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The design of emergency centres has changed fundamentally in the last fifteen years as they have expanded to meet rising attendances and governmental targets for waiting times.  Units have doubled in size and now contain many specialised sub-elements, although this may now be seen as the last throes of a process of territorial departmentalisation which has proved inflexible and institutional.

The 21st century model is changing as we seek to find a more generic design solution to the brief for health facilities, and a kinder and more attractive environment. This is particularly relevant for Emergency departments, at the hard end of the clinical process, where it is essential to create a more effective and flexible workplace and a more dignified patient experience.

With more than 150,000 attendances a year, the reconfiguration of the facility at Northwick Park has the potential to become a benchmark project in terms of design and performance.

The specific challenges at Northwick Park involved integrating and connecting the new centre into the existing campus, working on a very tight site and meeting a challenging programme. Having inherited some exemplar proposals for a combined new build/ refurbished option which proved impracticable, we developed a 100% new build scheme, at speed, with stakeholder consultation.

The triangular plan form achieved some complex clinical adjacencies, removed many of the compromises and reduced the requirement for decanting and enabling works. This increased the sums which could be spent on the clinical accommodation within an unchanged budget.