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Aura Planning helps define the feel of design outcomes that all involved want from a hospital, clinic or healthcare building

How Aura Planning can help with healthcare design 

Going to the hospital can be a confusing, frustrating and anxiety-inducing experience. Building design and the mood it generates is partly responsible. Before the additional constraints of the pandemic, hospitals already gave off a hostile message. At the Royal Surrey Hospital (RSH), for example, this begins in the car park or drop-off. The car-park is full, expensive and feels heavily policed. The drop-off is not a great alternative for minimising stress. It presents a barren environment that is poorly cared. It lacks any designed signals, other than ambulance parking bays, that the purpose of the building is to help you.

As one enters, the decor is markedly better but on the left of a small reception for such a large hospital, is a generous commercial cafe, one of the franchised private enterprises found in any high street. Further along there is a high-end supermarket in which sugary food is suppressed but still available. This reinforces the feeling someone is taking advantage of a captive market and an opportunity to profit. Further into the building  there are large sign boards and people asking informal questions about which way to go for an x-ray and so on. Once in your out-patient area you are back in the basic level of provision. The service at the RSH is renowned and once you are acknowledged by the system you become more confident that it will be worth the wait - which is usually unexpectedly short. 

This permanent built environment, together with personal perceptions, memories, experiences and expectations, will generate the atmosphere each out-patient will experience. Big life events happen here: taking a child into the hospital for treatment, arriving injured or with an injured person at A&E, accompanying a cancer sufferer who is someone close to you for a diagnosis, waiting for the birth of your child in the maternity ward. 

Aura Planning provides tools for describing what hospital atmosphere the different participants want - the feel of its environment. Typically this is one that encourages well-being and reduces stress or feelings of trepidation and even panic.  

Why Burland Aura Planning for hospital design

James Burland is an architect who, over a career designing a wide range of different buildings, felt the building user wasn’t getting enough say. Although users were often consulted, they were not encouraged to share the mood they wanted a building to give them. 

The permanent design features of a healthcare facility all influence how good it feels when used for what it has been designed to provide. All good architects can create moods through design. But they need to know what mood the creators and the users of the facility are after!  For users, those moods will be different depending on where they are in relation to the building and what they  want to do in the building. For the providers of healthcare facilities, it will reflect the kind of atmosphere that supports their perception of both a preventative approach to health and a healing  environment.

James encountered mood specification when designing large sports stadia where the spectator’s experience is crucial and carefully planned. The interplay of light, sound and air is the spatial experience and it differs depending on whether you are approaching, entering, moving through or spending time in the environment.


He researched the published literature on the area on a masters degree at Cambridge University and developed the Burland Aura Planning process. He has subsequently applied it to health and well-being projects from his past and current work. 

Who we work with

  • Hospital trusts and related charities who want to enhance the well-being of their facilities.

  • General Practitioners that are commissioning design teams for their new surgeries or that want to improve the building they are currently working from. 

  • Government Health Authorities setting performance briefs for current and future healthcare facilities

  • Social Care home providers commissioning new buildings or conversions of existing buildings

  • Health Centres and Gyms interested in improving results for their clients and increasing membership take up.


Project: The LINC Trust and the haematology ward staff at the Royal Gloucestershire hospital

Hospital Building Design 3 Burland Aura Planning.jpg

Initially the hospital needed a straightforward increase in treatment positions for their haematology unit. But the real challenge was to create a much stronger well-being effect by looking at the entire experience of arrival and being in the space. What can be seen as a very early example of aura planning is in the simple but effective change from a lean-to extension to an entrance sequence with a welcome and a place to find release for both the patient and the carer. This was done by simply rotating the building slightly and creating a new aura around the existing and new extension. The basis for the design was drawn from conversations with key people involved about the atmospheres they all aspired to.


“A collaborative process. Along the way, several additions were made to the original plans including a complete revamp of the phlebotomy rooms, rebuilding the reception area and replacement of much of the original equipment. This resulted in a total spend of just under £700,000.”


Interested in working together?

How does aura planning for hospital and healthcare design design work?

Aura Planning gathers perceptions from representatives of the participant group. For example, for a hospital this includes out-patients, carers, hospital administrators, caterers and shopkeepers who all share perceptions about the atmosphere they want. Atmosphere is something everyone feels and common perceptions emerge which become the descriptors for the aura of the  hospital environment that will support those different atmospheres.

When to talk to us about healthcare building design?

The earlier we can discover and define preferences for what everyone wants from a healthcare environment, the easier it will be to identify a site, a design or an existing building with potential for conversion in a way that will suit its users s  If there already is a site and a design underway and it will benefit from an Aura Plan’ by talking to us at the start or anytime during  the project to help define what you want. It will save you time and help you find the solution that feels right. 

What outcomes can aura planning achieve for healthcare building design?

  • Identify what people involved want from a healthcare environment so that it is more likely to delight and have the right aura

  • Clarity about the thing that is hardest to define, yet is the most important aspect of any building project: the feeling you want it to give you

  • Definition of the right range of atmospheres you need the building to provide.

  • Agreement about what all those involved want

  • Clear direction for all members of the design team

  • Seeing potential in a shared way, in a completely new design for a healthcare facility, or in a building to be converted for health care 

  • Identifying what all involved really value in the built environment of a healthcare facility and what the resources are spent on is for what is needed and not on what isn’t.    

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