Churchill Hospital hospice: A design for life

Architectural challenges don’t come much tougher than this: to design a sanctuary for the terminally ill. But that was the task faced by architect Nightingale Associates when it won the contract for the hospice at Churchill Hospital in Oxford.

When the Sir Michael Sobell House charity decided to replace its old hospice, the board’s main requirement was that the new building should not feel like a traditional healthcare building – an austere institution that lacked warmth and homeliness.

In fact, it was the shortcomings of the original 1970s-built building that informed the design of its replacement. After years of working in dark, claustrophobic wards, the nurses were desperate for light and airy bedrooms and more storage space.

Privacy for patients was also high on their wish list. The open-plan design of the old building meant that patients were constantly within earshot of one another and there was no private space where they could meet relatives.

Creating a homely atmosphere was always going to be a difficult task, as the hospice had to be equipped with large amounts of intimidating medical equipment. To help temper the clinical feel of the hospice, Nightingale decided to specify high-quality, natural products and also came up with a colour scheme that would create a warm and comfortable interior (see “Scheming in colour” on page 10 for the thinking behind the choice of colours).

To complement the materials inside, assistant architect Cristina Tegolo persuaded the client to employ landscape designer Jinny Blom to create a green space at the heart of the scheme (see “Getting the garden right”, overleaf). One difficulty for Nightingale was making sure that its design choices and specifications were implemented throughout the design-and-build project’s contract.

The architect’s solution to the design challenges is an unashamedly modern design. The brick and render finish of the single-storey, horseshoe-shaped building gives the hospice a crisp, uncluttered appearance.

The south-facing side of the buildings is punctuated by clean geometric shapes in the form of an elliptical chapel, and rectangular plant rooms that bookend the curved terrace.

One of the reasons for the contemporary design was to allow as much daylight into the building as possible, by incorporating rooflights along its curved spine. “The easy thing would have been to have gone for a traditional pitch roof and hidden all the plant beneath it, but that would have left no room for rooflights,” says Nightingale partner Richard Harrington.

To the rear of the building is a series of large glazed rooms facing onto the garden. Between these and the bedrooms in the curved terrace is a glazed corridor, which runs the length of the building. This allows sunlight to enter the rooms off the corridor, which include bathrooms, a grieving room and a flower preparation room (see above for a map of how these buildings are related).

To ensure that Nightingale’s design and specification remained intact during the build phase, the architect formulated a tight specification that gave the contractor little room for manoeuvre on the designs and materials. Peter Jackson, surveyor at main contractor Leadbitter, said this made the project fairly straightforward.

“We didn’t have to move too far from the original specification, as this had been sewn up during the tender stage,” he says.

Nightingale was retained as the client’s agent during the project, which Tegolo says took the strain off the client and gave Nightingale a degree of control during the build phase. Leadbitter awarded the job of developing the design drawings to local practice Oxford Architects, but Nightingale director Ginny Cook and Tegolo still had responsibility for the specification.

The tightest elements of this were for the flooring, chapel, doors, windows, custom-made furniture, brick, ironmongery, and the internal rails. Linoleum flooring was specified throughout, except in the bath and shower rooms, where slip-resistant vinyl was chosen. Tegolo says she is keen on lino because it is a natural product and doesn’t lose its colour over time. In the original hospice, the nurses had learned that carpeting was far from ideal. Mary Walding, a practice development nurse for the charity, remembers: “The carpets in the old building stained dreadfully and were not good for infection control.”

The doors and windows were a good example of Tegolo’s demanding specification. She wanted aluminium-framed windows externally because of the metal’s weathering properties, and timber on the inside because of its warm appearance and natural finish.

She specified Velfac windows and doors or similar, but because the specification was so tight there was only one other manufacturer that could meet Tegolo’s requirements, and its products were no cheaper. So Velfac was specified and the manufacturer firmed up the detailed designs for the doors and windows.

The handrail was one specification that had to be adapted. Tegolo originally specified an ash handrail with an acrylene body fixed to the wall with shock absorbers, chosen because it was easy to clean and replace if damaged. The tender was about £5000 but when it came to buying the rail, the price rose to £50,000 because of the curve of the wall. In the end Leadbitter saved money by specifying an ash body for the rail, which fixed directly to the wall.

The oval chapel was designed to cater for any religious ceremony, purposefully without windows because they would have offered views of the road outside, which would have been a distraction. Instead, a stained-glass window from the old hospice chapel is the focus of the room. Tegolo originally specified a timber and slate floor, but Leadbitter insisted that it was changed because the timber was cut to an elliptical shape. Over time, the wood have had to shrink in more than one direction. Leadbitter was unsure whether it would be able to do so without cracking, so Oxford Architects removed the slate from the specification when it firmed up the chapel designs.

Sobell staff are impressed. “All the nurses comment on how much better it feels than the current hospice,” says Mary Walding.

Nightingale’s Harrington is very pleased with the finished building. “The bedrooms here would put a private hospital to shame,” he says. He adds that the positive outcome was the result of the close collaboration with the hospital staff and users. “We looked at the experience of the patients, staff and visitors and looked at what the environment could do for them. It’s not about getting the patients in and out as quickly as possible. As a result, the quality of material and light in this building is of a particularly high standard.”