The Building Better Healthcare Awards honour excellence and innovation in healthcare, highlighting projects that enhance patient experiences and outcomes. As part of our winner spotlight series, we're featuring exceptional initiatives that exemplify collaboration, creativity, and impact. In this edition, we showcase one of the 2024 winners, Medical Architecture, and its patient-focused approach to transforming healthcare and driving progress across the industry.
What motivated you to participate in the Building Better Healthcare Awards, and how did you anticipate they would benefit your projects?
Participating in the Building Better Healthcare Awards is always something we value, as the quality of entries is consistently high, and the judging process is carried out rigorously by a panel of respected judges. Receiving the judge’s recognition is therefore a great way to celebrate the success of a project with all those that have played a part, from inception to completion.
The submission process also provides the opportunity to bring the project team and the client together to reflect on the journey of delivering the building, to evaluate the early feedback and indicators of performance, and to identify the key lessons that can be shared with the industry.
Could you share more about the winning project, including its goals and key elements involved in bringing it to life?
Sycamore is a new medium-secure mental health facility providing inpatient accommodation for 72 male patients with a range of forensic mental health needs, including complex personality disorders and/or learning disabilities.
In secure mental health inpatient units, boredom leads to challenging behaviours and poor physical health. Following clinical engagement, the facility was devised as a ‘village campus’, providing a wide variety of indoor and outdoor settings for relaxation and activity, ensuring a meaningful day for patients.
Six patient wards are paired together and arranged around a large recreation courtyard. This forms a secure boundary without the need for high fences and the feeling of confinement they can create. To be inclusive of patient needs, the courtyard is separated into a ‘Passive Zone’, with restful spaces, and an ‘Active Zone’, with a 200m jogging/walking loop, social table tennis area, basketball court, mini-tennis court, and a fitness ‘trim trail’, to promote physical activity and the associated wellbeing benefits.
With rich landscaping and integrated security measures, this shared space does not feel like a typical forensic mental health facility. Additionally, ward bedrooms are arranged to face outwards, with views to the surrounding mature woodland. Abundant daylighting, attractive views and a sense of spaciousness contribute to the therapeutic qualities of the environment and play an important role in patient health, wellbeing, and rehabilitation.
What has been the most valuable lesson or insight you gained from working on this project?
Designing buildings for forensic mental health is niche and decisions made at early concept design require a different way of interpreting the brief, compared to how we approach more ‘standard’ healthcare projects. The clinical and estates teams were at the table with us right from the outset; we all recognised that it was essential to agree the new facility’s security strategy before anything else, as this would inevitably influence every design move.
At masterplan level, this included agreeing the overall secure site boundary, being very conscious of how this fit within the landscape of the site and how it would appear to visitors and the wider community as a first impression of the facility. This then led to agreeing required access points into the secure perimeter and an understanding of site-wide movement of people and vehicles, within and outside of this secure line.
Once this was established, the placement of each of the buildings, and understanding their relationship between, and to each other, started to fall into place.
Aligning medium security and safety with a domestic or therapeutic feel is not easy; with a growing number of patients increasingly volatile and severely unwell, design decisions become more risk averse. This can detrimentally affect the architecture, which, in turn, impacts the patient environment, and ultimately, their recovery.
Our concept of creating a meaningful day for patients was retained at the forefront of everyone’s minds, and this, balanced with the agreed security needs, ensured that the resulting building was not compromised in appearance or function.
In your view, how have the Building Better Healthcare Awards influenced your projects or your organisation's direction?
It is important to note that we believe the measure of a building’s success should not be on the number of awards won. The ultimate measure should be on the lasting positive impact of the building on those that use it and experience it, and on the planet.
However, we like to think that winning a Building Better Healthcare Award indicates an approach to building a design that is thoughtful, stakeholder-led, and evidence based, in the pursuit of a positive impact
We also believe that our organisation’s direction is influenced first and foremost by our desire to create therapeutic environments that promote wellbeing and recovery, with a focus on sustainable impact. Success in the Building Better Healthcare Awards, does however provide the encouragement that we are on the right path.
What impact has your project had on patients or healthcare delivery since its implementation?
The first patients moved into the building in October 2023, and the feedback since has been extremely positive. Shortly after the opening, John Carson, Head of Capital Development at NTW Solutions, said: “This has been a fantastic scheme to deliver for CNTW and there was a true team spirit with all involved, especially with the clinical teams on site. That teamwork has paid off and it is inspiring to see the unit in use and heartening to hear the early feedback from clinicians about the quality of the accommodation."
"This is a flagship development, and it has set a new standard, not just for our future projects but for the whole mental health sector,” Carson added.
During a six-month post-occupancy review, Dennis Davison, Associate Director, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, provided this feedback: “The building is doing everything we had hoped for. The patient experience has vastly improved. Patients are more active; they have more choice and opportunities. We are running 80 activity sessions per week, including tournaments, fun runs, and Sports Relief events. The building has shown that it can cope with the physical demands of the patient group, and this has given staff confidence in the environment.
"The detailed twelve-month post project evaluation report highlighted consistently high scoring against a range of metrics including the quality of the patient and staff experience, safety, sustainability and service user satisfaction."
Can you highlight any innovative or unique aspects of your project that set it apart?
One of the most innovative aspects of the building’s design is the variety of spaces, both inside and out, which provide opportunities for mitigating boredom. This is achieved in a range of settings that can be accessed autonomously, from bedrooms to living spaces, and sheltered gardens to open courtyards, with opportunities for both structured and unstructured sports and activities. The focus is on providing choice, with consideration for patients who are at different stages of their recovery, or that are experiencing different levels of comfort towards social interaction.
For example, in creating the design for the large central recreation space, landscape architects, Colour, drew reference from prospect-refuge theory. Originally developed by geographer-poet Jay Appleton in 1975 to explain preferences for certain landscapes, the theory proposes that most people have an “inborn desire” for environments that allow the capacity to observe opportunities (prospect) from a place of safety (refuge).
With this in mind, the courtyard is separated into two distinct character zones—‘Passive’ and ‘Active’. The ‘Passive’ zone provides opportunities for ‘refuge’, with restful places to sit amongst plants and grasses. These smaller-scale spaces offer a sense of enclosure, combined with views out to the wider recreation area to provide gentle enticement into the activities offered. The ‘Active’ zone includes a range of facilities for physical activity, as well as a collection of personalised paving markers with local reference points displaying motivational messages and distance indicators to encourage goal setting.
To provide patients with additional choice of open or private spaces for activity and wellbeing, at the centre of each ward, a private landscaped courtyard for relaxation is provided, and between each ward pair is a designated activity courtyard. Patient bedrooms also feature bespoke fitted furniture to assist with personal workouts.
The Building Better Healthcare Awards continue to champion innovation and excellence across the sector. With entries for the 2025 edition opening in March, don't miss your chance to showcase your network - sign up for the newsletter to stay updated and be a part of the conversation.