For decades, concerns have been raised about Broadmoor’s facilities. In 2003, the Commission for Health Improvement described the hospital as ‘totally unfit for purpose’. Following eight suicides in as many years from 2001 to 2008, the hospital was ordered to improve facilities.
The design of Broadmoor’s original Victorian buildings did not always turn out to be optimal for patient welfare. The T-shaped wards are barely usable, as they prevent lines of sight. This poses an increased suicide risk, and also prevents nurses from being able to care efficiently for patients. Most damningly, a 2009 CQC found Broadmoor’s facilities to be completely inadequate and overcrowded. We were told time and again by staff that Broadmoor is really difficult to renovate. The buildings, many of which are over 150 years old, are listed buildings, and this level of protection means that they are incredibly difficult to undertake construction work on. In one particularly chilling example of the red tape this creates, when the hospital looked to remove window bars in order to prevent patients hanging themselves from them, they found that to do so would be illegal, due to the obvious historical significance of the buildings.
Finally, over 150 years after its doors opened, Broadmoor is moving house. In 2009, plans began for the hospital to uproot from its original Victorian site, where countless dramas have played out since 1863, and to move to a new, purpose-built hospital next door. It is a huge moment, possibly the biggest moment in Broadmoor’s long and venerable history. The entire project was anticipated to cost in excess of £200million, and a preliminary, very optimistic moving-in date of June 2017 was suggested. The new Broadmoor has yet to open.
Although parts of the old buildings have been closed down or repurposed in the run-up to the move, there will be a moment when the old Broadmoor closes its doors for the very last time. What do key staff members and select patients feel about the move? As Pete Turner told us, ‘The move to the new hospital will be a powerful moment.’
Strange as it sounds, there is plenty of nostalgia for the old hospital and all of its history. Both patients and staff have been involved in the decision-making on how the new premises will look and feel. Of course, the intention is that the new wards will be better ventilated, air-conditioned and rather more fragrant than the old Victorian wards and the stuffy 1970s additions. Most staff we asked about the move spoke highly of the redevelopment team at the new hospital.
Pat McKee has been an active participant within the redevelopment team. An enthusiastic cheerleader for the new hospital, he phrased this pivotal moment in history beautifully: ‘In 1863, a new group of patients and staff walked into a state-of-the-art hospital. Now, a new group is doing that very first shift.’
Pat is full of praise for the layout of the new buildings. The new wards are light, bright and airy. Every ward will have its own gym equipment. There are three gardens in the new intensive care ward, to aid well-being. Each ward will have just ten to 12 patients, depending on the ward.
While the Victorian Broadmoor could not have been built with modern standards of patient care in mind, the new hospital is. In the new buildings, the whole place is purpose-built for technology, especially the central building. There is a free flow of lines of sight, which means no need for an escort. In the old hospital, accessible space for patients is limited to the terrace. That will all change. There is a glass-fronted shop, albeit shatterproof glass, hairdressers, cafes, and working areas.
We asked Pat what the patients’ opinions of the new hospital were. Some, he said, were not interested because they will not be cared for at the hospital by the time the move happens; others are concerned they haven’t physically seen it.
Pat described an art competition going on amongst the patients about the transition, to build enthusiasm and engagement in the project from the patient base. However, when asked whether any patients are likely to be able to physically see the hospital before they move, the answer was an indefinite maybe.
The new security control room and high secure perimeter access the latest technology. Lines of sight have been carefully enhanced across the campus, and ligature points diminished wherever possible. The new visitors centre will be much improved in terms of the experience that it offers.
A series of induction videos have been created for the patients to watch, too, as well as welcome packs. Once the wards had been carpeted, decorated, and all but ready to go, patients were able to see pictures of them. Having viewed these, patients said that they liked the look of the larger rooms and bedrooms, and the wet rooms. Several of the patients we met at the patient forum were especially pleased that they can regulate water temperature and room temperature in the new buildings.
It has not all been plain sailing. The Kier Group, a UK construction company with an annual revenue in excess of £4billion, has repeatedly pushed back its estimations of when the redevelopment of Broadmoor’s new hospital will be completed. Just the phase-one block-building programme ended up being delivered 16 months late.
Kier have also ended up slipping on budget big time. The total capital cost of the project is projected at £249million and rising, at least £17million more than originally budgeted. Because of slow delivery on the project and concerns over the growing budget, the Hospital Redevelopment Board have retained consultancy company Arcadis since 2017 to oversee progress. On the flipside, the view taken by West London NHS Trust is that with patient safety always a priority, they can’t move until they can be sure it is safe and secure.
While Kier leads on the construction of Broadmoor, Oxford Architects are taking the lead on designing and planning how the new hospital will look. Following an intensive appointment process, they began work on the project in 2009, initially predicting that it would be completed in its entirety by 2016.
Between these three companies, plans for the new Broadmoor are very slowly becoming reality. Parts of the new hospital have already been completed. The Paddock Centre, a 70-bed ward designed by Oxford Architects, was finished in 2005 at a cost of £25million.
Plans for the new hospital place it at a similar scale. With a footprint of 32,500m2, it will provide wards and facilities for 234 patients, and Broadmoor came to Oxford Architects with briefs for the wards already developed. Oxford Architects, under Project Architect Rick Lamb and Partner Nick Caldwell, then created a brief for the Entrance Building, Central Building, perimeter security and secure external spaces.
Within these buildings and spaces they designed facilities for administration, shops, recreation, archive, canteen, visitors, group therapy, security and faith areas, consulting with clinicians, nurses, psychiatrists, psychologists, estates, security, department heads and head of service in order to do so. They also visited other mental health facilities in the UK. That was the best way to see what worked well, and what didn’t.
The final concept for the design was based on buildings surrounding a garden. The three wards slant off from the strikingly beautiful Central Building, with a large stained-glass window designed with input from patients and the chaplaincy. Central Building, while not very originally named, will be the central hub for all patient treatment and therapies, as well as where administrative staff will be based, while the three wards will obviously be for patient accommodation. This is a change from the current site, in which areas for rehabilitative work, admin and patient living are intermingled throughout the hospital, leaving staff often having to work in isolation from others in their team.
On top of the design focus on clear lines of sight, large glass wall panels and CCTV will hopefully put an end to the current level of observation and supervision required. The intention is to allow staff to focus on treating their patients rather than just checking up on them, as more time will then be allotted to therapeutic activities. Each ward building roof will be topped with large Velux windows, which can open on a central pivot, creating areas that are not only well lit, but well ventilated, a far cry from the old Victorian T-shaped wards. Every detail has been considered, even the fitting of the bedroom windows, which are deliberately angled to allow in more light, but also to enhance privacy. A great deal of thought has gone into the artwork, the ceiling heights, the gardens and even the curtains, which are flame retardant.
It’s not just the physical building that’s being restructured, but the care pathway with it. The new focus is on a clear, measurable plan that sets out and promotes the route to recovery. The hope is that, in the new facilities, it will be easier for patients to undertake ‘meaningful activity’, which can include exercise, therapy, and the various workshops available, with each patient aiming to complete 25 hours a week in these areas.
We noticed that many hospital staff are using the move as a chance to examine and to improve their broader clinical practice. For instance, while security and care is 24/7, therapies and workshops exist only in the standard working day, five days a week, and discussions are currently in place as to whether these might be more effective were they also available in the evenings and at weekends.
Once the move to the new hospital is finally complete, the intriguing question remains of what is to be done with the original site. The intention is to sell off the old buildings and use this capital to help fund the new hospital. There has been talk amongst developers of Broadmoor being converted into luxury flats, and an apocryphal story about it being turned into Crowthorne’s first luxury hotel, potentially themed around Broadmoor’s gory history. What it would be perfect for is a filming location!
While any developers would be faced with the same listed building restrictions that have hamstrung Broadmoor staff for years, the hotel concept has been taken up elsewhere. In Oxford, it’s possible to stay in the Malmaison, a converted former prison in which the cell rooms are now luxurious double rooms built from joining three cells rooms together, while the Karosta Prison Hotel in Latvia, formerly a KGB prison, trades off its dark past, advertising itself as ‘unfriendly, unheated, uncomfortable’. Broadmoor’s beautiful views, scenic local walks and golf courses and proximity to central London and Heathrow are all factors that make it potentially desirable as a hotel.
History buffs and preservation society members have been worried by the idea of converting Broadmoor into a hotel, arguing that doing so threatens the building’s heritage. Many British government-owned buildings have been sold off over the years and fallen into disrepair and dereliction, including a number of historically significant hospitals. Many people would be desperately sad to see Broadmoor go the same way, including many of the hospital’s own patients and staff, and us. Clive Bonnet and Pat McKee are particularly passionate exponents of the history of the old hospital, while acknowledging the many benefits of the new site.
Does it really make any sense to have a luxury hotel right next door to a high security hospital? Half of the pretty rural views would be over a functioning mental hospital. Not only does this raise concerns over security, but also the privacy of the patients.
Considering the lengths journalists have gone to in the past to secure photographs of patients such as Peter Sutcliffe, building a multi-storey building with potential sightlines into the complex is likely to worry staff, patients, and those who might visit them. There are plans in place that trees will be planted to screen the hospital from the hotel and vice versa: this would be for aesthetic effect in addition to the intense security surrounding the new building itself. However, in an age of £50 drones that take little skill to fly, which have already been confirmed to be used to smuggle drugs into a number of different English prisons, this is unlikely to resolve all the problems this may raise.
Broadmoor Hospital these days is corporate. Well-run. Brimming with well-intentioned and risk-averse staff. The shift to the new site and the sale of the old buildings will not change that. As things stand, the fate of the iconic Victorian building, and its ultimate use or purpose, remains in doubt. There is even talk of doing away with the very name Broadmoor and all the sensationalist associations that come with it, if not now then in the foreseeable future.
Clive Bonnet marvelled that ‘Broadmoor was the first ever high secure hospital when the Victorians built it. They couldn’t have chosen a better site. A moor where you can see for miles. That’s important, therapeutic. “I can see what I can be striving for,” the patient thinks. “The real world is out there.”’
He remembers being overwhelmed by a sense of permanence on his third shift in, walking up Upper Broadmoor Road: ‘In 1946, when Dad started, they were telling him the place was finished. People always say that, but it is just changing. Broadmoor will never finish, Broadmoor is here forever.’