The new Bishop Auckland Hospital was one of the first NHS projects to be selected for Private Finance Initiative procurement. Peterjohn Smyth's design concept, which challenged the Trust's initial assumptions about the siting of the new building to bring the entrance front onto Bishop Auckland's main street and to make it possible to build it in a single phase, won the competition. Although the hospital is arranged on four floors, the plan keeps vertical travel to a minimum by locating related functions such as theatres and surgical wards on the same floor. The design humanises what is a compact, relatively high density complex partly by splitting the building into two parts: diagnostic and treatment at the front with wards behind; and partly by the use of gables, oriel windows and chimneys and a horizontal layering of high quality materials, including a base of rubble stone, reflecting the architectural character of the neighbourhood.