The Managing Director of HKS, Francis Gallagher, and the Partner and Regional Practice Director of Health at HKS, Jane Ho, talked to Building Better Healthcare about co-designing one of the most advanced hospitals in Europe at approximately the cost of over £900m.
Balfour Beaty was the construction contractor on this project
HKS collaborated with fellow UK-based architectural firms Cagni Williams and Sonnemann Toon Architects on this groundbreaking project.
Balfour Beaty was the construction contractor on this project.
The new Midland Metropolitan University Hospital
The Midland Metropolitan University Hospital, part of the New Hospital Programme, is now the largest acute care hospital in the West Midlands, bringing together acute and emergency care from two separate hospitals into one centralised hub.
The eleven-storey hospital spans 84,000 sqm and provides a purpose-built emergency department with imaging and diagnostic services and a dedicated children’s emergency department and assessment unit.
The Midland Metropolitan University Hospital, part of the New Hospital Programme, is now the largest acute care hospital in the West Midlands
The new hospital provides over 700 new beds with half of inpatients being cared for in single rooms with ensuite bathrooms.
Further, single occupancy rooms allow for easy adjustment to accommodate additional levels of isolation if required. Individual patient rooms and bays have also been designed to promote patient safety and ease of visibility for staff.
The new Midland Metropolitan University Hospital also includes:
- 13 operating theatres for emergency, planned, and maternity surgery.
- A midwife-led birthing unit and delivery suite
- Two maternity wards and antenatal services
- A neonatal unit
- Same-day emergency care for adults
- A regional sickle cell and thalassaemia centre
Uniquely, the hospital also includes two levels of car parking space below the building.
The state-of-the-art facility will also be a community regeneration catalyst in an area with high levels of deprivation
"It's a great use of land, as opposed to having a separate car park that would take up a lot of space. By tucking it underneath the building, we were able to take advantage of the slopes and topography on this site; one part of the site was seven metres lower than the road level, which allowed us to do this. I think it's a real benefit," Managing Director of HKS, Francis Gallagher, explained.
The state-of-the-art facility also serves as a community regeneration catalyst in an area with high levels of deprivation, according to HKS.
"This had to be more than a normal hospital. It had to give something back to the locality," Gallagher said.
Cross section: Midland Metropolitan University Hospital
The design of Midland Metropolitan University Hospital
With future-proofing the hospital in mind and to optimise flexibility, the hospital design is based on a single structural grid, which accommodates a wide range of clinical and functional spaces that can be easily adapted for future expansion.
"The structural grid within this project is a regular grid flow, with a 7.8m by 7.8m grid from the car park to the podium, to the wards, and what this allows the trust to do is adapt and change the hospital throughout time because the grid is so uniform. They can change departments. They can reuse them rather than worrying whether they can do that or not in the future.
"So this was all in our mindset, initially, to make sure that everything was as efficient as possible and could be adapted as healthcare projects need to as we go through time," Gallagher explained.
The building’s external envelope facade materials are also organised by vertical elements to break up the building mass and reflect the rhythm of the structural grid
"You normally have the structural grid, but when you're planning internally for a clinical planning grid, we wanted to make sure that both were tied in together so that you can get your car park space, your imaging has certain sizes of rooms, and your operating theatres have certain sizes of rooms that we have to adhere to with design standards.
"So we were trying to make sure that all stacks up, and then bedrooms are obviously a bit smaller than operating theatres. So, we're trying to stack all those up and trying to create that efficiency vertically up the building as well.
"So to really be rigorous with that was certainly a lesson for us all to learn to make sure that we stuck with it for the future planning, future resiliency of the project," the Partner and Regional Practice Director of Health at HKS, Jane Ho, added.
Further, the building’s external envelope facade materials are also organised by vertical elements to break up the building mass and reflect the rhythm of the structural grid.
Site plan: Midland Metropolitan University Hospital
Technology
The single structural grid can also support the delivery of new service models and working practices as medical technology and acute healthcare needs evolve.
"We [were] designing for the specialist equipment in the spaces according to the worst case scenario; trusts pick their equipment slightly later and so we were always trying to plan ahead for that because technology is always changing. The structure and the space of the building had to also allow for future adaptations when the equipment is renewed in seven to twenty years. The design had to make sure they could get the equipment in now and in the future," Ho explained.
The single structural grid can also support the delivery of new service models and working practices as medical technology and acute healthcare needs evolve
One of the specialist technological equipment that the design team considered was the Da Vinci Robotic Surgical System, which the Trust planned to put in theatres.
The Da Vinci Robotic Surgical System will enable surgeons to perform minimally invasive procedures with a greater range of motion and improved visualisation.
In the design of Midland Metropolitan University Hospital the team also considered the robotic pharmacy in the hospital as well.
The Winter Garden and other green areas
Midland Metropolitan University Hospital’s Winter Garden covers five floors across the east-facing side of the building.
The garden provides a bright and modern arrival point to the hospital with transparent lift cores, stairwells and walkways, which enhances daylight, connectivity and wayfinding across each floor.
The Winter Garden also gives way to an outdoor roof terrace, which is accessible to patients, visitors and staff. It also features an expansive art gallery space, overnight visitor facilities and a multi-faith prayer room.
The Winter Garden also contributes to patient and staff well-being by providing a peaceful and therapeutic space that promotes healing, relaxation and reflection.
The garden provides a bright and modern arrival point to the hospital with transparent lift cores, stairwells, and walkways, which enhances daylight, connectivity, and wayfinding across each floor
"With the Winter Garden, we've got a large, extensive space when you count up the area, [it’s] bigger than a football field and this is going to be multi-purpose. First of all, [it will] allow first-time visitors to orientate themselves very simply as they come to an entrance.
"[When it comes to] adaptability and future-proofing, I think the way that we see the Winter Garden being used, it can be used all year round, it could be used for presentations, it could be used for community functions.
"It could be used for small gatherings, or pop up clinics or units or teaching. So that was the use of the big green landscape outside," Gallagher said.
In addition to the Winter Garden there is a Community Hub.
"That just houses a very small, little kitchenette and little meeting space, workshop, bathroom facilities, but basically, like a little potting shed area, so it's linked back to the garden as well, so the community can use that," Ho added.
The Winter Garden
Sustainability
The Winter Garden has an ethylene tetrafluoroetilene (ETFE) roof, which is a transparent plastic material designed to have long durability for outdoor applications.
The ETFE roof offers a highly transparent, lightweight and sustainable façade, bringing natural light into the heart of the building and views out over the immediate neighbouring communities, Birmingham, and the surrounding countryside.
"The Winter Garden with ETFE cushions to protect it from elements, this was to kind of act as a heat sink that could then be distributed throughout the building," Gallagher explained
The Winter Garden is also passively ventilated, and the hospital also incorporates intelligent lighting, solar PV panels and water conservation measures.
The design team also created internal courtyards and terraces that contribute to bringing natural light into the building and there are large windows, further enabling natural light to enter
HKS also designed around the canal and the bionet diversity around the building and the little wildlife part next to the canal.
"It was very much trying to retain that with all the landscaping as well," Ho said.
The design team also created internal courtyards and terraces that contribute to bringing natural light into the building and there are large windows, further enabling natural light to enter.
Large windows have been included throughout the hospital to let natural light in
Overcoming challenges
HKS overcame a sudden change of contractor in the middle of the build.
Initially, HKS started this project with Carillion as the building contractor, which started construction in 2015. Carillion then stopped working on the project in 2018 as the construction company liquidated.
The Covid-19 pandemic additionally caused a one-year delay to this project before Balfour Beatty came on board as the building contractor in the year 2020.
"During that year, we worked very closely with the trust to look at how to essentially de-risk the project so that they could tender it back out to a new contractor.
Our team has been fantastic, working on this all the way through. They've been on it for 10 years
"And so for a new contractor to be interested, there were aspects that we were trying to identify with, the things we finished or not finished, how far along they had got with the build because essentially this build was half built.
"And so when Balfour Beatty took that over, they were very aware that the shell was already up, and they were almost doing a fit out," Ho explained.
Overall, HKS created a practical clinical build that promotes healing and wellbeing with large windows to promote natural light and sustainability was considered in the design and build.
The Winter Garden and the Community Hub also contribute to patient healing and wellbeing, and the design has also been future-proofed, which enables the Trust to adapt and change the build to suit the needs of patients in the future. Moreover, the build can adapt to technological changes.
"Our team has been fantastic, working on this all the way through. They've been on it for 10 years," Ho concluded.