Nuffield Transplant Unit

One of Peter Womersley’s earliest engagements with the health care profession was an appointment with an ‘occupational psychiatrist’, who ‘diagnosed a lawyer, a solicitor, or an economist’ after three days of observation of the ‘problem child’ who wanted to be an architect! Thankfully, Womersley pursued his dreams and realised a range of architecturally distinct projects from his base in Melrose in the Scottish Borders. The Nuffield Transplantation Surgery Unit was one of the first buildings designed and built specifically for the purpose.

Prior to designing the Nuffield, Womersley was also responsible for Dingleton Hospital Entrance, a small admissions unit to Herdmanflat Hospital at Haddington, near Edinburgh and a group practice surgery at Kelso in the Borders - the former, an example of Womersley’s subtractive architecture, the latter illustrating a later, additive approach. He referred to the subtractive method as ‘basically Miesian’ wherein the simple open volume, derived from the plan, is broken down by a series of other closed volumes with specific functions. The majority of Womersley’s early commissions were private houses and were designed ‘from inside out’. Their aesthetic arose from a sequential working method of plan-section-model and it was the first three-dimensional explorations that would generate the character and, ultimately, the detailing for his schemes. In the Nuffield, with his assistant Joe Blackburn, Womersley crafted a ‘strange, exotic, sculptured, ochre-coloured, fort-like concrete building’. Blackburn was formerly employed by the Scottish south-east regional hospital board, from whom Womersley received some of his commissions.

Outwardly, Nuffield appears to be additive architecture insofar as a series of discernible volumes compose the whole. The main floor was cantilevered above a basement plant room that exploited the sloping site. A separate administrative block stood apart, but was attached by the circulation core and overbridge that connected to the rest of the hospital. In fact, the highly articulated in-situ cast concrete elements were the ‘logical and accurate expression of its inner arrangement.’ At the core of the scheme were six sterile wards for six patients recovering from transplant surgery, with an obvious need to avoid bacterial infection. The sterile areas also included surgical theatres accessed via a decontamination room. The clean areas were surrounded on three sides by a ‘dirty’ corridor from where patients and surgery could be observed. Patients were kept in isolation for five to six weeks and any building element that had the potential to transmit infection was moved to the outside of the sterile envelope. Curtains, for example, could be electronically operated by the patient from within, but hung outside of their recovery room. The individual volumes are themselves quite ornate, again an external appearance informed by internal need.