Sussex Community NHS Foundation Trust (SCFT) is looking to develop the East Brighton ‘Brighton General’ site into a purpose built Community Health Hub for patients from across Brighton and Hove, and Sussex.

The Brighton General site, which is owned by the Trust, was originally built as a workhouse in the 1860s. It became a general hospital in 1948 but by 2009 the wards no longer met the relevant standards and there has not been a hospital on the site since then.

This development project gives us an exciting opportunity to redesign the site in a way that makes sense for our patients, their carers and our staff and brings our buildings and facilities up to the standard we want and need to truly provide 21st century care.

The scope for development has a much broader remit than just renovating or replacing old buildings. SCFT is working with other physical and mental health care providers to explore other opportunities that could allow us to add to and modernise existing services. For example, we are exploring with local commissioners and local people, what additional services could be provided from the site, including GP services.

The Trust has engaged with patients, the community, the public and people who work from the Brighton General site since the launch of the project in November 2017.

In 2018, we drew up a shortlist of design options for the site and asked people what they thought was important.

84% of the public and 86% of staff already consulted say they are supportive of the Trust’s vision to redevelop the Brighton General site and build a modern community Health Hub.  Over 80% supported the idea of bringing GP and pharmacy services on site.

Over half of the people who attended community roadshow events in the city about the project preferred a design option that concentrated health facilities on a small campus facing Elm Grove.

A summary of the patient, public and staff engagement that has taken place so far is available here.


Latest news - Outline Business Case with NHS regulator

The current preferred option for the redevelopment of the Brighton General site is ‘Option 5’ of the Outline Business Case (OBC).

The Trust’s Board approved Option 5 (which is described in the summary document here) with some small changes. The details are set out in the Board paper here.

The OBC was submitted to our regulator, NHS Improvement (NHSI), for approval at the end of 2018, following its approval by the Trust’s Board and NHS Brighton and Hove Clinical Commissioning Group. NHSI consideration of the OBC is still underway.

We are keen to move on to the next stage of the project – developing a Full Business Case in consultation with staff, patients, local people and partner organisations – and will post updates here as and when things change, so that we can continue to involve local people and providers in conversations about this project.

The Trust will also be posting #BuildBetterNHS videos and updates on social media.

The site covers an area of just over four hectares - equivalent in size to four football pitches - in east Brighton at the top of Elm Grove by Brighton Racecourse.

The site currently houses a range of community, mental health, rehabilitation and outpatient services. It also accommodates a number of health service administrative and support staff. Much of the estate is used for offices or team bases for staff working in the community.

Services

Provider/s

A number of children’s physical and mental health, and social care services.

Sussex Community NHS Foundation Trust, Sussex Partnership NHS Foundation Trust and Brighton & Hove City Council

Adult Podiatry, Speech and Language Therapy, Osteoporosis and Falls Prevention, Occupational Health

Sussex Community NHS Foundation Trust

The Sussex Rehabilitation Centre

Sussex Community NHS Foundation Trust

Physiotherapy, Dermatology, Hand Therapy

Brighton and Sussex University Hospitals NHS Trust

Adult Mental Health Services

Sussex Partnership NHS Foundation Trust

Various Clinical Admin/Support Teams, including Trust HQ

Sussex Community NHS Foundation Trust

Various non-Clinical Admin/Support Teams

Sussex Community NHS Foundation Trust

Finance Team

Brighton and Sussex University Hospitals NHS Trust

Hilltop Nursery

Sussex Community NHS Foundation Trust

The current buildings are no longer fit for the delivery of modern health and care services. Many buildings are decaying badly, are damp and provide inflexible layouts originally designed for Victorian workhouse buildings. Feedback from patients and service users has told us that clinical areas are fragmented, the site is difficult to navigate and that the overall environment is not welcoming. Buildings are becoming increasingly expensive to maintain as they age, diverting funds from our budget that we would much rather spend on frontline NHS service delivery and patient care.

A number of buildings have deteriorated so badly they have to be left empty for many years and those that are occupied are under-used. Overall the site is approximately 50% utilised.

The first phase of the project is simply about looking at the various options for how the site could be organised in the future, and deciding which one works best for everyone involved.

The Trust has appointed a consortium led by Rider Levett Bucknall (RLB) who has undertake an assessment of the services currently located on the site and what those services need, in terms of space and facilities, now and into the future.

About the Health Hub;

What is the timescale for the project likely to be?

This is a highly complex programme of work and nothing is going to change in the immediate future. The project has been delayed whilst the NHS has had to shift its focus to responding to Covid-19, but our intention is to move forward with as much pace as is realistically possible. SCFT’s Board has approved the Outline Business Case for the redevelopment. The next step is for the Trust to seek approval of the OBC from our regulator, NHS England and Improvement. Once approval is obtained, the development of a Full Business Case (FBC) can begin and an application for planning permission can be submitted to Brighton & Hove City Council.

This timetable may change but the target dates we are currently working to are:
•Regulator approval of OBC by end of 2020/21
•Full Business Case approval – 12-18 months after OBC approval
•Site preparation work to start – after Full Business Case approval
•Health Hub expected to be operational – 2025

The project will move forward to the next stage – developing detailed design plans and a Full Business Case in consultation with local people, patients and staff – after approval of the OBC by NHS England and Improvement.
 

Has the delay caused by the need to focus on responding to the Coronavirus pandemic led to any changes to the project brief?

No. There is no change to the brief and we are proposing to build the Health Hub with the same services that we had planned prior to the Covid-19 pandemic, as there is a continuing need for them in the community.

Will the project assist in the NHS response to Covid?

Given the timing of the project, it is highly unlikely that the facility will contribute to the treatment of Covid-19 patients. However, there could be a small cohort of patients living with longer term and possibility life-limiting health conditions that have been brought on or exacerbated by Covid-19. As a future location for a wide range of community health services, the new Health Hub could contribute to meeting these patient needs. The way in which the new facility will enhance local health services also means that it would have a role in any future pandemic response.

How much will the new Health Hub cost to build? 

It is hard to give even approximate numbers at this stage but we do expect the final cost to reach tens of millions of pounds. Projecting what the final costs will be over the life of the project is complicated and part of the financial modelling work that forms part of the business case. The final cost of the Health Hub will depend on the final design and will become publicly known once a contractor has been appointed.


What benefits will the redevelopment offer?

Improved accessibility: the Health Hub’s street level entrance on Elm Grove will make access to clinics easier for people in wheelchairs, those who have difficulty walking and those visiting the site with young children.

Improved working environment for staff: the Hub will provide local healthcare staff with a modern workplace that will in turn help services to attract and retain high quality staff. By concentrating the majority of services in a single building, co-located teams will be able to work together in a way that benefits individual patients.

More services on site: all existing Brighton General patient services are expected to remain in the new development, with the exception of services run by Brighton and Sussex University Hospitals NHS Trust (BSUH) which BSUH plans to move to its own estate – a move linked to the ‘3Ts’ development of the Royal Sussex County Hospital site already underway. The Health Hub will also introduce GP and pharmacy services to the Brighton General site.

Better car parking: this project aims to ensure that there will be sufficient car parking spaces for staff and users of the new healthcare facility through the building of a new multi-storey car park for the sole use of staff and service users. The main entrances to the Health Hub and new Sussex Rehabilitation Centre building will also feature disabled parking bays outside.

Better for the environment: we want the new development to improve access to the site for staff and patients in ways that are sustainable and support the local environment. We are committed to working with the Council and public transport providers to lobby for improved public transport provision to the site. We will also provide showers and cycle storage in order to encourage active travel and will incorporate more charging points and pooled electric vehicles in our planning. The project will allow for improved landscaping and the creation of new green space through its parking management strategy and we will work with organisations such as the RSPB to protect bird habitat and other biodiversity on the site. Both the health and housing schemes will meet high environmental standards. SCFT’s award-winning Care Without Carbon team is recognised as being at the forefront of sustainability in the NHS and will be involved in the Health Hub design. In addition to the environmental benefits of including sustainable, low carbon technologies, materials and methods in the design of the site, these will also deliver a financial benefit in the form of lower maintenance costs, particularly energy usage.

More local housing: as the NHS will not need the whole site for the Health Hub, there’s potential for part of the site to contribute to meeting the city’s growing need for new housing.

New local jobs and training opportunities: the project has the potential to create hundreds of new jobs within the local economy. We will look to appoint contractors that can deliver other social benefits, such as apprenticeships delivered in partnership with the city’s local universities and further education colleges.

New community spaces: there are currently two community spaces identified as possible ideas to incorporate in the redevelopment:

The Varndean building – this is the surviving original Gatehouse and the current intention is for this to be used as a nursery for the benefit of both NHS staff and the community. It would be roughly double the size of the OFSTED outstanding Hilltop Nursery that is currently on site and would allow for an increase in nursery places.

A small, unused building adjacent to the back of the Arundel Building. This could be retained in order to house a community centre/café. However, it should be noted that there are other requirements that the project is likely to need to accommodate (including a possible children’s play area, which town planners would like to see included). These ideas are very much at an exploratory phase.

Whilst the Trust will not be the developer for the new residential quarter, and it is too early for any firm commitment about community resources, we will be keen to see the land released for new housing supporting community uses as well as housing development.

 
Will the project provide community beds for patients? 

Through engagement with our local health system, the Brighton General site has not been considered an ideal location for community patient beds. We are continuing to work with our partners as part of the local NHS Integrated Care System to evaluate the need for an intermediate care unit in the city and where this may be provided.

Will the Health Hub accommodate the needs of patients from individual services to have discrete entrances where appropriate?

Yes, the majority of services will be accessed through the same front door but we recognise that this will not be appropriate for some sensitive services. The Health Hub will be designed to provide separate entrances for patients using these services.

Public involvement

How has the Trust asked for the views of local people so far? 

We are committed to full public engagement and so far have reached tens of thousands of people with project communications and activity. Widespread support for the redevelopment has been expressed through a public and patient survey that received over 700 responses and attendance at over 20 community events in the city. 84% of the public who took part in the survey were supportive of SCFT’s vision to redevelop Brighton General; over 80% supported the idea of bringing GP and pharmacy services on site; and over 50% of people who attended engagement events preferred an option that concentrated health facilities on a small campus facing Elm Grove.


How will Brighton General patients continue to be involved?

The views of patients and carers will continue to be important throughout this project. A Patient Reference Group has been established and will run for the duration of the redevelopment. User groups will be established to support Full Business Case planning and patient and carer representatives will be invited to join these groups As soon as the Full Business Case planning phase begins, we’ll be resuming a programme of community events to update local people and community groups and hear their views. Details will be publicised on the Trust’s website and within the project’s #BuildBetterNHS e-newsletter. Anyone interested in receiving updates on the project can sign up for the #BuildBetterNHS newsletter here: http://bit.ly/BGHealthHub

What about communicating with people who aren’t online?

Ahead of resuming a programme of community events, SCFT is regularly sharing updates with local media.


Impact and involvement for staff

How has SCFT canvassed the views of staff on site so far?

The project team spoke to representatives of all clinical services provided on the Brighton General site about what their services may need, in terms of space and facilities, before a preferred design option for the redevelopment was chosen. Staff who work on or from the site were also invited to participate in a survey in 2018, along with patients and members of the public. 84% of respondents were supportive of the plan to redevelop the site.

Will staff be involved in designing the new Health Hub? 

Yes. Staff input will continue to be an important part of the planning and design process. During the Full Business Case phase of the project, the Trust will be asking representatives from each Brighton General service to participate in user groups set up to support the detailed design of internal layouts within the new buildings.

Will space for staff training be included in the new Health Hub design?

Yes. While there are plans to include a space for large group meetings, training sessions and other events, we’ll also be involving staff in conversations about how space can best be used to support effective training. We are planning to provide a multi-function meeting/training facility that replaces the existing Arundel Suite – and expect this to be used by staff from across our localities and not just those based in Brighton. In the long term, we expect a blend of digital and face-to-face interaction for training and meetings. We expect all staff to have access to appropriate training and infrastructure (facilities and digital platforms) to support this across all our localities.

What additional spaces and features will there be for staff to use?

Our plans include providing rest areas for staff, as well as a café within the Health Hub. There will also be community space provided for wellbeing activities, such as yoga classes, that staff will also be able to use.

 When will staff who currently work on the site or use it as a base be affected?

Although it is the Trust’s intention to progress this project as quickly as is realistically possible, changes to working environments will not happen for some time. This is a highly complex programme, with lots of complicating factors, so we can’t give a more definite idea of the likely timeframe yet. There will be no changes to the working environment of any staff on site this year as a result of this project. We will keep staff and all those with an interest in the site updated as plans take shape.

Is this project going to result in teams being downsized?

That is not the Trust’s intention. This project is about providing a better working environment and facilities for our staff and creating a health facility that is accessible, efficient and sustainable for decades to come.


Will the redevelopment mean that some teams who are currently based on the Brighton General site will need to relocate? 

It is genuinely too early to say. The process of deciding which services will ultimately be part of the redeveloped site is extremely complex, involves multiple organisations, and will take a prolonged period of discussion and consultation to finalise. Current plans involve most patient-facing services currently provided remaining on site, with the exception of services run by Brighton & Sussex University Hospitals NHS Trust (BSUH). BSUH has decided on a strategy to co-locate these services with its other services on their own estate.

 Will the café currently on site be incorporated into the new Health Hub?

 Our plan is to have a café-type facility on site but we haven't made firm decisions about what the food offer needs to be or how best to provide this facility to meet the needs of patients, staff and members of the community. The café, offering a range of healthy meals and snacks, has the potential to add to the life of the Health Hub if run well. We intend to engage with patients, staff and the local community to make sure this café is a success

Housing development

 How much keyworker housing will there be within the new development and who will own it?

We plan to include keyworker housing in the redevelopment and the balance of the housing mix on the site is still being worked on. Ownership of keyworker housing is also something that will be determined further down the line – for example, it could be the NHS or a housing association. We'll also be looking at ensuring access to keyworker housing for health and social care staff as part of the overall provision.


How will historical buildings that are important to Brighton’s heritage be preserved?

The Trust is absolutely committed to the preservation of the Arundel Building, which is a landmark Grade 2 listed building that is visible in the skyline from locations across the city. Furthermore, any scheme will retain much of the curtilage wall around the Brighton General site. The project team has worked closely with the council’s heritage advisors to ensure a development that not only addresses health needs but adds residential development to the area in a sustainable and sympathetic modern urban setting that respects the site’s Elm Grove frontage and workhouse history.

Will affordable homes be built on the land released to fund the Health Hub?

The Trust is working closely with Brighton & Hove City Council to explore ways in which affordable housing can be delivered on the site, while still providing vital facilities for NHS and specialist social care services. The Council is exploring possible options for delivering low-cost homes as part of the overall scheme (for example, by entering into a partnership with a social housing provider or partnership working with Homes England).

SCFT is very aware of the need for more housing in Brighton – and affordable homes for keyworkers, in particular – but it is important to remember that the Trust is not a housing provider, our first priority is healthcare and the quality of the environment we provide for our staff and patients.

Balancing the affordability of the Health Hub and new housing will be key for this project’s viability. Insufficient income from housing would make the entire project unviable, meaning no redevelopment and no health, housing, economic or environmental benefits for Brighton & Hove.

 

Engagement activity has been and will continue to be phased. This ensures that stakeholders are being engaged at the right time, and being given the opportunity to genuinely be involved in the planning process.

Here is a summary of public, patient and staff engagement undertaken so far.

Public & Patient Engagement

The Trust held a public and patient drop-in event on Thursday 7 June 2018 at the Brighthelm Centre in central Brighton. The event shared a shortlist of options for how the new Health Hub could be developed and invited people to share their views and provide their preferred option for redevelopment through a survey.

Over 20 community groups were visited by Trust representatives during summer 2018, in order to canvas local views and provide information about the Health Hub project.

Trust representatives visited services provided from the site to gather views from patients, service users and their carers in 2018 and to encourage participation in the Public & Patient survey.

A Patient Forum was established in 2018 and will run for the duration of the project through which patients and carers can give their views. In addition, wider communication and engagement with patients and carers who use services currently provided from the site will continue throughout the project, using a variety of new and existing mechanisms, including open meetings, written and online updates and surveys, social media and the Trust’s website.

Staff Engagement

Assessors have spoken to representatives of all clinical services provided on the site about what their services may need, in terms of space and facilities, now and into the future.

A series of staff engagement events were held in 2018 and views on a preferred design option were collected via a staff survey.