At ADP, we believe that architecture has the power to transform. Communities can be rejuvenated, business revitalised and a new sense of place created. This ability to change our physical world means that architecture has an intrinsic effect upon quality of life. We ensure that people – their needs, both physical and emotional – are at the heart of our design process.
ADP was founded in 1965 and has grown to become one of the most respected and stable practices in the United Kingdom.
Perhaps nowhere is this more relevant than in our designs for the healthcare sector, where a patient’s physical environment has long been noted as having a direct affect on wellbeing and recovery. Placing people at the centre of our work means we celebrate difference: each project, each client and each community is unique, with individual aspirations and requirements. As a result, the solutions we deliver are bespoke, the product of close engagement with our clients and thoroughly analysing a particular site. This understanding arises from a consistent, diligent process. We examine the site with rigour and sensitivity, unlocking its potential through creative, inspiring design concepts. Consideration creates clarity in our designs: emerging from intelligent analysis, our architecture has an elegant simplicity, intimately connected to context and need. Our buildings are not about fashion, or a predetermined style. They embody powerful, simple ideas delivered well; solutions that just feel right, fitting both their setting and their purpose. This philosophy creates architectural intelligence: a concept that embodies the analysis, science, design and engineering of intelligent structures. These should serve and celebrate people. This results in architecture that inspires: both appropriate and sustainable, contextual and contemporary.
From our original office in Henley, servicing clients in the Thames Valley area, ADP has grown to international standing and now has studios in Birmingham, Delhi, London, Manchester, Newcastle, Oxford and Sherborne. Our combined resources of over 100 staff operating from 7 regional studios, 6 in the UK and 1 in India, gives us an international perspective and a proven capacity to handle major commissions. This is combined with the flexibility to serve our clients from friendly local studios. A strong performance in recent, economically turbulent times means we are now well-positioned for growth, and ADP is currently exploring opportunities both regionally in the UK and internationally, in Europe and Asia. In addition, the practice has recently expanded its commercial experience with the creation of a new commercial architectural division. The practice is currently ranked within the top 20 of the Architect’s Journal AJ100 Annual Survey of UK practices. ADP is accredited to: » » » » » »
ISO 9001 Quality Management ISO 14001 Environmental Management BREEAM assessors Investors in People CHAS Constructionline
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001// Runcorn Cancer Support Centre (left) Working with Macmillan Cancer Support, ADP developed a new oncology and therapies centre at Halton General Hospital in the late 1990s. Following successful use, the focus of the unit at Halton is changing. The new facility unites complimentary therapies with counselling and advice services for cancer patients, to supplement and support the clinical treatment they receive in the main hospital. As a result, people are at the centre of the design - patients, families, carers and staff. Their emotional and psychological needs are met within spaces that feel tranquil and domestic in scale, with careful thought given to sensory stimulation. This includes the use of natural daylight and landscaping, which introduces the therapeutic presence of nature into spaces both inside and out. In addition, the combination of services, whether it be Ayurvedic massage or an advice centre, are fully integrated into a single point of contact for patients and their families.
‘Patient-centred’ care has become a familiar term in both the healthcare sector itself and Government policy. Yet, as a number of White Papers and reports have shown, it is seldom fully realised. And no wonder: it is a wide-ranging idea that requires nothing less than a paradigm shift in the way we view patients, and a realisation of the corresponding changes this will produce in every aspect of the sector – from information management, to commissioning, to the training and resourcing of medical practitioners themselves. It also has important and no less fundamental implications for the built environment in healthcare. Within our practice, we think of patient-centred healthcare as a very personal, quiet revolution. ADP has been working on environments that place the patient first not for the last two, or five, or even ten years, but in fact for over the past twenty. It began, and continues, to be driven by one of our most successful long-term partnerships to date. Working with Macmillan Cancer Support, we have actively explored and helped define the design of patient-centred environments in the UK for very nearly a quarter of a century. During that time, we have learned a lot about the needs of patients, and which elements of design they particularly value, improving their experience and outcomes. This fundamental tenet of our approach has proved invaluable to our healthcare clients, whatever the type, size or scope of their project. © architects design partnership llp
002// St. Margaretâ€™s Hospice, Yeovil ADP worked closely with the Hospice Association - an independent charity - to develop a design tailored to the qualities of this site in Yeovil, and the patient-focused care that the Hospice Association exists to provide. An extensive landscaping scheme incorporates many indigenous species and aims to encourage wildlife. The main access drive is lined with silver birches and hedges to enhance the impression of approaching a country house, rather than a medical facility, which helps to relax patients and relatives as they arrive.
PLANT OVER TREATMENT
RECOVERY PREP THEATRES TREATMENT DIAGNOSTICS CONSULTATION RENAL ENTRANCE EXIT
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003// Diagnostic Treatment Centre Concept (left) This design concept adopts principles of the Lean Method to produce an integrated, one-stop-shop for patients. This allows for the fast and efficient turnaround of clinical cases within an outpatient environment, with patients examined, scanned/diagnosed and operated upon (if necessary) within a smooth workflow. State-of-the-art technology has been incorporated within the design, and includes diagnostic imaging and six high-tech theatre suites. The flexible facilities are further enhanced by mobile scanning facilities and space provided for specialist clinics aimed at key target groups, such as children.
Underpinning Lean thinking is the positioning of the patient as a ‘customer’, adopting philosophies long held in the business sector to improve the patient experience and outcome. The positioning of patients as customers was duly noted in the Darzi Review (2008), which identified the rising expectations of patients in the 21st Century. As architects, we play an instrumental role in realising environments that can meet the needs and expectations of patients, and we know that in order for the needs of a customer to be met – whatever sector they are in – they must be at the centre of the design process. As a result, we see the positioning of the patient as customer under the Lean Method as a fundamental facet of the NHS commitment to ‘patient-centred’ care.
Once again, our work with Macmillan Cancer Support has proved highly pertinent: we have researched Lean design principles along with US initiatives, such as evidenced-based design and generative space. Working with Macmillan’s building team and eminent US academics, we have carried out ‘building in use’ workshops, and conducted extensive analysis on single bed versus multi-bed ward concepts for palliative care and general inpatient facilities. Our research has included all facets of service delivery and patient outcomes, taking into account staff footfall; supply distance travel; patient efficiency in space utilisation, and patient flow along with many other aspects. Techniques have involved patient and staff tracking, along with equipment and supplies, to establish working patterns and efficiency. The resulting analysis informs areas such as frequency of supplies top-up, staffing ratios, waste removal and other issues key to working patterns. © architects design partnership llp
004// Health Centre, Glastonbury (left) Currently practicing from a cramped and dated building, the Glastonbury Health Centre took the decision to acquire the current site and redevelop a new practice building. ADP have worked closely with the GPs to facilitate their vision. Our proposal replaces the existing GP surgery with a new £2.5m health and wellbeing centre. It will accommodate the four existing GPs, and their expanding portfolio of services and therapies that they are able to offer, but currently struggle to provide due to the constraints of their existing building. A total of 1,200m2 of accommodation is required, which may also include a pharmacy, dentist, opticians, and flexible space that will be used by the local children’s support services and other community-based groups. The resultant facilities will provide a holistic environment rooted in the community, which also offers future flexibility and potential expansion. The GPs had been looking at two alternative sites for the last two years, but we were able to demonstrate that they could stay on their existing site if developed in phases. The additional cost of phased development is being viewed against a much higher cost of decanting from their building during construction works. Affordability has been key throughout the development of the project, and ADP’s team has worked closely with the PCT and district valuer to ensure guidelines and financial constraints have been clear throughout.
With the increased importance of patient-centred care, so more services are being delivered on the frontline - within local communities. Often the first touchpoint between a patient and a healthcare service, primary and community care is undergoing great change to deliver a wider and more varied range of services than ever before. Additional drivers including patient choice, personalisation and the devolution of decision-making from the centre to local level, with the development of LINKs and GP consortia, will further empower frontline care. It will also require new ways of working, and increased levels of integration between services across the health and social care spectrum, including providers and patients themselves. In order to design buildings that reflect this focus on local delivery and integration - with the added requirement for multi-use and flexible space - we orientate our work around the patient experience. We seek new and innovative ways to interlink spaces and services to improve healthcare outcomes. © architects design partnership llp
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13 005// Hodge Hill Health and Wellbeing Centre, Birmingham Hodge Hill is being developed for Birmingham East and North PCT, part of the comprehensive Birmingham and Solihull LIFT programme. A ÂŁ4m new facility, it demonstrates the integrated, flexible role primary care is increasingly required to adopt. The centre will encompass 2742m2 of flexible, integrated healthcare facilities over three floors and will offer a wide range of services, including: 3 GP practices, dentistry, physiotherapy, health information services, school nursing and health visitor accommodation.
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006// NICU and Midwife Led Unit, Luton and Dunstable Hospital (left) Following ADP’s development of a new development control plan for Luton and Dunstable Hospital, we were appointed to develop a new Neo-natal Intensive Care Unit (NICU) at the site. The new facility will incorporate 46 cots and associated clinical support facilities, located next to the women’s hospital. The facility will provide much expanded and more appropriate facilities for special care at various levels. As part of the NICU project, ADP has been working with the Maternity Department at Luton and Dunstable Hospital to develop existing facilities to provide a Midwife Led Unit (MLU). The emphasis of this unit is to provide optimal birthing spaces and facilities that focus on the mother and partner, providing an environment that is less stressful and conducive to normal birth. This scheme includes four delivery rooms, one featuring a birthing pool, and has involved close collaboration with ADP’s interiors team to ensure the right balance between best practice in a home environment and good patient safety is achieved. Extensive consultation with the Trust and key users (including hospital and community midwives), has included regular discussion sessions, visits to other units and a review of case studies illustrating best practice.
When considering facilities for women’s health - in particular maternity and neo-natal care - high-tech spaces are not the only option. For over 40 years, we have been providing hospital environments for giving birth. However, there is some concern amongst doctors and midwives that these medicalised environments can give rise to higher levels of intervention and increased risk. Although technology is often essential, the ambience of the space we build does have a significant impact on our health and emotional wellbeing. It’s not just about a bed: designing ‘good’ spaces for mothers to give birth can involve consideration of access, including community-based, and easy wayfinding to reduce stress. Similarly, security and privacy is vitally important, controlling who has access to the spaces and when. Privacy can also be enhanced by soundproofing. Family and birthing spaces must be welcoming, quiet, and controllable with comfort carefully considered - utilising space, light and colour. External space is important, too: providing links to gardens and courtyards can significantly reduce stress. © architects design partnership llp
MENTAL HEALTH AND LEARNING DIFFICULTIES
007// Arbour Vale Special School, Slough Our work in the education sector, providing facilities for children with special educational needs, further strengthens our experience and understanding of the wide variety of environments needed for those individuals with learning difficulties or mental health issues. Here, the pupil - who may also be a patient - is at the centre of the design process, and as designers, we strive to create inspiring, creative learning and support environments. ADP was commissioned by Slough Borough Council to produce a broad outline planning application for the redevelopment of Arbour Vale Special School and Beechwood Secondary School. Arbour Vale provides education and support to pupils with special needs from nursery age, to post-16. The scheme involved relocating the two schools onto a single site, sharing some of their facilities, such as sports and leisure areas. The development would also incorporate a residential unit for children with autism, where cognitive therapies like the exercise shown opposite, can be employed.
The terms ‘mental health’ and ‘learning difficulties’ cover a tremendously diverse spectrum, and the types of buildings required to deliver treatment, assessment and support are correspondingly diverse. They can include community-based care, or medium to high security conditions where increasing levels of dedicated specialist care is required. Like all areas of the healthcare sector, there is increased focus on integration between services with a particular focus on clarity, safety and accountability. At ADP, we remain focused on the needs of the people behind the labels. As a result, we create spaces that provide safety and security, but which are also calming and provide of sense of place where possible. The initial briefing process is crucial to the development of a clear service model that informs the design process. We believe in working in close consultation with user groups, including staff, to inform the design and to develop key ideas in clinical and management attitudes. We create clear planning strategies to define circulation and access routes within facilities, along with correct gender and care group zoning. This enables flexibility in planning and use. It is important to utilise these circulation areas as positive spaces that facilitate informal interaction. We understand that it is important that the layout and orientation includes personal, private and secure space for the patients - as well as meeting the needs of the staff. Observation is key to the
successful function of mental health facilities, and must work both formally and informally to create a safe and secure environment for all. At Milton Keynes General Hospital, ADP worked extensively to improve the Campbell Centre mental health unit. Built in the 1980s using the Oxford Method construction system, the Centre has successfully provided mental health facilities for a number of years. However, with increases in patient numbers and a need to focus more on the patient environment, ADP worked with the PCT to develop a new solution for the existing building to prioritise patient dignity and privacy in a secure environment. The entire building has been reconfigured to allow the introduction of split male and female services, incorporating almost 100% single bedrooms. All rooms have ensuite bathrooms, and an ICU is also provided. In addition, ADP worked with the King’s Fund to develop courtyards that are focused on the patient experience and aim to enhance the localised environment. The design process involved intense use of patient group consultation, and proved highly valuable in achieving patient ‘buy in’ and respect for the new facilities. The works were completed in five phases over a 2 year period so that the majority of the building could be occupied at all times. The proposals worked with the Oxford Method building fabric to exploit its flexibility in adaptation, and allowed added value in a number of areas.
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008// Oaksey House, Lambourn (left) This £2.7m pioneering facility for the holistic treatment of injured and retired jockeys is the first of its kind in the UK, and was designed in partnership with the Injured Jockeys Fund – a registered UK charity. Oaksey House is divided into two primary functions. The first is a residential village for retired jockeys and IJF beneficiaries. In total, there are twelve residential units, including three that are double units and one with respite care facilities for nursing staff. The design for these units focuses on providing a high quality, domestic living environment centred around the inhabitants – home care technologies have been integrated to facilitate independent living. The second aspect of Oaksey House provides rehabilitation for injured jockeys, with treatment both clinical and complementary. Three flexible paramedic and physiotherapy treatment rooms have been provided, with a state-of-the-art rehabilitation gym designed specifically with the needs of the jockeys in mind. In addition, there is a recreational gym with further specialised equipment, including two racehorse simulators. A sauna facility is also provided, able to accommodate eight riders and a wheelchair, with a large flexible community room and smaller meeting room also incorporated.
With an ageing population estimated to grow from 4.7 million to 8.2 million by 2031, and the increased emphasis on a wide variety of health and social care services being delivered locally, the notion of assisted living is becoming ever more important economically, as well as socially. Whether providing care for the elderly, or rehabilitative care, assisted living is fundamentally about providing facilities that enable individuals to live as independently as possible. Environments are typically domestic in scale, encouraging a sense of place and ownership that is often lost in a larger ‘institutional’ healthcare environment. Safe, comfortable spaces with access to complementary services, such as holistic therapies or physiotherapy, and which integrate with home care technologies, can bring much-needed choice, dignity and support to individuals and their families. For assisted living facilities, we utilise our commitment to, and experience of, patient-centred environments whilst drawing lessons from other sectors, including our residential sector work. We believe clever design and technology can work together to orientate comfortable, personalised spaces that support an individual’s independence and care. © architects design partnership llp
009// Oaksey House, Lambourn
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010// Endoscopy Unit, Royal Surrey County Hospital (left) Having worked with the hospital for a number of years, ADP were commissioned to help develop a masterplan for the site. One of the key projects in unlocking the site development has been the construction of a new Endoscopy Department on a rooftop area of the hospital. This results in freeing up key space in the heart of the hospital where demands on space are strongest and also provides the catalyst for future rooftop development. The current endoscopy facilities are undersized and require major equipment upgrades and rationalisation of workflows. By providing a new, larger facility much greater workflow can be handled and the service future-proofed. From a patient perspective, the new facility will provide privacy and dignity in split male and female areas, which allow flexibility to share facilities and to provide adequate space for either sex depending on daily clinics. General workflow and patient flow in the new unit will be vastly improved: great care was taken to understand the various key flows and this was translated into a pragmatic design. When complete, the project will provide new bed lifts and circulation to provide access to additional future accommodation on the roof, allowing economic development of the hospital estate.
While frontline care has broadened in scope, and continues to do so, acute care increasingly focuses on areas like trauma and A&E. In addition, hospitals are developing and targeting specialist services that cannot be delivered at frontline level.
However, with the emphasis now heavily on outcomes rather than process, and the rising expectations of patients themselves, patient-centred design is gaining momentum and significance in acute care.
It is perhaps in acute care that patient-centred design is the hardest to achieve. Hospitals need to respond to large numbers and increasingly complex clinical considerations, ranging from hygiene and a reduction in the spread of HCAIs, to accommodating highly technical facilities. As a result, it is easy to see rooms and facilities as the housing for equipment or the optimum number of beds â€“ not as a holistic, therapeutic environment for individual people.
It is no easy feat to accommodate these often conflicting needs, however. It takes experience, and understanding â€“ both to respond to the emotional and psychological needs of patients, and the practical and technical demands of clinical delivery. We apply innovative design and strategic thinking to work toward harmonising patient-centred care with acute service delivery. Our experience includes schemes both large and small, often with complex site requirements or phasing within existing hospitals. ÂŠ architects design partnership llp
EXCELLENCE IN RESEARCH
011// Cardiovascular Research Centre, University of Leicester (left) ADP’s design for the new centre aims to enhance the existing cardiovascular research facility already on site. The design joins together laboratory and office space, enabling world-class cardiovascular research teams to be brought together under one roof, promoting collaborative working and helping to push forward the boundaries of research. Arranged over four floors, the building will enable code information to be captured from patients attending cardio-respiratory services at Glenfield Hospital. The Leicester Biobank, situated on the ground floor of the building, is capable of processing and storing samples from up to 100,000 individuals. Also located on the ground floor will be the laboratory facilities, including -80ºC freezer stores and a supporting write-up area. On the first floor, smaller laboratory areas (including two tissue culture laboratories that will need to conform to Containment level 2 of ACDP) and further write-up zones will support the main laboratory. The Data to Knowledge Unit located on the third floor will implement strategies and tools to manage, analyse and interpret the generated data. Providing a total of 2300m2 of laboratory, office and storage space and covering a footprint of approximately 500m2, the project is on target to achieve a BREEAM rating of ‘Excellent’.
The ambition of the Government and the healthcare sector as a whole, to continue to deliver a world-class clinical research community, lies in the ongoing collaboration between the NHS and public sector bodies including the National Institute for Health and Clinical Excellence (NICE), and the higher education sector. At ADP, we have particular experience of delivering state-of-the-art teaching, clinical and scientific research facilities that often house the very latest technology and equipment. The utilisation of space and resources is key to a successful design – often, such facilities are used exclusively by a single department, with limited sharing of resources and low spatial utilisation, particularly in specialised areas. In addition, energy usage and wastage is often very high.
Flexibility and shared access to resources have become increasingly important issues in the design of teaching and research facilities. Not only does this produce more efficient buildings, with far higher levels of utilisation, but it allows for knowledge sharing and interaction between researchers across different subject areas – creating an essential ‘creative’ environment that supports worldclass research. There are many similarities between the design of technical teaching and research facilities and the challenges we face in the design of acute services, and we therefore ensure we cross-fertilise best practice and technical knowledge in each area.
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012// Postgraduate Medical School, University of Surrey The accommodation comprises laboratories, offices, teaching and conference facilities over a total of approximately 3,500 m2. ADP worked closely with a design and build contractor on the detailed design and construction phase of the project.
Developments for 2009-10
1. 2. 4. 7A. 7B. 8. 11. 13. 14. 15. 16. 20.
3. Extension to St. Lukeâ€™s wing for new Chemotherapy Unit on G/F 6. MAU extension (220m2) 12. Expansion of MAU (300m2) 17. New helipad 19. Endoscopy Department and offices 21. Refurbishment and extension to pathology laboratory 22. Additional short-stay orthopaedic beds
New clinical pathology laboratory and offices (820m2) Existing chemotheraphy/OPD to be reorganised/expanded Extension to haste Theatre 12 (160m2) Theatre 13 (100m2) Move oxygen plant Possible renal unit levels A&B, two levels of parking below Ante-natal Breast Clinic 30-bed ward (700m2) Paediatric OPD (560m2) ICU extension
013// Masterplan, Royal Surrey County Hospital (left) ADP has been working with Royal Surrey County Hospital NHS Trust over the last five years on a number of projects including a new CT scanner facility (£1.2m) and works to the pharmacy (£200k). Other schemes include major alterations and extensions to the Pathology Department (£3.1m), potential projects for a new Endoscopy Department (£2.5m), Breastcare Clinic (£1.5m), Oncology Department (£3.5m) and masterplan works for projects over the next five to ten years. All projects have been developed in tandem with a development control plan, and traditionally procured. The majority of the projects involve working over and under live hospital departments, and involve a number of phases to maximise space utilisation during the build phase. By working closely with the Trust we have developed an understanding of their working and key interdepartment relationships.
In the current economic climate, as with all areas of the public sector, our healthcare clients are faced with the challenge of how to do more, with less. Even with promises to increase healthcare spending and ring-fence budgets, the sector faces cuts and as a result, efficiency remains very high on the agenda. To be efficient, it is important to have a strategic perspective: an understanding of current strengths and weakness, and a set of aims to work toward. Perhaps the most important strategic study for the development of a healthcare site – be it a GP surgery or a urban hospital – is a development control plan, or a masterplan. Masterplanning is about looking forward, and this is particularly critical in our austere economic climate. A strategic process that rationalises and improves upon the present, masterplanning also anticipates future needs. We see masterplanning as part of an integrated whole - the outward expression of a healthcare organisation’s aims and objectives, and a demonstration of the foresight and commitment needed to achieve them.
The production of a masterplan or development control plan presents many challenges, and unique considerations. The process is a progressive development. At ADP, we are experienced at assisting our clients through this process so that the end result is a hard-working masterplan to help each client manage their future, and enhance the present. Masterplanning is about strategic vision, and each is unique. We believe masterplans are vital documents, not only in importance, but also in terms of energy. They demand great creativity, skilful analysis and meticulous attention to be carried out successfully. We relish these demands, and our staff are highly-skilled at delivering critically-acclaimed masterplans across a wide variety of sectors - from education, to healthcare, to residential.
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014// 360Ëš MRI Facility, Nuffield Orthopaedic Centre A world first, this design allows an entire surgical team to have full and unprecedented access to the patient, undertaking complex surgical procedures with continuous MRI image monitoring of their position within the body. Working closely with a client and a turnkey contractor enabled ADP to deliver a building which could support pioneering technology with minimum disruption to the Trust and to patients.
THE VALUE OF REFURBISHMENT URBISHMEN T REF »
Considers how the building looks - looking at the surface presentation
Interior and landscape design may have immediate value
Considers how a building looks and works - getting beneath the surface
Often comprehensive in scope, the building is changed considerably, but much of the original structure and fabric is utilised
Considers how redundant buildings viewed as ‘waste’ can be adapted to fit new uses
Lean times can create many useful opportunities for capital projects in the healthcare sector, one of which is refurbishment. At ADP, whatever the state of the economy, we believe refurbishment has many advantages. In fact, in many instances, it can actually emerge as the preferred option. As well as being inherently more sustainable, refurbishment is cost and time effective. In logistical terms, refurbishment projects can often be more easily phased to ensure that works are less disruptive. Furthermore, creative and innovative refurbishment can increase the value of existing building stock, and can preserve historic buildings whilst keeping them in active use. Refurbishment itself is a catch-all term, and can include each of the three elements shown in the diagram above, or a combination of two or more. It can range in complexity from a fresh new interior for a tired waiting room, to the extensive remodelling of a hospital department, or the reuse of a redundant, outmoded building. Whatever the form of refurbishment, it requires careful analysis of current uses and needs, and the ability to creatively reinterpret existing spaces to meet those needs.
Types of Refurbishment
At Royal Surrey County Hospital, for example, ADP is undertaking the refurbishment and extension of the Pathology Department. This £3m project involves providing an additional floor and staircases to the existing two storey building to improve the internal workflow. The refurbished Cytology, Histology and Molecular Biology laboratories will house state-of-the-art technology including clean rooms, fume cupboards, extraction systems, downdraft benches as well as improved security systems. We have considerable experience across a wide variety of sectors in refurbishment schemes, and this allows us to apply a broad context of experience that can prove of benefit to improving healthcare outcomes. It means we can really make full use of our ingenuity, applying best practice and ideas from across the public and private sector, whilst grounding each solution in sound strategic awareness of healthcare delivery and the patient experience. For example, our work in the commercial sector may inform our designs for open-plan administrative spaces that boost productivity, or enhance waiting areas with a more comfortable, ‘hotel’ feel that actively improves the patient experience. © architects design partnership llp
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015// Goscote Palliative Care, Walsall (left) Following development of a new masterplan for the old hospital site in Goscote with the PCT, ADP has been working with Ashley House to deliver one of the projects under LIFT. The building provides a unique mix of palliative care and community services, and consists of approximately 2500m2 of accommodation over two storeys. This is broken down into inpatient facilities, day hospice and outpatient rehabilitation, oncology and consultation, along with supporting staff accommodation. A BREEAM ‘Excellent’ rating was achieved at the design stage of this project through the joint effort of the whole design team. The Trust also played their part in meeting the target rating by supporting a green travel plan, forming an arts strategy, adopting policies on procuring energy efficient equipment and signing up to the NHS Corporate Citizen model - all measures that will continue to encourage sustainability once the building is occupied. The building was the first to achieve BREEAM Health ‘Excellent’ in the country at design stage, led by ADP’s in-house BREEAM assessor.
Healthcare buildings are civic, social structures that occupy a prominent part in our built landscape – each of us, at many different stages of our life, will interact with a healthcare building in some form. This prominence makes the healthcare built environment a key advocate of sustainable design. Yet we also believe sustainable design in healthcare has a very real role to play beyond thought-leadership and advocacy: it can create a more efficient healthcare estate in the UK, and it can contribute proactively to healthcare outcomes and the patient experience. Like patient-centred environments, sustainability requires us to look at the whole picture – how systems, materials, energy and form can integrate to deliver hardworking, responsible buildings. This holistic view means that sustainability doesn’t work in isolation, but is an integral part of the design process. For us, this
approach is central to our entire architectural philosophy. We search for clever, measurable solutions to issues of sustainability, ideas that often add value for our clients in very practical ways – such as lifecycle costing and energy efficiency. If sustainable design can contribute to a reduction in running cost and maintenance, then so too can it improve the patient experience. Maximising natural daylight, for example, may reduce energy costs but it can also make a patient feel more at ease. Similarly, outdoor spaces create habitats and green corridors for wildlife, but they also provide restorative contact with nature; providing tranquil areas for relaxation and reflection by a wide variety of end users.
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016// Luton and Dunstable NHS Foundation Trust (left) Working with the Trust, ADP has produced a comprehensive development control plan for the site and developed a number of feasibility studies based on this. ADP worked closely with the Trust, helping them to manage the process of moving departments from the secondary setting out to primary care (including Audiology, Physiotherapy, Musculo-skeletal, and Dermatology). We also undertook a feasibility study of the Trust’s Bariatric Unit, one of the largest of its kind in the UK. This study involved looking at the bigger picture, allowing for increased patient numbers following recent studies into health trends. The design team worked closely with both the Physiotherapy and MSK Departments to help reorganise the space. In addition, we have completed a new Oncology Unit (£1.5m) and construction has just commenced on a new NICU (£6m). Other feasibility studies have included maternity services, the redevelopment of A&E, catheter laboratories, Endoscopy, a 28-bed ward, and the redevelopment of Nightingale Wards. The Luton site is very tight, making vehicular and patient access very difficult. All projects involve working around live departments, and fairly complex enabling works packages. The NICU is currently being implemented under Procure 21, with ADP employed by the P21 provider.
Looking good on paper is one thing, but we much prefer to see our buildings become a reality. The clients we work for have requirements that must be met with physical solutions. Consequently, we ensure that our designs are buildable within the parameters our clients set, be that a tight budget or a sensitive site. We believe the best design arises from a collaborative effort. With people and communities at the core of our philosophy and approach, we make sure we listen to our clients. Our task as architects and designers is to realise the aims and objectives of a community or organisation into inspiring, hard-working architectural solutions. At ADP, we foster and support long-term relationships through framework and partnering agreements, and many of our clients represent repeat business. Our significant experience of stakeholder consultation and participation is a guarantee for clients, new and existing, that their needs and aspirations will always be taken into account. Our focus on bespoke solutions derived from close collaboration, and thorough analysis, means that our track record of consistently delivering projects on-time and on-budget, that exceed expectations, is formidable and
reflected in the number of our clients who return to us time and time again. Key to our success is our flexibility - particularly with regard to the often complex procurement routes in the healthcare sector. ADP have direct experience of a wide variety of procurement scenarios, including LIFT/LIFT Express, 3PD, Traditional, Design and Build, SEC, Procure 21 and PFI. With Procure21+, we recognise the clear advantages to both the client and contractor, in terms of smooth delivery and outcome certainty - utilising our existing Procure 21 experience, we believe we can bring valuable experience and skill to any suppy chain. In addition, our cross-sector experience, for example in the Building Schools for the Future programme and OGC, has many comparable parallels to routes within the healthcare sector. Cumulatively, it means we have a very practical, hands-on understanding of procurement and we are well-placed to help our clients choose the best approach to minimise risk.
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