Lean streets

HD, Jul/Aug 2003 by Leissner, Travis, Gay, Anna, Ostle, John

in 1998 a merger brought the old Hexham Hospital under the control of Northumbria Healthcare NHS Trust. The unit was built in 1939 to treat the war wounded and the people of Tynedale had campaigned long and hard for a new hospital. After the merger, the trust acquired the "Black Mart" site; a piece of brownfield land next to the old buildings. The resultant project to build the new Hexham General Hospital (HGH) has turned out to be one of the fastest PFIs on record. The outline business case was approved in September 1999 and the preferred bidder, Catalyst Healthcare, was appointed in July 2000. Planning permission was granted in December 2000, with full business case approval and contract signing achieved in April 2001. Work on site started that month, and the key was handed over on 9 May this year. Finally, patients were transferred to the new building on 10 and 11 July.

The trust's newest replacement facility contains 98 beds, including two 27-bed medical wards, a 28-bed surgical ward, a 10-bed maternity unit and a six-bed critical care unit. Catalyst will be responsible for the life-cycle maintenance of the hospital for the next 30 years. The scheme was managed within a two-year, L28m construction programme led by Bovis Lend Lease.

The redevelopment has been designed to offer a new dimension in healthcare delivery for the community. The facility replaces the existing hospital completely, which is to be demolished in the next phase of work. The surplus site area made available will be redeveloped as car parking and for alternative use.

The compact design of the new unit incorporates a full-range of services whilst providing shared functions for a the project's next phase - which will house a primary care centre, and education, research and teaching facilities. It will also include an emergency care centre, an additional 30-bed surgical ward, a chronic disease management centre, and a children's health centre.

Work is currently underway on the 1,600 m^sup 2^ primary care centre, which occupies part of the former hospital site. Discussions are also underway between Catalyst and the trust for a third phase, involving the provision of a keyhole surgery unit.

LOCATION AND ACCESS

The sloping topography of the site has been used to provide entry to the new hospital at both the garden level (for service traffic) and ground level (for public and staff access). The orientation of the building with its triangular wards facing north-east and west presents an exciting architectural statement to the town. The ward areas are situated so that the patient rooms look out over the town to stunning views of the Pennine Hills in the distance to the north and west. After undergoing a successful move management, the eagerly awaited facility is now fully operational.

The three-level building has a blend of traditional and innovative architectural forms and has incorporated the local vernacular of this historical abbey town. Constrained to a brownfield site adjacent to the existing hospital infrastructure, the concept for the site plan warranted a development with an extremely efficient footplate. The design maximised the availability of the "Black Mart" end of the site - an approach that provided surplus land in the overall development to be available for sale for alternative use, buffered by the landscaped car park to the east. This single phased approach minimised if not obviated disruption or disturbance to the existing operations during the construction period and also saved the hospital the significant additional expense of double decanting. The layout of the single-phase footprint also leaves the existing energy centre and mortuary untouched until the end of the building of the new hospital.

Main access to the hospital site is off Corbridge Road, which is well serviced by public transport. Upon arrival, visitors and patients will gain entrance under the protection of a stylised porte-cochere "main entrance" over a drop-off for the public. It is penetrated by a cylindrical lobby vestibule that protects visitors and patients from the elements. There are five dedicated entries to the site. They include A&E (for ambulances, taxis, cars and bicycles), bus stop/ pedestrian entry, service entry and pharmacy entry (to the south of the mini-roundabout), and auxiliary/ emergency vehicle entry.

THE USER EXPERIENCE

The design of the facility seeks to separate, as much as possible, inpatient flows of staff and patients from outpatient and visitor flows. This avoids the indignities suffered by patients in theatre gowns or bedclothes being pushed along corridors that are also being used by visitors and suppliers of goods etc. The lack of such separation is a major flaw in the concept of the NHS hospital street. Similarly, the centralised lifts are divided into 'back of house' (staff and inpatients), and public (outpatients and visitors).

Internally, the most apparent feature is the multi-functional space of the voluminous, two-level main lobby, which has a conveniently located reception. But it's not necessarily the information kiosk that will capture your attention. More than likely, you will be attracted by the music coming from the grand piano or the aroma of freshly prepared food from the dining area.