Jaime Bishop, a director of Fleet Architects, AfH executive board member, and the competition’s organiser, describes the shortlisted and winning entries, discusses how candidates addressed the brief, and explains how the winner and two “runners-up” were chosen.
An evening late last autumn saw the third annual AfH Student Health Design Award celebrated. Those gathered at the RIBA’s London headquarters watched presentations by the eight shortlisted candidates before the judges retired to an ante-room to debate and elect a winner. After an hour the judges, chaired by AfH president John Cooper, emerged to announce the results. The awards were conceived in 2007 to bridge a perceived schism between the practicing architectural design community and academia. From both perspectives, my experience is that one is often viewed as not aligning with the other’s 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 a strong interest in the UK healthcare infrastructure, is vital to its success. The brief and eligibility 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 AfH.
Judging criteria
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 was felt that it would also be counter-productive to ignore all purely pragmatic, specifically health-related design issues in favour of students’ esoteric ponderings. Therefore neither approach excluded a project from winning. AfH is particularly keen to celebrate when a proposal has engaged with the experience of staff and building users, asking: “What will it be like to be inside this building, and how will that affect healing on a one-to-one scale?” The criteria specifically stated that a “crudely elevated massing model” would not fulfil the brief.
Key criteria
The key criteria considered by the panel were:
• Creativity – Had the student imaginatively explored the brief to deliver an interesting proposal?
• Patient /staff-centred – How had the applicant considered the experience of its clients?
• Aesthetic – Does the visual resolution of the project suggest a suitable response to the brief, be it an elegant synergy of function and expression, or a logical response to context?
• Graphic quality – Does the quality of the graphical submissions support a comprehensive, sensitive, and detailed investigation of the subject?
• At what stage in the student’s career was the project undertaken?
Meanwhile specific example points to be disregarded by the panel were:
• Practicalities – issues such as the number of sluice rooms etc (unless the success of the idea at the core of the design hinged on these details.)
• Guidance (HTMs, HBNs, etc) – Any technical advice or regulation unless specifically invited on board by the student’s choice of brief.
Submissions and judging process
The shortlisting process reduced the initial 80 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 look through prior to the event, before meeting the other panellists and finally electing a winner. The judging panel included individuals with a broad spectrum of backgrounds and professional skills, including medical practitioners, architects, architectural tutors, the sponsor, and the 2008 competition winner, Elaine Neish.
The winner
Iseult O’Clery (Awarded £1000) The Republic of Ireland, University College Dublin. Has completed 4th year (RIBA part 2).
In Praise of Chimneys: Primary healthcare 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, and inhabited space. The grain of the surrounding buildings was translated through these structural chimneys, so that to move through the health centre meant moving through a terrace of houses, transversing the walls. GP and dental rooms sit 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 (see “The judging panel” on page 51) noted: “The winning entry made the familiar space of the consultation new again, demonstrating the potential that buildings have to positively influence the experience of patient and healthcare professional.”
‘Patient-centred response’
Iseult O’Clery 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 said: “A very patient-centred response to the brief given, yet with as much thought given to the practitioners, 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 relationship between the community and the canal. We were particularly pleased with the detailed engagement with the patient (service user) /clinician interface, which included 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 O’Clery’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. Alongside the overall competition winner, two entries received the second prize, jointly, each being awarded £500.
Share of second prize
Jing Zhao China/US, Texas A&M University, 2nd year M.Arch student.
A Clinic on a Creek: Clinic and Wellness Centre. This 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. The 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 that visitors could enjoy walking on the creek and watching the water. To maximise views of nature, the building was linear in shape. Elaine Neish commented: “There’s something satisfying about being able to continue on a journey and look back to a specific point from whence you 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, to shorten the travel distances for patients and staff and set up connections between related treatment areas. Judge Thomas Gardner was taken by how the scheme “combined the natural opportunities offered by the site with a sound understanding of the programme”.
Share of second prize
Agnes Wesolowski Germany, University Of Applied Sciences & Arts, Dortmund, Graduate.
Ipomoea – A Hospital for Tanzania. This project’s aim 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 of 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 (gathering place), 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 Wesolowski explained that two different types of walls ensured patients had a safe environment. Compressed earth bricks provided shelter and privacy, while insecticide-treated nets created an external membrane capable of keeping insects out, but 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”.
‘Charming and disarming’
This was a charming and disarming proposal that took a practical problem, that of malarial mosquitoes within a naturally ventilated public building, and derived a simple and elegant kit of parts. The proposal evolved beyond a collection of “shoe-box” architectural components, and the entrant demonstrated it could be assembled into deep plan, sun-shielded, matt groundscraper-punctuated small courtyards, with sunshine streaming between the straws of the roofing.
The other shortlisted entries
The other candidates and entries shorlisted were: Geoffrey Liddle UK, Northumbria University, 1st year of Diploma in Architecture
Memory Centre: Dementia Care. With dementia affecting around 700,000 people in the UK, this scheme was dementia and improve the quality of care. Geoffrey Liddle proposed moving 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 memory, 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 the entrant’s proposals. Ewan Cooper with Ashleigh Donaghey UK, London Metropolitan University, Candidates have completed 4th and 5th years 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 the entrants 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 of the site) once again to the surface. Although not resolved, Ewan Copper and Ashleigh Donahey’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. Jonathan Schofield UK, University of Westminster, RIBA Part 2.
Thames Salmon Rehab. Sited at Fisherman’s Wharf, London Bridge in London, “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 has recently started to return after a long absence. The project focused on five elements of routine 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 – since the health of the river and the community are linked. AfH was delighted that such a graphically challenging and contemporary project was shortlisted this year. A brief which could be considered controversial showed that the wider “wellbeing” of a community, a topic now widely mooted, could be extrapolated into a science fiction flight of fantasy with our disbelief reassuringly suspended. As judge Paul Serkis noted: “Extremely interesting and thought-provoking, but above all showed a great depth and displayed an ability to think in some instances in a non-conformist way.” Soren Thiesen, Denmark, The Royal Danish Academy of Fine Arts School of Architecture.
A 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 woman has a risk of being raped in her lifetime. This scheme used the wall as a symbol for security, creating a protective space for rape victims. Soren Thiesen 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 as not to be “disturbed” by people coming and going, and included a herbal garden. 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”. She said: “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 Thiesen made an excellent presentation. The rehabilitation clinic for rape victims was one of our most challenging topics and was confidently and delicately addressed. The miniature vignettes hidden within his submission could have been used more widely – their subtle use of materiality and gravity portrayed his approach. Alexander Thomas UK, London Metropolitan University, RIBA Part 2.
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 Thomas 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 Le 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 to show how a building type such as a hospital can be woven into an urban fabric with elegance and poise.
Quality of design
AfH was exceptionally pleased with the range of submissions this year. The quality of design and engagement with the building programme (or brief) to generate form has demonstrably grown year-onear. 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. Judge 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 ranging 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.”
Challenging flaws
In the design of her consulting and examination room Iseult Clery’s project ultimately challenged flaws in one of the most common of clinical rooms which are repeated unchallenged time and 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 it, sometimes is on another planet, but actually, setting the sights on another planet allows some reining in but ultimately results in a far better design.” As the event organiser I hope to 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.”