A new community hospital for the Forest of Dean

Planning the transition between Lydney and Dilke Hospitals and the new Forest of Dean Community Hospital

Our Trust is excited to be in the final stages of preparation for a move into the new Forest of Dean Community Hospital.

Teams from Dilke and Lydney Hospitals are getting ready to transfer across to the new 24-bed hospital in Steam Mills Road, in Cinderford, following an expected handover in January 2024.

There will be around eight weeks of work to prepare the building after handover –  for cleaning and installation of IT as well as fitting for furniture and equipment – before the process of moving colleagues and services in can begin. 

The complexity of combining teams from two sites into a new hospital means that moves will be phased over a number of weeks and will result in some disruption to services as relocation of staff and equipment takes place.

Some additional details around this process are:

• There will be a gradual reduction in inpatients at Dilke and Lydney so that we have 24 inpatients to transfer to the new hospital when it opens. We expect inpatients and ward staff to transfer to the new hospital about 10 weeks after handover.
• Approximately four weeks before the move to the new hospital, we will close the kitchen at Lydney in order to transfer some of the equipment to the new site. This will result in the inpatient ward at Lydney closing and the remaining patients transferring to Dilke.
  Dilke will be the only inpatient unit for a short period until all patients move to the new hospital.
• Our current plan is that the existing X-ray equipment from Lydney will transfer to the new hospital – it will take an estimated 14 weeks to move and install.
• People requiring X-ray will therefore be booked at another unit while this work is carried out. There will be additional capacity for X-ray at Dilke Hospital. Alternatively, people will be offered another site, such as Tewkesbury Community Hospital, another community hospital or Gloucestershire Royal Hospital.
• Rapid Response, Therapies, Midwifery and Children’s Services will move into the new hospital 10 weeks after handover.
• Dental services are planned to move during weeks 10 and 11 after handover.
• Outpatients services will move into the new hospital 11 and 12 weeks after handover
• Minor Injury and Illness Unit (MIIU) will move from Lydney Hospital 13 weeks after handover. The MIIU at Lydney will remain open until then – please remember that Dilke MIIU is closed.
• The new endoscopy service will take time a few additional weeks to become operational and is due to open 20 weeks after handover.

Douglas Blair, Chief Executive at the Trust, said: “This is an exciting and important development for our services in the Forest and Dean and we’re looking forward to getting into the new hospital.

“Obviously, that is tempered by the fact that the move itself will add additional work at a busy time of year. Anyone who has moved house knows how much work there is to be packing up and getting everything ready while still carrying on with all your normal work and responsibilities.

“We’re going to be in that position for a little while and our move is quite a big one, involving dozens of people across a number of different services.

“I hope the public will be considerate with our staff while we work through this process. There will be unavoidable disruption, but we will do all we can to mitigate it and will have a fantastic new hospital up and running at the end.”

Sustainability and the new Forest of Dean Community Hospital

When we think of sustainability, the concept can be somewhat vague – perhaps images of ‘green initiatives’ and ‘environmentally friendly’ practices coming to mind. But what do these really mean? And how do you apply ‘being green’ to building a hospital?

The Forest of Dean Community Hospital, located in Cinderford, serves as a prime example of sustainable healthcare. Commissioned by Gloucestershire Health and Care NHS Foundation Trust and delivered by contractor Speller Metcalfe, it has been designed to achieve the sustainable BREEAM Excellent certification and showcases various features that make it a model of sustainability and environmental best practice.

‘A nice thick jumper’

At the heart of the hospital’s sustainable design lies a focus on energy efficiency. The building features extremely thick, 250mm insulation in its walls and roof – essentially enveloping the hospital in a nice thick jumper, which significantly reduces the energy needed for heating and cooling. Compared to a typical new build home which may have 100mm insulation, this is extremely energy efficient.

Moreover, in 2021 the government announced a pledge to ensure that Britain’s homes, services and businesses are powered by affordable, clean and secure electricity by 2035 – a commitment to ultimately decarbonise the UK’s electricity system. The Forest of Dean Community Hospital relies solely on electricity (i.e., no gas or fossil fuels), and uses alternative air source heat pumps, mechanical ventilation recovery systems and on-site renewable energy sources to offset its energy consumption.

In fact, the hospital will be a net contributor of electricity to the national grid, so its carbon footprint will decline over time, which could lead it to achieve net zero in the future.

Overcoming challenges of redevelopment

A testament to sustainable redevelopment, the scheme has been built on what was historically a coal mine and a post-industrial site. The construction team faced the challenge of investigating the location of coal seams and mine shafts, undertaking extensive probing and remediation strategies to ensure the safety of the site prior to laying the foundations – ultimately transforming a site with complex requirements into a sustainable community asset.

Achieving BREEAM Excellent

Prior to construction Speller Metcalfe, Gloucestershire Health and Care NHS Trust and our wider project stakeholders worked together to explore areas of carbon reduction and focusing on the building’s lifecycle, with a target of achieving a BREEAM Excellent certification.

BREEAM Is a sustainability assessment method that sets standards for the environmental performance of buildings and infrastructure. It takes account of a wide range of factors, including energy, water, health and wellbeing, transport, materials and waste.

Sustainable materials

The team is committed to identifying materials that meet the green credentials of the BREEAM assessment. This uses a ‘cradle to grave’ approach which considers the raw materials, their manufacturing processes, embodied carbon and ease of recycling. The Forest of Dean team has achieved the maximum score for the material section of the assessment.

Preserving ecology and biodiversity

The project demonstrates a commitment to both preserving and enhancing local ecology and biodiversity. Extensive consideration has been given to the surrounding wildlife, such as dormice and bats, to ensure the hospital does not encroach onto their existing habitats. As an example, prior to construction the team was on site overnight to carry out light level surveys to understand how the design would impact on the bats’ flight path and are now installing dimmable night-time lighting at the hospital entrance.

Additionally, the hospital incorporates bat and bird boxes throughout the site, while also committing to planting of significantly more plants and trees than were previously in situ, which will ultimately enhance its biodiversity by over 10 per cent.

Efficient operations and connection to nature

Efficiency plays a vital role in the sustainable operation of the hospital, but not just in terms of energy. The layout has been designed that corridors were minimised to reduce staff walking distances, and as a result maximising their day-to-day efficiency. Additionally, a crucial aspect of the design has focused on the connection to nature, so all 24 in-patient rooms have a view directly out to the forest or the surrounding environment. The therapeutic benefits of connecting patients with nature are well-documented, and this deliberate design choice aims to positively impact patient recovery rates and overall well-being.

Integration with the community

The Trust recognises the importance of community integration as part of its sustainability strategy, both in the way that it serves the local area and how it employs local people and procures local goods and services.
For example, an analysis was done of the Forest of Dean area, calculating the commute times and carbon footprint of different journeys. Another example being that over 70 per cent of the supply chain for the hospital build has been procured from within 30 miles of the site, and many from the Forest of Dean itself.

The Speller Metcalfe team was also recently awarded its first ever 100% score through the Considerate Constructors Scheme – an independent organisation that audits construction sites and focuses on: ‘Respecting the community, caring for the environment and valuing the workforce.’

Throughout the construction, the site team has made efforts to engage with the community, held educational events and promoted a sense of ownership among local residents. The NHS intends to continue this approach, whether that’s through volunteer involvement in the grounds and gardens, art projects or community use of meeting spaces within the hospital.

New Hospital name confirmed: May 2023

‘Forest of Dean Community Hospital’ has been agreed by the Trust as the official name for the new hospital.

The name was agreed by both the Hospital Programme Board and the Oversight Committee and is in line with NHSE guidelines which recommend names which are clear, logical and descriptive and contain a geographical reference.

Work on the hospital in Steam Mills Road, Cinderford, is progressing to schedule, with the steel frame, roof and external walls finished and work progressing well on the internal layouts.

Building work is due to be complete by early 2024 in preparation for a process of cleaning and equipping to allow teams to transfer onto the site.

When complete the hospital will feature a 24-bed ward made up of single rooms with ensuite facilities. The Trust has experience building and staffing hospitals with single rooms and ensuite bathrooms and has found they maximise privacy and dignity for patients, maintain infection control standards and give patients the confidence and space to move around.

The hospital includes a Minor Injuries and Illness Unit, x-ray, radiology and ultrasound services, consulting and treatment rooms for outpatient clinics, a children’s clinic area, endoscopy suite and clinic space for dentistry and podiatry.

It is also being designed with a focus on sustainability – aiming at an Excellent rating using the construction industry’s BREEAM standards – to help reduce energy consumption and support an NHS ambition of net zero carbon emissions.

Planning Update: March 2022

Our Trust is delighted to have been granted planning permission for a new community hospital for the Forest of Dean.

The decision was made by Forest of Dean District Council’s Planning Committee on Tuesday 8 March (subject to there being no objections raised by Natural England within their consultation period).

The Trust can now move forward with plans for the construction of the new hospital on the playing field at Steam Mills Road, in Cinderford, and reprovision of the skate park currently on the site.

Angela Potter, Director of Strategy and Parternships at the Trust, said: “An enormous amount of work, energy and thought has gone into the development and planning for a new community hospital in the Forest of Dean so I’m excited that we have reached another major milestone in this journey.

“Our aim has always been to develop 21st century facilities to house services which meet the needs of the community in the Forest of Dean, and a modern, new hospital will have an important role to play in achieving this objective.

“I would like to thank Trust colleagues who have been working incredibly hard to move this project forward. We are also grateful to everyone who has taken part in dialogue, engagement and consultation about the hospital over the last few years.”

Work will start imminently to begin to prepare the site and groundworks for the new hospital development and the Trust Board meeting on Thursday 31 March will be asked to give approval for the letting of the main construction contract.

The services to be provided by the 24-bed hospital were confirmed by Gloucestershire Clinical Commissioning Group in January 2021. It will have single rooms with ensuite facilities to minimise the risk of cross-infection and maintain infection control standards, and a purpose-built therapy gym for rehabilitation.

There will be a Minor Injuries unit with separate adult and children waiting areas, x-ray, radiology and ultrasound services, consulting and treatment rooms for outpatient clinics, a children’s clinic area, endoscopy suite and clinic space for dentistry and podiatry.

The hospital has also been designed with a focus on sustainability – aiming at an “Excellent” rating using the construction industry’s BREEAM standards – to help reduce energy consumption and support an NHS ambition of net zero carbon emissions by 2040.

Access to the site will be via a redesigned junction where the current skatepark entrance is located, leading to parking at the front of the site and the building positioned further back. Separate consultation on traffic calming measures around the entrance will be conducted by Gloucestershire County Council.

Planning permission for a new Skate Park at the Miners Field in Cinderford was granted by the council at the same planning meeting.

Work on the new Skatepark will begin shortly while preparatory work is expected to start on the new hospital site on Thursday 10 March, lasting until June when building work can begin.

Planning Update: October 2021

“We received a lot of feedback and have looked at everything we can to make positive changes to the building, such as taking ideas on material and colours to improve the appearance from different parts of the site.

“Some changes have been unavoidable – for example, the change in shape on one of the roofs is the result of new regulations on air exchangers due to covid. Our design team has worked extremely hard to create a hospital which is both pleasing and functions well.”

The ward is made up of single rooms with ensuite facilities to minimise the risk of cross-infection and maintain infection control standards, and a purpose-built therapy gym for rehabilitation.

The design includes a Minor Injuries unit with separate adult and children waiting areas, x-ray, radiology and ultrasound services, consulting and treatment rooms for outpatient clinics, a children’s clinic area, endoscopy suite and clinic space for dentistry and podiatry.

The hospital is also being designed with a focus on sustainability – aiming at an Excellent rating using the construction industry’s BREEAM standards – to help reduce energy consumption and support an NHS ambition of net zero carbon emissions.

It is proposed that access to the site will be via a redesigned junction where the current skatepark entrance is located, leading to parking at the front of the site and the building positioned further back.

Trust Chief Executive Paul Roberts said: “Our Trust – and the wider NHS – has used all the expertise available to us to design a high-quality and sustainable hospital with services based on the needs of the community.

“I’m looking forward to the outcome of the planning application and moving ahead with this important piece of work for healthcare in the Forest of Dean.”

As part of the hospital project the Trust will provide a new skatepark in Miner’s Field – with a planning application for the design also in progress – and will upgrade the surface of the Mount Pleasant multi-use games area.

Planning Update: September 2021

Thank you to everyone who submitted comments in response to the publication in July 2021 of initial plans and drawings of the proposed new community hospital for the Forest of Dean.

Comments covered a range of themes, including the design, use of single rooms, overall bed numbers, maternity services and urgent care. Summary responses to some of the points raised are below.

Bed numbers

Bed modelling was conducted jointly with Gloucestershire Clinical Commissioning Group and we believe the design provides sufficient beds to meet the needs of the local population of the Forest of Dean.

Current activity patterns demonstrate more than 90 per cent of Forest residents are admitted to a bed in one of the Forest hospitals but that nearly half of the existing 47 beds in the Forest hospitals are occupied by people from outside the locality (particularly from Gloucester and Cheltenham). These people will access rehabilitation beds local to them.

Throughout the Covid pandemic, Dilke and Lydney have been operating at reduced capacity of 30 beds, with no impact on patient flow.

Maternity Services

This has been fully reviewed as part of service strategy development, and the average number of births per annum in the Forest of Dean district and the rights of women to choose the place in which they give birth was considered.

However, the option of a midwife-led unit or a birthing centre not taken forward on the basis that a clinically safe and sustainable service could not be provided.

The NHS will continue to promote home births for women where it is clinically safe and appropriate to do so.

Single Rooms

Our learning from Covid-19 has clearly demonstrated that single rooms are a much safer option for infection prevention and control.

Patients have increased privacy and dignity when they have their own room with their own en-suite bathroom, and are often more confident to move around their own room and use the bathroom rather than a commode by the bedside which helps keep them mobile.

There is a greater use of digital technology which enables patients to keep in touch with their loved ones via virtual means outside of normal visiting hours which they can do without disturbing others.

Urgent Care

We have been commissioned to include a minor injuries and illness unit, open seven days a week from 8am to 8pm, with diagnostic support within the hospital.

This forms part of wider network of urgent care services – NHS 111, pharmacies, primary care, community services such as rapid response, and the emergency departments at Cheltenham and Gloucester.

Design

All of your comments, questions and concerns have been shared with the design team, and we are doing all we can to work with ideas and proposals regarding design or materials.

The Trust has been in regular dialogue with neighbours to the site and will continue to do so as we continue the process towards a full planning application.

Planning Information: July 2021

The Trust invited comments on the design and impact of the hospital on the Steam Mills Road site in preparation for a full planning application. This process closed on Friday 23 July 2021.

Considerable work has gone into understanding the site, including the history of mining in the immediate vicinity, natural habitats present, water flow and drainage, and access requirements.

The hospital design will provide flexible space, be environmentally friendly and reflect the unique heritage and landscape of the Forest of Dean.

Access to the site will be via a new junction where the current skatepark entrance is located, with parking to the front of the site and the building positioned further back.

Prior decisions on the location of the hospital and services within it will not form part of this planning process. For details on how those decisions have been made, please see the ‘Timeline’ section below and visit www.fodhealth.nhs.uk

Services which have been agreed and commissioned for the hospital include:

• Inpatient unit: 24 beds – all single rooms to ensure increased infection prevention and control and increased privacy and dignity
• Outpatient services: a range of consultation rooms, treatment rooms, group room and space for remote consultations
• Urgent care
• Diagnostic services – x-ray, ultrasound, a new endoscopy unit and facilities to allow access for two mobile units
• Parking for approximately 150 vehicles
• Multi-function group rooms for use by the wider community

Timeline 2015-2021

Engagement and consultation processes have been ongoing in the Forest of Dean since 2015, run primarily by Gloucestershire Clinical Commissioning Group. Below is a summary of that work. Full details can be found at www.fodhealth.nhs.uk