Hub space squeeze - where will ambulances go?
Earlier this year, NHS bosses agreed to add a 'public square' to the front of the Market Square neighbourhood health centre Hub
This could improve the look of the Hub - but raises a doubt over ambulance access
The agreement on the square came after pressure to reduce the dominating visual impact of the five-storey Hub on the lovely Water Gardens
Historic England were concerned that such a building would create a 'canyon' effect which would make the Gardens look smaller
The Council agreed with that heritage watchdog to add a 'public square' to the Waterhouse Street frontage of the Hub to soften the impact on the Gardens
But that leaves a question mark over how ambulances can access the Hub
Will an ambulance bay be awkwardly combined with the new 'public square'?
Or will ambulances just have to draw up in Waterhouse Street or Marlowes?
The authorities keep trying to squeeze too much into the unsuitable, too small Market Square
There are better options on the current site
Too small to cope? Doubts over plans for urgent treatment in Hub
The Market Square hub could see a big cut in local urgent treatment services
The Hub would be a neighbourhood health centre (NHC)
NHCs are intended to deal with just 18,000 ‘minor injuries/walk-in’ cases a year, according to a national policy document
Hemel Hospital’s equivalent urgent treatment centre sees 45,000 cases each year
That could mean a gap of 27,000 cases a year if the health centre Hub goes ahead
And that is without the impact of future population growth
Cue more queuing for Hemel patients at Watford General A&E?
The Market Square Hub would be a downgrade
Meanwhile the price tag for the Watford General rebuild rises to £2bn as cost control there goes out the window
Hemel deserves something much better, and those we elect should be demanding a fairer financial settlement
The document is the Activity Calculator in the Neighbourhood Health Centre guidance published by NHS England
Hemel Hospital's smart wards are just for filming
Those in favour of destroying Hemel Hospital claim it is derelict and unusable
That is nonsense.
The West Herts Trust makes money from hiring unused parts of the Hospital - including some of the Windsor Wing - for TV and film locations
There is a company called Location Collective which promotes our wards to producers
Our Hospital buildings are NOT all in 'disrepair' as some claim
Here are just some pictures used to sell our Hospital wards to the entertainment industry:
Few face-to-face hospital facilities likely in Market Square Hub
Access to face-to-face hospital services is likely to be minimal in the Market Square Health Campus/Hub
National NHS Plans for 'neighbourhood health centres' (NHCs) like the Campus show that:
- They would have ZERO fully-equipped consulting/examination rooms set aside for secondary shift (hospital-style) care
- Hospital specialists would have to hot-desk in 18 consulting/exam rooms with GPs and community healthcare
- There would be only TWO rooms for treatment connected with secondary shift care
- There would be 3 office-style rooms for virtual (online or phone) secondary shift appointments
This would be a huge reduction in face-to-face facilities compared with Hemel Hospital
In just one existing Hemel Hospital building, Verulam from 1992, there are about 40 consulting or examination rooms
The NHS is planning for rooms for many more virtual appointments at NHCs. These can be very convenient for patients, and can save money and travel time
But the NHS assumes virtual secondary shift appointments will last just 15 minutes, against 30 minutes for face-to-face. And virtual appointments are not suitable for some conditions and some patients, especially those who struggle with digital technology
These figures are taken from the NHS Neighbourhood Health Centre Activity Calculator.
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NHS has shrinking ambitions for Hemel Hospital
Just five years ago, local NHS bosses planned a big future for Hemel's Hospital
In 2021, West Herts NHS Trust set out their ambitions for a real specialist planned care Hospital at Hemel, to serve all of West Hertfordshire
A Trust document quotes a consultant as promising 'Great hospital care' at Hemel
But now the limit of the Trust's ambition is to build the small Market Square Health Centre
In 2021, the document said the NHS aim was for Hemel Hospital to:
- be a centre of excellence for people across West Herts who have long term and/or multiple conditions.
- have a new and unique purpose as the site for specialist planned medical care for the whole area
- become the Trust's site for specialist diabetes and rheumatology
The NHS trumpeted Hemel's proud role in the area's healthcare because:
- Tens of thousands of patients every year will benefit from our plans to transform how this site works.
Just over five years later, the NHS has ditched its ambitions for our town to be a 'centre for excellence' in specialist planned medical care for the 600,000 people of West Herts
Today, it wants us to welcome its slimmed-down plans - for a purely local 'neighbourhood health centre' to serve the town of Hemel alone.
The Market Square health centre would emphasise important GP, prevention and community services, but there would be only a small amount of room for any specialist secondary services.
The plan now is certainly to 'transform how the [Hospital] site works'
By demolishing the whole of the current Hospital and using the site for housing
The Trust's document, 'Your Care, Your Views', is below. See pages 20-24:
Your Care Your Views full version
Drastic cut planned in local hospital care space for serious conditions
The planned Market Square neighbourhood health centre (NHC) Hub would see a drastic cut in clinical space for local hospital style (secondary) care for serious conditions.
NHS plans for NHCs show that they will have only 99.8 metres clinical space devoted to secondary care. Secondary care would share just 113 sq m of other clinical space with community services. There would be 105 square metres clinical space for diagnostics – again shared with other services. Minor injuries (or urgent treatment) would have an additional 154 square metres clinical space.
So there would be a total of just 470 square metres for ‘hospital’ services in the Hub – at the most.
That compares with 20,000 square metres for hospital services on the current hospital site.
NHCs like the Hub will be dominated by GPs, community and mental health services.The drastic cut in accommodation for local secondary hospital services could mean patients with serious conditions travelling much more to Watford and St Albans Hospitals for care. The local numbers of such patients will grow rapidly in future as the total of over-65s increases by 20% by the late 2030s.
The figures are contained in a ‘schedule of accommodation’ for the biggest NHC, Core++. The link is below (go to Schedule of Accommodation):
https://www.england.nhs.uk/publication/neighbourhood-health-centres/
Consulting rooms could be slashed in Market Square Hub
- The number of local NHS consulting and examination rooms could be drastically reduced if the closure of Hemel's Hospital goes ahead
- NHS guidelines on the very biggest 'neighbourhood health centres', Core++, like the Hub planned for the Market Square, say they should have 31 consulting/exam rooms
- This would be a big cut on the numbers now available for use.
- Just a single 1990s building in Hemel Hospital - Verulam - has about 50 exam and consulting rooms.
- The health centre Hub will also have to house GP and community health services, so the cut in space for hospital style care would be serious
- According to the guidelines, only 16 of the rooms in the biggest heath centres would be for face-to-face consultation by clinicians
- The other 15 would be simple offices for 'virtual consultation', with no couch or other professional equipment
- So the Market Square health centre would be a downgrade
- There is nothing wrong with bringing different NHS services together
- The problem with the Hemel Hub is that the site is far too small for our growing and ageing population
- The relevant page from the NHS guidance is this:
NHS bosses' neglect laid bare as disused Hospital building crumbles
- A large part of the roof of a historic but disused Hemel Hospital building has collapsed
- Cheere House is very close to a car park and overlooks busy Hillfield Road and King Harry Street
- The building was declared unsafe back in May, but the Trust has yet to answer DHAG queries about public safety and the future of the building
- It seems unlikely that the 1832 building, Hemel's first purpose-built Hospital, can survive much longer
- But that could be seen as an opportunity for a good solution
- If Cheere House IS condemned and demolished, that would potentially leave the site free for a new hospital facility much larger than the Market Square 'Hub'
- NHS bosses' neglect has speeded up in recent years,
- In 2017 (picture with former MP Mike Penning) Cheere House was in decent condition, though disused
- Today (other picture) it is in a pitiful, and potentially dangerous, state, with a large section to the left open to the elements
2017 2026
DHAG constitution published
- A member of the public has asked whether the constitution of the Dacorum Health Action Group can be published
- This is an excellent idea - here it is
- DHAG constitution
Part of roof collapses on disused Hospital building
- Historic Cheere House - the oldest building in Hemel Hospital - has suffered a partial roof collapse
- The building, which is disused, overlooks car parks and town centre streets,
- Building inspectors say it is 'not an imminent danger'
- But Hertfordshire Building Control warn it 'could deteriorate more'.
- In May, notices appeared on Cheere House warning people to Keep Out
- A structural engineer has been called in to assess the situation of the 1830s structure
- Dacorum Health Action Group has asked West Herts Trust, which is responsible for the buildings in Watford, St Albans and Hemel Hospitals, what plans they have for Cheere House.