Vic Johnson
Managing Architect, Johnson Design Partnership Ltd
Award-winning architect Vic qualified in Hull, before migrating to Cambridge, where his wife Amanda was training at Addenbrooke’s Hospital at the time, and ultimately ending up in Westminster. Eight years and four children later, he lives in what he describes as a Shropshire idyll with his practice nurse wife Amanda, several teenagers and a number of ducks, dogs, rabbits and fish
“Isn’t it lovely?” remarked the elderly lady front of me at a public meeting to discuss new surgery premises plans. “It’s so very big and look at those windows, Margaret.”
Margaret seemed to agree as she peered at the plans of our health centre on the wall. Standing a few places behind her, I tried to gain a view of the plans over their shoulders. Twenty minutes passed with people demonstrating their indepth knowledge of what the developer was offering.
But I was perplexed. As an architect with countless years’ experience designing health-orientated projects, I couldn’t understand the plans and inadvertently blurted out: “But how do you actually get into the building?”
The crowd parted, the chatter died down and I feared the worst as everyone stood and stared at me. Then, after a short silence, someone interjected: “Er, yes, where’s the front door?” In fact, any door would have been useful; not one appeared to be shown on the plans and it was not at all clear how patients – or staff for that matter – would get into the building without having to resort to climbing in through a window.
Eventually, someone from the development company came forward and somewhat embarassingly admitted that the sliding doors to the front of the building may have been drawn slightly too thick on the plans to the extent that they looked like walls.
The point is that much of the so-called consultation process is extremely confusing, with no one making a genuine effort to explain, interpret or put forward anything remotely intelligible to anyone involved in the process, least of all Joe Public.
I learned a long time ago that old-fashioned plans, elevations and sections are all very well, but really they are quite an out-of-date way of getting ideas and spaces across, and serve little purpose than to allow the expert builder to turn the suggestions into reality.
The lesson is a simple one: if you are a practice manager and a client for a new surgery building, demand to see perspectives generated by computer so that they are practically scaleable, allowing you to see how the spaces really work. Yes, of course you need plans to understand office layouts, the proximity of the dispensary and whether the waiting room is actually within walking distance of the toilets – but beyond this you need proper design drawings and models showing what is really going on.
Also, demand to see physical models since these force everyone to think about any design in 3D, and not just 2D representations. Why should you understand plans and technical drawings any more than builders, architects and engineers understand healthcare delivery protocols?
Sometimes it is probably best to bring in an outside poacher-turned-gamekeeper – a client design adviser or senior architect (working for you and only you) to interpret and advise on what is being offered before it is too late. Believe me, there are many clients out there with unsuitable buildings simply because the line of communication became confused.
A harmonious strategy
Like restaurants or pubs, GP surgeries are usually developed in a convenient location for the very people who rely on the service. Yes, there are still a few domestic-type pubs around evolving into gastro establishments, but they initially started life as houses. Similarly, GP surgeries have evolved into health centres that some have called “Travelodge surgeries” – ie, it is all about perceived structural efficiency, with the partners demanding that clinical and admin staff work in a pleasant environment and patients go somewhere that fosters health
and wellbeing.
The secret of a successful GP surgery design is not rocket science. Beyond the all-important clinical need the strategy should focus on the human beings it serves and provide the aspects of any successful workplace environment: views out, natural lighting, natural ventilation, reassurance and security. The ability to open a window is always nice, but you’d be amazed at how many new buildings forget the basics of design and function.
Beyond the basic clinical needs, it is quite easy to satisfy the human psyche. In a GP surgery this is all the more important because of the nature of the visitors. The last thing you want to do is send patients out more disheartened and depressed than when they entered, all because no one stopped to think about the poor light, awkward corridors and claustrophobic spaces. Use the environment and the surroundings, plus a few architectural tricks of natural light and ventilation, to spread happiness and harmony.
Do not allow over-reliance on mere empirical data or performance figures that many people will throw at you. We all know the saying about statistics: they can either prove or disprove any theory, depending on who is using them and for what purpose. Consider instead the soft, more human aspects of any space. Hard criteria could relate to background illumination in lux and ventilation in air changes – any competent engineer could probably satisfy these within reason, but are these really going to fulfil the human desire for a pleasing view and natural light throughout the day?
Ecology and economy
The design of everything, from the humble window to the overall section through a building, can impact on its performance and eco credentials. There are various technical ways of measuring these, from BREEAM (Building Research Establishment Environmental Assessment Methodology) to carbon calculations, and at the end of the day not only do they save the planet but they also save money.
A recent design of our architects’ office has meant our quarterly electricity bill ranges between £50-£60, despite the firm having banks of computers, rows of printers, a handful of A1 plotters and fridges and kettles to keep the staff happy. This is a pittance compared with similar-sized offices around the country.
Our office negotiated a three-year low energy usage tariff “from the off”, which keeps our costs down, but our actual energy usage is low due to factors such as a lack of reliance on electric lights, etc. The office walls are acoustically and thermally separated from the adjacent workshop that neighbours us, and the roof space has been designed to facilitate stack-effect ventilation – so no air conditioning, cooling or mechanical ventilation is required.
Air conditioning can be expensive to run at the best of times, so designing it out reduces energy usage. In hot countries this may not be such an option, but interestingly Australian architects have been experimenting for some time with high thermal mass and naturally ventilated spaces to reduce air conditioning loadings.
We are currently exploring options with the government’s feed-in tariff scheme, which became available in the UK on 1 April 2010. If we install a photovoltaic array on our green roof, we could end up being paid more for the electricity we generate than the cost of that which we use. I’m sure this would be a nice scenario for any practice manager!
Striking design, responsible heart
Around 45% of the UK’s man-made CO2 emissions come from energy we use every day: at home, work and when we travel. By reducing our CO2 emissions, we can all play an important part in helping to prevent climate change and get lower energy bills too. The UK is committed to reducing carbon dioxide emissions by 34% below 1990 levels by 2020, and is seeking an 80% reduction in emissions by 2050.
As an architect, eco-design is intrinsic to the way I work. Passive eco features are always the starting point. Begin by getting the orientation right: maximise views out for waiting rooms and consulting rooms and minimise views in (although views through the front door can help to reduce intimidation). Add to this the ability to harness natural sunlighting and ventilation, and you have the main pieces of the jigsaw in place.
Of course, not all GP practices will start from scratch. Some architects’ expertise lies in adapting existing structures and weaving them seamlessly into the new additions. You will be surprised at how ugly annexes and extensions can be given a new lease of life with the help of lightboxes, better use of space and locally harvested materials.
Making your building “green” has become enormously popular in the last decade, but all too many projects place an over-reliance on what I call “gonks”: those so-called “green totems of mistrust”. In layman’s terms, these are the stick-on gimmicks that are nothing but half-hearted attempts at ticking the green box. If 99% of your building is inefficient and leaks energy through every cavity, who cares if you have a sedum roof or a handful of solar panels? It is important that we do more than simply nod in the direction of the environment. It is a fundamental part of every building and its protection is paramount.
Gonks include mini-windmills (anything less than 15m high is practically pointless), solar panels on north-facing roofs and non-indigenous green roofs imported from Europe. Indeed, “indigenous” is fast becoming the latest buzzword because it has a stronger, more lasting value than “green”. Indigenous doesn’t just mean materials (locally obtained wood, stone, slate tiles), it means workforce too.
So don’t overlook local suppliers in the misguided apprehension that those in the big cities know better. Often your local timber manufacturer may be the only firm able to supply a complicated roof profile. So think local first – it may make the difference between staying on budget or sailing over into the red.
