_space group was commissioned to redesign and extend Wansbeck General Hospital’s busy Accident and Emergency department. When carrying out this vital work in a hospital that serves the largely rural county of Northumberland, our paramount concerns were the creation of an efficient environment that made innovative use and re-planned significant areas within the existing building. Our approach meant that we could allow for additional examination rooms, cubicles and resuscitation rooms and provided a significant increase to the quality of care for patients.