Published date: 09 December 2024
Mount Gould Hospital: Unlocking value and optimising underutilised space
Making the best use of your estate is a challenge, especially as health and social care needs grow and change over time.
During a review into Mount Gould Hospital, NHS Property Services (NHSPS), Community Health Partnerships (CHP) and NHS Devon ICS found that the buildings across the estate weren’t being used to their full potential. Clinical services were being delivered from dilapidated buildings and admin services were in more modern, clinically suited spaces.
As your strategic estates partner, NHS Property Services worked with CHP, NHS Devon ICS and occupants Livewell, to develop a strategy to make more efficient use of the buildings on the 16-acre site. The project included relocating several services into more appropriate spaces and refurbishing the space into modern, fit for purpose clinical environments. Collaboration was a key part of this project. And as part of the NHS, we helped NHS Devon ICS and Livewell navigate the system to unlock funding, negotiate the lease and deliver an overall efficient estate solution.
NHSPS’ ability to assess, adapt and maintain NHS estates meant we delivered an end-to-end service across the project from Strategic Estate Planning and Options Appraisals, through to Capital Project Management, Lease Advisory and Facilities management.
The project was split into multiple workstreams:
- Plymouth Neuro Rehabilitation services were relocated from a dilapidated building into the Local Care Centre (LCC).
- Podiatry and Orthotics services who were occupying the LCC were relocated to the Beauchamp Centre.
- Riverside and Avon house were identified surplus and provided opportunity for disposal or repurposing.
This major initiative has made better use of NHS estate and has delivered more local, community-based care, by increasing appointment capacity to 170 per day, lowering wait times and creating more accessible parking and blue badge spaces.
“Whilst a key asset for healthcare delivery in Plymouth, developments on the Mount Gould site over the past 20 years have been frustrated not only capital and revenue limitations but also by the challenges presented through the site being in multi-ownership and multi occupation. Whilst the scale of these challenges can’t be downplayed the overall approach of the NHSPS team led by James has been professional, engaging and has ensured innovative workarounds on a range of difficult to solve barriers and issues. The team’s hard work and diligent approach has paid dividends with a new Podiatry and Orthotics base being established thereby enabling a new Plym Neuro facility to be progressed. An example of great collaborative system working through NHSPS, CHP, NHSE, Devon ICB and local Plymouth providers.”
Andy Collier, Estates Delivery Lead (Devon), NHE England South West
The Challenge
The Mount Gould Hospital site had faced difficulties due to misaligned building use and an estate that had grown organically rather in a planned way, resulting in ineffective resource allocation.
Mount Gould Hospital is a typical community hospital site made up of several different types of buildings across 16 acres. Some of the buildings were built in 2006 but most of the buildings date back to the 1970s and 1980s. The primary on-site tenant is Livewell Southwest, which provides integrated health and social care for people across Plymouth.
The need for redevelopment was identified in 2019 when Livewell Southwest and the estate owners - NHSPS and CHP - conducted site utilisation and clinical priority reviews to understand whether Mount Gould was being used to its full potential and providing the best environments to support patient care.
The reviews into Mount Gould Hospital identified that the site’s buildings were not being optimally used. For example:
- The specialist neuro team was delivering care out of a building that was not fit for the clinical services being provided. It would require significant investment to improve patient outcomes.
- Some administrative functions were working out of modern space that could be adapted to deliver essential clinical services and therefore better support the delivery of patient care.
The solution
NHSPS, CHP, NHS Devon ICS and Livewell conducted a site master planning exercise, focusing on:
- How all the buildings were currently being used and how we could maximise their potential.
- How modest changes to the buildings could improve patient care.
We reviewed a number of options and in 2020, started designing the programme which consisted of three workstreams:
- Plymouth Neuro Rehabilitation services which were in a dilapidated building were going to move to into the Local Care Centre (LCC) – a higher quality space that was underused.
- To make way for Plymouth Neuro Rehabilitation, Podiatry and Orthotics services which currently occupied the LLC were going to relocate to the Beauchamp Centre. Beauchamp was being used for admin services but had greater clinical potential.
- Riverside and Avon house were identified surplus and provided opportunity for disposal or repurposing.
It was a credit to all involved that the virtual meetings continued so productively during the very real challenges presented through the Covid pandemic.
Phase 1: Refurbishing Beauchamp Centre to host Podiatry and Orthotics services
To enable Plymouth Neuro services to move into the Local Care Centre building, the Podiatry and Orthotics teams that currently resided there would need to move elsewhere. The project team identified Beauchamp Centre as a suitable space. It was currently being used for admin services, but the Livewell team would soon be moving away from it. Plus, the building was originally built to deliver clinical services so there was recognition that it could be more appropriately used with some investment.
Using the NHS procurement framework, NHSPS procured the services of Mace Green as the lead consultant who in turn appointed Nevada as the principal contractor to work in partnership with our Construction and Property Management teams.
The Podiatry team was initially unhappy about relocating away from the Local Care Centre to Beachamp Centre. However, NHSPS explained that Beauchamp Centre was going to be purposely reconfigured and would provide notable benefits such as a custom orthotics area and dedicated car parking adjacent to the building. NHSPS kept open lines of communication with the customer and reassured them that their requirements were a priority, and that re-locating would benefit them and their patients, which they could see and were now happy with.
Sourcing capital to undertake the refurbishment was a challenge. However, working with NHS Devon ICS, NHSPS agreed that their innovative capital recycling policy should be used to partially fund this refurbishment. This policy seeks to use capital sales receipts from previous land sales in the area and reinvest them locally. As such, 50% of funds (£1.1m) came from this policy whereby and the other 50% (£1.1m) came from NHSPS’ Healthy Places programme fund.
As for the lease, in collaboration with NHS Devon ICB and Livewell, NHSPS negotiated a 25-year lease agreement for Beauchamp building.
In January 2022, works commenced to improve and redesign 762m2 of admin space at Beauchamp Centre to make way for podiatry and orthotics services. Works lasted around four months.
The space now consists of a dedicated waiting room, using the side entrance to create a main entrance, new consulting and treatment rooms compliant with the latest HBNs and a small extension provides a dedicated orthotics facility. There is also now a dedicated car parking adjacent to the building.
The speed at which this site was completed is a testament to the collaboration between NHSPS’ construction and project teams, their partners and the Podiatry and Orthotic teams. Working at pace enabled the broader Mount Gould programme to continue with certainty.
The Podiatry and Orthotics teams moved in during early May 2023 with an official opening ceremony taking place on 22 September 2023 to celebrate the hard work of everyone involved in renovating and relocating the Podiatry and Orthotics areas.
With this phase completed, the Local Care Centre was now vacant for refurbishment to begin.
Phase 2: Refurbishing Local Care Centre to host Plym Neuro services
In Autumn 2023, construction work began at Mount Gould Local Care Centre to reconfigure space for Plym Neuro services. They were currently in and old and worn building with significant levels of backlog maintenance that would have needed major investment to bring it up to standard. The LCC was a higher quality building and now vacant after Podiatry and Orthotics moved to make way for them.
Funded by CHP’s capital budget, the project represents their largest variation to date (£6.9m.) The project highlights the commitment to providing better healthcare in Plymouth and the surrounding region.
The project relies on collaboration between CHP, NHSPS, ReSound Health, LiveWell, University Hospitals Plymouth and NHS England. Working closely together allows the project to go ahead at speed with the support of all parties.
CHP plays a vital role, providing project guidance, operational support, and day-to-day management. This ensures a smooth transition and successful completion, while also maximising the LIFT estate's potential for integrated, place-based care.
Once completed in Spring 2025, the reconfigured Local Care Centre will provide a state-of-the-art and fit-for-purpose home Plym Neuro Rehabilitation Service. The modernised spaces and new technologies within the neurology service will benefit both patients and staff. The increased capacity will allow for more appointments.
Phase 3: Riverside and Avon House
Two administrative buildings, Riverside and Avon House were identified as being no longer clinically or administratively required by Livewell and provided an opportunity for disposal or repurposing. This is now part of Livewell’s estates strategy over the next two years.
NHSPS, as owner of the site, are exploring whether these buildings could be adapted to support keyworker accommodation.
“I am thrilled to see the variation commence at Mount Gould LCC. CHP are committed to ensuring that our NHS estate continues to make a valuable contribution to the delivery of health services in local communities and our buildings are positioned as core assets to support this delivery, once complete the new Plym Neuro Service will be a prime example of this. The increased capacity of appointments per year will benefit many patients and support the NHS in a time where it is much needed. Our partnership working and supporting NHS Devon ICB in their strategic aim, has allowed for this fantastic project to come into fruition, and I look forward to seeing the project progress in the months ahead.”
Simon Waters, Regional Director for the South, Community Health Partnerships
The impact
This is a landmark initiative that has improved NHS estates utilisation across both NHSPS and CHP’s portfolio, whilst also providing more, place-based care within local communities, something that is a core focus for the NHS.
Patient impact
20,000 patients in the local area will benefit from the re-location of Orthotics and Podiatry services and Plymouth Neuro-Rehabilitation service. They can now receive care in more suitable, fit-for-purpose environments to deliver better health outcomes.
Not only that, but more patients can be seen. For example, the Podiatry and Orthotics team can provide more than 170 appointments per day, far exceeding their expectations of the relocation and refurbishment.
Accessibility
The Local Care Centre is much closer to the car parking areas which is a very important consideration for the user groups as many had relatives or carers that would assist them. NHSPS also provided more dedicated parking spaces for Blue Badge holders. NHSPS made sure there was level access to the new main entrance and reception areas and more accessible WCs.
More efficient use of estate
Across the entire Mount Gould estate, all main purpose-built and repurposed areas are now used for their intended clinical use, with vacant space optimised, delivering significant value to NHS Devon ICS and Livewell. Admin facilities have moved out of high-quality clinical space, making much more efficient use of the estate.
Key NHSPS value-add areas
- End-to-end service: Our teams provided end-to-end support across our service offer from Strategic Estate Planning, and Options Appraisals and Funding Solutions through to Capital Project Management, Property Disposal and Investment and Facilities Management.
- Collaboration as your NHS estate partner: To deliver this project, we worked collaboratively with NHS Devon ICS, Livewell and our property colleagues at Community Health Partnerships to deliver this project. As your NHS estates partner, we listened to everyone's needs. We assigned and reported actions clearly and provided regular updates. We worked as one team throughout the project. This was a great example of the two NHS property companies working together effectively.
- Options analysis: This was a complicated site that required exceptional problem-solving skills. We used our local expertise (backed by national experience) to carry out a thorough evaluation of possible options to enhance the site's capacity and improve patients' health outcomes. The solution needed to be cost efficient and have minimal impact on service provision. We discussed the options with our partners, the ICS and Livewell, and delivered the solution for the local health system.
- Value passed back to the NHS: As part of the NHS, we can help our customers navigate the system more easily, including unlocking funding to re-imagine estates. With limited capital available for the project, we used our innovative capital recycling scheme whereby receipts from the sale of local land was used to support the refurbishment of Beauchamp Centre.
