A Choice of Secure Settings Promotes a Meaningful Day for Patients

Designed by Medical Architecture and built by Sir Robert McAlpine for NTW Solutions – Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Sycamore at Northgate Park Hospital is vital to the future delivery of modern and effective forensic mental health services in the north east of England.

The consolidation of services

The new facility is the catalyst to allow all secure services across the trust to be brought together from previously-dispersed sites, consolidated in a single, integrated secure centre of excellence. The entire redevelopment provides a total of 116 male inpatient beds, located in a combination of new and reconfigured existing buildings. The new-build element, named Sycamore, provides inpatient accommodation for 72 male patients with a range of forensic mental health needs, including patients with complex personality disorders and/or learning disabilities.

The project, which was delivered through Cohort 1 of the NHS New Hospital Programme, fulfils one of the trust’s key strategic priorities, forming part of its £72.6m Care Environment Development and Re-provision programme (CEDAR).

A meaningful day in a unique woodland setting

The existing hospital site is a large open campus, containing a mix of buildings and facilities. Much of the eastern portion, which was earmarked for development, is neighboured by a broad area of mature woodland. Proposals set out to develop a portion of the land for the new building, with the remaining allocated for housing development. Early feasibility work demonstrated benefits to siting the new hospital where it would be flanked by an aspect of trees on three sides: the natural setting enhancing the therapeutic nature of the accommodation.

It is well recognised that in secure mental health inpatient units, boredom leads to challenging behaviours and poor physical health. Therefore, a key driver for the design was to ensure a meaningful day for all patients, promoting recovery through activity. As a result, the facility is devised as a ‘village campus’ focusing on the individual patient and staff experience, with as many spaces as possible, both inside and out, offering opportunities for mitigating boredom. This is achieved in a range of settings that can be accessed autonomously, from bedrooms to living spaces, and sheltered gardens to open courtyards, with opportunities for both structured and unstructured sports and activities.

An inclusive outdoor space for communal wellbeing

The six patient wards are paired together and arranged around a large recreation courtyard. Each building is adjoined, creating a secure boundary without the need for fences, minimising the feeling of confinement. With rich landscaping and integrated security measures, this shared space does not feel like a typical forensic mental health facility.

The courtyard is separated

into two distinct character zones – ‘Passive’ and ‘Active’ – to ensure that all patients and staff are able to benefit from its therapeutic qualities. The ‘Passive’ zone provides opportunities for refuge, with restful places to sit amongst plants and grasses.

These smaller-scale spaces offer a sense of enclosure, combined with views out to the wider recreation area to provide gentle enticement into the activities offered. The ‘Active’ zone includes a 200m jogging/walking loop, activity spaces and a fitness ‘trim trail’ to promote physical activity and the associated wellbeing benefits. Within the main reception building – which provides the public frontage to the facility – a covered sports barn allows activities to continue in all weather conditions.

Choice of open or private outdoor space

In addition to these communal spaces, at the centre of each ward, a private landscaped courtyard for relaxation is provided, and between each ward pair is a designated activity courtyard, with sports court markings. This arrangement offers safe access to a variety of different outdoor areas.

In each ward, the bedrooms are arranged to face outwards, with views to the surrounding woodland. The majority of the day activity and living space is at the centre of the ward with direct access into the courtyards. Abundant daylighting, attractive views and a sense of spaciousness contribute to the therapeutic qualities of the environment and play an important role in patient rehabilitation.

Personal spaces for individual wellbeing

Whilst use of the common spaces is actively encouraged, it was acknowledged that this patient group may choose to spend time in their own room, particularly in the morning and evening. To maximise the opportunity for activity, the design of the bedrooms stemmed from a detailed re-imagining of how these spaces could work. In an evolution of previous designs for the trust, the bespoke fitted furniture is devised to assist with a personal workout outside of scheduled recreation time. Adequate floor space for exercise and a television, which can be easily viewed from the bed or floor, enables a patient to either be active or to rest.

The transition from private bedroom to shared circulation and day spaces has been considered to provide a reassuring path into more stimulating environments. The bedroom corridors are single-sided, with immediate views to the landscaped ward courtyards from each bedroom door, providing orientation, good observation and balancing circadian rhythms.

Challenging the stigma around mental healthcare

The exterior appearance of the new facility is extremely important and has a major role to play in reducing the stigma surrounding mental illness, as well as engendering pride in the building as a workplace. The front reception building provides a secure boundary to a large section of the internal plan, reducing the need for high fencing. A visible and publicly-accessible cafe with integrated artwork provides a welcoming space for visitors and staff working across the site.

A consistent and controlled palette of materials and architectural styles has been developed to integrate the building with the most recent additions to the hospital site and to present a positive image for visitors and new arrivals.

Paul Yeomans, Director at Medical Architecture, said: “It is fantastic to see this important project realised. The technical requirements for forensic mental health buildings, particularly with regards to security, can present challenges to the creation of supportive and recovery-focused environments. However, standing in the thriving central courtyard, it is hard to tell you are in the middle of a forensic hospital. That normalising of the accommodation will have such a positive impact on patient wellbeing.”

Mark Gibson, Healthcare Sector Managing Director at Sir Robert McAlpine, said: “Working closely with CNTW NHS Foundation Trust and our outstanding team of specialists, we are delighted to have delivered these state-of-the-art mental health facilities. The Sycamore building provides healthcare excellence for the benefits and welfare of patients in the region and their families.”

John Carson, Head of Capital Development at NTW Solutions, said: “This has been a fantastic scheme to deliver for CNTW and there was a true team spirit with all involved, especially with the clinical teams on site. That teamwork has paid off and it is inspiring to see the unit in use and heartening to hear the early feedback from clinicians about the quality of the accommodation. This is a flagship development, and it has set a new standard, not just for our future projects but for the whole mental health sector.”