Blossom Court, St Ann’s Hospital London

Blossom Court, the new inpatient building for St Ann’s Hospital, prioritises independent access to outdoor space for patients, to promote their mental and physical wellbeing and reduce pressure on staff.

Designed by Medical Architecture for Barnet, Enfield and Haringey Mental Health NHS Trust, the building comprises three Adult Acute wards and one Eating Disorders ward, with shared accommodation including visiting space, staff rest and a multi-faith room. The building is part of wider development of the site to create a people-focused healthcare campus, masterplanned by Medical Architecture.

Consolidation to improve the quality of care
Over time, St Ann’s Hospital has seen multiple phases of rationalisation to make it more effective and efficient. At the time of project inception, over half of its buildings lay vacant. Maintaining this surplus estate was diverting vital spending away from the provision of healthcare. 

Around the same time, Care Quality Commission reports identified that the Trust’s existing inpatient facilities, which dated back to the 1930’s, were no longer fit for purpose. The therapeutic environment was no longer appropriate for modem mental healthcare, and this impacted on patient experience and staff satisfaction. 

Following extensive consultation, the Trust concluded that the surplus land would be allocated for residential development to fund the required healthcare improvements. At least 50% would be affordable homes, including dedicated units to ensure staff could afford to live locally.

A people-focused healthcare campus
Medical Architecture worked closely with Barnet, Enfield and Haringey Mental Health NHS Trust to develop plans for a new mental health inpatient building, which would form the initial phase of a cohesive new healthcare campus. 

The campus masterplan prioritises people, with roads and parking organised around the site perimeter. Buildings are organised along a generous boulevard where activities can safely spill out from individual buildings, creating an activated street scene. 

To create a physical connection with the existing neighbouring community, the original perimeter wall was partly demolished; creating a new opening that connects the boulevard with the local network of streets. The new inpatient building is prominently located, promoting the hospital’s mental health services and challenging any stigma that surrounds them.

A therapeutic environment for patients and staff
The new building is designed to address the complex needs of a mental health ward with a simple solution and an integrated approach. The four wards are arranged around two private two-storey courtyards, each with a ward on its ground and first floor. The courtyard arrangement offers private views, abundant daylight and a positive focal point for its patients. 

The ward plan forms a simple loop, providing two choices of route within the ward. This gives staff or patients the opportunity to back away from escalating and challenging situations. This arrangement also allows subdivision for separating patient groups and the creation of one-way circulation routes to aid social distancing.

Independent access to outdoor space
Providing easy access to good quality outdoor space is one of the building’s fundamental design principles, a move which has taken on heightened importance during Covid-19. 

Both storeys are configured to provide direct access to outdoor space without the need for direct staff supervision, something which was severely lacking in the previous inpatient facilities. This autonomy reduces pressure on staff, removing a potential source of conflict and frustration. 

The generous ground floor courtyard features a deep overhang in front of its dining and activity rooms for shade and shelter. On the first floor this overhang creates a terrace bordered by glazing. Visual connection to the larger courtyard space beyond enhances the impression of a spacious outdoor retreat.

Promoting all aspects of health and wellbeing
A member of the clinical team made a comment early in the design process that patients commonly left mental health wards in worse physical health than when they arrived. This helped inform the approach to physical and mental wellbeing throughout the scheme, to ensure that both aspects were addressed.

To support physical health, inclusive exercise equipment is provided in the courtyards and gardens that are directly accessible on both levels. As they can be independently accessed, patients are able to be active at a time that suits them.

The layout of the courtyard allows an abundance of daylight to enter into the heart of the building, creating the opportunity to connect with the time of day, the seasons and the changing weather. The interiors have been designed to create calm, organic environments, with natural oak finishes creating a visual connection to the outside space.

A new way to see mental healthcare
The two-storey building has been designed to integrate with the adjoining residential development, adopting an architectural language that will complement high quality housing. This has been balanced with the need to ensure appropriate levels of security, privacy, safety and environmental quality. 

The facade features a simple palette of high-quality brickwork that will age well, is robust, and integrates with the materials of neighbouring buildings. The large Britplas ‘Safevent’ windows—some of the largest the supplier has ever installed at 2.1m high—address ligature risk and can be opened wide to reveal a fine perforated steel mesh. This allows good ventilation whilst preventing the passing of contraband. A brick relief pattern around the window emphasises their size, the pattern handed to create a sense of play along the elevation.

A long-term view of sustainability
To maximise its longevity and sustainability, the building has been designed to be as flexible and adaptable as possible for future use. Each ward is designed to a standard template, and the stacked wards efficiently share risers. Space standardisation allows services to swap or adapt in the future.

The building is designed with passive measures, favouring low energy and low-tech solutions to control the internal environment. These include tall ceilings, window vents at a high level and exposing the building’s thermal mass to reduce overheating in the summer, along with a high level of insulation to the envelope to retain heat in the winter. This is supplemented by air source heat pumps and a roof covered with photovoltaic cells to provide a renewable source of energy. The building is designed to achieve BREEAM ‘Excellent’ and is now awaiting certification post construction.

Ruairi Reeves, Director at Medical Architecture, said,

“Blossom Court provides a therapeutic, calm environment for patients and staff with good daylight, private views and access to outdoor space. It creates a building that everyone can be proud of, while helping to reduce the stigma of mental health and promoting integration with the local community.”

Jinjer Kandola, Chief Executive, Consultant Clinical Psychologist, Barnet, Enfield and Haringey Mental Health NHS Trust, said,

“Blossom Court sets the bar high – this is how all mental health care should look and we are committed to improving the rest of our estate over the coming years, so all our patients can enjoy the quality of environment that Blossom Court now provides.”

Andrew Wright, Director of Planning and Partnerships, Barnet, Enfield and Haringey Mental Health NHS Trust, said,

 “This has been a thoroughly positive experience and a great example of what can be accomplished through collaboration and partnership with service users, staff, the design and construction team, our local Council, the Greater London Authority and others. The team took a collaborative approach and really listened to service users and clinicians about the needs of our different mental health wards. The enthusiasm and vision of the team inspired us to think critically and creatively about how to best meet the environmental needs of our service users.”