JGoodwin Stage 3 Dissertation by JessGoodwin

Maggieâ&#x20AC;&#x2122;s: The Future of Healthcare Architecture? An analysis and understanding of Maggieâ&#x20AC;&#x2122;s Newcastle in contrast to other UK centres and how the architects have used the building aesthetic to affect the user and influence healthcare facilities. Jessica Goodwin

“There

is so much more to be done”

– Dame Cicely Saunders

Contents

Illustrations

Abstract

Introduction

The Origin of the Brief

Clinical Domesticity

The Effect of Nature

Structural Integrity and Materiality

Conclusion

Bibliography

Illustrations [Note: All photos are taken by the author unless specified otherwise] Front Cover: Paul Raftery, http://www.ribaj.com/buildings/maggie-s-newcastle-at-freemanhospital-newcastle-upon-tyne, [accessed, 11/01/15]

Figure 17: Chris Gascoigne, http://www.zaha-hadid.com/architecture/maggies-centre-fife/, [accessed 01/15/15] Figure 18: http://www.scotimages.net/Property/Maggies/Kirkcaldy/index.html, [accessed 11/01/15] Figure 19: Jill Tate 2011, http://www.medical-architecture.com/projects/ferndene/, [accessed 11/01/15]

Left Contents Image: [taken, 12/12/14]

Clinical Domesticity: Page 23: Figure 20: Norman Cornish, http://www.normancornish.com/, [accessed11/01/15]

Right Contents Image: [taken, 12/12/14]

Figure 21: [taken, 12/12/14]

Abstract: Paul Raftery, http://www.archdaily.com/415127/maggie-s-newcastle-cullinanstudio/520a468ee8e44e8d40000059_maggie-s-newcastle-cullinan-studio_maggies_paulraftery_06-jpg/, [accessed, 11/01/15]

Figure 22: [taken, 12/12/14]

The Origin of the Brief: Page 10: Figure 1: https://pengeandcatorcouncillors.wordpress.com/2012/06/22/st-christophers-hospice-familyfun-day-2/, [accessed, 11/01/15] Figure 2: landliving.com, http://veredes.es/blog/no-se-preocupe-de-sus-males-para-esotiene-la-arquitectura-pedro-hernandez/, [accessed, 11/01/15] Figure 3, 4, 5: JDDK Architects, http://jddk.co.uk/sectors/health/day-services-outpatient-suitest-oswald-s-hospice-newcastle-upon-tyne-client-st-oswald-s-hospice, [accessed 11/01/15]

Figure 23: Paul Raftery, http://ad009cdnb.archdaily.net/wpcontent/uploads/2013/08/520a45efe8e44e8d40000057_maggie-s-newcastle-cullinanstudio_maggies_-paulraftery_05.jpg, [accessed 11/01/15] Figure 24: [taken, 12/12/14] The Effect of Nature: Page 25: [taken, 12/12/14] The Effect of Nature: Page 29: Figure 25: [taken, 12/12/14] Figure 26: [taken, 12/12/14]

The Origin of the Brief: Page 14: Figure 6: Richard Murphy Architects Ltd. http://www.richardmurphyarchitects.com/viewItem.php?id=2452, [accessed 11/01/15]

Figure 27: Roger Stirk Harbour & Partners, http://www.rshp.com/render.aspx?siteID=1&navIDs=1,4,23,567,1509&showImages=detail&sortBy=&sortDir =&imageID=2934, [accessed 11/01/15]

Figure 7: https://www.maggiescentres.org/our-centres/maggies-dundee/architecture-anddesign/, [accessed 11/01/15]

Figure 28: Werner Huthmacher, http://www.zaha-hadid.com/architecture/maggies-centre-fife/, [accessed 11/01/15]

Figure 8: [taken 12/12/14]

Figure 29: Page and Park, http://pagepark.co.uk/projects/maggies-centre-inverness, [accessed 11/01/15]

Figure 9: http://www.archdaily.com/415127/maggie-s-newcastle-cullinanstudio/520a4646e8e44e8d40000058_maggie-s-newcastle-cullinan-studio_ground-png/, [accessed 11/01/15] Clinical Domesticity: Page 18: Figure 10: [taken, 12/12/14] Figure 11: [taken, 12/12/14] Figure 12: [taken, 12/12/14] Figure 13: [taken, 12/12/14] Figure 14: Richard Murphy Architects Ltd. http://www.richardmurphyarchitects.com/viewItem.php?id=2452, [accessed 11/01/15] Clinical Domesticity: Page 21: Figure 15: [taken, 12/12/14] Figure 16: [taken, 12/12/14]

Structural Integrity and Materiality: Page 34 Figure 33: Cullinan Studios, http://www.architectsjournal.co.uk/news/daily-news/cullinan-designed-maggies-centre-innewcastle-opens/8648219.article, [accessed 12/01/15] Figure 31: [taken, 12/12/14] Figure 32: Roger Stirk Harbour & Partners, http://www.rshp.com/render.aspx?siteID=1&navIDs=1,4,23,567,1509&showImages=detail&sortBy=&sortDir =&imageID=3699, [accessed 11/01/15] Figure 33: Roger Stirk Harbour & Partners, Roger Stirk Harbour & Partners, http://www.rshp.com/render.aspx?siteID=1&navIDs=1,4,23,567,1509&showImages=detail&sortBy=&sortDir =&imageID=3699, [accessed 11/01/15], [accessed 11/01/15] Figure 34: MJP Architects, http://www.mjparchitects.co.uk/projects/maggies-cancer-carecentre/, [accessed 11/01/15]

Abstract

This dissertation explores how Maggie’s Newcastle, designed by Ted Cullinan, has been able to create a domestic aesthetic within an inherently clinical field. By analysing the brief and other Maggie Centres, I will contrast these techniques used and discuss how Maggie’s Newcastle fits in with the ethos the brief states. By the use of innovative methods and a mix of clinical and domestic architectural features I will seek a comparison between the Maggie’s effect and other healthcare facilities. By doing so, I will conclude how future healthcare architecture can learn from this and how Maggie’s Newcastle has encapsulated the essence of the scheme.

Introduction

and help from designated professionals. In total, there are now fifteen Maggie Centre’s open throughout the UK, with seven in the development stage and even more in planning.

Maggie Centres are a type of non – residential hospice directly aimed at providing palliative care for cancer patients. The scheme is derived from an architect called Maggie Keswick Jencks, who personally suffered breast cancer. During her treatment, Maggie realised that ‘there was no one place or one person to turn to’1. People in her situation were not in the position or comfort to have a casual conversation with professionals. The only time they would be able to see them, even to ask questions of reassurance, is by appointment.

Maggie Centres are based on the ‘principle of creating a strong relationship between its cancer support centres and oncology departments’2. To achieve this, the majority of Maggie Centres lie within the hospital grounds or as near to it as possible, allowing frequent public transport links and enabling the centre to act as a drop in after people have been to visit the hospital.

Maggie sought to resolve this problem and in 1995 the first Maggie Centre was opened. Charles Jencks, Maggie’s husband, took over the charity after Maggie’s death in 1995, and has made it into the success that it has Maggie Centres have become a place that is widely acknowledged as somewhere patients are able to seek comfort and compassion amongst themselves, whilst having the opportunity to obtain advice

become today. Architects such as Richard Murphy, Zaha Hadid and Frank Gehry are among the ‘celebrity architects’3 that design these centres. It seems to have become a fashion, for a big architect firm

Marcia Blakenham, Maggie Keswick Jencks, ‘Foreword’ in ‘A View from the Front Line’’, (2007), https://www.maggiescentres.org/media/uploads/file_upload_plugin/view-fromthe-front-line/view-from-the-front-line_1.pdf, [accessed 21-08-14] p. 2.

Charles Jencks, ‘The Architecture of Hope’, in ‘The Architecture of Hope’, By Charles Jencks and Edwin Heathcote (London, Francis Lincoln Ltd. Publishers, 2010) p.34.

Ken Worpole, Modern Hospice Design: The Architecture of Pallative Care, (USA and Canada, Routledge, 2009), p.50.

or name to design one of these buildings. However, this observation

references to other centres around the UK; highlighting which have

is contested by Charles Jencks in his claim that, ‘some of his

achieved better results and what could be added to improve

acquaintances have become notorious’4, with these associates being

Newcastle Maggie’s. Furthermore, I will look into how the

people he and Maggie have met throughout their careers. Although,

architecture is used to help the patients, how it has been manipulated

the scheme has been around for nearly two decades now and up and

to fit into its environment and how its internal features help create the

coming architects are still designing these centres. For example,

overall aesthetic. Throughout my dissertation I will refer to hospice

Reiach and Hall architects - Maggie’s Lanarkshire and Rem Koohaas

and hospital architecture and discuss what can be learnt from one

– Maggie’s Glasgow. Designing one of these centres, gives you an

another to help this architectural intent move forward.

iconic status within the architect world, especially for new architects, with their work displayed alongside some architect legends, such as Gehry. The ability for their design to be able to withstand the scrutiny the project presents, ‘a competitive situation has developed’5. It seems obvious that this is a trend, the charity should be more than happy to see through, especially if they continue to produce buildings to this standard.

In this dissertation I am going to primarily look at Maggie’s Newcastle, and analyse how the architect, Ted Cullinan, has managed to achieve the brief requirements set by Maggie herself. I will analyse the techniques he has used to accomplish this and contrast this with 4

Charles Jencks, ‘The Architecture of Hope’, in ‘The Architecture of Hope’, By Charles Jencks and Edwin Heathcote (London, Francis Lincoln Ltd. Publishers, 2010) p.33.

Ibid., p.34.

The Origin of the Brief

The modern hospice movement is mostly associated with Dame Cicely Saunders and St Christopher’s Hospice, London which she founded in 1967. This hospice is the first ‘research and teaching hospice linked with clinical care’8; educating hospices and staff in

In order to understand Maggie Centres and their concepts fully, we need to first look at healthcare architecture as a whole. In this chapter I will investigate previous healthcare concepts and architectural intents. I will discuss how these became apparent and how Maggie came to see the need society had for change.

palliative medicine. Saunders saw the need of the patient to be more than just pharmaceutical care and sought to provide psychological and emotional support. The rise of the hospice movement was encouraged by the progression in people’s views on dying in comfort, where a lot of patients decided that they would want to return home, to be surrounded by their family and in comfortable settings.

A hospice has no set definition; it is more a ‘concept for healthcare delivery’6, a place where people are focused on providing emotional, psychological and medical care. This type of care is palliative, an ‘active holistic care of patients’7 and is aimed at those who are terminally ill.

In terms of design, hospices require an architectural balance. They are not hospitals, in which a more sterile and oblique outlook can be taken, yet they are not homes, where personal taste and opinion can be expressed. Many find, ‘private medical care promotes its facilities as offering hotel – quality accommodation’9, yet the balance of clinical

Thomas J Simms, A Perspective on the End of Life: Hospice Care, in ‘Topics in Advanced Practice Nursing eJournal’, (2007) Medscape, http://www.medscape.com/viewarticle/549702_3, [accessed 09/10/14]

The National Council for Palliative Care, ’Pallative Care Explained’, (2014), http://www.ncpc.org.uk/sites/default/files/PalliativeCareExplained.pdf, [accessed 06/10/14]

Cicely Saunders Institute, ‘The Institute – Cicely Saunders’, (Kings College London, 2014), http://www.csi.kcl.ac.uk/cicely-saunders.html, [accessed 08-1014] Ken Worpole, Modern Hospice Design: The Architecture of Pallative Care, (USA and Canada, Routledge, 2009), p.20.

and comfort is still argued over today, with hospices trying to create

Category’12 for their day services outpatient suite at St Oswald’s

a domestic environment that has the clinical reassurance of a

hospice. They are known users of the evidence based design

hospital.

scheme and incorporated a ‘central atrium providing natural light and ventilation into the bright and airy heart of the building’13 (figure 3). This enabled them to appeal to the psychological nature of people

Hospices have become more architecturally valued over recent

and meet the criteria researched in which ‘the provision of clean air

years, as more and more research on the benefits of building

were seen as essential’14.

structure and design has become apparent. As research has become more important to the consumer and charities, organisations and the NHS have been given or raised more funding; evidence based design

Alvar Aalto’s Paimio Sanatorium in Finland (figure 2), is well known

has become key to the development of hospices. This approach

for its use of sunlight to maximise patient benefit in its design, with

allows architects to integrate information, proven by researchers, on the ‘health impacts of specific characteristics of designed spaces’10 and utilise them as ‘guiding principles in their design’11. JDDK architects based in Newcastle were shortlisted for the ‘Building Better Healthcare (BBH) Awards 2010 in the Social Care Design

Agnes van den Berg, Cor Wagenaar, ‘Healing by Architecture’, in ‘The Architecture of Hospitals’, ed. by Cor Wagenaar (Rotterdam, Eelco van Welie, Nai Publishers, 2006), p.254. 11

JDDK Architects, ‘Latest News: JDDK Hospice Designs Shortlisted for National Healthcare Awards, October 2010’, http://www.jddk.co.uk/news/read/27, [accessed 19/10/2014]

Ibid., p.254. 13

Ibid.,

Agnes van den Berg, Cor Wagenaar, ‘Healing by Architecture’, in ‘The Architecture of Hospitals’, ed. by Cor Wagenaar (Rotterdam, Eelco van Welie, Nai Publishers, 2006), p.255.

Top Left: Figure 1: St Christopher’s Hospice, London Bottom Left: Figure 2: Alvar Aalto’s Paimio Sanatorium, balcony space

Above: Figure 3: JDDK Architects, St Oswald’s Outpatient Suite, central atrium providing ventilation

Top Right: Figure 4: JDDK Architects, St Oswald’s Outpatient Suite, external view Bottom Right: Figure 5: JDDK Architects, St Oswald’s Outpatient Suite, private balconies for patients. 10

areas provided specifically so that patients can sunbathe; a known

more about their clients need and with hospices having such an array

cure for tuberculosis, which the sanatorium was built for. It is this

of clientele, one can only see how it would help more.

‘architectonic’15 feature that helped distinguish it at its time and help secure it as a ‘key landmark in the architecture of the modern world’16. This combination of patient need and architectural design

The idea for the centres stemmed from the time that Maggie spent in

could be argued as one of the first recognisable uses of evidence

hospital. The series of windowless waiting areas and demoralizing

based design.

clinical atmospheres that she encountered, left her feeling that she was 'not of value'18. From my own time in hospital, I can relate to this statement. Hospitals are places that take your privacy away from you,

Although the majority of architects agree with evidence based

places where ‘you’re a number’19 in a system, places where you are

design, there are some who are sceptical about it; with the big debate

no longer an individual. The interiors manage to deprive you of

on the integration of science and the arts being at the forefront of the

anything stimulating and in most cases the large multi-storey

argument. Many do not believe that these two topics can co-exist and

hospitals can’t even provide an interesting view. These institutions

feel that by using science within architecture or art we will ‘erode the

need uplifting, Maggie’s have highlighted this problem and helped

intuitive and artistic side of the profession’17. Personally, I think

people realise the difference it could make to healthcare facilities and

evidence based design is a good way of architects understanding

patient health.

‘Paimio Sanitorium – Technical Equipment’, http://www.alvaraalto.fi/net/paimio/paimio.html, [accessed 19/10/2014] 16

Ken Worpole, Modern Hospice Design: The Architecture of Pallative Care, (USA and Canada, Routledge, 2009), p.12.

Maggie Keswick Jencks, ‘A View from the Front Line’’, (2007), https://www.maggiescentres.org/media/uploads/file_upload_plugin/view-fromthe-front-line/view-from-the-front-line_1.pdf, [accessed 21-08-14] p. 21. 19

Mardelle McCuskey Shepley, ‘Evidence Based Design and Architecture’, in ‘The Architecture of Hospitals’, ed. by Cor Wagenaar (Rotterdam, Eelco van Welie, Nai Publishers, 2006), pp.266-267.

Ken Worpole, Modern Hospice Design: The Architecture of Pallative Care, (USA and Canada, Routledge, 2009), p.5.

As Maggie travelled round different healthcare facilities, receiving

detail from there needing to be ‘as much light as possible’22 to

various treatments, she noticed the distinct lack of support within the

recommendations of utilising a ‘fish tank’23 within the design. The way

range of hospital like institutions. Maggie noticed ‘how much better

that the brief is written, allows freedom of design to be given to the

she felt when she began to take an active role in her own treatment’ .

architects and designers. All the components listed are necessary yet

She took control of her diet and completely rejuvenated herself, with

the focus is on the spatial qualities. How the architect wants to

this commitment and focus giving her a new drive. It was then Maggie

achieve these qualities is completely down to their interpretation of

began to think about the opportunities this ethos could give others if

the site, brief and context. The components listed within the brief are

they too were able to take control. She knew people suffering this

there to help the architect understand what is needed from each

disease needed 'a welcoming place near the hospital'21, somewhere

space. The fact that Maggie went into such detail only puts the

they could feel at home. Therefore Maggie started to come up with

architect at a greater advantage, as this allows them to understand

the brief for the centres.

their client’s needs so much more. Although, Cullinan found this brief

too generic, he sought ‘consultation with the heads of Maggie Centres’24 in order to find out what aspects of the brief had previously Before Maggie passed away, she was able to set up some basic

worked or failed. Despite this response being very intuitive and

guidelines and principles by which all Maggie centres should be

logical, does it highlight the need for the brief to be updated?

designed and have as an underlying foundation. These rules vary in

Ibid., p.3.

Ibid., p.5.

Cullinan Studio, ‘Maggie’s Newcastle’, http://www.cullinanstudio.com/uploads/documents/MaggiesNewcastle_CaseStu dy.pdf , [accessed02/01/15], p.2

Maggie’s Architectural Brief, http://www.maggiescentres.org/media/uploads/file-upload-plugin/maggiesarchitectural-brief/architectural_brief_maggies.pdf, [accessed 06/12/14], p.7.

It was only when the scheme became such a success in Edinburgh

needed? Does this appeal to all the users of the centre? I can

that Charles Jencks saw the potential. A new type of hospice had

imagine for some, a more discreet building may be preferred. The

been created. Jencks set about raising funds for future centres to be

fact that these buildings are so architecturally diverse and unique to

built and enrolled friends to help.

their context, makes them very obvious to the public. For a person who is shy or insecure about their illness, it may not be the best way to tell the world that they are suffering this disease. Yes, the buildings

The brief for a Maggie centre is very similar to that of a hospice, with

intentions are to uplift a person’s spirits and build confidence within

which ‘the hospice (and campus) must be designed so as to create

themselves. Yet the person has to have the confidence to walk into

a warm, welcoming, open and bright environment’25. The obvious

the centre in the first place. Perhaps if the entrance was disguised,

difference between the two is that one is a place where patients can

or the building more discreet, a broader range of people may be more

stay over and the other is seen as a drop in centre. This does of

open to the idea as they won’t see it as an advertisement of their

course, create boundaries between the two concepts and how they

illness. The layout of Maggie’s Newcastle (figure 9) allows the

overlap in terms of design. It is clear that parts of the brief for

entrance to be more concealed than others. It is away from the main

Maggie’s have been influenced by the rules of a hospice. Does this

road of the hospital grounds and has its own turn around area at the

further the need for the brief to be updated and could hospices take

front for disabled access. The landscape is built up around the

some advice from this document?

building, with it slowly curving away to allow for the entrance, protecting it from view further afield. On the other hand, Gehry’s design in Dundee, (figure 7), has an entrance that is positioned

Buildings that should ‘rise to the occasion’26 are what the brief defines

centrally within that façade. The surrounding landscape is flat and

as necessary for a Maggie centre. Yet is this monumentality truly

Ken Worpole, Modern Hospice Design: The Architecture of Pallative Care, (USA and Canada, Routledge, 2009), p.33.

Maggie’s Architectural Brief, http://www.maggiescentres.org/media/uploads/file-upload-plugin/maggiesarchitectural-brief/architectural_brief_maggies.pdf, [accessed 06/12/14], p.1.

Top Left: Figure 6: First Maggie centre, Maggie’s Edinburgh, designed by Richard Murphy, external view Bottom Left: Figure 7: Maggie’s Dundee, designed by Frank Gehry, main public entrance, highlighting lack of privacy Top Right: Figure 8: Maggie’s Newcastle, external view, curving embankments to slowly display the entrance Bottom Right: Figure 9: Maggie’s Newcastle ground floor plan

has no environmental features to create privacy. In fact the whole

Clinical Domesticity

building is very much on show.

An alternative perspective of the statement, ‘rise to the occasion’27, is how the building rises to meet the public’s needs, with the people wanting spaces that are of ‘sensuous richness, not of endurance and anxious distress’28. As discussed later, Maggie’s Newcastle uses rich furnishings and a domestic appearance to create a sense of home and belonging, allowing people to feel comfortable amongst the space. Although, has this difference in opinion lead a mixture of interpretations to be made amongst the designers of the centres? Each centre is unique in appearance, yet does this distinction reflect internally within them all?

It is said that ‘domestic interior has always demonstrated a feeling of intimacy and hominess’29, something that every Maggie centre has strived to achieve. The balance of domestic and clinical environments is something Maggie’s has tried to encapsulate and define within each building. Newcastle and other centres have responded by including interchangeable spaces, artwork and domestic furnishings. But why have their designers been so keen on providing a more domestic environment for their audience? According to Posonby, homes relate to the ‘world of domesticity’30 and are ‘contrasted with the public world of work and business’31. This alone matches Maggie’s original thinking, embodying her view of clinical environments and socially repelling starkness. In this chapter I am going to look at Maggie’s Newcastle’s internal features

Maggie’s Architectural Brief, http://www.maggiescentres.org/media/uploads/file-upload-plugin/maggiesarchitectural-brief/architectural_brief_maggies.pdf, [accessed 06/12/14], p.1.

Witold Rybczynski, ‘Home: A Short History of an Idea’, (USA, Viking Penguin Inc., 1986), p.218. 30

Ken Worpole, Modern Hospice Design: The Architecture of Pallative Care, (USA and Canada, Routledge, 2009), p.10.

Margaret Ponsonby, ‘Stories from Home English Domestic Interiors 1750-1850’, (USA, Farnham: Ashgate Publishing Company, 2007), p.21. 31

Ibid., p.21.

and try to understand why each element has been composed to have

periods of time. The back rest is formed from the offset exposed

this aesthetic.

metal ribs, (figure 13), part of the balustrade which is used to

David Wallis, Marcia Blakenham (best friend of Maggie) and Laura Lee (Maggie’s Nurse) are three people employed to maintain the high standard of design throughout all Maggie Centres. This means that

integrate the material elements and create a manlier aesthetic. This lack of care shows how much the architectural intent is valued within the building and how much they strive to keep its prolific status.

all furnishings match the aesthetic they originally wanted to create. However, these people don’t see how well the patients are able to interact with the furnishings. Yes, the type of furniture is very desirable visually, (figure 10), yet they are not always suitable for someone who is frail and weak. When I visited Newcastle Maggie’s, Karen Verrill, the centre manager, told me of how she has applied for chairs with headrests. These simple ergonomic and clinical features seem to have been overlooked in the design process of this facility, yet ‘ergonomics is well situated to contribute to improving quality of care’32, which suggests that these factors are of huge importance. Another example within the centre, is on the balcony space overlooking the main seating area, where there are some integrated bookshelves and seats. These seats are so narrow that the majority

Controversially however, one of the first things that I noticed when visiting the centre is the attention to detail the designers have taken. Small ornamental objects that you would find in a home are located throughout the building. Simple objects such as tea and coffee canisters and cake stands stand proudly on the kitchen surface. Better still, they are actually used. It is these features that help distinguish a hospice from a hospital. They help to diminish the clinical feel of the environment; in fact it makes them feel more like a home. ‘Home’ originates as being ‘the place where a person feels they belong’33, this definition alone describes the ethos of Maggie’s and encapsulates the concept.

of people would find them un-comfortable to sit on for extended 32

Neil Charness, ‘Reviews of Human Factors and Ergonomics, Volume 8: Healthcare Human Factors/Ergonomics’,(Santa Monica, CA Human Factors and Ergonomics Society, July 2014), http://erg.sagepub.com.libproxy.ncl.ac.uk/content/22/3/29.1.full.pdf+html, [accessed 20/12/14], p.29.

Cambridge Dictionaries Online, http://dictionary.cambridge.org/dictionary/british/home, [accessed 06/01/15]

Kitchenism’34 is a term Jencks uses to define how the kitchen is at

large kitchen table it wasn’t long before they too were answering my

the centre of the building, either literally in organisation of the plan or

questions. With all the centres incorporating a table so large and

experientially in how the majority of the activities focus’ around this

centralised within the building, it is easier for staff to provide a

environment. In Edinburgh, Richard Murphy has designed the

supportive environment for their users. I found that Karen was on a

building plan to revolve around the kitchen. However, Newcastle

first name basis with most of the visitors to the centre, and they were

uses the social aspects of a kitchen such as tea making and group

happy to include her with every day conversation and divulge

discussions to focus the kitchen as the social hub of the centre. As

personal information willingly.

the brief states ‘room for a large table to sit 12’

allows group

discussions, seminars and overall social encounters to take place. On my visit to Newcastle, whilst sat in the kitchen, I was able to

Cullinan has introduced a variety of colour and textures throughout

observe a user come into the centre, be greeted, just as one would

the centre, varying in the form of materiality, furnishings and finishes.

greet a friend, and set about making their own cup of tea and settle

A mixture of concrete, steel and oak, gives a hardy appearance to

down to read the newspaper. It was obvious that this person had

the interior, helping Cullinan to achieve a more appealing finish to

used the centre before, yet they radiated such liberty and

men, something he learnt that the centres lacked from his research.

contentment as they went about such a familiar task. These actions

Cullinan’s approach to this problem has worked well within the

alone have proven Maggie’s philosophy, in which she originally

centre, ‘including robust materials … appears to have been

started the centres, ‘that each person is ‘in charge’ of their own

successful; more men have visited Maggie’s Newcastle than any

disease as they are of their own life’36. By them sitting around the

Charles Jencks, ‘The Architecture of Hope’, in ‘The Architecture of Hope’, By Charles Jencks and Edwin Heathcote (London, Francis Lincoln Ltd. Publishers, 2010) p.13. 35

Maggie’s Architectural Brief, http://www.maggiescentres.org/media/uploads/file-upload-plugin/maggiesarchitectural-brief/architectural_brief_maggies.pdf, [accessed 06/12/14], p.5.

Marcia Blakenham, ‘Maggie’s Centres: Marching On’ in ‘A View from the Front Line’’, (2007), https://www.maggiescentres.org/media/uploads/file_upload_plugin/view-fromthe-front-line/view-from-the-front-line_1.pdf, [accessed 21-08-14] p. 30.

Top Left: Figure 10: Maggie’s Newcastle kitchen corner seating, shows lacks of ergonomic provisions Bottom Left: Figure 11: Maggie’s Newcastle, view of kitchen showing domestic furnishings

Above: Figure 12: Maggie’s Newcastle, integrated seating up the main staircase, and shows impracticality of seat depth

Top Right: Figure 13: Maggie’s Newcastle, mezzanine level, showing metal ribbed seating Bottom Right: Figure 14: Maggie’s Edinburgh, ground floor plan, shows centrally placed kitchen.

other Maggie’s’37. The exposure of these materials within the centre,

depth of colour with the remaining being provided by all the additional

allows for the furnishings within the space to become more

furnishings such as rugs, light shades and cushions. Similarly to

prominent. This helps accentuate the space and make it more

Cullinan, Zaha Hadid uses furnishings to bring colour into her centre

accessible to a variety of audiences, with ‘the lack of conventional

in Fife. Internally, the centre has crisp white walls, and uses the

feminine interiors is a great by-product of the architecture’38. Cullinan

contradicting shape of the internal curved walls against the straight

also has fixed gym equipment in the roof garden in a bid to have more

rigid external form to extenuate elements within the design. The white

masculine activities within the centre. Yet since the centre opened,

walled minimalism that Hadid has gone for relates to the amount of

Karen informed me that they are still awaiting their first proper use,

light she is able to get into the building, with ‘the need for light and

an area that hasn’t completely reached its potential.

the link between illumination and well – being’39 being of importance within a hospice. The white walls are then used to help manipulate the light deeper into the plan of the building. Although this tactic has

The exposed areas of walls are painted with an off white, so as not

worked well, and Hadid has still created a sense of well-being, this

to give a harsh cold feel. The lack of colour allows for the material

lack of stimulus can be harmful to the occupants of such a space,

elements to bring warmth into the building. Personally, I have never

simulating negative psychological effects. It has been proven that

seen concrete as a warm material, yet upon my visit I was surprised

under and over stimulus within an area can create a monotonous

to see how it can be in such a domestic environment. The exposed

affect within a room; the brain eventually adapts to the patterns,

beams and columns were not overpowering in any sense and

colours and contrasts, leaving it to, in effect, disregard the initial

seemed to help enclose the space more and give a more intimate feel. Cullinan also allows for the slate stone flooring to add an extra 37

Cullinan Studio, ‘Maggie’s Newcastle’, http://www.cullinanstudio.com/uploads/documents/MaggiesNewcastle_CaseStu dy.pdf , [accessed02/01/15],

centre%27s-laura-lee-on-the-healing-power-of-architecture/3135714.article, [accessed 24/12/2014] 39

Ruth Slavid, ‘Maggie’s Centre’s Laura Lee on the healing power of architecture’, BD Magazine, [March 2009], http://www.bdonline.co.uk/maggie%27s-

Charles Jencks and Edwin Heathcote, ‘The Architecture of Hope’, (London, Francis Lincoln Ltd. Publishers, 2010) p. 132.

response and leave them redundant40. I find that Cullinan has been

In a study that experimented with colour in health facilities, it was

more liberal with the use of colour, and hasn’t taken this stripped back

proven that patients responded more positively, with them saying that

approach as far as Hadid. By Cullinan exposing the materials used

is was ‘cleaner, quieter, and more likely to make them feel good’43.

in the building, he has not only allowed the users to see the qualities

Ferndene mental health residency in Prudhoe, Newcastle, is

of the build, but allowed the form of the building to help influence the

interior. Hadid’s minimalist approach has hidden any elements of

company in healthcare design. Similarly to Maggie’s, within

construction within the design and limited the effect of the

Ferndene, the architects wanted to create a colour scheme that

architecture on the user, with it becoming a background rather than

reflected ‘a sense of playfulness, space and light and avoids an

a stimulus. Yet many ‘patients tell us that the architecture makes their

overly clinical atmosphere’44. Both these buildings manipulate colour

smashed egos expand again’41. In Maggie’s Fife, the main focus is to

to improve user experience, an attribute that is proven to succeed.

bring the landscape into the building, giving purpose for her rejection

Although this element does seem to be mainly incorporated into

of architectural flaunting. However, Jencks describes this centre as,

smaller healthcare facilities, as the Maggie scheme grows, hopefully

‘the least residential in feel. This is no simulacrum of domesticity’42,

larger healthcare facilities will be able to learn from them and develop

the need of colour and personal expression is apparent; Hadid runs

their interiors to be a more user friendly space.

the risk of allowing the minimalism to become over powering and gives it the ability to undermine any personality the building has.

G Meerwein & B. Rodeck, ‘Color communication in Architectural Space’, Translated by F.H.Manke, (Birkhauser, Ruckstahl AG, 1998), p.9. 41

Charles Jencks, ‘The Architecture of Hope’, in ‘The Architecture of Hope’, By Charles Jencks and Edwin Heathcote (London, Francis Lincoln Ltd. Publishers, 2010, p. 13-14.

Sheila J Bosch, Rosalyn Cama, Eve Edelstein, Jain Malkin, ‘ The Application of Color in Healthcare Settings’, http://www.ki.com/pdfs/Color_in_Healthcare_Settings_Paper.pdf, [accessed 18/12/2014], p.35. 44

Charles Jencks and Edwin Heathcote, ‘The Architecture of Hope’, (London, Francis Lincoln Ltd. Publishers, 2010) p. 127.

Medical Architecture, ‘strategy, design, evaluation’, [leaflet obtained 25/07/2014], p.15.

Top Left: Figure 15: Maggie’s Newcastle, use of exposed timber Bottom Left: Figure 16: Maggie’s Newcastle, use of exposed concrete

Above: Figure 17: Maggie’s Fife, mix of curved and straight walls, minimal white walls and glass south façade with surrounding landscape.

Top Right: Figure 18: Maggie’s Fife, Use of furnishings to inject colour into the centre Bottom Right: Figure 19: Medical Architecture’s Ferndene project, example colour scheme 21

Throughout Newcastle Maggie’s there are various pieces of artwork

Within each Maggie centre there is a range of spaces varying from

displayed on the walls. These pieces of artwork are loaned out to the

public to private. This variety is important to allow each patient to

centre and changed when the loans expire. The current artwork

have the choice of where they would like to be on the social scale.

displayed is by Alan Toring and the late Norman Cornish. Norman

Intimate areas are provided for those who would like to seek solace,

Cornish is a ‘celebrated mining artist’45, who was born locally to

whilst slightly larger areas are there for those who would like smaller

Newcastle in County Durham. His work within the centre is primarily

group discussions or more intimate conversations. Creating intimate

black and white portraits. Art itself is known to be an encourager of

areas within a design can be difficult and some almost look like they

‘social reform’ , its presence within a space, has the ability to

are accidental. For example, Cullinan has placed discreet seating

completely alter a mood and become a source of enlightenment for

booths up the side of ‘a staircase – doubling as bookshelves’47,

people. With a piece of art or painting being of a more condensed

(figure 12) a feature that is known to help ‘create an atmosphere of

piece of colour or stimulus, the effect can be greater, with the art not

cozy domesticity’48. These private spaces use soft furnishings to help

becoming something people adapt to. The artwork by Alan Toring is

enclose the surrounding environment, recreating a household

more colourful than Norman Cornish’s. It is less traditional than the portraits, with colourful lines and splashes around the canvas. The contrast and diversity of the art gives the user a more positive distraction, engaging a wider visual appeal.

‘Normal Cornish’, http://www.normancornish.com/biography.html,[accessed 18/12/2014]

Cullinan Studio, ‘Maggie’s Newcastle’, http://www.cullinanstudio.com/uploads/documents/MaggiesNewcastle_CaseStu dy.pdf , [accessed02/01/15], p.1.

Yuri Borev, ‘Aesthetics’, http://independentacademy.net/science/library/borev_est_eng/art_functions.htm, [accessed 18/12/2014]

Witold Rybczynski, ‘Home: A Short History of an Idea’, (USA, Viking Penguin Inc., 1986), p.221.

Top Left: Figure 20: Norman Cornish work Bottom Left: Figure 21: Maggie’s Newcastle, Alan Toring artwork displayed on 12/12/14 Above: Figure 22: Maggie’s Newcastle, open plan office space

Top Right: Figure 23: Newcastle Maggie’s, public area, tai chi room Bottom Right: Figure 24: Newcastle Maggie’s private meeting room

setting within the centre, with ‘domesticity, privacy, comfort, the

The Effect of Nature

concept of home’ . 49

Newcastle Maggie’s strives to maximise the domestic capability of the centre, yet this building is still a workplace for some. The main workplace for the staff is located next to the front door (figure 22).

The exterior garden and courtyards spaces for Newcastle Maggie’s were designed by award winning Sarah Price. In most of her designs she draws upon her fine art background to try and give users ‘deeper connections with the natural world’51. Contrastingly, Price prefers to

This space feels like a reception, something that stems away from

steer clear of radical landscaping and would rather use ‘plant forms’52

the original Maggie concepts. It makes people feel like they need

to extenuate elements. This aspect is unclear in Newcastle Maggie’s

permission to go further. This instantly creates a restriction on their

and I believe may have been restricted due to others input.

use and makes their first impression relate to the formalities of a hospital environment. The organisation of the plan is something I believe that Cullinan has overlooked or taken his concepts of making an open plan environment too far. Maggie’s Highlands, designed by Page and Park, uses the ‘mezzanine [which] accommodates the centre’s offices’50, as a private area for staff. This separation between

As previously mentioned, evidence based design is a key movement for the majority of design decisions taken today. Roger Ulrich, a leading psychologist, is a keen enthusiast for evidence based design and ‘conducts scientific research on the influence of

work and public space is something Newcastle would benefit from.

Witold Rybczynski, ‘Home: A Short History of an Idea’, (USA, Viking Penguin Inc., 1986), p.51.

Phaidon, ‘The Phaidon Atlas of 21st Century World Architecture’, (Phaidon Press Limited, 2008), p.277.

Sarah Price Landscapes, http://sarahpricelandscapes.com/?page_id=27 , [accessed 20/12/2014] Ibid,.

healthcare facilities on patient medical outcomes’53. In one of his

facing walls floor to ceiling windows. This allows maximum sunlight

earlier papers, Ulrich found that people ‘prefer natural scenes more

and heat into these parts of the centre as well giving them a view

than urban views’54. Cullinan has encompassed this result into his

onto the main external courtyard space, another way Cullinan has

design; by enclosing banks of earth around the centre. He has

manipulated the natural scenery into his plan. The plan of the building

provided a protective barrier for the building and also created a shell

protects this external courtyard from the wind, which potentially

like feel; pushing the nearby hospital further into the distance.

makes this space ‘as much as 5°C’56 warmer than the fully exposed

Cullinan may have been inspired for this design quality from the brief

roof garden. This architectural dialogue between buildings and

which states ‘the ‘outside’ of a garden is a buffer to the real

climate has been a ‘lifelong preoccupation’57 of Cullinan’s, a

‘outside’’55, which also supports Ulrich’s theory on nature being more

noteworthy feature that in a building such as this, becomes an

evocative for users to witness.

integral part of the building’s inhabitancy.

Situated on the north-east coast, Newcastle’s climate is constantly

Hospices in particular ‘should employ natural materials and facilitate

changing, something Cullinan was aware of. To help this situation he

a rapport with nature’58, the use of timber within Maggie’s Newcastle

orientated the building south, and made the majority of the south

clearly complies with this. To help create a relationship between the

Roger S. Ulrich, PHD, ‘Effects of Healthcare Environmental Design on Medical Outcomes’, http://www.capch.org/wp-content/uploads/2012/10/Roger-UlrichWCDH2000.pdf, [accessed 20/09/2014]

Ellis Woodman, ‘Maggie’s North East by Cullinan Studio’, [22 May 2013], http://www.bdonline.co.uk/maggies-north-east-by-cullinanstudio/5055143.article, [accessed 20/12/2014]

Roger S. Ulrich, PHD, ‘View through a window may influence recovery from surgery’, https://mdc.mo.gov/sites/default/files/resources/2012/10/ulrich.pdf, April 1984, [accessed 19/12/2014]

Ibid.,

58 55

Maggie’s Architectural Brief, http://www.maggiescentres.org/media/uploads/file-upload-plugin/maggiesarchitectural-brief/architectural_brief_maggies.pdf, [accessed 06/12/14], p.6.

G Meerwein & B. Rodeck, ‘Color communication in Architectural Space’, Translated by F.H.Manke, (Birkhauser, Ruckstahl AG, 1998), p.11.

landscape and the centre, Cullinan has used a lot of glazing to bring

Price will have had to be very selective with the type of plants she

the outside in. Although, in contrast, corten steel is used to frame the

has chosen. Heavily fragranced plants are not suitable for these type

glazing. Similarly, Hadid’s Maggie centre in Fife has a relationship

of gardens as many cancer patients will have nausea as a side effect

with the surrounding environment. Like Newcastle, a wall of glass on

of many of the treatments, where 'people on chemotherapy are

the south façade opens the building up onto the grass bank and trees

especially sensitive to smell'61. This may have restricted Price to her

that surround it. The building itself is a ‘continuation of the existing

choices of plants, and probably provided a challenge for her.

tree line’59; however the material of the external envelope contradicts this use of natural elements, by Hadid choosing to use a material that reflects the ‘asphalt of the car park’60.

Maggie's Newcastle has a rather more discreet garden landscape than some of the other centres. Many of the other centres use biological metaphors as influences to integrate sculpture and

In the past year Newcastle Maggie’s has had approximately 8000

reconfigure the external surrounding. Maggie's Inverness is designed

bulbs planted ready for the spring. This vast amount of plants, should

by Charles Jencks; he uses two mounds of earth covered in grass as

provide a radical change to the muddy banks I witnessed on my visit.

a symbolic reference to a dynamic balance of cells communicating

Although many did note how pleasant the gardens were in summer,

between one another, (figure 29). To an uneducated or inartistic eye,

the lack of colour I witnessed did leave some doubts. This is where

these two mounds may appear insignificant and dull, they 'provide

the outside disappoints. Surely the point of all this glazing is so that

minimal engagement with nature'62, a necessary component of the

the view (and the effects of the view), can be reaped all year round?

centre’s gardens. Patients do not want these crude art pieces and

Zaha Hadid Architects, ‘Maggie’s Fife’, http://www.zahahadid.com/architecture/maggies-centre-fife/ , [accessed 20/12/14] 60

Charles Jencks and Edwin Heathcote, ‘The Architecture of Hope’, (London, Francis Lincoln Ltd. Publishers, 2010) p. 127.

Clare Cooper Marcus and Naomi A. Sachs, ‘Therapeutic Landscapes: An Evidence Based Approach to Designing Healing Gardens and Restorative Outdoor Spaces’, (New Jersey, John Wiley & Sons, 2014) p. 117. 62

Ibid., p. 126.

confusing landscaping features, when this ill. It is the simple things

well with the centre being able to make the most of this space in the

that are needed to make them feel human; 'simplicity, peace and

summer, for example last year they hosted a barbecue at the centre

quiet'63 is more essential than artistic expression. Although it is

as a fundraiser. Maggie's London, on the other hand, has been

argued that these artistic expressions provide ‘open-ended

criticised for its lack of seating 'one lone, exposed bench does not

stimulation and reflection’64.

meet the needs'65, nor does it provide secluded, private areas patients can sit and reflect or just take in the surrounding nature. This is a clear ignorance of the clientele from the landscape architect, Dan

Cullinan has used the small scale of this project to his advantage,

Pearson. However, some say that Pearson has exemplified

with Maggie’s Newcastle being approximately 300sqm. He has

Japanese gardens in his design, in which ‘privacy and reflection are

provided seating areas outside that relate to the dining space within.

concerned’66 and ‘emotions and feelings are ‘finely tuned’’67.

This is necessary for cancer patients as many are weak, so plenty of seating is needed. The glass wall from the kitchen onto the courtyard is reclining and opens out merging the two spaces. This then means

Cullinan has made a feature of the roof space by covering it in turf

that the long kitchen table can be used for those wanting to get some

and enabling public access to this area. This external space provides

fresh air whilst still being protected from the harsh northern winds.

greenery for the mezzanine level as well giving the users views of the

The merging of spaces strengthens the inside out relationship Cullinan has created throughout his design. Practically, it also works 65 63

Ken Worpole, Modern Hospice Design: The Architecture of Pallative Care, (USA and Canada, Routledge, 2009), p.85. 64

Ken Worpole, Modern Hospice Design: The Architecture of Pallative Care, (USA and Canada, Routledge, 2009), p.85.

Ibid., p.85.

Top Left: Figure 25: Newcastle Maggie’s, view of roof garden Bottom Left: Figure 26: Newcastle Maggie’s, view of courtyard

Above: Figure 27: Maggie’s London, external view, shows lack of seating.

Top Right: Figure 28: Maggie’s Fife, external view, overlooking landscape on the south façade Bottom Right: Figure 29: Maggie’s Inverness, aerial view of metaphorical mounds 29

surrounding area. Considering how confined the downstairs is, with

The brief states that each centre should try and be something

views only onto the centres courtyard, the users are able to get a

‘people wouldn’t have quite dared build themselves’70. Newcastle

sense of context. This also makes the building appear to be rising out

Maggie’s stands out amongst its surroundings, its curved ‘pringle’

of the ground, another perspective Cullinan has emphasised with the

shaped roof being an iconic feature against the monolithic

enveloping banks on the ground floor. Here, the topography of the

background of the Freeman hospital. Although the majority of the

site has been taken into consideration, with the centre slowly

centre’s architects have decided to run with this bold statement

creeping into view as you drive through the hospital grounds.

building, Cheltenham Maggie’s, designed by MJP architects, is

Personally, I think the roof gardens make an attractive addition to the

situated next to a grade two listed building. For this particular centre

centre and fit in with one of Cullinan’s main ethos’ of ‘human

the architects have tried to create a link between the existing

occupation’68 being key. Within Cullinan’s original design proposal for

building and their own, creating a more discreet succinct design.

the centre, he included a ‘continuous walkway69 that allows for public

The surrounding trees, disguise the timber cladding used on the

access around the building, (figure 30). Unfortunately, due to funds,

extension and help blend this in amongst the original setting. This

this element of the design had to be cut. Although the centre still

could be considered a weak approach as these buildings have

works cohesively, I didn’t see the emphasis on human occupation

become renowned for owning their design and creating bold

straight away. Maybe this element would have helped focus that

architectural statements within a stereotypical environment. These

aspect of the design for me.

Ellis Woodman, ‘Maggie’s North East by Cullinan Studio’, [22 May 2013], http://www.bdonline.co.uk/maggies-north-east-by-cullinanstudio/5055143.article, [accessed 20/12/2014] 69

Maggie’s Architectural Brief, http://www.maggiescentres.org/media/uploads/file-upload-plugin/maggiesarchitectural-brief/architectural_brief_maggies.pdf, [accessed 06/12/14], p.8.

Ibid.,

buildings use the bold attitude to help ‘raise your spirits’71 and

Structural Integrity and Materiality

create positivity amongst the users. Some of the centres seem to have really understood the brief when it comes to the landscaping. Cullinan and Price have achieved a good

Just like every design that Cullinan Studios creates their ‘long life,

balance of components, creating a visually pleasing and natural

low energy’72 motto is always achieved and Maggie’s Newcastle is

approach. Although, in the centres as a whole, the clienteles

no different. The overall scheme has been awarded an excellent from

response and an understanding of their needs seems to have been

the BREEAM rating. BREEAM (Building Research Establishment

lost. Even Jencks himself seems to have got caught up in the creative

Environmental Assessment Methodology) is ‘the world’s foremost

response, rather than remaining focused on the task at hand.

environmental assessment method and rating system for buildings’73. This accredited system considers the building’s initial environmental impact (including waste, material transportation and production pollution) as well as the running of the building; encouraging low carbon, low impact and low energy designs from architects and designers.

Maggie’s Architectural Brief, http://www.maggiescentres.org/media/uploads/file-upload-plugin/maggiesarchitectural-brief/architectural_brief_maggies.pdf, [accessed 06/12/14], p.1.

Maggie’s, ’The Architecture and Design of Maggie’s Newcastle’, https://www.maggiescentres.org/our-centres/maggies-newcastle/architectureand-design/, [accessed 06-12-14] 73

BREEAM, ‘What is BREEAM?’, http://www.breeam.org/about.jsp?id=66 , [accessed 06/12/14]

Cullinan has used the surrounding landscape of the centre to enclose

way, by keeping the main architectural feature solely about the

the external envelope partially. He has built up banks of the ground

architectural intent and hiding the elements that make the building so

to create an insulating barrier for the external wall. As well as

sustainable. The key architectural element is the floating roof that

providing extra insulation and shelter for the external walls; the banks

covers the whole of the building and some of the private gardens.

act as an extenuation of the building and form a south facing

Sustainable features such as natural ventilation, high insulation and

courtyard that ‘visitors can enjoy while feeling protected and

the use of timber, are integrated to allow the focus to remain on the

enclosed’74. This impression is something that is also achieved at the

roof. An example of the integration is how ‘the external walls are over

front external view of the building, with the centre appearing to be

insulated to reduce energy consumption’76.

wrapped in a protective duvet. Cullinan has also said that he wants the building to be ‘one that saves energy and enjoys saving energy and shows off about it’75. This gives us the impression that Cullinan

Like Maggie’s London, Cullinan has emphasised the curved roof

wanted to make a statement externally with the sustainable elements

within his design, yet applied a sustainable architectural feature to it.

of the design; another reason that the landscape is allowed to make

The surface of the roof is covered in photovoltaic panels. The cells

such a bold impact on the building itself.

work by ‘using layers of semi-conductive material’77 to convert

The Maggie’s centre in London, designed by Rogers Stirk Harbours and Partners, uses sustainability within its design in a more discreet

Cullinan Studio, ‘Maggie’s Newcastle’, http://cullinanstudio.com/project/maggies-newcastle, [accessed 06/12/14]

‘Maggie’s Opening Film – Newcastle’, https://www.youtube.com/watch?v=dMrZGAWubc8, [accessed 20/11/14]

E-architect, ‘Maggie’s London’, http://www.e-architect.co.uk/london/maggiescentre-london, [accessed 29/12/2014] Energy Saving Trust, ‘Solar Panels’, http://www.energysavingtrust.org.uk/domestic/content/solar-panels, [accessed 29/12/2014]

Top Left: Figure 30: Section of Maggie’s Newcastle Bottom Left: Figure 31: Maggie’s Newcastle, external view showing photovoltaics on roof

Above: Figure 32: Maggie’s London, internal courtyard, covered by overhanging roof

Top Right: Figure 33: Maggie’s London, external view, shows architectural feature of floating roof Bottom Right: Maggie’s Cheltenham, external view, shows use of timber for majority of structure. 33

sunlight into electric energy. The stronger the sunshine is, the more

advantageous to most designs, as they are manufactured off site,

effective the cells are, yet they still transmit in ordinary daylight. The

creating a shorter build time and allowing for a higher quality control

shape of the roof will help reflect the energy back into the panels and

method to be implicated. In terms of sustainability, in some cases,

allows the panels to be more efficient.

pre-cast panelling is able to be reused within other builds, so long as there is no structural damage when the current building is at the end of its lifespan. In order to set the pre-cast concrete, moulds need to

Maggie’s Newcastle was awarded the ‘RIBA Regional Award and

be formed. Commonly made of timber, these moulds are at their most

Sustainability Award’78 in 2013. Yet the majority of the Newcastle

cost effective if they can be reusable, an element that can hinder

centre is built out of concrete, a material known for being harmful to

architectural design and would have been a keen consideration of

the environment. During production, concrete produces high

Cullinan’s during the design process.

amounts of CO₂ and requires a lot of embodied energy. Fortunately, over the past few decades, concrete production has improved, in which the ‘energy consumption of cement has fallen by over 40%’79.

Unlike Newcastle, Maggie’s Cheltenham decided to minimize their

Another disadvantage of using concrete, is its lack of recycling

use of concrete and use timber as their primary structure. Timber is

prospects at the end of the building’s life cycle with the majority only

a strong, durable, renewable material that can be easily treated for

being able to provide a ‘significant quantity of recycled aggregate’80.

weathering and fire protection purposes. However, timber doesn’t

Cullinan has chosen to use ‘a 300mm thick reinforced concrete

possess the same thermal qualities as concrete and therefore isn’t

frame, with infill concrete walls’81. These pre-cast panels are

as efficient in retaining heat. With concrete having such an innate

Cullinan Studio, ‘Maggie’s Newcastle’, http://www.cullinanstudio.com/uploads/documents/MaggiesNewcastle_CaseStu dy.pdf, [accessed02/01/15]

Ibid., p.216.

Michael Stacey, ‘Concrete – A studio Design Guide’, (RIBA Publishing, Michael Stacey and the Concrete Centre, 2011) p. 216. 79

Michael Stacey, ‘Concrete – A studio Design Guide’, (RIBA Publishing, Michael Stacey and the Concrete Centre, 2011) p. 219.

density, the material allows the building to become highly efficient in

with Maggie’s Newcastle being a fine example to other healthcare

heat storage as a result of its thermal mass.

facilities. However, I do think that by having the sustainability system integrated within the design, new builds are at an advantage to existing buildings. For example, Maggie’s Newcastle uses the

Internally Cullinan has managed to create a comfortable environment

orientation of the building to receive the maximum amount of sunlight,

all year round. By taking advantage of the concrete’s material

which is then ‘kept within the building by the thick insulation84. This

properties, he has managed to manipulate the sun’s heat through the

level of insulation, is a design choice made by Cullinan in the early

building so that the energy is stored and keeps the building warm

stages of the building’s development. For an existing building that

throughout winter. For the summer, Cullinan has kept the ventilation

doesn’t have this, heat will be lost through any cold bridges within the

system basic, by providing windows that can open and close

buildings junctions.

manually, implementing rapid cooling strategies making it ‘simple for people to control their environment’82.

Within other healthcare facilities, sustainability is becoming of major importance. ‘Healthcare facilities are key consumers of energy’83, with the scale of the buildings and the amount of people that need treating, meaning vast amounts of water, electricity and gas are used. The BREEAM standard exemplifies buildings of high sustainability, 82

Cullinan Studio, ‘Maggie’s Newcastle’, http://www.cullinanstudio.com/uploads/documents/MaggiesNewcastle_CaseStu dy.pdf, [accessed02/01/15]

Cullinan Studio, ‘Maggie’s Newcastle’, http://www.cullinanstudio.com/uploads/documents/MaggiesNewcastle_CaseStu dy.pdf, [accessed02/01/15], p.2.

Michael Phiri and Bing Chen, ‘Sustainability and evidence-based design in the healthcare estate’, (Heidlberg, Springer, 2014), p. 7.

Conclusion

As the Maggie’s scheme becomes more popular and renowned, Cullinan’s design will become more prominent and iconic. The whole building is articulated to respond to its brief and surroundings, as well

Maggie’s Newcastle has become a place heralded in the North East for its intuitive and practical design. The status and excitement surrounding a building belonging to such a commended scheme, puts a huge amount of pressure and scrutiny on the architect. Yet Cullinan needn’t worry. Cullinan has managed to achieve a comprehensive and indulging building that encapsulates the concept and needs of a Maggie Centre. Maggie’s Newcastle has proven its

as having a huge connection with its users. Yet the Maggie scheme alone helps users develop a deeper connection with the centres. The centres are there for emotional support in a time of need, the staff and people, help develop this connection for each individual. The building alone creates an environment that ‘is very enabling’86, a great encouragement for everyone, yet it is the human support that really makes these buildings achieve their purpose.

worthy of this prestige. Within the brief Maggie says how she wants the centres to ‘feel like a home people wouldn’t have dared to build themselves’85, and Cullinan has accomplished this. He has combined innovative sustainable methods and bold architectural decisions with a balance of domestic and subtle features that, together, generate a striking first impression, whilst still allowing the users to feel welcome. In comparison to the other centres, Cullinan’s approach seems more contrived. He appears to have a better understanding of the client needs and intuitive knowledge of what will create the aesthetic he desires.

Maggie’s Architectural Brief, http://www.maggiescentres.org/media/uploads/file-upload-plugin/maggiesarchitectural-brief/architectural_brief_maggies.pdf, [accessed 06/12/14], p.1.

Since Maggie wrote the brief for the centres in the 1990’s, there has been a lot of architectural and medical advances. As the scheme has developed, fellow architects, educators and the public have witnessed the positive effects these environments can have. Healthcare architecture and future Maggie Centres can learn a lot from what has already been designed. These impressive buildings, not only recognise and acknowledge the need for good architecture within the world, they highlight the importance architecture can have

Karen Verrill. Personal Interview, 12/12/2014

among society. This field of architecture should learn from these

it simply, healthcare architecture is of too high a demand, to be

centres and benefit from their knowledge and experience.

given the quality of design it deserves.

Cullinan’s design approach has highlighted the need for the brief to

The need of progression in this architectural field is apparent.

be reviewed. By analysing the current centres in a way that

Maggie Centres alone have proven that architecture can have a

highlights strengths and weaknesses, it could be possible for a

massive impact on personal health and well-being. Yet, for many

generic structure, layout and format to be created for these centres.

this field is over looked, the generic images and ‘fear of illness’

The negative being that these constraints may be too restrictive for

nature that we have, convinces us that a clinical sterilised

the prospective architects and interest may be lost in the scheme.

environment is what we need. Maggie Centres are a leap in the

Alternatively, these generic guidelines, could be formulised to help

right direction for better healthcare environments, yet as Dame

healthcare centres as a whole and help integrate the distinctive

Cicely Saunders once said, ‘There is so much more to be done’87.

design features of Maggie’s among healthcare architecture.

However, most healthcare facilities cannot respond to their design needs in the same way as Maggie’s do. The domestic element of the centres creates a distinction between clinical and psychological facilities. With people relating professional and medical assurance to a sterilized hospital environment. Another restriction on integrating a higher standard of design would be due to cost. To put 87

St Christopher’s Hospice, ‘Dame Cicely Saunders, (2014), http://www.stchristophers.org.uk/about/damecicelysaunders, [accessed 11/10/14

Bibliography

Jencks, Maggie Keswick, ‘A View from the Front Line’’, (2007), https://www.maggiescentres.org/media/uploads/file_upload_plugin/view-from-thefront-line/view-from-the-front-line_1.pdf, [accessed 21-08-14]

Books and Journals

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Berg, Agnes Van Der & Wagenaar, Cor, ‘Healing by Architecture’, in ‘The Architecture of Hospitals’, ed. by Cor Wagenaar (Rotterdam, Eelco van Welie, Nai Publishers, 2006) Blakenham, Marcia, ‘Foreword’ in ‘A View from the Front Line’’, by Maggie Jencks, 2007, https://www.maggiescentres.org/media/uploads/file_upload_plugin/viewfrom-the-front-line/view-from-the-front-line_1.pdf, [accessed 21-08-14] Blakenham, Marcia, ‘Maggie’s Centres: Marching On’ in ‘A View from the Front Line’’, (2007), https://www.maggiescentres.org/media/uploads/file_upload_plugin/view-from-thefront-line/view-from-the-front-line_1.pdf, [accessed 21-08-14] p. 30. Bosch, Sheila J & Cama, Rosalyn & Edelstein, Eve & Malkin, Jane, ‘ The Application of Color in Healthcare Settings’, http://www.ki.com/pdfs/Color_in_Healthcare_Settings_Paper.pdf, [accessed 18/12/2014] Charness, Neil, ‘Reviews of Human Factors and Ergonomics, Volume 8: Healthcare Human Factors/Ergonomics’,(Santa Monica, CA Human Factors and Ergonomics Society, July 2014), http://erg.sagepub.com.libproxy.ncl.ac.uk/content/22/3/29.1.full.pdf+html, [accessed 20/12/14] Cooper – Marcus, Clare & Sachs, Naomi A, ‘Therapeutic Landscapes: An Evidence Based Approach to Designing Healing Gardens and Restorative Outdoor Spaces’, (New Jersey, John Wiley & Sons, 2014) Heathcote, Edwin & Jencks, Charles, ‘The Architecture of Hope’, (London, Francis Lincoln Ltd. Publishers, 2010) Jencks, Charles ‘The Architecture of Hope’, in ‘The Architecture of Hope’, By Charles Jencks and Edwin Heathcote (London, Francis Lincoln Ltd. Publishers, 2010)

Meerwein, G & Rodeck, B, ‘Color communication in Architectural Space’, Translated by F.H.Manke, (Birkhauser, Ruckstahl AG, 1998) Phaidon, ‘The Phaidon Atlas of 21st Century World Architecture’, (Phaidon Press Limited, 2008) Phiri, Michael & Chen, Bing, ‘Sustainability and evidence-based design in the healthcare estate’, (Heidlberg, Springer, 2014) Ponsonby, Margaret, ‘Stories from Home English Domestic Interiors 1750-1850’, (USA, Farnham: Ashgate Publishing Company, 2007) Rybczynski, Witold, ‘Home: A Short History of an Idea’, (USA, Viking Penguin Inc., 1986) Simms, Thomas J, ‘A Perspective on the End of Life: Hospice Care’, in ‘Topics in Advanced Practice Nursing eJournal’, (2007) Medscape, http://www.medscape.com/viewarticle/549702_3, [accessed 09/10/14] Shepley, Mardelle McCusky, ‘Evidence Based Design and Architecture’, in ‘The Architecture of Hospitals’, ed. by Cor Wagenaar (Rotterdam, Eelco van Welie, Nai Publishers, 2006), Stacey, Michael, ‘Concrete – A studio Design Guide’, (RIBA Publishing, Michael Stacey and the Concrete Centre, 2011) Ulrich, Roger S, PHD, ‘Effects of Healthcare Environmental Design on Medical Outcomes’, http://www.capch.org/wp-content/uploads/2012/10/Roger-UlrichWCDH2000.pdf, [accessed 20/09/2014] Ulrich, Roger S, PHD, ‘View through a window may influence recovery from surgery’, https://mdc.mo.gov/sites/default/files/resources/2012/10/ulrich.pdf, April 1984, [accessed 19/12/2014] Worpole, Ken, Modern Hospice Design: The Architecture of Pallative Care, (USA and Canada, Routledge, 2009)

URL’S

‘Paimio Sanitorium – Technical Equipment’, http://www.alvaraalto.fi/net/paimio/paimio.html, [accessed 19/10/2014]

Borev, Yuri, ‘Aesthetics’, http://independentacademy.net/science/library/borev_est_eng/art_functions.htm, [accessed 18/12/2014]

Sarah Price Landscapes, http://sarahpricelandscapes.com/?page_id=27 , [accessed 20/12/2014]

BREEAM, ‘What is BREEAM?’, http://www.breeam.org/about.jsp?id=66 , [accessed 06/12/14]

Slavid, Ruth, ‘Maggie’s Centre’s Laura Lee on the healing power of architecture’, BD Magazine, [March 2009], http://www.bdonline.co.uk/maggie%27s-centre%27slaura-lee-on-the-healing-power-of-architecture/3135714.article, [accessed 24/12/2014]

Cambridge Dictionaries Online, http://dictionary.cambridge.org/dictionary/british/home, [accessed 06/01/15] Cicely Saunders Institute, ‘The Institute – Cicely Saunders’, (Kings College London, 2014), http://www.csi.kcl.ac.uk/cicely-saunders.html, [accessed 08-10-14] Cullinan Studio, ‘Maggie’s Newcastle’, http://cullinanstudio.com/project/maggiesnewcastle, [accessed 06/12/14] Cullinan Studio, ‘Maggie’s Newcastle’, http://www.cullinanstudio.com/uploads/documents/MaggiesNewcastle_CaseStudy. pdf, [accessed02/01/15] E-architect, ‘Maggie’s London’, http://www.e-architect.co.uk/london/maggiescentre-london, [accessed 29/12/2014] Energy Saving Trust, ‘Solar Panels’, http://www.energysavingtrust.org.uk/domestic/content/solar-panels, [accessed 29/12/2014] JDDK Architects, ‘Latest News: JDDK Hospice Designs Shortlisted for National Healthcare Awards, October 2010’, http://www.jddk.co.uk/news/read/27, [accessed 19/10/2014]

The National Council for Palliative Care, ’Pallative Care Explained’, (2014), http://www.ncpc.org.uk/sites/default/files/PalliativeCareExplained.pdf, [accessed 06/10/14] Woodman, Ellis, ‘Maggie’s North East by Cullinan Studio’, [22 May 2013], http://www.bdonline.co.uk/maggies-north-east-by-cullinan-studio/5055143.article, [accessed 20/12/2014] Zaha Hadid Architects, ‘Maggie’s Fife’, http://www.zahahadid.com/architecture/maggies-centre-fife/ , [accessed 20/12/14]

Videos and Interviews ‘Maggie’s Opening Film – Newcastle’, https://www.youtube.com/watch?v=dMrZGAWubc8, [accessed 20/11/14] Karen Verrill. Personal Interview, 12/12/2014

‘Normal Cornish’, http://www.normancornish.com/biography.html,[accessed 18/12/2014] Maggie’s, ’The Architecture and Design of Maggie’s Newcastle’, https://www.maggiescentres.org/our-centres/maggies-newcastle/architecture-anddesign/, [accessed 06-12-14] Maggie’s Architectural Brief, http://www.maggiescentres.org/media/uploads/fileupload-plugin/maggies-architectural-brief/architectural_brief_maggies.pdf, [accessed 06/12/14]