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Penoyre & Prasad was set up in 1988 by Greg Penoyre and Sunand Prasad. Since then the practice has had a strong involvement in culture, education and healthcare projects. Sunand Prasad is currently RIBA president-elect and will take up his post in September 2007 when current president Jack Pringle steps down.

There are many reasons to be grateful for the NHS. My youngest child has a neurological condition that requires specialist eye care.

My experience of NHS hospitals is that they are soulless and depressing. Outpatients' departments are often barren and rundown. The clinical treatment my daughter receives in Glasgow is, however, exemplary and similar to that provided at Moorfields, which now has a new building by Penoyre & Prasad. The Richard Desmond Children's Eye Centre (RDCEC) is colourful, lively and filled with light. It is leagues above other NHS buildings I know.

Creating supportive environments for children with sight problems is a challenge we have met in our practice (gm + ad).

Our Hazelwood School project in Glasgow, for children with dual sensory impairment, is almost complete, following an 18-month period of design development and consultation and a two-year build programme. In this respect, it is similar to the briefing and construction period for Moorfields.

We discovered how important it is to make the route through the school clear and the spaces well defined. We also came to recognise that colour and contrast could be a means by which partially sighted children could orient themselves - they provide a visual cue. Our design process required only a light touch, and the architecture grew from understanding the needs of the children and their carers. The form was dictated by the control of light coming into the building and the site and not from any wish to impose an architectural style straight off.

Hazelwood is for the education of children who are blind or have severe sight impairment. It sits in its own parkland setting, separate from surrounding buildings, so identity was not an issue.

In contrast, the children who will attend Penoyre & Prasad's Children's Eye Centre have sight problems but are not blind. The architect has designed an extension to a complex hospital building sited in a dense urban location in Islington, and has given it a distinct character.

Moorfields Eye Hospital is an imposing late-Victorian hospital with an international reputation. It cares for over a quarter of a million patients each year and attends to over 180,000 outpatients. Some 10 per cent of outpatients are 16 or younger and there are 1,300 NHS paediatric admissions a year. The hospital is the largest paediatric ophthalmic unit in London and has grown organically over the last 110 years. Inside, it is a warren, and nigh on impossible to find your way around. Glimpses inside the wards indicate an environment which is functional in the extreme. The NHS Foundation Trust recognised that although Moorfields was internationally respected for treatment and research, the hospital itself was unwelcoming and impersonal, particularly for children and their families.

In 2002, the trust approved the creation of the RDCEC to provide a separate accident and emergency paediatric unit, primary-care clinic, and short-stay accommodation for daysurgery patients. It was important that the building had a dedicated recovery area next to the operating theatres in the main hospital, and space for research teams. The new building was to connect to the main hospital but be distinct. Penoyre & Prasad responded to an OJEU notice and was appointed in 2003.

From the outside, the RDCEC has a surprisingly corporate feel. The south elevation is ordered by slick glass curtain walling which covers almost the whole front. The curtain walling is visible underneath a veil of sculpted aluminium louvres, representing the flight of a flock of birds, which acts as a brise soleil. The glass elevation and sculpture are abruptly punctured by a balcony and bay window in red, which defines the waiting area of the outpatient clinic on the third and fourth floors. The balcony also acts as a marker for the extension, making it visible from the junction of Peerless Street and City Road.

The colour may be cheery, but the materials chosen to express the balcony are hard, and similar to those found in speculative office developments. As are the granite panels that form the gable wall that visually separates the extension from the adjoining hospital. The panels chosen are dull, but for the splashes of primary colour in the form of circular windows that extend in a random pattern like bubbles. Unfortunately, they look like an afterthought.

Internally, despite a more subtle use of colour, the architect has been spartan in its treatment and there is little softness in the surfaces, particularly the polished-concrete columns and the plate-glass balustrades. There is lots of natural light in the public spaces but the overall effect is still clinical - but then cleanliness is a real issue.

The glass wall of the facade is directly south-facing and fronts onto an open, tree-lined park, which is the courtyard of an adjoining social housing scheme. This provides a pleasant aspect and good views for those inside the RDCEC. Nevertheless, the sun is obviously a problem, and even on a dull spring day many of the cellular treatment rooms and offices behind the brise soleil had their blinds fully closed.

The waiting rooms on the third and fourth floors are welcoming. The children inside didn't seem troubled by the strong shadows and were running around happily. At street level, the reception is defined by a continuous glass screen which brightens up the arrival point, and the use of colour makes for a cheerful space inside. Within the very pleasant reception area, there is a shop and an optician and, once a contract is set up with a service provider, it will have a café with chairs and tables running along the frontage.

The circulation appears awkward and the accommodation seems rather strangely positioned throughout.

To be fair, this came about after extensive consultation with user groups and is a necessary response to the request to have direct connections through to the existing hospital at specific levels.

So, for example, the pre-operation area is housed on the ground floor behind the reception. When ready, the children move up an internal stair or lift to the first floor and the day surgery units. The location of the day-surgery units next to the existing operating theatres was, it seems, fundamental. Also, you might expect the outpatients' clinical accommodation and waiting room to be behind the reception, but instead it is on the third and fourth floors.

Penoyre & Prasad tried to mitigate the difficult circulation by planning an open sequence of doors leading from reception to waiting rooms and the outpatients' accommodation above, but security measures imposed by the hospital make that transition difficult.

The building has six storeys above the ground floor.

Research departments are contained on the second floor and the short-stay hostel accommodation is on the fifth. The sixth floor has the plant rooms, which is a pity as there are great views from the top. Patients' records and offices are housed in the basement and light reaches there from a continuous 1,200mm slit in the pavement along the front of the glass reception screen. Again, that seems an opportunity lost, for it limits the potential of the café area and entrance to open up more directly to the street.

The Moorfields Eye Hospital is on the edge of a conservation area and seemingly local planners could accept the six storeys of accommodation for the new children's eye centre only if the top floor could be classified as plant room, was set back after five storeys, and was not defined as usable space. This is patently absurd, given the poor design quality of adjoining hospital buildings and the 20-storey housing blocks sited immediately across the road.

After it won the commission, Penoyre & Prasad developed the project with clinicians and key user groups until the internal and external form was agreed and signed off and the Stage 2 design report produced. The extension was then tendered using the Procurement 21 process. Balfour Beatty won the contract and was appointed as principal supply chain partner. Penoyre & Prasad was then novated as its architect. Given that the user group/architect connection was reduced, the building has retained a high standard throughout.

I was impressed by the quality of finish and the depth of thought applied by the architect. The NHS Foundation Trust and Penoyre & Prasad should be pleased with the outcome. I hope it sets a design level for future NHS buildings, and it may well become an exemplar project.

As I left, I wondered what would have happened if the architect had been less polite and not so obviously 'architectural'.

If it had questioned the brief and pushed the clinicians and the planners more. RDCEC is not cutting-edge architecture - but then I suppose it doesn't need to be.


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