REPORT ON THE REDEVELOPMENT OF THE NELSON HOSPITAL,
from Ian Ayres, Chief Executive, Sutton and Merton PCT.

By the Spring of 2002, there have been many changes to the NHS with the NHS going through its largest reorganisation since 1948.  This has happened at all levels from the Department of Health down to hospitals such as the Nelson. 

The Department of Health and NHS has been integrated into a single structure:  Regional Offices have been abolished, removing one layer from the structure.  300 National Health Authorities have been abolished and been replaced by 28 Strategic HealthAuthorities.  There are 9 Departments of Health and Social Care.  There are no longer any Community Trusts – all activity has been passed to the PCTs (Primary Care Trusts).  Many senior managers have been displaced.

The Nelson and West Merton PCT was formed in April 2000 as a merger of GP and community nursing services.  The new Trust based its headquarters in the Nelson Hospital and transferred ownership of the site from the Epsom & St Helier NHS Trust to the Nelson and West Merton PCT.  The Nelson and West Merton PCT has subsequently joined with the East Merton and Sutton PCG in April 2002 to form the SUTTON AND MERTON PCG.  This organisation has 1500 employees (the Nelson and West Merton PCT had 200) and there are 42 premises in total. 

Plans to rebuild or renovate the Nelson Hospital have been talked about for many years but little or no action had been evident.  The site is dilapidated both inside and out and, until the formation of the new PCT, there had been little sign of increased services being introduced.  Since its formation the PCT has been working with local GPs, nurses and hospital clinicians to develop a new vision for the range of services that could be provided from the site.  This vision has been shared within the local NHS and with the London Borough of Merton, and has wide support.

As a result of such extensive support, the PCT re-launched the New Nelson Community Hospital Project in January 2001, in order to develop the vision more fully.  A project manager was appointed and a new management group set up to lead the work.  A Reference Group was also established to provide a wide range of input from the local NHS and Borough. These two groups are complimented by an additional group (The Nelson Community Reference Group) run by the local MP, Roger Casale, which has the aim of providing a focus for community regeneration in the area.

The main objectives of the New Nelson Community Hospital Project are to:

• Address health & safety and maintenance issues on the site
• Improve and expand services provided from the existing buildings
• Examine the financial and practical viability of developing the site in the long-term and prepare business plans to support the proposal

A Feasibility Business Case for the redevelopment and expansion of Services at the Nelson Hospital was developed in the summer and autumn of 2001 and demonstrated that the site had a future.  It also recommended the developing of the site by the knocking down of the old buildings and replacing them with a modern hospital.  There was wide support from Social Services, local acute trusts, the voluntary sector and health authority.  The development of the site is likely to be funded by PFI.  A Strategic Outline Case is currently being worked on and will be complete after the summer. This phase of the project has included expert financial advice, looking at what is viable and planning it, determining what physically can fit on the site, what it would cost, etc.  The next stage is the Outline Business Case, which includes a specification of what is required on the site.  Then there is the Final Business Case.  At this point tenders are invited to develop the site. The likely date for development is 2005 and there will be a public consultation. The site will respect architecturally the surrounding area.

It is planned that there will be GP services, community nursing services with clinics for children and the elderly, a diabetic clinic, primary community care for minor injuries (24 hours 7 days per week), ambulatory care (walk in walk out) with x-ray, ultrasound, giving blood and seeing consultants.  There will be day surgery, day hospitals for the elderly, etc.  Also there will be community mental health care.  The PCT is working with the voluntary sector and the community.  There will not be beds on the site.

A lot of work has now been done to address the health, safety and maintenance issues at the Nelson.  Current refurbishment and improvement at the Nelson Hospital includes the painting of the downstairs windows at the front; the main waiting room has been decorated and the roof has been patched; the car park is to be enlarged and parking will be over the old florist’s site and conditions on the building of the car park have been imposed to preserve the trees.  The hospital site is now full and being used entirely for health care.  The Wimbledon School of Art have left the Nelson (they had occupied half of the top floor.)  An Internet Café has been introduced for staff with the help of the League of Friends.

If you have any questions about the project, please contact Ian Ayres, Chief Executive of the Sutton and Merton PCT on 020 8251 1111.
 
Document produced July 2002.

Link to the urban design task force Nelson Hopsital workshops