Deerns wins lead design role at Niguarda Hospital

Deerns has won a competitive public tender to lead the multidisciplinary design team for the refurbishment of Pavilions 10 and 4 at Grande Ospedale Metropolitano Niguarda in Milan. Working with InAR, Deerns is developing the technical and economic feasibility study for new healthcare facilities within the protected buildings.

“We are the general point of contact for the client, coordinating the whole design team across the different disciplines,” explains Cesare De Mezza, Senior Project Manager at Deerns Italia. “I am proud to lead the team working on such an important renovation in my city.”

The buildings date from the 1930s and retain distinctive façades, large windows and generous internal heights. Their renewal will accommodate psychiatric and psychological care, paediatric neuropsychiatry and a small nuclear medicine unit serving oncology patients.

The appointment builds on Deerns’ earlier work at Niguarda supporting preparations for the 2026 Winter Olympics, including emergency coordination and medical assistance facilities. Subsequent commissions have also strengthened the working relationship with the hospital’s technical team.

A new home for psychiatric and specialist care

The planned accommodation occupies 2 buildings:

• Pavilion 10 at 15,000m2 is organised across several levels, each dedicated to specific healthcare and support functions. These include psychiatric inpatient wards, the clinical psychology department, rehabilitation psychiatry laboratories, support functions serving the psychiatry department and the cognitive neuropsychology unit, and a healing garden. A shell-and-core space has also been reserved for future development.
• Pavilion 4 is 2,500m2 in area and accommodates a complementary range of specialist healthcare services including a child neuropsychology department and nuclear medicine department.

This functional distribution has been designed to ensure efficient clinical operations, optimise patient pathways and provide an integrated environment that supports both care delivery and advanced diagnostic services.

Coordinating healthcare expertise

Deerns will lead the consortium and bring together mechanical, electrical and plumbing engineering, building physics, energy assessment, acoustics and building management systems. InAR is responsible for architectural design, medical planning, civil and structural engineering, and fire safety design.

This combination connects the hospital’s clinical requirements with the practical demands of adapting an existing building.

For Deerns, the commission marks an important development in its role in healthcare: taking responsibility for overall design coordination while continuing to provide specialist engineering expertise.

The current commission covers technical and economic feasibility, including drawings technical assessments and cost documentation. The package will undergo external validation before the hospital proceeds with subsequent procurement decisions. This provides a coordinated basis for evaluating the refurbishment’s technical requirements and affordability.

Reconciling heritage and clinical requirements

Retaining the pavilions’ architectural character requires close coordination between building services, structural interventions and room layouts. The designs must address heritage authority requirements alongside fire safety assessments and the seismic performance of an ageing structure.

A detailed survey campaign has established the buildings’ existing condition and informed the initial design package submitted for approvals. Understanding these constraints early helped the team identify where contemporary hospital requirements can be accommodated and where further coordination is needed.

Cost assessment is equally important. Earlier budget assumptions required reassessment against current construction costs. Working with the hospital, the team has adjusted the proposed scope. These decisions align the design more closely with available funding while retaining the principal clinical functions.

Reducing demand through integrated engineering

The project’s energy strategy targets nearly zero-energy building performance within the constraints of the protected fabric. Connecting the pavilions to Niguarda’s existing central heating and cooling infrastructure avoids the need for dedicated new thermal generation equipment. The designs also use the hospital’s existing medium voltage electrical network.

“Our goal is to create buildings with very low energy demand, integrated with the hospital’s existing infrastructure,” says De Mezza.

Building physics and services design are being developed together to reduce demand and support efficient operation.

3 key measures include:

• High-performance glazing to limit summer solar gains and reduce winter heat loss
• Building management controls for lighting, temperature, humidity and ventilation
• Assessment of rainwater collection for toilet flushing and irrigation

The sustainability assessment also considers construction product lifecycles, economic sustainability and operational waste management. Ongoing collaboration with the hospital will be essential to integrate the refurbished pavilions into established campus processes.

Preparing for future hospital needs

A robust information and communications technology infrastructure will support future smart hospital applications. At this feasibility stage, Deerns is establishing the foundations and guidance for capabilities such as digital wayfinding and asset tracking, allowing the hospital to introduce suitable solutions as its needs develop.

For Deerns, the value of this appointment lies in connecting specialist engineering with responsibility for the complete design process. The project will give Niguarda a practical route to bringing a valued historic building back into clinical use, with lower energy demand and infrastructure that can support future healthcare technologies.