healthcare book>

Images from left to right, from top:

Clackmannanshire Community Hospital, Istanbul BioCity, Milton Keynes General Hospital, Sheffield Northern General Hospital, Hereford County Hospital Redevelopment, University Hospital of South Manchester, Yorkhill PICU, Queen Mary’s Hospital, Brentwood Community Hospital, Paul O’Gorman Leukaemia Research Laboratory, Sheffield Northern General Hospital, Tepnel Life Sciences

“ We have found the team from Atkins to be experts in their field and we have benefited greatly from the pro-active approach they have brought to solving challenges. ”

Jane Connechen Practice Manager

Gillbrae Medical Centre, Dumfries

Sketches from left to right, from top:

Fife PPP; Cork Medical Clinic; Al Zahra Hospital; Murray Royal Hospital, Perth; Kazan A&E Hospital;Victoria Hospital. Kirkcaldy; Seafield Residential Care Home, South Ayrshire

01_Introduction

02_Our Design Approach

03_Our Services

04_Healthcare MasterplanningIntroduction

Hereford County Hospital Redevelopment University Hospital of South ManchesterGlasgow Royal Infirmary MasterplanMonklands Hospital MasterplanLibya Medical City Masterplan

05_Healing EnvironmentsIntroduction

West of Scotland Heart & Lung Centre Gynaecology Unit, Glasgow Royal InfirmaryFace Projects and Design Standards, LondonNHS Shetland Term Commission Neonatal Unit, Birmingham Women’s Hospital

06_Mental HealthcareIntroduction

Tayside Mental Health Developments Seafield Residential Care Home, AyrshireRoyal Edinburgh Hospital RedevelopmentLaureate House, ManchesterErskine Nursing HomesSlagelse Psychiatric Hospital, Denmark

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07_Community HealthcareIntroduction

Gillbrae Medical Centre, Dumfries NHS Grampian Consultants Term Commission Anchor Care Homes, SurreySpire Shawfair Park Hospital, Edinburgh Peninsula Dental Schools, Southwest New Diabetes Centre and Medical Innovation & Research Unit, Birmingham

08_Biomedical & ResearchIntroduction

Paul O’Gorman Leukaemia Research Laboratory, Gartnavel Hospital, Glasgow Life Science Innovation Centre, AberdeenTepnel Life Sciences, LivingstonRegional Radiation Protection Services, BirminghamBlood Transfusion Service National Term Framework

09_International and Independent Healthcare Introduction

Al Zahra Hospital Dubai Kahzan A&E HospitalPrincess Royal Medical Centre, GibraltarIndependent Sector Treatment CentresCork Medical Clinic, IrelandDubai Health and Wellness Centre

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Main entrance of Independent Sector Treatment Centre, Shepton Mallet

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Atkins is one of the world’s leading engineering and design consultancies. We are a robust company which has been operating for over 70 years. Our access to a wealth of internal specialists brings significant value to our clients, allowing us to harness an unrivalled pool of creative, professional people to produce outstanding solutions to challenging problems. Our dedicated healthcare teams deliver design expertise directly to both public and private health providers, and to constructor or developer led partnerships. We have a long history of involvement in healthcare design, reaching back over 30 years. We have designed two of the first wave publicly and privately funded hospitals and are currently designing the first health sector project in Scotland procured through a Competitive Dialogue process. We designed some of the first Independent Treatment Centres for the NHS in England and have been responsible for the first specialist Cardiology Centre in Bahrain. We have the ability to innovate, change and adapt for new models of healthcare and for new methods of design and procurement whether they be locally, nationally or internally focused. In this book we have brought together our ideas on design for healthcare from visioning and masterplanning through to programme completion and ongoing framework management. Through examples of our recent projects, we illustrate how we translate these ideas into practice and demonstrate our numerous relationships with healthcare providers.

Ian Tempest, Healthcare Director

200 Broomielaw, Glasgow, G1 4RUTel: 0141 220 2000Email: ian.tempest@atkinsglobal.com

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Our Design ApproachHealthcare facilities are at the heart of communities, and are a benchmark for society’s civilisation, yet are too often seen as machines for efficient treatment delivery, not as celebrated design icons. At Atkins we are passionate about design excellence and strive to ensure we successfully deliver on both these criteria. Healthcare is process driven. Technology, functionality and efficiency are the foundation for all our designs yet never to the exclusion of delight and architectural ‘place-making’. Healthcare is a holistic experience, not just a biomedical procedure In our designs, we aim to create a salutogenic physical environment, that is, one which is psychosocially supportive and engaging both mentally and socially. From Florence Nightingale’s 1859 prescient ‘Notes on Nursing’ to Dr Roger Ulrich’s persuasive business case for his evidence based “Fable” hospital, we understand and contribute to the growing body of research on the effect of our built environment on patient outcomes. For example, we can provide support for an economic basis of your healthcare design decision, by utilising the latest tools whole life cycle costing and risk assessments. Patient safety and risk assessment is increasingly relevant to all healthcare design decisions. Our extensive experience ranges from inception to detail design, for example: infection control specifications of self-flushing, no-touch taps and copper products; to consideration of construction disruption and risk mitigation feasibility in design of strategic masterplans. The most important period of any design is the initial briefing and feasibility stages. This is particularly relevant in healthcare due to the ever changing medical technology, high cost of construction / disruption, large numbers of stakeholders and increasingly the need to demonstrate value for money and sustainability credentials. We have valuable market knowledge and change management experience to bring to all elements of healthcare procurement, including writing briefs as a client’s advisor; investor technical reviewer; or responding to briefs as a contractor’s designer. Project examples of these roles include Guys & St Thomas Hospital in London; new Karolinska University Hospital in Stockholm, Sweden; and new Mental Health Developments for NHS Tayside as demonstrated in the following pages.

Our ServicesRegardless of the scale or size of a project, we have the necessary range of technical skills and experience. Each service may be procured individually or as part of a multidiscipline package from a single source:

Energy supply Microclim

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ArchitectureMasterplanning

Structural EngineeringCivil Engineering

Mechanical EngineeringElectrical Engineering

Landscape ArchitectureHealthcare PlanningBuilding Surveying

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Specialist services for healthcare We offer the following specialist disciplines relevant to the healthcare sector.

Healthcare Planning Atkins’ healthcare planners come from health service backgrounds – generally as clinicians and managers. This enables us to provide expert solutions and liaise knowledgeably with clinicians, managers and designers alike. In turn this promotes healthcare buildings which:

Have a high functional quality •Efficiently serve patients and staff•Are sympathetic to human needs•Provide the flexibility to accommodate advancing technology•Meet strict cost and quality parameters•

Extensive health service experience, together with a notable track record in all aspects of healthcare capital investment, ensures that Atkins has a complete understanding of the needs of healthcare clients, encompassing:

Strategy and planning•Project briefing preparation•Estate rationalisation•Business case development•Commissioning and evaluation•

Healthcare Engineering With over 20 years experience gained primarily within the NHS, our Authorising Engineers for medical gas pipeline systems (MGPS) and high voltage systems (HV) are suitably qualified and experienced to provide clients with expert advice concerning the safe systems of work required for effective system management. Our extensive MGPS experience includes cylinder manifold installations, liquid oxygen systems, medical and surgical compressed air systems, medical vacuum systems and anaesthetic gas scavenging systems.

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Fire Engineering Our national team of Fire Safety Engineers develop fire strategies for the design of complex buildings and advise on the management of fire safety in completed buildings. We have an excellent working knowledge of both the UK NHS Firecode guidance and international healthcare guidance, for example NFPA and FGI Guidelines for Health Care Facilities. Our experience includes the devising of both full and partial Fire Engineering solutions for complex healthcare premises where major refurbishments are linked to existing retained sites.

Landscape Design We can create distinctive and therapeutic landscape solutions for many types of healthcare projects, delivering measureable patient and wider user benefits. Our designs are always mindful of the needs of patients, staff and visitors and we seek to develop our solutions alongside the users and maintainers of our schemes. Our goal is to provide uplifting and comfortable environments which promote recovery but which also recognise the practical multi-functional demands of healthcare facilities such as parking, delivery, security and emergency access.

Technical Advisory Services We also regularly act on behalf of our clients in an advisory capacity, our key roles include:

We work as • technical advisors within our client’s team to support their development aspirations, provide technical documentation and analysis to permit successful appointment of their contracting partnerWith their thorough knowledge of the technical subject matter, our specialists regularly undertake • due diligence reviews to identify the consequential, commercial risk to investors or lendersWe take on the onerous role of • independent tester and provide technical advice, commonly at the implementation stage, including reviewing the designs prepared by the contracting partner and check on site activity to ensure it is in accordance with the contract terms

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Courtyard design at Stracathro Hospital, AngusCourtyard design at University Hospital of South Manchester

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Sustainable Design Atkins is committed to leading the way on sustainability. Our goal is the delivery of a low carbon economy in all of our many fields of operations across the globe. Our highly qualified staff are well placed, utilising multidisciplinary teamwork, to provide a comprehensive and holistically sustainable design service for the benefit of our clients across the healthcare sector. We can deploy a range of experts from BREEAM assessors, to green transport planning advisors, and deliver designs using WRAP, our waste reduction specification tools developed for the Carbon Trust. The diagram above illustrates our fully integrated sustainable design approach for a new project. Stage 1: the Sustainability Strategy (SS) is the vision agreed with our client and is the foundation for all project design development. Stage 2: the Sustainable Action Plan (SAP) is our translation of the vision into the ten key target principles of WWF’s globally recognised One Planet Living initiative. Stage 3: the Sustainability Identification and Implementation Framework (SIIF) is where our design is continually refined, with options assessed and agreed, to finally determine the optimal solution using our proprietary simulation Carbon Tools. As part of our continual focus on embedding into all our services the challenges and opportunities a carbon critical economy will bring, we have invested significantly in developing a unique suite of Carbon Tools, providing simulation, assessment and decision making. These eight tools allow both Atkins and our clients to understand and thereby reduce our carbon footprint (both embodied and operational), thus enabling us all to live within our fair share of the earth’s resources.

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Sustainable Design Atkins is committed to leading the way on sustainability. Our goal is the delivery of a low carbon economy in all of our many fields of operations across the globe. Our highly qualified staff are well placed, utilising multidisciplinary teamwork, to provide a comprehensive and holistically sustainable design service for the benefit of our clients across the healthcare sector. We can deploy a range of experts from BREEAM assessors, to Green Transport Planning advisors, and deliver designs using WRAP, our waste reduction specification tools developed for the Carbon Trust. The diagram below illustrates Atkins fully integrated sustainable design approach for a new project. Stage 1: the Sustainability Strategy (SS) is the vision agreed with our client and is the foundation for all project design development. Stage 2: the Sustainable Action Plan (SAP) is our translation of the vision into the ten key target principles of WWF’s globally recognised One Planet Living initiative. Stage 3: the Sustainability Identification and Implementation Framework (SIIF) is where our design is continually refined, with options assessed and agreed, to finally determine the optimal solution using our proprietary simulation Carbon Tools. As part of our continual focus on embedding into all our services the challenges and opportunities a carbon critical economy will bring, Atkins has invested significantly in developing a unique suite of Carbon Tools, providing simulation, assessment and decision- making. These eight tools allow both Atkins and our clients to understand and thereby reduce our carbon footprint (both embodied and operational), thus enabling us all to live within our fair share of the earth’s resources.

Stage 2

Zero Waste

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Culture & Heritage

Equity & Fair Trade

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Identification & Implementation Framework (SIIF)

VISION

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Carbon

Curves for Buildings

Water Balance

Site Wide Heating

Embodied Carbon

Micro Climate

Renewable Energy

Carbon Curves for Transport

The ten principles of One Planet Living

Carbon Simulation Tools OPTIONS

FEEDBACK

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Concept masterplan for BioCity

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We have undertaken masterplanning exercises that range from large acute hospital developments, both greenfield and on existing complex city sites, to plans for modern mental health campuses and for community facilities.

Step 1: A comprehensive environmental assessment

The masterplan provides a vision, as well as a strategic decision-making tool for how the site or area will be developed, including how the plan will be implemented, and the costs, phasing and timing of the development. The challenge is to develop an imaginative masterplan that will create a real sense of place and inspire change, but is also practical and deliverable.

From within Atkins we can provide all the specialist disciplines necessary for a successful masterplan, as illustrated opposite.

Step 2: Project design

Key aims in designing large complex projects are:

To create clinical relationships that promote patient-focused care and efficient deployment of staff•To integrate the external layout with the internal departments to create entrances and routes that allow easy and intuitive •wayfindingTo design communication routes that segregate visitors from staff and patients. This promotes patient privacy and dignity •and supports efficient movement of staff and patients around the hospitalTo create a design that facilitates all efforts to reduce Healthcare Acquired Infections•

Step 3: Ensuring sustainability

We also work to meet the strategic goals of our clients including addressing future change, by identifying early masterplan, flexibility and development opportunities. Our designs can contribute to efficient staff working and so ensure that the building is sustainable in terms of available workforce.

We also work with our clients on the choice and sourcing of materials to reduce the impact on the environment and to contribute to reducing life cycle costs.

Healthcare Masterplanning

Masterplanning Core Team

Development Economics

Transport Planning

Utilities

Architecture

Landscape and Urban Design

Environment

Land Use Planning

Hereford County Hospital RedevelopmentIn the first wave of PPP hospital redevelopments in the UK, this project pioneered many of the healthcare design and construction innovations which have now become industry norms, including:

Environmentally friendly narrow plan design to enable natural light and ventilation •Three enclosed themed courtyards with hard and soft landscaped gardens for wayfinding•Whole life costing to promote high quality construction materials and ease of maintenance•Use of latest 3D CAD technology to reduce both material wastage and fabrication timescales•The full interior design and furniture was incorporated with the cooperation of the Trust•Consideration of Infection Control throughout design development, led to lowest UK rates of Healthcare Acquired •Infections. (MRSA incidence April 03 - March 04 report 0.04 /1000 bed days)

This project was a demanding mix of new build, refurbishment and extension, which required a five year phased construction programme to ensure the existing clinical facilities on this congested city site continued operation without disruption. The result was the successful completion of a brand new, rationalised acute service facility for the whole county, previously spread over three sites. Main new build facilities included:

250 beds for acute, coronary, intensive care and high dependency care•Day surgery and operating theatres•Emergency, orthopaedic and a full range of outpatients facilities and diagnostic imaging•Paediatric, obstetrics and neonatal services•Age care and rehabilitation facilities•A full range of support facilities including sterile services, labs and catering facilities•

Atkins provided facilities management for the hospital, as well as architectural, landscaping, structural and building services engineering design services. Our designers were involved in complex masterplanning and the detailed programming of the construction phases to ensure the safe delivery, as well as a successful end product upon completion of this major capital works in a historic city centre site. The archaeological remains of an ancient Monastery within the site added to the overall design and logistical challenges.

Client: Hereford Hospitals NHS Trust Location: Hereford Value: £65m Status: Complete Area: 15,000 sqm (+10,000 refurb)

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Main entrance of Hereford County Hospital

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University Hospital of South ManchesterUniversity Hospital of South Manchester, ‘Wythenshawe Hospital’, is a highly regarded regional specialist centre for cancer, cardiology, burns, plastics and cardiothoracic transplant surgery as well as providing general hospital services to the local community. It is also a major centre for clinical teaching and research. This early Private-Public Partnership project was to add extensive new build facilities:

320 beds for acute, coronary, burns, intensive care and high dependency care•Emergency receiving unit, fracture clinic, rehabilitation facilities•Six theatre suites, radio diagnostic unit, teaching and seminar facilities•77 beds for mental health, including adult acute, old age, mother and baby and PICU •ECT suite, outpatients suite, and clinical psychology •

This variety of clinical services demanded a detailed and intuitive approach to the complex masterplanning, particularly with the requirement to integrate the new building with existing buildings and to co-locate a mental health unit with a large acute hospital. The level of specialised surgical services also required new thinking about the design of critical and high dependency care. The client required a flexible and extendable solution for these highly-serviced facilities that allow easy expansion of each unit and flexibility in the acuity of patients treated within the units. Atkins provided healthcare planning, masterplanning, architectural, landscaping and civil/structural engineering and since its completion in 2002, the building has continued to delight both client and users of the building. The client recognises the functional success of the building in meeting their initial brief, but also in providing future expansion opportunities such as space to develop the Emergency department beyond an Accident and Emergency service to a full assessment and admission area. The design also offers internal flexibility such as the provision of swing beds to allow bed allocations to be varied according to clinical need. Patients and visitors appreciate the coherent wayfinding solution which makes patient journeys short, simple and pleasant, contributing to reducing the anxiety caused by entering a new environment. This was achieved by the integration of architecture, interior design, landscaping, narrow planning and an extensive art-in-hospital involvement. Less aesthetically obvious but just as significant, are the environmental benefits of a building designed for lower energy consumption and reduced maintenance costs. The application of whole life costing and our use of latest 3D CAD technology both contributed to this sustainability and also to a project delivered within budget and in programme.

Client: South Manchester University Hospitals NHS Trust Location: Manchester Value: £113m Status: Complete Area: 24,000 sqm

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Main reception area of University Hospital of South Manchester

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Glasgow Royal Infirmary Masterplan

Atkins has delivered many construction and feasibility projects at Glasgow Royal Infirmary, an urban, century old, congested hospital site. Over ten years, our healthcare team has developed a solid understanding of the complexities of this site and our client’s priorities. Following our initial strategic masterplandesign, we were commissioned as project manager, medical planner, shadow architect and CDM coordinator on a phased design and build project for the new maternity facility, followed by a new emergency receiving, plastic surgery and burns unit and, finally, a multi-storey car park. We were responsible for procurement advice, preparing the employers requirements including full multidisciplinary exemplar designs, and finally monitoring quality, programme and costs. The hospital remained operational during the redevelopment. By adopting a consultative approach and engaging with a wide range of stakeholders, we successfully overcame this principal challenge of the project. The Maternity facility handles 6,000 births a year with 14 delivery rooms, two operating theatres, 18 day beds, neonatal care and full antenatal services. The plastic surgery and burns unit comprises 6 operating theatres, 85 in patient beds, outpatients facilities, medical photography facilities and support accommodation. The new emergency receiving facility deals with 70,000 cases annually, and replaces the hospital’s century old accommodation. The car park has 1,000 spaces over four levels. The recent gynaecology unit and extension is the latest phase from our original masterplan, please refer to page 28 for more details on this project.

Client: NHS Greater Glasgow & Clyde Location: Glasgow Royal Infirmary Value: £100m Status: Complete Area: 25,000 sqm

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Aerial view of Glasgow Royal Infirmary

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Monklands Hospital Masterplan

We have delivered several projects across the Monklands campus, amounting to some 5,000 sqm of extensions and alterations including: day surgery, dental, ophthalmic, cardiology, outpatients, endoscopy, dermatology and renal clinical services. From this extensive experience of over ten years, Atkins has built-up a rapport with the client’s team, an in-depth knowledge of the site, building and logistical challenges, as well as an appreciation of the local clinical and public sensitivities of any potential redevelopment. Latterly Atkins assisted in the decision making on the long-term investment at Monklands Hospital, with our strategic report for the long-term redevelopment potential. In particular, whether the original 1970s hospital fabric and service infrastructure has the capacity to sustain and indeed develop its healthcare delivery into the 21st Century. Key challenges included safe construction, access and demolition in the two land-locked ward towers above a two storey podium containing all theatres, imaging, emergency and outpatient care on this steeply sloping site. Our innovative and sustainable phased solution included relocation of mental health services and a new state-of-the-art acute clinical block, providing long-term, as well as the immediate decant facilities necessary to enable the safe refurbishment of all retained fabric and services, minimising both clinical and public safety risks. Following on from the success of the above study, Atkins was commissioned to provide a detailed design vision for the retained 1970s ward towers. In particular, their potential to accommodate modern healthcare standards and single bedrooms, together with improved safety, privacy, dignity, infection control and support facilities. We were subsequently also commissioned to develop design proposals for a new build Mental Health facility at Monklands. In this latest feasibility, we designed four independent, sustainable, predominantly single-storey buildings which were set into the steeply sloping landscape thus minimising their environmental impact. We created a clear identity for each clinical service, easy wayfinding, safe access to gardens, and ultimately a salutogenic architectural vision as an integral element of a holistic therapeutic service.

Client: NHS Lanarkshire Location: Monklands Hospital, Airdrie Value: Various Status: Complete Area: 15,000 sqm

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Concept for the new mental health facility

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Medical City Masterplan, Libya

The brief for Medical City Libya, is to create the region’s premier location for healthcare delivery and to reverse the current flow of healthcare tourism. The overall development will serve as a new town centre for the district and include a comprehensive range of residential uses and supporting functions, retail facilities and community services both for residents of the development and for the surrounding neighbourhood. Our client has determined a number of primary core uses to be developed for the whole Medical City and for the healthcare campus zone specifically. The state-of-the-art healthcare campus functions will be the heart of the 180 Hectare Medical City and include:

500 bed general hospital•Specialist clinical institutes, including: cardiac centre (80-100 beds); cancer treatment and research centre (80-100 •beds); diabetic centre (100-120 beds); women’s and children centre (100-120 beds). Support centre: clinical and non-clinical services, e.g. labs, pharmacy, mortuary, stores, laundry, catering.•Medical education centre •Staff residences •Step-down facility / patient hotel•

Increasingly, patients are choosing hospital and care settings not only for the best clinical services available, but to satisfy their expectations for welcoming, healing environments in which safety, dignity and personal comfort are decisive factors. Our innovative holistic masterplan will incorporate the latest healthcare design philosophies including evidence based design and ‘salutogenic’ concepts, for example views of nature, access to gardens and parks, etc, for enhancing human health, wellbeing and quality of life. Low Carbon and sustainability principles including flexibility, adaptability and expansion are also key factors in our masterplan design concept.

Client: Confidential Location: Tripoli, Libya Value: Confidential Status: Current Area: 180 Hectares

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Concept masterplan for Libya Medical City

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Healing EnvironmentWe recognise the importance of the emotional and aesthetic aspects of the healthcare environment rather than simply the functionality. Providing visual connections for the patient to the natural environment, and especially to sunlight, can promote wellbeing and positively impact on recovery time. A key mediator of this positive impact is the reduction of stress, for example, waiting areas designed with comfortable seating, relaxed decoration and lighting schemes and views to a garden or courtyard that allow natural light to penetrate. We can also achieve this with intuitive wayfinding which avoids overwhelming signage and journeys with several twists and turns by designing entrances and atria such that the route to almost any area can be located and followed from the entrance. Lighting can have an impact in almost any hospital area. Simple ideas such as off-setting corridor lighting in wards from the centre to spill down one of the corridor walls can reduce the institutional nature of a healthcare facility. Non-visual design aspects can also stress patients such as unwelcome noise and uncomfortable temperatures. By enabling the patient to shut a door of their own or manage a room’s temperature, they feel more in control of their environment. The inclusion of art and plants within hospitals has been demonstrated to contribute to the therapeutic environment. One of the earliest art projects in the UK was at Wythenshawe Hospital (page 16) in the 1970s. In Atkins’ renewal project at Wythenshawe, art was again included in the design from inception and informed the creation of art works for display in the hospital and the approach to interior design. Landscape design also has a powerful ability to enhance the environment. Our Tayside Mental Health Project (page 38), our landscape architect and artist worked together with the patient and staff to design a landscape for mental health wellbeing. There are external spaces for quiet reflection, for wandering among plants, for meeting and conversation, for sport and games and for pure enjoyment of the stunning panoramic views of the Perthshire hills.

West of Scotland Heart & Lung Centre

Atkins provided full multidiscipline consultancy services for this phased extension and upgrade for the new West of Scotland Cardio Thoracic Services in this National Waiting Times Hospital. This was a successful major redevelopment of a 1980’s facility to create the national centre for excellence for heart and lung surgery in Scotland, one of the newest and largest centres in Europe. Our designers worked closely with the client, their user teams and the various contractors from the outset to ensure patient safety and infection control was considered from feasibility for both the completion and execution of all the new facilities. Our project acted as the pilot study for NHS Scotland’s latest guide on Healthcare Associated Infection – System for Controlling Risk in the Built Environment (HAI SCRIBE). All parties bought into using this practical risk control toolkit from project inception. The result was raised awareness, minimal disruption and the safe and successful completion of all six contracts, many simultaneously completed, within the live operational environment of this former private hospital. The six construction projects within this live hospital included new and upgraded operating theatres, new cath labs, new and extended ICU’s, all of which required intricate healthcare design capability and technical expertise. The upgraded Facility comprises two 36 bed wards, an 8 bed cardiac unit, six 8 bed HDU wards plus 22 ICU beds, 3 cath labs and 14 operating theatre suites, along with new car parks and helipad. Atkins was subsequently commissioned for several further phases of works at this hospital, including upgrades to their national conference centre, a new orthopaedic outpatients and a new cardiac skills lab for regional staff training.

Client: National Waiting Times Board Location: Golden Jubilee National Hospital, Clydebank Value: £10m Status: Complete Area: 9,000 sqmH

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Interior of ICU ward, West of Scotland Heart & Lung Centre

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Gynaecology Unit, Glasgow Royal Infirmary

This new state-of-the-art Gynaecology Unit and extension is a subsequent phase from our original Glasgow Royal Infirmary masterplan commission (see Page 18). Atkins provided full multidisciplinary design services, CDM coordinator and cost management, utilising traditional construction procurement. This challenging construction project is sandwiched between the continuously occupied ground floor, containing the hospital main entrance, outpatients and retail units, and maternity floors above. Our solution comprised the careful management of all health and safety and infection control risks, in conjunction with continuous consultations with the wide range of stakeholders involved. The new unit provides 33 beds, a 2-theatre operating suite, and support, on the upper ground podium level, directly below the new Princess Royal Maternity unit, on this congested, century old, city centre hospital site. As the Gynaecology project progressed, Atkins design scope was considerably increased. Following contractor tender, we successfully managed client changes, adding offices and clinical training accommodation on the level below the Gynaecology floor, plus alterations to existing maternity theatre suites on level three above, creating an additional theatre and birthing suite. The overall development is the final element in a jigsaw, which creates a new centre of clinical excellence serving the community of Glasgow.

Client: NHS Greater Glasgow & Clyde Location: Glasgow Royal Infirmary Value: £9m Status: Complete Area: 3,000 sqmH

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Interior of new gynaecology ward, Glasgow Royal Infirmary

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Face Projects and Design Standards

Atkins was commissioned to prepare feasibility studies under the ‘Improving the Face of Guys and St Thomas’ programme. This scheme set out to improve patient access and wayfinding in these two randomly extended, century old hospital sites of St Thomas’ and Guys, both in the heart of London. Our proposed masterplan for St Thomas’ created a holistic architectural vision for a future hospital campus development and also provided potential for planned growth well into the future. We were further commissioned on an innovative project to develop an interactive design standards suite of documents. The project’s purpose was to capture best practice in design, simplify procurement, standardise components to secure economical maintenance and to reduce repeated design errors. Overall, the design standards ensure cost-effective design quality for incorporation in all future refurbishment and new build projects across the Foundation Trust’s sites. We successfully overcame the challenge of achieving a consensus from the many and diverse stakeholders for the design standards by implementing group workshops where Atkins provided an independent technical chairperson. Ten key qualities, drivers and objectives were crucially agreed by all at the outset. These included: Privacy and Dignity; Infection Control; Ease of Maintenance; Sustainability; Welcoming and Non-Institutional. The completed ‘Design Standards’ is an innovative and comprehensive guide, backed by a ‘live’ interactive website, which will provide a basis for whole life, design-led and qualitative consistency and improvement for the Guys and St Thomas future investment programme, from maintenance to major capital projects.

Client: Guys & St Thomas’ NHS Foundation Trust Location: Guy’s Hospital & St Thomas’ Hospital, London Value: NA Status: Complete Area: NAH

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Concept for St Thomas Hospital main reception

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NHS Shetland Term Commission

Client: NHS Shetland Location: Shetland Value: Various Status: Ongoing Area: Various

Atkins has been successfully redeveloping NHS Shetland’s healthcare estate, particularly at Gilbert Bain Hospital, for many years. We are currently providing architectural, mechanical, electrical, civil and structural engineering design services to Shetland, through a term consultants commission, which covers both maintenance and capital projects. Sized to serve Shetland’s 23,000 permanent population, plus the oil industry, the projects are remarkably diverse as the Shetland Island’s isolation requires almost entire self sufficiency. Our projects have encompassed many disparate functions and geographical locations across the isles, including:

Gilbert Bain Hospital•Montfield Hospital, Elderly Care Home •Brevick House Occupational Therapy Unit•Whalsay GP Surgery •

Gilbert Bain is the island’s main general hospital based in the capital, Lerwick. Our redevelopment for this original 1959 facility over the years has involved new build A&E, outpatients, radio diagnostic, dental facilities, maternity facilities and wards. Over this period both our client and designers have worked together to develop their understanding of the projects. More recent projects include: new occupational and physiotherapy departments, a new laboratory suite, a new twin theatre suite, maternity upgrade and new sterilising unit and pharmacy. The accumulated total to date has an approximate cost of £14m equalling over 10,000 sqm of new or refurbished hospital space. The Whalsay Island GP Surgery off the north east of Shetland mainland was extended to create additional consulting rooms, treatment rooms and a dental surgery. The construction, valued at £550k, was executed in three distinct phases to ensure continuous operation throughout the project. Atkins also provided a multidiscipline design team for the construction of a £3m new build health centre adjacent to the existing facility in Brae, a village in the far north of Shetland mainland. The facility comprises: an NHS doctors practice including chiropody and community nursing care, an NHS Dentist with three dental chairs, NHS out of hours facilities, pharmacy and minor procedure areas.

Brae Health Centre •Scalloway Health Centre •Mid Yell Health Centre•Kantersted Resource Centre•

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Dining room, Montfield Care Home

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Neonatal Unit, Birmingham Women’s Hospital

We were appointed through the ProCure21 framework to provide full architectural and lead consultant services for the redevelopment and significant expansion of an existing, tertiary Level 3 Neonatal Unit based at the Birmingham Women’s Hospital NHS Foundation Trust. The new unit will accommodate a total of 50 cots varying between intensive care, high dependency and special care levels with an associated outpatients / day clinic area and seminar suite. The use of cutting edge technologies in respect of the patient management systems has been an essential cornerstone of the design approach, which has been developed in close partnership with the Trust’s user group, medical physics and Control of Infection officers, with the aim of maximising the efficiency of the operational working zone around each cot bay and freeing up wall space for glazed screens to facilitate optimal observation natural daylight, and views of nature. The critical need to enforce infection controls throughout the unit is reinforced through the use of sensor taps throughout, materials and components with antibacterial properties, non-dirt trap detailing and clear signage designs. The scheme had been developed to achieve compliance with the latest NHS Health Building Note guidance and a BREEAM Health rating of Excellent. Early consideration was therefore given, from the outset of the design process, to optimising orientation, views, natural ventilation and the use of elements such as sedum roofs, sun catchers, shading devices and optimal use of materials and components with BRE ‘A’ ratings . The building has had to fit into a tight location within the existing hospital estate and to allow for potential vertical expansion and connectivity to future adjacent developments. The architectural solution sets out to provide a bright, high spec, contemporary environment for the patients, parents and staff and has been developed through close consultation with the wider user group, parent’s representatives, developmental care specialists and control of infection advisers.

Client: Birmingham Women’s Hospital NHS Foundation Trust Location: Birmingham Womens Hospital Value: £5.5m Status: Complete Area: 2,000 sqmH

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Neonatal Unit courtyard, Birmingham Women’s Hospital

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Concept main entrance of Murray Royal Hospital, Perth

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Mental HealthcareThe impact of the environment and society on our mental health is widely acknowledged. In our experience it is particularly important to work closely with the users, carers and staff to develop a holistic design for the environment that positively reinforces the therapies and encourages wellbeing. This can be achieved by the designer’s careful use of form, scale and materials to enhance the experience of spaces, lighting, landscape, colour, art and importantly provide a degree of choice and control of the user’s environment. For example, our designs for the replacement hospital at Murray Royal are based on research that utilises the best evidence regarding lighting, acoustics, art, air quality, colour and nature. Our design aspirations for a ‘humanisation’ of psychiatric institutions are carefully balanced by both operational and environmental safety and security concerns. The vulnerability of mentally ill people to both self harm and harm from others, require the consideration of all details and the overall layout to minimise these inherent risks. Patient observation whilst maintaining a sense of privacy is important. Our mental health design for Laureate House, South Manchester encourages patients out of their bedrooms through the location and variety of both interior and exterior, formal and informal, gathering spaces, which encouraged interaction and promoted a sense of connection in this metropolitan joint acute healthcare campus. Over the last few decades mental healthcare has shifted largely to out-reach and community bases, such as GPs and health centres. However there will always be an in patient component required for the most vulnerable individuals. In these cases, attention to design detail greatly impacts de-institutionalising facilities and promoting the core concepts of privacy, dignity and patient choice. For example, in the development of our designs for Royal Edinburgh Hospital’s replacement we worked closely with patient, carer and staff groups to refine the ward plan to allow the choice of gender segregation. Key to this was provision of flexibility of ‘swing’ bedrooms and easy adaptability of day areas, without losing safety of observation. At the new facility at Stracathro Hospital we have provided added flexibility with both ‘swing’ bedrooms and day spaces at the Adult Receiving Ward. Dementia care is expected to be a sector of future growth. We have worked with the University of Stirling’s Dementia Unit to refine our designs for both mental health and elderly care to ensure we incorporate best practice for residents suffering with dementia. At Erskine charity’s ex-service persons many nursing home sites, as well as their main hospital site’s dementia unit, we helped to define the briefs to incorporate not only safe wandering space but also simple and robust detailing and personalisation elements, e.g. own front door.

Tayside Mental Health Developments

We are providing multidiscipline services to the ‘taycare’ consortium which was appointed Preferred Bidder in July 2009 for this £95m new build Mental Health Developments Project at Murray Royal Hospital in Perth and Stracathro Hospital in Angus. Atkins is providing architectural, medical planning, civil and structural, landscape, ecology, acoustics and fire engineering design services for both sites. Together we aspire to deliver the highest possible quality of environment for mental healthcare. The result will be two new state-of-the-art campuses which will facilitate delivery of NHS Tayside’s healthcare model for the communities of Perthshire and Angus for the next 30 plus years. Both sites will create an enhanced patient environment that supports human dignity, wellbeing and growth. The design makes the most of each sites’ best views and aspects. As a consequence of extensive consultations with clinical and technical user groups, patient and community representatives, our design proposals meet NHS Tayside’s requirements for the safe care of diverse mental health patients. At Murray Royal Hospital, the new facilities replace the existing, out-dated Victorian and post war buildings and provide a new expanded mental health service comprising 66 beds in General Adult Psychiatry (GAP), 50 beds in Psychiatry of Old Age (POA) and 67 beds in a Secure Care Centre (SCC) split between medium and low secure wards. The GAP and POA wards are linked through central patient and public support accommodation including ECT / dental suite, outpatients facilities, day hospitals, therapies department and social hub facilities (such as café/dining and shop), providing an integrated campus facility. Due to the security implications, the SCC remains a separate building but connected through a coordinated masterplan to provide a cohesive architectural solution and joined up mental health service. At Stracathro Hospital, the project brings a new, coordinated mental health service to the hospital in replacement of old, out-dated facilities elsewhere within Angus. A 25-bed GAP ward and a 27-bed POA ward are linked in a single building with social and patient support accommodation including day hospital, tribunal services and a gym.

Client: NHS Tayside Location: Murray Royal Hospital, Perth & Stracathro Hospital, Brechin Value: £95m Status: Ongoing Area: 30,000 sqmM

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Concept main entrance of Murray Royal Hospital

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Seafield Residential Care Home

Client: South Ayrshire Council Location: Ayr Value: £6m Status: Complete Area: 2,500 sqm

Atkins was commissioned by South Ayrshire Council in autumn 2007 to provide lead consultant and multidiscipline design services to deliver a new 54 bed care facility, including continuing care and respite/rehabilitation beds, within the grounds of the category B Listed Building Seafield House. Our innovative design was very well received by the client and was also highly commended in the University of Stirling’s Dementia Care Unit’s review. The approved design is arranged in two elements:

The ground floor consists of two dementia continuing care ‘houses’, around two courtyards.•The upper accommodation is Respite and Rehabilitation care, overlooking the northern courtyard.•

On the ground floor, public rooms are wrapped around the central courtyards (alternative therapy, staff and administration, physiotherapy) with ‘pausing’ spaces in-between to provide views in and out of the courtyards. These spaces provide rest and views from the internal wandering routes. The residents’ bed spaces are located on the exterior wall, providing each resident with (supervised) access to the wider landscape of Seafield House grounds. The building massing defines a series of external spaces. The main entrance courtyard is a shared amenity (front garden) and another, located to the rear, provides residents with safe wandering space and a greenhouse (back garden). The building sits low in the landscape, on a very private site, and the design aims to create both internal and external spaces of high quality.

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Concept model for Seafield Residential Care Home

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Royal Edinburgh Hospital Redevelopment

Initially commissioned in 2000, Atkins provided full design services for the complete re-provision of this existing Victorian and post war mental health hospital campus. We developed detailed designs to fully explore the client’s requirements and allow a Design and Build Contractor procurement. We subsequently won the Technical Advisor commission to support NHS Lothian in their revised PPP procurement strategy in 2004. In the development of our designs, we worked particularly closely with the various stakeholder and users groups, with Atkins staff based in the hospital, which give us valuable insight and empathy with both patients and staff in their day-today endeavours. Our architectural solution took advantage of the wonderful views and natural south-facing slope of this greenfield site to maximise both the internal and external environment’s therapeutic benefits for patients and staff. Sustainability issues were intrinsic to the proposals and included thermodynamic modelling to determine solar treatment, zoning for daytime and 24 hour occupancy, natural ventilation strategies, rainwater harvesting and combined heat and power, as well as off-site fabrication for construction waste reduction. The completed project is a replacement of the old Victorian Royal Edinburgh Hospital in Morningside on an adjoining greenfield site to provide a landmark world class healthcare facility. Purpose designed accommodation included main reception hub with social facilities, outpatient departments, care of the elderly day unit, life-skills centre, clinical centre, university education suite and 354 in patient beds. The in patient beds catered for care of the elderly, dementia, general and acute psychiatry, intensive care psychiatry (IPCU), rehabilitation and substance misuse / alcohol dependency. In addition a £5m new build, standalone unit housing Scotland’s national centre for acquired brain injury, Robert Ferguson Unit, was developed for the nearby Astley Ainsley Hospital.

Client: NHS Lothian Location: Royal Edinburgh Hospital Value: £95m Status: Complete Area: 45,000 sqmM

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Concept main entrance for Royal Edinburgh Hospital

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Laureate House

Atkins was responsible for the full multidiscipline design of the new Laureate House, a 77 bed mental health unit at Wythenshawe Hospital South Manchester. The Atkins team consisted of architects, structural engineers, services engineers, landscape architects, healthcare planners and CDM coordinator. The unit comprises of a 28 bed old age psychiatric ward, a 10 bed mother and baby ward, an 8 bed intensive care ward and a 31 adult acute ward. The design for the unit was developed through close collaboration between the Atkins healthcare architects and healthcare planners, the Hospital Trusts’ own healthcare planners and user groups consisting of members of staff and patient groups. The building was designed on the basis that each of the wards comprises of small close knit social areas arranged around a central courtyard, providing formal and informal interaction spaces. Each ward has access to nature via an external garden space specifically designed by our experienced landscape architects to meet the requirements on safety of the differing patient groups.

Client: South Manchester University Hospitals NHS Trust Location: Wythenshawe Manchester Value: £20m Status: Complete Area: 6,000 sqmM

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Entrance to in patients, Laureate House

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Atkins has been heavily involved in assisting the Erskine charity for over ten years. Erskine provides care home facilities, including dementia care, for ex-service personnel, many of whom have a mixture of severe physical and mental impairments, often as a direct result of services for their country. Pre 2000, Atkins assisted Erskine identify that there was a need to develop further facilities which would enable them to meet a growing demand and address the long waiting lists for residential care. In total, they have now implemented five new facilities and a major extension, as detailed below. Our deep empathy and understanding of the operational needs of this vulnerable client group, together with our technical skills, has been pivotal in the successful delivery of these projects. We provided project management, design, technical advisory and CDM coordination services in the implementation of these projects. The projects which Atkins has been involved in to date include:

Location Description Dates Value Area

Mains Drive, Erskine 34-bed new build care home 2004 £3.5m 1,500 sqm

Main Erskine Hospital, Bishopton

180-bed new build care home, including 12 bed Dementia unit.

2006 £16.5m 10,000 sqm

Erskine Edinburgh Home new build 40-bed care home. 2007 £5m 10,000 sqm

Erskine Park, Erskine 44-bed new build care home 2006 £5.5m 2,000 sqm

Erskine Glasgow 46-bed new build care home 2008 £6m 2,000 sqm

Erskine Edinburgh Expansion 48-bed, new build care home, and the first dedicated Army Recovery Centre.

2009 £7m 2,500 sqm

Erskine Nursing Homes

Client: Erskine Hospital Charitable Foundation Location: Various Value: £45m Status: Live Area: VariousM

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Main corridor of Erskine Hospital

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Slagelse Psychiatric Hospital

We were awarded third place in an open design ideas competition for a new mental health hospital in Denmark. The impending construction of this psychiatric facility in Slagelse is expected to be the largest of its kind in recent times in Denmark. It is also anticipated building will make a decisive contribution to the future design of mental health facilities in Denmark. We are hopeful that at the second phase of this competition, we will be invited to submit fuller developed proposals. In particular, the competition jury praised Atkins submission in the following areas:

Flexibility•Reality within an estimated building cost •The variation in landscape scale, from public park to small enclosed courtyards•The variation and scale of the scheme•The variation in the administration and learning areas•

The jury summarised the highlights of our entry as follows:

The design of the hospital arrival points give a very clear and unifying scale and identity for the campus. The landscaping response also demonstrates good variety, especially in its urban public realm balanced with a more private, human scale for users. Security is well considered, with good observation from the upper storey Hub, and few corridors, and where they do exist they are more like rooms, with a series of events and views. The jury liked the park area being pulled right into the heart of the campus, and into each patient unit. The patient unit works well, is flexible and has good relationships internally as well as externally with nature. Each unit includes both a sheltered internal garden, as well as access to the larger overall park area.

Client: Sjælland Region Location: Zealand Denmark Value: NA Status: Competition Area: 45,000 sqmM

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Concept main entrance, Slagelse Psychiatric Hospital

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Reception for New Diabetes Centre and Medical Innovation Development & Research Unit, Birmingham

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Community HealthcareA large proportion of the delivery of healthcare is through community based projects. This is expected to increase in the future as we support the re-focus of health policy, to reorientate the delivery of healthcare away from acute hospitals and into the community, with a more local and socially integrated service model. The General Practitioner (GP) is often the first point of contact into the healthcare system, but increasingly primary and community care nurses and other allied professionals contribute to a multidisciplinary team providing diagnosis and treatment from primary care resource centres. The very same design issues apply to this sector as the whole of healthcare, e.g. process ‘versus’ place; customer focus; public realm; sustainability and partnering. Although the design solutions are often on a smaller scale, they are no less important for the local community in which these facilities reside. Our investment in community healthcare is typified by the recently opened light and airy Gillbrae GP building in Dumfries. Because change is inevitable, due to ever developing medical and technological advances, we provided standardised room sizes and opportunity for easy expansion of up to 40% of the footprint. Robust materials, simple detailing, natural ventilation and daylighting all reinforce our sustainable solution, which was best summarised by “long life, loose fit, low energy”1. For NHS Lanarkshire we developed strategic plans for their whole estate, supporting their vision of new models of care and taking more healthcare out to the community. This included rented retail spaces in local shopping centres, to new state-of-the-art, joint venture inclusive community centres. With OR International (see page 84), we have developed new healthcare delivery methods to assist in waiting time reductions in England. We have just completed our third ISTC facility in Shepton Mallet, Bristol and Devizes. We also worked in partnership with the contractor to develop fast, off-site construction techniques, which minimise waste, site disruption and also infection risks to neighbouring patients. The community healthcare sector will continue to expand and develop, fuelled by demographics and economic pressures. There will be a movement of services from hospital (both acute and mental health) into community settings such as specialist diagnostics, treatment and step-down care; supported by technology (e.g. PACS, telemedicine) and medical advances (e.g. new psychiatric drugs). Increased groupings of like services for instance children, elderly, chronic conditions, and an integration of health and social care will provide a more holistic and accessible service to our local communities.

1 Attributed to Alex Gordon Past President RIBA (1974)

Gillbrae Medical Centre

Atkins provided architectural, building services and landscape design for this new build two storey premises to provide up-to-date facilities and to allow expansion for this local community GP practice. The practice comprises reception and waiting areas, 17 GP and nurse consulting rooms, treatment suite with minor ops rooms, health education room, community offices, training facilities, seminar room and library together with administrative and archive facilities. Facilities were also provided for a pharmacy to be fitted out after occupation of the medical centre. The design required detailed user consultation and the design concept was developed from the following drivers:

Wayfinding: obvious entrances, intuitive and direct routes to all public facilities. •Secure by Design: good observation from reception of the waiting area, patient toilets, interview rooms, GP and nurse •consulting corridors with discrete and secure access to staff-only areas. The GPs were clear that aggression was a low risk issue in this locality, therefore the reception was designed to be open and welcoming.Consulting rooms: this is the “building block” for the GP practice design. Considerations were room proportions, •location of the GP’s desk (both for patient welcoming but also for GP security) views, observation and couch access. A welcoming environment, patient comfort, acoustic separation for privacy, good daylight, natural ventilation, and infection control were all agreed at an early stage, through mock-ups and other media.Flexibility: the building is designed to allow for up to 70% expansion by completion of the courtyard. Internally the •room sizes are standardised and ‘loose fit’ to allow easy adaptability, thus providing a long-term sustainable solution.

The client and developer, Medical Centres Scotland Ltd, set an ambitious brief of design quality, high percentage of useable space (high net / gross floor area ratio), more onerous design and infection control guidance included in the recently published SHPN36: part 1: General Medical Practice Premises in Scotland and a tight budget to meet the agreed rental return. The design team were novated to the principal contractor under a design-and-build procurement route. Although a small building, there were many interested parties including end users (GPs), NHS Dumfries and Galloway (sub-lessees), end user’s project monitor, client, client advisor, district valuer, pharmacy lessee and employer’s agent, all of whom we successfully engaged with appropriate points in the project’s development.

Client: Medical Centres Scotland Ltd Location: Dumfries Value: £2.2m Status: Complete Area: 1,500 sqmC

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Reception, Gillbrae Medical Centre

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NHS Grampian Consultants Term Commission

Client: NHS Grampian Location: NE Scotland Value: £2.5m per annum Status: Complete Area: Various

For almost a decade Atkins has provided a full multidiscipline design service to NHS Grampian Estates and Facilities Management Department in support of their minor works programme across their extensive acute and primary care estate. Over this period our staff established an intimate working knowledge of their estate and at any one time we had up to 100 live projects at various stages of the design and construction process. Working closely with their project officers and clinicians we were sole provider of consultancy services on their maintenance programme and provided a complete package of all design services. Close working relationships were established which enabled us to successfully complete many complex phased projects in live hospital environments whilst allowing the clinicians to maintain delivery of their clinical services throughout the construction period.

Typical framework projects included:

Family Planning Clinic• We provided multidiscipline design services, including interior design for this family planning clinic in the centre of Aberdeen. The building was Category B-listed and the sensitive design of the entrance hall enhanced the qualities of the original Victorian interior. With the use of materials such as glass blocks, oak, and comfortable furnishings, privacy and a relaxed atmosphere was created.

Neonatal Unit, Aberdeen Maternity Hospital, Aberdeen•The neonatal / special nursery unit was one of our many extensions and alterations to Aberdeen Maternity Hospital. Enhanced facilities included ultrasound, new labs, consulting rooms, medical and administrative support services and staff facilities.

Banchory Doctors Surgery•This highly complex major refurbishment and extension project, which was completed in phases, with the erection of temporary decant accommodation, maintained the function of the premises throughout the construction works.

Eastend Kitchens, Foresterhill Hospitals, Aberdeen•Our multidiscipline design team planned the extensive upgrading of this major Grampian facility serving over 3,000 meals per day. Carefully considered phasing and logistics ensured successful delivery.

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Eastend Kitchens, Aberdeen Royal Infirmary

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Anchor Care Homes

This project, which will be built in West Byfleet in Surrey, aims to set a new higher standard for care of frail older people. Our brief was to create a truly unique environment for the care of frail older people establishing an exemplar model for our client, Anchor’s ‘Care Leadership Vision’. This is achieved by increasing space standards, providing higher levels of specification, offering a variety of socially supportive and recreational facilities within an integrated landscape, all of which were incorporated into our exemplar design. Our design delivers the client’s vision of care, but also deals with the challenges of developing on green belt land. Our initial communication of the design concept to the local planning authority was simply leaves set within the landscape. These were developed through the design into a series organic building forms with low green roofs and timber solar shading that are quietly integrated into the overall landscaped setting. Building on the work of this innovative exemplar concept design, the client plan a series of similar high quality developments which will be rolled out across the country.

Client: Anchor Trust Care Leadership Location: West Byfleet, Surrey Value: £20m Status: Current Area: 10,250 sqmC

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Concept masterplan of Anchor Care Homes

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Spire Shawfair Park Hospital

Client: Spire Healthcare Ltd Location: Edinburgh Value: £12m Status: Complete Area: 4,000 sqm

Spire’s latest hospital is constructed in a new business park near to the Edinburgh Royal Infirmary and acts as a satellite facility for their successful Murrayfield Hospital. Atkins undertook civil and structural engineers and building services for the first phase of this development. It sits on a greenfield site in the new Shawfair Park in Edinburgh’s South East Wedge development area. Despite being on a flat, greenfield site, the ground conditions provided a technical challenge. Several levels of mine workings are thought to exist directly below the plot. The shallower voids needed to be grouted to stabilise the underlying rock. Sustainable drainage from the low lying site is fed via porous paving, through filter trenches into attenuation tanks before discharging into a purpose built pond. The pond is part of a chain of water quality improvement facilities throughout the new development area. The structure is a two storey steel frame supporting roof-mounted plant. The floor slabs absorb vibration and sound at the sensitive areas of the internal accommodation. The hospital includes linear accelerators housed in dense, radiation-absorbing structures. All aspects of the site layout, infrastructure, foundations and superstructure have been designed sustainably and allow future phases to be easily plugged on as demand increases, while maintaining maintenance and emergency access and egress routes. The site layout also have the ability to facilitate the movements of a mobile PET (Positron Emission Tomography) scanner vehicle which makes weekly visits to provide further specialist diagnostic facilities. Our low carbon design approach provided an energy efficient building which allows high levels of user control and ease of maintenance through maximisation of natural ventilation and daylighting. With whole life cycle costs at the forefront of the building services system designs and installation / replacement methodology throughout the process, the final solution is cost effective and sustainable, which goes beyond current legislative energy and carbon targets.

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Front elevation of Spire Shawfair Park Hospital

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Peninsula Dental

Atkins provided building services engineering and CDM coordinator services for two discrete developments which form the Peninsula Dental Schools’ new teaching establishments at Devonport, Plymouth and Treliske Hospital, Truro, Cornwall. Each of the Dental Schools are self contained developments including teaching and training space to full NHS HTM standards for 48 chairs arranged in 5 dental clusters in addition each facility has a sterile services department. The Devonport project is constructed on the site of the Cumberland Centre Hospital and is a discrete three storey building whilst the Truro development is a four storey building which includes two storeys of medical research laboratories, formed as an extension the Knowledge Spa at Treliske Hospital. Both of these technologically innovative projects were designed utilising sustainable, low carbon principles, including ground source air ducts to temper the air intake, thus reducing energy input to the mechanically ventilated clinical spaces. Most spaces, however were naturally ventilated where practicable, and natural lighting was optimised throughout.

In the post-occupancy evaluation assessment, it was confirmed our Truro design achieved a BREEAM ‘excellent’ rating.

Client: Royal Cornwall NHS Trust and Plymouth NHS Trust Location: Plymouth and Truro Value: £14m Status: Operational Area: 5,000 sqmC

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Main reception of Peninsula Dental

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New Diabetes Centre and Medical Innovation Development & Research Unit

Atkins was commissioned as architect to develop this specialist outpatient and medical research facility on the site of a demolished Victorian ward block. It forms the first of a number of research and development buildings that the Trust is seeking to develop under the Outline Planning Approval granted in 2006 for a Medi-Park campus extension to their current hospital site. The building, situated on the Heartlands Hospital site, will provide day care for diabetes patients and state-of-the-art research facilities for the Medical Innovation Development & Research Unit (MIDRU). This creates a National Centre of Excellence to combine clinical and scientific expertise in the development and evaluation of advanced technology / materials infection control. The facility includes a number of passive and active sustainable design features, including increased insulation, rainwater harvesting, solar water heating and ground source heating. The central double storey atrium running the length of the building forms a central circulation concourse and waiting area, providing access along the spine of the building to natural daylight and natural stack ventilation.

Client: Heart of England NHS Foundation Trust Location: Birmingham Value: £8.5m Status: Complete Area: 4,000 sqmC

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Main entrance of New Diabetes Centre and Medical Innovation & Research Unit

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Interior of Life Science Innovation Centre, Aberdeen

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Biomedical and Research Laboratories present particular challenges to designers as we are often designing for processes that are still experimental and for technologies that are still in the development phase. Atkins has designed laboratories for the National Health Service, Universities, and many national and international private clients. Our approach is to listen closely to our clients in the briefing phase so that we really understand all the laboratory processes and operational requirements. We pay particular attention to how the laboratory equipment is to be installed, serviced and maintained through the whole life of the building, thus helping to ensure that the facility remains flexible to changing requirements. The whole building needs to be flexible to facilitate the dynamic nature of research. And so we keep listening throughout the design development phase, using design tools that reflect the design back to the client so that the agreed design solution is fully understood and bought into by staff. Laboratory buildings are required to comply with a complex range of building standards and stringent codes to ensure safety and security for both the public and the users of the labs. We understand the regulatory framework and will design safe, efficient, secure, comfortable and ergonomic environments. This design approach extends to the areas beyond the primary work zones. So we design peaceful sanctuaries for staff rest areas and for training and management. We are confident of our ability to engage with a diverse range of end users in order to translate highly complex briefs into functional and delightful working environments.

Paul O’Gorman Leukaemia Research Laboratory, Gartnavel Hospital

Atkins provided multidiscipline design services for a new medical laboratories building for NHS Greater Glasgow at Gartnavel General Hospital. The building, which is partially owned by Glasgow University, accommodates Oncology, Immunology and Haematology laboratories together with a Leukaemia Research Fund Centre for the University. This new state-of-the-art facility brings together previously disparate departments which were spread across the city, into one centralised, functionally efficient, modern building. The location is publically prominent, at the edge of the Victorian, Listed Gartnavel Hospitals site, and highly visable across the pond from the main artery, Great Western Road. The building comprises three simple architectural elements – a copper box, a ground floor plant enclosure below, and a blue tube plant room above. Each of the main three ‘copper box’ floors are designed around fabulous views across the pond to the Campsie hills, with a large open plan laboratory to create a communal village centre, and all associated specialist support rooms or restful staff accommodation arranged immediately off. Our in-house architects, building services and structural engineers jointly developed highly efficient designs for the integration of complex and innovative services, structure and fabric in this technically challenging project. At the same time they realised a design which is both aesthetically pleasing for passers-by and most importantly, an enjoyable place to work in.

Client: NHS Greater Glasgow & Clyde / University of Glasgow Location: Gartnavel Hospital, Glasgow Value: £7m Status: Complete Area: 2,500 sqmBi

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Pond elevation of Paul O’Gorman Leukaemia Research Laboratory

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Life Science Innovation Centre

In 2007, Atkins was commissioned to provide multidiscipline design services for the new Life Science Innovation building adjacent to the Aberdeen Royal Infirmary, for the University of Aberdeen. Initially, the unit was to be designed for multi-let occupancy, however the University soon attracted a single tenant, Wyeth Research. The design of the building was then modified to accommodate their specific requirements. Wyeth is now part of Pfizer, the largest pharmaceutical company in the world, with an R&D budget of the order of $7 billion dollars annually. Their Aberdeen facility, partly funded by the Government Development Agency, Scottish Enterprise Grampian, will work with shark antibodies to create drugs to help the fight against Alzheimer’s. The building is fully serviced to the requirements of a class 2 laboratory. Specialist services including cryogenics, fully integrated and automated Building Management Systems, Lighting Management Systems and Enthalpy Controlled Air Conditioning, were designed for the space. Energy efficiency was at the heart of Atkins’ design, thus allowing the project to receive a very good BREEAM rating, and a 20% carbon footprint reduction against a notional building of the same type. The building contains four main laboratories, ranging from general aseptic areas to finite protein purification labs, involving fume scrubbing and bio-hazard containment plant. This state-of-the-art project was delivered within the programme and budgetary requirements of the client.

Client: University of Aberdeen / Wyeth Research (part of Pfizer Inc) Location: Aberdeen Value: £3.2m Status: Complete Area: 1,025 sqmBi

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Exterior of Life Science Innovation Centre

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Tepnel Life Sciences

Tepnel Life Sciences is a provider of outsourcing services for the UK pharmaceutical, biotechnology, and healthcare industries. With specialist design and build contractor Thermal Transfer, Atkins provided architectural design services for this new build facility in Livingston’s Eliburn Campus. The facility comprises laboratories, incubator rooms, instrument rooms, administration areas, boardroom, with provision of future expansion. Key features of our innovative design are the ‘racetrack’ of glazed circulation to allow the client to take visitors on a full tour without disturbing activities or cross-contaminating sterile facilities, and the cross section developed to efficiently distribute ventilation throughout the building. The campus setting of the facility is enhanced by the adjacent pond and the open countryside beyond. The grouping of respite accommodation and expansive glazing are specifically designed to take advantage of the best views and aspects from the site.

Client: Thermal Transfer Location: Livingston Value: £4m Status: Complete Area: 2,000 sqmBi

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Main entrance of Tepnel Life Sciences

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Regional Radiation Physics Protection Service

The RRPPS was set up in 1949 as a radiation protection advisory service and has since expanded making it one of the largest NHS commercial providers of personal dosimeter services in the UK, whereby records are maintained for more than 70,000 employees of both public and private sector organisations. The service had to be relocated within a very tight timescale, to alternative premises, off the main acute hospital campus, as part of the overall construction plan for the Birmingham New Hospitals (JV) PPP works . Following a feasibility exercise undertaken by Atkins and Faithful+Gould in the early part of 2008, Trust board approval was given to proceed with relocation of the service to a Business Centre estate. Atkins was then asked to advise on potential P21 PSCP partners and were subsequently appointed by the Trust’s appointed PSCP, Integrated Health Partnerships, to provide a full architectural and lead consultant service to take the project through to completion. The decision was taken to redevelop an existing warehouse unit to allow for the subdivision of space at ground floor level, the addition of a new first floor mezzanine level and the reconfiguration of the external envelope to incorporate new fenestration and access doors. This required obtaining Landlord’s Licence to Alter and West Midlands Counter Terrorism and Environment Agency approvals in addition to the statutory planning and building regulations approvals. The RRPPS accommodation comprises, in the main, specialist equipment calibration rooms which utilise x-ray equipment and radioactive sources ,an electronics workshop and a fully digital dosimeter analysis and report suite all with associated administrative, staff amenity and training areas. In addition, the facility had to accommodate the IT back-up Hub to the main hospital site and provision of ‘white space’ for future expansion.

Client: University Hospital Birmingham NHS Foundation Trust Location: Queen Elizabeth Medical Centre Value: £3.2m Status: Complete Area: 1,800 sqmBi

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Exterior view of Regional Radiation Physics Protection Services

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Blood Transfusion Service National Term Framework

We were initially appointed for a three year term framework agreement in 2003 to provide multidisciplined services to address the back-log maintenance and refurbishment of various Blood Transfusion Service’s properties across the country. Following on from our successful refurbishment of the Bridle Path Centre, Leeds in early 2004, our current appointment has been extended and we have now completed over forty further projects with a total construction value of approximately £11 million.

Typical revenue refurbishments works have included: upgrades to specialist laboratories, conversion of existing offices to specialist laboratories; relocation of Liquid Nitrogen Stores; clinical waste conversion; creation of new donor suites; refurbishment and conversion of office accommodation.

Specialist laboratory projects examples are: Stem Cell, Bacterial Screening or the PTI Laboratories, responsible for ‘Processing, Testing and Issue’ of blood and blood products, plus general upgrades to incorporate streamlined work flows and new ‘Best Practice’ laboratory guide lines; Typical maintenance works have included: new generator and air conditioning replacement; heating and cooling repairs and replacement; roof and structural repairs; lighting and benching upgrades.

We have also provided various nationwide surveys on the Blood Transfusion Service’s estate. These began in 2005 with a Disability Discrimination Act (DDA) Audit, followed by a space planning exercise and most recently a full condition survey.

Separate to the above contract, we have also delivered several technologically innovative projects for the Scottish National Blood Transfusion Service. These include the £6 million flagship Regional Headquarters in Glasgow; Regional Transfusion Centre and Haematology Unit, Inverness; Blood Transfusion Regional Centre, Aberdeen; Protein Fractionation Centre, Edinburgh and most recently the £7 million Paul O’Gorman Leukaemia Research and Laboratories, Gartnavel Hospital, Glasgow, please refer to page 66 for more details on this project.

Client: Blood Transfusion Service Location: Various – National Term Framework Value: Various - £60,000- £1.5m Status: National Term Framework Area: VariousBi

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Exterior of Scottish National Blood Transfusion Regional HQ, Glasgow

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Concept masterplan for Dubai Health and Wellness Centre

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International and IndependentHealthcareAs you would expect from a global organisation like Atkins we have a healthy portfolio of both non-UK and non-NHS projects. At the turn of the 21st century growth in the Middle East saw our involvement in healthcare design throughout the Gulf. Exciting concept designs for Al Zahra Hospital in Dubai built on our experience of designing flagship commercial buildings for our clients in the Emirates. In Doha we assisted with the preparation of the functional programme brief for the new Cardiology Centre, and we were responsible for design delivery for the Cardiology Centre in Awali, Bahrain. Other projects have followed as we have demonstrated our ability to integrate our understanding of local culture, environment and knowledge of local legislation and technical standards, with our international experience of best practice and emerging healthcare models. As well as designing to local or UK standards when required, we are often asked to design to the US Healthcare building codes. This experience helped us win competitions such as the design of a hospital in Kazan in Tatarstan, Russia and masterplanning of a hospital in Libya. A long-standing client of ours is the Ministry of Defence (MoD) for which we have designed a modern replacement for the Royal Naval Hospital in Gibraltar. This new Princess Royal Medical Centre opened in 2008, and in contrast to the grand old traditional hospital, it is a modern, integrated primary care-led healthcare model for the Joint Services Healthcare Service. Atkins has undertaken a number of innovative projects for Defence Estates in the colony and beyond, including a hospital in Kosovo. Designing for emerging models of healthcare is standard practice for us but sometimes we are asked to tackle highly unusual concepts in healthcare. One unique project was when we assisted the MoD with specifying a potential new type of hospital ship. This project was entitled the Joint Casualty Treatment Ship, designed for deployment close to action zones and also for relief in civil emergencies. The project brought together Atkins experience in Defence with our healthcare expertise to develop innovative technical solutions.

Al Zahra Hospital

We developed concept designs for this new 200 bed flagship hospital for Al Zahra Hospitals, one of the foremost providers of private healthcare in the Gulf. Al Zahra proposed to expand their presence in Dubai with the highest quality design solution for a technologically advanced hospital on a premier site close to the famous Jumeriah beach. The hospital was designed to be built in phases and to expand, even to potentially double in size in the future. The clinical facilities include: an emergency and trauma centre; critical care unit; operating theatres; imaging, specialist investigations and treatment suite; an obstetrics suite and special care baby unit. A particular feature of this private hospital was the creation of various ‘Clinical Institutes’ with specialist outpatient and in patient areas integrated with one other on the same level. Full support facilities are provided including laboratories, sterile services, catering and residencies. Discrete, back of house servicing was achieved by a below ground service road adjacent car parking, and an interstitial middle ‘service’ floor. The emergency and investigative / treatment areas provide easy accessibility on the lower floors while the clinical institutes occupy the upper floors, affording dramatic views over the beach and to the Arabian Gulf. The overall campus, which also comprises residential and research facilities, is architecturally bound together by a seven storey “spine” which unites the various departments and services therefore facilitating orientation, wayfinding and circulating routes for patients, staff and visitors.

Client: Al Zahra Hospital Location: Dubai Value: £55m (UK equivalent) Status: Concept Design Area: 35,000 sqmIn

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Concept elevation, Al Zahra Hospital

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Kazan A&E Hospital

Our winning design for a limited international competition, Kazan Accident and Emergency (A&E), is the conceptual design of Kazan Hospital No 1, a world class A&E facility for the citizens of Kazan, the capital of the Republic of Tartastan, third capital of Russia. Atkins’ winning concept is based on projecting a caring, maternal and organic image for the hospital, in contrast to the stereotypical brutally clinical / functional appearance of existing healthcare facilities. The diagram of ‘mother and child’ was developed, based on a number of sculptures and works of art and was carried throughout into the spatial planning of the hospital. Symbolically the most critically ill patients are protected and encompassed by the more able, which also works functionally for the hospital by placing the most heavily serviced components centrally. The value of the external environment in contributing to the recuperation of patients is reinforced by the integration of landscape and courtyards while the soft curves and organic forms break the clinical stereotype.

Client: Tatarstan Government Location: Tatarstan, Russia Value: £72m Status: Awaiting government approval to proceed Area: 72,000 sqmIn

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Concept sketch, Kazan A&E Hospital

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Princess Royal Medical CentreBefore a solution could be designed for a new building, a new model of healthcare delivery for the Joint Services in Gibraltar had to be envisioned. This involved the modernisation and integration of primary and secondary care services for servicemen and women and their dependants. The Princess Royal Medical Centre replaces both a hospital and a cramped GP and social work centre at opposite ends of the Gibraltar Rock. The new combined facility is located within the Devil’s Tower Camp adjacent to the airport. The facility provides consulting rooms for the extended primary care team, treatment rooms and dental surgeries grouped around a core reception and waiting area. On upper levels there is an operating theatre and recovery suite, in patient wards, paediatrics, obstetrics, radiology, pathology and minor injuries / emergency receiving facilities. The service population on the island is small, so each of these facilities is of the smallest possible scale. The challenge was to devise a sufficiently sophisticated solution at this small scale to allow the service to support any level of illness or injury until safe evacuation to the UK can be achieved. Other ancillary accommodation includes a dedicated sterilisation suite, stores, workshops, offices, staff rooms, laundry, library and mortuary which allow the facility to operate as a self-contained environment. Atkins provided a full multidisciplinary design service and the contract was administered using the DEFCON 2000 Conditions of Contract and included management of the migration of equipment and fittings from the existing Royal Naval Hospital (RNH) to the new PRMC. This project exemplifies Atkins’ core ability to assemble resources from the broad range of expertise and capability that exist in the company to deliver a total and coherent end-to-end service. For example:

Atkins’ in-house medical planning team supported the MoD strategic process, bringing their experience of innovative •healthcare delivery models such as nurse-practitioner led and ambulatory care models.Atkins’ healthcare architects then developed the brief into estate provision options that could then be benchmarked •and tested by Atkins’ cost, value and risk specialist, Faithful+Gould.Atkins also made use of their FM expertise to assess risk and develop a planned maintenance plan for the existing RNH •estate and its assets to ensure that spending on its upkeep was optimised to the programme for its replacement by the new facilities.Finally, Atkins’ healthcare architects and engineers completed the detailed design for the new integrated healthcare •facility and are making preparations to manage its implementation with the transfer of primary and secondary care of services.

Client: Ministry of Defence Location: Gibraltar Value: £15m Status: Operational Area: 2000 sqmIn

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Princess Royal Medical Centre in front of the Rock of Gibraltar

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Independent Healthcare OperatorsThe independent sector within the UK is often at the forefront of new models of care or technologies. At Atkins we developed the first of the new type of Independent Sector Treatment Centres for UK Specialist Hospitals Limited. Healthcare operators in the independent sector are often keen to challenge established practice in healthcare and it is invigorating for us to work alongside our clients in developing new solutions and models. When the ground-breaking work on new models of healthcare is proven, we are often asked to roll out the new model to several different locations. This is the case for Erskine Charitable Foundation, Anchor Care Leadership, and for OR International, where we have recently completed two further ISTC facilities at Emerson’s Green and Devizes in South West England. A long-standing client of ours is the Ministry of Defence (MoD) for which we have designed a modern replacement for the Royal Naval Hospital in Gibraltar. This new Princess Royal Medical Centre opened in 2008, and in contrast to the grand old traditional hospital, it is a modern, integrated primary care-led healthcare model for the Joint Services Healthcare Service. Atkins has undertaken a number of innovative projects for Defence Estates healthcare facilities over the years in the UK, Cyprus and Kosovo.

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Main entrance of Independent Sector Treatment Centre

Independent Sector Treatment Centre

Atkins formed a consortium with OR International, an American developer of speciality hospitals, and New York - Presbyterian Healthcare, one of the leading healthcare providers in the United States, to take forward the development of the new Independent Sector Treatment Centre (ISTC) at Shepton Mallet, which will carry out some 11,000 operations each year. Designed to provide additional capacity for NHS patients and so contribute to reducing waiting lists, the technically advanced centre was one of the first of its type in the UK. It focuses on hip, knee, cataract and general surgery and serves residents within a 40-mile radius. A highly accelerated programme was needed to allow our client to meet the demands of its contract with the NHS. The centre achieved practical completion only 10 months after starting on site and was handed over both on time and in budget. Our team was responsible for the project management, healthcare planning and concept design that enabled this “superfast-track” design and construction. Our multidisciplinary capability also allowed us to provide architectural, mechanical and electrical services design, building specifications, IT systems design and installation, planning supervision and quantity surveying. Following Shepton Mallet’s success, Atkins has subsequently delivered two further ISTCs with this client.

Client: UK Specialist Hospitals Limited Location: Various Value: £12m Status: Operational Area: 1,200 sqmIn

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Main entrance of Independent Sector Treatment Centre, Devizes

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Cork Medical Clinic

The Cork Medical Clinic is a major private healthcare facility located on a prominent but steeply sloping greenfield site on the outskirts of the city of Cork in the Republic of Ireland. The site enjoys dramatic views north to the city of Cork and along the N71 valley to the South West. The hospital incorporates the latest technological advances in healthcare treatment facilities and in advanced IT support systems such as electronic medical records. The project has completed masterplanning and design for the planning application. Designed to maximise the potential to treat patients as day patients or with minimally invasive treatments, the clinic also has 78 in patient beds including nine intensive care beds and in patient operating theatres. The ambulatory care zones have suites for imaging, radiotherapy and same-day surgery, and there are 28 consulting suites available to lease by local consultants. The site has a range of support accommodation including kitchen and dining facilities and conference suite. Our design includes 450 car parking spaces, service roads, landscaping and utility authority infrastructure. Atkins’ concept design developed three functional zones – patient accommodation, clinical service and consultant, linked by a central circulation spine. This approach provides clarity for the visitor and patient, and also allows a clear servicing strategy to be developed to meet the differing demands of each functional grouping. The building form has been developed in response to the demands of the site with consultant suites located in the curved element to the western boundary to respond to the natural forms of the site boundary to the West, and with conferencing and administration functions on the upper level, which take advantage of the views off the site. Our building services design is as innovative as the healthcare model and incorporates renewable energy technologies including ground source heat pump, photovoltaic and solar panel arrangements to reduce energy consumption and contribute to an environmentally sustainable design.

Client: Sheehan Medical Location: Republic of Ireland Value: £50m Status: Complete Area: 12,000 sqmIn

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Concept courtyard design, Cork Medical Clinic

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Dubai Health and Wellness Centre

Atkins’ client, Dubai Healthcare City’s (DHCC) vision is to be the internationally recognised location of choice for quality private healthcare and the premier, integrated centre of excellence for clinical and wellness services, medical education and research in the region. The Wellness Centre is a separate 19Ha campus, located on the extended Dubai Creek, which will compliment the healthcare service offerings of the DHCC main Medical Centre. The two centres together aim to create a full healthcare continuum where patients can receive a holistic array of services. The DHCC Wellness Centre will include the following zones: hospital, outpatient clinics, healthcare education facilities, hotels, spa resorts, long-term care facilities and residential areas. Atkins is delighted to have won this exciting opportunity, and is currently developing the masterplan and sustainable concept design with the DHCC team.

Client: Dubai Healthcare City’s (DHCC) Location: Dubai Value: Confidential Status: Ongoing Area: 19 HaIn

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Concept masterplan, Dubai Health and Wellness Centre

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“ I have found the advice and guidance provided [by Atkins] to be particularly well considered and researched.

Their professional approach and deep understanding has allowed me to concentrate upon my vision for Erskine, of delivering the best quality care environment for ex-service men and women. “

Colonel Martin F Gibson OBE DL Chief Executive

Erskine Nursing Homes

Sketches from left to right, from top:

Murray Royal Hospital, Perth; Kazan A&E Hospital, Russia; Independent Sector Treatment Centre, Shepton Mallet; Life Science Innovation Centre, Aberdeen; Royal Edinburgh Hospital; Crosshouse Hospital, Kilmarnock

Contact:

Ian Tempest200 Broomielaw, Glasgow, G1 4RU

Tel: +44(0)141 220 2000Web: www.atkinsglobal.comEmail: ian.tempest@atkinsglobal.com

© Atkins Ltd except where stated otherwise.The Atkins logo, ‘Carbon Critical Design’ and the strapline ‘Plan Design Enable’ are trademarks of Atkins Ltd.