Presentation on the thinking behind the briefing and design of the new 800 bed hospital by two key members of North Bristol NHS Trust - David Powell (Former Director of Capital Projects) and Tricia Down (Head of Capital Planning and PFI Procurement.

1. Trying to Build a Quality PFI
Tricia Down and David Powell

16. Innovation and Patient Care: New facilities should apply radical, cutting edge
design to provide state-of-the–art environments geared for top performance in patient
care. The facilities should provide for standardisation and flexibility.
Flexibility: Environments should be extremely flexible to respond to changes in the
way healthcare is provided. The Trust is determined to create an environment that
can constantly evolve and adapt.
Clear Welcoming Urban Site: The hospital site should be welcoming and logically
laid-out to the best principles of urban design and landscape design. Facilities and
spaces should create an environment within the site boundary that uplifts, is
consistent with and blends with the external environment and does not jar. New
facilities and buildings should sit comfortably within the site master-plan.
Connecting the Inside to the Outside: The inside of the facilities should be
connected and in harmony with the outside with use of landscaped courtyards,
sympathetic glazing, open and interesting circulation, and non institutional patient
and staff areas.
Excellent Finishes: The finishes within the facilities should be intelligently planned
and executed, avoid institutional blandness, exemplary in terms of use of materials
and workmanship and significantly above the normal hospital standard.
Sustainable Development: The facilities should achieve the highest standards of
energy efficiency and a minimal carbon output. Maximum use should be made of
sustainable practices during construction and for the minimisation of the operational
carbon footprint. They should

17. • Minimum 2.7 floor to finished ceiling height in smaller rooms or
technical rooms such as labs, but aim for 3m in larger rooms, open plan
offices, seminar rooms and public spaces and 3.1m to 3.4 in rooms such
as theatres and catheter labs.
• Preference for plasterboard ceilings where possible, if not then
plasterboard margin with tiles. Check for the number and layout of
access panels
• If tiles are used, larger format tiles preferred – preferably planks
• Tiles should be flush edged or tegular. Avoid standard lay-in tiles.
• Where tegular tiles are cut, ensure there is a good proposal for how the
edge is finished
• Be careful about tape and jointed plasterboard where there is a lot of
light washing down on the wall (natural or artificial). Joints need to be
invisible. Encourage use of bevelled joint to all four edges. These are
now available.
• Consider locations for art and other wall mounted articles (notice
boards, leaflet racks etc) very early on so they can all be co-ordinated
• Use paint specific to the need. Matt paint is the preference.
• Only use specialist paints in those areas that require it. Be very careful
about the use of high gloss resilient paints such as Armoursheen as
they can show every brush mark and are very difficult to remove.

18. Reception
Desks
• Good quality, durable solutions required. Higher initial outlay
recovered over course of life of good quality product.
• Ensure sufficient contrast between floors, desk carcass and desk
top. Check requirements for DDA access.
• Avoid stainless steel plinths which can be confusing for visually
impaired.
Trunking • Avoid trunking wherever possible unless flexibility dictates
otherwise.
• Go for an elegant solution if it is required, minimising joints
between pieces.
• Consider the effect of trunking on the architecture – for example,
does it have to cross tall windows or are risers required?
Balustrade
s
• Capping to balustrades - if wood is selected, an agreed level of
acceptable variance in the colour and texture of the wood should be
agreed up front.
Service
access
• Be clear about whether staircases and corridors really are only for
service access as their level of finish will be far inferior to public
staircases
Fixtures • Coat hooks – ensure robust but attractive. Check spacing – is there
room for coats?
• Sockets – if DDA sockets are required in one part of a room, use the
same sockets throughout the room.
• Where final procurement of fixtures is outstanding, assume worst
case scenarios to ensure that space is available

26. Ward corridor
Overall ward
corridor
Incomplete (ceiling, flooring
including bedroom thresholds,
perch and associated lighting,
handrails, wall and corner
protection)
• Items to be amended or added.
Workmanship to be reviewed by the Trust
and amendments agreed.
Ceiling at bedroom
entrance
Ceiling missing • Item to be added. Workmanship to be
reviewed by the Trust and amendments
agreed.
Inspection doors Paintwork and sealant of architrave
to walls not complete
• Workmanship to be reviewed by the Trust
and amendments agreed.
Frame has very visible joints • Butt joints to head of painted frame
required.
Architrave profile is obtrusive • Width and projection to be minimised so
that the doors and details become less
apparent.
Choice of ironmongery • To be consistent with Building
Specification/RDD.
Door seals partially missing • . All seals to be provided to meet acoustic
and fire protection requirements
Tape & joint wall Visible horizontal joint at lower half
of wall
• Achieve consistent standard of finish to
match other joints in this wall.

31. ‘We rob banks’

33. Hospital Buildings
Claudia Bloom, Director
A partnership

34. Avanti Architects
About Us
Founded 1981
4 directors and 7 associates
Current staff 60+
QA certified ISO 9001:2008
EMS certified ISO 14001:2004
Office Locations
London
Cork
Range of work
masterplanning
advisory services
feasibility studies
architectural design
sustainable design
landscape design
interior design
wayfinding, signage & graphics
Range of services
new build
regeneration & conservation
masterplanning & urban design
feasibility studies
interior design
project supervision

35. Avanti Architects - Projects + Locations
Health projects value
building projects £500m +
advisory services £2bN +
Current healthcare projects
include projects at:
The Children’s Hospital, Sheffield
Torbay Hospital, Devon
Ulster Hospital, N. Ireland
St Georges Hospital, London
Cork University Hospital, Eire

36. • Ulster Hospital
• North Bristol Hospital Trust
• Southern General Hospital, Glasgow
• Alder Hey Children’s Hospital, Liverpool
• Tameside General Hospital
• Watford Health Campus
• BECaD, North West London Hospitals
• City Hospital Birmingham
• Hinchingbrooke Hospital
• Kidderminster Ambulatory Care Centre
• Northwick Park Hospital
• Whipps Cross University Hospital
• Whittington Hospital Acute Services
Healthcare PFI experience – Trust Advisor

37. • Pontefract Hospital
• BECaD, North West London Hospitals
• Gloucestershire Royal Hospital
• Papworth Hospital
• Colchester General Hospital
• Walsgrave Hospital
• Newham General Hospital
• Whittington Hospital
• Prospect Park Mental Health Hospital
• Peterborough Mental Health Hospital
Healthcare PFI experience – Consortium Architect
Education PFI experience – Consortium Architect
• London Borough of Hackney PFI / BSF programme – 3 schools
• London Borough of Camden – UCL Academy
• London Borough of Tower Hamlets – Morpeth School
• Birmingham BSF – ‘Blue Sky’ reference project

39. • Masterplan
• Enabling works
• VIE & Core nodes
• Estate decoration strategy
• Somerset and Westgate
• Monks Park House - redevelopment
• Frenchay – site redevelopment
• Consolidation of accommodation from site disposals
• Academic – Learning and Research
• Pathology (phase 1 with Design Buro)
• Science Quarter
• Public space
• Café…….options 1, 2 and 3
• Cossham Hospital
• Renal dialysis at Cossham
• BUI
• BIRU
• PPU
• Endoscopy into Cossham
• Data Centre
• Beaufort House
• Cherry Tree Centre
• Jigsaw masterplan
• And offices….

40. PFI
• PSC – review
• New TA appointment
• Design Panel
• Visits/precedents
• PFI PQQ review
• PFI – PITN 3 to 2
• PFI – FITN
• PFI – to FC……
• Marking up drawings right up to the signing of the contract
• And then RDD
• And compliance on site
• Through to furniture and curtain procurement

45. Existing mature planting and underlying geometry.
The main Arrival space and hospital entrance would best be located at the intersection of the
two entrance axes.
The inherent orthogonality reinforces the geometry of the above and the retained buildings

46. The site figure inverted; i.e. thought of as a sequence of places / spaces defined by
buildings.
The antithesis of buildings as objects surrounded by residual space.
Current scheme

47. Foundling Hospital by Brunelleschi

48. Using visible spatial depth as the ordering tool.

49. Diagrammatic site layout
Academic Zone
Maternity + UTC
Hospital
Non Clinical support Zone
Residences
Ambulance Entrance
M
ain
Entrance
Future growth
Future growth
Urgent T.C
Acute

50. Benson & Forsyth Sketch –
Site plan showing Existing Trees / Potential open spaces and site available for Phase 1
Green fingers
pathologyPFI site