Maggie’s Centres: wellness through building design and the environment

In March 2017, the 20th Maggie’s Centre was opened in the grounds of Forth Valley Royal Hospital in Falkirk. Designed by architects Garbers & James, it is expected to receive 3000 visits in the first year.

Maggies Centre Forth Valley, Garbers and James

Maggie’s provides free practical, emotional and social support to people with cancer and their family and friends, following the ideas about cancer care originally laid out by Maggie Keswick Jencks and co-founded by her husband Charles, who is a landscape architect. Among Maggie’s beliefs about cancer treatment was the importance of environment to a person dealing with cancer.

She talked about the need for “thoughtful lighting, a view out to trees, birds and sky,” and the opportunity “to relax and talk away from home cares”. She talked about the need for a welcoming, reassuring space, as well as a place for privacy, where someone can take in information at their own pace. This is what Maggie’s centres today aspire to.

A number of high profile architects have designed Maggie’s Centres across the UK – from the late Zaha Hadid to Frank Gehry, Richard Rogers and Rem Koolhaas.

The Maggie’s Centre in Kirkcaldy, Zaha Hadid Architects

Promoting wellbeing through the natural environment and effective design

Drawing on research which considers the significant impact that environment can have on wellbeing, Maggie’s Centres are designed to be warm and communal, while at the same time being stimulating and inspiring. The interiors are comfortable and home-like. Landscape designers and architects are encouraged to work closely together from the beginning of a project as the interplay between outside and inside space, the built and the “natural” environment, is seen as an important one.

A building, while not wholly capable of curing illness, can act as “a secondary therapy”, encouraging wellness, rehabilitation and inspiring strength from those who move around it.”

Each of the centres incorporates an open kitchenette where patients can gather for a cup of tea, airy sitting rooms with access to gardens and other landscape features, and bountiful views. There are also private rooms for one-on-one consultations; here Maggie’s staff can advise patients on a range of issues relating to their condition, whether that is dietary planning, discussing treatment options (in a non-clinical setting) or delivering classes such as yoga.

Spaces to promote mental wellbeing as well as physical healing

Maggie’s Centres are also about offering spaces to people to help improve their mental wellbeing. As well as quiet tranquil spaces for reflection and meditation, there are also central areas, focused on encouraging the creation of a community between the people who use the centre. Wide-open spaces, high ceilings and large windows, with lots of opportunities to view the outside landscaping and allow natural light to enter are a key feature of many of the Maggie’s Centres.

The locations also try as far as possible to provide a space free from noise and air pollution, while remaining close enough to oncology treatment centres to provide a localised base for the entire treatment plan of patients.

Fresh air, low levels of noise and exposure to sunlight and the natural environment, as well as designs that provide spaces that promote communal interaction to reduce feelings of isolation and loneliness, have all been shown to improve mental as well as physical wellbeing. In this way, the physical attributes and design of the Maggie’s buildings are helping to promote mental as well as physical wellbeing of patients and supplement the care being given by the cancer treatment centres located nearby.

Interior of the Maggie’s Centre in Manchester, Foster and Partners

Award-winning architecture and design

In 2017 Maggie’s Manchester was shortlisted for the Architects’ Journal Building of the Year award. And many of the individual centres have won regional design awards for their innovative use of space and incorporation of the natural environment into their designs.

A Maggie’s garden was also featured at the 2017 Chelsea Flower show, highlighting the importance of environment, and the role of the natural environment in rehabilitation and promoting wellness among those who are ill.

Final thoughts

How design and landscape can aid and empower patients is central to Maggie’s Centres. They are a prime example of how people can be encouraged to live and feel well through the design of buildings and the integration of the surrounding natural environment. These environments are the result of a complex set of natural and manmade factors, which interact with one another to promote a sense of wellness, strength and rehabilitation.

They demonstrate how the built environment can contribute to a holistic package of care – care for the whole person, not just their medical condition. Other health and social care providers can learn from them in terms of supporting the wellbeing of patients, carers and their families.


You can find out more about Maggie’s Centres though their website.

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Read more about innovative building design in our other blog articles.

Can the NPPF be used to encourage better design? A look at a recent High Court decision…

by Laura Dobie

A recent High Court decision has significant implications for interpreting the design policies in the National Planning Policy Framework (NPPF) and the National Planning Policy Guidance (NPPG).

Handing down the decision in Horsham District Council v. Secretary of State for Communities and Local Government (1), Barratt Southern Counties Limited (2) on 23rd January 2015, Mr Justice Lindblom stated “It is not a general principle in planning law that an acceptable proposal for development should be turned away because a better one might be put forward instead”, dismissing the notion that this principle had not persisted with the introduction of the NPPF.

The case revolved around the question of whether an inspector had failed to take account of whether a better designed scheme could be conceived for a development site.

The Court dismissed an application under section 288 of the Town and Country Planning Act 1990 by Horsham District Council for an order to quash the decision of the inspector – appointed by the first defendant, the Secretary of State for Communities and Local Government –  to allow the appeal of the second defendant, Barratt Southern Counties Limited (“Barratt”), against refusal of planning permission for a development of 160 dwellings on land to the north of West End Lane in Henfield, West Sussex.

The Council had contested the grant of planning permission. During an inquiry the council submitted that the proposed development was a poor design which obscured views of the landscape, that a well-designed scheme should contain view corridors to retain these important views, and that it was fundamental to the principles in the NPPF regarding good design and the need to incorporate development into the character of the area, that such a scheme should preserve these views.

The inspector concluded that the likely “adverse environmental effects” of the proposed development were “limited” and did not outweigh “the considerable social and economic benefits” with respect to the early provision of new homes in circumstances of a local shortfall. He considered that policy in the NPPF did not indicate that the development should be restricted, and that the development would therefore be “sustainable”, and “the presumption in favour of such development should be applied”.

The Council argued that the inspector was not entitled to grant planning permission for Barratt’s proposal while it was still possible for a scheme to come forward in which long views from the site would be better protected, in light of policy set out in paragraph 64 of the NPPF that “permission should be refused for development of poor design that fails to take the opportunities available for improving the character and quality of an area and the way it functions.”

In his ruling, Mr Justice Lindblom stated that the NPPF does not say that a proposal which does not take every conceivable opportunity to enhance the character and quality of an area, or which does not deliver as well in this respect as a different proposal might have done, must therefore automatically be rejected.

He noted that the inspector focused on the policy in paragraph 64, as well as the wider policies on the design of development within which that paragraph is set, and that he exercised his own judgment on the issues relating to “good design” and “poor design” in light of these policies, concluded firmly that the proposal was not of “poor design”, and brought that conclusion into the comprehensive assessment of the planning merits on which he based his decision.

Referring to the decision in First Secretary of State and West End Green (Properties) Ltd. v Sainsbury’s Supermarkets Ltd., Mr Justice Lindblom stated that in this case, the fact that an alternative approach could have been adopted in the design of the development, and that this could have maintained some views from the site which would have been obscured by Barratt’s development, did not mean that the design of the proposal the inspector was considering contravened government policy in the NPPF.

The judge went on to state that the inspector was entitled, and in fact, required, to exercise his own judgment on whether the scheme constituted poor design under the NPPF, and that he did so in an entirely lawful manner, applying NPPF policy appropriately. He noted that, “It may be that the council disagrees with him, but such disagreement is not ammunition for a legal challenge.”

The Court also reiterated the principle that an application under section 288 of the 1990 Act does not afford “an opportunity for a review of the planning merits” of an inspector’s decision.

This case indicates that an acceptable scheme cannot be rejected to encourage an improved scheme, given the design policies of the NPPF and the NPPG.

Full details of the final judgement are available here.

Blustery conditions: conflicting priorities in wind farm planning decisions

by Laura Dobie

The recent decision by the Secretary of State to refuse planning permission for Spring Farm Ridge wind farm brings into focus the tension between government policy and targets on renewable energy, and opponents of these schemes who are concerned about the possible negative effects of renewable energy developments, in particular on the environment.

Government policy on renewable energy

The UK government “is committed to supporting renewable energy as part of a diverse, low-carbon and secure energy mix.” (DECC, 2012, p.4), and recognises the contribution that renewables can make to energy security, the decarbonisation of the economy and sustainable growth. It has a target set out in the 2009 EU Renewable Energy Directive to deliver 15% of the UK’s energy demand from renewable sources by 2020, and it is anticipated that renewables will play a key role in the UK’s energy mix in subsequent decades.

The most recent update to the Department of Energy and Climate Change’s Renewable Energy Roadmap suggests that the UK is making good progress against this target, although it acknowledges that the siting of certain renewable energy projects has caused concern. It recommended that greater numbers of communities should be actively involved in small-scale renewable energy projects and emphasised the importance of ensuring that communities are properly engaged with, and can see the benefits of, renewable energy developments.

Public opposition to wind farm projects

While wind turbine developments can offer a range of community benefits, wind farms have faced considerable opposition from local residents and other stakeholders concerned with environmental and other costs of such developments, particularly their visual impact: optimal sites for developments tend to be in rural, coastal and remote locations in which the natural environment is prized.

While there has been much debate around nimbyism, with suggestions that people tend to favour wind power until schemes intrude upon their local areas, developments may well have an impact at the individual level: a recent study has found that operational wind farm developments reduce house prices in areas in which turbines are visible, in comparison with locations where they are not visible.

In its campaign against a wind farm development, Allt Duine, on the edge of the Cairngorms National Park, the Save the Monadhliath Mountains group has highlighted the potential impact of the scheme on the landscape and wildlife, and also on tourism: the development could have negative effects on the amenity of the area for those who visit the Cairngorms for leisure. While renewable energy schemes can create new jobs in communities, they could also have a negative effect on another major employment sector in rural areas.

It is clear that there are competing interests at stake in the siting and construction of wind farms: the need for a greater proportion of renewable energy in the UK’s energy mix, and the need to protect our natural landscape and heritage assets. The job creation potential of such schemes must also be weighed against the possible adverse impact on the tourism sector.

The Spring Farm Ridge Development

On 22nd December 2014 the Secretary of State for Communities and Local Government refused planning permission for a commercial scale wind farm, Spring Farm Ridge, between Greatworth and Helmdon in Northamptonshire, overturning the recommendation of the Inspector.

He acknowledged that all communities have a duty to help to drive up the use and supply of green energy, but that this does not mean that the requirement for renewable energy will automatically take precedence over the environmental protection and planning concerns of local communities.

While the Secretary of State agreed with the Inspector that the benefits and disadvantages of the proposal were finely balanced, he disagreed with the Inspector as to where the balance should lie. The proposal would not accord with the Development Plan and, although there were some material considerations which counted in favour of the proposal, including the renewable energy benefits, the Secretary of State did not consider those benefits to be sufficient to outweigh the likely negative effects of the development, notably identified harm to heritage assets, as well as to the character and visual amenity of the area.

This decision highlights the competing environmental priorities and stakeholder interests which are at play in proposals for new renewable energy developments, and the challenges in determining whether renewable energy benefits should override the negative environmental impacts of these schemes in planning decisions. Perhaps there is a need for greater community engagement and careful consideration of the siting of such developments in relation to the natural environment in order to gain wider public acceptance for such schemes and to improve their chances of approval in the future.

Further reading

Some resources may only be available to Idox Information Service members.

Recovered appeal: land at Spring Farm Ridge, land to the north of Welsh Lane between Greatworth and Helmdon (ref 2165035, 22 December 2014) (2014). Department for Communities and Local Government

Gone with the wind: valuing the visual impacts of wind turbines through house prices (2014). Spatial Economics Research Centre

Renewable Energy Roadmap Update 2013 (2013). Department of Energy and Climate Change

Renewable Energy Roadmap Update 2012 (2012). Department of Energy and Climate Change

Breathing space (natural landscape protection and wind energy development), IN Holyrood, (Renewables No 6 Winter 2013 supplement), pp32-33

Wind trap (opposition to wind farms in Scotland, IN Urban Realm, Vol 3 No 12 Winter 2012, pp87-89,91