Is Watford is a Victorian hospital – discuss

“Victorian” is over-egging it Sir Mike

Sir Mike Penning said recently in the House of Commons that “Watford is a Victorian hospital” but that isn’t quite right. Accuracy is important – otherwise people end up saying all sorts.

Clinical services at Watford are concentrated in the Princess Michael of Kent (PMoK) building which was built in 1984 (based on a 1960s design) and houses the emergency department as well as the majority of inpatients wards, the main theatre complex, outpatients, ICU and radiology. Since the mid-2000s a series of modular buildings have been used to keep the ensemble viable, but maintenance is becoming critical and it seems clear that the first objective of the plan for Watford is to retain the PMoK, with some re-modelling.

Support (Admin) and non-clinical services on the site are delivered from a variety of buildings, some in very poor condition. The site originally housed the Watford Union Workhouse, built in 1837, and some of the original buildings (which are Grade II listed) are still in use, although not for the delivery of clinical care.

For accuracy, this is what the CCG’s current SOC says about Watford buildings:

Over 80% of the site is assessed to be in ‘poor’ or worse condition, with 40% of the buildings over 40 years old. Investment in backlog maintenance over the last five years has been targeted on statutory compliance (asbestos, legionella, ventilation systems and infection control) and on improving the resilience of critical infrastructure (power supply, steam and pressures systems, lifts and fire).

  • Support and non-clinical services on the site are delivered from a variety of buildings, some in very poor condition. The site originally housed the Watford Union Workhouse, built in 1837, and some of the original buildings (which are Grade II listed) are still in use, although not for the delivery of clinical care. None of the buildings are considered to have viable long-term future for the delivery of healthcare services.
  • Clinical services are concentrated in the Princess Michael of Kent (PMoK) building which was built in 1984 (based on a 1960s design) and houses the emergency department as well as the majority of inpatients wards, the main theatre complex, outpatients, ICU and radiology. The building fabric, utilities infrastructure, layout and space allocations are poor creating an unsatisfactory clinical environment and poor patient experience. Investment in the critical infrastructure is essential if the building is to be retained.
  • The Women’s and Children’s Services (WACS) building was constructed in the early 1960s and is no longer fit for purpose as a clinical building. Investment over the last five years has focused on keeping services delivered in the building ‘safe’. The design, layout and condition mean that even with major refurbishment the building cannot be made suitable for clinical services.
  • The Acute Admissions Unit (AAU) is a modular building. It was opened in 2009 to provide inpatient services and facilitate the co-location of emergency services at WGH. The building and major equipment will require mid-life investment if it is to form part of the long term estate plan for WGH.
  • Since 2011, a series of temporary modular buildings have been added to the site to provide surge capacity and support the introduction of new care pathways. Most recently, WHHT acquired the Shrodells unit to provide the required flexibility on site to enable service reconfiguration and reduce pressure within PMoK. This only provides a short-term solution as the building suffers from similar problems to the WACS building.

So lets be clear here. The base we have to go on is 1960’s vintage – less than ideal – in fact it’s critically flawed. Patching up and refurbishing is fine if the base was good. But really is it not just better, fairer, faster and cheaper to start again ?