New Children's Hospital at Mater site

Access, travel times, and the question of accessibility for the community of greater Dublin, and for those beyond greater Dublin, remain a concern for many of the stakeholders who presented to the review team. These issues have been the source of many submissions and protests to the Minister and to the media.

Comprehensive travel studies have been provided by the NPHDB consultant team. The panel was made aware that a comprehensive Traffic Impact Assessment has been submitted to, and negotiated in detail with, Dublin City Council as part of the planning consultation for the new development. These have reassured the Clinical Review Team. The studies appear to be thorough, well tested and statistically reliable, and they have taken into account the ‘worst case scenario’ – the possibility that the Metro North station will not be developed on the site.

There are also a several background issues which were thought worthy of consideration in the current debate:

Emergency: there is already significant emergency paediatric traffic in Dublin’s city centre. The busiest children’s emergency department in the city – the CUH at Temple Street - is situated 400 metres from the proposed development at Eccles Street. No information which we have received or presentation we have attended has identified that access to Temple Street is of major concern. CUH Temple Street currently deals with 45 000 attendances per year. The proposed volume of activity at the new NPH on opening will be around 65 000 attendances per year ie an increase of 45% on existing levels.
Parking: there is virtually no parking on the CUH Temple Street site. There will be 736 patient parking spaces in the NPH development, which will be secure and safe with direct lift access to the main foyer and the emergency department. A significant proportion of these will be dedicated for emergency patients.

Travel management: The traffic studies looked at journey times for emergency patients from inside and outside the Dublin conurbation using the M50 and established the travel times along the major radial routes from the orbital motorway to the Eccles Street site at various times of the day. They identified, not surprisingly, that the longest journey times are in the morning peak period. The majority of paediatric attendances at emergency departments take place between 12.00 and 20.00, when the journey times are at their shortest.

Elective care: The OCSC Travel Time survey report identifies that elective care is, by its definition, planned and that tertiary attendances from ouside the Dublin conurbation can be planned to make effective use of the highway networks.

The availability of good public transport is a strong positive for the Mater site. One of the laudable successes of the existing Mater Hospital has been to increase staff use of public transport to 70% for journeys to work by means of Mobility Management Planning. It is important in the wider context of Europe-wide carbon reduction targets that the NPH is not planned around over-reliance on private car transport for staff travel. Furthermore, for parents who are staying at the hospital with their children for significant periods of time, the ability to access the city centre for brief periods of time on public transport is an advantage.

Access is less of an issue for parents than appropriate and high quality care. Currently parents can and do travel across the globe to access care for their children.

The provision in Ireland of a first class facility that unites expertise and develops local care is by far the most important factor for this group.
There has also been comprehensive planning and coordination with local councils and ambulance services.

There are general concerns (very acute for some groups) about the expansion / future proofing options given the choice of the inner city Eccles Street site, with little current land for expansion once the only remaining building footprint is committed to the Rotunda Maternity Hospital for tri-location with the adult and paediatric hospitals.

The NPH Development Board has planned expansion space within the facility envelope, but this is not widely known nor understood. More importantly, the Temple Street facility will remain committed to health care service use once the Children’s Hospital moves. This was confirmed by the Temple Street Board.
It would be advantageous to have a ‘master planning’ process for the Temple Street site with a view to having the site committed to children’s health care and having a binding understanding with the Temple Street site owners. Being able to speak to this availability more explicity would allay some concerns. Beginning the dialogue with the hospital and clinical community now will be an important part of long term strategies.

The Clinical Review Team supports the overall design proposed for the NPH on the Mater site. However, a number of concerns about elements of the existing design were raised by clinicians during our interviews. As a result, and in line with established practice, we would recommend a focussed review of some elements of the planned facility; namely:

• Emergency department design
  
• Radiology adjacencies
  
• Patient flows (particularly to operating theatres and the paediatric intensive care unit)
  
• The vertical alignments and associations of the usual ‘hot floor’ elements.

Design development should at the earliest opportunity test the plans against patient journeys to ensure the facility is child focussed and operationally efficient. A wide range of clinician representatives should be involved in this work, and it would be beneficial to have greater clinical representation on the development board.

As a general point, the design of every department in the new NPH should be of a comparable standard, or preferably superior to, any current facilities for children in Dublin.

Parents and Care Givers
The review team heard from a group of parents and care givers, representing a coalition of around 40 disease-specific support groups.

This coalition of parents is passionate and committed to the NPH project, and they clearly want to see early progression on the current selected site. They spoke positively about their engagement at all stages of the planning process and expressed grave concerns regarding any delay that may be consequent on decisions taken as a result of the independent review. The parents expressed disappointment at the division within the clinical community and institutional leadership regarding the progression of the NPH project. They suggested that there remained (sadly) an inappropriate weighting on an individual institution’s welfare rather than a genuine priority for the child and the future of child health.

The parents also pointed out – from their own experience – the poor state of the current children’s hospital facilities and the woeful nature of parent and patient accommodation in children’s hospitals. They expressed their concern that any delay in this development in improving the physical environment in which children are cared for, would unnecessarily place children at risk of serious harm.

BostonB wrote: »

I have no idea what travel survey this refers to and you've posted no links. From where did you drag this up from?