"Creating an impression: Midlands’ massive hospital" RIBA Journal

"Big hospitals might be the most difficult buildings to design. Circulation is a real head-scratcher, needing discrete routes for staff, visitors, ‘blue-light’ arrivals and bed-bound patients in constant motion between wards and clinical areas. Added to that are countless conduits for fluids, gasses and data to rival those of any science lab. There’s a panoply of spaces with unique and onerous requirements, from adjacency to infection control. So the question in my mind, en route to the new Midland Metropolitan University Hospital, is whether it’s been possible to do all that, on a tight budget, and still deliver a pleasant, even uplifting experience for patients.

First impressions are ambiguous, but hopeful. The 736-bed acute general hospital, which replaces two existing facilities, sits on a 6.5ha brownfield site in Smethwick, just west of Birmingham. Towering over terraced houses and tatty sheds, the 11-storey megastructure has a scale and functional clarity that might more readily suggest industrial than therapeutic use, but there’s evident refinement in neat steel and terracotta cladding, delicate cross-bracing and inset balconies. The impact is further softened by glimpses of greenery on high-level terraces and the building’s signature feature – a quilted ETFE enclosure wrapping over one end.

The imposing bulk arises from the architects’ early decision to reject the sprawling arrangement envisaged in the brief in favour of stacked accommodation. That has several advantages, says Laura Cagni of Cagni Williams, which worked as architectural design lead alongside HKS as architectural project lead and Sonnemann Toon as architectural clinical lead.One is efficient planning and reduced travel distances. A logical layer-cake has produced a form resembling a super-sized hovercraft. At the base is a two-storey carpark, partly hidden by cutting the building into sloping ground. It is topped by a three-storey rectangular podium with chamfered corners, containing all clinical departments, from A&E to operating theatres. Above this ‘hot block’, a boxy superstructure faced in orange terracotta contains the wards. At the southern end they meet an external winter garden, sheltered by that sloping plane of translucent ETFE like a six-storey windscreen. [...]"

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