This was a rare chance to place a modern hospital in a woodland setting, making the most of the beautiful, natural, healing environment. Our design has sought to enhance and celebrate that natural beauty from the moment of approach, through arrival and throughout the patient’s time in hospital.

Like the healthcare on offer in the new Heatherwood Hospital, we took a holistic approach to designing both the masterplan and the hospital buildings, drawing in the landscape to maximise its links with nature and place wellbeing at its heart for generations to come. 

The main arrival area to the hospital site is enclosed by woodland, which will be protected and enhanced with planting in celebration of its setting and in order to screen the adjacent car parking. Semi-mature trees form an avenue along the approach road providing a structure and threshold to the hospital, complemented by an underplanting of ornamental shrubs.

This naturalistic planting scheme blends into a more formal, sensory and textural planting scheme towards the building complex itself leading the visitor on a journey through nature into the hospital and encouraging a sense of calm. Defined by high quality natural stone paving, the generously proportioned main entrance area extends to include the taxi/bus set down/pick up zone and creates a legible route linking the shared cycleway to the main steps and lift to the building entrance.

Once inside the main entrance of the planned-care hospital, nature and landscape will be reflected on two sides, both from the adjacent, double height café with views into the woodland setting and in front through glass walls and doors into the courtyard area outside the main waiting space.

Patient bedrooms will have views across the treetops and access to outside terraces supporting the recovery process. All in-patient rooms, where people are likely to stay for longer periods, are on the top floor where they can enjoy the visual connection with the woodland setting, both near and far. So it’s not just views of the treescape in the distance. In the South facing rooms, it feels as though you can almost touch the trees, and enjoy the life and activity within their branches. With a broad range of species identified from pipistrelle, noctule and brown Long-eared bats to woodland birds including cuckoo, song thrush and yellow wagtail, along with the landscaping designed to protect them, these are expected to be lively and varied natural scenes. 

The building and its materials have been carefully selected to respond to its setting, with the main entrance sited at the first floor level making the most of the tree canopy as a backdrop and vertical timber cladding on the upper levels offering a notional tree-house. 

The floor to ceiling glass wall of the café space, timber rather than aluminium framed to reflect its setting, will present woodland views and glimpses of nearby nature walks. A large, biodiverse balancing pond making use of the site’s natural run off will offer an ecologically diverse habitat with terraced access down to water level on one side allowing safe interaction with aquatic life. The remaining embankments will be planted with marginal aquatic planting, merging into the grassland of the woodland clearing.

Opportunities to experience nature have been built into public spaces within the building complex, including the communal courtyard which links the main hospital with the GP hub and administration building. This will include semi-mature arboretum trees and sensory and textual planting. Elsewhere, a sheltered roof garden enclosed on all four sides will offer micro-climate conditions conducive to a creatively planted, verdant oasis for retreat and relaxation. Whilst it will be accessible, this interior garden will be primarily experienced from within the building, offering a pleasant and relaxing view from the spaces that overlook it.

Ecologically diverse, green and nature-attracting interior courtyards are a prominent feature of another major hospital we have been working on which is now approaching completion.  

Head west across the Welsh border to a vastly different but equally beautiful landscape, on agricultural land outside Cwmbran, and you will find the newly opened Grange University Hospital. The £230 million specialist and critical care centre, commissioned as part of the Aneurin Bevan University Health Board’s Clinical Futures Strategy, was due for completion in 2021, but this spring large parts of the flagship 471 bed facility opened a remarkable one year early in response to the coronavirus outbreak.

Right back at the beginning, long before considering what the hospital would look and feel like, deciding where on the site it would be situated was key. We started by consulting the community. Strengthened by the public response, we advocated strongly for it to be sited in a way that maximized views of the surrounding landscape. Sited on the edge of a designated area of special landscape, it is an incredible setting, which we sought to celebrate throughout the hospital site planning and design. The building offers panoramic views of its stunning natural surroundings, maximising opportunities for patients to engage with the healing natural landscape.

As much of the existing ecological habitats in and around the site have been protected as possible, and in many areas enhanced. Existing trees, woodland and hedgerow pockets have been retained where feasible, and in line with the aspirations of the Torfaen Biodiversity Action Plan, further developed to increase coverage and species richness along with the planting of new woodland, meadow and grassland. Belts of woodland planting extend along the banked edges of the parkland where the approach roads enter the site helping to screen them from views from the hospital wards and visually link the parkland with its wider rural setting.

The unique natural environment is also actively reflected in the design and built form of the hospital itself. Fully integrated into the surrounding landscape with its open agricultural land, parkland and residential community to the west, the design seeks to capitalise on the healing benefits for patients of providing views out to the open countryside.

We made the conscious decision to run the countryside right up to the building – wrapping around it.  Until now, hospitals have been surrounded by car parks but we sought to avoid a sea of cars engulfing the building, so the car park is sited to one side, allowing us to maintain a green, open frontage to the hospital’s approach and entrance. Open parkland to the west of the hospital includes wildflower meadow and grassland planted with specimen parkland trees that extend right up to the building.

Within the built environment of the hospital, the public realm and open space offers a healthy and therapeutic environment, providing opportunities for relaxation and exercise for patients, staff and visitors.

Using a considered palette of materials to respect and reflect its surroundings, this integration with the landscape continues within the main hospital complex. A series of five internal courtyards overlooked by the wards bring natural daylight and an attractive and restful outlook with natural, visual interest and stimulus throughout the year. The design concept draws on the spirit of the original spring that was located on the hospital site, using planting, paving and decorative features to convey the sense of the original tributary moving through each space, reflecting the different local landscapes it passes through, from open heath and woodland to lowland meadow. Each courtyard has a different planting character but will be tied together by the ‘tributary’. As far as possible, native species have been planted in preference to non-native but in all planting sources of pollen; nectar; berry and other food sources for insects and birds have been actively considered. The latter will also be planted for their sensory qualities and seasonal interest.

Windows from the wards and patient bedrooms will look out internally onto these vibrant, natural spaces that change with the seasons.

This seasonal and varied planting concept also extends to the central lawn area at the main entrance with its flowing carpet of vibrant heathers reflecting the local heathland and parkland within the grounds of the historic Llanfrechfa Grange. This will be overlooked by the floor to ceiling glass walled frontage of the hospital restaurant, with views across the lawn to the countryside beyond.

Situated on the first floor, the restaurant facade is wholly transparent with an external balcony terrace that doubles us as sheltered walkway underneath on the approach from the car park to the main entrance.

Built in protection for the Grade II listed Grange House and the adjacent walled garden brings a further opportunity to interact with the original landscape. Part of the original Grange estate, we worked with a group of local volunteers to clean, clean up and restore the walled garden, returning it to some of its former glory. Our concept is that it will become a popular place to get some fresh air and exercise demonstrating the therapeutic benefits of planting and gardening. Possible future uses include a productive garden that can be managed as a community project, with potential for a café, shop, nursery or allotment.

Elsewhere on the site a Play Garden provides access to nature for the hospital’s youngest patients and visitors with timber fencing and shelter, beech hedging and border of colourful sensory planting, maximising the use of natural materials.

So much has changed since Ulrich’s now famous ‘View through the window study’ as understanding has grown of the power of nature on recovery, healing and wellbeing. The challenge now is to build on this work, find ways of capturing the evidence and monitoring the outcomes on patient health and staff recruitment and retention.  We embrace, embed and celebrate nature in healthcare design at every opportunity, often requiring creative solutions to significant financial and practical complexities. Fortunately, this is a challenge we relish.

This article was originally published in Heath Estates Journal in September 2020. See article here.