History:
The case for energy saving hospitals became compelling in the UK following the fuel crisis in the mid 1970s. Hospitals are major consumers of energy because of their size, continuous occupancy and the fact that they are highly services buildings. In 1979, Howard Goodman, then Chief Architect at the Department of Health, commissioned a study on the development of a low energy hospital.
The study was based on Nucleus design concept that was a standardised design developed by the Department of Health with uniform cruciform templates. The objective of this study was to halve the energy use of a typical Nucleus design. A multi- disciplinary team of professionals produced a report and were then invited to develop a live project.
The Nucleus planning system includes a set of pre-planned templates for each of the main hospital departments and a set of overall planning rules that set out the main circulation and services distribution routes. This arrangement helps to establish key planning relationships between departments, the ratio of internal to external space by the template dimensions, and the alternation of closed and open spaces.

Architecture:
St Mary's Hospital was in development from 1981- 85 and in construction from 1985 -91. The architects were Ahrends, Burton and Koralek.
The planning is based on four standard cruciform Nucleus templates that are cranked radially off a hospital street that joins them to the main circulation routes and public spaces. The contiguous arms of the cruciform plans create courtyards bringing light, air and a view into the heart of the building.
The siting and planning responds to the energy saving concepts in relation to the orientation for maximum solar gain, location of energy centre close to the centre load, high efficiency artificial lighting and maximum natural lighting. Many heat recovery techniques were used and a research study to monitor and evaluate performance was undertaken. The features include exhaust air heat recovery, heat pumping and combined heat and power. The engineering services are controlled by a computerised Building Management System. An interstitial floor allows for maintenance access to services without disrupting hospital activities.
Another feature of the design of the hospital has been the incorporation of artwork into the design and layout of the building from its earliest stages. Healing Arts, a charitable trust within the hospital, organises a programme of visual and performing arts. The themes of the work relate to the local setting and refer to water, sea and sand but the displays also involve relate to the island community drawing attention to the contribution the hospital makes to the place and the people.