Hammersmith Bridge and Hammersmith Social care alternative

Not enough people read this to justify a new post, but some information about Hammersmith Bridge cropped-up.

How the survey was done
abasurveying.co.uk/portfolio-items/hammersmith-bridge/

Why the bridge is thought too weak for traffic: "critical faults" is all it says. here
lbhf.gov.uk/transport-and-roads/roads-bridges-and-pavements/hammersmith-bridge-closed
Someone has started some freedom of information requests on a site that shares replies
whatdotheyknow.com/search/hammersmith%20bridge/all

What the £40 million is for.
I guess that the problem is council-speak. The right decision has probably been taken but councils can't explain why they need £40 milllion; they don't see the need to explain or guess what voters want to know. Richmond council changed a load of street lamps for probably very good reasons to do with cost, but couldn't explain why. The circular said the old ones had "reached the end of their working lives".

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Hammersmith & Fulham Council will abolish home care charges for elderly and Disabled people, it was announced last night (3 December 2014).

Speaking at a packed public meeting organised to celebrate the United Nation’s International Day of Disabled People in Hammersmith Town Hall, H&F Council leader, Cllr Stephen Cowan, said: “I am pleased we have found the money from back office cuts, such as from the council’s PR and admin budgets, and today announce that this administration will abolish what has rightly become known as a tax on disability.”

The final decision will be voted on at the council’s annual budget-setting process in February. If approved, the changes will take effect from next April.

The council says that abolishing care charges will cost £324,000 a year in lost income but that the scheme is being funded by £400,000 cuts in PR, council publications and lamp post banners.

There are 1,266 people in H&F who need help to carry out everyday tasks, such as having a bath, cleaning or doing the shopping. H&F’s home care charges are currently paid by 313 people in H&F. The current home care charge is £12 per hour and for some residents this vital service can be as much as £281 a week.

 - quote from Hammersmith web site December 2014

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I don't know much about this but it sounds good. There is a lot I don't know!

I do know the Richmond council list of social care agencies, annotated with care quality commission reports and personal notes for one client here

http://bit.ly/homecarerichmond

I imagine that Hammersmith, as an inner city area, has more budgets floating-about than Richmond - budgets that can be transferred to social care or PR, council publications and lamp post banners. On the other hand Richmond has money for Villiage Plans including cutting down trees, anti-cruising lights, anty-gypsy gates, a £5,000 grant to a brass band, and the things written on blue signs saying "I am voting .... for.... ". I'm told that 58% of Richmond spending is on social care, so it only takes a small change in social care spending to fund or cut a lot of the things that people notice more, like pot-hole mending or sixth forms in schools or weekly bin collection or a brass band. Which seems a terrible system.

I don't know how many people fund their own care, un-known or barely-known to the council in Hammersmith - maybe there are community care plans for both boroughs somewhere online with estimates on them, although they could be among the back office costs and publications that are cut-back to fund more care.

I don't know how much money Hammersmith saves when a client can postpone their move to residential care, with its expensive 3-shift costs, and so postpone the time that they run-out of money for fees and ask the council to pay. It could be that free home care (at the point of delivery) on presription or social worker referral saves money rather than costing money. I imagine that there are charitable trusts and central government organisations that would fund this kind of research if it hasn't already been done. At the time that Richmond Council ran-down its respite care daycentres, they admitted in a public meeting that the work hadn't been done; they had no idea how much money the spending saved them.

Clearly the cost of means-testing is reduced if people qualify for care whatever their means. There's an implication, without detail, in the Hammersmmith system that the council  manages the care. So maybe there is an opt-out or opt-in system. But if people can manage their own care on a subsidy, there's complexity again in the extreme case of someone who exploits an ill person or fakes illness in order to get money for another purpose. So, broadly, it saves a lot to have no means-testing but I don't know how the detail works.

I don't know the party politics of Hammersmith Council.

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Talking of Hammersmith, in case someone from there reads this, it would be good if they could get experts from Bucharest to look after Hammersmith Bridge. I understand that there is a bigger one to the same design in Bucharest so there might be someone who is good at maintaining the things.

Richmond Council elections Thursday 3rd of May

https://www.richmond.gov.uk/council/elections_voting_and_registration/electoral_data/scheduled_elections/local_council_elections_2018

UPDATE
Councillor Brian Marcell from the majority party has just canvased me about voting on Thursday 3rd of May. He is on the social services committee of the council, which apparently spends 58% of the budget. "It should be more", I said, and mentioned Mears Care as well as spending on nasty anti-gay-cruising tactics on Barnes Common. And I promised to email him some alternatives to Mears Care, so this is the Writetothem.com email. I wish I'd written "spend more on the niceness budget and less on the nastyness budget", but I got close. You can see that the niceness budget is under-spent if you read the bit in red further down the page.

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MEARS CARE ALTERNATIVES

We met on the doorstep at 2 Avenue Gardens just now and I promised to email some alternatives to Mears care. 

My googled notes of care quality commission reports on agencies in the council booklet of local care agencies are on http://bit.ly/homecarerichmond 

They quote the care quality commission reports on any that did well or badly, and the ones contracted to the council do badly. 

Some newer agencies have spent money on public relations and got themselves quoted in newspapers, claiming that more automated management allows more money to go to the carer and provide a better service. The names I googled are 

• https://supercarers.com/ 
• https://supercarers.com/ https://myhometouch.com 
• https://vida.co.uk/ 

BARNES COMMON NASTYNESS

On another subject, the council had found tens of thousands of pounds for car park security off Rocks Lane, and work by Continental Landscapes for Friends of Barnes Common to cut down trees and clear undergrowth in the area. 

Looked-at closely, the work is a very expensive project to discourage gay cruisers on Barnes Common at night. Trees hundreds of years old have been felled to reduce shadow. Large areas have been cleared of smalller plants. Search lights are installed on the car park and the sports ground next door. There is also a hieight restriction on the car park to stop gypsies. And an account of Friends of Barnes Common visiting Friends of Tower Hamlets Cemetry to compare notes, which are quite clear on the Tower Hamlets site: they want to discourage gay people from cruising. 

I really think the council should spend less on nastyness and more on social care. After all, the kinds of voters who ask for anti-gypsy gates and anty-gay search lights are probably not marginal voters anyway. 

I will try to take the subject up with Richmond and Hounslow parks department and find out if they can take gay peoples' opinions into account and save a bit of council spending at the same time.
Yours sincerely,
John Robertson, 2 Avenue Gardens, London SW14 8BP 0208 286 9947

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Someone has just knocked on my door to ask about "local issues", which always sounds like something out of League of Gentleman.

I came-up with one or two, starting with the idea that "local people" can vote on what council money is spent on, even if is is earmarked for an insurance-like service that people have paid-for over decades. Such as social care. I think this is a bad thing.

The candidate looked like someone forced to be patient, so I got specific to social care in Richmond.
He wasn't a candidate for the party in power, so I don't think I bothered him too much. It would have been more embarrassing to say this to the face of someone from that party, so maybe, if you're mixed-up with that party, you don't hear about this....

Council social services offering a legal minimum minus what the council can get away with.
Assessments don't always happen unless a high priority. The chance of an elderly person getting an assessment like this...
http://www.housingcare.org/information/detail-1621-housing-options-for-older-people-hoop-a-selfassessment-.aspx
... are low

For example if you don't have the money for social care, the council contractor gets this report from the care quality commission. Not many agencies get bad reports. One or two are "outstanding". So presumably the council has picked the worst ones because cheapest, although even that may not be true because worse home care will increase demand for residential care so it's a false economy financially.

Care Quality Commission report on Mears Care

Mears Care 114b Power Road, Chiswick W4 5PY
Tel: 020 8987 2350
Email: richmond.care@mearsgroup.co.uk
Web: www.mearsgroup.co.ukhttp://www.cqc.org.uk/location/1-138291078

Some aspects of the service were not safe.

There had been improvements in the way in which the staff were deployed and care visits were scheduled. However, further improvements were needed to make sure people always received the right care at the time they needed this.

Some aspects of the service were not responsive.

Some people did not receive care visits at the right time to meet their needs and there was variations about the timings of calls each day. In addition the provider did not communicate when care workers were running late or when there were changes in care workers.

Some aspects of the service were not well-led.

There had been improvements at the service and these had made a difference to people's care. However, further improvements were still needed to make sure people received a consistent service which always met their needs.

Most care quality commission reports on Medacs Healthcare offices are bad on more than one point. The web site is mainly about recruiting staff.

My source for this is the care quality commission and the booklet listing care agencies. The booklet which is about all you get off the council if your savings are about £23,500. If you or someone you know are learning how the system works, there is a set of notes that I did for myself here which may be useful. It is basically the council list of home care agencies plus annotations from the care quality commission, and I think it might include a link to housingandcare.org list of residential care options
http://bit.ly/homecarerichmond


Oh and I mentioned that gay cruisers on Barnes Common now face cut-down trees, cleared undergrowth and floodlights at council expense.

-------------------------------------------------------------------------------------------------------------------- 07.4.18 Local people are against dogs: official. Kennel Club’s Worry Over Richmond’s Restrictions on Local Residents and Visitors The Kennel Club is concerned that following its Public Spaces Protection Order consultation, the London Borough of Richmond upon Thames is still planning to introduce measures which will seriously restrict not only the freedom of dog walkers, but also of any other member of the public who chooses Richmond’s large open spaces for recreation. London Borough of Richmond upon Thames has consulted with its residents on Public Spaces Protection Orders (PSPO) to help the police and council tackle anti-social behaviour on public land. A PSPO is a new measure which replaces existing legislation and introduces wider discretionary powers to deal with any particular nuisance or problem that is detrimental to the local community’s quality of life. The orders can be enforced by fixed penalty notices or prosecution by police or council officers. When Richmond opened up its consultation period earlier this year, it was met with great concern from many dog owners in the area especially in regards to restrictions on the number of dogs which may be walked at once. A large petition was carried out by residents of Richmond, which gained over 1,700 signatures, and 59% of respondents to the consultation also disagreed to the council limiting dogs being walked at any one time to four. However, Richmond has still taken the decision to impose a four dog restriction on dog walkers. The council is proposing a 12 month pilot scheme to license up to 15 people to be exempted from this restriction; however, there appears to be no obvious reason why this number has been decided upon. This potentially leaves some dog owners having to take their dogs out on separate walks. The Kennel Club is further concerned by some of the other byelaws that are being suggested. For example, a byelaw is being proposed that a person in charge of a dog on any of Richmond’s open spaces where dogs are permitted, must not cause or permit annoyance to any other person or animal, or cause damage to any council structure, equipment, tree, shrub, plant, turf or other such council property. The Kennel Club is in complete agreement that dogs should always be kept under suitable control, but is concerned that there is no clarification by the council to what constitutes an annoyance. Would the occasional bark be constituted as an annoyance, and how will annoyance to another animal be measured and assessed? There is concern that annoyance to people is a very low bar to pass. The second clause about damaging turf and trees is also very ambiguous and worded so that any typical dog behaviour could fall under this. While the Kennel Club wouldn’t expect enforcement in this manner, it cannot be taken as a given and tough enforcement could take place under these new protection orders. There are many other restrictions to be put in place, such as restrictions on anyone disturbing any animal, digging, damaging or disturbing the ground or removing or displacing any stone, soil or turf. Questions need to be asked to what these restrictions would include, for example, would swatting a mosquito, shooing away a pigeon, throwing a skimming stone, feeding the ducks fall under this? Would walking across a park disturb the ground, especially if wearing studs if playing sport? Other clauses include not throwing or using any device to propel or discharge any object which is liable to cause nuisance, injury or damage to any other person, animal or structure. This would therefore include throwing a ball or frisbee around a park, which could lead to injury or nuisance. Caroline Kisko, Kennel Club Secretary said: “While the Kennel Club can support reasonable PSPOs and is happy to help work with councils and advise on dog issues to try and ensure responsible dog ownership, we are very concerned to read Richmond’s proposals which seem not only extreme but very restrictive on its many residents. If enforced to the degree it implies, it will seriously limit any enjoyment that members of the public can enjoy in the London Borough of Richmond.” A meeting by London Borough of Richmond upon Thames is being held on Tuesday 11th July to provide the opportunity for the councillors to review the proposals and consultation responses, and the Kennel Club will be present to voice its concerns. For further information on the results of the consultation and the proposed PSPOs, please go to https://consultation.richmond.gov.uk/environment/pspo/. The Kennel Club runs KC Dog which is a dog owner campaign group, free to join, which keeps members updated on dog access issues, and other relevant Kennel Club campaigns, which may affect dog owners across the country. Visit www.kcdog.org.uk for more information or join us on twitter @KC_political.

Social Services and the new Richmond Rapid Response and Re-ablement team

(Update - Greater London Authority's contribution is dance)

There is no money for social services, housing benefit or health but there is still a National Tennis Acadamy down the road and, I read £100 million for one of several unpopular higher education colleges to build a Cultural and Education District in Stratford. That's University College London that is 79th most popular out of 83 colleges for teaching economics. University of the Arts is the least popular of any higher education institution on unistats, using the Complete University Guide or Guardian University Guide to the figures. And Saddlers Wells, who dance apparently. Don't you want to string these people up from a lamp post? It's still illegal, but if you did it in artistic form to an orchestra you might get a grant for it.

You could write to them - there is a web site to find your GLA member who is probably Tony Arbour and send an email, or it can find london-wide assembly members as a list that you can compare against the GLA budget committee membership. I found one with a long-term interest in the arts who is on the committee and wrote to her. No reply after a week.

I have suggested to the GLA that they get their lobby briefs from these agencies checked and put them up for comment by the public before believing every word about public benefit and repeating every world class cliche.

Social services don't exist on a scale to match demand

It turns out that neither Richmond council's social services nor Richmond Rapid Response and Re-ablement Team exist on a scale to match demand. Council social services can find private visiting help and send a list of details, or manage it for a £50 weekly admin fee. They might offer a free assessment, and they can post a list of agencies which provide home visiting staff, leaving a patient or carer to check them against care quality commission reviews and find out the price.

Richmond Rapid Response and Re-Ablement team, part of a new local NHS trust, was unable to make appointments or keep-up with requests for decisions from West Middlesex hospital for most of 22nd of December 2017.

There used to be some kind of home service run from Barnes Hospital, but this doesn't appear to exist either

In a country that can afford Trident, MI5, and the Commonwealth Games with a local council that can afford new street furniture as part of a local village plan.
Can I have my tax back, please, if it is not going to be spent on sensible things?

Social care without social services

From someone who has to do a little bit of work as a carer, I understand this

There is a machine called a pivotelli that can open a pill box, ring a buzzer, and text a carer if the person who needs pills forgets to take them.

A simpler version from a couple of suppliers has no mobile texting system built-in

There is a flat-screen clock that displays day, date, and time in a simple way once set-up.

An offer of these, free at the point of delivery, to anyone suspected of bad memory problems by hospital staff or a GP, could automate some of the problem-solving that social services are asked to do. Patients differ, but if the things are doled-out to the wrong person, that's only about £100 cost and no great human stress, except maybe to the patient who has to turn the thing on and can't work-out how.

If anyone who works in social services could try to get together a list of tasks that need automating or simplifying by making free at the point of delivery, then I am sure a lot of the work could be reduced.

Lifts: I am no so sure about this idea but think there is something in it

Another relatively cheap solution is the fitting of a straight-line stair lift. These things are not very good. They are slow. They are beige. Frail people can fall-off them, so in some situations a carer could be needed as well as a lift. Wheelchairs do not slot-on to the things as far as I can see. But they are often available second-hand for next to nothing, and the ones that go round corners are only a few hundred pounds more.

I suggest that everyone over the age of 70 or who is thought at risk of needing a stair lift should be offered one, with fitting, free. That way, when the time comes, they can come home from hospital with less work from social services (who don't exist) to get a lift fitted.

More practical is a through-floor lift, or one fitted out of doors. The price for a through-floor seems rather elastic. I heard of a quote of £11,000 for one delivered months after payment and after much pushing from an unstable company (British Homelifts), but the cutting of the hole in the floor and the assembly of large macano-like devices is contracted-out, and the lifts themselves from Pollock, Terry, Wessex, or ? Dolphin often come-round second-hand for free. About half the ads on ebay say in the small print that they are from contractors and that you can contact them for a quote to install.

http://www.for-sale.co.uk/through-floor-lift

There is a UK firm that makes in China called Stiltz as well. A lot of the skill seems to be assembling local contractors willing to cut a hole, install a lift, and check it works; the cost of the lift itself is not the problem.

https://www.london.gov.uk/in-my-area/richmond-upon-thames

On another subject I should mention this in a future post some time. Greater London Authority's page for Richmond on Thames

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other posts on one page

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.”

Are there any other ways to fund adult social care by reducing long-term illness?

There is another post below about funding adult social care from a private fund
There is another post below about what MPs from 3 parties said about ring-fencing social care

I think there should be a ring-fenced fund for health and social services, and a ring fenced fund for welfare benefits. National funds, debated in parliament, and sub-divided by region according to need. I think these notional funds should become more actual and clear over time, and be linked to something like all of VAT revenue plus more. I think that embassies, circuses, submarines and the like should not have a ring-fenced budged. I think that insurance-like services are what people pay tax for, and should be accounted-for in an insurance-like way.

This is a post about getting people to be more healthy - live fast die young as Blondie put it - rather than being depressed or demented or diabetic or dotty or desparados in some way that's less fun.

One part of this has already been done. It is to label parts of NHS budgets as "health promotion" and re-allocate them to councils, who at best use them for adult social care and at worst use them for a new Town Hall. I doubt any council is skilled in promoting health - councils have trouble being good at any one thing because they do so many different things with so many people involved. Their accounts don't track the effects of more or less spending either - they don't link spending in one area with saving in another.
But there are instances of better cycle lanes of maybe free swimming passes or more hedges in the centres of dual carriageways that might make a difference.

I think that central government, with laws and ministries, and perhaps the EU, can make a big difference.

Label the health data of mass-produced food in as large a typeface as fits. 

This would inform people about the food they're eating, and the advice they get on telly or from GPs. At the moment there is a system where smokers face rather disgusting images on their fag packets, which I think is over-kill, while eaters of saturated fats can be blithely unaware because the food labelling is too small to read. I don't think this is too paternal; I think it's just giving information in more readable way. I don't think this is impossible. If it can't be done by regulation, it could be done by charging higher VAT on badly labelled mass-produced food. As for food made in smaller batches, the same principal applies but the job that grocers have to do is different. They may not have a packet for a particular type of food. Obtaining the information to print might be a more significant part of the price of the food. I think the GLA has plans for nutrition labelling on restaurant signs, and nobody has said it's impossible.

Tax fags & booze by unit of tar or alcohol, rather than by litre or pack. 

I don't know if this is possible but there have been efforts with alcohol to enforce minimum prices or such like; this is a similar idea. The current tax system has led to a progressive strengthening of beer strength over the centuries. People who don't like fags argue that the cancerous compounds are too complicated to measure and tax, I expect, but a BBC book from years ago called "Can you avoid cancer?" suggested that tar was a major indicator of how dangerous a fag is. Since then, a generation has talked about secondary effects, and "sending out messages" and generally acted like school prefects, but I still believe what I read in a BBC book decades ago.

Print nutritional data on till receipts

Here's an idea for a pilot scheme that one of the supermarkets might try if given a subsidy to try it. Build nutritional data into the same stock database that tracks price and availability for the till receipt. The big supermarkets have already tried adding special offers and nectar points; I don't think this is much more complicated. As a result, there could be more shops printing out nutritional data at the bottom of the till receipt as well as the total price and the special offer on petrol. There could also be a tax or regulation to discourage advertising of fatty foods that are often eaten as part of an unbalanced diet. And a tax on meat - one of those categories of food - to justify high spending that exists at the food standards standards agency to regulate meat sales. I should have slipped that one in un-noticed in the middle of a paragraph, because some of the few people who read this will think "extra tax for meat: never!", but I hope those people read the other paragraphs as well, in case they agree with the rest.

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A Vision for Adult Social Care: capable communities & active citizens

Bedtime reading. I doubt I'll agree with it if I read it.
http://webarchive.nationalarchives.gov.uk/20130107105354/http:/www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_121971.pdf

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Are there any other ways to fund adult social care like a private fund?

There is another post about reducing the need for healthcare by making healthy life easier.

Could people club together to fund a trust which pays government (or whoever else) to provide adult social care? This would by-pass elected chancellors and their decision-making-ability-deficits. https://en.wikipedia.org/wiki/Edhi_Foundation has done this in Pakistan and managed to run Accident and Emergency departments and ambulances in a country that has no government budget for healthcare.

A quick google didn't find easy estimates of the cost of adult social care per person.
The figure in England is tens of billions for a population of 53.01 million.
That's from the figures in a big font size on page six of this:
http://www.nao.org.uk/wp-content/uploads/2015/03/Adult-social-care-in-England-overview.pdf

Assuming that a billion is a thousand million, that's a thousand pounds each per person alive per year of life.

Assuming that a trust fund can make 10%, that's £10,000 per year in trust per person.
The 10% figure is based on P2P lending recently on the smaller sites. I don't know if large-scale investment could ever make that much after inflation so call it £20,000 or £40,000 in trust per person.
This american page suggested 6% after inflation is a better rule of thumb if you include admin costs of private funds with their accounting, sales, porsche-driving fund managers and city centre offices to support. A fund would also have to pay admin costs, so a rough-and-ready way of running it cheaply would be good. The picture is from http://www.jeffbevan.co.uk and shows how someone sells eggs in Street in Someset. It also shows what people both love and hate about welfare state compared to private insurance: it may be cheap to admnister but it's hard to get a receipt and prove what you are entitled to.

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