The NHS is taking co-ordinated action to invest in mental health services in Sussex, with the aim of transforming the way people receive treatment, so they continue to benefit from safe and high-quality mental healthcare whenever they need it.
As part of this approach, Sussex Partnership NHS Foundation Trust (the Trust) - alongside its system partner, NHS Sussex - recognised the urgent need to improve the quality of mental health inpatient services in East Sussex. To help achieve this, they decided in January 2020 to meet head on the challenges faced with some hospital buildings which were out-of-date and not fit for future purpose.
Working with service users, their carers and families, local voluntary and community groups, people who experience health inequalities - as well as GPs and other health care professionals - proposals were developed to provide new facilities which could deliver all inpatient services in East Sussex on a single site.
This would enable the Trust to respond more effectively to the changing needs of the communities it serves - and to attract and keep the best staff as the site could become a centre of excellence for mental health services.
The first phase of what will be a long-term programme is to move mental health inpatient services at the Trust's Department of Psychiatry in Eastbourne to a new 54-bed hospital for adults and older people on a greenfield site in nearby Bexhill-on-Sea. This has been primarily funded through the national initiative to eradicate dormitory accommodation in mental health facilities.
The new hospital will be called Combe Valley, a name taken from a nearby countryside park and is set in an undulating hillside site in the north east of Bexhill, surrounded by residential streets as well as a large housing development currently under construction.
Trust Chief Executive, Dr Jane Padmore, said: "Combe Valley Hospital will eventually provide high-quality mental healthcare for people across East Sussex and beyond in an exceptional and, importantly, therapeutic environment.
"The new hospital will not only enable us to further improve the care we provide to the communities we serve, but also to recruit and retain the best people. Vitally, the hospital is being developed in partnership with people who use, or have used our services in the past, to make sure the facilities are fully co-produced at every stage.
"It has been designed to a high-quality standard, and we hope that the innovative approach taken by our design and build partners will mean that Combe Valley will set a benchmark that other similar developments seek to be measured against.”
Combe Valley Hospital is being built in partnership with Kier Construction and Gilling Dod Architects who have been tasked with designing a therapeutic environment that makes the most of the site's natural assets. Work started in July 2023, and will be completed by the end of 2025, with it being open for patients by the beginning of 2026.
This move will not only remove out-dated dormitory accommodation - replacing the current shared wards with individual bedrooms, each with ensuite bathrooms - but also provide a modern and improved therapeutic environment for patients and create enough capacity to meet future inpatient needs.
Following a formal public consultation, which saw majority support for the plans, the new facilities received business case approvals from the NHS and Government nationally, as well as planning permission for the site from Rother District Council, after consultation with the local community.
At the same time, the Trust worked closely with architects to begin the comprehensive design process, adhering to the principles of co-production at all times. This involved services users and staff being placed at the heart of the engagement process. Others involved included clinical and other key stakeholders such as trauma-informed and neurodiversity specialists.
In addition, the Trust also engaged with a range of operational staff, including infection control, health and safety, fire safety and estates and facilities. This makes sure that the hospital will not only provide the high-quality care promised but creates an environment which functions in the most effective and modern way.
All these disciplines brought a positive desire to make the building the best it possibly can be, which was warmly embraced by both the Trust, as client, as well as the supplier-side teams.
The natural setting for Combe Valley is ideal for a mental health hospital, providing an exciting opportunity to create a tranquil and therapeutic healing environment for patients. Landscaping is key to the design and the building will benefit from internal gardens as well as widespread greenery surrounding the site.
The main entrance of the hospital will be at the end of a tree-lined avenue, and it will wrap around a 'Village Green'. At the building entrance, people will see through the reception area to the 'Village Green' and beyond, creating light and an openness to the interior. The green will be surrounded by a café, visiting rooms and shared therapy spaces. Beyond that, there will three wards towards the quieter, more private side of the site.
Dr Padmore added: "After working with clinical teams and service users, our architects proposed ward layouts which would most effectively meet the needs of both patients and staff.
"Among the priorities we identified through consultation were the need for excellent lines of sight from central ward rooms, bedrooms to be clustered in three small groups of six, quick staff response times and flexibility to adapt to changing needs. All of which have been achieved.”
Gilling Dod presented a design which resembles an 'X-wing' shape and means that no patient bedrooms face on to the ward gardens but instead look out across the wider rear gardens, ensuring privacy and dignity, and bedroom corridors are single-sided which ensures that they are filled with natural light.
Bedrooms are an individual’s sanctuary. This is why Combe Valley’s bedrooms have been given extra care and consideration. So, for instance, the Trust worked with service users and staff to make sure there was agreement about what would be the ideal bed position.
Bedrooms will be complemented by a half-bay window which is angled towards the bed so that people can look directly out of the window towards trees and other greenery. The half bay will also incorporate a window seat and a desk/dressing table, making sure that people can benefit from natural light and calming views of nature at all times.
Each ward will feature an activity room, a therapy room, and a quiet room. Off-ward, patients will have access to a gym, studio, group room, spiritual room, and art room. The art room will also include a kiln for firing pottery.
There will also be a fresh cook kitchen - a first for the Trust for some time - in the knowledge that freshly cooked and varied food can make a significant difference to people's recovery.
In addition, the first floor will house a well-equipped education hub, providing a variety of spaces for training and learning. Central to this will be a medical education suite which will enable a variety of scenarios to be simulated and observed from a training room on one side and managed from a control room on the other.
The mixed-use training spaces will become a key training hub for staff and students. There will also be a neuromodulation suite on-site which will provide several therapeutic interventions for both inpatients and outpatients.
Staff welfare has also been an important factor in the building design, with staff benefiting from six staff restrooms and four locker/changing rooms available across the hospital. Multi-disciplinary working is supported throughout, with a large staff base and ward clerk/admin office on each ward, as well as a variety of flexible spaces available across the building.
The psychological benefits of being immersed in nature are well-known and the design and operational function of Combe Valley not only adopts these principles but takes them further by providing access to nature at all stages of a person's recovery.
The X-wing shaped wards should enable the natural benefits of the greenfield site to be utilised to their full potential. Patients will have free access to ward gardens which will boast views out to the mature trees surrounding the site. Also on ward, a therapy garden will be used for a variety of activities including horticulture and exercise.
The central village green is surrounded by the shared therapy rooms which open out on to corresponding outdoor rooms that have been designed as part of the landscape architecture. This includes a café terrace for sharing a chat over coffee on a sunny day, a sheltered exercise area for outdoor yoga, and a calming area next to the spiritual room.
The wider grounds will be extensively landscaped with trees and meadows, alongside existing greenery. These will be used for walking trails, group activities and horticulture.
Importantly, the new building will be highly sustainable and will contribute to NHS Net Zero targets. To that end, Combe Valley will benefit from high levels of insulation and be completely electric, utilising air-source heat pumps, photo-voltaic panels, mechanical ventilation heat recovery, and air handling units to service the building.
The Trust is equally as proud of its co-production approach to this project which has been as rewarding for its partners, Kier and Gilling Dod. The involvement of service users and staff can be seen throughout the final building design. Some examples have resulted in what seem to be simple measures but are highly beneficial to the patients of the future as well as being very cost-effective. These measures can really make a successful hospital.
An area of focus for patients, service users and staff has been the been interior design which has been woven into the overall theme of ‘The Natural World’. This can see seen in the colour palette, the use of timber finishes and even in the building form itself, as well as area such as wayfinding.
This major programme for the Trust - the largest that it has embarked on for some time - has been exciting, challenging and the result of a many years' work from a range of talented and dedicated staff. It also could not have come to fruition without the expert help and support it continues to receive from its design and build partners.
On a final note, Dr Padmore said: “The opportunity to build a new hospital from scratch doesn’t come along very often. We will ensure that the high standard of the building’s design is matched by the high standard of therapeutic care we provide to patients at Combe Valley Hospital.”
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