The Hub

From Office to Operating Suite: Unlocking Adaptive Reuse Potential in St Kilda Road’s Aging Commercial Towers

[Author]

Maxim Bachimov

As vacancy rates continue to rise in Melbourne’s once-prized St Kilda Road commercial precinct, an opportunity is emerging to rethink the role of these aging buildings. Many of the towers lining this iconic boulevard—particularly B and C-grade stock—no longer meet modern workplace expectations. But with increasing demand for healthcare infrastructure and a renewed focus on integrated precinct models, could these towers be reimagined as vertical health and care communities?

At Studio STH, we’ve been actively testing this proposition. Over the past 18 months, we’ve assessed a range of commercial towers along St Kilda Road for their potential to be converted into Class 9a compliant healthcare environments. These buildings are well-located, well-serviced, and structurally sound. They sit within reach of major hospitals, research hubs, and public transport—ideal characteristics for outpatient care, day surgery, or even aged care services.

But as we’ve explored these opportunities, another possibility has emerged: could these towers support multiuse programs that combine healthcare with residential, aged care, or key worker housing? And if so, what design and planning strategies are needed to unlock this potential?

Understanding the Constraints of Health Conversion

Retrofitting an office tower into a healthcare facility is not a straightforward fit-out. It involves navigating major shifts in regulatory class, building performance, and clinical workflow. The most significant challenges include:

Fire compartmentation and egress: Commercial towers often lack the exit widths, separation, or fire-isolated compartments required for patient care.
Structural limitations: Existing floor slabs may not support operating theatres or imaging equipment, especially where vibration or deflection performance is critical.
Floor-to-floor heights: Often less than 3.6m, these limit the space available for air handling, medical gases, and service reticulation—especially in surgical or technical zones.

These constraints, while significant, are increasingly solvable with a combination of modular prefabrication and intelligent architectural planning.

Design Solutions: Applying Modular Systems to Real Projects

At Studio STH, we’ve worked closely with leading industry partners to apply and adapt existing modular technologies in ways that solve real challenges on tangible healthcare projects. The key is understanding how to integrate them into complex retrofit environments—while maintaining compliance, performance, and clinical integrity.

Operating Theatres: Modular Raft and Ceiling Systems

We’ve collaborated with suppliers such as Wilhelm to implement modular ceiling raft systems that integrate surgical lighting, HEPA-filtered air, pendants, and mounting structures into pre-engineered formats. These systems:

Minimise ceiling zone depth.
Reduce on-site coordination and installation time.
Improve infection control through factory-tested components.
Allow prototyping of surgical environments to validate layouts and user experience prior to installation.

This level of precision is especially valuable in constrained retrofit settings, where ceiling space is limited and room sizes are fixed.

CSSD (Central Sterile Supply Department): Modular Process Zones

For CSSD environments, we’ve worked with clinical engineers and equipment planners to adapt modular zoning layouts that suit retrofit conditions. These layouts can be:

Designed and tested offsite.
Delivered in phases to support staged commissioning.
Configured for compliant clean/dirty segregation and air pressurisation.

Modular layouts make it possible to bring highly technical spaces like CSSDs into older buildings that might otherwise fall short on spatial separation or flow.

Room Systems: Bedheads, Ensuites, and Façades

Studio STH has also worked with:

Stryker and Getinge, with their modular bedhead systems that integrate medical gases, nurse call, power and comms into efficient vertical panels suited to tight layouts and lower ceilings.
Sync, co-developing a prefabricated ensuite pod specifically designed for health projects. These units meet DDA, AusHFG, and structural constraints—while significantly reducing time on site.
Façade system manufacturers, using modular cladding upgrades that can be applied externally to improve thermal, acoustic and aesthetic performance without major structural intervention.

Across each of these areas, our role is to connect clinical requirements with buildable solutions—delivering outcomes that meet compliance, program, and cost expectations.

The Case for Mixed-Use Health Precincts

Beyond healthcare alone, we believe the most compelling opportunity on St Kilda Road lies in vertical mixed-use developments that combine:

Healthcare services (e.g. day surgery, imaging, mental health, rehabilitation).
Aged care (supported or assisted living).
Residential (key worker or downsizer housing).
Retail or wellness amenities (e.g. pharmacy, physiotherapy, cafés).

This multiuse vision aligns with broader trends in urban renewal, including:

The 20-minute neighbourhood concept.
Government support for ageing in place.
ESG-focused investment into adaptive reuse and embodied carbon savings.
Growing demand for healthcare-integrated living environments.

Barriers to Delivery: Planning Needs a Pathway

Despite increasingly favourable feasibilities and obvious societal benefits of this opportunity, a primary challenge remains: planning approval uncertainty.

Currently, there is no specific or streamlined planning approval pathway to facilitate the conversion of existing buildings into an alternative land use and development outcomes- other than a ‘standard’ planning permit application process.

Each project is tiresomely assessed on a case-by-case basis, with limited guidance on performance benchmarks or planning precedent. Further, there is no statutory recognition or appreciation for the physical challenges to achieve successful adaptive reuse conversions. This uncertainty limits investor confidence, increases holding costs, and risks project viability.

Studio STH believes it is time for industry and government to consider introducing a dedicated planning approval pathway for adaptive reuse proposals, including details to accommodate facilitating health-focused outcomes. This could include:

Building condition thresholds.
Prescribed compliance options.
Performance-based assessments.
A fast-track planning approval pathway for identified building types

A Smarter Future for City Health Infrastructure

Adaptive reuse isn’t just about sustainability - it’s about architectural resilience, economic viability, and delivering care where people live. Underutilised towers should not be considered redundant—they’re rich in latent potential. With modular innovation, integrated design, and bold regulatory support, they can become the next generation of inner-city health precincts—supporting patients, residents, and entire communities.