Public consultation on the plans for Barnes Hospital

Public consultation on the plans for Barnes Hospital

Short response in black; full text of the presentation from here in green with red annotations below. An earlier draft of the short bit, and about the same version of the rest, has been dropped-off in the trust's consultation box at one of their meetings.
Try the "classic" link to read this without links down the side.
The only team that uses these buildings just now has about 700+ outpatients according to
http://www.swlstg-tr.nhs.uk/our-services/find-a-service/service/richmond-older-people-community-team

Short response

Don't waste the 2003 in-patient building if it's useful

The large 2003 building looks suitable to let as a private nursing home with space for intense care. I think this is the most important point. [added 8/12/17] The rooms are large, according to Friends of Barnes Hospital (fobh.org.uk), built as 6-bed wards,  but that could be a good thing. It could allow space for a loo & shower in each room - something that care homes often lack.

People who aren't quite conscious and can't leave their beds might do better in shared rooms.

I can't find the planning application for the building online under the postcode SW14 8SU, so I don't have any plans except the outline further down the page

Short-life housing is a way of securing the site

https://uk.cameloteurope.com/contact-us/uk-south-east-office can find short term tenants for any usable buildings, as can short-life housing associations.
Westminster Housing Co-op is the nearest one on search engines.
Either or both agents could handle the letting of hard-to-use property, if it is possible at all, leaving the completely un-usable property easy to identify and develop bit-by-bit, with less pressure to sign-up to large contracts and possibly get them wrong.  See "next consultation" "new name" and the next paragraph for why I think a large project will go wrong.

added after printing a copy for the health trust
Workshop space, film sets, art studios, a laundry...
Camalot Europe have no success letting for work in the UK, according to their web site and impressions of Ruffells Garage next to Barnes Hospital, which they managed for a while. They might find someone willing to live in a workshop, but not to work in it.

Another quick search throws-up this link
http://self-help-housing.org/directory-existing-projects/#London
including Meanwhile Space, which promotes good jobs in a town that's very short of workshop space according to a glance at this...
https://www.london.gov.uk//about-us/london-assembly/london-assembly-publications/helping-small-businesses-thrive-london (formatted report:
https://www.london.gov.uk/sites/default/files/helping_smes_to_thrivefinal.pdf )
There are also agencies who let car-parking space in small units, which are easy to search for. I don't know how to search for agents who let large units.

Short life GP surgeries possible

I hope there is a supply of GPs looking for surgery space and patients who want to sign-up with them. I know from Behind Closed Doors that existing GP waiting lists are full, but I don't know if that's down to funding or job applicants or space or what. Anyway,  I vaguely hope that the GPs can be offered space in existing buildings if they want. It may not be necessary to build a new building. Once they have moved-in, they could give an opinion about the cost and the benefit.

I rather like the idea of some local GP surgeries running from converted private houses and prefer it to more corporate buildings, but if there is a genuine reason to subsidise a GP landlord, like a demand for a GP and a psychiatrist working together, that's better still and I am sure that staff in hospital clinics who get one diagnosis over-and-over again would be interested in working with a GP surgery where there are loads of different problems. (I get this information from contacts at an HIV clinic which has just been separated from related sexual health services - anyone in a clinic that's like Ford of Dagenham would want their skills used a bit more).

Copper Door Handles

One small suggestion. I read that copper door handles are anti-bacterial. Either copper or coppery brass. So I suggest copper or coppery brass door handles in any new buildings for sick people and a gradual change-over in others.

I saw this on a Dara O'Brian TV show, and dont more technical references than a quick online search, but I expect that an NHS trust has plenty of well qualified people who know almost off-hand whether it is true.

Access: left turns at the level crossing from South Worple Way

I think the site suffers from a no-left-turn rule at the level crossing to the north east.

This has recently been imposed under pressure from local residents, because of the risk of squashing people who wait at the level crossing in the path of any car that needs to turn left. (A primary school is round the corner,)
I think that a bollard would do the same job as the no-left-turn law.

Ideally with help from Railtrack who might allow more land at the corner to be un-fenced to allow space for pedestrians waiting. I think that a bollard with tyres round it would be good to reduce damage for drivers negotiating a tight bend. I think that the cameras and no-left-turn rules are a hazard for people leaving the hospital, from experience: my mother is an outpatient and was caught on camera trying to do a left turn with slightly bad memory and concentration.

Access: need another gate into the site at the north

I think more access points are required, with one at the north, at least for pedestrians and preferably for vehicles, because I don't see much chance of getting a bus-stop to work in South Worple Way or White Hart Lane.  White Hart Lane is narrow; South Worple Way is single track.

I doubt it's possible to persuade Railtrack to narrow the strip of land next to their railway track, in order to widen South Worple Way, but maybe someone more expert knows for sure..

Why I think a big development will go wrong and suggestions that follow

Next consultation in a different style, please

The wall boards for consultation include attempts to mislead, paid-for by  taxpayers, who cannot claim the money back for working to un-pick the deceptions in order to reply. I hope the next consultation is more straightforward. The boards also use buzzwords like "modern" or "excellent" which make critical thought harder. My buzzwords back: "red flag", "machiavellian". The last one sounds a bit harsh, but the team at Barnes have 1.5 psychiatrist posts of which  the half is vacant, a home support team of un-known purpose, and none of  the buzzwords like "memory clinic", or "recovery college", that are used on other sites. So it's worth asking whether services are deliberately managed badly on that site to encourage people to say they'll travel further just to escape.

Everybody knows that there is not enough money for mental health services. (https://www.nhs.uk/Services/hospitals/Overview/defaultView.aspx?id=3042). The next suggestion is similar - about the name of the team.

New name "Improvement and re-use team" or "improvement and letting"

There is a team at St Georges Trust called "Estate Modernisation", and I think, after talkling to one of them, that the name reduces critical thought by the team members. It was the sort of language used before bad housing developments in the 1960s. It reduces the need to question what is being done.

I think this only adds to the impression that  health trusts can get building plans wrong, as for example at Queen Mary's where clinics now have to pay a high rent to Sodexo, or at St Georges Tooting where some obsolete wards are left unused, rather than let as offices or converted to flats.

Party Donors as public sector business partners

I suggest trying to be very open, transparent, and accountable if dealing with any party donor as a business partner if it can't be avoided altogether.

The current consultation isn't just a planning consultation; it is a consultation with NHS patients and taxpayers by a health trust, but it doesn't say anything about money. It is not transparent.

I don't believe the view of politicians, that parties need extra funding beyond the subsidy they already get. I think that donations to central parties should be capped to a total, just like funding for local campaigns. I think that would make it easier for public contractors to stop making party donations and political parties accepting them.
Meanwhile, while it is still legal for an NHS trust sign a contract with a party donor, it think it's best avoided.

Green text, below, is consultation quoted from here; red is point-by-point notes
Welcome

South West London and St George’s Mental Health NHS Trust (the Trust) welcomes you to our consultation event to showcase the initial plans for the Barnes Hospital site.

In the last few years the Trust has been developing options for our Barnes Hospital site as part of our Estate Modernisation Programme (EMP). The EMP, which has been approved by our local authority partners, will modernise our built estate – replacing outdated buildings with state-of-the-art facilities – and will facilitate improved service delivery, particularly in terms of our community services.

This is untrue.
The trust has a large building built in 2003 on the site, that takes a large proportion of the area. - the one with blue window frames you can see on the aerial photo.
.
This is worrying
Anyone who says "modernise" is ducking a chance to say something sensible, but the team is called "modernisation". A point about language, but also about the quality of decision-making at a time when it's known that these decisions are often taken badly. For example the old Queen Mary's Hospital site was replaced by a much smaller site and a Private Finance Initiative building owned by Sodexo, who charge a very high rent to each clinic. I know the Private Finance Initiative has ended, but worry about general money management. The remaining land at Queen Mary's has gone for very upmarket housing for people who like to live in old buildings - nothing too modern. I suppose they find old buildings relaxing to live in if the things are well insulated and easy to maintain.

Meanwhile the St Georges site is ringed with empty wards, which I guess could be turned into flats or let as office space. The problem isn't that they are old, but that they look too cold without a lot of insulation and to isolated from other buildings.

I suggest that the department should be re-named "improvement and letting"so that they ask themselves "how is this an improvement?" or "why is this space not let?". They do not talk like this at the moment. I spoke to one official who really seemed to believe that new bricks were better than old bricks, or that's the argument he used.

One small suggestion copper door handles
I read that copper door handles are anti-bacterial. Either copper or coppery brass. So I suggest copper or coppery brass door handles in any new buildings and a gradual change-over in the others.

Explanations about this blog
This blog page has got "election" in the title to attract politicians' attention, that's all.
And the blogging software doesn't seem to encourage printing, but control+P might do it from the "classic view" that doesn't have titles of other blog posts down the side. It fills about 10 or 11 pages on minimal margins

Short version
I picked out the red points and cut-out repatition to make a short summery at the end

As the leading provider of mental health services across south west London, we are committed to delivering the highest standards for the 1.1 million people we serve in the boroughs of Richmond, Wandsworth, Kingston, Merton and Sutton.

We have representatives here today from across our organisation and the EMP team.

We hope we can answer your questions, whether it is about the future development of the Barnes Hospital site or the work we do across the five London boroughs we serve

What is an outline planning application?

An outline planning application seeks to establish the principle of a proposed development. The detailed aspects of a scheme, specifically access, appearance, landscaping and layout in scale are called ‘Reserved Matters’. It is possible to seek outline permission with all or just some of those matters reserved.

In the last few years the Trust has been developing options for our Barnes Hospital site as part of our Estate Modernisation Programme (EMP). The EMP, which has been approved by our local authority partners, will modernise our built estate – replacing outdated buildings with state-of-the-art facilities – and will facilitate improved service delivery, particularly in terms of our community services.

for future consideration.

Further down the page it says that this will be a "new healthcare facility on the site of the Garden House", and, when asked, it turns out that this depends on getting a government grant to build the thing. There is nothing on the plan to say how this will be better.

Subject to outline permission being granted, we intend that a further community consultation would be held before ‘Reserved Matters’ submissions are made to the local planning authority

We hope we can answer your questions, whether it is about the future development for the Barnes Hospital site or the work we do across the five London boroughs we serve

Background

First opened as Barnes Isolation Hospital in 1889, Barnes Hospital joined the NHS in 1948 and is now being managed by South West London and St George’s Mental Health NHS Trust.

Mental health inpatient services have not been provided at Barnes Hospital since 2013 and the site is significantly underused, with approximately 25% of the site currently in use to provide healthcare services.

The remaining buildings are unsuitable for modern mental healthcare services.

This is misleading

The blue-window building covers a lot of the site. It was built in 2003. I guess that it is an inpatient building that could be converted for use as a private old peoples' home for people with advanced dementia.

After dropping-in to an exhibition and asking someone from Friends of Barnes Hospital, it turns out that the 2 stories are built with 6-bed wards, so there could be a cost in conversion to a care home, but care homes tend to have rooms that are too small, and room for walk-in shower in each one would be good, so maybe the six-bed rooms are the right size for one person, rather more conscious with lower care needs, now. Then there are people who aren't very conscious and can't leave a bed unaided. That's a group who might suit a shared ward.

I'm told that the building called Elizabeth Lodge - a wing of the 2003 building, was built as a tall hall or ward, but converted later into half a dozen bedsits.

These are photos from "lost hospitals of London", before boarding-up, which says that the older barn-like buildings were built to keep fever patients in beds twelve feet apart with maximum ventilation.

Also, just looking at the site, I saw that there are some two-story house-like buildings as well as the barn-like ones and the H-shaped building still in use.

Some planning applications, later withdrawn, mention staff accommodation on the site.
https://www.richmond.gov.uk/media/11630/barnes_site_forms_march_2014.pdf
[page 9 of 21, "planning application history"] but don't say how much is there and ready to let. I guess that the two story house-like buildings were once staff housing.

Whilst the Trust has added security to the building, with the buildings being vacant, they unfortunately continue to be a target for vandalism and anti-social behaviour.

This is misleading.
There is very little evidence of vandalism so far.

The associated costs mean that we are having to spend money on floorspace that we don’t need – money that we would much prefer to spend on patient care.

There is a simpler solution.

https://uk.cameloteurope.com/contact-us/uk-south-east-office can find short term tenants, as can short-life housing associations. I think Westminster Housing Co-op is the nearest one. Someone at Richmond Housing Partnership might be able to suggest which ones are easy to deal with.


One of these agents could handle the letting of hard-to-use property, if it is possible at all, leaving the completely un-usable property easy to identify and develop bit-by-bit, with less pressure to sign-up to large contracts and possibly get them wrong.

The gate house looks as though it is built to house a caretaker and could be re-opened and let just as it is. It has steel shutters on it at the moment, but there is a photo of it in use by the last occupier who were a psychotherapy organisation here .

OS Map extract 1896 –appearance of hospital site
OS Map extract 1920 – expansion of hospital site
OS Map extract 1936 – expansion of hospital site
View of the existing site View of the existing site

The views don't show the large 2003 building which is to be demolished

Did you know?
The Trust employs over 2,000 staff to provide care and treatment for approximately 20,000 people in South West London and beyond. 

What is the Estate Modernisation Programme?

The EMP is an exciting programme which will revolutionise the way mental health services are delivered in south west London for generations to come and will also provide new facilities for our local communities.

?.

We are working with local people and service users to transform mental health services in south west London through a multi-million pound investment in our services and facilities.
Barnes Hospital patients have not been consulted directly.

What does this mean for Barnes Hospital?

Earlier this year the Trust carried out an initial stage of marketing to help us to understand the potential options for the Barnes Hospital site and to inform our next steps.

We are now bringing forward outline plans for the site, which will maintain excellent mental healthcare services alongside new homes and community uses. We hope this will enable us to appoint a preferred bidder for the site, who will deliver excellent value for the NHS and allow us to reinvest all funds from the sale of the site into our services.

I think the trust needs to be very transparent about appointing party-donors as builders, whichever party they donate to. I don't see why a political party needs donations from anyone, and think the practice of large govenment contractors donating to parties should end; government should not do business them.

An update about Springfield and Tolworth Hospitals

In October we were delighted to announce the selection of Springfield and Tolworth Estate Partnership (STEP), a partnership between Kajima Partnerships and Sir Robert McAlpine Capital Ventures Ltd,

McAlpine are party donors
as our preferred development partner to deliver the new hospitals at Springfield and Tolworth. STEP will work alongside the Trust to progress the EMP and transform the way we deliver mental health services for generations to come.

?

The announcement of the preferred development partner marks a significant milestone in the development of the EMP, and enables the proposals to be finalised for a full business case to be submitted to the Government for approval.

View of the new hospital at Tolworth
View of the new hospital at Springfield
“ We are now bringing forward outline plans for the site, which will maintain excellent mental healthcare services alongside new homes and community uses.”

Our commitment to delivering high quality care

The Trust provides a wide range of inpatient and community services to over 20,000 people each year. These include local services for children/adolescents and working age and older adults, as well as a range of specialist mental health services on a regional and national basis.

Our values are to be respectful, open, collaborative, compassionate and consistent. We work in partnership with those who use our services, their relatives, carers and friends, and other stakeholders to ensure that we uphold and promote these values.

Crucially, we will be retaining a presence at the Barnes Hospital site. Staff and service levels will not be reduced in the borough as a result of the EMP and we are working closely with Richmond Clinical Commissioning Group (CCG) to develop the services we can deliver in Richmond.

Will my care be affected in any way?

While we transform our estate, care will continue to be provided throughout. Any
relocation will be agreed with the input of clinicians, to ensure new locations reach
the needs of our patients and carers. Minimising disruption to our patients is a key
objective of both the Trust and STEP.

Some teams may be required to work from another location within the borough and
staff will work closely with patients and carers to ensure they are fully aware of any
changes to their services.

The clinics at Queen Mary's Hospital have to pay a high rent to Sodexo. It could be that some of them would be cheaper to run at Barnes if patents are able to get to Barnes.

Access would he hard without a northern gate to the site, so that people could walk from more bus stops; at the moment there is access for drivers and fit people but not for ill people.

Once any relocations have been agreed the Trust will provide regular updates and
work with key external partners such as service user/carer groups, Healthwatch, local
GPs and the CCG to ensure that all the people we serve are aware of the changes.

Our values are to be respectful, open, collaborative, compassionate and consistent.

Opportunities and constraints

We have been considering options for the future of Barnes Hospital for a number  of years.

The site offers an opportunity to deliver a mixed-use development that would positively contribute to the local area while retaining a valuable healthcare use.

Opportunities

• Bringing back into use an under-utilised site to provide much-needed housing for the borough as well as to support investment in new healthcare facilities
  This isn't what happened at Queen Mary's; the risk is that demolishing and building for its own sake will waste a lot of money. For example Queen Mary's moved to a building with very high rents to Sodexo who built it under the Private Finance Initiative.
• The site is well connected, conveniently located close to transport links, shops and local facilities
• Retention of a significant number of existing trees will contribute to high quality amenity space as well as acting as a green buffer
• The northern part of the site is away from neighbouring properties and provides a good opportunity to deliver a new healthcare facility
• It is an ideal location to deliver high quality new homes of varying size and tenure
• There is a possibility that the site could accommodate other community uses, such as a new school

Principal Planning Considerations

• Relationship with neighbouring properties and the railway line
• Proximity of the nearby Queen’s Road Conservation Area
• Adjacent Old Mortlake Burial Ground
• Existing locally-listed buildings on the site
• Availability of funding for potential social and community uses on part of the site

Land for social and community uses

We are currently in dialogue with the London Borough of Richmond upon Thames for part of our site to be made available for an alternative community use, such as a new school.
This area of land, to the south of the site, is not included in these plans and any proposals would be subject to a separate planning application.
The total site is approximately 1.45 hectares and would be divided as follows:

• New homes - 0.68 hectares 
• Healthcare - 0.23 hectares 
• Land for alternative community use - 0.54 hectares

Proposed Site Layout

New homes

As part of this development, we aim to help meet a pressing need for new housing in the borough, and a mix of both private and affordable homes is proposed.

I don't see anything concrete about a number of affordable homes and suggest that initial planning permission state some kind of condition.

A quick google found me a planning report  (page 9 of 21) quoting "Barnes Working Group" with this suggestion:

It suggested the site is best used for the provision of accommodation for working age adults as well as affordable accommodation for other groups. It reported Richmond Council's priorities for the site as affordable housing, extra care housing and adults' mental health housing.


We are proposing a total of 76 homes, including:

• 64 apartments, featuring a mix of one, two and three bed units
• 12 terraced four bedroom homes

All new homes will have outdoor space, either balconies or private gardens, and  have been designed to meet the London Housing Design Guide standards for size and residential amenity.

A modern healthcare facility

The new healthcare facility will be delivered to the north of the site, in the location of Garden House (the H-shaped building) , which is currently being used to provide healthcare. The Trust is committed to provide out-patient services on the site and this facility will enable the Trust to continue providing excellent mental healthcare services ...

"excellent" is a PR word that just confuses; NHS Choices don't quote staff or patients as using that word.

We have all seen reports of acute mental health service wards where the psychiatrists share phone calls each week about the least unwell patient to discharge, and we all know that there is more demand for acute mental health services, as for dementia care, than there is money to pay for it.  So to say that the trust provides excellent mental healthcare services, or that any trust can provide sufficient mental healthcare services, is untrue

...for generations to come.

This is an easy way to help people.

Most of us live less than 100 years and value our property in proportion.
Health trusts live longer - the fever hospital was built in the 1880s - so health trusts are  interested in returns more than 100 years away. So I propose 100 year leases rather than freehold sales.

The development of a new facility would improve patient experience, moving away from the current buildings which are outdated and unsuitable for modernisation.

This is untrue and important.
The 2003 building is the largest on the site. A large brick building with blue window frames that looks weatherproof and well insulated. The two-story part of it, to the South West, is in the area of the current planning application, and a "proposed vehicle and pedestrian access plan" shows it replaced with housing and a turning circle.

Another  plan shows four parts called "lodge" with different names, and a central "esl unit" as well as office space, reception and a large laundry.

After a quick look at a couple of dementia care homes with high-care units, I guess that the 2003 building is the same kind of thing; it could be let as it is, maybe for conversion, rather than demolished to make way for something else.

I read that the trust no longer funds many dementia beds, and so the ones at Barnes were abandoned to maintain a "critical mass". This is not the same as their being no demand for dementia care; there is obviously growing demand with new care homes being built all the time. I saw one called Atwood House being extended by Barchester Healthcare just recently.

Illustrative view of the proposals looking from the north east
Proposed site layout
Illustrative view of the proposals looking from the south west
Key

• Shared Surface
• Street/Parking Zones
• Communal Gardens
• Private Gardens
• Defensible Space
• Existing Trees to be removed
• Existing Trees
• Proposed Trees

Design precedent

• South Kilburn Masterplan - Alison Brooks Architects
• Anne Mews - Allford Hall Monaghan Morris
• Newhall Be - Alison Brooks Architects
• Newhall Be - Alison Brooks Architects
• Elmwood Court - C.F. Møller
• Culverin Court - Hawkins Brown
• Ham Close - BPTW Architecture

Highways and access

I think the site suffers from a no-left-turn rule at the level crossing to the north east. This has recently been imposed under pressure from local residents, because of the risk of squashing people (including children) who wait at the level crossing in the path of any car that needs to turn left.

I think that a bollard would do the same job, ideally with help from Railtrack who might allow more land at the corner to be left for pedestrians waiting. I think that a bollard with tyres round it would be good to reduce damage for drivers negotiating a tight bend. I think that the cameras and no-left-turn rules are a hazard for people leaving the hospital, from experience: my mother is an outpatient and was caught on camera trying to do a left turn with slightly bad memory and concentration.
A specialist transport consultant, Motion, has been appointed to undertake assessments of the local highway network, alongside an assessment of the potential changes in the number and types of vehicle movements.

Access

I think more access points are required, with one at the north, at least for pedestrians and preferably for cars, because I don't see much chance of getting a bus-stop to work in South Worple Way or White Hart Lane. So there is good transport nearby, but none very near.

There is a single-track road called South Worple Way on the south of the site. Drawings show it as a wider road - maybe two track. This is a sign of something wrong; the people who commissioned that picture should do their jobs differently or not remain in post.

The site currently has three access points from South Worple Way and a one-way vehicular system is operated within the site due to the width of the road.

The proposals would retain two of the three existing access points and maintain a one-way circulation, with a dedicated entrance and an exit serving both the new homes and healthcare facility.

There is no clarity about the healthcare facility yet. Central government may fund a building for a GP surgery, if a GP wants it, and existing outpatient clinics will probably continue in the same building or a new one.

Parking provision

All residential parking for the scheme will be accommodated within the site and will have no impact on local parking provision. A total of 86 car parking spaces are proposed,including eight disabled parking spaces, at a ratio of 1.17 spaces per home.

30 of the parking spaces would be provided at street level and another 56 would be in basement parking below the apartment blocks. New residents will not be issued with parking permits and will not be allowed to park in existing local Controlled Parking Zones.

To promote sustainable travel, the plans include 142 cycle spaces for the residential properties and a further 30 cycle spaces associated with the non-residential floorspace.

Dedicated car parking spaces will be provided for the healthcare facility.

Local links

South Warple Way is a single track road.

I don't know if RailTrack would allow railway land to be used for road-widening; I haven't seen it done before, and they need space for signals, so I guess they wouldn't allow road widening onto the edge of railway land.

I think they might allow one corner of land - the odd square meter - to be used to allow more pedestrians to stand on the corner by the level crossing, without risk from cars turning left on the sharp corner.

I think the council could put-up a post or a removable bollard, maybe with tyres round it for padding, to separate pedestrians and cars.

I think the current no-left-turn sign and camera could go, which would be a great benefit to people using the hospital site.

The site benefits from excellent public transport links, being approximately half a mile
from Mortlake train station and 0.7 miles to Barnes train station.

There are a number of bus stops a short walk from the site which are served by bus routes providing links to Richmond, Hammersmith and Wandsworth.
Proposed vehicle and pedestrian access plan

To promote sustainable travel, the plans propose 142 cycle spaces for the residential properties and a further 30 cycle spaces for the commercial units.”