The RIBA, 27th August 2009, Article prepared by Jaime Bishop, Director Fleet Architects, Event Organiser and Executive Board Member Architects for Health
On the 27th of September the third annual AfH Student Health Design Award was celebrated. Those gathered at RIBA watched presentations by the shortlisted candidates before the judges retired to an anteroom to debate and elect a winner. After an hour the judges, chaired by John Cooper AfH president, emerged to announce the results.
The awards were conceived in 2007 with the goal of bridging a perceived schism between the practicing architectural design community and the academic arena. From both perspectives, the other is often viewed as not aligning with their respective goals, be it preparing students for the challenging array of potential briefs in Healthcare or demonstrating that these vital pieces of community infrastructure can be delightful works of architecture.
The ongoing support for this event by Brookfield, the global asset management company with interest in the UK healthcare infrastructure, is vital to its success and has demonstrated a genuine commitment to the development of the quality of healthcare related design.
As in 2010, the 2009 competition was open to students of all schools of architecture or interior design internationally.
Entrants were invited to submit projects addressing healthcare topics completed during the course of their studies, or alternatively to adopt a sample brief supplied by Architects for Health.
In order to achieve the initial goals, the judging criteria were developed to partially suppress the demands of practical healthcare design and enable the more poetic experiments of contemporary architecture students. However, it would also be counter-productive to ignore all purely pragmatic, specifically health-related design issues in favour of the esoteric ponderings of students. Therefore, neither approach excluded a project from winning.
Picture Credit Below: 'Embedded', by Orit Balicer The Bezalel Academy of Art and Design, Jerusalem, Israel. 2009 Submission.
AfH are particularly keen to celebrate when a proposal has engaged with the experience of staff and building users, asking: what it will be like to be inside this building? And how will that effect healing on a one to one scale? The criteria specifically stated that a ‘crudely elevated massing model’ would not fulfil the criteria.
The panel were instructed to judge individual projects against the brief and the program of the building type they chose. However the first three years have witnessed the development of briefs in order to test how they can benefit the needs of architectural academics and practitioners alike.
Example points to be disregarded by the panel:
First came the short-listing process, which reduced the initial eighty entries to eight. Entries were received from all over the world, with the eventual shortlist representing students from China, Ireland, Germany, Denmark and the UK. The judges were then provided with a pack of material to peruse prior to the event, before meeting the other panellists and finally electing a winner.
The judging panel included a broad spectrum of backgrounds and professional skills: medical practitioners, architects, architectural tutors, the sponsor and the 2008 winner, Elaine Neish, who comments: ‘The judging process was exciting for me to take part in - to be on the 'other' side so to speak. Much more of a relaxing and enjoyable evening than having to present the year before! It’s great to be included on the judging panel as you hear a plethora of responses from the medical side as well as other peers’.
Paul Serkis (Brookfield - Sponsor)
Paul has over 20 years experience in the construction industry, having held senior positions in the delivery of projects together with SPV Director/Bid roles in PFI. He began his career at John Laing Construction as a sponsored undergraduate completing his Quantity Surveying degree at LJMU. His learning and experience continued holding a number of commercial positions on a variety of projects including MOD, Health, Laboratories and Retail facilities. He became a member of the RICS in 1996 and completed a diploma in law in 1999. Paul moved to Wates in 2001 to drive forward the PFI Education Business until joining Brookfield in 2005 to focus initially on closing Peterborough hospitals. Paul’s is Commercial Director- Infrastructure responsible for the PFI/Infrastructure business unit in both strategic positioning and bidding for new opportunities.
John Cooper (Chair of Judges), Chair of Architects for Health
John studied architecture at Cambridge University and in his early career taught at the universities of East London, Brookes Oxford and De Montfort. He formed Avanti Architects with four colleagues in 1982. After twenty years at Avanti, John joined Anschen and Allen. In seven years John directed twelve major projects. These span the full range of health care from complex tertiary hospitals for oncology, paediatrics and maternity to innovative community facilities. He has completed designs for new types of hospitals which have 100% single rooms, migrating many of their ambulatory services into the community. He has worked in Ireland, Norway, and Australia and collaborated with his colleagues in the USA. John is the current Chair of AfH.
Dr Sam Everington
Sam is a GP in the East End of London’s Bromley by Bow Centre. The Centre is used by the government as a model for “healthy living centres” and NHS Lift premises. It was formally designated by Government as a ‘healthy living centre’ in 2000 and achieved Beacon Status in 2001. In 2003 it was designated by government as a national “children’s centre”. Sam is a qualified Barrister and a member of BMA and GMC Council. In 1999 he received an OBE for services to inner city primary care and in 2006, The International Award of Excellence in Health Care. He is a Director of Community Health Partnerships (NHS Lift) and an Ambassador for Social Enterprise (Cabinet Office)
Dr Patrick Hutt
Patrick Hutt is a newly qualified GP who has written extensively on General Practice. He is author of Confronting an ill Society, a biography of David Widgery, a radical East End GP. At University College London he is currently researching the evidence for differing health centre configurations, motivated by the recent proposals for polyclinics. He is Junior Editor of InnovAIT – the journal for GP trainees. He lives in and is from Hackney.
Thomas Gardner
Thomas Gardner is currently project architect and key Sustainability Group member at Allford Hall Monaghan Morris, following work for Urban Salon, Meadowcroft Griffin and Wilkinson Eyre. He has wide project experience, including leading the completion of Sunshine House, an RIBA award-winning Child Healthcare centre in Southwark. He is a studio teacher at Cambridge University, and has previously won an RIBA East student award. He and his work have featured in journals including Building Design and the Guardian.
Elaine Neish (2008 Winner)
Born in Aberdeenshire; qualified (Bachelor of Architecture), Mackintosh School of Architecture Glasgow School of Art 2001. Worked 4 years as an architectural assistant in practice for Dunwoodie Architecture and Design, where the interest in Healthcare design emerged. Qualified (B.Arch) University of Newcastle Upon Tyne 2008, Children's Language and Speech Clinic won the Architects for Health Student Award 2008. Current projects include the redevelopment of South Tyneside District Hospital Accident and Emergency Services, whilst undertaking Part 3.
Francesca Pont
After graduating from London Metropolitan University in 2004, she joined Cottrell & Vermeulen Architecture. Francesca maintains strong links with the university and is currently a co-tutor for a Post-Graduate Unit and qualified for the RIBA Part III in 2006.
Geoffrey Liddle,
UK, Northumbria University
1st Year of Diploma in Architecture
Memory Centre: Dementia Care
Dementia affects around 700,000 people in the UK, and Geoffrey’s scheme was designed to increase awareness of dementia and improve the quality of care received.
He proposed to move the Alzheimer’s Association office to the strategically central location of South Tyneside Hospital. The scheme also aimed to accommodate a mixture of social and clinical support for dementia sufferers, their carers and families. Relevant medical facilities such as dental treatment, chiropody and eye-testing would be offered, alongside therapies to aid remembrance, such as gardening and music therapy. Using a domestic vernacular and familiar materials, the scheme sought to provide a homely environment, full of warmth and light. A wonderful subject that will certainly be examined in future years, this project was mature and well-dressed and made even more poignant due to the personal experiences that had informed Geoffrey’s proposals.
Ewan Cooper With Ashleigh Donaghey
UK, London Metropolitan University, Finished 4th year and 5th year respectively
‘Brook House’ Managing degrees of Freedom : Mental Health Unit (Sample Brief)
Mental health is a community wide problem for Hackney. This scheme proposed a mental health unit that reflected the character of the area’s Victorian terraces, and used a number of smaller buildings to populate the southern face of the site and a part of adjacent parkland - hoping to engage with public space as opposed to creating a world within a world, as is common with mental health buildings. Each room looked onto an enclosed winter garden, and Ewan and Ashleigh were interested in how encouraging patients to cultivate and take responsibility for plants could be therapeutic. They also found a metaphor for the work of the mental health unit in the idea of bringing the buried Hackney Brook (which runs under the western edge the site) once again to the surface.
Although not resolved, Ewan and Ashleigh’s proposals stood out for the freshness of their graphics, mixing media of freehand sketches, collage and models. As with the winner in 2007, they used the medium as a designing investigation and not merely a representation of ideas.
Jonathon Schofield,
UK, University of Westminster, RIBA Part 2
‘Thames Salmon Rehab’
Sited at Fisherman’s Wharf, London Bridge, ‘Thames Salmon Rehab’ explored how the improved ecology of the river Thames could improve the health of both humans and the school of Salmon that have recently started to return after a long absence.
The project focused on five elements of routine which are controlled by the Thames tide rising and falling twice a day: scavenging the river bed, fishing, transporting fish, a live fish market and sleeping. It proposed that, as the river gets cleaner, more species of fish and river life will return to the Thames, also improving the health of the inhabitants – the health of the river and the community are linked.
AfH were delighted such a graphically challenging and contemporary project was short-listed this year. A brief which could be considered controversial showed that the wider ‘well-being’ of a community, a topic widely mooted these days, could be extrapolated into a science fiction flight of fantasy with our disbelief reassuringly suspended. As Paul Serkis noted: ‘Extremely interesting, thought provoking but above all showed a great depth and displayed an ability to think in some instances in a non conformist way. (Salmon? Brilliant!!!!).’
Soren Thiesen,
Denmark, The Royal Danish Academy of Fine Arts School of ArchitectureA
Trauma Centre for rape victims in Cape Town
South Africa has the world's highest rate of sexual assault; Every 26 seconds a woman is raped and every second women has a risk of being raped in their lifetime.
This scheme used the wall as a symbol for security, creating a protective space for rape victims. He talked us through a user’s journey - at the arrival garden, they would be greeted by a staff member, who would guide them through the process – taking them to the trauma and emergency department, or continuing into the meeting area where they could tell their story. This part would be separated from the administrative section, so that it would not be disturbed by people coming and going, and included a herbal garden. Judge Elaine Neish felt it was an ‘Interesting scheme where the journey through the building can be read as a parallel with the progression of treatment of the patient. I enjoyed the protection of the solid thick walls and the enclosure of the building, with only a tree signalling the entrance.’
Having travelled to London from Denmark Soren made an excellent presentation of his project. The rehabilitation clinic for rape victims was one of our most challenging topics and was confidently and delicately addressed. The miniature vignettes hidden within Soren’s submission could have been used more widely - their subtle use of materiality and gravity portrayed his approach.
Alexander Thomas,
UK, London Metropolitan University, RIBA Part2
‘A Venetian Hospital’
Working within the current municipal hospital of Venice, this project attempted to encourage a co-habitation of hospital and city in the formation of a new city quarter. The urban strategy looked at unifying the disparate buildings that currently make up the hospital ‘centre’. Focusing around a new school of physiotherapy, the scheme also re-used an existing boat delivery department to make a lecture hall. Around this a series of layers were formed, with an outer and inner arcade that related to the city and the public room respectively. Alexander was interested in the juxtaposition of old and new concrete, with the existing columns becoming wrapped by new cladding.
The Venice hospital proposal faced the twin challenges of knitting a hospital campus into the fabric of Venice, and obvious comparison with the Corbusier’s unrealised hospital proposal for the city. While it was generally accepted that for this competition the ‘programmatic’ requirements were central enough to be successful, it did serve how a building type such as a hospital can be woven into an urban fabric with elegance and poise.
Jing Zhao (Share of second, awarded £500),
China/US, Texas A&M University, 2nd-Year M.Arch Student
A Clinic on a Creek: Clinic and Wellness Centre
Playful and free in its depiction and ideas, the scheme was a refreshing offering from a student from the respected programme at Texas A&M University. Aiming to create a friendly healthcare environment, Jing Zhao took two main approaches - involving nature and creating a pleasant walking experience.
This scheme had two parts – an outpatient clinic and a wellness centre – and began with the idea of using a creek on the site, having it move through the building, so visitors could enjoy walking on the creek and watching the water. To maximize the view of nature, the building was in a linear shape. Judge Elaine Neish commented that: ‘There’s something satisfying about being able to continue on a journey and look back to a specific point from which you have came. The corridor with continual and changing views would be a great experience for any patient or staff member on what would normally constitute a tedious journey through a hospital corridor.’ Issues such as circulation had also been impressively planned, with a semi-lattice structure, in order to shorten the travel distances for patients and staff and set up connections between related treatment areas. Thomas Gardner was taken by how the scheme combined: ‘The natural opportunities offered by the site with a sound understanding of the programme.’
Agnes Wesolowski (Share of second, awarded £500),
Germany, University Of Applied Sciences & Arts, Dortmund, Graduate
Ipomoea - A Hospital for Tanzania
The aim of this project was to develop a clinic for Tanzania, which could be built in the actual economic conditions of the country, responding to the unpredictable environment and preserving local culture. The new clinic was planned on the outskirts of the city Kigoma, in a region severely lacking health facilities, and needed to be flexible.
The hospital contained two basic architectural statements - a raised platform and a roof. This theoretically infinitely extendable structure would be able to host all needed functions, ensure hygienic conditions, and provide urgently needed cross-ventilation and shadow. The platform would create a new neighbourhood agora, typical for a Tanzanian city- small-scaled and open.
Filling between existing columns, volumes could be built up around a series of staggered patios. These green enclosures would provide light and ventilation, and collect rainwater. Agnes explained that two different types of walls made sure patients had a safe environment. Compressed earth bricks provided shelter and privacy; the insecticide-treated nets created an external membrane, capable of keeping insects out, allowing the wind to flow and views to be seen. As Thomas Gardner observed, this brought together ‘Local building methods and patient needs into a sophisticated composition.’
A charming and disarming proposal that took a practical problem, that of malarial mosquitoes within a natural ventilation public building, and derived a simple and elegant kit of parts. The proposal evolved beyond a collection of ‘shoe-box’ architectural components and Agnes demonstrated it could be assembled into deep plan, sun shielded matt groundscraper punctuated small courtyards and sunshine streaming between the straws of the roofing.
Iseult O’Clery (Winner awarded £1000),
The Republic of Ireland, University College Dublin
Finished 4th year (RIBA part 2)
In Praise of Chimneys: Primary health care centre, Portobello
This scheme took a site on the south side of Dublin, beside the grand canal, for a primary health centre with community functions. The proposal was inspired by a childhood memory of a visit to the family doctor that began with the solidity and warmth of a chimney. Throughout the project concrete chimneys became structure, stairs, light wells, inhabited space. The grain of the surrounding buildings was translated through these structural chimneys, so to move through the health centre meant to move through a terrace of houses, transversing the walls.
GP and dental rooms are sat like attic spaces on the top floor, collecting light through a wooden box/object which opens to reveal an examination space. This piece of furniture also hides (scary) medical equipment and a sink. The doctor’s rooms are expressed to the south with deep windows overlooking the canal. The scheme also proposes that each room has a small waiting space, (to avoid the crowded feeling of large waiting rooms) semi-enclosed and lit from above with reflective copper ceilings. Waiting patients overlook the roofs (and chimneys!) of the artisan dwellings nestled below. GP Patrick Hutt noted: ‘The winning entry made the familiar space of the consultation new again, demonstrating the potential buildings have to positively influence the experience of patient and healthcare professional.’
Iseult also suggested that stairs enclosed within the walls could lead staff to a half-level overlooking the public functions on the ground floor, with these enclosed stairs allowing staff to circulate independently of patients. Elaine Neish liked this, commenting that it was a: ‘Very patient centred response to the brief given, yet as much thought given to the practitioners too, with 'secret' stairs to their own private suites.’ The ground floor also had community spaces, such as a yoga studio and café, with pivoting doors allowing it to be almost totally opened up on both sides, encouraging a porous relationship between the community and the canal.
We were particular pleased in the study of the detailed engagement with the patient (service user) /clinician interface including a considerate yet challenging palette of materials. The drawn submission skilfully and evocatively described the materiality and how it might impress upon the function of the space. Expanding on the scale, Iseult’s proposals were firmly cemented within the context, and the play with the chimney as an icon to develop ideas around was charming and welcome.
AFH were exceptionally pleased with the range of submissions this year. The quality of design and engagement with the building program (or brief) to generate form has demonstrably grown year on year. Health buildings should not just be extruded health plans or clichés of biophilia, there are nuances of space and relationship which are worthy of concerted and critical evaluation. Thomas Gardner feels it was a valuable event for this reason: ‘It was particularly exciting that students had really chosen to investigate health across this wide range of scales. Urban propositions, such as revitalised sections of Venice or fishing the banks of the Thames, set out a context and ambition against which the smaller scale proposals, concerned with giving individuals a view of the sky or access to the pleasures of a garden, could be set and understood…In future it would be fascinating to see students push the range of scales further, investigating issues from microbiology to the global health economy, without losing sight of this very real, very personal, human scale environment in which actual lived experience takes place.’
In the design of her consulting and examination room Iseult’s project ultimately challenged flaws in one of the most common of clinical rooms, flaws which are repeated unchallenged time and time again. Student work is a fertile territory with the licence and luxury to take a critical position on healthcare design which could and should influence practice in the future. As Paul Serkis, from sponsor Brookfield, observed: ‘I found myself indulging in Architect speak which let’s face sometimes is on another planet, but actually, setting the sights on another planet allows some reigning in but ultimately results in a far better design.’
As the event organiser I hope that we will increase our direct engagement with students next year. Our goal ultimately is to invite design based research into the healthcare arena, and to prepare students to be more predisposed to work as architects and designers in the Healthcare sector to the benefit of employers and the future of our built healthcare environment. As Panellist Patrick Hutt noted: ‘I hope that this competition will encourage more people to pursue careers in health related architecture. It is a discipline worthy of attention.’
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