The Royal London Hospital

2007–12, 17-storey block for the Royal London Hospital, designed by HOK for Skanska.

The new Royal London Hospital
Contributed by Survey of London on April 29, 2019

A 1992 report on health services in the capital by the pathologist and administrator Sir Bernard Tomlinson recommended the closure of St Bartholomew’s Hospital in Smithfield and the transferral of medical and teaching facilities to the Royal London Hospital, with a minor injuries unit at Smithfield. Tomlinson’s recommendations sparked contention and were only partially implemented, yet the merger in April 1994 between Barts, the Royal London Hospital and the London Chest Hospital generated the impetus for reorganisation and large-scale redevelopment. The merger represented the start of a protracted and complicated story, partly so due to uncertainty over the future of Barts. The East London and City Health Authority determined that it was more economical to concentrate critical medical services on a single site, and selected the Royal London Hospital for expansion. A new general hospital in Whitechapel was intended to augment the state of public health in Tower Hamlets, a borough with significantly higher sickness, mental illness and mortality rates than the national average.1

In 1995 the newly formed Royal Hospitals NHS Trust commissioned management consultant MHA to produce a strategy for transferring services from Barts and the London Chest Hospital to the Royal London Hospital, in association with specialist hospital architects Llewellyn-Davies, cost consultant Davis, Langdon & Everest, and services engineer Troup Bywaters & Anders. These consultants recommended retaining and reconfiguring the main hospital building, yet identified a large redevelopment area. The site of the nurses’ homes to the south-east of the hospital was identified for a six-storey clinical centre providing operating theatres, diagnostic services and surgical wards. A day-care and outpatients’ centre was proposed for the rectangular site skirted by Stepney Way, Cavell Street and Newark Street.2

The Trust subsequently invited the Health Management Group (HMG), John Laing Construction and Millennium Hospitals to develop plans. With a projected cost of approximately £260 million, the scheme for a new hospital was set to be the largest healthcare PFI project undertaken in the United Kingdom. Deterred by its likely cost and complexity, Laing withdrew from the competition in May 1996. HMG emerged as the favoured bidder, with a scheme developed by David Hutchison Partnership. Their proposal was formed on similar lines, with the retention of the main hospital building, along with the Alexandra Wing and the Grocers’ Company’s Wing, and the construction of a medium-rise 1,100-bed hospital to the south-east.3

The closure of Barts was prevented by the new Labour Government in 1998 after an inquiry headed by Sir Leslie Turnberg, who recommended its adaptation into a specialized cardiology and oncology centre. The specification for the new Royal London Hospital was consequently reduced to 900 beds. By 2003 two consortia were in competition for the project, which covered work at Barts and the Royal London Hospital. For the Whitechapel scheme, Bouygues Group engaged Nightingale Associates to draw up a submission with the assistance of Terry Farrell & Partners. This consortium was pitted against the Swedish contractors Skanska and fund managers Innisfree, which enlisted HOK International, an American firm recognized for its work at the Northwestern Memorial Hospital in Chicago. Led by design director Larry Malcic, the HOK International team gained preference.4

HOK’s initial scheme was criticized sharply in 2004 by the Commission for Architecture and the Built Environment (CABE), which objected to its bulky massing, confusing planning, and lack of coherence with its immediate vicinity, particularly the main hospital building fronting Whitechapel Road. The design of the new hospital was considered to repeat ‘mistakes made in large projects in the 1960s’, which would be costly to remedy. CABE also voiced concern that the internal configuration of the new hospital had been compromised by a focus on the proximity of certain departments, at the expense of other factors such as natural daylight. Another issue was the unavailability of the large and underused Post Office site to the north-east, which deprived the new hospital of a street front. These objections were coupled with remonstrances from Ken Livingstone, who threatened to apply mayoral powers to obstruct planning permission. HOK withdrew its proposal to concentrate on revisions, amid reports that Nightingale Associates and Farrell & Partners were seeking to usurp their scheme. HOK returned to CABE three months later with an amended design incorporating a public square on the south side of the main hospital building, necessitating the demolition of its east wing. The revised scheme gained the partial support of CABE and, after additional alterations, was granted planning permission in March 2005.5

The project was divided into two main components – the construction of a new hospital and the renovation of the main hospital building fronting Whitechapel Road. These schemes were accompanied by a number of subsidiary projects: a four-storey outpatients’ block to the west of the new block, a multi-storey car park on the site of the disused dental institute in Stepney Way, and a nursery building on the site of the boiler house in Pasteur Street. This ambitious scheme was realised partially by the construction of a new hospital building in 2007–12. This block occupies an extensive site formerly occupied by the east wing of the main hospital building and a series of nurses’ homes. The building has also engulfed a swathe of the London Hospital estate, bounded by Raven Row to the north, Milward Street to the east, Stepney Way to the south, and East Mount Street to the west.6

The new hospital comprises a bulky cluster of three towers; a squat eleven- storey north tower and two nineteen-storey towers connected by a bridge straddling Stepney Way. The upper floors of the reinforced-concrete frame are clad with grey sun louvres and sheer blue glazing in an assortment of tones, with navy blue reserved for the north tower. An underpass between the central tower and the south tower serves as a continuation of Stepney Way to Cavell Street, with a pick-up and drop-off point for patients and visitors. Parking for ambulances is provided to the east of the north forecourt and along Milward Street, adjacent to the accident and emergency department. The roof of the central tower is capped with a helipad and an emergency unit for the Helicopter Emergency Medical Service (HEMS). The new building opened in March 2012, after twelve weeks of transferring patients, departments and equipment from the former hospital via a scaffold bridge. A formal opening by Queen Elizabeth II took place in February 2013. At the time of writing (2019), the hospital contains 675 beds arranged over 110 wards, and twenty-six operating theatres.7

The north block of the hospital is fronted by a paved forecourt and a car park on the south side of Whitechapel Road, accessed by East Mount Street. A set of revolving doors at the north-west corner of the block serves as the main public entrance to the hospital, opening into a lobby and a corridor that drifts southwards to Stepney Way. Two separate canopied entrances on the north front provide direct access to the children’s hospital, the women’s centre, the renal and urology department, and the accident and emergency department. On the ground floor, most of the combined footprint of the north and central blocks is dedicated to an extensive accident and emergency department, comprising distinct areas for initial examinations, paediatric care, imaging, treatment and resuscitation. This department is a leading major trauma centre that attends to approximately 160,000 cases each year.8

A covered forecourt with Wade’s statue of Queen Alexandra announces the main entrance to the south tower. A lobby with a reception area screens ground- floor clinics. Staircase and lift lobbies are scattered throughout the blocks, largely connected by a central north–south corridor piercing each block from the first floor upwards. The lift cores present the principal mode of public circulation in the hospital, providing access to different departments and facilities. Light wells over the first-floor radiology department form a cleft between the north and central towers, securing a therapy garden for the second-floor outpatients’ department. The second floor also contains prayer rooms for Christian, Muslim and Jewish patients and visitors. Operating theatres are located on the third, fourth and sixth floors, and contain specialized equipment such as the da Vinci system for pioneering robotic surgery and virtual reality technology. The fourth floor contains ten operating theatres assigned to specific types of surgery, and two emergency theatres. The women’s centre and children’s hospital occupy the sixth, seventh and eighth floors of the hospital. The ninth floor is dedicated to the renal and urology departments. The upper storeys of the central and south towers contain inpatient therapies and wards, skirting the exterior of the building to secure natural light and views. The fifteenth floor and part of the fourteenth floor are currently unoccupied and unfinished, following a controversial agreement with the Department of Health to reduce costs. Plant rooms are installed at the peak of the building, along with facilities for the HEMS, including offices, an operations room, storage for equipment and training, and a water tank. The 28m2aluminium helipad, accessed via a sloping walkway, was produced by Bayards, a Dutch construction company.9

The functionalism of the interior spaces of the hospital has been relieved by the installation of artworks under the auspices of Vital Arts, a charitable organisation based at Barts Health NHS Trust. Artworks have been dispersed throughout the building, concentrated in foyers, corridors and public areas less affected by rigid controls on hygiene, which restricted decoration of the wards. The ground-floor foyer to the children’s hospital and women’s centre is adorned with LED signs and bright screen printed tiles with patterns inspired by Islamic art, designed by Morag Myerscough. The children’s wards were fitted with colourful over-bed trays, bedside cabinets, and bed curtains with an inward-facing design, each printed with whimsical views of London created by the artist Ella Doran. In another collaboration with Myerscough, the architects Cottrell & Vermeulen were commissioned to create a playspace and a garden for the seventh-floor children’s wards, both completed in 2013. A double-height atrium was redesigned as an ‘oversized living room’, with giant prefabricated installations including a chair, a television and a lamp introducing focal points for children’s activities and games. The terrace between the north tower and the central tower was converted into a roof garden designed to evoke an ‘enchanted forest’ with a shingle-clad den, a tepee and a pergola, enclosed by wicker fencing to mask the ubiquitous blue glazing. Elsewhere there are signs of continuity and tradition, such as the entrances to the south block referred to as Cavell and Lückes. The south concourse on the ground floor of the central block contains the London Hospital Bell, donated by Thomas Lester of the Whitechapel Bell Foundry to mark the opening of the institution’s first purpose-built hospital in Whitechapel Road in 1757.10

  1. Building Design, 13 August 2004: St Bartholomew’s Hospital Archives & Museum, SBHSHA/7/1a. 

  2. ‘Building Renewal: Healthcare’ supplement, Building, Vol. 260, No. 7881, 24 February 1995, pp. 4–29. 

  3. Building, 17 May 1996, p. 7: Hospital Development, Vol. 35, No. 8, September 2004, pp. 6. 

  4. Building Design, 7 November 2003, p. 2; Building Design, June 2003, p. 2: AJ, Vol. 203, No. 13, 4 April 1996, p. 7:BMJ, 14 February 1998; BMJ, 4 July 2017: Bernard Tomlinson, Report of the Inquiry into London’s health service, medical education and research (London, 1992): Construction News, 17 October 1996. 

  5. AJ, Vol. 220, No. 17, 4 November 2004, p. 5: Building Design, 6 August 2004, pp. 1, 9; 13 August 2004, pp. 8–9; 27 August 2004, p. 1; 12 November 2004, p. 4; 19 November 2004, p. 3: Hospital Development, Vol. 35, No. 8, September 2004, p. 6. 

  6. RLHA, RLHLH/S/1/3; RLHLH/A/5/15, pp. 318–21:

  7. Care Quality Commission (CQC), ‘Barts Health NHS Trust Inspection Report’, 12 February 2019 (online: 

  8. CQC inspection, 12 February 2019. 

  9. CQC inspection, 15 December 2016 (online: Guardian, 8 March 2006 (online: elegraph, 5 March 2006 (online: mothball-250-beds.html); 18 July 2015 (online: 2bn-every-year.html): Bayards (online:; /about-us). 

  10. Icon, No. 119, May 2013, pp. 59–60: Building Design, No. 2050, 1 March 2013, p. 2: 

Brewers' Company almshouses and garden
Contributed by Wendy_F on May 12, 2018

In 1882 the Rev. Sidney Vateber and his charitable committee turned a ‘dirty and neglected piece of ground in front of the Brewers' Company almshouses (funded by John Baker's charity) on the south side of Oxford Street (now Stepney Way), just at the rear of the London Hospital, from a public nuisance, which it was, into a thing of beauty.’ The half acre ground, donated by the Brewers' Company, was provided with landscaping, iron gates, and an ornamental water feature with fish. A garden house was gifted by Lord Brabazon who founded the Metropolitan Gardens Association in the same year. The garden was intended for the use of patients, particularly the many consumptives, and local working people. Mrs Charles Cheston gave a water filter installed with ‘homely white crockery-ware mugs’ and a notice to ‘please help yourself’. The donors, it was reported, ‘will feel amply rewarded… when they see working-men spending their dinner-hour... washing down their bread and cheese with a draft of fresh, filtered water'.1 Some of the charitable contributions had questionable origins. Charles Cheston was for decades solicitor to William Amherst, Lord of Hackney, and oversaw construction of much of Dalston and Stoke Newington. When Cheston committed suicide in 1906 it was discovered he had embezzled around £250,000 (perhaps £25m today), ruining Lord Amherst. Charles Cheston was also for many years trustee and treasurer of the East London Hospital for Children.

  1. East London Observer, 8 July 1882 

Rashid Ahmed's description of working in the Royal London Hospital
Contributed by Survey of London on Feb. 20, 2018

Rashid Ahmed is a Rehab Support Worker on the Community Stroke Team at the Royal London Hospital, here he describes how the team work in the hospital and local area.

"[The Royal London Hospital] is one of the main hubs for taking on patients. We get patients from various parts of London. They’re not necessarily just from Tower Hamlets. However, once they're here and we're doing ward based work we might be treating patients from the borough and out of the borough. But once patients or ourselves are off the ward, we're community-based, we’re predominantly working on patients from Tower Hamlets.

It is a huge facility we have here, with space and resources. We didn’t move in immediately once the hospital had opened because we had our own service changes within our department, and we probably came in probably a year or two later once the building was trying to open up and start accommodating and delegating space for specific services. We’re here now, yes. We’ve been here probably two, three years now.

We're the stroke platform part of the neuro-team. We deal specifically with stroke patients. [We are based] on the second floor, we have one office dedicated to the stroke team…They’re also working on a ward based on the third floor. Where we are based now is one of the gyms of three or four gyms. This gym is used for neonatal patient’s exercise groups as well as in-house training.

We certainly do use other parts of the hospital in terms of recruitment and training, our own personal development. We have other rooms dedicated for us when we need to have access to other rooms just for, like for example my timetable we try to schedule the patients and its therapist.

Some rooms are equipped with projectors, computers. Other rooms don't have anything in it. Again there could be different group sizes, so you're fishing around for appropriate space for specific training rooms.

The building we have now is far more superior [than the former hospital] in the sense that it's very modern, updated equipment, more space, even on the ward, even for patient specific rooms.

However, when they built these departments, I think that this is just my own personal opinion, is that they need to accommodate more input from the people who will be working within the building. I don't know where they get their -- who their consultants they design this with.

But they should consult with frontline workers because they’re the people who know what's needed. The space is always an issue regardless, even though we have more space it’s still an issue when you're moving around large pieces of equipment within rooms that we still consider to be spacious.

But it is easier when you've got patients who are severely unwell and require more than one health professional within the room. It becomes quite tight when you have these specific treatments to help the patient recover. There’s a lot to take in when we're thinking about space and resources...

We use the shops that are around here. Tower Hamlets, Whitechapel, is vast for food. We've got large options and variations for types of food that you might want. You might want Indian fried food, one might want sandwiches. There's options and the availability is there.

We also have a restaurant on the site on the fifth floor. That’s an option for staff and families and carers. We also have a cafe on the Ground Floor. We're not short for options. There's a lot to choose from.

Our team is made up of people who come from all different walks of life. Some people come from South London, some people are coming from Walthamstow. People come from different places or commute, some on bikes, depending on the time of the year, some with trains and underground. Yes, it's quite varied."

Rashid Ahmed was interviewed by Shahed Saleem at the Royal London Hospital on 26.02.16. The interview has been edited for print.

The Royal London Hospital, view from the north-east
Contributed by Derek Kendall

The Royal London Hospital, view from the north
Contributed by Derek Kendall

Statue of Queen Alexandra by George Wade, 1908
Contributed by Derek Kendall

View from the 8th floor of the Royal London Hospital, looking west
Contributed by Shahed Saleem

The Royal London Hospital, view from East Mount Street
Contributed by Derek Kendall

Royal London Hospital under construction, c.2010, photograph by Chris Redgrave
Contributed by Chris Redgrave

Royal London Hospital, view from the north-west in 2013, photograph by Chris Redgrave
Contributed by Chris Redgrave

Royal London Hospital, view from the north-west c.1999, photograph by Chris Redgrave
Contributed by Chris Redgrave

Plans of demolished nurses' homes (Old Home and Alexandra Home) - drawing by Helen Jones
Contributed by Survey of London

Plans of nurses' and doctors' housing (Edith Cavell Home, Resident Doctors' Hostel and Knutsford House) - drawing by Helen Jones
Contributed by Survey of London