Published: 16/09/2004, Volume II4, No. 5923 Page 37

Ten years in development, the Evelina Children's Hospital is a design triumph thanks to the biggest ever charitable donation to the NHS. Emma Forrest reports

Most publicly funded building projects take a while to get off the ground. But 10 years is a long time by anyone's measure.

That is how long it has taken for a new£60m development to become a reality at London's Guy's and St Thomas' Hospital trust.

The 16,000m2 Evelina Children's Hospital was completed in August, and services are due to be rehoused by January of next year. It is to replace cramped paediatric facilities currently housed in both of the trust's hospitals.

At present these are nine floors apart in the Guy's Hospital tower and include an intensive care unit that has no windows.

'Here everything will be available under one roof. A sick child impacts on the whole family, and this building is designed around the needs of the whole family, ' says senior projects manager Alastair Gourley, who has been working on the St Thomas' Hospital-based scheme for five years.

Of the building's seven storeys, the first floor, largely open plan, is for outpatients and therapies.

Director of capital projects Graham Soper has been overseeing development of the new building since its earliest days.

The decision was taken to create a new children's hospital in 1995 and invitations were sent out for bidders to become a partner in a private finance initiative deal to build the hospital. However, a year later the Treasury deemed none of them good enough.

'After that we developed our own publicly funded solution, ' says Mr Soper. In what is believed to be the largest ever single charitable donation to the NHS, Guy's and St Thomas' Charitable Foundation donated£50m to the project. The trust is providing the other£10m.

'Cash had been set aside in the early 1990s and remained a protected fund for future development. The foundation was keen to see it benefit children, improve the patient experience and provide quality architecture, ' says Mr Soper.

It has become something of a cliché of modern healthcare provision to design 'a hospital that doesn't look like a hospital', but the Evelina may have cracked it.

'One of the advantages of working with architects who have never done a hospital before (Hopkins Architects) is that they didn't have any preconceived ideas, ' says Mr Soper. 'They were willing to listen.'

The building has an open and airy feel. Where long corridors are necessary, light can still get in.

Areas that are typically staffed by people who do not get outside much, such as the operating theatres, are also full of light through the use of frosted glass walls. Curvy walls try to avoid an institutional feel.

Each inpatient unit floor will have a play area (designed to look like a rocket launcher) which will be the first thing people see when they step out of the lifts. Wayfinding is to be eased through each floor having a theme, such as ocean, beach, arctic or forest.

'You will not have to be able to read - let alone read English - to find your way around, ' explains Mr Gourley.

A dominant feature of the seven-storey L-shaped building is the four-storey atrium, also known as the winter garden.

All inpatient units, which begin on the third floor, have a view of this space and beyond to the Archbishop of Canterbury's palace and gardens.

The atrium will house the hospital school and a cafe - and provide a home to performances and exhibitions.

'We have been criticised by people who have said we are wasting a lot of space by having this, but how can you call it a waste of space?' asks Mr Gourley, looking around.

Work began on site in February 2002. 'We advanced the design tender to a very advanced stage before appointing the contractor, Gleeson. This meant we could be confident of getting the outcomes we needed. Rather than being at the discretion of the contractor, the design has not varied from the start. Gleeson developed the tender with us and we negotiated a fixed price with them, ' adds Mr Soper.

Gleeson's contract extends to the building alone - medical equipment was contracted much later. Otherwise, explains Mr Gourley, items such as the MRI scanner would have had to be chosen three years ago. Now the latest model can be chosen.

Each unit has been built in modular form to allow for future changes. The original tender also included the possibility of expansion, with a former doctors' home (now used for trust offices) next door marked for demolition if necessary. A prefab housing the staff gym is also destined for demolition if further work takes place.

'We are now coming to the last throes of a 10-year business case [which also saw schemes such as the move of accident and emergency from Guy's to St Thomas'], says Mr Soper. 'Work on the next 10 years is just starting now.'