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Teenage Cancer Trust, Cardiff, by ORMS

ORMS’ cancer treatment unit in Cardiff is designed to aid the recovery of its teenage patients, writes James Pallister. Photography by James Brittain

Every day in the UK, six teenagers are told that they have cancer. Teenage cancers tend to be particularly aggressive, their spread accelerated by growth spurts, and often involve lengthy spells in hospital. Unfortunately, the awkward in-betweenness of adolescence – not quite an adult, no longer a child – also applies to healthcare provision, and teenagers are usually offered beds in geriatric or paediatric wards.

The new Teenage Cancer Trust unit at the University Hospital of Wales in Cardiff, designed by London-based architecture practice ORMS, is part of a programme that aims to change this. The building – a squat, two-storey volume supported on steel columns fixed at jaunty angles – was commissioned by charity Teenage Cancer Trust (TCT), as part of a UK building programme for 22 units within NHS hospitals designed specifically for teenagers suffering from cancer.

TCT was keen to be a good client and, according to John McRae, ORMS director and project architect, this allowed a detailed design process to evolve – rarely possible in conventional healthcare procurement.

McRae says that the aim was to make the unit feel like a ‘boutique hotel’ – so instead of murals of Disney scenes or twee watercolours, the unit has flatscreen televisions and pool tables. McRae cites Alvar Aalto’s 1932 Paimio Sanatorium in Finland as an example of a building in which design can aid recovery, and of Aalto’s belief that a hospital can be a ‘medical instrument’. Over the past 15 years, the six completed Maggie’s Centres in the UK, which provide support for cancer patients rather than medical help, have also been designed around the notion that surroundings can affect how patients feel. But unlike Aalto’s sanatorium, built in a clearing deep in a pine forest, the setting of ORMS’ building is bleak. The unit is squashed into a 15 x 19m footprint, cheek by jowl with a set of grimy buildings built in 1971 as part of the original University Hospital of Wales complex, designed by SW Milburn and Partners.

Elevating the unit ensures the site remains flexible for future development

The free-standing unit is propped 6.5m above the ground on 16 individual raking steel columns, which form four W-shaped frames and hit the ground at locations defined by the service chamber at basement level, a fire escape route that runs across the site, and existing drainage runs. Bright blue mesh cladding provides a flash of colour amid drab surroundings. The mesh runs from belly to balcony, punctuated at first-floor level by a long, horizontal window; a protective clasp encasing the two-storey unit.

Elevating the unit was a practical solution, ensuring the site remains flexible for future development (there are plans to demolish a single-storey block in front of the unit), but it’s also a way of giving the building a bold external presence. The slender columns appear rather puny, however, compared with the bulk they support, and the gloomy space beneath the unit is only slightly alleviated by uplighting the mesh-clad soffit.

In contrast, the building’s interior impresses. Medical staff, patients and families were involved from the beginning of the process, and ORMS had the freedom to actually design, not just specify. The architect has produced some smart details. Curtains around beds, for example, reach all the way along runners on the soffit rather than a suspended rail, and, instead of stick-on bumpers to protect against knocks, walls have detachable dados. These simple considerations, outside the normal vocabulary of hospital design, make the environment less institutional.

The unit’s first floor accommodates eight patients in two wings of three-bed spaces that run at right angles to the balcony, with two private treatment rooms located off a central lobby. Above each bed, a bulkhead disguising services and a wardrobe to the side form an alcove. The ‘den’, an informal space overlooking the hospital campus, joins the two wings.

The second floor is mainly given over to social space, with large sliding doors opening on to the balcony. The building manages the transition between its clinical and domestic functions well. The staircase has a ‘domestic’ tread width of 900mm. The doctor’s office is tucked away behind the stair core, and a small room in which parents can prepare a meal or spend the night is similarly discreet. A semi-enclosed ‘chill-out’ space lends a Big Brother house aesthetic to the fit-out.

Disappointing though its exterior is, ORMS’s building raises the bar for healthcare provision

ORMS designed to project stage E, with Stride Treglown Davies then novated to contractor Cowlin Construction. Nevertheless, McRae says that ORMS was ‘heavily involved in resolving the details’, some more successfully than others. In one of the bathrooms, for example, an uncomfortable gap is visible between the wall and the end of the bath. McRae argues that it allows staff to help patients out of the bath, yet, on first sight, it seems an inelegant solution.

Nevertheless this building, though its exterior is a little disappointing, raises the bar for healthcare provision. It succeeds in its focus on the minutiae of the patient’s interior experience, and has a value that could extend beyond this site, with applications in other healthcare scenarios. This affirms the value of architects. By giving ORMS room to design rather than merely specify, TCT has allowed it to create a place that makes the everyday life of its patients more pleasant. It is vital to UK healthcare provision that this project doesn’t remain an anomaly; a luxurious one-off only affordable for the charitable sector.

Tender date March 2006
Start on site April 2007
Contract duration 20 months
Gross internal floor area 585m²
Form of contract JCT 98 WCD
Total cost £2.4 million
Cost per m² £3,400
Client Teenage Cancer Trust/Cardiff and Vale NHS Trust
Development advisor Derwent London
Architect ORMS Architecture Design
Structural engineer Price and Myers
M&E/lighting consultant AECOM
Quantity surveyor/planning supervisor/project manager Jackson Coles
Main contractor Cowlin Construction
Contractor’s architect Stride Treglown Davies
Annual CO2 emissions Uncalculated

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