Case Studies Health

Ysbyty Cwm Cynon, Mountain Ash

Planning and Design Process

Therapeutic design

The design of the building is focused on patient care through the therapeutic environment – an approach supported by a simple way-finding strategy, a strong landscape integration and a suite of sustainable strategies that include both renewable energy sources and passive climate control. All key design aspects have been driven by flexibility and sustainability.


The brief comprises 128 beds and 40 places, made up of:
100 – Active Rehab Beds
8 – Palliative Care Beds
5 – Midwife led beds
15 – POA beds
Adult Mental Health Day Unit – 15 places
Palliative Care Day Service – 10 places
Therapy Day Hospital -15 places

The Community Dental Department unit at the Cynon Valley hospital serves as a training base for the Cardiff & Vale Dental Teaching University, as is supported by a small base of student facilities, including computer labs and lecture facilities.

Key Sustainability Points

Social regeneration

This Scheme is seen as a fundamental catalyst to the social regeneration objective for the area, and is paramount in promoting community activity and sustainability.

Energy efficiency

Energy efficiency is central to the design of the new hospital. Practical and sustainable features have been adopted, including naturally ventilated wards that make the most of daylight and passive climate control through the building’s thermal mass, via exposed soffits in the wards. A biomass hot water system is among the features that further reduce the facility’s carbon footprint as well as operating costs.


“We feel that the ownership by community and staff has meant that the building has integrated well into the environment and the local community…this level of ownership is a testament to the community and staff involvement all the way through driven by the HLM team” Tim Burns, Head of Major Projects, Cwm Taf Local Health Board

Case Studies Health

Maggie’s South West Wales

Planning and Design Process


The Client’s brief asked for a nominal 300m² of accommodation that principally offered a warm invitation into a building that provides human comfort, information, instruction, retreat and enjoyment. The building should speak of the joy of living and functionally provide a central social kitchen and hearth; large and small activity spaces, relaxation and counselling rooms, as well as generous and comfortable toilet and services facilities, including an office base for staff. The building should clearly relate to its site and landscape and be fully accessible and sustainable.


The Architect Kisho Kurakawa configured the original concept design as a “cosmic whirlpool” to represent and encompass the universal nature and energy of life. The resultant dynamic spiralling form dictated the principles of organisation both for the building and the surrounding landscape, which the design team used to develop and realise, the final scheme.


The entire internal layout of the building is a response to the surrounding landscape. Light plays a vital role in the creation and reflection of energy in the building, being admitted both through the walls and the roof in a unique manner.


The dynamic geometrical form is precisely defined in plan through finely engineered precast concrete walls. They incorporate an array of traditionally proportioned small punched window openings which house simple timber opening lights supporting the low-energy, natural ventilation of the centre. They collectively provide a myriad of 360 degree framed glimpses into the beautiful surroundings in an apparently random pattern, placed at various heights in all of the spaces.


In addition, a large elliptical ocular roof light provides the warm expansive end ever circling daylight to the central drum. Clerestory lights along the length of the wings’ spinal ridges generate equally dynamic lines of light that move across the day to either side. The calm, welcoming, warm and light central drum-like space, including the social kitchen area and fireplace, leads into more focussed areas of programmed accommodation in the wings. 

Sustainability Outcomes


The roof’s oculus and spinal clerestorys maximise available daylight and the building uses natural ventilation.  The structure is highly insulated and has a high thermal mass façade. It does not have a large percentage of external glazing, therefore avoiding possible solar gain.

Reuse of materials

Demolition materials were re used, in particular the soils which were largely retained on site to avoid transportation emissions.


The use of native plant materials on site increases biodiversity, in addition to the continuing contact that users are encouraged to have with the land through the use of community gardening.

Sustainable Drainage

Sustainable drainage systems were incorporated into the scheme, including rainwater harvesting which is used for irrigation.


“As you walk through the doors you feel almost cuddled or hugged in the centre in this lovely round building. It’s so comforting. With the design of the new centre it means we can deliver our programme of cancer support to far more people. We have been limited in the interim centre by being only able to do one thing at a time but the very design of this centre – having the group room, the relaxation room and a separate drop-in area means we can do several different things at one time. We can deliver our service to far more people.”

Debbie Horrigan, Centre Head

Related links

Maggies Centres

Kisho Kurokawa

Case Studies Health

Alzheimer Society Respite Centre, Dublin

Existing Site
The new building is within the original perimeter walls of an 18th century kitchen garden situated in Blackrock, a suburb in the south of the city of Dublin. The garden was previously owned by a neighbouring convent that donated it to the Alzheimer’s Society for such a facility. The old garden walls were rectilinear, full-height and built of granite with warm bricks stocks to the sunward walls. Across the garden there was a slope of about two metres.

Planning Constraints
Under Irish conservation and planning laws, the garden walls were designated Protected Structures and were to be retained. The building was to respect the garden setting and the presence of the old walls. In addition, planning guidance required the building to be clad in brick to match the lining of the existing garden walls.

Design Process
Níall McLaughlin Architects were asked by the Alzheimer’s Society of Ireland to research and then design an exemplary day care and respite centre for people with Alzheimer’s disease. The initial brief was to research contemporary thinking about Alzheimer’s disease and then design the building from those findings. Use of colour, light, movement, space, materials, smells, orientation and special¬ised standards were researched in the context of the disease and its effects and incorporated in the design process. The centre would provide beds for 11 patients and facilities for up to 25 during the daytime. It also includes the national offices for the Alzheimer’s Society of Ireland and is intended to serve as an exemplar for future respite centre design.

People with Alzheimer’s benefit from remaining in company at the social hub of things, at the same time they feel a need to wander. These needs must be be reconciled and in the design for the new Alzheimer’s day care and respite centre, we achieved this through a plan that promotes wandering loops. These are journeys that one might take on an outbound meander that gently and directly bring one back to the sociable core. Journeys, where possible, are through gardens and rooms, avoiding claustrophobic corridors. No route ends on a cul de sac which might induce disorientation and/or panic.

The building consists of radiating walls supporting lanterns that bring light deep into the plan. By placing a radiating single storey building in the centre of the site we mitigated the slope, maximised views and enabled access for users to the resultant garden spaces that are created between the new construction and the old enclosure. As you move through the building you are constantly provided with glimpsed views of gardens. Each garden is orientated in a different direction and intended to be experienced at different times of the day. Users can move around rooms in the interior like a clock, experiencing change throughout their daily journey. Each garden is designed to generate character appropriate to its orientation and there are courtyards, orchards, allotments and lawns.

Materials & Methods of Construction
The timber frame of the building is clad in fair-faced brickwork chosen to weather and to match the warm bricks that line the existing original garden walls. External doors, clerestories and windows are framed in hardwood.

Designers Evaluation
The design integrates Níall McLaughlin Architects’ research findings with current thinking about Alzheimer’s disease and it includes wider design recommendations for older people. The research investigated contemporary writing on the subject, involved interviews with staff and volunteers; visits to other buildings and the observation of clients in their daily setting. The findings are manifest in the following features:
• Distances between seating areas are short
• Wide walkways have been introduced to ease assisted ambulant/wheelchair access and designed to enable two carers to walk with a resident.
• Toilets are located within very short distances of social areas and are visible from beds in bedrooms
• Lighting has been designed to minimise glare and shadow and to achieve even illumination throughout
• Floor, skirting and walls are clearly differentiated by use colour and tone; no patterns are used on floors and the possibility for sharp shadows has been minimised;
• Doors are colour coded to distinguish rooms between toilets, ‘my room’ or non-access
• Coloured walls are introduced in key positions to aid orientation
• The plan ensures intuitive, safe way-finding and there are no dark corridors or dead ends
• Raised planting beds are included in the garden
• Natural wandering loops are incorporated in the plan
• Continuous handrails are installed on walls throughout the building
• The sloping site has been organised to provide a central fully accessible level area with level access to gardens and courts.
• It is not a residential building, but the bedrooms are designed with window seats and built-in desks to allow someone to populate it easily with familiar mementos and objects
• The entrance is easy to find going in, but almost invisible once you are inside. This reduces anxiety for clients
• Every room has its own garden
• Rooms are connected by doorways and openings but they can be isolated if necessary to separate noisy, agitated or belligerent clients, allowing them to become calm in a safe place without agitating the rest of the community
• A z-shaped zone of ancillary rooms runs through the spine of the building allowing staff to work on tasks while maintaining constant passive contact with clients
• Staff rest space is removed from the client area to allow full wind down and relaxation.
• Three manager’s offices passively overlook the single entrance court, allowing an additional layer of unintrusive supervision.

Case Studies Health

Singleton Hospital Day Surgery Unit, Swansea

Singleton Hospital Day Surgery Unit required two new operating theatres and a 24 bed recovery suite, with pre-assessment facilities and staff support spaces. The challenge was to provide the facilities, creating an environment to enhance both the patient and staff well being, within the shortest timeframe achievable. The site for the development is at the northern end of the existing Singleton Hospital car park, across Sketty Lane, from the main hospital complex.
The development site is at the highest point of the Singleton Hospital West car park which slopes steadily down to the south. It is bordered on three sides by existing landscape with the main views from the site to the south out over the car park to Swansea Bay and to the west across Oystermouth to Mumbles, its Pier and Lighthouse. Opportunities for framing these views and screening the parked cars are exploited by the elevated position of the unit which through its precise siting also optimises the ground works, cut and retention, required.

Design Process
The building is roughly rectangular and orientated west-east along its long axis and north-south across the short axis. This responds efficiently to the slope and maximises the southerly aspect and views.

On the east west axis the building is set back from Sketty Lane beyond the group of existing trees to frame the westerly view. On the north south axis the building is located close to the line of the existing access/exit lane to ensure as level an access to the unit as possible. The result is the building itself is able to effectively act as a screen to the delivery and services area at the north west corner of the site.

Cutting into the site to create a level plateau, combined with the natural screening provided by the existing trees and shrubs means that only two elevations are highly visible with the other two almost completely obscured.

The speed of delivery required by the client, Swansea NHS Trust, determined that conventional forms of building and procurement would simply not have enabled the Trust to deliver the additional capacity by the required date and therefore only a ‘Volumetric Off-Site Manufacture’ (VOSM) approach to construction would enable the Trust to meet the objective of providing additional surgical capacity in the time frame specified.
The Need to Embrace New Working Methods
One of the key factors in speeding up the procurement of new health facilities is to bring the facility constructor/supplier/manufacturer into the process as early on in the project development as possible. By doing so, the traditional design, tender and construct phases are all overlapped with a consequent saving of time.
A second key factor is the constructor’s access to the ‘supply chain’ which brings both technical expertise and, through repeated use of the same supply chain (leading to longer term, stable, repeat supply contracts), a reduction in price.

A third key factor is the ‘right first time’ or ‘zero defects’ approach, at the heart of which is volumetric off-site manufacturing (VOSM) or modular construction.
The Architects view was that the only approach which would provide the best possible chance of achieving the required date for delivering additional capacity was VOSM. The consultant team therefore worked closely with a leading VOSM provider, to develop designs, costs and programmes from the outset.

Through collaborative working the standard VOSM product was used, but enhanced both technically and aesthetically, to develop a scheme that was client specific and significantly more visually appealing than a standard VOSM build.
The architectural approach has therefore been influenced enormously by the rigours of the volumetric manufacture method.

The concept was to create a contemporary building that responded directly to its location and used many of the features of vernacular buildings set within the landscape to recede rather than contrast or stand out.

Fibre cement horizontal boarding has been used, retaining the dark, slate grey colour but giving a more engineered appearance. The vertical joints between boards are butt tightly whilst the horizontal are overlapped like clap boarding to give a sharp clear line at every horizontal joint. This is an important detail to obscure the simple repetitive vertical geometry determined by the joint line between modules of the VOSM units and is done deliberately to signal that this is not a ‘temporary’ building but is as ‘permanent’ as any other modern healthcare facility.
The direction in which the cladding is fixed is also a response to the VOSM approach. The units (4m high by 3m wide by 12m long) arrive on site and are jointed together at which point the building is watertight. There is no need for a further roof to be added. The relatively long low profile of the 15-unit long building has been emphasised through the horizontal emphasis achieved in the cladding.

A site-specific external appearance referencing traditional materials and methods of cladding but executed in a way which achieves a more contemporary and consistent appearance has been achieved. The dark grey mass of the Unit is set on a light grey concrete block plinth, raised above the ground separating the contemporary, engineered and man-made from the natural ground.
The dark colour chosen for the cladding reflects the grey of slate and is fundamental to the idea of the building receding into the strong surrounding band of trees and shrubs much as black agricultural buildings and dark grey rendered or stone and slate roofed buildings do.

The only break in the long low form is the courtyard cut into the south side of the building which creates further opportunities for gaining natural light and heat, views to key patient and carer/visitor areas and provides a planted space immediately outside the main entrance and waiting area. The courtyard also acts to physically separate the internal public spaces from the more private recovery areas.

The addition of five VOSM units forming the plant room at first floor level to the north of the courtyard provides a vertical axis to anchor the building by its massing emphasises the location of the main entrance. The engineering plant has been split to be part on the roof – within this plantroom and part on the ground in a service area in the northwest corner. This enables us to balance the massing, avoiding a large roof top plant room whilst maintaining the appearance of a long low single storey building whilst keep the building away from the trees on the east (Sketty Lane side of the site) by having a small ground level services area.
The service area is screened from the car park by rendered walls and a timber slatted, steel framed gate and from rooms along the west of the building through the use of low rendered blockwork walls and tree planting to create a small semi enclosed court.

With little surface modulation to the east and west elevations, pre pattinated copper cladding is used as an infill layer at window level to create a band effect within which the smaller or horizontal windows sit. They also serve to direct the view to the main south elevation.

The main entrance is signalled by the massing of the plantroom, the courtyard and large areas of glazing looking on to it and by the raised timber slatted canopy. The entrance is reached by steps or ramp and the timber of the canopy is repeated in the planter around which the ramp wraps.
Sustainability Credentials
The VOSM method of construction has an inherently lower embodied energy level than traditional construction techniques by reducing waste through controlled construction within a factory environment. In addition, many components are recyclable once the building has reached the end of its 60 year design life. The use of natural light and ventilation has been maximised which brings benefits through relatively low energy consumption as well as improving the interior environment for both patients and staff.
Designers Evaluation
The VOSM approach greatly improved the timescale between project inception to completion. The whole building was transported to site, erected and made watertight in 5 days, and the period from inception to the first patient operation was 12 months.

Considering the building type and sector, this was a considerably quick programme and demonstrates what can be achieved when client/consultants and supplier/contractor work together from the offset and share knowledge in an open fashion.

The scheme is an award-winning project which demonstrates the opportunities of modern methods of construction, in particular VOSM construction, one of a very few built in Wales and for the public sector. The approach to the envelope, unlike other built schemes, demonstrates an innovative approach, utilising a dry-fix factory prepared material, which enables a quick build programme. The use of the cladding also disguises the repetitive nature of the module units, and gives the building a real sense of being a permanent, solid building, which indeed it is designed to be.
The design of the building has led to a significant increase in efficiency, enabling the Trust to perform more operations than was previously possible, due to the design led nature of the clinical layout.

The Trust has stated:

‘The Day Surgery development at Singleton Hospital has enabled the Trust to make major improvements in the delivery of day case surgical care as well as pre + post operative assessment. In focusing this activity in a purpose built, user friendly facility, we have found patient experience to be positively enhanced in terms of accessibility, efficiency and quality. The relatively short project duration meant that the Trust was able to respond to pressures such as waiting list targets in a proactive manner.’

The scheme was awarded a commendation award at the City of Swansea Lord Mayor’s Design Awards ceremony in 2006.

Case Studies Health

LLanfyllin Medical Centre,

The project at Llanfyllin Medical Centre saw the upgrading of an existing building and the construction of an additional new building for a primary health centre with a range of facilities. It is designed to cater for a wide range of patients spread over a large geographical area. The practice partners wanted to create a building that was not only contemporary and forward thinking, but at the same time, a real and lasting contribution to the local community. Whilst providing primary health care, the building is also the home of other community facilities including the Citizen’s Advice Bureau and Powys Drug and Alcohol Council.

Design Process
The architect and client agreed that a clear separation should be defined between the new and existing building: not just physically, but functionally. As such, it was planned that clinical spaces remain in the old building, whilst support and public spaces be housed in the new. The two would be linked via a bridge.

The centre was designed to engage with the community from the start. As such, the frontage marks the entrance and was planned to connect visually with the town. The public space to be created within the new building was envisioned as the start of the building choreography. From here, all the buildings facilities are accessed, with staff and conference facilities affording excellent views of the surrounding valley from the first-floor level. Furthermore, the patient treatment rooms and the reception waiting area all have wonderful views of the countryside.

Public circulation was designed to be kept at ground level, with a new chair lift introduced to access the upper floors and a series of ramps to connect the differing levels of the old and new buildings.

Construction of the building began in June 2001, with the original building still in use. The design is undeniably contemporary in terms of its design and composition but is also heavily referenced to the vernacular of the area. A timber framed structure, for example, is traditional in the Welsh borders and this has been translated into an exposed steel frame within which panels of brick, timber and render are inserted.

– The design team has created a remarkable little building nestled in the heart of the village.
– The material palette as well as the building’s massing creates an interesting and engaging juxtaposition with the adjacent church.
– A thoughtful design process has clearly been successfully executed, creating a building that the local community are proud of and the staff enthusiastic to work in.