FOR INFORMATION
RELOCATION OF THE REHABILITATION AND ASSESSMENT UNIT FROM
ST LEONARDS HOSPITAL SITE TO BOSCOMBE (PEER HOUSE)
1.0 Introduction
1.1 The Rehabilitation and Assessment Unit, (RAU), currently based at St Leonards Hospital provides vocational rehabilitation to help those who have a health condition, injury or disability to access and maintain their return to employment. The service is provided to the eastern side of the county Dorset.
1.2The building and land in which the RAU is based is not owned by the Trust and along with other ‘surplus land’ at St Leonard’s has been earmarked for development for some time. The RAU currently occupies a pre war Nissan hut which provides very basic accommodation and is not suitable for continued use.. Whilst not owned by the Trust there has been no lease or rental charge for the use of the premises / land.
1.3On this basis many other services previously based at St Leonard’s have relocated over recent years and the Trust has over a number of years been seeking alternative accommodation for the RAU, in the knowledge that we are expected to vacate the site.
1.4Initially the Trust was due to vacate the site since the 1990s at which point the building was due for demolition. However at that time no suitable alternative was available. Thenmore recently in March 2008 and is now anticipating that we may again be asked to vacant at short notice as the land is being marketed by English Partnership to be developed as a Care Village.
1.5In seeking suitable accommodation the Trust has explored a number of options. However it is important to recognise that the environment needs to be suitable for the client group, many of whom have physical disabilities, provide sufficient space for rehabilitation activities, and be accessible by public transport ( although the majority of patients receive hospital transport and will continue to do so). Further more any alternative accommodation needs to be affordable within the current limited budget which does not provide for expensive rental of premises.
1.6 Within the above constraints the only viable option is to relocate to Boscombe, to the former Peer House premises which are owned by the Trust and therefore affordable as it does not attract a commercial rent.
1.7 Peer House is based at the rear of the Trust’s Headquarters, and is a significantly more modern building than the current Rehabilitation Unit, which currently occupies a pre war Nissan hut. Peer House will undergo further refurbishment work to ensure the facilities are fit for purpose, modern and suitable for service users.
2.0Consultation and Service User Involvement
2.1Service users have been advised of the need to relocate the service over the last year. This has been achieved through designated meetings with Service users on the 20th and 22nd June 2007.
2.2A formal presentation was also made to the Trust Public and Patient Involvement forum on the16th July 2007 on the role of the service and need to relocate.
2.3Following this presentation the PPI wrote to the Trust (Appendix A) and formal advised that the relocation of the RAU in their view did not constitute a substantial variation. This was on the basis that nature of the service and capacity would not change only the location which remains the case.
2.4With Peer House now being the only viable and affordable option current service users were invited to two open days held at Peer House. The open days took place on Tuesday 4th November 2008 and Wednesday 5th November 2008. Ten service users attended on the first day, and thirteen on the second.
2.5An explanation as to why the service needs to relocate was given and a tour of the building outlining the planned refurbishment and proposed use for each room. In addition service users were asked to give any comments/ suggestions.
2.6 In order to facilitate discussion and the completion of the Service User Impact Assessments contained in the Protocol for Joint Health Scrutiny in Bournemouth, Poole and Dorset an informal presentation was given outlining and discussing each of the impact area.
2.7Following this service users were asked to give a score for each issue. This was repeated on both open days and the results combined to produce one impact assessment. The scores given by service users can be found at Appendix B.
2.8 Comments were recorded for each impact area, and service user’s suggestions will also be used to inform the planned refurbishment of Peer House. Many useful suggestions were made which staff were grateful for.
2.9Both staff and service users gave positive feedback on the open days, welcoming the opportunity to be involved, view the premises, commented what an enjoyable day they had, and many were looking forward to the relocation to Peer House.
2.0Impact Assessment Results
2.1All the service users were in agreement that the move to Peer House was a positive development both in terms of the enhanced and spacious environment that Peer House offers and in terms of location and access to local amenities. Specifically , Peer House will offer additional facilities including:
- Disable access toilet facilities
- Shower facilities
- Service user kitchen are
- Service user rest room
- Increased access to IT facilities and networks
2.2All the suggestions made will be incorporated into the refurbishment/ design brief including:
- Automatic doors
- Designated parking spaces adjacent to the unit
- Appropriate colour schemes
- Heating / temperature controls
2.3Whilst extremely positive about the proposed relocation, it was recognised in the contact of the impact assessment that all other aspects of the service would remain the same, ie: function, capacity, availability, etc, and therefore there was an overall view that the move itself did not constitute an ‘substantial variation’
2.3The views of the RAU Service users Impact Assessment endorses the view previously expressed by PPI Forum.
2.4The Staff impact assessment at Appendix C also demonstrates a positive impact across all areas and concurs with the Service user Impact assessment and PPI Forum view that the relocation does not constitute substantial variation.
2.5It is particularly important to emphasis that the service being provided will remain the same with the except location.
2.6An analysis of where geographically service users come has demonstrated that for the majority there will be little or no impact, whilst it is accepted that for a small minority their journey may increase slightly.
2.7Whist 59% of attendees currently receive hospital transport , and this will continue to be the case – it was also worthy of note that some service users felt that having Public transport available was also an added benefit and gave choice.
3.0Options Appraisal
3.1Option A) Do Nothing
Should the Trust do nothing – the RAU will be expected to vacate the site at St Leonard’s and with out a suitable alternative venue the service would cease.
Doing nothing at the present time would enable to the service to continue at it’s present location for a short while – however, a suitable and affordable alternative is currently available and this would present a missed opportunity.
3.2Option B)Relocate to Boscombe
Peer House is a suitable and affordable alternative. It is favoured by Service users and Staff over the current location. No other alternative is available.
The building is vacant and work to refurbish can commence immediately, the RAU is fortunate to have been left money in trust which can be used to refurbish the building to a high standard and will provide long term secure accommodation for the service.
3.3Option C) Continue to Seek Alternative Location
The Trust could continue to seek an alternative affordable and accessible location.
However, the Trust has been seeking an alternative for several years and the current proposals is the only viable option. Continuing to see an alternative may result in a missed opportunity and could jeopardise the continuity of the service.
3.4Preferred Option And Time scale
The Trusts preferred option is Option B.
It is planned that the refurbishment of Peer House will commence mid March 2009, and should be completed within 14 weeks from start on site.
The Rehabilitation and Assessment Unit will be able to relocate from St Leonards Hospital at the beginning of July 2009.
4.0Required action
4.1This paper is for information and the committee are asked to particularly note:
- the requirement to move, albeit the service will remain exactly the same, except the location.
- The involvement and consultation with service users and staff and their positive feedback on the proposed move and preference for the Boscombe site:
APPENDIX A
Appendix B
Impact Assessment Form taken from the Protocol for Joint Health Scrutiny in Bournemouth, Poole and Dorset completed by Service Users:
Name of PPI Forum or Service User Group:Service Users currently attending the Rehabilitation Assessment Unit at St. Leonard’s Hospital (November 2008).
Key to completion and scoring
The impact of the change is being assessed using a matrix that looks at four impact areas: Impact areas 1, 2, and 3 each have three aspects, measuring the impact no a seven point scale that ranges from a major positive impact at +3 to major negative impact at -3.
The change may be considered ‘substantial’ if:
- Any one aspect has a major negative impact score (-3) or
- Any one aspect has a major positive impact score (+3) or
- Where a number of negative impact scores give cause for concern or
- Where there is a big discrepancy between the scoring of the relevant NHS Trust and PPI / user group consulted.
The Scale
Major Positive Impact = +3 Major Negative Impact = -3
Medium Positive Impact = +2 Medium Negative Impact = -2
Minor Positive Impact = +1 Minor Negative Impact = -1
Impact Area 1 – Changes in Accessibility
Reduction or Increase of a
service on a particular site / - 3 / - 2 / - 1 / 0 / + 1 / + 2 / + 3
Accessibility to local services for disadvantaged or hard to reach groups / - 3 / - 2 / - 1 / 0 / + 1 / + 2 / + 3
Relocation of all or part of a
Specialist service / - 3 / - 2 / - 1 / 0 / + 1 / + 2 / + 3
Comments on Impact Area 1
“Peer House has bigger rooms – and a better environment.”
“There is more wheelchair access [at Peer House].”
“[Peer House has] more space for Service Users.”
“It’s a shame that the green houses are not available here.”
“I like the ramps for disabled, and the drop curbs etc.”
“Peer House has a better atmosphere – lighter building.”
“It is more central to be in Boscombe.”
“There is more opportunity to travel by public transport.”
“Same transport costs.”
“More for some individuals.”
Suggestions
“It would be good to have door sensors so that the doors open automatically.” / “Better access especially with automatic doors.”
“It would be good to have parking badges for RAU clients.”
“Work benches would be better in the middle of the wood work room – due to vibration.”
Impact Area 2 – Impact on the Wider Community
Degree of impact on the local economy / - 3 / - 2 / - 1 / 0 / + 1 / + 2 / + 3
Extent of impact in relation to transport, including public transport, to and from the service / - 3 / - 2 / - 1 / 0 / + 1 / + 2 / + 3
Impact in relation to an area that is undergoing or in need of regeneration / - 3 / - 2 / - 1 / 0 / + 1 / + 2 / + 3
Comments on Impact Area 2
“Here we can have access to local shops to show people how to budget / shop / look after themselves.”
Positive comments about transport - “We can travel direct on public transport.”
“There are a lot more facilities here than at St. Leonards.”
“Helping me to use the bus as it is nearer.”
Suggestions
“Need to be able to control temperature of rooms so Service Users are comfortable – not too hot.”
“We would like to be able to see the plans for the changes before it starts.”
Impact Area 3 – The Patient Population Affected
Affect on the whole community / - 3 / - 2 / - 1 / 0 / + 1 / + 2 / + 3
Affect on a small group who are accessing a specialist service / - 3 / - 2 / - 1 / 0 / + 1 / + 2 / + 3
Impact of proposed changes on patients at the point of delivery / - 3 / - 2 / - 1 / 0 / + 1 / + 2 / + 3
Comments on Impact Area 3
“No contest for building quality [Peer House is better quality than St. Leonard’s].”
“There is a better lay out, more privacy; it’s a major positive impact.”
“Heating quite hot.”
“Looking forward to the move.”
“St. Leonard’s looks very male dominated compared to Peer House.”
“Not fair staff have to fight to park.”
Suggestions
“Yellow decor too bright – neutral would be better.”
Impact Area 4 – Impact on National / Local Targets
Please give details on how the proposed changes contribute to national / local targets for improving health.
“Walking in the door is a dramatic difference.”
“Shame the service at St. Leonard’s could not be renovated – would be a lot cheaper.”
NHS Trust requesting completion, contact details and return date.
To be completed by NHS Trust requesting completion.
NHS Trust:
Dorset Healthcare NHS Foundation Trust
Contact within Trust: Jane Elson, Director of Older Peoples Mental Health, Addictions and Psychological Therapies.
Form to be returned to:
Form to be returned by:
Details of person completing form
Name: Jane Elson
Organisation / group: Dorset Healthcare NHS Foundation Trust / Date: 03/12/08
Appendix C
Impact Assessment Form taken from the Protocol for Joint Health Scrutiny in Bournemouth, Poole and Dorset completed by staff:
Name of NHS Trust or PCT:Dorset HealthCare NHS Foundation Trust
Key to completion and scoring
The impact of the change is being assessed using a matrix that looks at four impact areas: Impact areas 1, 2, and 3 each have three aspects, measuring the impact no a seven point scale that ranges from a major positive impact at +3 to major negative impact at -3.
The change may be considered ‘substantial’ if:
- Any one aspect has a major negative impact score (-3) or
- Any one aspect has a major positive impact score (+3) or
- Where a number of negative impact scores give cause for concern or
- Where there is a big discrepancy between the scoring of the relevant NHS Trust and PPI / user group consulted.
The Scale
Major Positive Impact = +3 Major Negative Impact = -3
Medium Positive Impact = +2 Medium Negative Impact = -2
Minor Positive Impact = +1 Minor Negative Impact = -1
Impact Area 1 – Changes in Accessibility
Reduction or Increase of a
service on a particular site / - 3 / - 2 / - 1 / 0 / + 1 / + 2 / + 3
Accessibility to local services for disadvantaged or hard to reach groups / - 3 / - 2 / - 1 / 0 / + 1 / + 2 / + 3
Relocation of all or part of a
Specialist service / - 3 / - 2 / - 1 / 0 / + 1 / + 2 / + 3
Comments on Impact Area 1
“59% of the clients receive hospital transport and this will continue. For the majority of people the proposed site will require less travel and is more accessible with good public transport. It is central to the patch it serves. For a small number of people the journey may increase by approximately 6 – 7 miles.”
Impact Area 2 – Impact on the Wider Community
Degree of impact on the local economy / - 3 / - 2 / - 1 / 0 / + 1 / + 2 / + 3
Extent of impact in relation to transport, including public transport, to and from the service / - 3 / - 2 / - 1 / 0 / + 1 / + 2 / + 3
Impact in relation to an area that is undergoing or in need of regeneration / - 3 / - 2 / - 1 / 0 / + 1 / + 2 / + 3
Comments on Impact Area 2
“The unit will be nearer agencies such as Jobcentreplus and closer to local employers. The land at St. Leonard’s Hospital has been declared surplus and the building is earmarked for demolition."
Impact Area 3 – The Patient Population Affected
Affect on the whole community / - 3 / - 2 / - 1 / 0 / + 1 / + 2 / + 3
Affect on a small group who are accessing a specialist service / - 3 / - 2 / - 1 / 0 / + 1 / + 2 / + 3
Impact of proposed changes on patients at the point of delivery / - 3 / - 2 / - 1 / 0 / + 1 / + 2 / + 3
Comments on Impact Area 3
“The number of clients attending is small (approximately 40). They attend over a significant period of time the treatment package can last for up to a year for the more complex people.”
Impact Area 4 – Impact on National / Local Targets
Please give details on how the proposed changes contribute to national / local targets for improving health.
“This is a like for like provision. The improved accessibility will assist those clients with a physical disability access the provision of a service which aims to help then obtain / retain employment. The sighting of the unit in the centre of Bournemouth will aid links to employers, community employment services and other similar agencies involved in this process. The unit will be able to develop more formal links with initiatives such as condition management programme.”
PPI forums / Service User Groups Involvement
Please list those organisations asked to complete SV2
Service users attending the Rehabilitation Assessment Unit during November 2008.
Details of person completing form
Name: June Wood
Position within NHS Trust: Head Occupational Therapist, Vocational Services. Date: 18/09/08
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