of Maggie Jencks, with a comparable “humane” response to creating a facility to treat the whole person. Jane Carthey presentation.

Ruari Reeves, (Ruairi Reeves CV) Associate MAAP, presented the story of the New Glenside Health facilities in Adelaide, highlighting the benefit of the “enablement stage” where a new model of care could be tested. This new 129 bed mental health facility, quietly understates it’s “big idea” through modest single storey architecture. The re-interpretation of the South Australia vernacular architecture with a combination of verandas and gardens provides a uniquely local response whilst delivering a potentially global solution for large scale mental health facilities. Ruairi Reeves presentation.

Jeff Menkens and Brendan Kelly, (Jeff Menkens & Brenden Kelly CV) Principals at Hassell’s Perth Studio, concluded the presentations with a detailed design presentation of the 800 bed Fiona Stanley Hospital in Western Australia. Whilst absorbing the scale of the scheme across the equivalent of four city blocks, the team managed to retain the original concept of reflecting the bush-land context. It was refreshing to hear how the façade treatment had been inspired by a particular native flower, responding to the specific solar conditions of this location. Brenden Kelly and Jeff Menkens presentation copy.

John Cooper summarised the evening’s presentations as a “embodying synergies across context, master-planning, civic importance and local sensitivity,  providing a uniquely Australian contribution to the Global debate on Healthcare design”

Lastly we would like to thank our guests, who having seen 14 healthcare facilities in 10 days across the Netherlands, Norway and England, managed to find time (and the energy) to participate in such an enjoyable and informative evening.

RCJ 14.05.12