How do you turn a haphazard collection of buildings from different eras into a hospital fit for the 21st century? Llewelyn Davies was tasked with the creation of a Blueprint Masterplan for University Hospital Lewisham. Moritz Spellenberg, Associate Director at Llewelyn Davies, discusses the challenge.
Moritz Spellenberg, Associate Director at Llewelyn Davies
Playing to our strengths
Llewelyn Davies has a long history of estate master planning and healthcare experience. In this brief both aspects of our expertise came together.
Our appointment at the end of 2023 was to create a development control plan to inform University Hospital Lewisham’s long-term capital decisions and short to medium-term investment strategies.
Establishing spending priorities is crucially important as the hospital is not part of the existing National Hospital Programme and is therefore reliant on alternative funding routes, such as internal capital allocations, NHS England funding and public sector decarbonisation grants. The masterplan identifies areas where the Trust should be investing and, equally important, where they should disinvest by, for example, demolishing buildings that are no longer fit for purpose.
The level of investment we are talking about is significant and will deliver major infrastructure additions and upgrades, as well as new and refurbished buildings.
Where we are now
The Masterplan process commenced at the beginning of 2024 with several rounds of consultation, involving a wide group of stakeholders including clinical leads and staff with drop-in sessions to encourage maximum clinical engagement. This was underpinned by thorough desktop studies and onsite observational surveys.
The outcome, by summer 2024, was a strategic masterplan, setting out development priorities for the next 10 to 15 years. This strategy document was endorsed by the senior leadership and approved by the Trust’s Executive. Llewelyn Davies is now engaged in the initial stages of implementation which includes dialogue with the local planning authority. Their support will allow us to get the first priorities underway.
The existing signage at University Hospital Lewisham.
The overall challenge
Our development proposals needed to be able to accommodate a long-term clinical strategy and be flexible enough to support future changes in capacity and demand. We also needed to ensure that it encompassed the requirements for building maintenance and lifecycle replacement.
As with many established UK hospitals, Lewisham presents a mix of building types from the 19th century onwards. Some are of heritage interest, others are additions from the 1960s and 70s, and there is a 7-storey block built around 20 years ago under the Private Finance Initiative (PFI). Retrofitting is always the preferred solution, and the local council has a retrofit-first policy. Realistically, however, some of these buildings are dilapidated and need to be demolished. The hospital’s current building stock is around 75,000 sq m, our proposals add potential development of a further 45,000 sq m, whilst 15,000 sq m will be upgraded and another 15,000 sq m would be demolished under the Blueprint Masterplan.
Lewisham presents a mix of building types from the 19th century onwards. Some are of heritage interest, others are additions from the 1960s and 70s, and there is a 7-storey block built around 20 years ago.
Getting the basics right
There was a clear requirement to rationalise the Lewisham estate by consolidating clinical and non-clinical services.
Site surveys and feedback from staff and patients revealed the difficulty people encountered in accessing hospital services. There’s a multitude of entrances with no hierarchy and finding your way around is very confusing at the best of times. Our plan envisages keeping the emergency, acute care zone at the heart of the building and consolidating the various and currently dispersed outpatient areas into a single block with a dedicated entrance on Lewisham High Street. Outpatients will know exactly where to go and there will be separate entrances for inpatients, maternity, and emergencies.
The new outpatient entrance will also help to better integrate the hospital with the local community. At the moment, the high street rather bypasses it but the new entrance and the provision of opportunities for retail units and cafés on the hospital frontage will redress this situation.
The 5 phases of the masterplan
Cutting the carbon footprint
The NHS aims to achieve net carbon zero emissions by 2045, and the Blueprint Masterplan for University Hospital Lewisham supports that target with measures to gradually reduce the hospital’s overall environmental impact.
For example, the existing steam-based heating system will be replaced with renewable energy sources wherever possible. As a result, although the building footprint will increase by around 45,000 square metres, the actual carbon emissions will reduce significantly.
Over time, the hospital will move to an all-electric estate. The value of this, of course, depends on where you source your electricity from and how green your grid is. To supplement this, we have also looked at renewable energy sources on site. Apart from photovoltaic panels, other possibilities include a ground source heat pump system powered from boreholes in Ladywell Fields, a park bordering the hospital. A nearby urban development also raises the possibility of linking the hospital to a local energy network powered by the excess heat from a massive new data centre. And of course, the building work will incorporate measures to make the hospital more energy efficient with appropriate facade soultions, smart building technologies and the use of low consumption fittings.
First steps
One of the early priorities addresses car parking and traffic circulation on site. The present situation is confusing and potentially dangerous, with visitors, staff, and delivery vehicles constantly crossing each other’s paths.
The longer-term delivery
Development in the context of a working environment is always difficult. It becomes even more challenging with a hospital that needs to maintain uninterrupted access to critical services.
That has meant designing an effective Development Control Plan with logical phasing and a decant strategy that allows for certain functions to be moved to alternative locations either temporarily, while work takes place, or to a new permanent home.
Moritz Spellenberg discussing the Masterplan on site at University Hospital Lewisham.
Looking forward
We view any development control plan as a live document that requires adapting and updating as the various phases of the programme are delivered.
We conducted a similar exercise with Great Ormond Street Hospital in 2005, and we continue working with this client to this day. Our relationship with the Trust’s Redevelopment Team is a very successful one, and at Llewelyn Davies, we are confident that we can continue to add value as their plans evolve over the next 10 to 15 years.
Any further questions?
If you have any further questions about this article, please contact us via london@ldavies.com or 0207 907 7900
