What’s the relationship between design and wellbeing? Within the sector of healthcare architecture, and with the progression of technology, there’s been a strong focus on the value of making clinical spaces more human. Now, extensive research, data-driven decisions and constant reassessment are increasingly present in hospital design. While there’s a contemporary transition to a user-centred design, the ambition to humanise healthcare spaces is not revolutionary. Various designers over time have created their own ideal on how architectural and interior design can heal patients.

A 'Nightingale ward' at St Thomas's Hospital ca. 1910-17 King’s College Archives: StTs ward

Architect George Godwin and nurse Florence Nightingale transformed hospital design in an endeavour to improve public health in the Victorian period. Some of their initiatives encouraged tall windows for sunlight, fresh air ventilation and beds far apart in wards. Their separate work propelled a ‘real change in attitudes towards healthful buildings for the care of the sick’.

Powell & Moya, Wexham Park Hospital (1965) in Slough, London.

The beginning of the 20th century saw a recognition of the need for private rooms in public hospitals. The 1960s saw a boom in hospital architecture with a large UK government investment of £500m over the decade. While it soon became restricted by a politically charged context and cost-planning, it was clear that there were changing attitudes to illness and care. Some hospitals were designed to favour generous natural light as sunlight is proven to have antibiotic properties. Enclosed gardens became part of some schemes. 

The Architectural Review (May 1970) admired Powell and Moya’s Wexham Park Hospital, Slough (1965) for, ‘the sheer humanity of its scale… Slough’s humanity is firmly rooted in Philip Powell’s personally held conviction that a hospital as a building itself has a duty to provide mental therapy to those who work or stay there.’ 

In recent decades, increasing attention has been paid to humanise hospital environments. David Bissonnet, a Purcell Senior Consultant, has worked for years on healthcare, with a special emphasis on patient-focused experience design. His new-build project the Big C centre in Norfolk is a celebrated example of cancer care units. The design was rooted in the needs of the people who spend their days in the environment. David asserts that patient experience is key for successful design. ‘What will the patients see as they enter go to reception and waiting area and then are treated or consulted? What is their experience? How can the layout furniture colour and art contribute to them being as relaxed as possible in an intimidating situation?’

The Big C Cancer Family Centre project at the Norfolk and Norwich Hospital was a new building where the client, a charity, had previously worked from a cramped existing building. The site is an exposed position at the hospital main entrance near the existing cancer treatment departments. The building is two enclosing curves, with the idea of ‘protecting against the outside world.’

The design called for a clear understanding of the client’s needs. David said, ‘the charity wished that the patient experience should be as unmedical as possible. This led to a design based on the way that a domestic house is used. The entrance has no reception desk and visitors are greeted by staff or a volunteer. The living room is visible from the entrance, with its fireplace, the hearth, the kitchen table and the library and therapy rooms, that could be bedrooms. The furniture, curtains, a warm colour scheme and the pictures on the walls aim to make people feels as relaxed as possible. The spaces are flooded with natural light and gardens are made private by curving screen walls give people contact with plants, water and nature.’ As a result, ‘unprompted, many clients said that Big C was like a house that they would like to live in.’ While this is a more domestic approach, it underpins the relationship between design and wellbeing, with tailored design for the use of the place.

The ideal of a humanistic healthcare architecture to improve wellbeing is now accepted and achieved in many healthcare buildings. It operates as a symbol for wider social concerns about the care of patients in modern medical practice, as well as a movement towards the importance of design psychology. Quality architecture and tailored design is important when considering healthcare service design. While improving the functional abilities for institutions and companies, it’s important to design a user-centred environment that will improve the health sector experience. Ultimately, effective design can work to actively improve the patient’s good health and as a result, make better rates of recovery possible.

‘Living with Buildings’,, October 4 2018–March 3 2019

By Jess McCulloch