Heatherwick Studio’s first completed healthcare scheme is a new Maggie’s Centre that turns an unloved patch of city centre hospital estate into a landscape-festooned, lightweight timber refuge for cancer patients. James Parker reports.

Heatherwick Studio’s first completed healthcare project globally is a typically adventurous structure for a Maggie’s Centre on a tight, sloping corner of a hospital site in Leeds. However, this biophilia-embracing design displays a particular amount of care and sensitivity to its users, as well as modesty – in keeping with the highly sensitive nature of the client’s aim to both support and inspire cancer patients and their families.

St James’ University Hospital is thought to be the largest teaching hospital in Europe, its buildings densely packing a dense site to the north east of the city centre. It is also home to the Leeds cancer centre, serving a wide variety of patients across Yorkshire, and it was these two combined factors that led cancer charity Maggie’s to locate its 26th facility here.

The key challenge to architects Heatherwick Studio was that the project would of necessity be removing the last green space in the whole campus, and therefore the practice pledged to not only restore this greenery, but increase it using substantial roof gardens. However, having not designed a therapeutic environment before, the architects were faced with wider challenges, not least the need to elevate the typical ‘clinical healthcare experience.’

Project leader Angel Tenorio tells ADF: “We are genuinely interested in improving people’s experience and how the physical environment has a direct effect on people’s lives.” Heatherwick has worked on a number of healthcare projects such as a shortlisted bid for a new clinic at Great Ormond Street, but this is the first to reach fruition for this famously inventive practice, perhaps demonstrating the open-minded attitude of the client. Maggie’s Centres have of course seen a bevy of top-name architects design buildings over the years, from Frank Gehry to Zaha Hadid. Many of them no doubt enjoyed the chance to create small, beautiful healing environments which were also free from many of the constraints of full-blown ‘medicalised’ facilities.

In this case, however, Tenorio says that the practice jumped at the chance to “design something that brings joy and a sense of hope to people who are dealing with cancer, as well as their friends and family.” As he says, each Maggie’s Centre, by freeing up the ability of designers to create comforting spaces, “offers the opportunity to bring something truly inspiring to people’s lives.”

The brief to the architects was “very open,” says the architect, “to create a home for people that they wouldn’t have dared build themselves.” This trusting approach has also in the past contributed to the range of often idiosyncratic design responses from leading architects to the charity’s various sites. Tenorio does say however that “rather than come in with a magic bullet,” Heatherwick Studio engaged in a “lengthy back and forth” design process with the client, to establish the psychological implications of each of their decisions on users in this sensitive setting.

Site & form
Although the construction would be taking the last patch of green space, it was an unprepossessing grass-covered spot, containing landfill spoil from the construction of the adjacent multi-storey car park. The 6-metre level difference between the top and bottom of the site would “typically make the building be semi-sunk into the hillside,” says the project leader.

The design instead takes advantage of the slope, avoiding further unnecessary excavation, and providing a series of extensively landscaped roof terraces, the largest central one being accessible and offering expansive views of the Yorkshire Dales. With the tall buildings nearby providing something of a wind-tunnel effect, the building itself, as well as the tree-heavy landscaping, is designed to shelter and envelop the 110 visitors expected per day from the moment they arrive on site.

The spruce-framed construction sits amongst retaining walls designed in close collaboration with the landscaping architect to further minimise excavation. The site sits on a ‘blue route’ for ambulances heading to A&E, which could not be closed for long periods, so construction had to be as efficient as possible. This is one of the reasons why manufacturing the ribbed timber sections in Switzerland, and assembling them in pairs using timber plates onsite, proved ideal.

The idea for creating three forms came from the desire to place the counselling rooms “at the centre of this garden,” i.e. the extensively landscaped site. Topped by roof gardens, these ‘pods’ resemble large planters formed of curved and ribbed glulam, the one at the highest part of the site providing a protective canopy for the entrance. This and the lowest pod house full-height rooms, and the taller third volume is three storeys and sits at the centre of the site. The CLT slab roofs overlap each other slightly, connected at high level by strips of glazing, letting light flood in and creating an appealingly organic terraced composition.

The form of these curving timber vessels echoes the centre’s role supporting and giving advice to cancer patients and their families. Says Tenorio: “It’s something of an analogy for the strength that people need to gather to go through the process of cancer.” The lowest roof garden is viewable from the publicly accessible terrace, however all three are viewable from windows of surrounding wards, providing a new green outlook for many patients at Jimmy’s.

The remaining spaces created within the building, surrounding the pods, amount to one interconnected public circulation area – there are 23 spaces in total in this deceptively small 430 m2 building, all of which have their own interior design treatment. The site gets a good amount of light in the morning and late afternoon, but is shaded by the car park in the middle of the day. This helped orient the counselling rooms so that windows were located to “focus on the moments they will receive most of the sunlight.”

Tenorio says that one of the key things that charity founder, designer Maggie Keswick Jencks, had in mind in her blueprint for her first Edinburgh centre, was avoiding the traditionally inadequate welcome that NHS facilities tend to give. Jencks died of cancer before its completion in 1996, but was only too aware of “exactly how unwelcoming and sterile hospitals were,” says Tenorio. He adds that the design maxim being that “receiving a cancer diagnosis” – which many visitors will have just endured prior to arriving – “shouldn’t be any harder than it already is.”

Although the spaces within are free flowing, the overall effect of the forms is to provide an embracing, comforting feel, enhanced internally by the three overlapping and canopy-like structures. The placing of the two entrances has been carefully considered, working with the landscape designer to create a “seamless and natural” entrance, while locating them “in the most protected way for people on site,” i.e. under roof canopies that will provide shelter on rainy days. One connects the existing hospital with the centre directly, and leads straight into the communal kitchen, “the building’s heart,” says Tenorio; the other comes into the circulation space. Benches are provided outside the entrances for patients who may wish to have a moment of private reflection before entering.

Interiors
Once inside, the design is intended to intuitively guide the patients but also allow them to explore for themselves, and gain some agency at a very disorienting time. There is no reception desk – as per usual in Maggie’s Centres – but instead a variety of peaceful, bright areas to sit and read, or have a coffee around the kitchen table. Short runs of timber stairs connect the different mid levels; patients never need to ascend a full storey, but instead mezzanine-like distances – helping them navigate the building, and also tackling the gradient.

The pod spaces were designed to feel deliberately ‘private,’ in contrast to the rest of the building, as “when people are having therapy they want to feel protected.” The common areas have tall windows, giving a visual connection to the landscaping, enhancing the activities provided here such as group therapy and yoga, as well as sitting and having a conversation with family members. Trees on the landscaped terraces outside dapple the light falling into the interiors, and users can feel the breeze internally thanks to opening windows.

Lighting is an important part of the soothing ambience of the interior, with LEDs integrated into the exteriors of the timber pods, allowing the warm tones of the material to glow without the light source being fully visible. The luminaires are integrated into timber shelves and window sills, the shelving cleverly placed between the vertical ribs and along the floor-to-ceiling windows. This provides more storage space for books as well as for personal artworks to make the interiors feel more homely. Outside, the lighting is directed onto the trees, which creates projections of leaves to the interior once the sun goes down.

Tenorio says that the designers “almost had to work backwards, to specify how the lights would be integrated at an early stage, as the building was still taking shape when the lighting design came on board”. They worked closely with lighting consultant Light Bureau as the lighting positions dictated some of the shelves’ locations.

The shelves also provide a key location internally for some of the many planters within the centre, that make it an unusually verdant healthcare interior. Tumbling out of their containers, the plants enhance both walls and stairs to imbue something of a feeling of a timber conservatory to the common spaces. Tenorio: “We wanted the plants to be the heroes.”

With Thomas Heatherwick having come from the world of furniture design, it’s no surprise that key pieces here are designed by his studio. The practice designed two tables inspired by the building’s timber fins and built, by Temper Studio, from cork and engineered beech timber, which sit in the ‘heart space.’ The kitchen table is an important social centrepiece of every Maggie’s Centre, and here, the table’s ribbed timber legs provide a tie-in with the overall structure. Heatherwick Studio was responsible for the interior design, and worked with Coexistence to find other pieces of furniture that fitted within the architects’ vision.

The focus on natural materials is perhaps most evident in the upholstery, chairs and tables, as well as the substantial curtains which are made of wool. Such products’ tactile qualities are “often missed in healing environments,” says Tenorio. Natural finishes used include porous lime plaster, aiding internal humidity.

Timber
The decision to use timber, in addition to its therapeutic natural qualities and abilities to construct the building’s sculptural form, was also partly as a response to the complexities of the site. The sloping, and also contaminated land would have required “significant amounts of deep piling,” says Tenorio. Instead, a lightweight set of connected pavilion-type structures over a “rough” slab would provide the minimal loads and maximum environmental benefit.

A further pragmatic reason to choose timber was that its inherent insulating properties mean that the structure could be used exposed but also running from the interior to the exterior, “without having very complicated cold bridging details,” says the project leader. The glulam fins in turn all provide structural support, in combination with the slab and lightweight timber cassette walls providing a monolithic whole that avoided the need for steel connecting plates, giving cost savings.

The building is virtually all-timber, including the lift core, however window frames are aluminium due to their size.

The internal carpentry, such as the bespoke handrails, was done by local craftsmen from Yorkshire, who, Tenorio reports, “were inspired by the building and its purpose, which really helped bring everyone together.”

The CLT roofs’ design challenge was to remain watertight while providing the layered build up that would support thriving gardens, featuring trees, shrubs and flowers. The system chosen was low-tech, specified with the landscapers and roofer, “a combination of working with different trades.” It features automated irrigation, but is simple and low-maintenance, comprising CLT slab, OSB layers forming the drainage gradients, protected by a membrane, an “egg box” drainage layer, and finally a lightweight layer of soil. The changing gradient has been used to make areas offering deeper soil for larger trees.

Reactions
Angel Tenorio gave a talk at the hospital during the project’s gestation, and one comment he received vividly demonstrated both the power of the design, and the lack of expectation from patients thanks to their previous experience of health buildings. A cancer patient asked him, “Is that building really going to be for us?” Now, following completion, the building is a huge success, its landscaping changing through the seasons. Tenorio highlights how its comforting form delighted one user, a young girl, prompting her to say she loves coming to the centre because “it’s like her blanket.”

The centre received 3,300 visits before it was locked down in March 2020 (it reopened in the summer and continues to support visitors and families both in person and remotely over Zoom). On revisiting in June, its project architect saying happily that the garden was “flourishing, and changing, and will be a continual surprise.” Around a third of users have been NHS staff, using this reassuring and beautiful space as a breakout area from the extra challenges they are facing from Covid.

Hopefully we may reach a time when such genuinely caring building design isn’t a stunning and sadly paradoxical exception in healthcare, but something that we may rightfully come to expect.

Project Factfile

• Client: Maggie’s
• Architect: Heatherwick Studio
• Landscape designer: Balston Agius
• Lighting consultant: Lighting Bureau
• Structural engineer: AKT – II
• Construction manager: Sir Robert McAlpine
• Timber contractor: Blumer Lehmann
• Table manufacturer: Temper Studio