I gasped when I first set foot on Snow Fox. An actual, audible gasp. I didn’t know hospitals could look and feel like this. But even then, at my most hopeless, I couldn’t help but feel buoyed up by the surroundings. Everywhere there were tones, shapes, materials, pictures and words to steal the attention, little hooks for the minds and senses of children and adults alike.
It was a hot, rainy weekday in June 2019 and we had come to Snow Fox, a ward for regular paediatric outpatients at the Evelina London Children’s Hospital, with our three-month-old daughter, who needed a blood transfusion. Though she was, as yet, undiagnosed, we were beginning to realise there was something gravely wrong. She’d been admitted to our local hospital three weeks earlier with a haemoglobin level that was termed “incompatible with life” and been transfused over a number of days. There, the ward’s bare walls bore peeling paint and our bed overlooked the hospital’s bins. The bleakness of our circumstances was mirrored by the environment.
But not on Snow Fox. Experiencing its warm lighting, bright colours and upbeat design, I was instantly struck by a calm I hadn’t felt since before my daughter was born, and a confidence that this was the place we needed to be.
“We knew people would be coming back to Snow Fox frequently, so the art needed not to feel stale,” says Peter Shenai, creative strategist at Art In Site, an organisation that transforms caring spaces with art and design, and which led on this aspect of Snow Fox’s renovation less than a year before we first went there.
My daughter was subsequently diagnosed with a rare blood disorder, Diamond-Blackfan anaemia, and has a blood transfusion once every three weeks in order to stay well. Three years on, she still receives her treatment at Snow Fox and we both find new things to see and enjoy on the ward each time we go, from graphic illustrator Andy Goodman’s bedhead puns (such as bed 10’s “Getting ahead of oneself”, in which the torsos of running bodies are detached from and ahead of their legs, and treatment room B’s “Owls and a pussycat”, where the viewer is encouraged to seek out the single cat in a sea of owls, its shape the same as one of the owls, but turned upside down) to the playful marquetry panels on the walls made from glossy and matte hygienic PVC wall-cladding materials – an example, says Shenai, of working innovatively within “a different set of constraints”, including fire-resistance and infection- control compliance. Among the panels at the Evelina is the eponymous snow fox in grey and white, accompanying families down the corridor to their bay, a treatment room or the parents’ kitchen.
As the parent of a child who is dependent on hospitals to sustain life, it took me a while to admit to the difference a well-designed ward made to my family’s sense of wellbeing. It felt shallow to prize aesthetics so highly when they were merely the backdrop to my daughter’s life-restoring treatment. But as our visits to Snow Fox became more routine, I began to feel the impact of our surroundings holistically. Everyone, staff and parents alike, seemed at ease, which could only, I thought, be good for my daughter’s experience of the place.
Bringing this kind of empathy to the process is entirely the point, agrees Louisa Williams, who set up Art In Site in 2003. “We talk about the building being part of the care team,” she says, “and art and design as an extension of the bedside manner, which goes beyond the bedside to our journey there, the places where we wait, the whole of the hospital space.”
Art In Site was commissioned by Liz O’Sullivan, arts manager for the Guy’s and St Thomas’ Trust (GSTT), to redesign several areas of the Evelina, which treats newborns up to 18-year-olds, with an approach that is not just aesthetic but also pedagogical. The challenge was to address a sweet spot between what patients, their parents and clinicians all felt was important in a space that was to be as inspiring as it was distracting and soothing. “It’s not about being childish; it’s about being young-friendly,” she says, with things to see and engage with that support play therapy, which in turn aids with cooperation in kids.
With this in mind, several conceits were developed with manga artist Kiriko Kubo for different areas of the hospital – the Evelina Gang, a group of characters of mixed abilities, backgrounds and ages, to explain processes in cartoon strips along the walls of paediatric A&E and phlebotomy; and in the main building, baby animals to inhabit “different terroirs” of the hospital. In Arctic, for example, Wolf is a clinical research facility with friendly pictures and fun facts about baby wolves across its walls. “Wolves act as a pack,” says O’Sullivan, as do arctic explorers and patients on clinical trials.
In Sky, a cardiac unit, Art In Site installed a backlit Corian wall featuring a line of trees with singing birds peeking out from their greenery and frogs on the ground. The scene is animated by the movement of the sun, which lights up in different areas of the sky according to the time. An illuminated disc over the trees signals that it’s 7am and time for breakfast, whereas a yellow circle of light up high says it’s lunchtime. At night, this circle is white and represents the moon. “We’d heard that children get disoriented about time in hospital,” says Williams, “so these beautiful colour shifts, which move through the day, were designed to give them those cues – and to give their parents a sense of change. It’s those moments [in the outside world] that we’re trying to connect people back to, sensitively.”
Much consideration has gone into helping young minds make sense of experiences that can be alienating, which in turn makes the job of parents, doctors and nurses that bit easier. “The question is always, ‘What can we do to make all this a bit sweeter?’” says O’Sullivan. “Kindness sits at the centre of it all, and the uplift it brings carries a greater value than the price tag.”
So what is the price tag? Shenai tells me that there’s a movement to get 1% of a hospital-build budget allocated to art design, but that this is at the discretion of the team behind it. Invariably, he says, it takes “activist personalities” – be they architects, clinicians or arts managers like O’Sullivan, a job role that is certainly not common to all trusts but is fast proving its worth at the likes of GSTT and Great Ormond Street, where you can’t move for multisensory stimuli designed, as Shenai puts it, to “bring emotion and delight” to the place. Because hospitals all too often dehumanise just when a human touch is most needed.
Tim Shaw has personal experience of this. A freelance art technician, he and his partner, Niamh White, set up Hospital Rooms, a charity that commissions extraordinary artwork for NHS inpatient mental health units (IMHUs), after his best friend was sectioned. He was shocked by the unit when he visited her. “It was a starkly unpleasant space,” he says, “white, sterile, patronising, with small, dark windows and TVs in laminate boxes that were too big for them. It felt more like a cell than a bedroom.” Shaw resolved to start transforming IMHUs with museum-quality art. At Jasmine Lodge, a mother-and-baby unit near Exeter, the corridors are lined with primary-coloured giant figures made by Julian Opie, which give a sense of movement and progress, while in the dining room a graphic mural in pastel hues by Mark Titchner reads: “Love reveals the world.” The message in every artwork, literal or otherwise, is one of hope, of which women struggling with their postnatal mental health need to be reminded. (I certainly did.)
In seven years, Hospital Rooms has completed almost 800 artist workshops to create 150 artworks for 25 projects all over the UK, helping the NHS “dream bigger about what’s possible within four walls: wall murals, kinetic sculpture, photos, hanging pieces, video works… art which rivals those in cultural institutions”. Shaw and White recently collaborated with Hauser & Wirth gallery in London for an exhibition, Like There is Hope and I Can Dream of Another World, featuring the work of Mark Titchner and Harold Offeh, among others, and a programme to raise £1m for the charity over three years.
Art In Site and Hospital Rooms both, it seems to me, have names that make a statement: that good art and design in caring spaces shouldn’t be aspirational or decorative but part of the furniture, as integral to a hospital as the brickwork. Aesthetics empathise, they calm, they trigger memories and start conversations, not just among patients and their parents but with clinicians, too. Williams tells me that at the Evelina, A&E doctors asked the artist to include certain things for kids to count or find in the cartoon strips, making for playful interactions with them. This in turn builds trust. “If children are frightened and resistant, they delay all the procedures and there’s a load on the system,” she says. In A&E, the benefit of their work is measurable in improved patient flow and wait times.
On our first day at the Evelina in 2019, Patrick Gallagher and Hana Hassan, a nurse and nursing assistant, greeted us, two stricken parents and our anaemic baby, with a warmth and attentiveness we’d not experienced at our local hospital. They both still work there and are members of what has become a kind of extended family to us. It’s not easy – emotionally or technically – to cannulate a distressed child, or to field their anxious parents, but we have always felt supported by the calm competence of our clinical team. There are, of course, many factors at play here, but I can’t help but feel the surroundings must impact on them much as they do on us – as Shaw puts it: “It’s about valuing people and giving self-worth.”
How we feel in hospitals can affect us for life. Art and design might not be first-line treatments, but their presence in caring spaces can have a bearing on long-term health outcomes. “Artwork is often a crucial point of memory – and it really matters if you can take positive memories along with you from a hospital visit,” says Shenai.
And we do. Some of our hardest moments have been spent on Snow Fox, but my feelings about the place are overwhelmingly good and I believe the same to be true of my three-year-old girl. It’s no longer the place that causes her pain but the place that keeps her well – and our family in one piece. There’s nothing shallow about that.
