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Alder Hey - the hospital in a park

The new Alder Hey Children’s Hospital in Liverpool engages children with the external environment and the local community with the hospital.
The ambience of the new Alder Hey Children’s Hospital in Liverpool is so upbeat (without any cloying false jollity) that it is sobering to visit the bereavement garden that BDP’s landscape team has designed. This calm space, shielded by shrubs, is set around a fountain that can be switched off if a child has died by drowning. It is accessed by the two bereavement suites which look after not only the 80-odd children who die at the hospital every year, but also those who are brought in from other hospitals.

It is hard to imagine how a garden, however sensitively designed, can start to address the scale of loss that those parents experience. It does its best however, and is a measure of the care that has gone into designing all areas of the environment. Fortunately, the rest of the project caters to the living, whether they be patients, siblings, parents or the 300-odd staff who work in the hospital.

BDP was both architect and landscape architect for the project, but David Houghton, the hospital’s project manager for the redevelopment, references another set of designers altogether. These are the children of Liverpool who, through a council, not only contributed to the brief but also supplied some of the early design ideas.

It was evidently a formative experience. Jack Hutton, who was a patient at the hospital and chaired the young people’s forum, is now completing architecture studies and spent a six-week placement with BDP in Manchester. His one-time second in command is now studying to be a paediatric doctor.

The hospital sought input from the young people because the previous hospital, while known for its paediatric success, was a crumbling and unfriendly building where long-term residents might spend their entire stay looking out on a grubby brick wall with a few services climbing up it. 
    
The new hospital, on an adjacent site, was to be very different. ‘One of the key things that we were trying to see from start to finish,’ said Jenny Ferguson, BDP’s landscape lead on the project, 
‘was that it was designed by the children, for the children. This was true from the early concept designs where we had to get an idea of how it was used, how the children felt when they came to 
the hospital, what their concerns were and what excited them. It had to feel welcoming, comfortable, familiar and safe.’

While the average stay is only two nights, there is a small cohort who are inpatients for weeks, months or even years, while others make multiple visits, probably mainly as outpatients. When the hospital asked these children and their healthy contemporaries what they would like from a hospital, their answer was a landscape architect’s dream. They wanted daylight and views, outdoor places to play and contact with plants and animals. And this is what they have, with the restriction that most of the animals are in the form of the delightful sculptures and drawings of artist Lucy Casson.

The relationship between inside and outside is most easily explained by the new designation of 
the hospital as Alder Hey in the Park. The building consists of three fingers thrusting out into an existing park, with two very different landscaped areas set between them. At the ‘palm’ where the fingers meet is an atrium which forms the core of the hospital and behind this is the car parking. Most visitors arrive by car and move directly into the atrium. The result is that, in contrast to many hospitals which are surrounded by a sea of tarmac, visitors who are dropped off by car or taxi, or who walk across the park, never see a car parking space.

The most prominent aspect of the model was the use of grass-covered roofs stepping down the profile, contributing to a Teletubby effect. While these roofs are impressive when seen from across the park, they are far less prominent when looking out from the building or in the immediate vicinity. Then the dominating factor is the range of greenery not just in the two interstices of the fingers, but also in lightwells and terraces.

Where the green roof does have an impact is on the play spaces at the ends of wards on the first 
and second floors. These are brilliant interventions, sheltered but open spaces that enjoy magnificent views. Surfaced with a springy green layer made from recycled trainers, they provide a feeling of being outside while remaining usable in most weather. Around the edge, at eye level for many, is the green roof, planted with a wildflower mix that offers interest and excitement in the summer and still gives a feeling of immersion in the natural world in the winter. 

As an added bonus, these play balconies contain an aquaponics system in which decorative and fascinating fish provide the ammonia-rich excreta that is then circulated to nourish hydroponically grown plants – initially Swiss chard but possibly to be replaced with herbs. These harvests are used in the individual kitchens that supply each ward. And it is not even necessary to change the water in the fish tanks, since the effluent is being removed.

This interest in growing to eat extends outside as well. There are already fruit trees and the hospital is partnering with Incredible Edible Todmorden to create a dedicated food growing area.

For David Houghton, this connection to outside is a relinking with the past. ‘The original Nightingale wards had balconies,’ he said. ‘We removed them and now we are putting them back.’

The two long gardens between the fingers have, deliberately, very different approaches and atmospheres. ‘We saw the building as having risen from the sandstone that is the bedrock of Liverpool,’ Jenny Ferguson said. ‘There are two chasms carved into it.’ One is conceived as a wet ravine with a profusion of greenery. It has been designed for exuberant activities, including a playground. The other chasm is ‘a dry canyon, carved from the rock’. This is intended as a more passive space, meant for sitting and more contemplative activities.

Indicative plant lists

Entrance and public realm: tree and specimen species 
Species chosen for their naturalistic style to respond to open parkland setting adjacent to hospital. Native species coupled with ornamental grasses and perennials create a dramatic and welcoming entrance.

Acer saccharinum
Alnus x spaethii
Betula utilis var. jacquemontii
‘Silver Shadow’
Liquidambar styraciflua
Sorbus aucuparia var.edulis
Prunus x yedoensis
Pyrus calleryana
‘Chanticleer’
Quercus palustris
Anemanthele lessoniana
Achillea
‘Walther Funcke’
Acanthus mollis
Stipa gigantea
Mahonia eurybracteata subsp. 
ganpinensis
‘Soft Caress’
Leucothoe ‘Scarletta’

Wet ravine garden: tree and specimen species  
Species chosen for their dramatic visual and tactile effect as part of a dynamic and active garden to promote physical rehabilitation and play. Species to include edible fruiting trees as part of community orchard.

Betula albosinensis ‘Burkill’
Dicksonia antarctica  
Ginkgo biloba  
Magnolia x loebreri
‘Leonard Messel’
Malus domestica ‘Cox’s Orange Pippin’ –  (edible apple)
Parrotia persica
Prunus maackii
(MS)
Pyrus communis ‘Conference’ (edible pear)
Rhus typhina
Trachycarpus fortunei 
Fatsia japonica
Fargesia nitida
(bamboo)
Crocosmia ‘Lucifer’

Dry canyon garden: tree and specimen species
Species chosen for their colourful and sensory qualities to promote calm and relaxation as part of a healing environment. Species to include herbs traditionally grown for medicinal use.

Acer palmatum ‘Fireglow’
Aralia elata ‘Variegata’
Buddleja alternifolia
Buddleja
‘Buzz Lavender’
Davidia involucrata
Cercidiphyllum japonicum
Philadelphus
‘Belle Etoile’
Pinus sylvestris ‘Watereri’
Santolina chamaecyparissus
Stachys byzantina
Rosmarinus officinalis
Lavandula
‘Grosso’
Verbena bonariensis

Wildflower species for green roof and meadow
Native wildflower species chosen to increase the biodiversity of the hospital landscape and create a seamless transition from park to hospital.

Anthoxanthum odoratum (sweet vernal grass)
Festuca rubra trichophylla (slender creeping red fescue)
Festuca rubra subsp. commutate (Chewing’s fescue) 
Galium verum (lady’s bedstraw) 
Trifolium pratense (wild red clover) 
Origanum vulgare (wild marjoram) 
Lathryus pratensis (meadow vetchling) 
Centaurea nigra (common knapweed) 
Stachys officinalis (betony) 
Clinopodium vulgare (wild basil)

There have been some teething troubles. Despite the best advice (from Sheffield University) on choosing the wildflower mixture and the substrate, a section of the green roof at the end of one of the ‘fingers’, where it is on a 40 degree slope, died. The reason was that the irrigation system was set too deep for the fledgling roots, and additional surface irrigation was necessary until the turf had established itself.

The playground is under-used and Houghton aims to remedy this by installing outdoor screens with details of appointment calls, since he believes patients, and particularly parents, are nervous about spending too long away from this vital source of information.

But in general terms, this is an outstanding success. Job done, then? Well, not according to David Houghton. ‘From my point of view, the job is only halfway through,’ he says. This is because there is still a lot of work to do with the park in which the hospital sits – a radical re-ordering and reorientation, as well as new planting. And there are more research buildings to be constructed, to join the first fine example by Hopkins Architects.

There has been some very vocal local dissent about the work, but people are now being won round. To understand what has happened and what will happen, it is necessary to look back at 
the previous hospital and how the brief developed. David Houghton is very well placed to do this 
since he was in charge of the estate for the previous hospital. Now abandoned and due for demolition, it stands next to the new building, a confusing agglomeration of Victorian buildings and later add-ons. It was not fit for purpose, both because of its state and because of the conditions of the patients. Some children spent their entire time in the hospital looking out at a blank brick wall.

The park is roughly square. The old hospital occupied much of the northern part of it, while 
the new hospital is in the south eastern quarter, stretching its arms out towards the west. There is as little division as possible between hospital and park, with a relatively elegant railing separating 
the two and a small ha-ha. Research by the Prince’s Trust showed that by reorienting the park so that it runs north-south rather than east-west it would unite the disparate communities around it, rather than, as previously, acting as a barrier. 

Opinions differ about the virtues of the original park, with David Houghton describing it as a ‘swamp’ and Jenny Ferguson more enthusiastic. 

In the short term however there has been some loss of parkland and this was of course unpopular. The aim is for the new park to offer far more in terms of activities and already, on the day that I visited, locals were being drawn in to a programme of bulb planting. As a result, the initial opposition has disappeared.

BDP is working on the design of the new park, with construction due to begin once demolition 
of the old hospital is complete. And then Alder Hey in the Park really will be in the park. It will take a while to discover if clinical outcomes have improved as a result of the changes but the hospital certainly looks wonderful and is becoming, as intended, a part of the community.

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