Design spotlight: The Royal National ENT and Eastman Dental Hospitals

Published: 14-Dec-2021

We look more closely at the winning entry in the Award for Best Healthcare Development (Value >10m) category at the 2021 Building Better Healthcare Awards

In the first in a series of interviews with some of the winners of this year’s Building Better Healthcare Awards, BBH editor, Jo Makosinski, speaks to Duncan Leach of BMJ Architects about its work on the Royal National ENT and Eastman Dental Hospitals project, which picked up the 2021 Award for Best Healthcare Development (Value >10m) for the submission by UCLH, Arup MEP, and BMJ Architects

Increasingly, hospital buildings are being designed to make an impact and to enhance and reflect the communities they serve, as well as improving the overall experience for staff, patients, and visitors.

And this approach was evident in the design and delivery of the new Royal National ENT and Eastman Dental Hospitals, located close to University College Hospital in Bloomsbury, central London.

A state-of-the-art health centre providing world-class dental, ear, nose, throat, hearing, and balance services for children and adults; the centres, which previously operated on two separate sites, have been combined to create one of the largest specialist facilities of its kind in Europe.

Externally, it is split into two different approaches and that’s something that adds to its richness

Commissioned by University College London Hospitals NHS Foundation Trust (UCLH), the design brief was to put patients at the heart while maximising clinical space and reflecting the architecture of the local area.

But the restricted and congested site, nestled in the heart of a streetscape of largely-Edwardian buildings, called for a very-specific approach.

Initial designs were drawn up by the now-defunct Steffian Bradley Architects, before the project was taken over by BMJ Architects, which saw it through to completion.

And, to make the building fit in with surrounding architecture, and create a landmark for the area, a separate design firm, Pilbrow & Partners, was brought in for the planning stages to design the eye-catching façade of the building.

The site, within the Bloomsbury Conservation Area, required a high-quality architectural approach, taking account of the area’s decorative brickwork, stone dressings, string courses, and oriel bay windows.

Originally designed by Pilbrow & Partners to be laid brick by brick, BMJ worked collaboratively with Mace and its specialist sub contractors to rejig the proposal to enable the façade to be erected using 248 pre-fabricated units, complete with pre-cast concrete, bricks, curtain walling, bay windows, and perforated brick panels – a solution which saved more than a year in construction work.

The façade is rich in modern reinterpretations of the heritage context, informed by up-to-date sustainable design strategies. And the result is a building which, on approach, offers two very-different views.

Speaking to BBH, Duncan Leach of BMJ Architects, explains: “When you are coming to the hospital from the north, oriel bays protruding from the building present clear glazing into the corridor waiting areas.

To deliver a really-good healthcare building with good-quality spaces for patients and excellent patient experience, and to have it operational on day one after handover, is not something that is done often in healthcare architecture, and that’s something we are really proud of

“However, when you approach the building from the south it is very different because the glazing around the windows are screening for solar gain by perforated brick panels that give a nod to the Edwardian terracotta and brickwork oriels you see around the area. /

“Externally, it is split into two different approaches and that’s something that adds to its richness.”

So, too, is the interior of the building split in two in what the architects have dubbed an ‘on stage/off stage’ approach.

Leach explains: “From the original concept, the client’s requirement was for this on stage/off stage planning.

“All the internal flow was done in a way where clinical staff would come in from one side of the building, and patients would come in from another, and they would meet in the middle.

“This meant the patient journey from the front door to the clinical spaces was as simple and straightforward as possible.

“Once the patient arrives, they travel via the stairs or lifts to the main corridor and all waiting rooms are accessed from here.

“Looking over Huntley Street, this corridor is very well lit with natural daylight and the views really help with navigation and orientation.

“From that corridor patients access all consultation rooms, while the clinicians enter from another corridor. This works really well.”

Delivered as part of Phase 5 of UCLH’s revamp plans, the building is arranged over nine floors – three below ground and six above ground – housing 10 procedure rooms for complex surgical treatments, more than 60 clinic and testing rooms, hearing and balance rooms featuring some of the very latest medical devices, and 84 dental chairs, as well as an MRI and CT scanners in the basement.

The main outpatient accommodation is above ground, with MRI, imaging facilities and procedures in the multi-level basement area.

The long, narrow footprint of the site led to a ‘functional zoning’ approach which maximises the efficiency of the floor plate, which is split into three horizontal bands: front public – waiting reception; mid – clinical accommodation; and rear – service – staff, utilities, stores, and FM.

To have delivered this project through such sensitive and exciting architectural treatment, and to have that recognised by the judges, makes us feel it was really worthwhile

“It is a very-complicated site and really constrained and it is very difficult to build any building of that complicated nature there,” said Leach.

“To deliver a really-good healthcare building with good-quality spaces for patients and excellent patient experience, and to have it operational on day one after handover, is not something that is done often in healthcare architecture, and that’s something we are really proud of.”

The development is also innovative for the use of engineering design innovations, including circadian lighting control, medical gas installations, and healthcare-compliant electrical services supply and distribution (UPS and IPS).

Led by MEP consultant, Arup, the vertical distribution of services below and above ground was also highly co-ordinated, reducing the amount of detailed co-ordination required by the contractor, and the likelihood of issues being encountered on site.

And Building Information Modelling (BIM) was used to simulate and assess the designs, which helped expedite the decision-making process.

As a result, the project has received a BREEAM ‘Excellent’ sustainability rating.

On winning the BBH Award for Award for Best Healthcare Development (Value >10m), he added: “To deliver a functional hospital sounds basic, but such a complicated development means a lot of collaborative effort.

“To have delivered it through such sensitive and exciting architectural treatment, and to have that recognised by the judges, makes us feel it was really worthwhile.

“There are always a number of hurdles in healthcare to getting buildings across the line, but in this case we had a very supportive client with the drive and energy to see it through and we believe we have create a truly-landmark building.”

Project team

Contractor: Mace

Executive architects: BMJ Architects

Supervisory architects (façade): Pilbrow & Partners

Supervisory architects (clinical): Scott Tallon Walker

MEP sub contractor: Dornan

MEP engineer: Arup

Project management: Henry Riley

Structural engineer: Clarke Nicholls Marcel

Curtain walling: Fleetwood Architectural Aluminium

Pre-cast concrete cladding: Techrete

Brickwork: Swift Brickwork Contractors

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