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INSIGHTS
Dorset Eating Disorders Unit © Pillar Visuals
A new wing at Stoke Mandeville Hospital in Buckinghamshire is an example of a client brief that was initially unaffordable, but by creating flexible multi-functional space the architects reduced the building’s overall size and cost. This design (which won an award for its use of materials) lent itself to volumetric modular construction. “We believe at the time of completion in 2009 it was the UK’s largest modular healthcare building, says Reeves.
The other all too frequent challenge is the ‘stop/start’ nature of projects, says Reeves, as each individual business case stage has to be signed off. “It’s a challenge for any architect,” he adds.
Dispelling the stigma
Mental health accommodation was once poor, dark and claustrophobic. Knotts details how in the practice’s early days they had heated discussions with clients as it sought to improve designs: “We helped pioneer a new approach in design to invest in circulation space, creating single loaded corridors with daylight, views out, and direct access to outdoor space.”
Where in the past there has been a stigma around mental health buildings, resulting from the historic asylum model, mental health is becoming more normalised and the buildings located closer to communities. A project that exemplifies this is Blossom Court in Tottenham, London – a mental health inpatient unit in a tight, urban site completed in 2020. The architects’ two-storey form provides its “own secure boundary, removing the need for secure fencing around its perimeter.” Despite the sensitivity of the function, the building has become firmly cemented within the community and its urban fabric, and offers a positive therapeutic environment. The interior and exterior connect successfully, with residents and staff benefitting from natural daylight, views and easy access to a courtyard and terrace in each pair of wards.
Sustainability stance
While sustainability and BREEAM have become core parts of Medical Architecture’s work, they say working to the standard presents challenges, especially in the mental health sector. For example, promoting rainwater harvesting to attain credits could pose a risk to patients who might drink the water. “It’s about striving for those credits that you know will have a positive benefit on the project,” asserts Knotts.
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Jean Bishop Integrated Care Centre © Jill Tate
They look to combine – where possible – therapeutic design benefits with achieving sustainability, “enhancing biodiversity in the grounds,” for example, says Reeves. Using higher quality or durable natural materials – that can be repaired, rather than replaced – helps improve quality as well as sustainability. He says that when they have achieved BREEAM “Excellent” in projects, it’s generally where the strategy “has been to really focus on health and wellbeing.” A former RIBA Part 3 examiner at Newcastle University, Knotts is keen to make sure the practice maintains its links with academia so students are aware of what healthcare architecture could offer them, and to inform them of the firm’s past projects. “Healthcare isn’t necessarily seen as a ‘sexy’ sector,” she admits, accepting that students often end up working in the field as a “happy accident.” She adds however: “the environments we design make a real difference to people, and the work we do is incredibly rewarding.”
Successful strategy
Healthcare projects do get recognised in industry awards from time to time, such as the Friendship Hospital in Bangladesh, by Kasef Chowdhury/URBANA, winning the 2021 RIBA International Prize. Medical Architecture’s schemes are no exception. It has three RIBA awards for Hopewood Park Hospital, Roseberry Park, and Bamburgh Clinic, and recently Clock View Hospital in Liverpool won in the 2022 Architecture Today Awards for ‘buildings that have stood the test of time’. The judges said the 2015 project “set a new national benchmark in mental health facility design.” Reeves says it’s hard to achieve such success without an “ambitious client,” explaining: “When they are open to setting a benchmark for what good looks like, and understand the value of what you bring to a project, the results are always more successful.” The practice is now at a scale where it is “looking forward to designing and delivering larger projects of up to £150m,” says Knotts. With the UK facing a recession, the short-term prognosis for investment in healthcare projects isn’t clear. However, NHS trusts are acutely aware of the work needed to be done to improve their estates; “maintaining an ageing estate does not always provide long term value,” adds Reeves.
Healthcare architecture may not often see the glamour or budgets of other sectors, but the success of Medical Architecture’s focus is self-evident as it continues to grow as a practice, produce well-regarded buildings, and nurture its staff. g
ADF MARCH 2023
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