PRINCIPLES OF DESIGNDEMENTIA CARE

The World Health Organisation states that, 35.6 million people have dementia and there are 7.7 million new cases every year. Dementia is one of the major causes of disability and dependency among older people worldwide.

Although dementia mainly affects older people, it is not a normal part of ageing. The disease is the healthcare challenge of the 21st century. Our ageing population means the high incidence of the disease is set to soar.

- The disease costs the economy £23 billion a year

- Over 800,000 people in the United Kingdom affected.

- By 2040 the number affected is expected to double

People with dementia in general hospitals have worse outcomes in terms of length of stay, mortality and institutionalisation.

Planning for the future is needed now to ensure that the right care, support and environments are available. This includes: effective care settings, encouraging and supporting independence among those with dementia and promoting new cost-effective models of service that provide enhanced care.

Creative use of artwork to prevent overlooking from a corridor window and provide point of interest. St. Nicholas’ Hospital, Newcastle upon Tyne.

Dementia is not: Dementia isn’t when you can’t find your car keys. We all do that. It’s when you’re standing at the door with your keys in your hand and you don’t know what they are there for.

ENABLING DESIGN

A landscape of therapeutic gardens to encourage outdoor activities and provide a tranquil focal point for the hospital. Roseberry Park, Middlesbrough, UK

Thoughtful BriefingUnderstanding your objectives is the first step to developing a comprehensive project brief. This is an iterative process which requires a methodical approach. We will:

Listen to you and your project stakeholders. •Gather supporting information, data and surveys. •Record, and classify what we have heard and the information received. •Communicate the project brief clearly and concisely. •

At Medical Architecture we formulate an approach to delivering your plans that responds to the context and is based upon experience and adherence to standards. We also draw on evidence-based research and a range of relevant guidance prepared by us for government and specialist housing providers to embed best practice. Projects are benchmarked against the best international examples healthcare design ensures world class services are matched by world class new facilities.

Your Business Case must be affordable and calibrated to deliver the best long-term value whilst providing robust and inspiring healthcare architecture. Our tiered approach to developing design options ensures best value.

Value engineering ensures that the budget is being used to deliver an •affordable facility. Whole life and revenue costs that reflect effective use of workforce, •sustainability, running costs, adaptability, maintenance cycle and end life costs. Qualitative benefits in privacy and dignity of patient environment, workplace •quality, ease of wayfinding, safety and security as well as your organisations brand identity.

MAKING IT HAPPEN

Effective Stakeholder EngagementBuy-in from stakeholders can be pivotal to the success of delivering a project vision. Without a forum for engagement, stakeholders may not understand benefits the project offers. A successful engagement often leads to stakeholders becoming the most powerful advocates of change. Our team is experienced in managing client relationships effectively through patient and staff consultation and workshops and staff group sign-off processes including:

Patient’s representatives. •Clinical staff groups. •Estates management. •External Stakeholders. •

A programme for consultation and approvals is agreed providing a purposeful framework for engagement. We communicate using language and tools appropriate to the audience, neither loaded with jargon nor patronising. Where needs appear to conflict, design options are balanced to reflect the needs of clinical stakeholders. We ensure that each group get a sense of participation in the process to ensure ‘buy-in’, whilst also effectively managing expectation.

We understand that healthcare professionals have limited time available for meetings. To get best value from stakeholders we encourage workshop based interaction with participants carefully selected to represent an aspect of planning that is relevant to their role. We plan engagement to be:

Communicated well in advance. •Conducted in an efficient manner, seldom more than 90 minutes. •Use easily understood methods to conduct appraisals. •Record the process giving feedback to participants. •

Achieving excellent service led design needs an ambitious client, thoughtful briefing and effective stakeholder engagement. Medical Architecture draws on knowledge, experience and foresight to enable you to realise your service vision.

INFORMED DESIGN

Different height planters accommodate various stages of frailty, from wheelchair user to more able bodied. Roseberry Park, Middlesbrough, UK

Laying the foundationsThe project brief determines the planned size, functional content and model of care. Location, existing landscape and buildings will each offer a unique prospect. Our team formulate design options that manage constraints and capture the opportunities. Risks identified during the initial stages are mitigated and value designed in. Thorough appraisal of options provides a robust business-case for the planned investment.

Communicating a Clear ConceptOverarching aims for each project shall be self-evident in our design concept sketches and modelling. Clear communication with the project team and stakeholders builds support and leads to a shared project vision that provides the momentum to carry each scheme forward. We facilitate “perfect day” workshops in collaboration with stakeholders model the planned operation of new facilities. This provides an understanding of practical dynamics of care for specific user groups and allows us to tailor design to the needs of those patients.

Flexibility, Growth and ChangeResilient buildings must be adaptable to respond to a wide range of changing needs. For example, we know that the number of younger people with dementia is increasing due to changes in lifestyle choices. An older person with failing memory and an inability to reason is supported by an environment that is recognisable and familiar. Younger patients have larger visitor groups and differing social interests. Our understanding will help create an adaptable environment that satisfies variable age groups and staffing configurations.

DESIGNING FOR WELLBEING

Easy access to outdoor space for the elderly patients, achieved by wrapping the building around a series of gardens, allowing direct access from anywhere in the building. Highcroft Hospital, Birmingham, UK

A third of dementia sufferers currently live in care. For an individual with dementia, being placed into care is both stressful and traumatic. With a declining memory, the setting of care needs to directly respond to these emotions. Design plays a big part in creating an atmosphere that is tranquil and familiar.

Well designed dementia care settings give a positive first impression; they are reassuring and promote self-confidence in the patient, carer, family and friends. Thoughtful planning helps care staff, improves efficiency and communicates a purposeful professional ethos.

With over two decades of design experience and knowledge drawn from a wide range of successful projects you can be confident that design for dementia care delivered with our team will deliver or exceed your planned objectives. We benchmark designs to ensure best practice and apply evidence-based research to form environments that are responsive to the challenges dementia patients face and supportive for those who provide care.

Right to Left. Use of daylight and natural materials in spaces to improve circulation and promote healthy lifestyle. Glenside Health Services, Adelaide

Contemplative spaces with views of therapeutic gardens. Tyne, Low Secure Unit, Northgate Hospital, Morpeth, UK

Integrated artwork providing wayfinding. Rose Lodge, South Tyneside, UK

Privacy and DignityProviding an environment that fosters choice and independence without compromising standards of care begins with good design. We consider the building users as individuals with some common needs. There may be a constantly changing mix in terms of gender, pathology, ethnicity and the degree of risk which they present. We have developed planning strategies that enables the individual and group to co-exist in easily managed clusters. The threshold between the private domain and communal areas of residential care represents one of the most important transitions. Different rules in each space and lack of differentiation between communal and private space can create conflict.

Orientation and SafetyA reassuring environment helps patients understand where they are, the time of day and provides cues to behaviour. This enhances the sense of well-being and can reduce stressful demands on staff and carers. Our method of design provides clear wayfinding and consistent legible planning. Ready availability of sanitary facilities with consistent and easily understood signage reduces anxiety. Landmarks in circulation help stage the patient journey and good visibility helps staff observation. Boundaries and enclosure are necessary and should be easily supervised.

Support for FrailtyAs physical ability and reactions decline, so does cognitive ability. Older people can be at increased risk of injury from trips, slips and falls. These risks are greatly compounded by admission to an unfamiliar setting such as hospital or institutional care. Injury undermines confidence as well as personal well-being and increases the cost and complexity of care. Falls are responsible for at least 40% of all accidents in hospital. Our design pays special attention to supporting frailty by providing reassuring handrails, incorporating rest places and ensuring that potential obstructions are easily navigated by use of accessibility aids, good lighting, floor surfaces and colour contrast.

Internal Environment A therapeutic environment fosters wellness and encourages activity. Daylight reinforces our circadian rhythms and provides cues to passing time. Ventilation should avoid draughts but provide fresh air. Both long views with landmarks and activity as well as short local views offer scope for enjoyable engagement and reflection.

Sensory DesignDementia reduces the response of all five senses. Sensory design modifies the reactive nature of the surroundings. Good building acoustics can make the environment intelligible and calming which is vital for dementia patients. Our team designs to accommodate degeneration of sight and a changing perception of colours. We use colour contrast studies to ensure that patient navigation and orientation is made easier. Tactile materials such as textured wood finishes provide warmth and assurance. Use of aroma around dining areas is particularly important in stimulating the physiology for good nutrition.

Careful selection of materials, finishes, lighting and furniture to provide quality and comfort. Glenside Health Services, Adelaide.

Healthy LifestylesA sense of well-being is underpinned by promoting healthy living. The environment has a role to play in encouraging activity. Creative circulation routes with alternative choices promote walking. Multi-use rooms may be used for dance and physical activities. Those who have very limited mobility are to be encouraged by wheelchair friendly routes and with wellness guiding design, even those who are bed bound will appreciate access to balconies and gardens.

Interior Design and FurnitureInternal finishes mean a lot to all of us. Co-ordinated design and furnishings make the difference between an institutional care setting and one which is personal and reassuring. Careful selection of materials, finishes, lighting and furniture contribute to quality and comfort. Artwork can help reminiscence. The bedroom is the one place that can be identified as a person’s own where self-identity is reinforced through design to accommodate familiar personal objects and environmental cues.

Gardens and LandscapeIt is a well understood notion that people’s mental health is enhanced through access to the external environment. A connection to outside space offers recognition of the seasons and the chance to engage in horticultural activities during the spring and summer months. Gardens must be safe and navigable so that residents can enjoy unrestricted access to them; essential for their independence and well-being. Seating and patios can provide opportunities for residents to eat outside. Potting areas can allow residents to help with gardening while outdoor spaces can also be used for group events.

Staff SatisfactionThe best people provide great care. Design plays an important role in providing an attractive workplace. Successful environments create opportunities for informal social interaction between residents and their carers. Spatial features can reduce patient anxiety; especially for those with challenging behaviours. This helps reduce staff stress and good observation means staff can focus on their tasks without distraction. A great workplace helps recruit and retain the best staff.

Facilities ManagementMaintenance and Facilities Management access for delivery of food and clinical supplies needs to be arranged so that there is minimal disturbance of the patient environment. This can be achieved by careful zoning of the building, but must be considered from the outset.

1. Acoustic ceiling to reduce reverberation2. Colour variance to define space3. Efficient lighting4. Space to sit/rest/meet visitors/chat5. Defined staff bases6. Personalisation/recognition of space7. Discreet storage8. Handrails and support

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1. Reception desk, welcoming and accessible2. Good lighting3. Comfortable and inviting waiting space4. Dropped ceiling to define space. Acoustic

properties improved to reduce reverberation5. Artwork /point of interest6. Clear and readable directional signage

RESPONSIVE DESIGN

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We wanted to provide a stimulating external environment that encouraged curiosity and activity for the patients. We located a number of interactive objects within a series of intimate courtyards that were safely and directly accessible.

Westerdale Unit, Roseberry Park

Client: John Laing Social Infrastructure with Tees, Esk and Wear Valleys NHS Foundation Trust

Role Lead Consultant, Master Planner, Architect, Interior Design

Value £75m

Status Completed 2010

Located within the Roseberry Park campus, the specially designed Westerdale unit is divided into two wards for thirty-two Older Adult patients, with separate assessment and treatment beds for people with dementia and for those with functional mental health problems. Our design was guided by the sensitive interpretation of the Trust’s brief and service user aspirations to reflect the clinical requirements of a modern mental health service and workforce.

The unit is located within the 142 bed Adult Acute ‘village’ setting underpinned by a strong landscape framework affording seamless integration of gardens and inter-connecting outside spaces. Varying sequences of landscape and architecture convey a sense of domesticity and tranquillity, inverting the traditional mental health model. The design was manipulated to reduce its bulk into recognisably human scaled spaces and focused upon the individual patient experience, breaking down the accommodation into a number of ‘houses’ arranged around large activity garden. This created an architecture of enclosure without fences to help remove stigma and encourage service users to partake in activities in shared spaces as they would in the community.

This design concept is combined with a strong landscape and art strategy to provide an attractive and comprehensible environment – one which is easy to navigate and which will stimulate therapeutic engagement and help support recovery. As patients and staff move through the campus complex, spaces become intimate, more human and small-scale; passing through the civic spaces of the entrance plaza, and on to the residential streetscapes of the central shared garden, ending at the private domesticity of the ward interiors with its private gardens and bedroom views.

The therapeutic benefits of contact with nature is fully utilised where each patient has close, generous and free access to the outdoors to a variety of sensory experiences. As soon as a patient opens their bedroom door they get a view of a garden, the corridor acts as a buffer with built-in window seats where they can relax before entering more public day spaces.

The Westerdale unit’s layout is arranged for flexibility but accommodating the particular characteristics of the older adult patient. Bedrooms are clustered around the perimeter of the ward units, keeping private space away from the day space and public areas. Challenging Behaviour patients were specifically catered for alongside other dementia sufferers, with dedicated facilities so that appropriate care can be provided without disturbing the other patients or disrupting care patterns.

Significant and meaningful engagement with service users and staff occurred to test, challenge and respond to the emerging design principles to ensure that the provision was truly representative of their needs. Consultations took place with patients, their carers and staff across all elements of the conceptual and detail design, thus creating a real sense of ownership and understanding amongst all the project stakeholders.

MIDDLESBROUGH, UK

Focused features of contemplation in the landscape. Activity garden in a secure courtyard. Roseberry Park, Middlesbrough, UK

We worked with a number of artists to develop a stimulating environment for the patients and staff. A poem was set into the ground that weaved from building to building and within the landscape. A series of bird boxes we created, forming special artworks in their own right while encouraging new wildlife. Super-sized photographs of the nearby north Yorkshire countryside were commissioned, providing a special connection with local area. Roseberry Park, Middlesbrough, UK

AwardsRIBA Award 2012 RIBA Award 2012 - Client of the Year RIBA Northern Network Awards 2011: Gold Award RIBA Northern Network Awards 2011: Hadrian Award (North East Project of the Year) Design & Health International Academy Awards 2010: Highly Commended - Mental Health Design

Dementia Care Centre, Monkwearmouth Hospital

Client: Northumberland, Tyne and Wear NHS Foundation Trust

Role: Lead Consultant, Architect, Healthcare Planner, Interior Designer, Landscape Architect and BIM Coordinator

Value: £9 million

Status: On site

The new purpose built Dementia Care Campus, located at the Monkwearmouth Hospital in Sunderland, consolidates the Trust’s Dementia Care Services into one location. The Campus provides 24 new inpatient beds with assessment and treatment facilities alongside existing refurbished inpatient accommodation. A Day Hospital provides clinics and session work departments for adults and older people, replacing existing accommodation which restricted patient mobility and privacy.

Medical Architecture worked alongside the Iris Murdoch Dementia Services Development Centre at Stirling University, to encapsulate the latest findings in Dementia-related research.

Extensive stakeholder engagement during briefing led to a design which is responsive to the specialist level of care and clinical needs of the most extreme cases. User group engagement was particularly fruitful. A clear sense of purpose drove the initial high level discussions about the particular type of service being proposed, and how it improved the client’s existing care offer. As alternatives emerged, designers assisted by formulating diagrams to clarify the options in the context of the other desirable features that the team wanted. This approach paid dividends throughout the project.

Guidance and legislation have been tested throughout, rather than taken at face value. Ergonomics of the patient group were carefully studied to ensure that the building really suited its users, rather than simply complying with existing guidance.

The client demanded the very best environment for dementia patients that was affordable. The weekly operation of each ward was examined so that shared facilities and storage could be arranged accordingly, linked to a new site facilities management hub. This is positioned strategically on the site so that deliveries can be made without compromising traffic flow and wayfinding. Preconceptions were challenged, resulting in better value for money. Expensive but inappropriate features were dispensed with, while spatial standards were tailored to actual needs. Rooms design as adaptable to support both open-plan living spaces and intimate, cosy areas for privacy. Wards planned with courtyards giving direct and free access to safe, secure and stimulating therapeutic gardens from most patient rooms. The internal layout was interrogated to ensure ward plans were kept as wide and spacious as possible. This fresh and investigative approach to design is clearly evident in the layout of sanitary facilities and in the finishes and colours throughout the building.

SUNDERLAND, UK

Early visualisation of main living / dining space. Concept diagram

Early stage design sketches of living and dining spaces. Monkwearmouth Dementia Care Centre, UK

Reservoir Court, Highcroft Hospital

Client: Northern Birmingham Mental Health NHS Trust (now Birmingham and Solihull Mental Health NHS Foundation Trust)

Role: Lead Consultant, Architect, Interior Designer, Healthcare Planner, Landscape Architect

Value:: £2.5m

Status: Completed January 2002

Integral to the reprovision of inpatient services on the Highcroft Hospital site, Birmingham and Solihull Mental Health NHS Foundation Trust embarked on a PFI development made up of a series of new buildings including Reservoir Court, providing assessment for organic and functional mental illness with a 28 bed older adult inpatient unit supplemented by a Community Centre.

Designed to prompt a change in the ethos of mental healthcare with an emphasis on integrating design and service principles, the focus was on individuals’ dignity, privacy and self-determination, their treatment and rehabilitation essential to a modern, safe and effective service. Consistent with the Trust’s model of care in a sympathetic, domestic environment the unit provides graduated and controlled territory central to the successful design and operation of a modern dementia care setting.

Resulting from a skilful use of existing topography and sited on a small hill between two stands of mature trees, the design took a relaxed approach to geometry and used the articulation of massing at every opportunity to scale down the building form. The alignment of the building cranks around in response to the site contours with the overall effect of making the building feel organically rooted in its context.

The highly articulated massing serves to dissolve the functional content allowing the building to respond in an extended series of forms of more human scale. Entered at the lower level giving good public access to the Community Centre you arrive at the private and sheltered inpatient floor from the lift or stairs to views of the generous central garden.

The inpatient accommodation is arranged as a necklace of private bedroom pavilions arranged around three walled gardens viewed from the circulation wandering route. Used as essential extensions to the building these additional outdoor ‘rooms’, separated by the more public dining and lounge spaces, offer places for creative meandering, therapeutic activities and contemplation while providing shade and shelter. Additional, more small intimate and quiet day spaces are located at the pavilion ‘knuckles’ with views out to the woodland and street below.

Designed as two flexible wards for organically or functionally ill patients the space now functions as one dedicated Dementia unit easily adapted due to the inherent flexible design. Since opening, Reservoir Court has featured in both architectural and health service journals as an exemplar inpatient facility. It continues to be visited by both national and international healthcare clinicians and designers and used as a benchmark in providing inpatient accommodation.

BIRMINGHAM, UK

A safe and secure internal courtyard garden. A sympathetic, domestic environment. Highcroft Hospital, Birmingham, UK

From Brief to Building - the process.Places to pause along the corridor.A calm and nurturing garden.Highcroft Hospital, Birmingham, UK

We wanted to create a spacious, flexible living area where various activities could take place at the same time. To achieve this, while providing intimate spaces for smaller groups of patients, we developed a series of bespoke room dividers. These were designed to incorporate special cabinets to safely display individual artwork, objects of interest, and provide storage, helping to personalise the space while creating a stimulating patient environment.

BRINGING VALUE

We worked closely with an artist and the end users to create a bespoke interior design that was both reassuring and stimulating for a sensitive patient group, picking up themes of nature taken from the nearby Northumbrian countryside. Even the furniture was specially designed, with careful selection of cleanable fabrics and colours, to help move away from a feeling of institution yet provide the required functionality of a hospital environment - Ferndene, Children and Young People’s Centre, Northumberland, UK

ABOUT US ...

Specialists in the design and planning for Healthcare environments, Medical Architecture are an award-winning design practice which delivers intelligent cohesive facilities across the globe. Founded in 1991, our practice focuses specifically on the Healthcare sector, bridging the gap between policy, vision and function. Our design ethos is underpinned by research and evaluation of lessons learnt and the adoption of innovation in construction methods. Our buildings are flexible, responsive and adaptable to future needs of clinical standards thus enhancing the care path of patients (and staff efficiency). With a deep-set understanding of the Healthcare sector and models of care, we consult and advise professional bodies at early stages of development to ensure our buildings are truly immersive and relative to the built environment and the communities they serve.

Operating from offices in London, Newcastle upon Tyne and Sydney, we are committed to the provision of innovative healthcare buildings that enhance the delivery of care across a wide range of sectors within the healthcare spectrum. With an international benchmarking knowledge of recent projects and continuous exchange of the latest thinking in healthcare environments, in an established network of international specialists, conferences and industry forums, we are able to improve outcomes through research and the application of evidence based design. We are conversant with current international health building standards and assist in the preparation of technical guidance in the United Kingdom. Our award-winning projects achieve excellent standards in design through an informed approach that combines theory and practice.

Integrating art within the building to create a uplifting and reassuring environment. Ferndene, Children and Young People’s Centre, Northumberland, UK

Understanding the needs of the people we design for is critical to the success of design and delivery of high class care facility. Our approach to every project is to engage with all stakeholders to bring the absolute needs of end-user to the forefront of decision making, ensuring that delivery of the facility provides a high level of care for patients and a sound working environment for clinical staff. Key to this we provide:

Leadership in healthcare planning, design and evaluation to bring knowledge and experience to benefit your project.

Evidence-based design, targeted at the therapeutic environment for patient well-being. This will contribute to your improved healthcare outcomes.

Integrated design from strategic planning through to architecture, landscape and interior design, allowing you to benefit from fully co-ordinated delivery from business plan to fit-out.

International experience that helps you to benchmark your project against the best world-class standards and recent best practice.

Purposeful and attractive design that supports a high quality, low stress environment, contributing to the recruitment and retention of your valuable staff.

Collaborative teamwork with clients, contractors and specialist consultants, demonstrating this through an increasing portfolio of valued, longstanding, partners.

Sustainable environments that are flexible and adaptable to changing requirements and economic to run, to deliver you long term value of your investment.

Award-winning design that delivers imaginative and innovative buildings, communicating your professional ethos and reflecting the best of your organisation’s culture.

OUR OFFER

Courtyard providing therapeutic spaces for overall wellbeing. Bamburgh Clinic, St Nicholas Hospital, Newcastle upon Tyne, UK

Raechal FergusonSenior Director

Raechal has a particular interest in applying model of care briefs into a cohesive design solution to enhance the recovery care path of patients and creating effective working environments for staff. With over 20 years of experience in healthcare design Raechal has a deep set understanding of the impact design has on healthcare environments. She encourages an inclusive approach with all stakeholders and promotes a collaborative consultation process to inform the design process. With a specialism in mental health and the ability to cite validated exemplars and benchmarking data she can add value in delivering models of care internationally.

She is both strategic and effective in leadership, which is reflective in her track record of delivering a range projects that include analytical feasibility work, refurbishments within existing facilities and completed new build development. A spearhead for the adoption of BIM and Revit at Medical Architecture, Raechal continues to drive integrated project delivery methods through work sharing technologies.

We recognise that the implementation and delivery of a successful Dementia Care facility requires a high level of knowledge and experience, skill and insight, as well as technical capability, commitment and a pragmatic team to work alongside stakeholders. Our team of healthcare specialists bring design flair, know-how and understanding of the steps necessary to gain stakeholder endorsement, statutory approval and to take the building through procurement, in delivering a world class facility.

With acute understanding of the challenges faced by the onset and development of Dementia, our design leaders, Raechal Ferguson and Lianne Knotts provide high level inspiration and innovation underpinned by evidence- based research. Lianne has spoken at a number of high profile industry events regarding her work at Ferndene and, more recently, regarding her peer review role on the Monkwearmouth Dementia Care Centre project.

Lianne Knotts RIBAAssociate Director

Lianne has a high level of expertise in the healthcare sector, specialising in the design of mental health facilities across the UK and providing health planning and user consultation expertise internationally. In the vast spectrum of mental health, Lianne continues to apply evidence-based research to understand the intricacies affecting each specialism within the sector, providing bespoke approaches to inform design concept and details; creating environments that enhance care through sustainable and flexible design.

With a successful track record of delivering a number of high quality projects from inception to completion, Lianne most recently delivered the multi award-winning Ferndene, Children and Young People’s Centre, in Northumberland; a scheme that required extensive collaborative working to create a bespoke environment, appropriate to the needs of the young patient group without compromising safety and security.

DESIGN LEADERS

We designed the new hospital to resemble a small village, in order to create an intimate, reassuring scale for the more vulnerable patients. Inpatient buildings are organised around a shared garden providing therapeutic landscape-based activities. This has created not only a place of refuge and healing but a positive focal point for the whole facility.

ACCOLADES AND AWARDS

AfH Gold Award Healthcare - Glenside Health Services RIBA/Guild of Architectural Ironmongery Specification Awards: Public Health Buildings - Ferndene, High CommendationBREEAM Award: Edge Lane

Northumberland, Tyne and Wear Staff Awards: Service Users and Carers Involvement - FerndeneConsiderate Contractors Award: Bronze - FerndeneConstructing Excellence National Awards: Integration and Collaborative Working - FerndeneHealth Service Journal: Good Corporate Citizenship - Ferndene INCA Awards, Non-Residential - FerndeneBuilding Better Healthcare Awards: Specialist Services Design - Ferndene Best Use of the Arts - Ferndene Best Interior Design - Ferndene Best Project Team - FerndeneConstructing Excellence North East Awards: Integration & Collaborative Working - Ferndene Client of the Year - Ferndene Project of the Year - FerndeneThe Legacy Award: Sustainability - Highly Commended, FerndeneSociety of British Interior Design Awards: Best Innovation - FerndeneRIBA Award: Client of the Year - Roseberry ParkRIBA Award: Roseberry Park D&H International Academy Awards: International Mental Health Design - Ferndene

RIBA Northern Network Awards: Gold AwardHadrian Award - North East Project of the Year, Roseberry Park D&H International Academy Awards: International Mental Health, High Commended - Rose Lodge Future Health Project - High Commendation, GlensideGIA & RIBA Architectural Ironmongery Specifications Awards: Winner of Winners -Rose Lodge Public Health Building - Rose Lodge

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Building Better Healthcare: Best Social Care Design - Rose Lodge Best Mental Health Design, Highly Commended, Roseberry ParkD&H International Academy: Mental Health Project - Wandsworth Recovery Centre Mental Health Project - Highly Commended, Roseberry Park

Building Better Healthcare: Best Project Team - Wandsworth Recovery Centre Best Mental Health Design - Highly Commended, Wandsworth Recovery Centre

RIBA National and International Awards: North East England Regional - Bamburgh Clinic

Building Better Healthcare Award: Best Future Design - Barnstaple, Hyper Modern HospitalConsiderate Constructors: National Award Winner - Silver, P21 with Laing O’RourkeGreen Apple Awards: Built Environment Bronze -Bamburgh ClinicBuilding Design: Health Building Architect of the Year - Highly Commended, The Treatment Centre, KidderminsterBuilding Better Healthcare: Best External Space - Bamburgh Clinic Best Mental Health Design - Bamburgh Clinic Best Patient Environment - Bamburgh Clinic

Building Better Healthcare: Best Designed Hospital - Highly Commended, The Treatment Centre, KidderminsterBuilding Better Healthcare: Best Designed Mental Health Hospital - Highly Commended - Highcroft HospitalAneiron Bevan Award :Small Heath Health Centre, Birmingham Art at Work Albany Lodge, St. AlbansCivic Trust Award: Albany Lodge - St. Albans

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45 Gee StreetLondon EC1V 3RSUnited Kingdom

T. +44 (0)20 7490 1904E. london@medicalarchitecture.com

25 Collingwood Street Newcastle upon Tyne, NE1 1JEUnited Kingdom

T. +44 (0) 191 269 1180 E. newcastle@medicalarchitecture.com

www.medicalarchitecture.com