Delivering Modern Critical Care Within an Existing Hospital
BMJ Architects designed a new Critical Care Unit within the East Wing at St Thomas’ Hospital, transforming former administration accommodation into a highly specialised clinical environment for some of the hospital’s most critically ill patients. The project forms part of the Trust’s wider commitment to expanding critical care capacity while making effective use of existing estate assets.
Concept and Strategy
Located within the original 1966 tower building, the project needed to meet contemporary critical care standards within the constraints of an existing hospital structure. Rather than developing a new-build solution, the design focused on adapting established accommodation to create a resilient, future-ready healthcare environment while maintaining operational continuity across the wider hospital.
A key challenge was the existing T-shaped floorplate, which did not naturally support the racetrack arrangement typically associated with modern critical care environments. Working closely with clinical stakeholders, BMJ developed a layout that optimised patient observation, staff workflows and departmental efficiency while responding to the physical constraints of the existing structure. The resulting facility provides 11 critical care bed spaces alongside staff accommodation, support facilities and specialist clinical infrastructure.
The conversion required significant technical coordination. Existing ribbed concrete floor structures were strengthened to support modern clinical equipment and servicing requirements, while the design team carefully balanced healthcare guidance, operational requirements and building constraints. Working within a live hospital environment demanded close collaboration between clinicians, estates teams and project partners to minimise disruption and maintain essential services throughout delivery.
Designing for Care, Performance and Long-Term Value
Alongside clinical performance, the design sought to improve the experience of patients, families and staff. Natural light, clear circulation routes and carefully considered finishes help create a calmer and more supportive environment within what can often be an intense clinical setting. The unit demonstrates how thoughtful healthcare design can support both operational excellence and the human experience of care.
By extending the life of existing accommodation rather than relying on new construction, the project also demonstrates a sustainable approach to healthcare development. Through adaptation, reuse and targeted intervention, BMJ delivered a contemporary critical care facility that meets modern clinical expectations while reducing the environmental impact associated with wholesale redevelopment. The result is a future-ready healthcare environment that supports excellent patient care and long-term value for the Trust.
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