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With the right architecture, the hospital building can be a ‘third carer’ for patients

Eleanor Young

A cash injection for some 40 hospitals by 2030 means an injection of new thinking is also due. We listen in to Ab Rogers’ RIBA + VitrA talk on his Living Systems concept for built environments that help alleviate symptoms and improve wellbeing

Perspective of Living Systems Health Centre.
Perspective of Living Systems Health Centre. Credit: Ab Rogers Design

Ab Rogers has spent a year researching how architecture can be a ‘third carer’ (the first two being the medical team and the family) and designing through collective intelligence after winning the 2021 Wolfson Economics Prize.

Rogers has been designing hotels, boutiques, festivals and houses for nearly 25 years as Kitchen Rogers Design and then Ab Rogers Design. But it was working on a Maggie’s Centre, designing a striking red-clad structure for London’s Royal Marsden Hospital, that brought him closer to understanding what architecture could do for a patient.

‘It can reduce stress and bring comfort to the patient,’ he says, adding that not only can it be a machine to fix broken bodies, but also important in health creation. And so he put together a team for the £250,000 Wolfson Economics Prize on health buildings in 2021.

Ab Rogers Design has always used experimental psychology to inform design but, for the Wolfson prize, was also informed by regular meetings of 50 advisors, from doctors to drug addicts to homeless people, all chaired by a urologist. The designs and wider proposals for planning and designing a hospital of the future, Living Systems, have absorbed and reflected those discussions.

  • Shared bed ward with visitor.
    Shared bed ward with visitor. Credit: Ab Rogers Design
  • Outpatient waiting room leading to balcony, showing vibrant colour palette and natural light.
    Outpatient waiting room leading to balcony, showing vibrant colour palette and natural light. Credit: Ab Rogers Design

‘It has been designing through collective intelligence,’ says Rogers. The proposition tackles the hospital’s role and position in the community, the infrastructure of the hospital and the micro level of surfaces and sensations. 

The proposed diagram for a new hospital has a compelling form: a 'flower tower' that fits the idea of an ecosystem for health, which ranges from hospital food growing on the roof, and chefs for each floor, to market and community spaces – markets, parks - on the floor plane (plant is tucked away on the third floor). There would be no carbon-costly basement. And the cleaners would have a sense of ownership through being local and directly employed rather contract staff.

The proposed petal-plan would also go some way to tackling the sheer volume of corridors in most hospitals and the complexity of wayfinding this generates. ‘There are so many signs,’ Rogers says. ‘It is hard having to navigate a series of corridors when you are stressed.’ The proposal’s emphasis is on empowering patients, giving them dignity and respect. 

Rogers is particularly compelling when talking about why natural light is so important. He argues that it gives a sense of the circadian rhythm and allows patients to feel alive; for the same reason wards all need a clock. ‘You need to disturb the day so it is not relentless,’ he says. On the importance of windows, he cites the medical value of ultraviolet light for vitamin E as an anti-bacterial agent. 

The final report asks fundamental questions concerning issues such as where you sit, or rather lie – proposing that if patients spend much of the time looking at the ceiling the designer should spend more of their time making a better ceiling and helping soften the acoustics so that people can feel at home. 

Would all this cost a lot more? Maybe. But Rogers points out that capital costs are a fraction of what a hospital costs to run. And in return, you get savings from lower energy bills, less waste, happier staff with reduced turnover and better health outcomes.

The work has already generated a huge number of conversations and the occasional request to build out the design – but no contract yet. Rogers is taking it slowly, wanting to ensure things are done properly. 

‘A medicine never goes on the market without full testing,’ he says. ‘But space is unsurveyed.’ 

RIBA + VitrA talk: The Third Carer: a vision for a new type of hospital with Ab Rogers is available shortly on the RIBA's YouTube channel


Exploded isometric drawing analysing the components of the podium.
Exploded isometric drawing analysing the components of the podium. Credit: Ab Rogers Design


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