HOK were appointed by Skanska as Lead Architect for the £1.1 billion PFI redevelopment of Barts and The Royal London Hospitals, providing full medical planning, architectural, interior and landscape design services for the scheme. The redevelopment saw the consolidation of cancer and cardiac services at Barts, with The Royal London serving as the primary acute hospital within the Trust. St Bartholomew’s Hospital (Barts) was founded in 1123 and is Britain’s oldest hospital. Serving a population of more than 2.5 million people, the hospital’s new nine-storey King George V building is a specialist cancer and cardiac centre located in the heart of central London. HOK’s successful design responded to a complex brief on an inner-city site, providing a phased solution that allowed the hospital to remain functional during the 10 year construction programme. The clinical design solution responded to the Trust’s output specifications by providing an integrated clinical facility for cardiac and cancer care with shared diagnostics and treatment platforms, one of the first such facilities in the UK. Site constraints included archaeological issues, St Paul’s sight lines, historical issues and planning guidance that would facilitate the creation of the best working and patient environments in the health service.