West side Storeys

West side Storeys

Scher, Peter


Peter Scher visits a well-designed facility in an attractive part of west London, but questions whether the multi-storey solution is appropriate for an EMI unit.

Since 1990 I have visited and reviewed six new NHS buildings for the elderly mentally infirm (EMI). All by different architects and all notable both for their architectural quality and the deep humanity the architecture embodies. They are as follows: Wellmead, Wanstead (HDSep 1990), Woodlands, Hillingdon (HD, Jan 1991), The Lodge, Hackney (Architect’s Journal, 18 May 1995), Church Crescent, St Albans (HD, Oct 1995), Woodlands, Lambeth (HD, Jan 1996), and this, the Butterworth Centre. Each facility is planned as a group of units, typically of eight beds, and most units include one two-bed room. The Butterworth Centre has been built within the grounds of an independent hospital on a lease to the North West London Mental Health NHS Trust.

The Butterworth Centre however differs from the other five in one very significant respect. All five are set in gardens of varied design and landscaping. Only Wellmead in Wanstead has bedrooms on an upper storey, its design reflecting the operational approach as a ‘house! The gardens and landscape are outstanding features of all five and are essential components of the care provided.


The independent Hospital of St John and St Elizabeth has a long history, moving to the site in Circus Road, St John’s Wood, in 1902 it has since been expanding and developing both services and facilities. Its main entrance was established in Grove End Road with the opening of the elegant new medical block and hospice by David Morley Architects in 1991 (see HD October 1991 pp 33-37). The Butterworth Centre is a four-storey rectangular block, with basement parking garage, adjacent to the original site entrance in Circus Road. This entrance is on the main axis of the high-domed chapel at the centre of the old classically-designed hospital. The new block faces the old convent building, another classical block across the entrance drive, which leads straight through a widening space to the formal courtyard dominated by the chapel. The rear of the Butterworth Centre is close and parallel to the site boundary and the flank of a villa on the adjacent site. There is a small area of grass and new-planted trees and shrubs in front of the building’s Circus Road elevation. Entering this site one progresses through a complex outdoor space formed by the varied hospital buildings around it.


The planning of the EMI centre is very straightforward and easy to grasp. Each of the three floors for bedrooms has a central area for group activities, ancillary rooms and vertical circulation (two stairways, a bed lift and a passenger lift). On either side of this area there is a seven-bedroom suite divided from it by a glazed screen. The bedrooms open off their own breakfast and sitting areas. The great virtue of this is that there are no corridors. The suite to the left (north) of the central area has one double bedroom and all bedrooms have an ensuite toilet and shower. None of the bedrooms are planned to face the site’s north eastern boundary so all have windows with excellent and varied prospects.

On the first and second floors the central activity area opens onto a wide balcony. On the ground floor this is where the building’s entrance is placed and the accommodation here will be occupied by patients being assessed. The third (top) floor is set back from the floors below on the two sides with the best orientation, providing a pleasant paved roof terraced with good views to the south, south east and south west. Beside this terrace are rooms for mixed activities, crafts and hairdressing/beauty services. The remaining spaces on the top floor are for staff rooms and the unit’s kitchen, and for plant.

When I visited the building it was stili very new and not fully occupied and even the bed areas in use seemed rather bare. The interiors have good daylighting and the finishes and colour schemes are pleasant. There are limited areas of rich colour used on the walls but the general impression is of a tasteful background (which it is intended that users will in time enrich with personal items in bedrooms and social areas). Occasional lapses in detail and finish quality of the work may not wear well under intense use but they do not significantly spoil the good architecture.

Patients’ bedrooms and all common areas used by patients have linoleum flooring, carpeting being restricted to the staff areas. Hospital beds and the sound but mundane looking furniture and furnishings confirm this unit as part of the NHS, not the private sector.


The site slopes towards Circus Road raising the ground floor some half-astorey. Between ground level and the ground floor the exterior is faced with bands of split-face ivory Forticrete blocks divided by narrow black string courses. The balustrade walls to the entrance steps and ramp have the same treatment. The basement car park, entered down a ramp on the north west side of the block, has 20 spaces for the use of the hospital, not the Centre.

The built form of the building, set above this podium, clearly expresses the three elements of the planning. The central element has the glazed entrance at ground floor with the smoothly curved white balcony fronts fronting the upper floor activity areas in line above it. The bedroom units on each side are clad in cream brickwork divided with single brick horizontal and vertical string courses. These are in orange/cream glazed lbstocks and delicately delineate the individual bedrooms. The aluminium windows, powder-coated a light grey/green, with sloping green slate alls are wellproportioned. The ground floor bedrooms and two corner bedrooms on each upper floor have French windows. On the least-favoured (north west) face of the building the bedroom windows are projected out at an angle from the facade, like oriels, to enhance the daylighting and view.

The setback top floor is painted white rendering and has a timber pergola in front of, and above, the roof terrace; the iroko has a natural finish. The posts start well below the parapet and are supported clear of the brickwork facing. Climbing plants will eventually decorate and enrich its current elegant rectilinear frame. This is no bland, run-of-the mill block but a simple, very well-proportioned and sensitive expression of a rational, uncomplicated plan.


A multi-storey design for an EMI unit has disadvantages and must be one of the least preferred options. Added to the expense of providing lifts and stairways are the hazards of their use by the mentally infirm patients and the costs and complexities of special controls. It may be that other suitable sites with the possibilities of single-storey solutions and secure outdoor space for patients to use could not be found or afforded by the trust. Certainly this unit is in an ideally accessible location for staff and visitors and the immediate neighbourhood is very agreeable with good services.

However the absence of ground space for the patients to experience and use is most regrettable. The gardens and landscaping are a supreme asset of the other five units I have assessed. Indeed they are more than an asset, they are a key element of the care of EMI patients. At the Butterworth Centre this element is available to a rather limited extent on the top floor roof terrace and the balconies. There are flower beds and climbing plants and no doubt large potted plants will be brought in as the centre becomes well-established. The framework for climbing plants and the glass screens above the balcony parapets are essential to guard against accidents and suicide attempts.

Choosing a location and a site appropriate for developing the building’s required function are matters for the client to decide at the inception stage. Aside from these matters the Butterworth Centre may be assessed as a work of architecture and in my view it is very good, and a well-designed healthcare facility.

Client: Central and North West London Mental Health NHS Trust

Architect: MLRS Architects (incorporating Williams Wren Partnership)

Quantity surveyor: Dobson White Boulcot

Services engineer: The Richard Stephens Partnership

Structural engineer: Faber Maunsell

Landscape architect: John Tierney Associates

Main contractor: Buxton Building Contractors

Cost: £3.8m

Site area: 1,450 m^sup 2^

Residential area: 2,705 m^sup 2^

Carpark/plant: 665 m^sup 2^

Planning consent: July 2001

Start on site (including demolition):

November 2001

Completion: July 2003

Occupation: August 2003

Copyright Wilmington Publishing Ltd. Apr 2004

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