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4 days ago
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St Helier hospital is older than the NHS itself. A once beautiful modernist building that admitted its first patients in 1941, it has been left to crumble. The white paint is chipping at every corner of its formerly gleaming exterior and its state of the art balconies have been fenced off due to modern safety regulations.
More pressing concerns for staff are the structural issues that make their already challenging jobs much harder. Large windows built for an optimal stream of ventilation are held together with masking tape to stop them falling in on staff and patients. Corridor floors are sinking into the ground and seep mud, and lifts are out of service so often that ambulances are used to take the most vulnerable patients from side exits in wards to the main hospital building or the intensive care unit.
Pauline Swift, a consultant nephrologist, says the state of the building has reached crisis point. She recalls how that morning – a cold morning in October – a nurse had tried to close a window in a kidney dialysis treatment room and it fell off in her hand. “Somebody ordered extra blankets because it was so cold because of the broken windows,” she said. “It’s a brilliant little unit but really do you want to be looking after your patients in this environment? None of us do.”
St Helier in Sutton is one of thousands of hospitals found in a Guardian investigation to be in a state of disrepair. A third of NHS sites in England require repairs in order to prevent serious and/or catastrophic failure, major disruption to clinical services or serious injury or prosecution.
The NHS is just one area of the public realm that has been left to crumble. A Guardian project has found more than 1.5 million pupils are studying in schools that require major rebuilding or refurbishment, or have a high repair need. Two in five court buildings are considered to be in poor condition, while thousands of prisoners are being held in buildings considered inhumane.
The problems at St Helier are obvious to even the untrained eye – buckets stand under gaping holes in the ceiling all around the building. The ceiling tiles that used to be there have disintegrated from water damage. A large sheet of tarpaulin can be seen bulging under a hole in a corridor ceiling and draining into a bucket below.
“I would say throughout the winter, when I walk through the hospital, I will probably be able to go to three or four places where I will find some sort of device being used to stop water escaping from a roof,” says James Blythe, the managing director at Epsom and St Helier Hospitals.
In February 2022, three days after Blythe started his role in the hospital, a busy renal ward had to be shut down and demolished as it was deemed too dangerous for patients. “It was subsiding so much that there were ceiling tiles falling on patients’ heads,” he says.
The Epsom and St Helier University hospitals NHS trust says it has spent almost £60m on improving the estates over the past five years and has had to cancel 600 operations directly because of the problems.
“The majority of our capital budget goes on backup maintenance ... It means that we’re not really able to invest in anything new, we just mostly do repairs and mandatory upgrades,” Blythe says.
Epsom and St Helier University NHS trust was one of the 40 places promised a new hospital under Boris Johnson’s new hospitals programme. The trust was promised a brand new specialist emergency care hospital in Sutton and significant investment in Epsom and St Helier hospitals to modernise the facilities. In September, the chancellor, Rachel Reeves, put the scheme under review, with the trust yet to gain clarity on whether it will receive what had been promised.
One of the wards in the hospital’s intensive care unit (ITU) was recently given a state of the art upgrade – with proper ventilation, heat regulation and a digital control system that can be accurately monitored. But other wards in the ITU were not so lucky and staff are left having to make decisions on which ward vulnerable patients should be treated in.
Jane Camilleri, the head of nursing for critical care, treats the hospital’s sickest patients day in day out on the ITU wards. She says the building’s issues are a “constant juggle”.
“There’s only certain types of patients we can put in here because the air exchange isn’t adequate, so patients with airborne infections, you will have to have next door because you’ve got the appropriate air exchange,” she says.
The ITU at St Helier does not meet NHS regulations in terms of bed space, air exchange and ventilation. But without funding, meeting those requirements is deemed impossible. Like elsewhere in the hospital, the team in the ITU has little choice but to keep doing the best for their patients in terrible conditions.
