HOSPITAL DESIGN
The masterplan for the Royal Victoria Infirmary, Newcastle upon Tyne Hospitals.
proposed new Richardson Wing at the Royal Victoria Infirmary site in Newcastle. The scheme is currently under development by Medical Architecture for the Newcastle upon Tyne Hospitals NHS Foundation Trust. He added: “Clearly, there are some very advanced hospital buildings being developed, like this one, which also stand up as great civic feature, rather than ‘just’ hospital buildings.”
Selecting a good design team Christopher Shaw next considered ‘How does one select a good design team?’ – potentially ‘a tricky business’. He explained: “You can see some clients picking individual disciplines, which can be a burden for some NHS Trusts, whereas with a collaborative, multidisciplinary team you could be seen as ‘putting all of your eggs in one basket’. My view is that the where a Trust is considering the multidisciplinary business approach, with fewer and fewer people with the requisite skills and knowledge out there, picking a multidisciplinary team can be difficult. The key is to ensure that you are getting good individual and organisational skills.”
At a time where – he contended – there was limited in-depth knowledge of, and skills in, hospital design and planning in the UK, he next addressed how the UK healthcare sector might potentially attract skills and capacity from other sectors. He said: “For example, we have very lively and skilled office and retail design sectors in the UK who may not be as active as they were, say, a year ago, so bringing those skills in, and perhaps re- thinking the design of a new hospital, may make considerable sense. Think about what a hospital is, and about 15 per cent of it is a hospital in the ‘old’ sense, with a clinical core. Then you have the ‘hotel’ parts – the inpatient wards, the administrative, and the ‘industrial’ parts,
22 Health Estate Journal March 2021
The Royal North Shore Hospital, New South Wales, Australia – Masterplan.
and so on. Maybe we can re-shape the way we procure our designs teams to match those functions more? Rather than looking for a single team that does it all, perhaps we should be seeing what we can bring in from other sectors, and I think there are certainly available skills out there.”
Bringing in skills from outside the UK It was also often worthwhile bringing in complementary skills from outside the UK, particularly given that there were a number of areas in mainland Europe that had been fairly active healthcare infrastructure-wise recently. Christopher Shaw said: “I’m also told that a lot of the skills (in healthcare infrastructure planning and design) from the UK dissipated out to Canada and Australia, so we need to think how we can pull those back to build the capacity and draw on the experience.” To follow this approach would, however, he conceded, require ‘new and different types of skills’, plus perhaps a ‘lead consultant’ or ‘lead designer’ who could ‘orchestrate’ things.
It was also important to be aware, especially on some of the larger current projects, ‘of some of the liabilities around at the moment’. He elaborated: “We are all aware of the awful Grenfell Tower fire in London, and the failures of some of the large construction companies recently on where the liability should lie, and currently there is a sense from the design community of unreasonable and very substantial costs being put on the design side.” This could be a deterrent, and his view was that, on this front, designers and architects needed to sit down with the lawyers, and ‘think a little bit more creatively about project insurance and different ways of carrying design and construction risk’. Otherwise, this was an area that was likely to remain ‘quite problematic’.
A different ‘take’ on design competitions
“The final point,” Christopher Shaw said, “is that outside the UK, it’s extremely common for design competitions to be seen as a way of selecting an enthusiastic, capable, and visionary design team. This does put a burden on the client, in terms of the organisation having established what the brief and scope are so as to orchestrate an effective and meaningful design competition. One of the peculiarities here is that in the UK we seem to blunder into procurement without a clear idea of the scope and the design brief. To give some sense of the difference, I remember going to a presentation on Copenhagen’s Bispebjerg Hospital project, and being faced with a potential competitor entering the room armed with several volumes of printed design brief – all perfect bound – and all incredibly detailed, multilingual, and providing the basis for a design competition. It looked as though months, if not years, of planning had gone into it, whereas in the UK one sometimes gets the impression the client would like a design competition, but doesn’t want to do all the associated prior work. Architects for Health is very happy to act as bridge to the RIBA to help organise design competitions; there are one or two going on currently.”
Getting the best from the design team
Once a design team had been selected, how should the client set about getting the best from the team? Christopher Shaw said this ‘worked both ways’, in that the healthcare organisation needed to be ‘a good client’. He said: “You need to have that individual design champion, somebody sufficiently senior, who actually participates in the process; it’s not something you can devolve down the
©Medical Architecture
©Medical Architecture
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