Birch Hill Centre for Mental Health is a new mental health hospital being constructed on the grounds of Antrim Hospital Estate. During the entirety of this project (from approval of business case to the current design stage) we have adopted a collaborative approach. Our Service User Consultant has been involved from the outset of the project having been involved from Design Team Selection, a member of Project Team, Project Board and various sub-groups.
The Service User/Carer Engagement Group was set up to actively influence, support and work together with the Trust on the design and development of the inpatient service on the Antrim Area Hospital site.
The overall aim of this group is to be an advisory group that will ensure that the voice of the service user and carer is heard throughout the construction project for Birch Hill Centre for Mental Health on the Antrim Hospital site.
This group is chaired and directed by our Service User Consultant. Members of the service user reference group also attend a number of other subgroups, including but not limited to Arts, Wayfinding and External Spaces, Internal Architecture, Internal Design etc. Members of this group are also invited to attend various workshops and meetings scheduled by the Design Team.
As key stakeholders, members of the service user reference group, have been fully involved at every stage of the Design process to date. Members actively propose solutions, deliver ideas and provide feedback to all aspects of the design stages. Service User involvement will ensure that Birch Hill environment and the delivery of care will be led and shaped by the people best placed to know.
The main aims and objectives of our Service User Reference group are:
- To develop an effective co-production culture in line with HSC values, guidance and behaviours.
- To provide a range of knowledge, skills, abilities and experience to the project team from group members to promote meaningful co-production.
- To use lived experience to inform the new build project.
- To provide a forum to promote partnership between service users/carers and the Trust.
- To influence the planning and development on Birch Hill.
- To represent the views of service users and carer.
- To work with the Trust to create an accessible environment for everyone.
- To provide additional representation on other sub-groups & workshops
Our collaborative working partnership and shared vision helps us ensure that our new service will be a centre of excellence and will make a meaningful difference and help change the landscape in the world of mental health.
Service User and carer representation at our meetings has been invaluable and their engagement has provided great insight, identifying gaps and providing learning opportunities.
The members of the Service User Reference group were invited to attend a Naming and Vision workshop alongside, Clinicians, Senior Management, AHP’s, the Design Team and other key stakeholders. Following active participation from service users at this workshop, all comments, themes and statements were considered in the naming of our hospital, ‘Birch Hill Centre for Mental Health’ and for each of our wards and patient departments.
Other key tasks which service user representatives have been involved in, is the Arts and Wayfinding strategy and the landscaping design.
Service Users representatives have also been central in the Arts Strategy and Design. They participated in a menti-meter session which detailed the existing art works across Holywell and Ross Thomson Unit to ascertain which types of artwork could potentially be transferred to the new hospital site. In addition to this, service user representatives were asked for the opinions and comments regarding the colour theme for each ward and how the entrance area of the ward should look and feel. This was undertaken through a series of workshops whereby the Design Team presented many different colours, themes and artistic impressions. Together we have been able to design a bright, airy and modern space in which to welcome our patients, visitors and staff.
It was agreed that each ward should have a visual identity which correlated to the ward name and the colour. Various designs and images were shared by the Design Team and service user representatives were central to the decision making process.
All decisions that have been made to date have been done so in full collaboration with our service users representatives. The aim is to create spaces which they, as experts by experience, will feel safe, comforted and be cared for in a therapeutic healing environment.
The Service User Reference Group meet on a regular basis and a member of the Core Team also attends. The meetings are chaired and directed by our Service User Consultant (NHSCT), and maintains a patient led approach. The Trust member provides updates to sub group members and outlines next actions.
The Meetings and Workshops scheduled by the Design team also follow our co-production ethos and approach to design considerations and decision-making.
The Design Team have also engaged with inpatients in Holywell and Ross Thomson Unit, to gain an understanding of their priorities and concerns for external spaces for the new building. There will be further engagement sessions with inpatients as the design stages progress.
On a regular basis, the Service User Consultant also meets with inpatients and discussions regarding the New Hospital take place with any pertinent information relayed back to the Core Team.
Birch Hill will have a total of 134 single occupancy bedrooms with en-suites so it is imperative that the bedrooms are designed to meet the needs of our service users. A key element of RIBA Stage 3 was the construction of two full size mock up bedrooms. Our service user reference group were the first to view the mock up bedrooms and complete a detailed questionnaire on the two designs. During the viewings we had detailed discussions around many of the features of the bedroom and en-suite and service users and carers also provided in-depth feedback following the review. This included detailed information to indicate the minimal range of clothing that would potentially be brought into hospital for an average of a 2 week stay. The comments received were taken into consideration and feedback to the Design Team has requested the need to widen and deepen the shelving within the built in wardrobe. Sectional storage beneath the window seat is also being considered as part of the detailed design for the bedrooms.
A series of engagement workshops were held involving the Service User Reference group members, current inpatients and the Design Team. A number of different workshop sessions were set up to look at various aspects of the building, including the external envelope, the landscape and the interior design features within the building. The workshops took the form of engagement sessions so that everyone had the opportunity to contribute to and inform design. The sessions allowed the design team to explore patient ideas and understand their preferences. Interactive activities were provided to assist with communication. Worksheets were provided with visual cues, which was a valuable tool for capturing comments and suggestions.
The feedback received from the engagement sessions was reviewed by the Design Team and checked against research and evidence and used to support design decisions.
Information was captured in relation to the current hospital facilities, namely Holywell and Ross Thomson Unit. Patients provided feedback in relation to aspects they did and did not like about the existing buildings. Further workshops examined what patients would like to see on approach to a mental health hospital. This information was used to inform the design of the external building envelope on the subject of architecture which highlighted that patients would prefer a more modern approach with a bright airy entrance area.
The engagement sessions have also explored the design of the external spaces including the internal ward courtyard areas. Feedback from the engagement sessions suggested that areas for recreational activities would be beneficial, a degree of privacy and the option for socialisation. Detailed design is ongoing with the Landscape architects which incorporates the comments received from patient engagement sessions. Further engagement sessions will be scheduled as the design progresses.
The Service User Reference Group provides a forum in which the members can speak freely without judgement. In addition to this, informal meetings are also scheduled with members and Trust employees, which has been invaluable in helping to build trusting relationships. Both of which have provided a avenue which allows their voices to be heard as some members described feeling overwhelmed in the larger group settings and workshops.
The sub group members have given the Core Team and design team a better understanding of the experience of being an inpatient for both the service user and their families. This has been invaluable in helping to shape new ways of working, the built environment and deciphering what matters most as an inpatient. It has helped to identify gaps in our designs and improve design details to assist in the creation of a centre of excellence in the field of mental health.
It became apparent that Service User Representatives found online Teams meetings difficult in terms of being able to voice their opinions and having direct face to face contact. We have members of our Service User Sub Group who have a diagnosis of Autism so found it exceptionally difficult to engage fully in conversations. As a result of the feedback from our Service User Representatives, and to reduce the barriers to communication, the decision was made to have as many face to face meetings as possible. To increase our working relationships, and proactive help and support our service users sub group members, informal meetings were also established outside of the Sub Group meetings. This provides service users with the opportunity to put forth any other concerns, comments or areas of feedback that they wished to convey.
We increased our communication channels to assist our service user representatives stay informed of the many meetings and workshops that were scheduled. A monthly calendar is sent to all group members detailing the upcoming events and meetings so that they can decide upon which of the sessions they wish to attend.
Going forward, we will strive to ensure that our collaborative principles are embedded and integral to every aspect of the design process. We will continue to provide support to our service users by ensuring positive and effective two way communication. This will ensure continuous improvement and assist us in the delivery of providing services and care in a patient led approach.
