Buildings that care: North London Hospice day centre by AHMM in Enfield, London
Inspired by Maggie’s Centres, AHMM’s North London Hospice day centre is sensitive and subtle, writes Christine Murray. Photography by Timothy Soar
The span of time between diagnosis and death is a surreal waiting game. Life goes on. For the dying and their family, there is much to do, and also, nothing to be done.
The work of North London Hospice, founded in 1984, bridges this traumatic gap, providing multi-faith palliative support for those living in Barnet, Enfield and Haringey. Its ambition is to preserve the dignity of the dying and the charity’s free-of-charge services span from creative therapy such as art classes to 24-hour in-patient care, physiotherapy and bereavement support. It also offers basic outpatient care in lieu of visiting a hospital.
Sitting like an oversized brick house at the end of a suburban block, the new North London Hospice day centre, designed by Allford Hall Monaghan Morris, is distinctive and dignified. Before North London Hospice opened this day centre, all services were delivered out of its facility in Finchley. Facing a significant increase in demand, the new centre triples the charity’s capacity to serve up to 300 of the 800 people per month diagnosed with a life-threatening illness in north London.
Inspired by the Maggie’s Centre concept, the charity hoped a new bespoke building and expanded service would increase their visibility in the community, boosting donations while doing more good.
The hospice has been hit by healthcare cuts and, although it still receives 23 per cent of its funding from local NHS Primary Care Trusts, the remaining £4.5 million needed to run the centres comes from charitable donations and legacies. AHMM took a heavily reduced fee for this job as its contribution.
Like Maggie’s, the charity wanted to create a home-like environment without an institutional feel, with a kitchen and living room at its heart. Unlike Maggie’s, the budget was limited to £1.8 million and the facility required more clinical spaces and treatment rooms than Maggie’s Centres, including an ‘emergency room’ with a hospital bed, patient lift and sluice room for visitors who become gravely unwell while visiting. It also required ergonomic furniture, wheelchair accessibility and infection control finishes.
The completed centre is much larger than the surrounding houses, but so was the previous building on the site - an unoccupied house once used as an NHS clinic. Its layout and lack of disabled access meant it was unsuitable for retrofit. But its massing was already much taller and larger than nearby residential buildings.
The road to planning was smoothed in advance by a pre-briefing session, held in 2009, for key stakeholders including local residents’ associations and ward councillors to discuss the design and materials. Their comments and concerns were absorbed into the planning application. And in 2010, a public exhibition was held, advertised by leaflet, where both drawings and models of the building were on show, with the architects on hand over a weekend to answer questions.
The monolithic quality of the building makes the centre stand out in its corner location, while the brick gables make it appear respectfully residential. The southernmost block - just one storey high - curtseys to adjacent neighbours, its pitched green-roofs overlooked by two treatment rooms above.
Other sustainable features include natural ventilation (topped up by mechanical ventilation with heat recovery), solar panels, rainwater butts and a ground source heat pump to fulfill the charity’s green agenda. The thick external walls and roof conceal both structure and drainage, keeping the internal spaces uncluttered while enabling large roof spans, with no need for trusses, as well as containing high levels of thermal insulation. This also allows the brickwork to span large openings, even at corners, giving the building its distinctive character. Aluminium-lined windows, recessed blinds and flush, diffusing, linear light fittings emphasise the building’s strong geometry.
On the ground floor, there’s a large kitchen and living room, a hair salon, a small room for art classes, an office and therapy rooms. While some similar establishments employ a patronising colour scheme, mistaking childish for cheerful, the material and colour palette here is adult, comprised of greys, a pale brick and timber. The entrance hall (created without a desk to make it more welcoming) could be the reception of a private club oroffice.
The care in this project lies in what is hidden, as much as what is on show. The centre is accessible without unduly expressing its accessibility. There is enough room for ambulances to drop off patients out front, as well as parking, ensuring short walking distances. There are level thresholds throughout, including at the steel-framed sliding doors to the garden, where the hard surfacing is easily navigated by wheelchair.
As many palliative patients fear becoming housebound, generous windows, controlled views and easy access to the outdoors (fitted with ergonomic garden benches) are among the centre’s greatest gifts.
The acoustic performance of the rooms was a key consideration for hearing impaired visitors, and the fine-textured plaster and brick was selected to help reduce sound. Should someone become sick while visiting, the ‘emergency room’ (labelled ‘rest room’ on the drawings) is invisibly concealed behind a timber wall storage unit with a panel door in the lounge. Additional storage, clinical devices and administrative spaces are similarly tucked away.
Furniture specification set a particular challenge. ‘We realised it was very difficult to find furniture that meets ergonomic and infection control requirements that isn’t hideous,’ says AHMM director Paul Monaghan, who showed me around the centre with associate director Susan Le Good. The seats need arms to help visitors stand up, but also require wipe-clean fabric. ‘The people visiting here are severely ill,’ Monaghan adds.
AHMM’s ambition was to use ‘ordinary’ stylish furniture where possible. In the café, these include Eames DAW chairs. But they struggled initially to find non‑institutional furniture for the lounge. ‘In the end, we learned of these chairs designed by Kenneth Grange, who found as he got older that he couldn’t find any attractive chairs that were easy to stand up from,’ says Monaghan. The result looks a bit like an Egg Chair, and would not look out of place in a stylish hotel lobby.
Accessed by stair or lift, the first floor features therapy rooms and training rooms, while the second floor provides private office space and a common room for volunteers, nurses and carers. These rooms are among the nicest in the building - a priority, given the stressfulness of the carers’ highly emotional and physical work, and a tribute to the contribution of hospice volunteers.
The design of this building is overtly self-conscious - there are no happy accidents here, because accidents of any kind have been designed out. It is likely to win awards for its completeness, and is felt by at least one member of the AJ team to be a Stirling Prize shortlist contender.There is something instantly likeable and uncomplicated about it, both in plan and form, which feels both fresh and familiar. It is a contemporary building that Prince Charles could love.
And, while not revolutionary, North London Hospice feels clean, modern, unbreakable, unfussy, fit-for-purpose, no-nonsense and welcoming. It feels like a building you can count on - a place tough enough, safe enough, to be sick in.
The building’s solidity will bring comfort to the charity’s many legacy donors; the way it says, gently, without boasting: ‘I’ll still be here when you’re gone.’