High-rise healing for young cancer patients

Built “on stilts” – a series of steel raking columns 9 metres high – by Cowlin Construction, and located between the adult and paediatric oncology centres at the University Hospital of Wales, the new TCT Cardiff unit was officially opened by Sarah, Duchess of York. The opening was also attended by rock band The Who’s “frontman” Roger Daltrey, and Kelly Jones of the Stereophonics, both active supporters and fund-raisers. TCT is a UK charity that helps young people fight cancer, and which has a number of other teenage cancer units located within existing NHS hospitals throughout England and Scotland. The total project cost of £3.4 million needed to build the new Cardiff unit was entirely raised by the charity. The so-called “Skypad”, thus named because of its elevated position on raking columns, is Wales’s first specialist teenage cancer facility of its kind, and is designed to provide a comfortable, relaxing, and specialist environment for young oncology patients that “fall between adult and paediatric cancer care”. Roger Daltrey alluded to this in his speech at the official opening when he said: “Without these units teenagers are put into children’s wards with babies and under 12s, or onto adult wards where they could be with geriatrics. That’s certainly not good for teenagers, and even worse for the older people.” Constructed to provide care for young cancer patients from across South Wales, the Skypad is, as ORMS describes it, “designed to give young people an environment more akin to a boutique hotel than a hospital ward, and therefore the very best chance of a positive outcome”. John McRae, a director at the London-based architect, adds: “While in recent years there is no doubt that bed space has improved, latterly especially with the provision of single bedrooms, as a practice we have often felt there may be something missing in the healthcare sphere. All too often clinical function has appeared to dominate design aspirations to an excessive degree, and for a teenager with cancer there is real danger that the presence of large items of medical equipment and, for instance, large bumper rails within their room or ward, can simply overload the senses. One of the prerequisites for healing is surely providing complete peace, and it is equally important to bring in daylight and sunlight to provide an uplifting, rather than a depressing, environment.”

Inclusive design

Intended to provide such an “uplifting” inpatient and day care environment for 13-21 year olds suffering from a variety of cancers, the Cardiff TCT Skypad has been designed and built as part of a joint venture between the Teenage Cancer Trust and Cardiff and Vale NHS Trust, which operates the University Hospital of Wales. In November, it was one of two projects to win a Judge’s Special Award at the 2009 Building Better Healthcare Awards. John McRae explains that a working group was formed in 2004 at “a very early stage in the project” comprising commissioning, nursing, and infection control staff, consultants and patients, as well as representatives from design team members project manager Jackson Coles, structural engineer Price & Myers, services engineer AECOM, development consultant Derwent London, and ORMS, to “guide the project from day one and get buy-in from the staff and patients”. “This group worked on a very hands-on basis,” he explains, “with, for instance, the patients getting involved from the very beginning in choosing aspects such as materials, colours, and graphics, for use around the interior, and the key items of furniture.” The decision to construct the two-storey building, a “bright blue pod” with a courtyard to the front, on metal supports, was taken for several reasons. These included, on practical grounds, positioning the structure above service chambers and fire escapes below, while from a patient and other user standpoint it was important to maximise incoming daylight and sunlight – key features of the new building – and to provide attractive views over the surrounding buildings in the vicinity to the hills and woodland in the distance. With the “entirely landlocked” site making access difficult, the entire structure (which took two and half years to complete) was built using a crane situated in the car park of the adjacent paediatric unit immediately to the north-west. On the first floor, designated “Zone 1”, and accessed via a lift/large lobby, is the central nurses’ station, with two single en suite inpatient bedrooms behind (or to the west) and two three-bed wards to the other elevation (to the east). The latter are separated by a chemotherapy preparation area, a linen store, and en suite bathrooms for the three-bed wards. To the front, or south, of this floor there is an assisted bathing area, with a sluice room, nurses’ WC, and filing/ storage area to the rear. John McRae says: “To create a deinstitutionalised feel we used what we describe as ‘sensitive architecture’ throughout the building to make the unit itself a vital medical instrument in the overall healing process. The bedrooms, for instance, do not feature the ‘traditional’ 150 mm bumper rail, but instead incorporate a full height panel extending from the floor upwards to around 900 mm, with a beige laminate dado rail.”