Circle Bath hospitalEdit profile
There is much evidence that a well-designed hospital can reduce recovery times and contribute to better outcomes for patients. Hospitals are public buildings: they ought to be the focus of architectural ambition. How people are treated ought to be as important as the treatment they receive. All too often, however, a visit to a UK hospital is an encounter with machinery. It ought to be a more human encounter. Health Properties, on behalf of healthcare partnership Circle, set out to realise these ambitions in 2005, by adopting an entirely new approach to hospital design. Rory Coonan Hon FRIBA, former director of architecture at the Arts Council of Great Britain, was appointed to help select great architects for the programme of 20 new hospitals, of which Circle Bath is the first. CircleBath provides operating theatres, bedrooms, consultation, treatment and recovery spaces, and offers both in-patient and outpatient accommodation. Its compact design encourages a sense of community and belonging. There are no ‘departments’ signified. In fact, the administrative structure of the hospital is entirely concealed from patients as unnecessary, and there are no signs at all! The hospital is planned around a central light filled atrium, promoting a sense of orientation and intimacy that is commonly lacking in larger hospitals. Divisions between functions are minimised, easing the stress involved in consultation, treatment and recovery for patients and reducing walking distances for staff. The double-height atrium forms the focus for patients, staff and visitors, with private consultation rooms leading from it at ground level and in-patient bedrooms arranged around it above. The main reception point, café and nurses’ station occupy the atrium where daylight, drawn through the circular sky lights, is softened by a translucent fabric ribbon tracing the shapes. The colour palette is a warm and friendly mix of ochre and rust, with natural wood acoustic panels above, interspersed with glass panels providing a visual connection to the atrium from the bedroom floor. The building is dug into its hillside site, its profile kept low. Public entry is from the road on the north directly into the atrium on the ground level floor. The northern façade comprises dark panelling at the lower levels, while on the south, extensive glazing opens out to views over the surrounding rolling countryside. Appearing to float above this recessive skirting, the rectangular upper volume and roof, enclosing all twenty-eight bedrooms, is clad in a reflective lattice of aluminium shingles. Throughout the building, there is an emphasis on natural light and views. Balconies line the building’s northern and southern edges, oriented to maximise views across the surrounding rolling countryside. Sympathetic landscaping further emphasises the therapeutic natural environment – an overall approach very different from more familiar hospital surroundings. The hospital is fully accessible, both physically and psychologically. No barriers are placed in anyone’s way – you can pop in for lunch if you wish. Security is discreet and designed to be practically invisible. At a physical level, all bedrooms are identical – there is no special ‘disability’ design whatsoever, since all spaces, including bedrooms, consulting and treatment rooms are completely and naturally accessible. The hospital was designed with as few corridors as possible, avoiding the confusion and disorientation typical of larger institutions. The ‘fully accessible’ approach has yielded other benefits too. Shortened travel distances on foot, central greeting points and critical adjacencies provide a building that is easier to staff and manage. The design incorporates coloured thresholds which define and distinguish the entrances to key rooms, such as the consultation rooms and the inpatient bedrooms. These coloured threshold spaces between main circulation routes also enable patients to orientate themselves easily and navigate their way round the hospital. Functional zones within the key rooms have also been defined with colour. Subtlety, rather than pursuing a loud or conspicuously ‘cheerful’ palette, has been a consistent objective. To those who expect a conventional hospital interior, there is none of the smells, colours, signs and sounds associated with a medical centre. The overall effect has led patients to question whether this really is a hospital, or a luxury hotel – much to the delight of staff. A collection of 14 large-scale contemporary paintings, from both emerging and established artists, line the atrium walls and are the result of collaboration with the Contemporary Art Society. The lifespan of technology is shorter than that of the building envelope, so the design is flexible to anticipate future demands and to allow technology platforms to change without significantly altering the structure. For example, the MRI magnet can be removed sideways and lifted to road level and the clear service diagram, which places the ‘engine room’ of operating theatres at lower level, allows for a clear separation between public (low mechanical services) and private (high intensity mechanical services). The CircleBath hospital is fundamentally sustained by its staff: there can be little future for any institution unless sustained by a community that cares for it. The radical, co-operative healthcare ownership model of Circle is the best guarantee of its sustainability. To the human factors should be added the fabric of the building which is self-consciously simple, rational and symmetrical: there are no awkward, indulgent projections – the perimeter is as small as it could possibly be – and therefore the amount of energy leaked is kept to the minimum. The first floor protects the ground from solar gain; the design avoids superfluous, expensive ‘kit’ for shading; it reduces the number of materials used to only four, as seen on the outside. The degree of glazing is minimised: less really is more. All air conditioning has been abolished throughout the hospital, except where required by regulation (in operating theatres). This radical step – which contributes massively to energy saving and cost-in-use – provides patients with greater control over their local environment: they can open their windows!