The design for the new Royal Liverpool University Hospital cohesively ties together an inspirational landmark building with complex clinical and technical criteria for a world-class facility. This replacement acute hospital will reconnect, engage with and enhance its immediate local and extended city context. The new hospital will replace the existing 1970s facility on the same site in central Liverpool and will include 650 single en-suite bedrooms, including 40 critical care beds and 81 emergency assessment beds. There will be 19 operating theatres (including robotic and hybrid theatres), making it Liverpool’s main accident and emergency centre capable of dealing with major trauma. The main acute services include cardiology, respiratory care and general surgery together with regional and national specialist services in renal dialysis, endoscopy, ophthalmology, haematology and vascular surgery.