Adapting the North Wing: Creative re-use at England’s oldest hospital

  • | Jeremy Trotter

The re-use of buildings is one method by which society can become more sustainable, as the adaptation of existing structures retains embodied carbon and minimises the need to use and transport new materials. However, adapting a building (particularly a listed building) to meet a purpose for which it was not originally designed can come with many challenges.

New occupants often require changes to layouts, which need to be made within the constraints of the existing structure, in a way that respects architectural significance. Another issue is to ensure that the social and historical significance of the building is not lost, but instead captured in its redevelopment. Insall is facing both these challenges in the repair, refurbishment and reawakening of the North Wing of St Bartholomew’s Hospital, in the City of London, working together with the charity Barts Heritage.

Founded in 1123, St Bartholomew’s Hospital is soon to celebrate its 900th anniversary, making it the oldest hospital in England. One of the earliest buildings on the site is the North Wing, which dates from 1732, to designs by architect James Gibbs.

The symmetrical North Wing, now Grade I listed, defines the north-west edge of the courtyard that forms the heart of the Hospital. It was constructed not for medical treatment, but for ceremonial, administrative and fundraising purposes. Until 1948 with the founding of the NHS, healthcare provision was largely provided by charity. Paintings – undertaken gratis by William Hogarth – line the stair adjacent to the Great Hall, which is the centrepiece of the wing. The walls of the Great Hall are adorned with plaques that record donations given by private individuals; they speak of a sustained commitment to the provision of healthcare over many centuries.


A conservator working in the great hall at St Bartholomew’s Hospital.

In the 1990s, St Bartholomew’s Hospital was threatened with closure, but was saved after a fierce and emotional campaign. Since then, the Hospital site has undergone considerable change, with a range of new buildings in the tight confines of its site in Smithfield. Gibbs’ East and West wings were adapted into high quality healthcare facilities, retaining the Georgian fabric and sustaining the continuation of healthcare on the site.

The North Wing masterplan proposals aim to reinforce this sustainable reworking of the complex by enhancing connections to the local community. The proposals will see a renovated St Bartholomew’s Hospital Museum and Archives, together with a new reception area for visitors. The reception rooms to the upper floors are to be refurbished to provide fully accessible, rentable office space and function rooms, thereby providing a means to generate valuable income to ensure the continued maintenance of the building.

Tackling the climate crisis involves not just reduction in carbon use through physical change, but also an enhancement of social links within the community, developing the connections between people and a place that encourage the long-term care of physical resources. These proposals are designed to revive the Gibbs’ North Wing to place it at the heart of a special and long-running institution, showing that with imagination, even historic buildings of great historical sensitivity can be adapted in a truly a sustainable way.