Dec 02, 2016 Last Updated 2:44 PM, Nov 30, 2016

Promoting rehabilitation

Published in Upfront
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Patients requiring long term ventilation make up a small percentage of all the patients in an Intensive Care Unit setting, yet they require a relatively high proportion of the unit's resources.

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The clinical success of the specialised Lane Fox Unit at St Thomas’ Hospital in London shows that patients benefit from a bespoke setting that promotes rehabilitation. Guy’s and St Thomas’ NHS Foundation Trust entered a partnership with BOC Ltd (a member of The Linde Group) to bring care closer to the patients in the South East by establishing a satellite centre to the existing Central London centre.

The Lane Fox REMEO Respiratory Centre is the UK’s first purpose-built centre to ‘wean’ respiratory patients from invasive mechanical ventilation, improving recovery rates and enabling patients to eventually return home. In line with NHS England’s plans, the centre helps match the gap in the provision of this specialist service, frees up critical care beds, improves the delivery of clinical services closer to patients’ homes and provides specialist training for local healthcare staff and carers.

Domestic feel

The design challenge for the architects and the project team was to combine the facilities of a high dependency unit with an environment that promotes rehabilitation and has a more domestic look and feel.

The building also needed to reflect Linde’s vision for a high standard of sustainable design and operation through efficiency and passive measures. Stakeholders involved included patient groups, family members, operational, medical and nursing staff.

Patients and their families and carers joined members of staff in working with the design team from the very outset. In the spirit of collaboration and teamwork, a wide range of options were explored, culminating in a holistic, all-encompassing design solution. The group collectively explored issues of patient observation to ensure reassurance without compromising patients’ privacy and dignity. Artist Lara Harwood was commissioned to provide a series of four bespoke murals in the key social spaces. These form a continuous narrative of recovery inspired by the ‘REMEO’ (I return home) ethos and alluding to the original Lane Fox unit’s unique history.

The building has been sensitively located adjacent to ancient woodland, and a nearby public footpath has been reinstated and enhanced. The planning of the interior progressed with particular focus on the patient rooms. Mock ups of concepts for fitted furniture were produced and put to the test by the user groups.

Calm atmosphere

The centre maximises views of the surrounding landscape – combining the need for observation with respecting privacy of the patients, an innovative 4-bed bay layout has been developed so that every bed bay has its own window with a view towards the woodland. All public and social spaces feature high-level glazing, circulation routes terminate with views of the landscape and natural daylight permeates all areas of the building. Extensive glazing with large folding doors, shaded terraces and a central courtyard blur the boundary between indoor and outdoor spaces, promoting a calm and therapeutic atmosphere. Indoor and outdoor areas are discretely provided with medical gases, nurse call buttons and power outlets to maximise accessibility for all patients. In the patient bedrooms, a bespoke joinery bedhead with integrated storage and gases promotes a domestic, non-institutional setting without compromising clinical functionality.

Sustainable design

The rooms have been laid out to optimise efficient staff work patterns, and to maximise staff visibility of the most vulnerable patients throughout the centre, through glazed screens and designing outboard ensuite bathrooms. Servicing arrangements have been carefully considered so that the clinical work is supported without disturbing patient areas.

Integration of state-of-the-art technology, including live video and data feeds to the St Thomas’ team, provides virtual access to expert consultants, enabling specialist healthcare to be delivered direct to patients rather than requiring travel to Central London. The centre will, therefore, become a major training resource for healthcare professionals.

The building reflects Linde’s vision for a high standard of sustainable design. Optimisation of passive design maximised natural daylight and minimised solar gain with a highly efficient building fabric, low air permeability levels and sustainable building materials and water conservation. To improve the potential for future flexibility, infrastructure has been put in place to allow future division of the 4 bed-bays into single bedrooms with ensuite bathrooms.

The design quality of the Lane Fox REMEO Respiratory Centre building has been more widely recognised through the award and shortlisting for several national and one international design awards. Commenting on the Centre’s recent wins at the Architects for Health Design awards, Jana Schulte, REMEO’s Business Manager, said: “We are very proud that Murphy Philipps received this acknowledgement for their outstanding design. The stamp of approval also comes from our patients and their families who regularly comment that the centre itself already makes them feel better.” At the opening of the centre, Lady Martha Lane-Fox, CBE, Chancellor of the Open University and Chair of Go ON UK, the digital skills charity, referred to the centre as “a major step forward in the integration of technology and healthcare to improve patients’ experience and outcomes”.

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