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Thursday31 July 2014

Sheffield hospital’s new medical ward is a picture of health

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Sheppard Robson brings colour and clarity to NHS design.

With its Colgate-white render and modish timber cladding, the new 168-bed medical block at Sheffield’s Northern General Hospital has finally exorcised the site’s resident ghosts. The hospital began life as a grim Victorian workhouse, and even as recently as 1967, the Sheffield Star felt that it hadn’t outlived its history. After the merger of two smaller facilities, the paper hoped the rebranding would “finally kill the workhouse stigma… that has haunted so many old folk needing permanent hospital care”.

Today, there will be no Dickensian moments for patients. The £30 million building is bright and spacious, with uplifting artwork and large windows for views over Sheffield. Combined with soothing colours and attractive signage, these make the wards feel as home-from-home as possible for a clinical environment. “A lot of research shows that the more you make people feel at ease, the better,” says Mary-Ann Crompton, project team leader for architect Sheppard Robson. “The less institutionalised you make it, the less anxious patients are and the better they recover.”

The new building is located at the southern tip of the steeply sloping 40ha site and provides most visitors with their first glimpse of the hospital. Fortunately, it’s an overwhelmingly positive impression, a world away from the sooty Victorian grandeur, depressing sixties brutalism and twee 1980s post-modernism that make up the rest of the complex.

The building creates a gateway to the site — communicated by the statement atrium and symmetrical projecting wings — but is not in fact one of the hospital’s main entrances. While visitors can come and go via a relatively discreet door, the main access to the new building for staff and patients is at the rear via a glazed bridge which connects to an internal street running the length of the hospital.

Sheppard Robson, working with its in-house interior design arm ID:SR, was architect for a consortium led by Kajima and United Medical Enterprises which won the PFI contract to design and build the 10,930sq m building in 2003. The architectural challenge was to improve on the public sector comparator, the outline design used to determine whether the PFI contract offered good value.

“The comparator was a dense figure-of-eight block, compact and efficient,” recalls design director Jason Speechly-Dick. “One challenge was to open that up, to unlock the possibilities of the site with respect to aspect and daylighting.”

The less institutionalised you make it, the less anxious patients are and the better they recover.

Mary-Ann Crompton, project team leader for architect Sheppard Robson

The solution came in the form of two L-shaped wings projecting from a central quadruple-height atrium, a focal point from which all wards are accessed. It sets up the design language for the rest of the building — lots of light, colour and transparency, thanks to a full-height glazed Shüco facade and circular rooflight. The curved glass balustrade to the central staircase was a design battle fought and won in the name of transparency.

The six wards enjoy views from the upper levels, while support functions are relegated to the ground floor and a services block behind the atrium. The ground floor is recessed, making the building appear to sit on piloti while also providing sheltered outdoor space under the overhang. Projecting bays on the south-facing facades are clad in vertical cedar slats, the remainder in white acrylic render chosen for its cost, durability and application speed. Plant has been placed on the roof, as far from the edge as possible to reduce visual impact.

Each ward has a combination of single rooms and three- or four-bed rooms, accessed from a central corridor. The relatively long and thin plan means that no one is ever too far from a window and a view. “But one downside is that staff say they have a long way to walk,” says Crompton. In each ward, the nurses’ station is located at the “elbow” of the L-shaped plan.

Sheppard Robson aimed to have as many single rooms as the budget would allow, for the sake of patient comfort and infection control. So half the beds are in single rooms, with en suite facilities. The single-bed rooms look north over courtyards created between the L-shaped wings, which have been landscaped to provide soothing vistas of trees and shrubs.

The multi-occupancy rooms feature a clever “staggered” plan which means everyone has access to their own openable window. Located along the front of the building, these multi-bed rooms have the best views, compensation for those forced to share. Sill levels are deliberately low so patients can see outside from their beds.

All rooms are surprisingly spacious, designed to DOH guidelines and allowing plenty of room for staff to manoeuvre around beds. The only complaint comes from the geriatric ward’s matron, who claims the beds are so far apart that patients with impaired hearing can’t chat with their neighbours.

The single-bed rooms look north over courtyards landscaped with soothing vistas of trees and shrubs.

 

Infection control had a major impact on the choice of interior finishes — such as scrubbable Dulux paint, curtains with infection-resistant coatings and vinyl Kvadrat chairs. Likewise, it influenced the choice of radiant ceiling panels for the heating system, which removed the ledges, pipework and surfaces associated with radiator systems. The desks and nurses’ stations were also designed by Sheppard Robson to minimise dust-catching ledges.

But what really makes the new extension succeed is the consistency in the use of colour and the integration of the artwork. That policy originated in early user group meetings, where Crompton says that staff were very keen to theme the different floors with colour.

The chosen leitmotif of the seasons works well in a building with four floors. “The seasons are something that everyone understands, a universal language,” Crompton explains. “It’s nature as healer.” One application is the way-finding system, where each floor uses a different colour and motif to represent a season. The designs were inspired by textile designer Lucienne Day, and are also used as manifestation for the glazed link bridge to the main hospital.

Inside the wards, the seasonal colours are used for accent walls and behind the nurses’ base stations. It reinforces the way-finding strategy while simultaneously adding warmth and personality to the interior.

There are also several art installations funded directly by the hospital, with the architect suggesting possible locations and what each piece could consist of. “We have tried to give it an overall theme, so it all works together with intent and purpose,” says Crompton. Works include a mosaic at ground floor level by local artist Joanna Kessel, canvases in the wards and staff areas, and textile pieces by artist Janet Bolton that line the corridor leading from the atrium to the glazed link bridge.

Walking across the bridge and into the rest of the hospital, the contrast between old and new couldn’t be more apparent — Sheppard Robson describes the new building as a “step change”.

The new building is certainly a break from the site’s troubled past, and the architect now hopes it will set the standard for good design in the trust’s future build programme.

In the architect’s own words: Sheppard Robson project team leader Mary Ann Crompton on how involving the interiors team early reaps benefits.

ID:SR is the interior design group of Sheppard Robson. It works on major projects with the architect, as well as independentlyon interior design projects.

Working together has a significant impact on a project such as the Northern General Hospital. ID:SR worked with us at pitch stage, creating sketches for the interior. It wasat this point, for example, that the design of the atrium was identified askey to the rulesfor way-finding — through signage and colour — which were then applied throughout the circulation areas. This cross-fertilisation of ideas was encouragedby holding twice-monthly design workshops.

In hospitals,the interior design and the way that patients, doctors and visitors experience the “everyday” is incredibly important. The building hasto work as a whole from the inside out. It’s a matter of using the finishesto give people an intuitive way of using the building without using signage, so people feel less anxious.

For instance, all the doors the public can go through are timber-veneered, and all the doors to clinical or services areas are white. We did a lot of research on fabrics for the curtains, and chose ones with a coating that helped to repel infection.
We didn’t havea lot of choice inthe flooring — the clinicians wanted washable finishes, so there was no chance to use a material other than vinyl. In the main atrium and the services block, we chose a speckled finish to the vinyl flooring, which reflects the blue, green, orange and yellow colour themes of the upper floors.

We also collaborated onthe detailing of the interior. Thinking about these things at an early stage meant we could secure fundingfor them underthe PFI contract.

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