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RIBA Awards 2015: Health

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Bernie Marden on how he created a RIBA Award-winning healthcare building in Bath with Feilden Clegg Bradley Studios

Designing for healthcare is challenging. There are the constraints of budgetary considerations and the difficulties of working with a client – the NHS – that constantly seems to be undergoing organisational change. Predicting what might be suitable over a building’s lifespan of 30 to 40 years is therefore extremely difficult, if not impossible. Flexibility and future-proofing have to be key ingredients.

When the Royal United Hospital in Bath set out to create a new neonatal unit, its architect, Feilden Clegg Bradley Studios, took what today seems an obvious stance – but at the time was unusual – and put the babies and their families right at the centre of the design.

In healthcare we are traditionally driven by what we need as clinicians to get our jobs done, and in turn we justify this by the assumption that it will obviously serve the needs of our patients, too. Arguably the reasonable expectation would be that safe and effective medical care would be a given, so how do we create room for innovation?

We invited the design team to immerse themselves in our world, and they very quickly gained insights into what it is like to spend day and night in the somewhat alien space of neonatal care. Most importantly, they simply and unobtrusively interacted with us.

Neonatology is about supporting families at the most precious moments of their formation, while at the same time guiding them through an experience that seems to threaten their very survival.  The often-quoted analogy of riding an emotional rollercoaster so aptly describes what families go through over the course of their stay, often lasting for three to four months.

What is required is a truly holistic approach, with attention to emotions alongside the hard-edged medicine, and we need a building that inspires this ethos.

The use of natural materials is an obvious step to achieving this. Palpable real wooden surfaces in a critical care area in this day of stringent infection control regimes? Our architects challenged us to remember the importance of the textural environment to the wellbeing of our patients and their families.

We helped them to understand our service. The different clients in a neonatal unit have often conflicting needs, which all have to be balanced. An example is the need to control light and sound. Premature babies need to be nurtured in quiet and relatively subdued lighting; the parents and staff benefit from knowing what time of day it is and whether it is sunny or cloudy outside. None of the cot spaces are in direct sunlight, but the circulating spaces enjoy flooding of direct or reflected sunlight, thus allowing the grown-ups to stay in touch with the outside world.

When we are ill we have our own specific needs, but we also rely on others who must themselves remain healthy – emotionally and physically – in order to care for us effectively.  The RIBA Award-winning Dyson Centre for Neonatal Care has this balance. All healthcare buildings must achieve this balance in order to be truly great.

Bernie Marden is consultant paediatrician and neonatologist at the Royal United Hospital Bath NHS Trust

RIBA Award winners

Maggie’s Cancer Care Centre, Lanarkshire by Reiach and Hall

Maggie’s Cancer Care Centre, Lanarkshire by Reiach and Hall

Maggie’s Cancer Care Centre, Lanarkshire by Reiach and Hall

Maggie’s Cancer Care Centre, Lanarkshire by Reiach and Hall

Client Maggie’s Centres
Contractor John Dennis
Contract value £1.8 million
Gross internal area 314m²
Region Scotland

This new Maggie’s Centre is on the old Airdrie House estate, which was enclosed by a belt of lime trees, some of which still survive. A new surrounding wall of hand-made Danish brick recaptures this sense of paradise (from ancient Iranian pari daiza – ‘walled enclosure’) offering a degree of separation from the nearby hospital grounds.

It conceals a modest, low building which gathers a sequence of domestic-scaled spaces. Visitors enter a quiet arrival court, defined by the low brick walls and two lime trees. At once one encounters a sense of dignity and calm. A linear rill, a spring, animates the space with the sound of running water. External courts catch sunlight, creating sheltered ‘sitooteries’ (a Scots gazebo). This is a truly memorable addition to a noble tradition of specialist health buildings.

Old See House, Belfast by RPP Architects and Richard Murphy Architects

Old See House Community Mental Health Facility, Belfast by RPP Architects in association with Richard Murphy Architects

Old See House Community Mental Health Facility, Belfast by RPP Architects in association with Richard Murphy Architects

Old See House Community Mental Health Facility, Belfast by RPP Architects in association with Richard Murphy Architects

Client Belfast Health and Social Care
Contractor Felix O’Hare
Contract value £4.3 million
Gross internal area 2,450m²
Region Northern Ireland

The brief for Old See House centred on creating a design that humanely meets complex operational requirements and provides inviting, open and naturally lit spaces, promoting a sense of calm and wellbeing. Despite covering 2,450m2, it manages to fit in as a sensitive addition to the neighbourhood.

The rear elevations are largely glazed with a zinc pitched roof above, enclosing and celebrating an inner courtyard garden, which provides abundant natural light to all areas. The reception and waiting spaces curve gently around the garden. Treatment and therapy rooms are light and airy, and generally look out on to smaller landscaped courtyards – security features are unobtrusive. The second-floor spaces are top-lit, with a balcony overlooking the central garden.

 

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