© Murphy Philipps 2025
Once a bold blueprint for modernising UK healthcare infrastructure, the Nucleus hospital design emerged in the 1980s as a modular, cost-effective solution to streamline construction and increase flexibility. The designs promised adaptable clinical spaces and rapid deployment – and they delivered. Today however many of these buildings show their age—burdened by outdated layouts, inflexible structures, and limited digital integration. Their original promise of scalability is at odds with the complexities of contemporary medicine, leaving them strained in delivering high-tech, patient-centred care.
But with over 100 of these hospitals still in existence across the country, an innovative and sustainable approach is needed to efficiently re-use and update for modern service delivery.
Murphy Philipps, as part of an IHP consortium directed by NHS England have developed a Standard Platform solution to re-use these template designs. With structural input from Perega, and services design by TB&A the aims are to provide a standardised Nucleus update. The output being a ‘Proof of Concept’ aligning with Government and NHSE objectives on MMC and Net Carbon Zero. A big focus therefore is utilising a kit of parts, such as layout, room, assemblies and components.
To understand the primary issues, research was carried out with 34 Trusts. The outcome of which drew some compelling conclusions
Some of the key physical constraints include:
Conservative estimates, suggests around 1,020,000m² of Nucleus accommodation exists across approximately 100 hospitals in England. This equates to around 5 wings per hospital.
Initial studies were based on the original Nucleus template at Newham University Hospital - an archetypal design. The Proof of Concept seeks to establish viability of an Inpatient Ward, with HBN compliant options, and wider block impact by:
MMC solutions support the kit of parts approach such as.
Our Inpatient review/Proof of Concept demonstrates that not only can a new compliant ward be housed successfully within the footprint of a Nucleus cruciform, but a full Nucleus block can be updated to support inpatient accommodation from a structural, MEP cost and delivery point of view also.
Alongside the ward study, outpatients, ICU Ward, and Imaging were all reviewed as part of the repurposing exercise
The standardised solution:
The proof-of-concept study that has been carried out would assist in streamlining the design process and could provide a route to fast-track approvals. Based on information received from other Nucleus hospitals, common strategies can be implemented with minor variations due to differences in footprint and GIA. A light refurb refurbishment model could provide a 10–20-year extension of working life, with a full refurbishment model offering potentially a 50-year extension.
A programmatic and standard approach is the obvious solution to refurbishing the modular, standardised nucleus model, and almost 35 years after the last hospitals were built under this programme we can look to modern construction practices to deliver this in an efficient way.
