NHS Ayrshire & Arran
Crosshouse Hospital Combined Assessment Unit
The Combined Assessment Unit (CAU) at University Hospital Crosshouse was delivered through NHS Ayrshire & Arran Board’s Building for Better Care programme of investment to modernise “front door” facilities at both Ayr and Crosshouse hospitals to provide new, modern, fit-for-purpose facilities that make it possible for patients to receive faster assessment by senior clinical staff at the earliest point of their arrival in each hospital. BMJ was a PSCM under NHSScotland Framework 1, acting as consultants to BAM Construction to provide full architectural design services for phased projects at both hospital sites.
CAU at University Hospital Crosshouse consolidates and relocates existing assessment functions at the hospital so that they are provided adjacent to the existing Accident & Emergency Department to provide a single point of access to unscheduled care at the hospital.
Challenge & Solution
The CAU was formed through refurbishing and extending an existing area of the main hospital ground floor previously occupied by a Clinical Decisions Unit (CDU). The main portion of the works comprised a new build extension, built as a first phase, within the hospital car park and immediately abutting the former CDU accommodation.
The newbuild accommodation provides a large reception and waiting area, 3 assessment bays for initial patient triage, 6 GP assessment cubicles, 35 single bed spaces with en-suite bathrooms, in line with HBN 04-01 and ancillary support and staff accommodation.
The second phase, an ambulatory care assessment unit, comprising 11 cubicles and support accommodation was formed in the former CDU space. The CDU, constructed in the late 1960s, comprised a CLASP type lightweight structural frame supporting Siporex concrete roof panels. The external perimeter was clad with RC panels. Window and rooflight openings were cut into the external wall and roof panels – both requiring innovative structural framing solutions relative to the existing lightweight structure.
Innovation & Added-Value
Determining core adjacencies and the spatial relationships of services and accommodation was key to interrogating the Schedule of Accommodation with development of the building’s form. Major design drivers included adjacency to A&E department and imaging; level access from the exterior (the existing ground level at CDU was significantly lower), provision of 100% single bedrooms; windows to all single bedrooms in line with Scottish Government
requirements; interstitial en-suite bathrooms to bedrooms to
maximise observation of patient bedroom from corridors, maximising opportunities for natural ventilation, natural light to staff areas and patient view to exterior.
The new build is arranged in a ‘racetrack’ configuration around a large courtyard. Infection Control required that there was no natural landscape adjacent to patient room opening windows and the courtyard is paved in a variety of ‘hard’ landscaping finishes – pavers, coloured slate, cobbles - to provide interest.
The overall design aesthetic of the building is in keeping with the existing hospital context, with the use of external materials – render, panelling between window pairs – metal cladding picking up visual themes from adjacent buildings.
The existing hospital remained fully operational throughout the course of construction. Works took cognisance of HFS HAI-Scribe infection control principles, both for design of the new facilities and the construction works.
Sustainability was a key design concern: many materials are specified for high BRE Green Guide ratings, many construction elements used are fully recyclable, there is extensive use of natural ventilation and construction detailing for high levels of air tightness.