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Writer's pictureTheo Petrides

Harley Street; Advanced Medicine in a Georgian Townscape...

Updated: Oct 30


Harley Street, renowned for its elegant Georgian architecture and as a world centre for medical practice. Harley Street exemplifies the fusion of historical preservation and modern adaptation in this prestigious medical district. Construction on Harley Street began in the 1750s, with many buildings, now standing as meticulously refurbished Grade II Listed structures that blend classic design elements with contemporary functionality for healthcare professionals.


Balancing architectural heritage with modern needs requires a nuanced approach at design stage, it often involves implementing non-invasive retrofitting techniques, such as the use of reversible interventions. A21architects applies Building Information Modeling (BIM) technology to precisely plan and execute renovations, enabling precise modeling of historic structures, facilitating the intelligent integration of modern amenities.


In the context of Harley Street's Georgian buildings, innovative extensions that have also become a hallmark of modern adaptations. One notable technique is the implementation of subterranean extensions, exemplified by the 15-metre-deep basement housing a proton accelerator at 141-143 Harley Street. Such underground expansions provide substantial additional space without compromising the building's historic exterior. We have found that many buildings require strengthening to their timber frames as well as structural underpinning to ensure the longevity of the building and to take the increased loads from contemporary uses.


Early morning piped liquid nitrogen delivery


Harley Street was initially developed in the 18th century as part of a larger plan to create a grid system of streets in the area. The street's construction began in the 1750s and continued through the 1780s. The development of Harley Street occurred in phases, with the southern portion being built first. The northern end, initially known as Upper Harley Street, was completed later, between 1770 and the 1820s. The Howard de Walden Estate, direct heirs to the original builders own the freehold and lease many of the buildings the area.


Georgian architecture drew from the classical revival movement, incorporating elements of ancient Greek and Roman design filtered through Renaissance interpretations. This style was further refined through the publication of architectural treatises and pattern books, which disseminated ideas across Britain and its colonies. The style evolved from Palladian architecture, inspired by Andrea Palladio's 16th-century designs. Georgian architects and builders relied heavily on architectural treatises and pattern books to inform their designs and construction techniques. I have included a list of key architects and documents who shaped Georgian architecture at the end of this article. These publications provided proportional systems, detailed orders, and exemplary plans that Georgian architects adapted to local conditions. The widespread circulation of these treatises ensured a consistent architectural language.


Harley street features large townhouses with characteristic sash windows. These spacious houses would later prove attractive to doctors, as they could be used for both living and professional purposes. In 1860, there were around 20 doctors practicing in Harley Street. The Medical Society of London opened nearby in 1873, further enhancing the area's reputation. The Royal Society of Medicine opened in 1912, solidifying Harley Street's status as a medical hub. The number of medical professionals in the area grew significantly over time, by 1900, there were 80 doctors in Harley Street and when the National Health Service (NHS) was established in 1948, there were around 1,500 doctors in the area. Today, there are more than 3,000 people employed in the Harley Street area, working in clinics, medical and paramedical practices, and hospitals.


Harley Streets special status is also recognised by the local authority, Westminster Council which has designated Harley Street as a Special Policy Area (SPA) to protect and enhance its unique character as a world-renowned centre for medical excellence. The Harley Street SPA encompasses Harley Street and adjacent streets, including Wimpole Street.


The SPA is there to protect and promote specialist medical facilities and functions. these include:


  • Preserve the area's special local distinctiveness, particularly relating to its land uses.

  • Ensure that the unique cluster of medical activity is not lost to other commercial uses

  • Supporting the provision of accommodation for patients using medical facilities in the area.

  • Encouraging the development and enhancement of medical facilities.

  • Maintaining and strengthening the reputation for best-in-class medical provision.

  • Avoiding leases with tenants who have a reputation for controversial medical procedures that raise ethical issue.

  • Seek a balance in the types of medical services provided in the area

  • Improve the quality of the medical offering

  • Potentially limit certain types of practices (e.g., cosmetic surgery) if they are deemed overabundant


This SPA designation helps maintain Harley Street's status as a global center for medical excellence while ensuring its continued evolution aligns with Westminster Council's vision for the area.


Many buildings in Harley Street are Grade II listed, meaning they are of special interest and considered to be of national importance. They are subject to regulations that protect buildings of historical and architectural significance. The listed building status of properties in Harley Street plays a significant role in maintaining the area's historical value and unique character.


The Georgian townhouses, which form the majority of the buildings, are protected from demolition or unsympathetic alterations. Any changes to listed buildings require special permission, known as listed building consent. This applies to both external and internal modifications, helping to preserve original features and layouts. The listed status encourages proper maintenance and repair of buildings using appropriate materials and techniques. By using listed building status and associated conservation policies, the historical value of Harley Street is carefully maintained, preserving its unique character as a world-renowned medical district while allowing for sensitive evolution and necessary modernisation.


Harley Street's journey from a residential Georgian development to a world-renowned medical district exemplifies the successful adaptation of historical architecture to modern needs. The area's commitment to preserving its Georgian heritage while embracing innovative medical technologies has created a unique environment where the past and present coexist harmoniously. As Harley Street continues to evolve, it remains a shining example of how careful urban planning, architectural preservation, and medical innovation can combine to create a truly exceptional urban landscape. The street's enduring prestige in the medical world, coupled with its architectural significance, ensures that Harley Street will continue to be a cornerstone of London's identity for generations to come.




  • "I Quattro Libri dell'Architettura" (1570) by Andrea Palladio, which provided foundational principles of classical design

  • Richard Boyle, 3rd Earl of Burlington (1694-1753), a prominent patron and designer

  • "Vitruvius Britannicus" (1715-1725) by Colen Campbell, a seminal work that popularized Palladianism in Britain

  • "The Designs of Inigo Jones" (1727) by William Kent, which disseminated Jones' influential interpretations of classical architecture

  • "The Builder's Dictionary" (1734) by A. Bettesworth and C. Hitch, an early encyclopedic resource for construction techniques

  • "The British Architect" (1745) by Abraham Swan, offering practical designs for builders and craftsmen

  • "The Works in Architecture" (1773-1822) by Robert and James Adam, showcasing their neoclassical innovations

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