HOSPITAL DESIGN AND CONSTRUCTION Need for ample light
Plenty of natural light throughout the hospital was another key design criterion, and all inpatient rooms feature a full floor- to-ceiling window. Shelley Hugill said: “Some of the inpatients – and especially those awaiting a transplant and CF patients – can be in the hospital for many months, so a comfortable inpatient environment for both the patient and their family/friends is paramount.” Antoinette Reis added: “The Cystic Fibrosis rooms, for instance, have fridges and entertainment facilities, as well as solid doors – for both infection control and privacy. They also have exercise bikes, so that the patients can do exercise with no cross-contamination risk. Within the first of the three Outpatients’ clinics, we have provided three consult/exam rooms with en-suite facilities, so CF patients don’t have to use the public WCs. The inpatient en suites have a door and a half opening, with the placement of the WC next to the half leaf enabling a nurse to dual assist the patient – small, but important, considerations.”
A ‘distinctive base’
Looking at the wider architectural design, and the Medical planner explained that the Trust and HOK had wanted the building to have a ‘distinctive base’. She elaborated: “The ground and first floor have a distinctive reconstituted stone exterior, which runs up and over the bridge linking the north and south wards. That is the public space, while where you see the glass cladding higher up – often combined with a rendered finish – is either CCA or inpatient space, or, lower down, the restaurant and other public areas. The fire safety consultants, Fire Ingenuity, put considerable emphasis on horizontal evacuation. With our plan, staff should be able to easily move patients along a floor, before transporting them down. “The ovals have created nice spaces at the nodes at each end of the building, which have some of the best views, and are shared staff spaces between the north and south wards. All the inpatient rooms enjoy views, and on a clear day you can see King’s College Cambridge from one side of the hospital.”
Illustrious neighbour Built on a greenfield site, the hospital is not just adjacent to, but is also connected to, Addenbrooke’s Hospital – via a basement-level tunnel which incorporates both patient and services corridors. Shelley Hugill explained that around 600 patients are likely to be transferred between Addenbrooke’s and Royal Papworth Hospital each year. HOK had, Antoinette Reis
A patient bedroom.
explained, enlisted the expertise of a wayfinding consultant to help reduce stress and anxiety for patients and visitors arriving – by ensuring they can quickly find their way to their destination. She added: “We also undertook movement studies to identify ‘travel times’. For example, there was a stipulated maximum time to get a patient arriving via ambulance at the emergency entrance up to a cath lab, since with heart attack patients, a 2-3 minute delay could be critical”. Shelley Hugill said: “It takes only about 90 seconds, for example, from the ambulance pulling up, for an emergency patient to be taken off, wheeled to a lift, and then taken straight into a cath lab”. HOK also had to optimise the transport times from an ambulance to an inpatient ward, and to a CCA room, as well as to effect a transfer to or from Addenbrooke’s.
Antoinette Reis, a Medical planner at scheme architects, HOK, who worked on the project for nine years right up to the hospital’s completion.
48 Health Estate Journal January 2020
The hospital’s emergency service I wondered whether, if a patient has a heart attack locally, they will necessarily initially be taken straight by ambulance to Addenbrooke’s A&E Department. Shelley Hugill explained: “We don’t have an Emergency Department here at the Royal Papworth, but we do have one emergency service – based on a cardiology procedure called PPCI – primary percutaneous coronary intervention, used on patients with high-risk NSTEMI – a type of heart attack caused by a severely narrowed artery. Such patients are now transferred direct by ambulance to specialists here for treatment within 24 hours, rather than being admitted to an acute hospital like Addenbrooke’s or Hinchingbrooke first.” The Trust says this rapid treatment pathway for one of the most severe types of heart attack ‘offers huge
benefits to patients’, with research suggesting that high-risk patients achieve better outcomes if they receive treatment to unblock the heart’s blood supply within 24 hours.
Royal Papworth Hospital admits heart and lung transplant patients from all over England, while its Sleep Clinic also takes patients on a national basis. Shelley Hugill added: “While many heart and lung services are regional, we are the only UK hospital to carry out a particular type of lung surgery – Pulmonary
endarterectomy. We thus see a real mix of cases. Of the six UK adult heart and lung transplant centres, we undertake the most transplants, with the best long-term outcomes.”
A surgeon’s wish fulfilled As we looked at the hospital exterior, I asked Antoinette Reis again about the thinking behind the oval design. She said: “During the design process, a cardiothoracic surgeon, Mr Steven Tsui, had just been to Chicago, and mentioned that he had seen the Anish Kapoor ‘Cloud Gate’ sculpture there. It forms the centrepiece of AT&T Plaza at Millennium Park in the Loop community area of the city. Mr Tsui described how the piece reflected the skies and surrounding changing cityscape, adding that one of his aspirations for the new Royal Papworth Hospital building was that it be not just a beacon in its own right, but should also reflect the changing environment around healthcare. On a good day, with some cloud, you can see all the clouds reflected in the building’s exterior.”
HOK and Royal Papworth Hospital NHS Foundation Trust also worked with a number of artists during the hospital’s design, among them Adam Ball. His most compelling artworks include large glazed panels at both the north and south entrances, which are backlit, and change colour to the tune of the seasons. Antoinette Reis said: “The fibre within the
HOK
The Royal Papworth Hospital NHS Foundation Trust
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