Enter and View visit to Springfield Village
10th and 17th November 2023

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Executive Summary
Overview
Healthwatch Wandsworth has the statutory authority to visit local health or social care services, using trained Enter and View volunteers, with the main focus on the service user’s experience of care. We decided to visit Springfield with a view to getting an impression of the developing footfall and, by talking to people passing through, to gather feedback on responses to the new development and its impact on the whole range of the community, including service users, families and carers, and residents of the new homes as well as hospital staff. 

We spoke to 82 people (24 service users or carers, family, or friends of service users, 40 Trust staff, and 18 others). This was a limited survey, not a random sample, and was based on opportunistic discussions with passers-by. We asked a few, mostly open questions about what people thought of the new hospital environment, as well as questions about their journey and demographic data. We were grateful to receive a rich, thoughtful, and varied range of comments from those we spoke to. The balance of views was clearly positive, but a range of less positive and even critical points were made by some of our interviewees. We have put the various feedback we received to the Trust and summarised their responses.
Due to the varied nature of the feedback we received and what we were told, we do not feel able to make specific recommendations for improvement, as we have done after other visits. We hope that the visit and the subsequent discussions we have had with the Trust will have provided a useful source of feedback to support the services in their efforts to maintain and improve the quality of care and that this report will be informative to Wandsworth residents about the new mental health facilities which have been developed in the heart of the borough. 

Acknowledgement
The Healthwatch Wandsworth Enter & View Team would like to thanks to the volunteers and staff involved in carrying out this work and helping write this report.

Contents
Executive Summary - 2
1.0 Introduction - 4
1.1 Context of the redevelopment - 4
1.2 Purpose of the Visit - 5
2.0 How we went about it - 5
2.1 Discussions with the trust - 5
2.2 Carrying out the visit - 5
2.3 Follow-up - 6
3.0 Main Findings- 6
3.1 Overall Reaction - 6
3.1.1 Service User/Carer, Family, Friend - 6
3.1.2 Staff - 7
3.1.3 Other respondents - 7
3.1.4 Totals - 7
3.2 Specific themes emerging from the survey- 8
3.2.1 Travel to Springfield - 8
3.2.2 Car Parking at Springfield - 8
3.2.3 Aspects of the new buildings - 9
3.2.4 Retail facilities - 9
3.2.5 Proximity of residential properties - 9
3.2.6 The Park -10
3.2.7 Other comments - 10
4.0 Conclusion - 10
5.0 Disclaimer - 11
6.0 SWLSTG’s response - 12

Report of Enter and View visits 10th and 17th November 2023

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1.0 Introduction
Founded in 1840, Springfield Hospital started out as an asylum where people experiencing mental illness were isolated from the community and the public eye for long periods, sometimes even for life. Successive waves of modernisation, new buildings, and profound changes in the way that mental health services are delivered has gradually transformed Springfield into a modern specialist treatment centre. It is operated by South West London and St George’s Mental Health (SWLSTG) NHS Trust and serves five South West London boroughs, rated as Good by successive regulatory inspections, although based within a range of older and unsuitable buildings. 

The aims of the Springfield redevelopment have been outlined by SWLSTG:
* to facilitate the treatment of mental ill-health and support for recovery in adults and children in accordance with the most up to date environmental and clinical standards.
* to help overcome the stigma of mental ill-health and the barriers between people suffering from mental ill-health and the wider community within which they live.

1.1 Context of the redevelopment
This estate modernisation and hospital redevelopment programme was launched over 10 years ago and has now come to fruition at Springfield with the creation of two new hospital buildings designed to be user-friendly as well as up to the highest modern standards. One, Shaftesbury, houses the Trust’s forensic service, whilst the other, Trinity, contains a number of adult in-patient wards, including one for patients with eating disorders and one for deaf patients, as well as outpatient clinics, community team bases, the Child and Adolescent Mental Health Service (CAMHS), the Recovery College and a conference suite. This £150m project has been self-financed by the hospital Trust through the sale of surplus land and buildings for housing development and refurbishment. The remaining surplus land is being landscaped into a 32-acre public park accessible to the whole community.

At the heart of the redeveloped site lies what is now called Springfield Village centred on Chapel Square, named after the old hospital chapel, repurposed as a gym and nursery. Alongside the two new hospital buildings, Trinity and Shaftesbury, lies a newly built residential care home (replacing one previously sited nearby) and a range of newly built private homes. One of the aims of this design layout is to bring the hospital and the local community closer together to help overcome the lingering stigma of mental illness. The two new buildings now provide a significant proportion of the Trust’s services so that almost all services are now in modern buildings. 

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1.2 Purpose of the Visit 
Healthwatch Wandsworth (HWW), set up under the umbrella of Wandsworth Care Alliance (WCA), is the local patient and public champion in the areas of health and social care services. To decide on where to focus our work we look at what people have told us when taking part in our surveys or sharing experiences with us, we speak to local health and care decision makers to hear about their plans to develop services and we use information on local health data to set our priorities. Good mental health services continue to be a high priority for local people. 

Healthwatch Wandsworth has the statutory authority to visit local health or social care services, using trained Enter and View volunteers, with the main focus on the service user’s experience of care. HWW, including members of our Enter and View team, were included in the general invitation to the formal opening of the new Trinity building at the Trust’s Summer Street party on 5th July 2023. After discussion with representatives of the Trust we decided that an appropriate and potentially interesting use of our Enter and View powers would be to revisit Springfield Village a little later in the year with a view to getting an impression of the developing footfall and, by talking to people passing through, to gather feedback on responses to the new development and its impact on the whole range of the community, including service users, families and carers, and residents of the new homes as well as hospital staff. We also wanted to attempt to address whether the redevelopment is meeting its original aims and objectives that were outlined by SWLSTG.

2.0 How we went about it
2.1 Discussions with the trust
We worked together with the Trust to arrange dates for two visits. As our key staff contact at Springfield was available mainly on Fridays, we agreed to visit on two consecutive Fridays in November. We decided to have a table in the main reception area in the Trinity building, this would act as a place that people could come to learn more about Healthwatch and Wandsworth Care Alliance as well as talk to us about their experiences of the redevelopment.

To ensure that staff, carers, service users and residents knew when we would be at Springfield and who we were, we worked with staff at Springfield to disseminate posters and information documents. Here we shared our contact details in case anyone wanted to get in touch with us before the visit or had any concerns about the visit.

2.2 Carrying out the visit
We visited Springfield Village on Friday 10th and 17th November 2023. On our first visit we were there from 11am until 4pm and on our second visit from 11am to 2pm. Our visiting team on each day consisted of four or five authorised members of the Enter and View team and members of Healthwatch/Wandsworth Care Alliance staff. 

We spoke to 82 people (24 service users or carers, family, or friends of service users, 40 Trust staff, and 18 others). This was a limited survey, not a random sample, and was based on opportunistic discussions with passers-by. We asked a few, mostly open questions about what people thought of the new hospital environment, as well as questions about their journey and demographic data. We were grateful to receive a rich, thoughtful, and varied range of comments from those we spoke to. The balance of views was clearly positive, but a range of less positive and even critical points were made by some of our interviewees. 

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2.3 Follow-up
We presented our emerging findings in an online meeting with representatives of the Trust on 20th December 2023. Following that meeting we sent the Trust a report setting out in detail the feedback provided by the people we had spoken to. The Trust have now sent us a written response, the main elements of which are reflected in this report. 

3.0 Main Findings 
3.1 Overall Reaction
We asked respondents “What do you think of this new hospital environment?” and a number of follow up questions depending on their circumstances. 
Analysis of the very diverse responses is inevitably very subjective and varied, limiting the identification of common themes, so we have decided to keep it simple for the purposes of our report. The great majority of our interviewees were generally positive about the redevelopment, although some of these mentioned specific comments or concerns which we recorded and reported to the Trust for their reflection and consideration about whether individual comments could indicate themes amongst wider patients and carers. 

A minority of interviewees’ responses could not be considered positive, and we categorised these as “mixed reaction or negative”. 
We set out the numbers below with some illustrative indications of people’s comments. We should highlight that the building works were ongoing when we were speaking to people and that we had asked them to reflect on their experiences when the building development was bedding in. In addition, some of the concerns raised by individuals have been resolved since our visit. 

3.1.1 Service User/Carer, Family, Friend
Generally Positive
17/24 (71%)
Among the comments made were: “beautiful”, “lovely”, “splendid”, “comfortable”, “relaxing”, “lots of space and air”

Mixed or negative
7/24 (29%)
Of these, two people had had tiresome journeys to get to the hospital from different parts of Wandsworth and one of these was angry for having come to the wrong place. One in-patient on a break from one of the wards in the Trinity building was generally unhappy about his first hospital admission and commented on the construction noise. Another in-patient liked the space but had some problems with the air-conditioning and electronic toilets.

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3.1.2 Staff
Generally Positive
30/40 (75%)
Epithets used include: “wonderful”, “fantastic”, “outstanding beautiful”, “well designed”, “nice to come here to work”, “definite improvement”

Mixed or negative
10/40 (25%)
Of these one acknowledged that the new facilities were good for service users but said they were less good for staff. Two liked the old buildings and thought it a shame to lose them, as well as having worries about the proximity of new residential properties. A peer support worker, with lived experience as a service user over 25 years ago, thought there had been some loss of space for activities. Another staff member was unhappy about working in what they described as a building site.

3.1.3 Other respondents
Generally Positive
16/18 (89%)

Mixed or negative
2/18 (11%)
One of these who worked at Springfield Nursery found the site too busy and noisy for her. The other person had come to visit the park from Southfields but felt that more shops were needed as well as another bus route.

3.1.4 Totals 
Generally Positive 
63/82 (77%) 

Mixed Reaction or Negative 
19/82 (23%)
By way of general comment on these survey results the Trust have said: 
“The new facilities have been designed to provide high quality inpatient services that deliver modern mental healthcare; giving people the best chance to recover in the best environment, and supporting our staff to deliver the outstanding care our service users deserve from us. We are pleased that the vast majority of those interviewed shared positive feedback of our new facilities and the wider Village that is taking shape“

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3.2 Specific themes emerging from the survey
As well as the illustrative indications given above of what people thought of the new hospital environment, we recorded in detail a considerable number and range of individual comments, mainly from staff, some raising specific concerns, which we have passed on as feedback to the Trust. The Trust has acknowledged the feedback and undertaken to consider it further in relevant forums. The main themes and the Trust’s initial responses to them are set out below.

3.2.1 Travel to Springfield
We also asked people about their journey to Springfield. Most of the service users who visit Springfield as outpatients are from Wandsworth and some appeared to suffer from the inadequacies of public transport, particularly from the west of the Borough. We saw very few carers, family or friends visiting their loved ones in the wards.

Half of the staff we spoke to travel from nearby boroughs and most of them walk, cycle, or use public transport. A few of them drive from Croydon with differing reports of traffic but almost one third of the whole group have longer journeys from more distant London boroughs, Essex, or Hertfordshire.
Regarding transport links the Trust highlighted that while they are out of their control, Springfield Hospital is located in between Earlsfield Station on one side and Tooting Bec and Tooting Broadway tube stations on the other. The site is served by the G1 bus which currently drops off on Burntwood Lane to the western side of the site. Visitors will soon benefit from improved transport links as the 315 bus route is set to be extended to the Hospital later this year. The extension to route 315 will mean buses will run between West Norwood and the new hospital in Tooting. 

3.2.2 Car Parking at Springfield
Against this background car parking on the Hospital site was the individual concern that was raised most often, mainly by staff but also by one service user.  There were concerns about the number of available spaces and the complexity of the charges for parking. A person using Springfield Nursery talked about the restrictions on the use of drop-off spaces. 

Concerning parking the Trust pointed out the environmental, health and wellbeing advantages of alternative means of transport to the private car and that car parking spaces are expensive to maintain owing to a combination of capital charges, maintenance, security, and administration, including the issue of parking permits. Car parking charges help to make the site a safer place and ensure there are enough spaces available for those that really need them. Staff can obtain a monthly parking permit which costs less for permanent staff working part-time. There is a graduated scale of charges for visitors. Staff who do not have a monthly permit can park all day for the minimum two-hour visitors’ rate. The car parking arrangements will be kept under review in consultation with staff.

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3.2.3 Aspects of the new buildings
Some staff told us of poor network connectivity in the Trinity building, a concern for staff increasingly using IT to support care. There were a variety of other positive and negative comments, mainly from staff, on space-related and other design issues as well as a number of what could be described as snags or teething problems often associated with new buildings. Service users were mostly positive but had some individual design dislikes.  Some staff had concerns about aspects of the buildings in relation to carrying out their work. We have passed all these comments as feedback to the Trust.
In response the Trust pointed out that the design of the new facilities and the wider development was informed by over 400 meetings, seminars and workshops with service users and their carers, nurses, doctors, and other clinical experts, as well as consultations with the local community. They have been working continuously with staff, both to understand how all concerned can work effectively in the new buildings and to make any necessary changes having moved in. In particular the Trust have set up a “Trinity Leaders forum” to tackle issues arising.  The Trust’s IT Department are aware of the connectivity issue and are putting forward proposed solutions for consideration. 

The Trust confirmed that there had been some initial snags reported when they first moved into Trinity, including a roof leak affecting Bluebell Ward, and the Estate Modernisation Team had worked through these. It was rectified quickly and the incident has not happened again. Through a variety of forums they will continue to log and rectify any future concerns. 

3.2.4 Retail facilities
As part of the new development a café/restaurant, Wellspring, has opened on the corner of the Shaftesbury building adjoining Chapel Square. We could see that it was attracting steady custom. We received a mixture of comments, mostly from staff about this but one service user suggested the need for a more multicultural theme. There was a general desire to see more shops, including a supermarket.  

In response the Trust told us that Wellspring restaurant offers a broad range of food across different price points in a fresh, contemporary environment. The restaurant opens between 7am and 4pm, Monday – Friday.  The menu is designed to cater to all dietary preferences and requirements. Wellspring restaurant is just one part of the food and beverage offerings that will eventually be available in Springfield Village. A coffee shop will also be opening in the Trinity building main entrance later in the year and a convenience store will arrive at a later date. 

3.2.5 Proximity of residential properties
A feature of the new development at Springfield Village is the close proximity of private residential properties to the hospital buildings. This results from new residential development on what was formerly hospital land as well as the conversion of some of the old hospital buildings dating back to the nineteenth century, which however were not sustainable as modern mental healthcare facilities. As already mentioned, one of the declared aims of this design layout is to bring the hospital and the local community closer together as to help overcome the lingering stigma of mental illness.
When we visited, we did not initially ask people directly about this aspect of the development, but it was raised with us on the first day and we asked more people on the second day. Unsurprisingly, views differed, and we reported the comments we received, both favourable and less so, to the Trust. 

In response the Trust re-emphasized that the proximity of the new homes is a vital component of Springfield Village aimed at reducing stigma and creating a community with mental health at its heart. The Trust is very proud of their vision and delivery of the village.

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3.2.6 The Park
Another feature of the new hospital design has been the creation of what will eventually be a 32-acre landscaped public park, London’s biggest new park since the 2012 Olympics. We carried out an hour’s observation in the park on the second day and talked to a variety of park users who welcomed the new public green space. However, there were some concerns about waterlogging on paths. Interestingly, many of the people we spoke to in the park knew little about the hospital, but they were unconcerned about its presence. We did not see any service users in the park on the cold November day we visited.

In response the Trust commented that every ward has its own green and outdoor space. A lot of service users are not well enough to go to the park at a given time, and may prefer to stay in the communal hospital areas or in Chapel Square – particularly in bad weather. Steps will however be taken to remind wards of the attractions of the park as the seasons change.

3.2.7 Other comments
We heard a few comments from individual service users about aspects of the care they were receiving from the Trust. Some of these were positive, in particular about the new outpatient clinics in the Trinity building, some less so. We passed these on in anonymous form to the Trust and they acknowledged the valuable feedback.

4.0 Conclusion
For Healthwatch Wandsworth this visit was a departure from our normal practice in exercising our Enter and View powers. In previous Enter and View visits we have focussed on a specific service or area of service provision and explored in some depth the experience of usually a relatively small number of service users who have given their consent to be interviewed. On this occasion we approached a large number of people going about their daily business and asked just a few quick questions about the new hospital environment. 

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Due to the varied nature of the feedback we received we do not feel able on the basis of what we were told to make specific recommendations for improvement, as we have done after other visits. We hope that the visit and the subsequent discussions we have had with the Trust will have provided a useful source of feedback to support the services in their efforts to maintain and improve the quality of care and that this report will be informative to Wandsworth residents about the new mental health facilities which have been developed in the heart of the borough. 

Regarding whether the Springfield redevelopment is achieving its aims:
* to facilitate the treatment of mental ill-health and support for recovery in adults and children in accordance with the most up to date environmental and clinical standards;
* to help overcome the stigma of mental ill-health and the barriers between people suffering from mental ill-health and the wider community within which they live,
it is difficult for us to draw any very definite conclusions on the achievement of these aims at this early stage. However, we can state that, in addition to the unmistakeable impact of the brand new mental health facilities built to a clearly high standard of design, we saw evidence of the wider community being present on the  site and enjoying use of facilities such as the park and coffee shop to a greater extent than was previously the case, which can be seen as a sign of progress towards overcoming the stigma of mental ill-health and the breaking down of barriers. There seems every reason to hope that this process will advance further as the redevelopment proceeds to completion and the new residential properties become fully occupied.

We are grateful to South West London and St George’s Mental Health Trust for facilitating this visit and to the many Trust staff, service users and visitors who kindly agreed to share their views with us.

5.0 Disclaimer
Please note that our findings in this report relate to observations and interviews on specific days.  It should not be taken as a representative portrayal of the views of all service users, staff, carers, and the general public of the redevelopment.

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6.0 South West London and St George's Mental Health NHS Trust's (SWLSTG) Response
Director for the Trust’s Better Communities programme, Ian Garlington, who led the development of the new Trinity building said:  

“We are delighted that 80% of the feedback received following Healthwatch Wandsworth’s recent Enter and View session is overwhelmingly positive. We worked in real co-production over a number of years to ensure our facilities meet the needs of our patients, their families and carers, and of course our staff. We are also extremely proud of the Village we have created – a community with mental health at its heart that is reducing mental health stigma and providing more housing and green spaces for the people of south west London. 

“We would like to thank Healthwatch Wandsworth for conducting such a robust review. In terms of feedback on areas for improvement, we are actively working with colleagues and wider stakeholders to continue to make our sites work for all who visit us and use our services.”
“We welcome feedback from everyone as we work to deliver our Trust mission ‘Making Life Better Together’. 

“Our Patient Advice and Liaison Service (PALS) team are here to help. As a patient, relative or carer, sometimes you may need to turn to someone for help, advice and support. PALS is a confidential advice and support service that can help with any concerns that you may have about any aspect of your or your loved one's care. Our Feedback Live service is also available via an online survey co-produced with service users, enabling patients and visitors to give real-time feedback on experiences with us to support learning and improvement.

“Following the £150m redevelopment of Springfield Hospital, we are excited about the future of local mental health services and we look forward to the opening of further areas of the new Springfield Park for our community at Springfield Village later this year.” 
“Finally, I’d like to take this opportunity to remind everyone that, as part of our ongoing commitment to our communities, you can sign up to FREE Mental Health First Aid training funded by our Trust charity.”

* Find out more about the Trust’s Better Communities programme - https://swlstg.nhs.uk/better-communities
* As part of this, the Trust’s Better Environments programme (https://swlstg.nhs.uk/better-environments) is delivering:
o Springfield Village, a new stigma-breaking community at the heart of Wandsworth with new mental health facilities for Springfield Hospital, hundreds of new homes and a brand new 32-acre park – new areas opening up to 2027
o A refurbished facility, Richmond Royal Health Centre, at the site of the former Richmond Royal Hospital – opening in late 2024
o A brand-new outpatient facility alongside a new school at Barnes Hospital in Richmond – delivered in spring 2025
o And five new wards at Tolworth Hospital in Kingston – delivered in 2027
* Find out more about the Trust’s Patient Advice and Liaison Service - https://swlstg.nhs.uk/advice-and-complaints-pals
* Access more information Feedback Live - https://swlstg.nhs.uk/your-feedback