INPATIENT FACILITIES


Historic hospital’s fitting replacement


Derek Shepherd, a director at P+HS Architects, describes the many different architectural, aesthetic, clinical, and service-user-centric elements the practice took into account in creating a new adult and older people’s acute inpatient mental healthcare facility in York for the Tees, Esk and Wear Valleys NHS Foundation Trust. The design and feel of Foss Park – which is nearing completion by Wates Construction – required that it should not only ‘not look or feel like a hospital’, but should also echo the heritage of the much-loved eighteenth century facility it has effectively replaced, while ‘revoking entirely’ the feeling of the asylums of earlier days.


‘We have come a long way’ is a comment I often hear within the circles of designing for mental health. Indeed, clinicians will often reflect on the provision of care over the past 30 years, and remark on the advancement and understanding of many specialist areas of mental healthcare. With this in mind, when tasked with reviewing modern mental health in the Vale of York, it was with nervousness and excitement that we at P+HS Architects began our journey working with Tees, Esk and Wear Valleys NHS Foundation Trust. The brief not only included the review of the existing Bootham Park Hospital in York, but also future options for inpatient care for the people of York and the surrounding areas. So, how far have we come? Bootham Park Hospital was purpose built in 1774 to provide accommodation for the ‘mentally infirm’. The healthcare facility was one of the first of its kind; indeed the recognition of the need to care for people who needed either acute care, or were unsuitable to be ‘sent to the workhouse’ had been highlighted in the press in 1772. The need for a ‘Lunatic Asylum’ was raised by a local journalist’s article, and led to the creation of the ‘County Lunatic Asylum, York’. Later named Bootham Park Hospital, it incorporated a celebratory plaque, revealed upon the hospital’s opening, which announced: ‘This Building was erected on general subscription in the year 1774 for the reception and relief of the Insane’.


A place in local residents’ heart And so it continued – with a place in the heart of all the local residents of York, Bootham Park provided mental health inpatient accommodation for over 200 years. However, following an inspection by the Care Quality Commission (CQC) in January 2015, concerns were raised about the environmental safety of patients within the hospital’s inpatient wards. Despite many attempts to improve the facility, it was agreed in September 2015 that the


THE NETWORK | JANUARY 2020


An aerial photograph of the Foss Park site taken in October 2019.


hospital was no longer fit for purpose, and patients were to be moved to temporary accommodation.


Options appraisal and review P+HS Architects was appointed early in 2016 to provide option appraisals for a number of potential sites in the locality for a new-build facility, with our brief to include an extensive review of Bootham


A historic engraving of the original 18th-century Bootham Hospital.


Park to ensure that all considerations had been given to the iconic former Asylum. Key elements of design were considered within the review of Bootham Park. It was acknowledged that privacy and dignity were falling short, with, for instance, the use of mixed sex accommodation and shared toilet and bathing facilities. The ability to provide a safe environment was limited, while there was no existing provision of access to external spaces. Poor observation also impacted on the efficient use of the existing buildings. Suggested alterations, part demolition, and reconstruction, were all considered and dismissed – due to the buildings’ mix of Grade I and Grade II listings. Extensive discussions between the City of York Planning department, Historic England, clinical and estate representatives at the Trust, and P+HS Architects, took place. While all options were considered, the balance between re-using the eighteenth century buildings and ensuring the highest levels of patient care was eventually


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