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Cathedral close: West End Medical Practice by Page\Park

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With its new medical practice in Edinburgh Page\Park Architects has created a sensitive design response in a fiercely protected context, writes Peter Wilson. Photography by Andrew Lee

Unusually for a building review, I’ll begin with a conclusion: the overriding architectural achievement of Page\Park’s West End Medical Practice is the successful way in which it responds to its urban situation, rather than in the quality of its interior spaces. Not that the latter are at all poor - it’s just that buildings comprised of small, discrete cells with specific functions don’t immediately lend themselves to the creation of remarkable interior volumes. Here, however, the feel-good dynamic manifests itself in the relationship created between the interior and exterior spaces - a design strategy that very evidently began with a forensic appraisal of the conjunction of the existing buildings with the rigorous planning and formal architectural composition of Edinburgh’s West End.

For those unfamiliar with Scotland’s capital, some context is needed here. As a World Heritage Site, it can take an inordinate length of time to secure planning permission - and, importantly, citizen approval - for the construction of anything in central Edinburgh. The forces of preservation and protection in this particular middle class purlieu are unusually strident in their resistance to the new and unusual and this project is the built conclusion to 10 years of abortive endeavour by several other architectural practices to propose an acceptable solution for this site.


The new West End Medical Practice lies within the precinct of St Mary’s Cathedral, itself a grand planning gesture that sits astride the strong east-west axis of Melville Street and Grosvenor Crescent and between Manor and Palmerston Places, which run from north to south. To the uninitiated, the cathedral and its adjacent buildings might seem cuckoos in the city’s Georgian nest, a Ruskin-inspired Gothic Revival agglomeration designed to appear as a medieval close or village. Those versed in Scotland’s architecture will, however, recognise its genesis in the religious schisms that have impacted so distinctively on the nation’s built environment over the past five centuries. Thus this cathedral of the Scottish Episcopal Church was deliberately intended to represent a better architectural model for contemporary society than that of its classically inspired neighbours.


In developing a solution satisfactory to all, Page\Park Architects has sought to unify the existing community of buildings with subtle additions that not only help create a quadrangular close with the domestic feel of a New Town mews, but which also defer to the verticality of the cathedral’s three spires. The primary addition provides new accommodation for the West End Medical Practice. Previously located on the ground and basement levels of the building diagonally opposite, these premises had long shown themselves to be unsuited to the needs of the practice’s 9,500 patients, many of whom found access difficult.

The availability of NHS funding was arguably the key to unlocking the corner garden site and, while the cathedral remains the landowner, the area’s Health Trust paid for the building works and rents the premises to the medical practice. The tenure arrangements are actually more complicated than this - the training facility for stonemasons that had previously spread itself across the site is now contained in new ground-level workshops beneath the medical practice’s first-floor administrative zone.


Reference to ground and first floors naturally brings the medical practice’s physical form into the discussion, and here a remarkable effect is achieved. From street level, the building looks to all intents and purposes to be a single-storey structure with deep eaves, sheltering a scalloped perambulatory terrace that offers a glazed face to the outside world. The pedestrian’s view is instinctively drawn over the medical practice’s horizontal mass and upwards to the cathedral’s central spire, a design move that, as the building’s buff-coloured Darney stone facings gradually mellow, will increasingly see the addition merge into the community of existing buildings. Even now, the retention of several mature trees (the reason for the scalloping of the facade) intermittently screens the project from the casual bypasser’s view.

Internally, the entrance and foyer spaces are surprisingly generous, with a feeling of quality detailing and finish emanating from the oak window reveals and the grey powder-coated window frames. The inbuilt banquette seating is reminiscent of those found in Page\Park’s Centre for Scottish War Blinded at Wilkieston, while the experience gained from designing two Maggie’s Centres (Glasgow and Inverness) is applied again in demonstration of the practice’s sensitive approach to facilities that provide both spiritual and therapeutic support to their users. Beyond the reception desk, the main consulting rooms are arranged along a top-lit corridor. Each has a view out to the small formal garden that separates them from the adjacent Walpole Hall’s new and matching foyer, a unifying move that again emphasises the desired cloister effect. In a fiercely protected heritage environment, this is an intervention that shows considerable maturity and subtlety to deliver a timeless design response.

Peter Wilson is an architect and director of the Wood Studio research centre within Edinburgh Napier University’s Institute for Sustainable Construction

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