Designing wellbeing: how better architectural approaches to hospital buildings can help patient recovery

Designing for patients’ mental wellbeing, Alder Hey Children’s Hospital pioneers a new approach to clinical buildings. As the architects behind the new Catkin Centre and Sunflower House, here are five insights from Alder Hey that we believe can provide a blueprint for the NHS and all healthcare providers...

The links between environment, mental health and physical health are now well-established - for example, a significant body of evidence shows that a connection to nature can improve patient outcomes and recovery times. Yet traditional hospital buildings are designed with virtually no reference to the mental wellbeing of their patients. Too often they are functional, forbidding and detached from the natural world. It is commonplace for people to say they feel ‘depressed’ by the thought of hospitals and their associated images of windowless waiting rooms and long artificially-lit corridors.

But why should it be this way? Imagine if typical clinical buildings were more like Maggie’s Newcastle, a drop-in centre for people living with cancer. Designed by Cullinan Studio, it is an uplifting, positive and homely environment, flooded with natural light and surrounded by a wild garden.

It’s an ethos we carried into our work for Alder Hey Children’s Hospital in Liverpool, supporting the Trust’s vision to create a 21st century ‘Health Campus’ integrated into a new park. We believe that the success of the project points the way for future NHS hospital and clinic buildings..

Five insights from Alder Hey for future hospital building design

1) Enable a joined-up healthcare approach by creating a ‘Health Campus’

The Alder Hey project brings together in two connected buildings a range of facilities that were previously scattered across the hospital site and the city of Liverpool: CAMHS, Psychology, Paediatric Neuro-Assessment and Crisis Care departments, plus an inpatient mental health facility.

Now, Alder Hey’s Catkin Centre and Sunflower House come together with the main hospital and a re-imagined Springfield Park to form a ‘Health Campus’, offering a new, joined-up approach to the treatment of physical and mental health for children and young adults, and giving patients what one clinician described as ‘a Ritz experience’.

This kind of innovative approach has great benefits -- but also challenges. Clinical and patient privacy needs must be balanced with maintaining a welcoming and open environment. With imaginative solutions, architects can meet these challenges and enable hospitals to deliver healthcare that joins up physical and mental wellbeing.

2) Design legible layouts that feel safe, warm and non-institutional

Traditional hospital buildings tend to be mazes without centres: confusing labyrinths of corridors and identical, boxy rooms that leave patients disoriented and alienated.

Alder Hey takes a completely different approach. Cloistered routes surround two courtyard buildings, where clusters of consulting rooms, bedrooms and day spaces are gathered around a central outdoor garden room offering activities and views. It is a legible layout: users can easily orientate themselves within the building, promoting feelings of security, and reducing stress.

3) Connect patients to the natural world outside

Alder Hey is the first children’s hospital in Europe to be integrated within a new publicly accessible park – and the new mental health buildings are surrounded by green space, trees and flowers. Along both sides of the new building, bedrooms and consulting rooms each have projecting bay windows that offer ‘child-sized’ refuge spaces that shield direct overview from outside and look instead towards the new Park. The central outdoor garden rooms offer fresh air, daylight and plants. So all parts of the buildings – and all spaces to wait, be alone or be sociable – give views of nature. Numerous empirical studies have shown that views and connection to nature reduces stress and heart rates, and improves feelings of wellbeing.

Of course, a new parkland setting is not a practical possibility for all hospital buildings. But architects and designers can find imaginative ways to bring patients closer to nature even in the most unpromising locations. Users of Maggie’s Newcastle can see the wildflower garden from every corner of the interior, even though the building’s setting is an otherwise nondescript hospital car park.

4) Make hospital buildings multisensory instruments for healing

Connecting with nature promotes healing because it provides a form of effortless stimulation appreciated via all the senses. The simple act of sitting in contemplation in a courtyard garden presents you with an array of subtly changing colours, textures, lights, sounds and scents.

As well as creating gardens and outdoor rooms, architects can bring nature into buildings by using natural materials. Internally, the Alder Hey buildings are made of timber, a material not normally associated with hospitals, but here revealed and expressed throughout. The wood creates a warm, tactile effect that can be appreciated with multiple senses: sight, smell and touch. The building itself can become an instrument of healing. The timber finish also provides an extremely robust finish to the interior – a critically important requirement of the brief.

5) Integrate hospitals into the community

Hospitals are public buildings, but even when they are in residential and urban areas it is rare for them to feel like cherished parts of the community. They are usually alien ‘other’ places: forbidding institutions, generally ignored and, when needed, approached with trepidation.

Alder Hey’s location within a new park points the way to new ways of thinking about hospital buildings. Why shouldn’t they be pleasant places to visit, positively integrated into communities, even loved? The British have a deep regard for the NHS. Visiting its hospitals shouldn’t be a matter of dread, but thought of warmly as an opportunity to find tranquility and restoration in a place of healing.

Alder Hey Children’s Hospital represents a new way of thinking about hospital buildings. As the architects, Cullinan Studio can offer insights and lessons from our experience in turning into reality the concept of designing for mental wellbeing and patient recovery.

If you would like to discuss any of the issues raised by this project, contact Roddy Langmuir.