Guest post by Helen Crow
The New Hospital Programme, announced as part of the Government’s Health Infrastructure Plan in September 2019, pledged to deliver 40 new hospitals by 2030 (later increased to 48). As of November 2022, only one of these hospitals was open to patients and five are under construction, due to multiple delays.
However, this programme represents a huge opportunity to transform the next generation of hospitals. It has the potential to deliver buildings that go beyond meeting clinical requirements; to create settings that are both healing and therapeutic by design. One way to do this is by incorporating green, active and healthy spaces that can benefit the wider community, creating what has been described as ‘a garden hospital.’
A substantial and growing body of evidence supports the healing power of green space in healthcare settings; for example, how it can reduce dependence on medication, reduce anxiety and speed up post-operative recovery times. The New Hospital Programme contains some fantastic examples of forward-thinking innovative design, where the integration of building and surrounding green space is at the core of the design vision.
The proposed Princess Alexandra Hospital in Harlow, Essex, is one of the most ambitious. No planning application has yet been submitted but the Princess Alexandra NHS Trust seems to regard the hospital‘s design as a blueprint for the role of many others, saying:
…it will be a campus of vitality and wellbeing. A beacon of health for the whole community, set in a therapeutic landscape. It will lead the way for other hospital buildings to follow. An exemplar of modern architecture that will deliver the best setting for our people to deliver the best care for you.
The trust lists one of their key considerations as “contact to nature to aid recovery, with stunning outside views, daylight from all directions, green courtyards and gardens.”
Some of the trust’s green space ideas could contribute to a net zero NHS, such as a ‘sky farm’ for growing fruit and vegetables. They say this will “enable us to work with community partners to provide opportunities for local people to understand how our food directly affects our health.”
A handful of hospitals in the New Hospital Programme are due to be built on completely new sites and these can offer some of the greatest opportunities for green space integration.
The proposed West Suffolk Hospital in Bury St Edmunds is a great example of this. The proposal is for a completely new building on land immediately to the southwest of the current hospital. The application by Ryder Architecture, on behalf of the West Suffolk NHS Foundation Trust, describes plans “to create a garden hospital sitting within the mature parkland setting of the Hardwick Manor site”, and explains what a ’garden hospital’ refers to:
“…The garden hospital as a concept seeks to connect the internal hospital environment with the natural world around it. Views out help with orientation and wayfinding as well as a sense of connection with the wider world […] Placing wards at levels where they can have a more direct relationship with the immediate landscape…”
The document describes the concept of a “healthy landscape” that provides access to and views of green spaces, and promotes healthy activity.
Mental health and rehabilitation facilities both offer some of the best opportunities for the integration of green space, as these are sites where service users are likely to stay for extended periods. Meaningful occupation and spending time outdoors in a natural setting can make a significant contribution to patients’ recovery in terms of their mental health and wellbeing.
The new National Rehabilitation Centre, which has planning permission to be constructed next to the Defence Rehabilitation Centre near Loughborough, is a great example of this. BS Stanford Ltd, the company overseeing the development, have taken advantage of the rural, woodland setting to provide a therapeutic space for rehabilitation. The Design Statement says: “The proposed design is based on the concept of bringing the ‘healing environment’ of the wider Registered Parkland and woodland into the building as much as possible to aid the patient’s healing process.”
The lower level of the building will be arranged in several blocks to create a series of courtyard spaces throughout the ground floor, furthering opportunities to be close to nature. The main accommodation building has large expanses of glazing, and is orientated east to west on the higher level to take advantage of the parkland views to the south.
Many urban sites have the opportunity for green space integration, too, especially if this is planned from the outset. The masterplan for the new Whipps Cross University Hospital in Northeast London includes a new, state-of-the-art hospital, car park, housing development, parks and public spaces, and improved access to the site to encourage active travel. When the Barts Health NHS Trust started consulting on their plans they set out a vision for a “hospital in a garden and a garden in a hospital.”
This hospital is adjacent to Epping Forest and in a newsletter from February 2021 the trust said, “our plans aim to transform the area […] re-establishing its connection to the surrounding forest.”
The 3Ts Project at the Royal Sussex County Hospital is set in a very tightly constrained, urban site in Brighton. The plans replace all the buildings on the main frontage of the hospital, but even here the architects have managed to squeeze in new green spaces. The Louisa Martindale Building, which is the first stage of the redevelopment, has 21 planters set out across a range of accessible courtyards and terraces. In total the green spaces on the building support 29 trees, more than 1,400 shrubs and perennials and over 450 square metres of specialist matting designed to support wildflowers and grasses.
These examples show that there are many ways in which the vision of a “hospital in a garden and a garden in a hospital” can be achieved if the relationship between the building and green space is an integral part of the design process from the outset. These plans can offer inspiration for all NHS trusts still in the design stages of their development and should give them the impetus to work with their architects and pose the question, “what could we do?”