A material level of care – Maggie’s Centre, Oldham

The world’s first hardwood CLT building is a highly considered centre for cancer patients that puts function and sensitive use of materials over form. James Parker reports.

The new Maggie’s Centre, sitting next to a typically forbidding Victorian NHS oncology building in Oldham, is a subtle surprise. Sitting on columns to grab views of its surroundings and shelter- ing a new garden beneath, it is architect dRMM’s first healthcare building. This box contains hidden treasures and embodies nature to support cancer patients and their relatives, in a building which has been realised with an unusual degree of care.

The first hardwood cross-laminated timber building ever created, this centre is a celebration of the materiality of timber, which in itself makes it something of an oddity in UK healthcare design. Also, you would not normally expect see a 7 metre birch tree in a glass lightwell in a building of this type. One of several other good reasons for it to be there, is that birch is a ‘pioneer species’ – typically one of the first to grow on polluted sites, and as such is a fitting symbol of the pioneering nature of this project, and of patients’ resilience.

Its architect, Alex de Rijke, was deter- mined to ensure that his building did not replicate any of the dehumanising flaws that he sees as exemplifying healthcare facilities in the UK. By both avoiding these tropes (suspended ceilings, vending machines, a general sense of anti-nature and blandness) and also by way of a distinctly user-sensitive approach to design that echoes that of the Maggie’s charity itself, the architects have created something wonderful.

As de Rijke says, the building not only sits in explicit contrast to NHS buildings, it was also an attempt to stand back from the pantheon of other Maggie’s Centres (which tend to sit on NHS campuses, and have been designed by world-famous firms). He sees it as standing out however by being less about form than content. “It’s quite a delib- erate reaction to many of the others, which often rely on form. They do tend to privi- lege the building as an object.” Instead this building is a somewhat humbler attempt at facilitating the service within it by paying meticulous attention to the details.

The architects were commissioned by registered charity Maggie’s to design this centre at Royal Oldham Hospital, following a donation from Oldham boy-made-good Normal Stoller, who developed the tubigrip bandage. Maggie’s had admired dRMM’s work, particularly in pioneering the use of soft and hardwood CLT, and believed its skills were the right fit for creating the “architecture of hope” which the organisa- tion aims for. And the result shows that being the first hardwood CLT building is only one of many remarkable things about this place.

Timber pioneer

The practice tested American tulipwood CLT in a collaboration with Arup to produce the ‘Endless Stair’ experimental sculpture in 2013. The same wood as used in Maggie’s Oldham (in fact the same batch) was then used by Alison Brooks Architects for their 2016 London Design Festival ‘Smile’ project with Arup, its highly variegated aesthetics and structural efficiency again coming to the fore.

This timber species is, despite its excellent strength to weight ratio and fine grain (“more akin to a piece of furniture than a construction material” say dRMM), something of a commodity product in the States. As de Rijke tells ADF, “Tulipwood’s prolific to the point that it’s almost a waste wood.” He adds: “It’s not particularly useful in its raw state, but once we cross-laminated it, it became something really special.”

Timber walls form the entire structure, apart from the steel columns they stand on and the glazing, with a series of ancillary rooms framed by structural walls. Tulipwood is “very good at coping with shear forces,” says de Rijke, “so it’s fantastic for walls, and can be used quite thin compared with normal CLT.”

However with the fairly long 12 metre spans this largely open-plan building required, he says it was more efficient to use more simple glulam joists for the floor and ceiling. “People often make the mistake that if you’re doing a CLT building you use it everywhere, whereas a better approach is to use each engineered timber product for what it’s best at. CLT isn’t great for floors because you end up using so much of it.”

He says despite the relative simplicity of the structure, hardwood CLT was “uncharted territory” for the local struc- tural engineers Booth King, however Arup passed on their research from the test projects undertaken on hardwood CLT with dRMM. The project was also aided by the fact that contractor Parkinson had worked on the all-CLT Blackpool Tower of Love with the architects.

The building’s exterior is made from an unusual custom-fluted and thermally treated version of tulipwood. The material was developed by dRMM especially for this project and creates a curtain-like effect. Inside, the ceiling is constructed from tulip- wood slats with gaps forming a plenum to aid the building’s natural ventilation as well as softening the acoustics, the wood coming again from offcuts from this project and also the Smile. “We stripped panels down into three different sizes to make a very quiet acoustic baffle-type ceiling that works as an attenuating soffit,” says de Rijke.

The purity of approach to materials even extends to the insulation which is cellulose panels made from compacted waste tulipwood from routing the openings to the building elements in the factory. The architects also wanted to avoid the use of toxins wherever possible in materials, so the internal timber is untreated (apart from being lacquered up to skirting height on the walls to protect it during cleaning), and MDF was avoided due to the formaldehyde present in its glue. The untreated internal surface also provides a tactile and soothing experience which many users of the centre are said to appreciate.

Supporting care

Maggie’s Centres offer a place to come to for patients who may have recently received a cancer diagnosis, and in this case perhaps in the adjacent breast cancer care unit. Therefore they may be in distress and needing comfort or may be dealing with the aftermath of chemotherapy, needing support, advice or just a chat and a cup of tea.

Alex de Rijke tells ADF that this is why this project needed to be much more than just a demonstration of a new material: “The main ambition was to create a
more holistic architecture of care. There’s nothing in the building next door which is going to look after you other than the clinical process of absorbing chemicals. You can’t go and talk to anyone about what a nightmare this may be, nor can your family and friends.”

There is only one small window to the front elevation facing the nearby hospital buildings, and the elevated box with its curtain-like cladding immediately presents a feeling of discreet privacy, but also a big difference from the norm. Patients coming from the oncology building cross a wooden bridge, and enter a naturally lit and venti- lated building which, instead of hospital disinfectant, smells of timber resin.

They are presented not with a reception desk, but an expansive soft latex resin floor in a warm “egg yolk” yellow, and an open area divided in half by a tree growing in the garden below, giving the impression that you are outside once more. The lightwell surrounding it, its undulating, seamless butted glass reaching up past the roof and through the floor into the void beneath, brings generous light into the space.

Patients can interact with staff, in a natural way that forms part of the ethos of empowerment that Maggie’s puts forward. de Rijke says: “You don’t make appoint- ments, but you always get help, it’s always very welcoming. There are no signs or name badges and it’s not choreographed, you have to speak to people.” He adds: “It’s a very shrewd managerial strategy and we took that as a departure point for the design.” He adds: “As a result, while there is no hierarchy of spaces such as a desk, the building does have a “set of carefully created experiences”.

The centre’s manager Bernie Byrne describes the lightwell as a “glass bubble” which “breaks up the size of the interior,” allowing people to choose how they use
the space. She continues: “They can turn towards the kitchen area if feeling sociable or enter the opposite end to sit and enjoy the view of the Pennines. The furniture is placed to allow people to sit in their own contained space while still being a part of the whole”.

Ranged either side of the entrance are the support rooms – a small consultation room for one-on-one counselling, an office, and a ‘nook’ near the entrance if users do not want to enter the open-plan space. A larger multi-purpose meeting room sits at the north-east corner, where practical sessions may take place such as learning how to apply make-up to suit the different skin tone chemotherapy brings, or try on wigs. Being cranked, the wall separating these rooms from the open-plan space not only gives emphasis to the tree and the entrance, it also reduces reverberation. On the other side of the tree along the west wall is the kitchen – featuring a large, dark walnut worktop – plus a library and computer area.

As patients undergoing chemotherapy can be very sensitive to direct sunlight, the spaces have been orientated to carefully manipulate light; to the north large floor-to-ceiling windows bring in soft light, and offer great backlit views towards the hills. As well as moderating light coming in to the centre of the unit, the tree attractively dapples the floor with moving shadows that rotate through the day.

To the south a deep loggia, adjacent to the kitchen, provides a space to sit outside but be protected from direct sun. Another sense affected by chemotherapy is touch, with cold surfaces tending to feel extremely unpleasant, so dRMM managed to obtain wood door handles to amelio-rate this.

The open plan space has an ingenious device to provide a more private area, for yoga or other activities, in the form of a beautiful curtain that matches the yellow floor, and runs around a bespoke track, making a circular ‘room.’ Designer Petra Blaisse from Inside/Outside made it shiny on one side and soft on the other, and easily reversed to suit the function desired.

This site was chosen by the architects because despite being cheek-by jowl with some typically bleak buildings, it gave them the opportunity to have a secluded garden underneath, which the alternative site in the centre of a car park would not have offered.

This would of course also mean the poten- tial to have a tree growing into the building.

Stones from the demolished single-storey mortuary on the site has been recycled into the landscaping and paths, which link into routes across the hospital site. Several new trees have been planted, including a tulip tree, which is a satisfying counterpoint to the material used to construct the centre.

Reactions

According to Bernie Byrne, it is a “wonder- ful privilege” to work in the centre. This painstakingly designed, calm building is having a commensurate effect on users. She tells ADF: “A frequently heard comment is how calming, restful and uplifting it is. The tree creates a sense of calm and tranquillity, grounding and relaxing visitors from the moment they enter, and the floor is often described as bringing sunshine into the building even on a cloudy day.”

The overall impression of Maggie’s Oldham is one of surprise, comfort and empowering delight, despite its relative humility as a piece of architecture. The fact we are surprised that a healthcare building can be like this is both a triumph and a cause of sadness. After all, shouldn’t it be a general rule that buildings for healthcare are in themselves the most, not least supportive that we build?

PROJECT FACTFILE

Project name: Maggie’s Oldham
Location: Royal Oldham Hospital
Client: The Maggie Keswick Jencks Cancer Caring Centres Trust
Architect & interiors: dRMM
Landscape design: dRMM/Rupert Muldoon
Gross internal area: 260 m²
Structural engineer: Booth King
Main contractor: F Parkinson
Timber consultant: AHEC
Artist (curtain): Inside/Outside
Timber supplier: Middle Tennessee Lumber
Landscape consultant: Hultons