A slice of history

To understand where the Royal College of Surgeons is headed, it’s helpful to know where it’s been. The story of the Royal College of Surgeons has three main protagonists: Surgery – its past, present and future; John Hunter – surgeon, anatomist, teacher and collector, and its home in Lincoln’s Inn Fields – a building that has survived change, adaptation and near destruction over more than 200 years.

The surgeons split from the barbers to form the Company of Surgeons in 1745, but it wasn’t until 1800 that the Royal College of Surgeons was established, with a remit to promote and encourage the practice of surgery.

John Hunter (1728-1793) was a surgeon and a scholar of human anatomy, highly skilled in the dissection and preparation of specimens. While most of his contemporaries stuck to human anatomy, Hunter’s lectures stressed the relationship between structure and function in all living things. He had a teaching museum at his home in Leicester Square, full of some 14,000 preparations of over 500 different species of plants and animals. After his death, the museum was entrusted to the Company of Surgeons, in recognition of his work and his status as the founder of scientific surgery.

Number 41 Lincoln’s Inn Fields was the Company’s home by the time that the Hunterian Collection arrived in 1799 and number 43 was purchased soon after but, even so, there was little space to house and display the collection and to carry out Company business. In 1806, George Dance was commissioned to design a ‘large and impressive’ building (part-paid for by the government on condition that it featured a portico and pillars) which opened on May 13, 1813. As the collection grew, so did the building; redeveloped and extended first in the late 1830s by Charles Barry (who was instructed to keep the portico) and later in the 1880s by Stephen Salter.

An obstacle to change

Fast forward 50 years or so to the Second World War. On the night of May 10 1941, the back of the Barry building and about two thirds of the collection was lost to enemy bombs and the subsequent fires. The lecture theatre, council room, President’s room, hall and stair were badly damaged, along with the library ceiling. The library interiors and structure, however, remained intact – including the reading room – saved from fire by large cast iron doors that are still there today.

Extensive repairs and refurbishment took place in fits and starts throughout the 50s and 60s. Much of it was respectful to the original Barry plan form, but constructed as replica using construction methods including faux classical column casings around steel posts. This served to blur the boundary between what was original historic fabric, of heritage value, and what was modern construction.

By the time Hawkins\Brown was employed in 2016, the Grade II* listed building was a sorry sight. Permanent accommodation was occupying temporary Portakabin-type structures and there was draughty single glazing throughout. The main entrance on Lincoln’s Inn Fields was inaccessible to many and the rear of the building on Portugal Street was an impenetrable line of railings and basement lightwells. Inside, warren-like corridors seemed to lead nowhere and there were multiple changes of level. The layout was hopelessly inefficient and sprawled across two buildings, the Barry and the Nuffield. Building and services management and maintenance had become an ongoing burden for the College, hugely wasteful of energy and resources.

The Royal College of Surgeons’ decision to commission extensive rebuilding, remodelling and refurbishment of the Barry building coincided with a broader programme of transformation and change within the organisation, which aimed to significantly improve the services provided from the London HQ and to strengthen its work in the regions. Its buildings were proving an obstacle to that change.

The future of surgery

The decision was taken to replace the post-war buildings on the site with one efficient building that could provide long-term accommodation for the College, enabling it to open up its activities to the public and better serve the international surgical profession, becoming the home of surgery in the UK.

Our approach was respectfully radical; refurbishing the surviving parts of the historic building, and completely removing the no-longer fit-for-purpose, post-war construction, separating it from the neighbouring Nuffield building, which could then be sold, and making clear the threshold between old and new.

The post-war building is gone, replaced with an extension built around a central atrium. New and old have been strategically stitched together into flexible, light-filled spaces to enable the college’s vision for a 21st century global institution.

Honest repairs

The brief was not a full restoration of the historic facade, but for repair work necessary to last for the next 60 years, in the spirit of the building’s continuous cycle of change. Crumbling areas of stone and render have been sensitively re-crafted by specialist stone masons. Given the nature of how the building has been added to and adapted over the years, a conservation strategy of ‘honest repairs’ seemed appropriate. By matching the materials and using the same techniques and construction methods, the repairs and indents are clearly visible and the building’s history is there for all to see.

The design of the new building follows a series of references to details and concepts in the design of the original. It allows the building, like the institution, to maintain a dialogue with its past. Recessed fluting of the chamfered precast concrete columns of the new Portugal Street facade references the historic portico columns facing Lincoln’s Inn Fields.

When old meets new

The celebration of the threshold between old and new is dramatic. The chief example is the original rear elevation of the Grade II* listed building, now a stunning internal feature, rising majestically through the atrium.

The entire wall has been treated with limewash, to stabilise, lift and unify its colour, while allowing the patina and texture of the brickwork to show through. The historic busts set in the original window spaces are lit from above by a ribbon roof light, with a nod to John Soane across the square. The barrel-vaulted glazed roof, suspended above the atrium echoes the gallery roof of the pre-war Hunterian Museum halls. And the terrazo flooring recalls the diamond pattern of the marble floor donated to the college in 1911 by Eliza MacLoghlin.

Traditional routes

In Charles Barry’s original plan the first floor library was the most important space in the building. It was reached from the entrance hall, via the inner hall and up the grand principal staircase to the top. Our new building plan follows the same sequence, with the atrium replacing the inner hall and the stairs leading to the entrance to the library on the first floor through a triple height enclosure. Enhanced detail and high quality finishes further emphasise the importance of the route.

The principal staircase continues on beyond the first floor, through the atrium, encouraging interaction between staff, surgeons and visitors and providing a public route for viewing the collections. It’s also the ceremonial route from the top floor down to the statue of John Hunter, proudly travelled by graduating fellows and members on Diplomates Day.

Adapting to change

A careful balance between refurbishment and adaptation to modern requirements has had to be struck for the library and its reading rooms. Now instead of simply serving as a repository for books, the space is used for a variety of meetings, functions and events. Mechanically heated and ventilated, the air supply in the floor is drawn vertically up and out through the existing coffered ceiling cut-outs. Look carefully and you can see the odd water mist head in the ceiling roses, providing sensitively integrated fire protection.

The green walls and light, bright ceilings reference the colour scheme adopted in the late 1880s when the rooms were extended and redecorated. Further shades of green around the principal staircase and in the entrance hall connect the spaces and reinforce Barry’s spatial sequence. Original floorboards are left exposed and lighting is layered, with highlights sensitively picking out bookcases, providing lighting levels for a variety of needs.

A more public face

The Hunterian Museum, one of the most significant private museum collections in the UK, has been returned to its original pre-Second World War home on the ground floor and is now complemented by a large and lively public cafe. When the Hunterian reopens in 2023, it will contribute a significant programme of events and exhibitions to engage the public in the work of the college.

New ways of working

The transformation of the Royal College of Surgeons isn’t just about the new building, it’s a cultural and institutional shift to more modern, flexible ways of working. Open-plan, activity-based workspace, with centrally shared social and informal meeting space is arranged around the atrium at upper levels. Flexible furniture, storage solutions and ‘touch down’ space is supported by bookable high-tech meeting rooms and tea points.

Creative re-use

There are fantastic views – over the tree tops of Lincoln’s Inn Fields in one direction and the London skyline in the other – from the terraces and function rooms on the sixth floor. Big enough to accommodate Diplomates Day – the biggest event in the calendar for graduating fellows and members – they are also available to hire for corporate events for up to 450 people.

The meeting rooms on this level – also overlooking Lincoln’s Inn Fields – re-use historic timber panelling from elsewhere. The Eastern wing is clad in the timber linings from the Council Rooms of the 1950s. The fireplace also comes from the Council Rooms but dates back to George II, around 1755. The Western wing reuses the fireplace and panelling from what was the President’s Lodge in the Nuffield Building next door.

The basement now provides a wide range of accommodation. There’s plenty of archive storage space for collections that aren’t currently on display, plus conservation laboratories and workshops for the specialists working on conserving the specimens. Plant rooms, kitchens and bike stores are also down there.

The lower basement is dedicated to surgical education and teaching spaces, including flexible multi-function surgical teaching laboratories, an immersive teaching room, seminar space and flexible social and refreshment spaces for visiting course attendees.