This scheme developed from a London-wide review of maternity services. The final agreed option makes use of four existing nucleus templates to provide a new maternity department, including a women’s assessment unit, an ante-natal ward, a post-natal ward, neonatal unit, consultant birthing unit and a midwife-led unit. The scheme was undertaken whilst 3 of the 4 nucleus templates were occupied during the 5 main construction phases. The scheme design has had to address the services, spatial and clinical constraints provided by the phased approach incurred whilst working within an occupied building.