checks and balances, and resolving any differences in opinion. The consensus formed here would go on to define the final layout of the unit. The architects also played a guiding role throughout these talks, as Guy Barlow explains: “The participants were a ‘lay’ part of the client – they might do one or two projects like this in their lifetime, so it’s also important to explain exactly what to expect at each stage, and how best to work with us.”

Pathways & timetables A new approach was developed in collaboration with Macmillan to translate bespoke health planning into physical layout for the new unit. In the existing hospital, care “timetables weren’t streamlined,” says Barlow. The new unit was the key to close this gap in efficiency. “They were all working in their own

silos, so bringing them together was intrinsically difficult”. To remedy this, he adds, “a key thing to start off with is what’s termed the patient pathway.” Through further consultation, the activity of patients and staff was logged and analysed, and journeys were mapped out diagrammatically to give a clear picture of what was required from the building, and in turn the architects.

Care pathways were defined and modelled for outpatient consultations and treatments, Macmillan support, outpatient treatment check-in, inpatient treatment check-in, and treatment itself. Using timetables and flowcharts, the design team was able to deduce a schedule of accommodation and footfall channels – all the while maximising the use of the space. Each pathway, says Barlow, “is designed to be a really simple journey.”

“By precisely working out how patients moved through their departments, and going through their timetables together, we could get that number from 22 exam rooms down to 15; 30 per cent less. And so that’s actually what we built”, Barlow says.

A welcoming arrangement Outpatients use the main entrance at the front of the building while there is a connection to the main hospital building via a glazed footbridge on the first floor at the back of the unit. “The building is based on an L-shaped plan, but curved to the accommodation so you get these sort of ‘hands’ opening to welcome people into the entrance,” Barlow explains. A patient garden and frontal greenery decorate the


A new approach was developed in collaboration with Macmillan to translate bespoke health planning into physical layout for the new unit

unit and make it more welcoming, while providing a dialogue with the neighbouring fields, and giving patients exterior space. Upon entering at the main entrance through automated sliding glass doors, the user is greeted by the new and enlarged Macmillan Information and Support Centre, combining rooms for complementary and alternative therapies and quiet rooms for reflection. The Macmillan Support ‘pathway’ ends here. To the right, a spacious waiting and reception area separates the user from 15 consultation rooms and further quiet rooms stacked along the spine of the building’s floor plan. In the centre of the circulation area is one of several ‘note pods,’ similar to nurses’ stations with head-height glazing and views into each consultation room. These allow staff to discuss confidential matters and take phone calls while supervising patients. To the left, a corridor leads from the waiting area to a lift and stairwell up to the first floor for treatment. Leaving the lift or stairwell at the first floor as an outpatient, or arriving through the aforementioned footbridge as an inpatient, patients can check in at the treatment reception, located in a central lobby. From here, patients can either join others in a bright and airy, open-plan treatment area or, alternatively, a separate suite of treatment rooms for more private care, along with staff accommodation and amenities located at the western end of the building’s upper floor.

“The feeling of a hotel” Patients were enabled to provide a key guiding voice when it came to the overall feel of the building, in the consultation process. Early on, it was clear what the group wanted. Contrary to the architects’ preconceptions that patients would want a “home away from home,” it transpired that patients wanted a facility that felt more like a hotel – somewhere “uplifting”. Much of Barlow and team’s work was an effort to respond to this challenge of balancing “non-clinical” design with the



The building’s design optimises views over surrounding countryside for patients


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