Ann Noble Obituary

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Ann Noble9th December 1942 – 9th December 2016

PhD, B Arch, MA Sociology,
Dip. Town Planning, RIBA

AfH Past President

An original founder member of Architects for Health, Former Chair and subsequently Life President, Dr Ann Noble has died peacefully after a long illness. She had a distinguished career in practice, teaching and lecturing internationally and had collaborated with and advised many leading practices including Ted Cullinan, SOM and HOK.

Ann Peerless was brought up in Somerset and studied at Bristol University, where she met her future husband, Paul, both reading architecture. She gained an MA in Sociology from the University of Essex in 1967, registered as an RIBA Chartered Architect in 1971, gained a Diploma in Town Planning from the then Polytechnic of Central London in 1974 and a PhD from Bristol in 1988.

Following three years working in Libya on social housing, Ann began Research & Development work for the Department of Health and Social Security (DHSS) Hospital Building Programme. Thus began a lifelong interest and passion for healthcare architecture, taking her to the very top of that profession and international acclaim.

For thirteen years from 1976, Ann was engaged with research and teaching at the Medical Architecture Research Unit and there established an advisory and facilitating service for General Practice Premises, and other primary care building developments for Inner London. At MARU, she was pivotal in teaching and mentoring the Masters Degree course in health facility planning, attracting students from across the globe.

Ann Noble Architects was established in 1989 and became renowned for expert advice and sound knowledge as well as designing and delivering a range of highly regarded healthcare buildings. The practice continued to gain commissions for assessment and evaluation, a mainstay of Ann’s belief in the value of structured research to inform decisions and future schemes.

Ann’s research portfolio is extensive and a continuing thread through her career, from a survey of shantytown dwellers in Benghazi and Tripoli for the Libyan Ministry of Housing in 1970 through to evaluation of wards, whole hospitals and dozens of primary care centres to patient safety research in 2007. Many of her papers were published by MARU and the Nuffield Trust book “50 Years of Ideas in Health Care Buildings” which Ann co-authored in 1999 is a definitive review of healthcare over the lifetime of the NHS.

Around 1990, as most in-house healthcare design services were abolished by the government, a small group of likeminded architects and others set up Architects for Health, as a means of continuing a thread of mutual learning and information sharing across the professions. Ann was among those early pioneers and the organisation grew in stature and membership. Professor Raymond Moss held the chairmanship until 1998 when Ann Noble was elected to that position, which she held for ten years.

During Ann’s tenure, Architects for Health developed a vibrant and varied programme of events for members, attracting guest speakers from across the healthcare world. The international visit programme was inaugurated by Ann, the most notable of which was a study visit to Japan in 2005 by a group of members and hosted by the Japan Institute of Healthcare Architects. That relationship is particularly poignant as the lead host was Professor Yusushi Nagasawa, who had been one of Ann’s students on the MARU course some years earlier.

In 2009, Ann received the Lifetime Achievement Award at the Building Better Healthcare Awards. Her citation includes this sentiment; “Ann has devoted her professional life to promoting excellence in healthcare environments”. Those words reflect a career, a lifelong passion and a depth of knowledge and dedication which her friends and colleagues will recognise. Ann’s influence and determination, imparted with kindness and good humour, has been the inspiration for many in the professions she worked with and knew.

Ann married Paul Noble in 1966 and they had a son, Jacob and a daughter Sophie, both of whom practice as professionals in the built environment. Behind the consummate professional, Ann was the caring matriarch of a loving and close family who enjoyed each other’s company at home and on fondly remembered holidays. The birth of her grandchildren was a source of great pleasure to Ann in her latter years.

Ann gave of her time and experience freely, mentoring and advising colleagues and protégés alike. She had the rare capacity of understanding healthcare architecture comprehensively and the rare gift of encouraging and enthusing others towards greater excellence in that field.

To make a donation to the Alzheimers Research Trust in Ann’s memory, please go to this web address http://ann.noble.muchloved.com where detailed instructions are available.

Phil Gusack Talk 2017 at AGM

Reshaping NHS Infrastructure: Will integrated care centres do the trick?

Dr Patricia Oakley is a woman on a mission. Having qualified originally as a pharmacist and becoming London Chief Pharmacist in the early 1980s she didn’t stop there. She has a masters and a doctorate; teaches and undertakes research at Kings College, London and is a Director at Practice Makes Perfect. She splits her time between London and the West Country.

On talking about building the case for change Pat told us that she talks from experience having been involved in policy making for integrated care centres. More usually she works every summer building forecasting models of the clinical workforce and particularly doctors, dentists and pharmacists in order to inform the Joint Investment group of the student numbers they need to admit to support the future workforce. These models look forward 20 years which is the time it takes for a student to become fully effective in the workforce.

At this point Pat became deliciously political, telling us how the UK only spends 6.5% of GDP on healthcare compared to France and Germany at 8-9% and the Swiss at 10%. Tony Blair moved spending on health from 5% to 10% which should be viewed as one of his most significant achievements. However it hasn’t been sustained at that level. The state also knows it requires a capital programme of £120b for healthcare.

Pat continued that the current NHS was designed for a life expectancy that was surpassed years ago. It has almost been too successful. Life expectancy and health into later life means we need a new asset class. This does not mean a return to the community hospital model (many of which were closed down but not knocked down). What is required is a care centre model creating places for care and for work.

80% of the budget within the next 30 years will be spent on care of the elderly who are physically well, socially engaged and psychologically content. These are the baby boomers who are healthier, wealthier and stealthier! It is the paradigm of chronic disease.

So, we need to think about the Mind the Gap programme that seeks to integrate mental health to close the 20 year life expectancy gap. We need to think about new science – therapeutics, genetics and molecular imaging.

Barnett et al writing in the Lancet in 2012 cited that ‘exercise is the miracle cure’. This means we must think about urban design and social space (and ban sofas!)

All this thinking is leading us to new design principles and new services such as ‘doc in a box’ and single people campuses / co-operatives. The GP practice is a ‘busted flush’ based on a 1911 model which no longer works.

So, what is the ‘place in the middle’?

This model is about placing social care; hospice and hospital at home; pharmacy and medicine; GP and community nursing and therapy on the high street. Hyper centres (the word hospital should be banned) then become about trauma; cancer; cardiac and stroke care; urgent care; maternity and neonates and mental health.

Some of this is happening already. The Nelson Centre in Wimbledon provides local care including a therapy theme park; genomics; outpatients; pharmacy; diagnostics; social space and GP adjacent to a retirement village. The model exists more widely in Denmark and the Netherlands.

Northumbria also has a pilot site.

This is about a crucible of change, happening at the centre of the community; a shared place for many professionals and new ways of working. It should become a focal point for new investment.

Pat finished by telling us we need fewer beds and fewer doctors but to deliver what is actually needed needs the construction of a persuasive, informed narrative which currently doesn’t exist.

Chris Shaw thanked Pat and said members were thoroughly engaged in this provocative and no holds barred talk. It was agreed that her passion for her subject and her knowledge of future policy requirements coupled with a style that takes no prisoners was entirely fitting for the Phil Gusack Talk 2017.

Healthcare Architect Needed for New Hospital in Georgia

We have had an enquiry from a German-Georgian construction company based in Tbilisi, searching for a strategic partner for the planning and design of a new hospital in Georgia

The basic requirements are as follows:-

  • Services for preparation of design-cost estimation documentation for infectious pathology, HIV and clinical immunology located in Tbilisi / Georgia
  • Support needed for engineering-design services required for construction
  • Land plot area is 5 000 m2
  • Estimated rentable area of the design building(s) is 10 567 sqm
  • Design should provide for accommodation of 100 beds
  • Design-cost estimation documentation shall be prepared in line with construction norms and regulations effective in Georgia, and in accordance with European Standards.
  • The design-cost estimation documentation shall provide for the measures of adapting the building to the needs of disabled

If any members are interested in taking up this challenge please send your statement of interest to us at General Enquiries on our Contact page. Your details will be forwarded to the company for their information and action.

European Healthcare Design 2017

VISIONING THE FUTURE:

DESIGNING FOR CHANGE IN PEOPLE-CENTRED HEALTH SYSTEMS

The European Healthcare Design 2017 – Call for Papers – have now been launched.
Organised by Architects for Health with SALUS Global Knowledge Exchange.

More information can be found here www.europeanhealthcaredesign.eu

LGHN website goes live!

The exciting news that the Landscape, Gardens & Health Network website is now live. Please visit at www.lghn.org.uk

Landscape Gardens and Health Network is an online resource for anyone interested in the role of gardens and designed space for health. It features current research and events that show the therapeutic value of gardens and green space. Landscape is taken in its broadest sense, embracing the natural and designed environment, highlighting its many relationships to human health and wellbeing.

TO INFINITY AND BEYOND

David Powell Development Director at Alder Hey Children’s NHS Foundation Trust can rightly be regarded as one of a very exclusive group within the NHS considering the total NHS workforce of 1.4m staff, David is doubtless one of handful – an expert client lead with a string of successful projects in his portfolio.

Architects for Health were delighted to welcome David Powell as guest speaker at the post-AGM presentation in February 2016. His experience and wisdom garnered over many years has most recently been applied to managing the design and construction of the Alder Hey Children’s Hospital in Liverpool – badged as the world’s first living hospital. Continue reading

10 reasons to become a member in 2016

You will enjoy

  • Excellent networking, socially and online with 4 free member events per year
  • Horizon scanning: talks and discussions with leading policy thinkers about future developments in such areas as clinical practice, policy and system transformation, impact of technology, innovation in design and construction
  • Study Tours and seminars to completed projects of note: recent venues have been in Cardiff and South Wales, Glasgow, Liverpool, Manchester, Bristol and Bath.
  • Sharing ideas about good design and how to achieve success; meet clinicians, designers, architects, engineers, planners, artists and others engaged in the design of healthcare facilities.
  • Access and influence: change and development in policy and standards through our working groups
  • International best practice: Attend the European Healthcare Design Congress; once again AfH is partnering Salus to deliver an international event in London on the 27-28 June 2016
  • Knowledge transfer: AfH is partner with special interest groups such as the Design In Mental Health Network; obtain discounted registration for members and a chance to share good practice through networking.
  • Recognition of excellence: Exclusive entry to AfH Design Awards- this year again there will be two displays at major conferences in London and Manchester and continued fostering of design in schools of architecture through the exhibition of student projects.
  • Get CPD points: All AfH events are considered valid for accredited CPD for RIBA members
  • An unmissable opportunity to showcase your projects and ideas in a way that is entertaining and fun at our annual November 20X2 event

Join online now

  • Members are eligible for special AfH member discount rates to the European Healthcare Design Congress on 27 – 28 2016 June in London- not to be missed!
  • Submit your projects for the AfH Design Awards – details to follow.
  • Two free member events and two National Conferences still to come in 2016
  • Remember, only those who are registered with the online membership system will be sent communications
  • All criteria for the different membership categories can be found in Membership

20 x 2: 26/11/15

The annual light-hearted and high-speed exposition of all things healthcare was hosted by NBBJ London on 26th November 2015. A regular and popular feature of the Architects for Health programme, the headline refers to invitations to up to 20 members to present a topic of their choice for no more than 2 minutes. There is no prescribed format and content can be any topic with at least a passing nod to healthcare design and environments.

Attracting a sizeable audience which, thanks to NBBJs gracious hospitality, was keen to provide ad hoc interjections of support or otherwise, the evening heard a wide range of differing two-minute monologues with accompanying ubiquitous PowerPoints. Continue reading