The £250,000 prize – second only to the Nobel Prize in monetary terms – was awarded to Ab Rogers Design and its ‘Living Systems’ proposal at a gala dinner, held last night (24 November) at the Royal Institute of British Architects in London.

Entrants to this year’s competition answered the brief’s central question: “How would you design and plan new hospitals to radically improve patient experiences, clinical outcomes, staff wellbeing, and integration with wider health and social care?”

Almost 100 entries were received, originating from 15 different countries, with judges whittling these down to a final shortlist of five. In addition to the winning entry, the shortlist included: proposals to base hospital design on neuroscience and the symmetry found in nature; redesigning hospitals into starfish-shaped pods to modernise hospital activity; reimagining the emergency department; and relocating acute and non-acute health facilities to town centres. Each runner-up receives £10,000 each.

The Living Systems team, led by Ab Rogers Design and featuring an advisory group alongside designers and engineers, pictures hospital buildings as a ‘third carer’ alongside medical staff and a patient’s family and friends. It also sets out a vision for smaller, 200-bed hospitals that could be built across England and act as community centres of wellness as well as cure.

Built using a prefabricated, modular design of 12 storeys, with an internal shell of cross-laminated timber, these hospitals would create wards that can be easily partitioned into isolation rooms – in response to infectious disease outbreaks, for example. A podium, a central open area on the ground floor, would include a thriving market and be an accessible meeting point for the entire community. 

Workforce challenges

Design of staff facilities, including common areas, would focus on improving working conditions and increasing staff retention and recruitment across the NHS – an important consideration not only given the heavy toll exacted on medical staff since the pandemic but also to address the urgent need to fill the huge number of vacancies across the health service. Indeed, data from the Nursing and Midwifery register shows the number of people leaving the nursing profession to be at its highest since 2017, with nearly 14,000 quitting between April and September 2021.

As part of the Living Systems design – and reserved especially for hospital staff and volunteers – a rooftop area would include offices, meeting rooms and congregation areas, as well as a bar and canteen. A series of raised beds would transform the remaining rooftop area into an allotment for growing fresh produce. Used by both staff and patients, these facilities would support a community education programme on healthy diet and lifestyle.

Healing design features extend to the location of the bulk of patient rooms and wards on the south side of the building, which aims to maximise natural daylight and provide outside views of nature accessible from every bed.

The winning team now plans to develop a research unit to help develop its concept further, with the ambition of realising its vision implemented across hospitals in England.

This is the fourth time the prize, run in partnership with think tank Policy Exchange, has been awarded since its inception in 2011 – and this year’s accolade coincides with the Government embarking on a national programme of hospital building over the coming decade.

Health and Social Care Secretary Sajid Javid congratulated Ab Rogers Design and the other entrants and noted that the New Hospital Programme over the next decade would provide “state-of-the art facilities for staff and patients, prioritising the latest digital technologies, sustainability, and modern methods of construction”.

He added: “This is how we will deliver world-class facilities for our NHS, as well as value for money for the taxpayer, as part of the biggest hospital building programme in a generation.”

A triumph for teamwork

Following the announcement, a thrilled Ab Rogers of Ab Rogers Design said: “Our proposal is the result of the collective intelligence of an extraordinary team of hospital workers, patients and thinkers, all coming together to create a humanist hospital. We now look forward to developing this into a real-life hospital.”

Lord Wolfson of Aspley Guise, founder of the Wolfson Economics Prize and chief executive of Next, welcomed the quality of the proposals received and described the winner as “a powerful and compelling proposition where the hospital building itself becomes an intrinsic element of patient care: nurturing people instead of simply housing them”.

Lord Kakkar, chair of the judging panel and chair of the King’s Fund, also praised the calibre of thinking behind each shortlisted proposal, adding that Living Systems stood out.

“Good hospital care is about teamwork,” he said. “The submission by Ab Rogers is a visionary proposal to make the hospital itself part of that clinical team, with the building aiding healing and recovery. The result is a thoughtful, consultative design, which recognises the needs of human beings in medical environments – whether they are patients, visitors or staff.”

The finalists

Winner

• Living Systems – led by Ab Rogers Design
  
  A multi-sensory, green hospital design, inspired by “the adaptive qualities of living systems found in nature”.

Runners-up

• Creating Complete Hospitals – John Simpson Architects; Ruggles Mabe Studio Architecture + Interiors; Create Streets and Create Streets Foundation; Dr Hervey Wilcox; and Natalie Ricci
  
  A hospital design that draws on neuroscience and the symmetry and shapes found in nature, and transforms hospitals from “factories for fixing” to “places for healing”.
   
• A Well-Placed Hospital – Andy Black – healthcare planning and management; Anthony Farnsworth – social care planning and management; Mungo Smith – MAAP Architects; Jaime Bishop – Fleet Architects
  
  A plan to “bring the hospital back into the town” to better serve the local community.
   
• Starfish Hospitals – Deirdre King with contributor David Leonard of Leonard Design Architects
  
  A total redesign and modernisation of hospital activity, divided into three settings: starfish-shaped hospital hubs; satellite specialist health centres; and a ‘hospital at home’.
   
• The Smart ED – Dr Susan M Robinson; James Lennon; Ciaran Rymer; Dr Roderick Mackenzie; and Ed Wilson
  
  A reimagination of the emergency department, which proposes innovations to reduce crowding in A&E – including first-class airline-style pods for patients with less serious conditions.

The judges’ panel, chaired by Lord Kakkar, included: Professor Brian Donley MD, chief executive of Cleveland Clinic, London; Dame Elaine Inglesby-Burke CBE, former chief nurse at Salford Royal; Dame Laura Lee, chief executive of the cancer charity Maggie’s; Robert A.M. Stern, founding partner of Robert A.M. Stern Architects; and Nigel Wilson, chief executive of Legal & General. 

The full submission for ‘Living Systems’ by Ab Rogers Design can be viewed at www.policyexchange.org.uk/wolfsonprize