The Christie Proton Beam Therapy Centre

The Christie Proton Beam Therapy Centre was designed to be the first high energy proton therapy facility in the NHS, the brief was to deliver a large comprehensive centre, including three 360-degree rotational treatment rooms and a fourth room, sized to take a treatment room in future but initially fitted-out with a fixed beam for medical research. Each of the 5 stories has a dedicated use: Ground Floor serves as the main entrance for PBT as well as OPD and links to the hospital. Level 1 is dedicated to Proton Therapy and Level 2 for pre-treatment clinics and treatment planning. Level 3 is dedicated to staff support, MDT and conferencing facilities, as well as shell space for future adaptable office needs. Level 4 is clinical shell space, designed to take a future inpatient department. The facility was also designed to receive a new Outpatients Department, a strong connection to the hospital was important. Strategic Vision: The main benefit of proton therapy is that it causes less damage to healthy tissue, especially advantageous for paediatric patients, as damage to their developing bodies can impact future quality of life. When commissioned in 2010, the NHS ran a PBT programme to treat patients abroad, however the number that could be treated was relatively small in part due to the cost of treatment, travel and accommodation. Patients were also screened based on ability to travel, as the risk of moving patients could often be greater than the risk of traditional treatments. In combination with the London PBT centre, this unit will increase the access to treatment tenfold. Another important contribution to the NHS plan for proton therapy is in the form of research. Through partnership between The Christie and University of Manchester, the facility aims to bring about ground-breaking developments in cancer care, reinforcing the importance of these globally influential institutions. Although the PBT facility will in many ways act as a standalone department, it extends the hospitals extensive oncology services with the addition of over 2,000m² of outpatient provision. Context: A major challenge for the project was delivering the incredibly complex facility within close proximity of neighbouring houses and within an existing operational hospital. In the early stages of design, the project team decided to position the bunker at ground level, rather than placing it below ground, avoiding the high water table and reducing local disruption and shortening the construction programme. The massing was developed to respect the density and heights of the neighbouring streetscape resulting in a development which responds to both the adjacent residential and institutional scales. External cladding materials were chosen to complement those used on the existing campus thus maintaining an architectural harmony. Design Approach: The facility was designed around a unique concept centred on the patient experience which became the main organizing principal of the design. Our concept consisted of 3 elements – Soothing Nature, Human Care and Healing Science. Public waiting spaces inspired by Soothing Nature capitalized on natural daylight, views and internal and external vegetation. Areas associated with Healing Science inspired by technology and the benefits it brings. Uniting these two potentially disparate themes was the Human Care element of the clinical support services. As patients receive treatment 5 days a week for up to 8 weeks, the aim was to create a supportive sense of community between patients and visitors. The main waiting area becomes a social hub, where visitors can share their experiences. Within this area, a space dedicated to teenage patients caters for their psychological and societal needs. An outdoor terrace provides patients with a retreat in times of stress. A separate pathway for paediatrics, which safeguards children via a segregated clinical environment offers a “positive distraction” that caters to their clinical needs. Play therapy is provided within waiting areas and an external courtyard, to help children cope with the stresses of treatment in a protected environment. Designing a building design to maximise the use of natural daylight into all staff workspaces was a challenging task due to the nature of the concrete bunker dominating so much of the site. Staff wellbeing was a major guiding principle, and the resulting the design ensured that no office is provided without natural daylight. The third floor of the facility is dedicated to staff functions; rest-rooms, lockers, training facilities and seminar rooms. A portion of this floor has also been designed as shell space in order to allow for future flexibility. It is anticipated that the facility’s use will adapt dramatically over time, as the clinical pathways for proton therapy are developed within the national and international frameworks, also allowing the research element to adapt in its response to changing needs of technology, research trends and partnerships. Sustainability: Designing for environmental responsibility in a facility with such heavy engineering components was a unique challenge: much effort was undertaken from the outset to ensure the facility reduced its impact as much as possible. Building orientation and architectural shading components were arranged to reduce solar gain into the main waiting area. Heat recovery systems were used to harness waste energy from the proton equipment and feed back into the heating systems of the building, drastically reducing the energy needed to maintain the building environment. Low VOC (Volatile Organic Compounds) materials were used throughout. Staff areas were designed to support alternative transport for staff and visitors and to support the hospital’s green transport strategies. The facility, despite its high energy use from the proton therapy systems, achieves BREEAM Excellent in the design phase and it is anticipated that it will achieve this through the operational stages of the project. The external environment of the building was designed to soften the public realm surrounding the building. Native planting used extensively with the majority of the mature trees along the perimeter of the site preserved, buffering the development from adjacent footpaths and residences. This helped to reinforce the concept design of the building and the themes of nature utilised throughout the public spaces.