Industry interview – Paul Yeomans, Medical Architecture
Jo Makosinski speaks to Paul Yeomans, director at Medical Architecture, about his experience designing healthcare buildings and how approaches have changed over the past two decades to create more-supportive facilities
Paul Yeomans, director of Medical Architecture
Q: When and how did you first become involved in the design of healthcare buildings?
A: I had been working at a well-known Newcastle practice for six years, delivering some lovely projects in the museum, education, and residential sectors. So, when I got a call from now retired Chris Shaw, I was at a little bit of a crossroads.
I’d been headhunted and MAAP (as the practice was know at the time and later rebranded to Medical Architecture) was looking to establish an office in Newcastle on the back of significant work it had started delivering for Northumberland, Tyne and Wear NHS Trust and Laing O’Rourke under the NHS ProCure21 framework.
Over a pizza, Chris told me all about the company’s philosophy and opportunities, saying: “I’m looking for somebody who can run our new studio. I don’t know how it’ll go, but the prospects seem good, and the opportunity is there if you are interested.”
Looking back, it was quite a leap of faith.
The company’s sole focus was the health sector and I’d never designed any healthcare buildings before, but Chris and the other directors were clear that first and foremost you should be a really-good designer, the nuances of healthcare design could be learnt.
In September 2006 I took that jump and set to work on my first healthcare project and building a team to support it.
I’ve never looked back!
Yeomans led on the design of Sycamore medium-secure mental health unit at Northgate Park Hospital, Cumbria. Image, Richard Chivers
Q: In your opinion why is building design so important in the overall delivery of healthcare services?
A: So much of our work is incredibly rewarding, not just in creating good buildings, but also genuinely-worthwhile design that enables clinicians to treat patients, and people to recover better.
I recognised this on my very-first healthcare project. It was a significant reconfiguration/extension of a Victorian mental health inpatient ward to create a modern, fit-for-purpose psychiatric inpatient care unit – often the patients with the most-challenging behaviours.
They arrive at the building at the peak of crisis, and for the first time in my career I witnessed that the architecture and building design was having a measurable impact on its users, rather than it being subjective and anecdotal, which is what I had been used to in other sectors.
Post-occupancy studies with this building revealed that there had been a 60% reduction in violent incidents and that prescription drug use had also dropped significantly.
This had a lasting impact on me.
Although this evidence was related to mental health design, our continued use of post-occupancy and benefit realisation studies in all sectors of healthcare design all point to the same findings – high-quality buildings improve the patient experience and the quality of care provided.
Cavell Passivhaus Community Health and Wellbeing Hub. Image, Pillar Visuals
Q: What has changed in terms of design approaches/interventions since your first project?
A: Throughout our history we have challenged the field of healthcare architecture to focus on improving the patient experience, supporting recovery through therapeutic design.
In an acute setting, the human experience makes a huge difference to wellbeing, recovery, and the perception of care quality.
Careful consideration of circulation spaces, wayfinding systems, artwork, lighting, and interior design can raise a mundane experience to a dignified and positive event.
I think the one fundamental aspect that has changed is the scale of healthcare infrastructure spend and ambition.
We are used to the cycle of government spending, the peaks and troughs, but in the last few years our clients are having to do more with less money and our designs have to be even more effective.
Dorset Hospital Critical Care Unit. Image, Renderloft
Q: What are the key things you have learned in your career designing healthcare facilities?
A: Architectural design is fundamentally about the way space, structure, and environmental conditions are modulated, and the way that a place is used.
The architect needs to deploy and orchestrate physics, social sciences, economics, and aesthetics.
I really love that in architecture you can join the dots in so many interesting and creative ways.
Specifically in healthcare, we’re in this brilliant position where you’ve got architecture at the crossroads of medicine, two great professions where you’re really making a difference.
Q: Did COVID change the way we approach the design of healthcare facilities?
A: I don’t think there were any fundamental changes as to how we design, but I think there was a change of mindset with healthcare organisations.
More importance was placed on looking after staff – providing much-better spaces for rest and wellbeing.
Also, there was clearly a heightened importance for control of infection and making sure that flows of patients/staff/visitors/FM worked well.
Our general approach to planning design is to ensure spaces are flexible and adapt to a wide range of situations and use – and the importance of this came to the fore during COVID.
New Specialist Hospital Building, Royal Victoria Infirmary. Image, Eye Level Creative
Q: How do you think design approaches will continue to evolve in the future?
A: The legacy of past and current underinvestment tells us that continuing with managed decline is an undesirable, risky, and expensive option.
Despite the poor state of public finances, good custodianship of our healthcare infrastructure goes hand in hand with providing what the public expect: modern and effective health services in buildings that are safe, attractive, and a great place to work.
This needs strong leadership, skill, and a concerted effort to secure short-term improvements while nurturing a long-term positive vision for our healthcare estates.
This dual strategy entails building a pipeline of rapid, revenue-driven, high-impact improvements alongside strategic plans that will underpin a robust and appealing forward vision.
New NHS facilities will integrate sustainable design, modern methods of construction, logistical automation, and digital technologies to ensure our healthcare infrastructure is fit for the future.
Biography
Paul is a director of Medical Architecture, with over 17 years of experience in healthcare design. In 2022, he was awarded a Fellowship of the Royal Society of Arts for his leadership in healthcare design. He is also an associate for the Design in Mental Health Network and member of their Conference Advisory Group and Design Awards jury. Through this role, he contributes to best practice guidance in mental health facility design to raise standards across the sector and improve the experience of patients and staff across the UK and internationally. Paul is a regular speaker at conferences and uses this platform to promote good-quality healthcare design. His project portfolio has received awards from the RIBA, Building Better Healthcare, Design in Mental Health, and European Healthcare Design.