Former WAN Awards judges discuss the growing importance of good design as an aid to recovery
As a race we are supposedly eating better, becoming far more aware of the consequences of unhealthy lifestyle choices, and more able to afford those better choices. However, statistics show that the spectres of three major health time-bombs loom before us: living longer into old age (with all its inherent health problems), rising cancer rates, and, of course, obesity.
According to Cancer Research UK: “One in two people born after 1960 in the UK will be diagnosed with some form of cancer during their lifetime. Lifetime risk in the UK has been found to have increased over time, due to longer life expectancy, meaning that more people are living into old age, where cancer is more common.”
The World Health Organization has also reported some shocking statistics, this time on obesity. Globally, a staggering 42 million pre-school children were overweight in 2013. Worldwide, the prevalence of obesity has nearly doubled between 1980 and 2008, with 1.4 billion people overweight and more than half a billion obese in 2008. WHO also notes: “Once associated with high-income countries, obesity is now also prevalent in low- and middle-income countries.”
Sadly, the indications are that many more of us will have to face the daunting prospect of spending time in hospital. Obviously what everyone hopes for first and foremost is excellent care from doctors, nurses and clinicians. But as we gain more understanding of the psychological effects our surroundings can and do have, architects too are playing an increasingly vital role in helping to create the right sort of healing environments. We asked two leaders in the field for their take on taking the institution out of healthcare design.
Firstly, we spoke to Pam Bate, Partner at Hopkins Architecture and former WAN Awards Healthcare judge. Hopkins was the force behind the benchmark-setting Evelina Children’s Hospital in London, designed for client Guy’s and St Thomas’ Hospital NHS Foundation Trust. The practice also worked with the Teenage Cancer Trust and architects Allford Hall Monaghan Morris (AHMM) on the UCLH MacMillan Cancer Centre, referenced later.
We also spoke with Piers Gough, Partner and co-founder of CZWG Architects, and former WAN judge, who designed the Maggie’s Centre in Nottingham, UK (shortlisted by us in 2012). Maggie’s is a well-established UK charity named after the late Maggie Keswick Jencks, whose centres are based on her idea of an alternative environment to hospital for providing advice and support for patients with cancer, and their families. Her belief was that ‘people should not lose the joy of living in the fear of dying’.
This is what our former judges each shared with us…
How profoundly do you think the built environment of a hospital or healthcare facility affects the well-being of patients and the performance of staff? Can it really make a big difference?
Pam: People in hospital would like to believe that the facility where they are being treated has the best doctors and the most up-to-date and innovative equipment to ensure that they and their loved ones are being cared for in the best possible environment. At the same time, they feel very strongly about their surroundings, especially when they’re stressed out and scared - both typical emotions encountered in a hospital environment. Because of this, it is now known that the inclusion of art and a general level of design empathy in hospitals helps to aid recovery and boost well-being to make people feel at ease in their surroundings and get better faster.
Piers: Buildings can always make degrees of difference to all activities. In healthcare, when staff and patients are both highly pressured, quality of environment is even more important.
What are some of the ways in which architects can help 'soften the edges' of what is, to most people, a frightening place?
Pam: A good clear diagram will aid navigation around the most complex of buildings so that people are able to intuitively find their way around. In association with that, art and wayfinding strategies become key; at Evelina Children’s Hospital, for instance, we had bright red centrally-located lifts taking patients, parents and children to all floor levels.
Piers: ‘Softening the edges’ is the kind of pathetic palliative offered by crass providers. Buildings have to be commissioned to be intrinsically beautiful and graceful from inception.
Is it all about form, or does function also have a role to play in making a healthcare facility less daunting for patients?
Pam: It’s a bit of both; form should be reflective of function wherever possible but occasional follies or deviations for the sake of creating a more welcoming and calming environment are always acceptable. Clarity of space and relationships between spaces is also important, as a way of demystifying the experience that is to come.
Piers: The function of a hospital building is to provide a positive environmental experience for staff every day. Patients and, as importantly, their families and friends need uplifting spaces. The daunting aspect is being ill. The building should provide the opposite: reassurance and hope.
Are there any common clichés or pitfalls in designing for healthcare - for example in a children's hospital, where does jolly and playful become trite or patronising?
Pam: Finding the balance to suit all ages is the key, but teenagers also like a trip into Neverland sometimes – it’s not all about computer games and the latest techno-fads. I think the Teenage Cancer Trust have pitched it right - a bit of everything tied together with some themes.
Piers: The pitfall is to think that it is a machine for processing illnesses. Good architecture rigorously incorporates the physical function and adjacencies of the brief, but makes the whole into a place of beauty and grace.
Can you give an example of a particularly successful design for healthcare project?
Pam: At the UCLH MacMillan Cancer Centre, AHMM worked with us and the Teenage Cancer Trust to provide a fantastic environment for the young cancer patients. It is an ambulatory place so the kids go home every evening, but during the day they can mix and download music, play snooker, receive intravenous chemotherapy, and do their homework. It all helps the chemo fit into their lives, rather than vice-versa, and we believe this results in a dramatically improved overall experience.
Piers: Any and every Maggie’s Centre is a gem of commissioning good healthcare architecture. What is shocking is that I have never experienced a beautiful modern hospital.
The WAN Healthcare Awards is now open for entries.