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Fit for purpose: City of Coventry Health Centre

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Sonnemann Toon injects colour and flexibility into a difficult health centre scheme in Coventry, writes Felix Mara. Photography by David Butler

Healthcare design, once shunned as dreary by many architects and a field which involves high levels of competence and accountability, is now as cool as in its 1930s idealistic heyday. Lubetkin and Aalto would applaud recent exemplars, including the best Maggie’s Centres and Teenage Cancer Trust wards and AHMM’s Kentish Town Health Centre.

Healthcare is a tonic for architects weary of catering for a Trimalchio’s feast of vacuous commissions for image-conscious clients, providing opportunities to use design skills to improve the way these buildings work and feel. But, as observed by Cressida Toon, a partner at Sonnemann Toon Architects, whose City of Coventry Health Centre (CoCHC) opened in December, they have increasingly complex briefs.

‘CoCHC was commissioned at a pivotal time for healthcare design,’ says Toon. ‘There were significant regulatory and guidance updates, including the final version of Health Building Note 11-01: Facilities for primary and community care services, which highlighted standardisation and flexibility, and the publication of Health Technical Memorandum 08-01: Acoustics, the Health and the Social Care Act 2008: Code of Practice for health and adult social care on the prevention and control of infections and related guidance, and BREEAM Healthcare.’

CoCHC was a tough commission as a large project with a tight budget, comprising GP practices, a walk-in clinic, podiatry and physiotherapy, plus child, family and sexual health services. An internal street with double-height, sky-lit atria channels visitors through the building and improves orientation by displaying first-floor GP accommodation. To provide flexibility, Sonnemann Toon specified post-tensioned slabs and developed modular consultation and treatment rooms. Each upper floor has a single waiting space for various services.

But the main feature was the oscillating floor plates strategy, with slab edges stepping in and out from one floor to another, providing further adaptability and enabling departments to expand and contract, and offering spacious waiting areas alongside other, more intimate ones. This also addressed the perceived need to break up the facade and reconcile CoCHC’s scale with smaller neighbours, using colour to reinforce surface modelling and cast shadows to avoid a monolithic, repetitive impression. Purists might consider this design strategy forced and meretricious, but it certainly won the planners’ support.

In its way, CoCHC is an image-conscious building and this extends to the use of colour, lighting and graphics. On a practical level, this assists wayfinding. Colours are used to identify floors and department entry points. Working with Frances Tobin Design, Sonnemann Toon, aware that this strategy can look garish, specified charcoal-coloured ceramic tiles, white walls and walnut doors as a subtle backdrop to chromatic highlights. Like the facades, the interiors use colours which relate to Coventry’s industrial past by referring to different types of metal.

After consulting groups working on each floor, copper was chosen for level two, where sexual health services are located, because it was considered a warm, reassuring colour, suitable for its predominately young patients. Steel was picked for the level four, for its calming effect on patients with mental health problems. A timeline mural provides visual interest on the ground floor and waiting areas are identified by printed vinyl wallpaper, designed by Kelly MacPhee after Coventry University School of Art and Design students were invited to compete for this commission.

CoCHC achieved the BREEAM Healthcare ‘Excellent’ rating required for the Strategic Health Authority’s approval of its proposal and was one of the first healthcare projects to target an ‘Outstanding’ rating. Sonnemann Toon had previously worked with the self-assessment methodology of the NHS Environmental Assessment Tool and relished the challenge of third-party assessment.

The success of the environmental strategy rested on good co-ordination and passive low-energy design, with summer passive purge ventilation. A number of conflicts involving infection risks needed resolution. For example, acoustic absorption required to control reverberation from concrete, which was exposed as a thermal regulator, and to avoid institutional suspended ceilings, was applied to walls rather than ceilings, and window blinds are external.

The BREEAM process encourages consultation, which seems marginal to an environmental assessment method, and nearly undermined CoCHC’s cohesion, for example, in the design of the murals. But, despite the tight budget, Sonnemann Toon retained artistic control and achieved high design and performance standards.

AJ Buildings Library

See images, drawings and details of the City of Coventry Health Centre by Sonnemann Toon Architects

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