Design process

In 1995, before the future use of the West Wing had been decided, the London-based practice, Greenhill Jenner Architects, had been engaged to manage a programme of external repairs to, and the cleaning of, James Gibbs's Grade 1 listed building, completed in 1752. At the time the building was only partially occupied and in poor internal condition. After a series of studies about its future use, it was agreed that the West Wing should be adapted to allow the consolidation of all outpatient services associated with breast cancer. This would bring two advantages - it would create a single multi-disciplinary centre which was truly patient focused and it would free up other space which formed part of the major PFI project upon which Barts was about to embark. The challenge was considerable; with the demands of a Grade 1 listed building and challenging 'wish-list' for medical equipment, costs would be high - but so too was ambition. 

The timing was right; the senior consultant was a powerful advocate, the head of fundraising was optimistic and the project manager enthusiastic, while the architects leading the design team, appointed under the OJEC selection process, already knew the building well.

The vision for the new centre was for a 'multi-disciplinary one-stop breast clinic…in a human and reassuring environment in which quality is key - in terms not only of the building fabric and finishes but of providing a patient-friendly service.'

In preparing the way forward and throughout the building contract, consultation formed an important part of the development process. A steering group, which included senior medical staff, worked closely with the full design team while the architects also met regularly with the patient support group, often in the shell of the building. All this helped to gain real information and ideas from those who had experienced or operated the service and to encourage a sense of ownership of the project as it developed. To resolve some of the more controversial design decisions, particularly that consulting rooms should not have views onto the square, a mock-up of a typical new consulting room was built, helping to convince senior clinical staff of the benefits of what was being proposed and illustrating to English Heritage the integrity of the architectural approach to the interior.

Key to the future operation of the building was the analysis of the patient journey by RKW Healthcare Strategists. This helped to plan a pathway through the building that would be easily understood, even by those for whom English was not a first language.