Thoughtful design and the patient experience

Since its first centre opened in Edinburgh thirty years ago, Maggie’s has been putting the patient experience at the heart of its cancer care centres. Its goal today remains the same as it was three decades ago: to provide a ‘home-away-from-home’ within the grounds of major NHS cancer hospitals for those grappling with the unknown while navigating a cancer diagnosis.

Guided by these values, the team at Maggie’s quickly realised that without the help of a specialist contractor aligned with their vision, what they might be able to deliver for patients would be limited.

Executing technical excellence in design and evoking the restorative power of great architecture called for experienced construction teams unfazed by the prospect of a challenge. While traditionally within healthcare environments, complex design is seen as surplus to requirements, when Maggie’s posed the ‘cosmic whirlpool’ concept to Sir Robert McAlpine for its Singleton Hospital project in Swansea, saying ‘no’ was not a consideration.

Forming a long-standing collaborative relationship between the contractor and the charity, the Swansea 
site build set the tone of what future Maggie’s projects should, and would, look like, kickstarting a 15-year 
long partnership that continues to this day. Prioritising bespoke, evocative design that meets the practical 
needs of patients while pushing the boundaries of traditional healthcare settings, Maggie’s and Sir Robert McAlpine have exemplified what aspirational 
healthcare design can look like.

But along this journey, challenges inevitably arise. Whether that be working within tight budgetary constraints, building on small plots of land, or pushing back against the traditional notion of healthcare settings, how have these challenges been navigated? How can set perceptions be changed? And, ultimately, what can be done in healthcare design to prioritise patient experience?

Mindful design decisions

A cancer ward is an inherently stressful environment. People walk in feeling understandably anxious, and potentially walk back out with a life-changing diagnosis. The purpose of mindful healthcare design is to provide peaceful respite; a breath of fresh air and a change of scene that can result in a moment of comfort, distraction, or even joy for anyone who steps foot into the space.

Achieving this can be simpler than expected. First impressions, for example, play a larger role than they are given credit for: walking into a hospital and being met with a receptionist at a desk, the line of sight often impaired by a large computer screen, limits the potential for, and quality of, human interaction. Which is why, at Maggie’s centres across the UK, an open plan layout is non-negotiable. Being greeted at the front door by a friendly member of staff mirrors the experience of being welcomed into someone’s home. Instead of a reception desk, patients are invited to sit at a kitchen island at the heart of the centre, and offered a hot drink.

Furthermore, you will not find a sign offering directions within a Maggie’s centre. People do not have signposts up in their home, so why, when trying to provide comfort for patients, would their care facility need them? Kickstarting conversations, asking someone where the bathroom is, strikes up a genuine interaction, offering guidance and support for patients.

Considerations like these are often overlooked in traditional healthcare settings, especially when budget and practicality are prioritised — yet make a world of difference to overall patient experience, as our support centres have demonstrated over the years.

One way that design choices like these can be justified to decision makers and budget setters is by demonstrating the multifunctionality of a space. When it comes to budgeting, spaces like a wellbeing room for yoga classes are deemed ‘less essential’, but a shift in perception can make any room a space for yoga, rest, or relaxation. Rather than designating rooms with a purpose, spaces can be made multifunctional to adapt to different needs. When thoughtfully implemented, these spaces can be designed as an asset to the healthcare facility.

For example, through the use of sliding doors, like those installed at the Maggie’s centre in Northampton, spaces can become transitional, meeting the changing needs of a healthcare environment. While continuing to boast a largely open plan building, rooms can, in effect, be ‘created’ as and when they are needed.

With doorways large enough to move furniture in and out comfortably, the space can become a counselling room, or bereavement space for those wanting total privacy. In the same vein, providing individual toilet cubicles with floor to ceiling doors, as opposed to a row of stalls, means that people can quickly excuse themselves, if needs be, to have a moment alone.

Enabling people to personalise the space in line with how they want to use it allows them to feel like it is theirs — encouraging a sense of autonomy and independence at a time when they may be feeling vulnerable and alone. It is this sense of autonomy that all healthcare providers should be striving towards for their patients.

Bringing the outside in

Before even setting foot in a Maggie’s centre, patients will have to walk over from the hospital and through the front door. Landscaping and outdoor design therefore play a critical role in delineating this transition. Leaving the hospital environment behind them, a thoughtfully crafted outdoor space allows patients a moment to breathe. This means landscaping design should be considered from the early stages of a construction project, rather than as an afterthought, to allow for mindful decisions that create a seamless flow from outdoors to indoors, and vice versa.

Furthermore, for those who are having a tough day of treatment, or are particularly fatigued, it is important that they can reap the benefits of well-designed outdoor spaces from the comfort of a cosy armchair, sat with a book in a warm room. Even if they do not feel capable of venturing outside, it is important that patients can see the changing weather and seasons and maintain connection with the wider world around them.

A beacon of hope

The teams at Sir Robert McAlpine and Maggie’s both understand that architecture and interior design cannot solve people’s problems when grappling with a cancer diagnosis for themselves or a loved one. However, when clearly laid out in an architectural brief, what can be provided is a place that acts as a beacon of hope; an uplifting space where patients and those affected can rest and receive care.

Beyond this, feats of architectural innovation are so out of the ordinary in a healthcare setting that they can provide a welcome distraction, albeit briefly, as patients start to come to terms with a diagnosis or treatment plan. At the centre next to Northampton General Hospital, for example, the building’s precisely engineered cantilevered roof acts as a talking point for those seeing it for the first time: architectural excellence creating an entry point for people looking to access the care and support available inside.

Putting theory into practice

Examples like the Northampton project show that the best way to achieve not just good, but unique and innovative results, is by giving contractors the room and independence to contribute to the design of a healthcare setting from the beginning.

The chance for contractors to share their expertise on how to transform architects’ visions into buildable designs should be offered at an earlier stage, allowing a variety of views to be shared as well as a view on what is practically feasible. It is this experience that is invaluable when hoping to inject innovation and creativity into a healthcare project. Indeed, having worked on ten projects with Maggie’s to-date, Sir Robert McAlpine knows the best ways to incorporate architectural innovation without forgetting the integral goal of every project — enhancing patient experience through design.

Wellbeing at the heart of every project

We have seen a boom in wellbeing initiatives, consideration and recognition over the past decade, which should be applauded. As all industries are addressing ways in which they can embed wellbeing, the healthcare property sector should be doing the same.

Serving the important purpose of providing life-changing cancer treatment to those in need is unquestionably driven by care and compassion. So, it is time that commissioners, contractors, designers and architects across the board integrate this same approach. Creating spaces that evoke a sense of welcome, belonging, peace and comfort should be viewed as an essential additional consideration within healthcare.

People who lose loved ones to cancer often come back to Maggie’s sites to reflect on quality time spent with family members in their final days. The importance of thoughtful design goes beyond patients, also providing support for family members and those bereaved. The fact that architecture in healthcare settings leaves such a lasting impression on those who experience it shows the power of great design and the importance of its careful consideration in healthcare settings.

While by no means a small ask, in an ideal world, the end goal for healthcare design is to see this mentality put into practice across the board. When all stakeholders in a healthcare project are aligned in appreciating the value and impact of bespoke healthcare design, patient experience can be enhanced for all.