Flagship NHP project sees vision become reality

The Midland Metropolitan University Hospital (MMUH) in Smethwick in the West Midlands stands as a testament to the transformative power of architecture, not only as a healthcare facility, but as a revitalising force within its community. As architects, HKS, Cagni Williams, and Sonnemann Toon, began this journey a decade ago, stepping onto a site that had seen better days — a closed Unipart warehouse stood on the site of one of the first GKN car part factories. Surrounded by a neighbourhood facing economic hardships, declining urban quality, and some of the UK’s poorest health outcomes, MMUH was designed to offer more than clinical services; it was conceived as a modern hub to foster health, community, and regeneration in Sandwell, West Birmingham.

One of Europe’s most advanced hospitals

Today, MMUH is one of Europe’s most advanced hospitals, pioneering innovative design, digital technologies, and green spaces. This flagship project, part of the UK’s New Hospital Programme (NHP), sets a new standard for clinical healthcare design, as well as being a community regeneration catalyst. The hospital provides emergency department, maternity, children’s, and adult acute inpatient services in an environment that is purpose-built for clinical teams to work together.

The building is a large area of accommodation, with approximately 80,000 m2 of clinical space, and 50,000 m2 of associated parking, built on a 16.7 acre site. Analysis of the brief produced a natural stacking of functions, with wards at the top, clinical areas in the middle, and the car park at the bottom, a unique and efficient arrangement for a building of this type. A clear and logical stacking of floors and functions maximises usable floor area, provides direct patterns of use, achieves desired clinical adjacencies internally, and satisfies maximum clinical travel distance requirements. By breaking down the functions into separate but related parts, with significant set-backs at levels 2 and 5, we reduced the scale and massing of the building so that a suitable human scale is achieved.

We also used the fall across the site of approximately 7 m to embed the lower parts of the building within the slope, thus further reducing its perceived mass and height. This provides a fully covered car park, providing safe access for staff and patients, and a drop-off for taxis, buses, and patient transport. In addition, the internal wayfinding via well-designed spaces allow visitors to navigate without the need for maps. This can be achieved by blending architecture, medical planning, interior design, and environmental graphics. We developed an efficient design with future-proofing in mind, based on a 7.8 x 7.8 m grid without internal shear walls, which allows for changes and updates without major disruptions or excessive costs in the future. Together, we put together an exhaustively researched ‘Design Standards Review’ report challenging previous NHS guidance, and this helped the scheme gain the support of the Trust Development Authority. 

Future-proof and flexible design

A foundational aspect of MMUH’s architecture is its flexibility — a core consideration that is vital to ensure that the hospital remains adaptable to evolving healthcare needs. The use of external cross-bracing eliminated the need for internal shear concrete walls, creating open-plan floors so that partitions can be placed where needed across all levels. This approach allows for a modular, adaptable layout that seamlessly spans parking, clinical zones, and wards without costly transfer structures. MMUH’s standardised internal structural grid layout provides the framework for spatial reconfigurations, supporting everything from minor refurbishments to major future expansions. This spatial flexibility not only positions MMUH as a ‘hospital of the future’, but also aligns with sustainable principles by extending the building’s lifespan through thoughtful, adaptable design. This future-proofing concept we designed 10 years ago is now one of the requirements identified by the New Hospital Programme.

Building quality and flexibility through prefabrication

Prefabrication played a crucial role in achieving high-quality construction and future adaptability at MMUH. The prefabricated façade — including the ETFE-inflated pillow roof over the Winter Garden — allowed for a rapid, efficient build while maintaining rigorous quality standards. As a consequence of the single grid, the prefabricated unitised façade is regular throughout the building. This modular approach also enabled significant adaptability. For example, following the Grenfell Tower incident, we were able to update the ward façades from the original specification of timber to terracotta without dismantling the existing facade support system. By building with resilience and quality in mind, MMUH stands ready to adapt to future standards and changes in the healthcare landscape.

Green spaces and biophilic design

One of the most distinctive elements of MMUH is its integration of biophilic design principles — a concept used within the building industry to increase occupant connectivity to the natural environment through the use of direct nature, indirect nature, and ‘space and place’ conditions, and thus promoting wellbeing through its the presence of nature. Greenery is woven throughout the hospital — from multi-level terrace planting to the 17-acre fully landscaped site with a large public green space, large enough for a cricket game. These green spaces do more than soften the building; they actively contribute to mental health, encourage physical activity, and support local biodiversity, not just for the benefit of patients, but the staff too. As a hospital dedicated to its community, MMUH’s green spaces serve as shared community assets, making the hospital a welcoming and inspiring destination beyond healthcare needs.

Six internal courtyards bring daylight into the ‘hot’ clinical areas, and are fully landscaped with mature trees and a variety of planting to offer natural views deep in the hospital plan.

MMUH is at the forefront of digital healthcare innovation, incorporating advanced systems that improve both patient care and operational efficiency. Central to this is an automated robotic distribution system (ARDs) that handles the delivery of medical supplies, medications, and essentials throughout the hospital. This technology minimises the manual handling of materials, reduces errors, and significantly boosts the speed and accuracy of logistics. By streamlining hospital operations, MMUH allows clinical staff to dedicate more time to direct patient care, establishing a model of efficiency that sets new standards for healthcare facilities.

Key technology and automation features

We summarise the main hospital technology and automation features:

• A wide range of advanced technologies has been integrated into MMUH to enhance efficiency, safety, and patient care throughout the hospital.
• Automated Guided Vehicles (AGVs): Aerocom’s AGVs automate the transport of heavy loads such as pharmaceuticals, linen, and equipment, across the hospital, saving man-hours, and allowing porters to focus on patient-facing duties, enhancing overall operational efficiency and care delivery.
• Next-generation pneumatic tube systems: Aerocom’s pneumatic tube systems stand out due to their advanced control software, RFID tracking, real-time automatic diagnostics, customisable security options, and integration with the Building Management System, offering greater efficiency and reliability.
• Advanced diagnostic systems: Cutting-edge MRI and ultrasound machines from Siemens enable rapid and precise diagnoses, ensuring exceptional care delivery.
• Stixx Pro fire suppression technology: A Swedish-designed Potassium-based system extinguishes fires without residue or damage, ensuring minimal disruption and maximum safety.
• Digital infrastructure: Schneider Electric EcoStruxure Solutions: A centralised IoT platform integrates HVAC, lighting, and power systems, enhancing efficiency, safety, and sustainability.
• 5G system and digital wayfinding: A 5G network powers advanced navigation tools, providing seamless, interactive wayfinding for patients and visitors.
• Fully converged cloud-based IT network: A unified IT platform simplifies management, enhances security, and supports real-time collaboration across the hospital.
• Digital design: BIM and Digital Project Management. BIM and cloud-based tools ensure precision, transparency, and collaboration, throughout the hospital’s design and construction.
• Drone-assisted operations improve safety and efficiency in building inspections by reducing the need for manual access to hard-to-reach areas.

MMUH’s role extends beyond healthcare; it is a catalyst for local economic and social revitalisation. Our original masterplan envisioned MMUH as a central hub, surrounded by new development plots and public spaces that encourage community interaction.

With the development of the inclusive masterplan on the 17-acre site, we encouraged and created permeability into and through the site and along the existing canal arm. Careful positioning of the development to the north of the plot allowed us to open up the south of the site for public green space, which is a valuable asset for both the hospital and the local community. Further south, additional development plots were identified and located so that these could be developed without affecting the main hospital activities.

The £15 m Towns Fund grant from Sandwell has further supported this vision, funding a new Learning Centre on one of the development plots, where healthcare education and career development initiatives will benefit both the hospital and the wider region. These efforts are part of a broader regeneration plan — the Sandwell Corridor, ensuring that MMUH positively impacts not just its patients, but the entire community.

Site-related challenges and architectural solutions

Transforming this historical industrial site into a cutting-edge hospital presented its own challenges — from logistical issues to the need for environmental remediation (there was a lot of abandoned asbestos in underground cellars that we discovered), and dealing with the unused dead end of the canal arm that cut across the location of the green. Yet, by respecting the site’s heritage (we now have the main part of the canal arm fully incorporated into the site, and the wider area masterplan, with its connection to the main canal), and viewing them as opportunities rather than as obstacles, MMUH’s design merges the area’s industrial legacy with forward-thinking architecture. This synergy of past and future underpins MMUH’s role as a beacon of healthcare and community empowerment in the region.

Conclusions

Healthcare institutions need architects to design spaces that are flexible, adaptable, and sustainable, and that can improve patient experience and health outcomes. The Midland Metropolitan University Hospital is a milestone in hospital design — a facility that embraces adaptability, integrates advanced technologies, and fosters a sense of community. More than just a hospital, MMUH is a resilient, future-ready institution that addresses immediate healthcare needs while laying the foundation for broader community development. With its advanced design, commitment to sustainability, and digital innovations, MMUH exemplifies a modern approach to healthcare that will inspire similar transformations across Europe.

The project was designed around the concept of a new approach to healthcare through wellbeing for both patients and the staff. The number of people using both the winter garden and the outside space is a fantastic testament that our vision has not only been understood, but is also much appreciated. It is a confirmation of how crucial it is to develop and communicate a strong, clear vision to all stakeholders, and to maintain this throughout the construction.

A tight-knit collaboration between the Sandwell and West Birmingham NHS Trust, the architects’ team, HKS, who expertly led the project team, Cagni Williams, who led the design, Sonnemann Toon for its invaluable clinical concept, Balfour Beatty, and all the consultants involved, together, turned this vision into reality.

Several meetings, in-depth reviews, and small focus groups, have been critical to inform and engage both the NHS and external stakeholders, building trust and support. In conclusion, we believe that MMUH solidified our expertise and experience in designing and delivering new generation, large-scale hospital projects — and we loved every moment of it.