ROUND TABLE 2017

An holistic arts and environment strategy for Community Hospital

An evidence-based, retrofit arts and environment strategy for the new East Lothian Community Hospital in the town of Haddington.

“Nature’s peace will flow into you as sunshine flows into trees.

The winds will blow their own freshness into you and the storms their energy, while cares will drop off like autumn leaves.”

John Muir ROUND TABLE 2017 2

CONTENTS

Vision 3 Strategic Objectives 3 Background 5 1. The Aims of East Lothian Community Hospital 5 2. Benefits of the Arts in Healthcare Environments 5 3. Creative Context 6 4. Funding Context 6 5. Design Principles 6 Thematic Approach 7 Proposed Projects 8 1. Public Spaces – Exterior 9 2. Public Spaces – Interior 14 3. Wayfinding 19 4. Therapeutic Design 22 5. Creative Events 31 Next Steps 33 Costs 34 Research and Consultation 35 Acknowledgements 36 Appendices 37 ROUND TABLE 2017 3

VISION STRATEGIC OBJECTIVES

The aim of this document is to propose an holistic, COMFORT dementia-compliant art and environment strategy that supports an ongoing patient-centred approach to care. Create a compassionate environment where creativity is integral to physical and emotional healing. In realizing this strategy, we will create an inclusive, people-centered healthcare environment where nature Help to meet the emotional needs of people in hospital by and the arts are instrumental in improving the physical including them in decisions about the spaces they occupy. and mental wellbeing of patients, staff and visitors. ABSORB Provide calming creative focal points that help to regulate mood and reduce anxiety in patients.

ACTIVATE Inspire staff, patients and visitors by providing interesting opportunities for physical and mental engagement.

Encourage public use of the building and its grounds, embedding the hospital within the East Lothian community.

LOCATE Create an easily navigable building accentuated by intriguing creative spaces and happenings.

Permeate the hospital building and grounds with relevant artworks that draw upon the unique landscape and stories of East Lothian. ROUND TABLE 2017 4

East Lothian Community Hospital Visualization of view looking towards Outpatient Department Image courtesy of Keppie Design ROUND TABLE 2017 5

BACKGROUND

1. BENEFITS OF THE ARTS IN 2. THE AIMS OF EAST LOTHIAN HEALTHCARE ENVIRONMENTS COMMUNITY HOSPITAL The provision of a creative material The new hospital is being built to: environment has an evidenced impact on the wellbeing of • Provide facilities that are up to date, fit for purpose, people who are experiencing physical or mental illness. and meet patient privacy and dignity issues. Incorporation of the arts in healthcare • Repatriate some services closer to home environments can reduce the levels of for the population of East Lothian. medication people require and can alleviate stress, • Bring together the NHS services that are as well as shortening the length of hospital stays: currently dispersed across East Lothian to improving the wellbeing of staff and patients means allow maximum integration to take place. improving the overall efficacy of the hospital. • Support the Scheduled and Unscheduled Care “The Psychological and Social Evidence shows that harnessing the arts • Plans by providing increased facilities locally Needs of Patients” in healthcare contexts contributes to: and releasing space within sites. British Medical Association, 2011 • Reduced drug consumption • Deliver strategic plans for transforming the way health services are delivered in the future, • Shorter hospital stays including greater integration with social care • Improved mental, emotional and spiritual wellbeing services and the shifting of care from acute • A reduction in violence and aggression to community health/ social care settings. • Increased job satisfaction and The hospital projects include the re-provision of all higher staff retention rates services at both the Roodlands and Herdmanflat Hospitals. • Better quality of service Pending the transfer of all clinical services to the new hospital, the existing buildings at Roodlands will be demolished and the Herdmanflat Hospital will close. ROUND TABLE 2017 6

BACKGROUND

3. CREATIVE CONTEXT 4. FUNDING CONTEXT East Lothian is home to a vibrant creative community. A core fund of £500,000 has been committed from A healthy formal and grassroots cultural scene revolves Edinburgh and Lothians Health Foundation to support around music, theatre, the visual arts, sport and therapeutic arts activity around the site. This will be food, and can provide the framework for a diverse augmented by additional funding from external sources approach to creative engagement at ELCH. where possible and appropriate.

Site-specific commissioning of permanent Since funding conditions do not allow for a paid member of work is proposed to take place in a number of staff to oversee an ongoing programme of creative activity locations using a range of approaches: at the site, alliances with key local organizations and community groups will be established and nurtured at the outset, so that sustainable arts and health activity arising • Direct approach where an artist or organization from this strategy can be sustained going forward through can be specifically identified and invited to establishment of relationships with key NHS staff. develop a proposal for a predetermined site • Open call where a brief is issued publicly and artists and organizations can respond with proposals 5. DESIGN PRINCIPLES • Collaboration between identified artists Keppie Architects have developed a thematic approach to and community groups, healthcare distinguishing each floor using colour. Verdant greens on users and healthcare providers the ground-floor suggest plant life and vegetation, warm oranges on the first-floor recall buildings and hills, while rich blues on the second-floor are a visual link to the big Community partnerships will ensure the engagement of skies and coastline of East Lothian. people from all age groups, and diverse social and cultural backgrounds in the creation of meaningful work that has genuine significance for the East Lothian community.

Cultural events and initiatives will be encouraged to interact with the hospital building and grounds, embedding the site within the social fabric of the surrounding area and working to ensure sound partnerships are established as a legacy of the initial investment. ROUND TABLE 2017 7

THEMATIC APPROACH

It is proposed that projects identified throughout this strategy will use the environment of East Lothian as overarching creative stimulus.

Into this broad theme a range of uplifting, personal and relevant sub-themes can be woven to:

• Tell local stories that examine the unique cultural heritage of East Lothian. • Explore the rich urban, wild, industrial and agricultural landscapes of East Lothian. • Celebrate communities and landmarks.

The hospital building and grounds will be enveloped in art, poetry and creative spaces that celebrate and reflect the East Lothian environment and its diverse inhabitants. ROUND TABLE 2017 8

PROPOSED PROJECTS

PUBLIC SPACES - EXTERIOR 9 THERAPEUTIC DESIGN 22 • Pathway Poetry 10 • Your Own Front Door – Mental 23 • Woodland Arena 11 Health and Palliative Care Wards • Green Gym 12 • Short Occupancy Wards 24 • Eco Playscape 13 • Ambient Soundscapes 25 • Mental Health Ward Garden 26 PUBLIC SPACES - INTERIOR 14 • Sanctuary 28 • Permanent Works • Ultrasound Diagnostics 29 - Atrium Feature Wall 15 • Physical Therapy Garden 29 - Outpatient Waiting Area 16 • Fabric Design 30 - OPD Courtyards 17 • Temporary Exhibitions 18 CREATIVE EVENTS 31

WAYFINDING 19 • Ward Identities, Signage and Interior Glazing 20 • Corridors 21 ROUND TABLE 2017 9

PROJECTS PUBLIC SPACES - EXTERIOR

SUMMARY IMPACT

A series of cross-disciplinary partnerships are proposed to • Accessible outdoor spaces people can explore and develop the outdoor space at ELCH. Biodiversity specialists, engage with will establish ELCH as a welcoming horticultural designers, poets, sculptors, historians, play healthcare environment, actively promoting a healthy specialists and community groups will work in consultation lifestyle and providing opportunities for holistic with staff and patient representatives to deliver projects that physical and mental stimulation to patients, visitors and permeate the grounds with unique and intriguing spaces. staff alike.

The grounds will be physically accessible, visually impactful • As well as providing peaceful and engaging gathering and have broad appeal for people from differing cultural and and resting places for staff and patients, the outdoor social backgrounds. areas will play a preventative role, encouraging exercise, play, discovery and learning for people of all It is proposed that the grounds will house: ages in the local community.

• a poetic pathway • sculptural seating areas • a woodland walk • wildflower planting • a community orchard • an open-air gym • play areas • flexible performance space • eco-discovery zones. ROUND TABLE 2017 10

PROJECTS PUBLIC SPACES - EXTERIOR

PATHWAY POETRY Commissioning strategy: Brief to be developed and issued through local and national networks. Punctuated with poetry inspired by East Lothian‟s rich It is proposed that a poet is selected by open call, heritage a pathway will create a physical “journey‟ for and paired with local fabrication company Old joggers, walkers and cyclists, enveloping the hospital in School Fabrications to deliver this project. statements and stories that arouse curiosity and which encourage people to travel from one point to the next. Collaborators: Physiotherapy Team, East Lothian Council Access Officer, East Lothian Council Biodiversity Officer, Sculptural seating areas, fruiting trees and way markers John Gray Centre, local history groups, Blooming will be installed along the path at regular intervals. Haddington, Paths for All, NHS Activities Coordinators.

On one level the path will provide an exercise circuit Budget: £40,000 (an additional £150000 to support that encourages exploration of and engagement with the linking of a new cycle path to the existing railway the outdoors by staff, patients and visitors, encouraging paths network will be sought from Sustrans). physical activity and contributing to a healthier community: on another, it will create a powerful interpretative link to the surrounding landscape. From harbour to town and hill, this project will engage people with the landscape and cultural heritage of East Lothian.

A physical therapy garden at the rear of the hospital will be incorporated within this project. This simple space will be surrounded by shrubbery and include a pathway designed to assist in the physical rehabilitation of patients. As well as stepped and flat areas, the path will require destination points and a seating area where patients can rest.

July Poem - Kirkby Stephen Poetry Path Silage. Tractor incises the first green furrow. Skillful geomatrician, the driver judges an arc of weather. by Meg Peacocke Photo credit: https://www.flickr.com/photos/summonedbyfells/ ROUND TABLE 2017 11

PROJECTS PUBLIC SPACES - EXTERIOR

WOODLAND ARENA Collaborators: East Lothian Council Arts Service, East Lothian Council Biodiversity Officer, “The opportunity is there to have a An accessible performance pavilion for use by patients, Lamp House Music, Haddstock, Rogue Village, health facility that also serves as a staff and members of the public alike is proposed for Lammermuir Festival, Blooming Haddington. platform for local arts.” development in the grounds. A robust, permanent Consultation response structure constructed from natural materials will Budget: £60,000. demarcate space where people can watch performances or gather with friends, relatives or colleagues to eat lunch outside the confines of the building. The space will be playful in nature, allowing for flexible use including: • small-scale concerts • theatre performances • exercise groups • informal picnic gatherings • play-based initiatives

Commissioning strategy: It is proposed that local company Old School Fabrications are invited to deliver this project as part of a package including the mental health ward garden and the sculptural seating interventions along the public pathway. Appointing one company to deliver the outdoor projects will ensure design and thematic cohesion across the site, and allow for flexibility of the budget across these discrete projects.

With specialized expertise in outreach, design, carpentry, casting, public art, metalwork and project management, their work incorporates a wide variety of materials and processes to realize accomplished projects in both public and private settings.

Rounds Performance Pavilion by SPORTS http://visuall.net/2017/05/19/rounds-whimsical-outdoor-performance-pavilion-by-sports/ ROUND TABLE 2017 12

PROJECTS PUBLIC SPACES - EXTERIOR

GREEN GYM Outdoor gym apparatus will give people the opportunity of a full physical workout in a beautiful outdoor space. Promoting physical exercise boosts mental wellbeing as well as enhancing cardiovascular fitness, flexibility, balance and coordination.

The equipment will be free for use and accessible by everyone wishing to make use of it, meaning it will offer equality of opportunity to people who could not otherwise afford to use a gym.

Collaborators: East Lothian Council Arts Service, East Lothian Council Biodiversity Officer, Lamp House Music, Haddstock, Rogue Village, Lammermuir Festival, Blooming Haddington.

Advisors: ELCH Physiotherapy team.

Budget: £24,000.

The Great Outdoor Gym Company http://www.tgogc.com/Blog/Reaching-Inactive-Groups-In-Hounslow.Html ROUND TABLE 2017 13

PROJECTS PUBLIC SPACES - EXTERIOR

“There will be many older people ECO PLAYSCAPE using these services and hospital visiting for children can be a It is proposed that Infinite Playgrounds are commissioned to challenging experience.” create a hand-built natural play area in the hospital grounds. Responding to a brief developed in collaboration with local “I would urge those planning the programme to ensure that facilities children the “playscape‟ will support free play, outdoor learning and activities for children are and social, emotional, cognitive and physical development incorporated and given priority.” in users. It will be designed to enable opportunities for participation by children of all ages and abilities. As well as being Consultation responses of benefit to children attending clinics at ELCH and families visiting patients, the site could be offered for community use by local schools and nurseries, encouraging children to lead healthier lives and creating the potential for intergenerational project work with older patients making use of the grounds.

Infinite Playgrounds was named Creative Company of the Year in 2016. All Infinite Playgrounds structures conform to the British Child Safety Standards BS EN 1176 and BS EN 1177. The company are CHAS and Constructionline-registered, RoSPA and RPII Infinite Playgrounds accredited. http://www.infiniteplaygrounds.co.uk/playgrounds/sen/

Commissioning strategy: Infinite Playgrounds, by invitation.

Collaborators: Brief developed by a commissioning group, to include children of East Lothian. Advisors to include the East Lothian Play Association, a representative from the Health and Safety Team at the Royal Hospital for Sick Children, Edinburgh, the Edinburgh Children‟s Hospital Charity and Support from the Start.

Budget: £35,000 (this funding will be sought from the Edinburgh Children‟s Hospital Charity). ROUND TABLE 2017 14

PROJECTS PUBLIC SPACES - INTERIOR

SUMMARY IMPACT

It is proposed that public areas within the hospital interior • Inspiring, welcoming and relevant artworks will incorporate both permanently sited works and a variety define the overarching character of the hospital and of changing exhibitions to stimulate interest in patients, encourage people to make use of social spaces. staff and visitors. • Developing work for these areas in collaborative contexts will foster a sense of ownership and an emotional connection with the hospital within the community who are using it. ROUND TABLE 2017 15

PROJECTS PUBLIC SPACES - INTERIOR

PERMANENT WORKS The atrium has to provide an uplifting welcome to people entering and returning to the building. The space must feel reassuring for patients who are taking time away from wards, and supportive for those who are experiencing the illness and loss of loved ones. As well as the point of arrival for patients, it must be a friendly greeting space for visitors who have friends or family members in hospital.

ATRIUM FEATURE WALL The large-scale feature wall in the atrium leading to the Outpatient Department is proposed to house the outcomes of a cross-community, intergenerational project that reflects the physical geography and diverse communities of East Lothian in a series of non- conventional “portraits‟ of the region. This work needs to be visually striking and genuinely meaningful for people throughout the social and cultural spectrum.

An artist will be sought by open call to engage with children, adults and older people in workshops and reminiscence sessions to create a beautiful and intriguing series of framed photographic artworks that draw on oral histories to tell the unique story of East Lothian.

Commissioning strategy: Artist appointed by interview following open call via local and national networks.

Collaborators: Brief developed in partnership with the Arts and Therapeutic Design group, incorporating stakeholder representatives.

Budget: £25,000. Nicky Bird and Jan McTaggart: Foxbar, Paisley. Back of Annan Drive, 1977? / Back of Springvale Drive, 2007 (Detail) From Beaneath the Surface / Hidden Place 2007 - 2010 ROUND TABLE 2017 16

PROJECTS PUBLIC SPACES - INTERIOR

OUTPATIENT WAITING AREA It is proposed that an ambitious and playful sculptural work is created for the main waiting space outside the entrance to the Outpatient Department in the main concourse. The work will enliven the atrium and reduce the clinical feel of the hospital, providing an impressive focal point for people entering the hospital and those spending time in the atrium.

The artwork should be durable and low maintenance, but could be reactive in the sense that it responds peacefully to environmental changes such as fluctuating light or the movement of people through the space.

By disrupting the area with meditative movement or nuanced light, a dramatic visual focal point can be created, bringing an otherwise static interior to life.

Commissioning strategy: Artist appointed by interview following open call via local and national networks.

Collaborators: Brief developed in partnership with the Arts and Therapeutic Design group, incorporating stakeholder representatives.

Budget: £60,000.

East Lothian Community Hospital Visualization of Outpatient Department Waiting Area Image courtesy of Keppie Design ROUND TABLE 2017 17

PROJECTS PUBLIC SPACES - INTERIOR

OPD COURTYARDS It is proposed that simple plinths with electrical supply are installed in three courtyard spaces beside the Outpatient waiting areas, for use as sculptural display space. Two plinths will house permanent site-specific art works with which people can interact from the waiting areas, and the third will house a different sculpture every year, as part of the temporary exhibition programming initiative led by East Lothian Council‟s Arts Service. The work for this area needs to provide a fun, interactive focal point that occupies people whilst spending time waiting for appointments or diagnostic procedures, and must encourage spontaneous engagement from people of all ages and abilities.

Commissioning strategy: Artist appointed by interview following open call via local and national networks.

Collaborators: Brief developed by a commissioning group to include East Lothian Council Arts Service and the Edinburgh Children‟s Hospital Charity.

Budget: £30,000 (additional funding will be sought to augment this budget from the Edinburgh Children‟s Hospital Charity to ensure specific relevance to children attending clinics).

David Faithfull Earth, Wind and Fission (Detail), 2013 ROUND TABLE 2017 18

PROJECTS PUBLIC SPACES - INTERIOR

TEMPORARY EXHIBITIONS Commissioning strategy: A specification for display space will be developed in consultation with East Lothian Visually appealing secure frames and lockable “craft cube” Council’s Arts Team. This brief will be met by the same cabinets will be purchased and customized to provide designer appointed to the “Your Own Front Door” Palliative modular, flexible exhibition space in the café space Care and Mental Health Wards project. Programming will adjoining the atrium. be overseen by East Lothian Council Arts Service who have committed to including ELCH within their portfolio of arts It is proposed that an annual programme of visual art and venues as part of their regional strategy. craft exhibitions will be held at the site. The programme will be facilitated by East Lothian Arts Service who work Collaborators: Keppie Interior Designer. in close partnership with a range of artists, patient groups, local schools, community groups and guest curators. As Budget: £6,000. well as opportunities to engage staff members and patients by exhibiting examples of personal creative work, this space will help create a sense of community and of joint endeavor at the hospital.

East Lothian Council‟s Arts Manager has indicated that the changing exhibition programme at ELCH will be incorporated within East Lothian Council’s own Arts Strategy, and will join a Steering Group of hospital staff who will ensure the suitability of work for display in these spaces.

It is envisaged that the programme will also include the chance for community members of all ages, abilities and backgrounds to exhibit their work in a professional setting.

There will be no ongoing cost for this programming service to NSHL.

Changing exhibition space will exist in areas of high footfall including: Old School Fabrications • The Café and Atrium Bespoke cabinets for Selected exhibition at Dovecot, Edinburgh • The OPD Courtyards ROUND TABLE 2017 19

PROJECTS WAYFINDING

SUMMARY IMPACT

Commissioning to support wayfinding and orientation is • Forging distinct ward and departmental identities proposed to take place throughout the site by creating will reassure people by making the building easier to visually unique thematic identities for wards and navigate. departments, within which signage and artworks will be selected. • Enhancing wayfinding will generate familiarity with the building among staff, patients and visitors, increasing operational efficiency and improving productivity levels throughout the site. ROUND TABLE 2017 20

PROJECTS WAYFINDING

“I had a major operation WARD IDENTITIES Commissioning strategy: A brief to be developed and before it was too ill to and issued through local and national networks. care, however after the Staff in existing named wards have expressed a desire Artist / designer to be appointed in consultation operation I had to stand to mark the move to new premises by renaming with the Arts and Therapeutic Design Group. up immediately and I their wards. It is proposed that each ward is given had to walk every day, a new name and distinct visual identity to assist that walk along the Collaborators: Keppie Interior Designer. corridor was the perfect with wayfinding and to celebrate the beginning of place for art, or for art a positive new era in East Lothian healthcare. Budget: £24,000. at the end of it” Additionally, it is proposed that an artist is appointed to create a set of identifying graphics Consultation response for each of the six wards, in the OPD, the Mental Health OPD and on the Therapies floor. Graphics will be placed: • at ward entrances • on interior glazing • on signage

Thematic approaches will be agreed in consultation with staff and will be consistent in relation to ward names and within the overarching theme, celebrating the environment of East Lothian. Themes for consideration could include: • Coastal ecology • Agricultural communities and stories • Ecology of the Lammermuir hills • Geographical landmarks of East Lothian • Industrial history • Heritage paths, the Herring Road • The writings of John Muir

East Lothian Community Hospital Looking towards Main Reception Image courtesy of Keppie Design ROUND TABLE 2017 21

PROJECTS WAYFINDING

CORRIDORS

Newly commissioned work is proposed to align with ward identities and positioned along and at the end of corridors, where it should constitute a destination point for people.

As well as differentiating wards and floors from one another, it should discourage people from going through doors to the outside of the building.

Existing work from the NHS collection will also be carefully selected to extend the thematic identity attributed to each ward. It is proposed that a review of existing work is undertaken and selected from in conversation with Ward staff.

Commissioning strategy: Artists appointed by open call.

Collaborators: Ward Staff.

Budget: £55,000.

Oak Prints by David Faithfull ROUND TABLE 2017 22

PROJECTS THERAPEUTIC DESIGN

SUMMARY IMPACT

Spaces within the hospital building will be individualized • Meditative artworks and interventions will mean and softened with soothing creative interventions people are comforted and anxiety is reduced. including visual artworks and sound. • Reducing the clinical feel of the hospital will help to create an inclusive healing environment where people feel safe, looked after and at ease.

• People in areas of emotional intensity will be afforded space for ‘time out’, and provided with contemplative focal points that promote relaxation, helping to counteract negative or destructive thoughts. ROUND TABLE 2017 23

PROJECTS THERAPEUTIC DESIGN

“From my mother’s last days in YOUR OWN FRONT DOOR – Commissioning strategy: Brief for visual art hospital I know how important a MENTAL HEALTH AND PALLIATIVE work developed in consultation with patients view of the outside was to her. and advertised through local and national I like the idea of hospital being CARE WARDS firmly rooted in and reflective networks. Designer appointed by open call. of its place in the landscape.” Allowing people living in hospital the opportunity to influence the environment around them will be vital in Collaborators: Ward staff, Patients, Keppie Interior Consultation response creating a sense of being “at home”. Creating ownership Designer, NHS Activities Coordinators. over personal space will encourage reassuring feelings of safety and security, reducing the clinical feel of Budget: £50,000. these wards and softening the environment for people experiencing challenging mental and physical health issues.

It is proposed that a designer is appointed to work with patients and families in both wards to individualize bedrooms, including the procurement of a series of cabinets and frames to house personal objects and images within bedrooms and outside bedroom doors. As well as assisting with wayfinding, these visual prompts will differentiate otherwise identical doorways from one another, reinforcing a sense of personal space and helping people feel at ease and at home. Frames and cabinets will be pre-printed with simple graphics, so they are never empty in the event that personal images are not available for use, in both wards, original works are proposed for purchase as opposed to multiples.

As people are likely to experience emotional moments in these rooms it is important that art works are unique, so that distressing feelings are not triggered if replicas are encountered unexpectedly in other contexts. Work positioned in communal areas and corridors will assist with wayfinding. All the work in these wards should be dignified, peaceful in tone, and reflect the contemplative beauty of the natural world. Image from “Washburn & Co.’s amateur cultivator’s guide to the flower and kitchen garden : containing a descriptive list of two thousand varieties of flower and vegetable seeds : also a list of French hybrid gladiolus,” (1869) ROUND TABLE 2017 24

PROJECTS THERAPEUTIC DESIGN

SHORT OCCUPANCY WARDS For the Short Occupancy Wards on the first and second floors, it is proposed that a series of printed multiples that embody the ward and departmental identities is purchased for display in each bedroom.

Commissioning strategy: Targeted purchasing within guidelines laid out in the NHS aquisitions strategy.

Collaborators: Keppie Interior Designer, Arts and Therapeutic Design Group.

Budget: £15,000.

Anna Davis - Red Ukelele (Detail) Screen Print ROUND TABLE 2017 25

PROJECTS THERAPEUTIC DESIGN

Award-winning Composer Pippa AMBIENT SOUNDSCAPES Commissioning strategy: A comprehensive brief Murphy has directed creative will be developed in consultation with patients and education projects throughout Playlist for Life, currently being trialled in East Lothian, families. It is proposed that celebrated East Lothian the world and has worked in explores the use of specific pieces of music with composer Pippa Murphy is commissioned to create this many different musical and personal resonance for people with dementia as an aid social contexts. She has devised personal work with patients, families and ward staff. pieces and trained teachers with to reminiscence and invoking a sense of belonging; the British Council in Scotland, “Playlists can help people with dementia feel safe and Collaborators: Ward staff, Patients, Families, NHS Syria, Vietnam, Botswana, Activities Coordinator Dementia Friendly East Lothian. India, Iran and China. that they belong; they can bring families and partners closer together and keep memories and relationships She has composed with asylum alive.” – Sue Northrop, Dementia Friendly East Lothian Budget: £10,000. seekers in Glasgow, Manchester and Edinburgh and lectures Patient representatives as well as music therapists and at Edinburgh, St Andrews and activities coordinators currently practicing within the Aberdeen Universities. She existing dementia care facility are passionate about the works regularly in cross-arts potential of music and sound to stimulate and reassure and multi-media collaborations and has worked with ensembles patients. Sound has the power to unlock memories including Scottish Opera, and feelings, to mentally “transport‟ people and to Scottish Ensemble, BBC SSO, enthuse and inspire in a variety of ways. Importantly, McFalls Chamber, Red Note the neurochemical impacts of music can also include the Ensemble and SOUND Festival. easing of pain, confusion and distress, meaning it has the potential to reduce the need for psychotropic medication.

It is proposed that patients on this ward work with composer Pippa Murphy to produce a series of immersive ambient soundscapes for use on this ward. Spellbinding sonic tracks will immerse listeners in a patchwork of familiar sounds from nature and daily life in both rural and urban contexts, enabling them to travel beyond the hospital in mind and memory. An easily operated device on which patients can play music, personal recordings and soundscapes will be purchased for bedrooms to enable individual choices to be made, and to give people control over what they listen to.

Still from Pop-Up Duets Pippa Murphy and Janis Claxton ROUND TABLE 2017 26

PROJECTS THERAPEUTIC DESIGN

MENTAL HEALTH WARD GARDEN Spending time outdoors in natural daylight is widely acknowledged to boost mood, stimulate brain function and reduce feelings of depression and anxiety, as well as regulate sleep. The secure garden outside the continuing care ward for people with dementia will be a safe space that is crucial in helping people living in the mental health ward stay connected with the outdoors.

Consultation with staff and patient representatives from the current dementia ward at Herdmanflat Hospital reveals that patients do not go outside often at present. Lack of access to outdoor spaces can quickly result in fear about going outside, meaning people then lose access to the myriad physical and mental benefits associated with spending time in the open air.

It is therefore proposed that a creative team is commissioned to develop the Mental Health Garden in close consultation with patients, families and ward staff.

The garden will incorporate: • A shelter • Tactile surfaces • A meandering pathway • Raised beds • Sensory and productive planting • A water feature ROUND TABLE 2017 27

A shelter built with tactile materials will provide a transitional seating area where people can spend time outside while still feeling enclosed and protected.

Sensory, productive planting and a water feature will attract wildlife and provide multi-sensory stimulation for people spending time in the garden.

Activities: Productive planting of herbs, fruit and vegetables in raised beds will offer therapeutic planting and harvesting activities patients can take part in alongside Activities Coordinators and visitors as well as volunteer gardeners. Because some patients use wheelchairs or need to be seated, beds should be built to allow wheelchairs and seats to sit beneath the surface.

Low maintenance flower beds visible from inside the building will reflect the passing seasons by incorporating plants that change colour and form throughout the year, and patients will be actively involved in planting choices for this garden.

Discussion with nursing and activities staff highlights the potential for a social engagement project run by NHS Activities Coordinators, involving selling of garden produce at a regular event, or by honesty box in the atrium.

Commissioning strategy: A brief will be developed in consultation with patients, families and ward staff. It is proposed that local company Old School Fabrications are invited to deliver this project along with other developments in the hospital grounds, including the performance arena and sculptural seating interventions along the pathway.

Collaborators: Ward staff, Patients, Families, NHS Activities Coordinators, Dementia Friendly East Lothian, Blooming Haddington. NHS volunteers, Royal Voluntary Service. St. John’s Hospice - A Modern Apothcary RHS Chelsea Flower Show 2016 Designed by Jekka McVicar, Built by Crocus Budget: £50,000. ROUND TABLE 2017 28

PROJECTS THERAPEUTIC DESIGN

“I would like to see carers involved SANCTUARY more in the design of spaces for both the patients and when The “reflective space” situated on the ground floor visiting someone in long term overlooks a courtyard garden, adjacent to the waiting hospital care, where you can go area for the ground floor lift. This space has to provide for privacy, design of spaces for dementia patients, and patients a sanctuary for people in need of a peaceful moment with different health needs, away from busier public zones, and is likely to be used by the design has to be right for people during moments of emotional intensity. It is an area everyone.” that needs to allow people to console, contemplate and meditate. As such it is important that the space affords Consultation response privacy, without being sealed off from view completely.

It is proposed that an artist is commissioned to work in collaboration with a horticultural designer to create an artwork that transforms the room and adjoining courtyard into one coherent tranquil and comforting environment incorporating images, words, plants and sculptural seating solutions.

Because the reflective space