The project is a physical medicine hospital for military veterans located in central London. This brief forces common issues, like pollution and noise caused by the urban environment, to be addressed. Despite the focus of the brief, many of the strategies are applicable in other hospital types and will only become more relevant as the large acute hospital becomes phased out and replaced by small specialist hospitals. The design focuses on critical elements which will influence the energy use and architectural quality the most, such as the ventilation strategy, the patient rooms and a central atrium for circulation, connectivity and daylight. The programme is spread over five floors with an additional half level for critical care and surgeries. Each floor has a dedicated function in order to simplify circulation and improve efficiency. The main component houses both the garden ventilation stack as well as the main functional space of the floor and can be easily adapted to either function - clinic or patient room - depending on future needs. Over 70% of the programme can be naturally ventilated for most of the year, but the system also allows for passive or active cooling when required.