Creative use of space – engaging the community

Trevor PayneDirector of Estates & FacilitiesBarts Health NHS trust

Barts Health – our sites

Royal London Hospital

Mile End Hospital

Newham University Hospital

Whipps Cross University Hospital

The London Chest Hospital

St Bartholomew’s Hospital

Plus four health centres and 69 community health premises

Size & Scale

• £1.6Bn turnover• 15,000 staff• Largest single PFI investment (£1.3bn) in the NHS • Largest Healthcare construction project in Europe• Grade 1 listed assets dating back to 1123• We treat more patients than visitors yearly to British Library or Tate Gallery• 191,000 KW hrs of power – same as 34,000 standard UK homes•Use enough water each year to fill 270 Olympic sized swimming pools• 44% of the estate is PFI

Age Profile of the Estate50%+ >30 years

30% built before the creation of the NHS

The Estate

Site GIA Hectares Bed Nos

Bart’s campus 142,000m2 3.46 250

Royal London campus 247,000m2 4.88 747

London Chest campus 17,000m2 1.61 103

Whipps Cross campus 90,964m2 17.86 589

Newham campus 53,000m2 10.4 452

Mile End campus 31,000m2 3.87 64

Various leased properties outside main campus sites

>12,500m2 n/a 0

Occupied space with no lease/license in NE London

>1,300 m2 n/a 0

578,375m2 across 4 London boroughs:

•City of London•Tower Hamlets•Newham•Waltham Forest

Largest NHS Trust footprintMicro version of the NHS – old & new280+ buildings

4 Health centres in Tower Hamlets:

•Spitalfields Health Centre (leasehold)•Steel’s Lane Health Centre (freehold)•St Peter’s Centre (leasehold)•Leopold Street Clinic (leasehold)

Poor health and health inequalities in East London have remained relatively persistent

Map shows historical poverty mapped by Charles Booth in 1898

Map shows hot spots of areas with high risk of diabetes, known to be linked to deprivation, in 2011

Overview of health issues in East London

1 Newham is the 2nd most deprived borough in England, City and Hackney the 4th most deprived, Tower Hamlets the 11th most deprived, Waltham Forest the 15th most deprived out of 152 in England.2 At birth 2008 – 20103 Rate per 1000 live births 2008 – 20104 Per 100,000 population aged 35+ directly age standardised rate 2008 – 2010 5 % of people on GP regulators with a recorded diagnosis of diabetes in 2010/116 Crude rate per 100,000 population 2008 – 20107 Crude rate per 100,000 population 2011. Chlamydia screening coverage may influence rate

Indicators Newham Tower Hamlets

Waltham Forest

England Average

Life expectancy (males)276.2 76.7 77.4 78.6

Life expectancy (females)281.1 81.4 81.9 82.6

Infant death25.3 4.0 5.4 4.6

Deaths from smoking4249 300 221 211

Early deaths: heart disease and stroke4

115 106 86 67.3

Early deaths: cancer4112 135 114 110.1

People diagnosed with diabetes5

6.9 5.8 5.9 5.5

New cases of TB4124 61 50 15.3

Acute sexually transmitted infections7

1673 1743 1359 775

Key:

Significantly worse than the England average

Not statistically different from the England average

Significantly better than the England average

Source: Association of Public Health Observations, Health Profile, June 12

Sustainable Healthcare?

• Life expectancy in 1948: Men 66 Women 70• In 1948 NHS spend was 2.4% of

GDP

• Life expectancy in 2009: Men 78 Women 83• In 2009 NHS spend was 9.8% of

GDP

Future health pressure

•Six Facet survey•Risk register•Estate strategy•Space Utilisation Models of care•Technology•Flexibility in design/operation•Future proof

Know your Estate

1885

33 Queens Square

Teenage Cancer Trust

Proton Beam Cyclotron and Gantry

Gantry

3 floor metal structure

Cyclotron200 tonnes

1.7 MW energy

20

Leading By Design - Generative Space

Health Design Leadership

Space/Environment

Health Culture

Generative

Space

• Life Enhancing

• Systemic

• Sustainable

• A place to flourish

Future flexibility

Links to the community – fuel poverty initiative. •London has the highest fuel

poverty rates in the UK

•Tower Hamlets is one of the worst affected areas in the UK with 330 excess winter deaths and a variety of associated health issues.

•Fuel poverty currently costs the NHS £850m a year through the treatment of winter related diseases caused by cold homes.

•For every £1 spent on improving the heating in a home the NHS saves £0.42.