On March 21st I took part in a guided tour of the new North Cotswolds Hospital in Moreton-in-Marsh. Tours of the building had been arranged to show it off to local people just before its final cleaning and the arrival of the first patients. I was invited to join one of the tour parties of around twenty people as a member of Gloucestershire LINk.
Households in the area had previously been leafleted by NHS Gloucestershire, the primary care trust (PCT), to advertise the new hospital’s opening on March 31st. An official opening by HRH Prince Michael of Kent took place on May 10th.
A week before the official opening there had been a fire, apparently caused by a physiotherapy machine. It was quickly put out, but even so the hospital was evacuated in the early hours of the morning and three fire engines attended. It is interesting that in spite of various allegedly hi-tech aspects of the building design, the fire was detected not by some ultra-sensitive smoke alarm but because someone smelled burning.
I wasn’t sure what I would learn from a brief tour of an empty hospital. My main impression was that it was, er, just like you would expect an empty hospital to be. It had empty rooms and empty corridors. Everything was new and bright.
In part it was bright because it was a gloriously sunny morning, but I noticed that all the lights were on too. The building was not designed to take good advantage of natural light. As the bulbs age, the diffusers collect dust, and the season changes, I think parts of the new hospital may descend into gloom.
A lot of effort has apparently gone into commissioning artwork for the hospital, but I was not particularly impressed. The artwork around the main reception desk requires constant electic lighting. Again, I think it will be hard to keep it clean and the bulbs well-maintained. None of the other artwork seemed to be integrated into the design of the building or into the signage the way it could have been.
A door from the main waiting area leads to a garden, where a scary sign says:
Notice: Adult supervision is required in the Garden Area at all times. No responsibility can be accepted for damage or injury due to improper use of this area.
I suppose that means if you slip on a fallen leaf and limp back round to the minor injuries unit you will be turned away. The garden is such a dangerous place that I saw no one venture into it. The tour didn’t visit it, perhaps because we were all adults and Matron might have found us difficult to supervise.
On the ground floor we saw the main reception area, the minor injuries unit (which is a corridor of the main building, not really a separate unit) and the gym. We were told that the gym is supposed to double as a classroom, but the signage in the corridor didn’t reflect this, and nothing about the design of the room made it look at all suitable for running classes. I suspected that there had been complaints about lack of a classroom, and the idea of using the gym for classes was perhaps a bit of hasty back-pedalling at the last minute.
The minor injuries unit (MIU) was not well signposted. I think most people looking for it will come though the hospital’s huge glass entrance doors and head straight for the large and well-signposted reception desk, only to be told that they have walked right past the MIU and will have to go back. MIU reception is a little hatch on the left of the main corridor.
On entering the MIU you immediately see a kind of intercom unit on the wall to your right. A sign says “Please wait to be called” although there is actually no waiting area, just the corridor behind the door. I suspect the MIU will sometimes overflow back into the main corridor where there is a lot of unused space between the main front doors and reception.
Across the MUI corridor to the left on the opposite wall there was a bracket for an alcohol gel dispenser. It should have been right beside the intercom, I thought. No one will go across the corridor for alcohol gel before going back to use the intercom, and there’s a risk that the intercom will become a hotspot for cross-infection if people in a hurry use it without cleaning their hands first.
Within the MIU there are facilities for x-rays and plaster. There is a separate waiting area for x-ray, but nothing to indicate that it’s there until you come across it.
On the upper floor we saw the nurses’ station, a couple of the 22 rooms for in-patients, and the day room. The day room did benefit from natural light, and it gave a spectacular view eastwards across the Fosse Way in the direction of Chipping Norton. By now, however, the view in the foreground from there will be of the building site where the new GP centre is being constructed, and in future the day room will provide a good view of the back end of that building. The day room seemed to have balconies, but I can’t imagine patients ever being let loose onto them.
The nurses’ station repeated the ground floor design flaw. It is spacious and looks exactly like a reception area. Visitors to the upper floor will tend to go there first, only to be told they have walked right past the little hatch in the corridor that is the real reception facility. If a lot of people arrive at the same time, there won’t be room in the corridor for them all to wait at the hatch, so they’ll overflow back into the stair-well and into the large wasted space of the nurses’ station.
The en-suite room that I saw looked like any hospital room. I don’t know what else to say about it. Everything in it was new except the curtains, which looked as if they might have come from the old hospital. We were told there is no room 13 at the request of staff, but my own feeling is that being nursed by staff who seriously believe 13 is unlucky is probably a worse fate than being allocated to room 13.
Outside we were shown a parking space for ambulances, although I thought it odd that there was no door into the hospital there. Anyone arriving in an ambulance has to get to the main door or else to the back door into the MIU. Also outside there is designated space for mobile units, but it didn’t seem that they would integrate with the hospital in any useful way.
Some things about the hospital tend to be left unsaid. The idea of hospital treatment in Moreton-in-Marsh is not new, but dates from the days of Florence Nightingale. There has been a hospital since around 1872, originally called Moreton-in-Marsh Cottage Hospital. Its first matron was Rebecca Horne, who had been born in Moreton-in-Marsh in 1840 and became a Nightingale Nurse. In 1900 the hospital acquired its own operating theatre.
In 1948, of course, the voluntary hospital was requisitioned by the NHS, and the Hospital Road site with its listed building is now valuable development land near the centre of the town that contributed £3 million to the cost of the project, according to an early estimate, the new hospital being on cheap land out of town.
The new hospital doesn’t increase the number of hospital beds available in Moreton-in-Marsh. A proposal to build a 50-bed facility on a brownfield site had been rejected in favour of this smaller unit. I have no doubt that the new facilities are probably better in some ways, but it’s not entirely clear how much better because none of the official information about the new hospital acknowledges the existence of the old hospital at all, and it’s been like this since the plan was first approved in 2006.
Management of the hospital by the increasingly controversial Gloucestershire Care Services is another thing that tends to remain unspoken. In June 2010 the Department of Health’s Revision to the Operating Framework for the NHS in England 2010/11 directed that:
Separating PCT commissioning from the provision of services remains a priority. This must be achieved by April 2011…
Yet in Gloucestershire the PCT remains unashamedly both the commissioner and the provider of services like the North Cotswolds Hospital, using its own logo on the leaflets delivered to local households.
My overall impression of the hospital was good, but with reservations. The design of the building didn’t seem to have been particularly well thought through, although on a sunny day before work started on the building in front, it looked nice.