The University Hospital Nottingham, Queen’s Medical Centre

The site of what is now the campus of the Queen’s Medical Centre in 1969, two years before construction commenced.

University Hospital when it was first planed was designed tol be one of the three District General Hospitals serving the Nottingham area.  In addition to providing for the comprehensive hospital needs of the district it serves, it was also designed to play its part in the overall provision of specialist departments shared between all the hospitals in Nottingham.  For example, facilities for neonatal surgery, plastic surgery and burns that are provided at the City Hospital, radiotherapy at the General Hospital and neurosurgery at the University Hospital.


This interdependence of clinical services at District General Hospitals and hospitals for the mentally ill is an essential part of the hospital plan for the area and extends to supporting services, e.g. laundry and CSSD.


Consideration of the requirements for clinical teaching and the need to complete the balance of hospital provision elsewhere in the Nottingham area led to an agreed complement of 1400 beds for the University Hospital.  Just over 1000 beds were provided for the acutely ill, including 144 children.  The maternity unit having 168 beds and 30 cots for newborn babies requiring special care.  84 beds for the assessment of geriatric patients, and 175 beds for the mentally ill, including 15 children.  The hospital when originally planned also included a major Accident and Emergency Department with its own radiological facilities, nine operating theatres and observation ward.


At the planing stage, facilities were included for geriatric and mentally ill patients.  These units now provide support during the day enabling a number of elderly and mentally ill patients to continue to live at home in the community. In addition to consultative outpatient clinics, a unit of 20 beds with theatre facilities were included in the plans to provided for surgery and other investigations which can be performed during the day without the need to admit patients to the wards overnight.


The Medical School accommodation when originally planed was designed to provide full academic facilities for training students;  coming with lecture theatres, laboratories, library, seminar rooms and all the necessary staff and ancillary rooms, appropriately located in relation to hospital departments and the University.


At conception the accompanying School of Nursing, was designed to undertake general training for the register and roll for all student pupil nurses in the Nottingham area, the Nottingham School of Nursing’s facilities occupied an area of about 40,000 square feet incorporating lecturer theatres, discussion rooms, common rooms for staff and students, and a work room for the preparation of teaching aids with the library linked to the Medical School library, giving extensive facilities to staff and students.


When planed the University Hospital was designed to employ a considerable number of staff that are required to be resident.  Recruitment of staff took place over a wide geographical area and the existence of well designed accommodation was to be a requirement in this respect.


Finally. When at the planing stage it was intended that a social centre will be provided for use by resident and non-resident staff. This is because those planing the whole complex believed this would encourage the formulation of good inter-staff relations.


___________________




Photographs take before construction work began

Spring Terrace

Spring Terrace

Looking down onto Spring Terrace

Looking down onto Spring Terrace


_______________

Official Opening of the QMC

Official opening of the Queen’s Medical Centre

Thursday 28 July, 1977

_______________


The Construction of the Queen’s Medical Centre

Medical School Construction, May 1972

Medical School Construction, May 1972


Medical School Foot Bridge Construction September 1973

Medical School, April, 1973

_______________

Queen’s Medical Centre: The Formative Years

Hospital and Health Services Review, March 1980


Queens Medical Centre, Nottingham, is the first and one of the biggest integrated hospital and medical, nursing and radiography training centres to be built in the country in this century. Construction of the four multi-storey blocks and interconnected central area began in 1971 and has been divided into two phases.


Integration is one of the key features of the Centre, some services such as audio-visual, pathology and library services being shared between University Hospital and the teaching schools, and academic units being positioned adjacent to appropriate wards on each floor.


Phase 1, comprising Nottingham University's medical school block, the University Hospital West Block (458 beds for adult medical and surgical patients and child patients and the accident and emergency service), part of the central area (out-patient clinics, support services and the schools of nursing and radiography) and accommodation for an ultimate total of 800 students and staff, became fully operational in July 1979. About 2,500 staff are now working in University Hospital and it is expected that a total of 5,000 will be needed when Phase 2 is running.


Phase 2 will open gradually during the 1980s geared to the availability of revenue money. Building is being carried out in three stages. The fully operational Centre should provide 1,490 beds for in-patients and places for 140 – 160 medical students a year.


The architects, quantity surveyors, civil and structural engineers for the centre are the Building Design Partnership.


Southend, the journal of the South Nottingham Health District, published the first part of a guide to the Centre in its January/February issue, with the second part promised for March. The information should remain up-to-date until the mid-1980s.


CHC Assessment


The 1979 annual report of South Nottingham CHC discusses the hospital. "The CHC have made a number of all-day visits to wards in the hospital and we feel that it is indeed a hospital designed for the patients – the ward accommodation, the day rooms, the bathroom and toilet facilities are excellent. The provision in our future new teaching hospital must be the envy of districts with older buildings, but the hospital provides better beds not new beds, and the cost of running them is higher. The staff who had to organise and carry out and transfer wards and clinics to University Hospital put in an enormous amount of extra work. The transfers went smoothly and even in the first running day of wards and clinics things went well.


"Members did a survey on the food in the hospital in September and found that patients on the whole like the system used to deliver a complete meal in an insulated tray for each patient.


"We carried out a survey of the phone system at the hospital and concluded that too few staff and inappropriate equipment resulting serious delay problems which must be rectified. A working party has been set up at the hospital to plan changes.


"We have made a number of visits to the Accident and Emergency Department which confirm that sometimes the department is extremely busy. We think that serious accident and emergency cases are treated quickly and well. Although the walking wounded often do have long waits in the department this is because genuine emergency patients are rightly given priority. We have pressed for patients waiting in the accident and emergency department to be given more information about the reasons for their waiting. We are pleased to report that this is sometimes done and we have been promised that it will become a regular feature. We were worried about the split casualty service for eye patients, but in fact we have had no complaints during the year.


"We have been pressing now for two years for action on the overheating in the wards caused by some reflections on the large window walls of the wards. This summer was cool but on one or two sunny days, conditions for staff and patients were intolerable. No firm decision about how to solve the problem has yet been taken, although money is available for a solution.


"We realise that there are number of teething problems. The signposting in the hospital is still inadequate. In particular there are no internal directory signs within the lists. The car parking at present is appalling and, reluctant as we are to see cash spent on concrete for cars rather than on patient facilities. We have supported the case of need for the multi-storey car park. The public are finding their way to the hospital but there are particular problems still for people travelling from the south of the country...


"Patients praise staff highly and mention particularly those who find time to talk to patients and give explanations. Patients have also said how grateful they are to the volunteers who act as guides and are particularly helpful to elderly patients."


Staff Residences


The residences were phased to accommodate the number of staff required at each stage of completion of the hospital. The hospital is built on the compact sands and rock of the valley side, but the 4 hectare residential area to the south is entirely on the alluvial valley floor. There is a perimeter ring road system on the hospital site, with links to surrounding roads, and giving access to all the site facilities. Cul-de-sac from this perimeter road penetrates the residential area, giving close vehicle access to all units, but leaving the central portions free of traffic.


Residential area development includes a range of accommodation from study bedrooms for junior nurses to family flats, and a social centre. It was conceived as a complete contrast to the hospital buildings, so that staff returning home should enter a compact group of human scale buildings and spaces, and an attractive, lively environment.


All the first phase units were three stories high, but demand for additional accommodation required the inclusion of three six-storey blocks in later phases. The three-storey blocks are H shaped, with a single central staircase and refuge chute in the "link", and bedrooms, bathroom, kitchens etc, in the flanking accommodation. This plan form allowed units to be placed end to end in various configurations, with the monopitch roofs running through. Each of the six-storey blocks is a separate unit, with the rings of study bedrooms and two staircases around the central core of bathrooms and services.


The poor ground required piled foundations – vibro-flotation and reinforced concrete ground beams under the three-storey blocks, and driven piles under the six-storey blocks.


All the superstructures are in load-bearing brick wall concrete block, with (precast) reinforced concrete floors. The external face of all ground floors is a dark facing brick laid in black mortar. Upper external walls are faced with white PVC weatherproofing on timber battens fixed back to the blockwork.


The monopitch roofs are brown concrete tiles on timber trusses; six-storey block flat roofs are bitumen and felt on installation on the concrete slabs.


Virtually all internal paintwork is in brilliant white to allow total flexibility of a range of colourful furnishings. All bedrooms and corridors are carpeted; toilets, kitchens, stairs and entrance areas have cushioned vinyl sheet flooring. Each study bedroom has a built-in unit finished with teak veneer and comprising a vanitory, wardrobe, bookcase and pinboard, worktop and chest of drawers.


Heating and water supply is via underground distribution pipes and calorifiers from the hospital sites central boiler house. The low-pressure HW radiators are quite capable of maintaining the high room temperatures that off-duty nurses seem to require.


The social centre is at the focus of the footpath system that limits the residences with the hospital, and has accommodated a variety of temporary uses during the development of the site. The two-storey portion has now reverted to its intended uses – squash court, cafe, bar and lounges – and the single-storey part.


Residences: Phase 1 completed in 1973 providing 358 beds; phase 2 completed in 1977 providing 325 beds; phase 3 is due for completion in 1981, with 113 beds at a current cost of nearly £8,000 per bed.


Contractors: Phase 1, Simms, Sons and Cooke Ltd; Phase 2, J. Searson Ltd; Phase 3, Thomas Fish and Son Ltd.


Architect, Quantity Surveyors and Structural Engineers: Building Design Partnership.


Heating, Electrical and Plumbing Engineers: Revall Hayward and Partners.


_______________

Photographs from the Queen’s Medical Centres formative years

West Block Entrance off Derby Road, 1977

Accident and Emergency Department, 1979

Medical School Research Laboratory

Six Bed Bayed Hospital Ward


_______________

‘THE QUEENS MEDICAL CENTRE’

Nottingham’s Medical Metropolis


By Paul R, Swift, Honorary Archivist, Nottingham University Hospitals NHS Trust


Having been part of Nottingham for the best part 34 years, the University Hospital, Queens Medical Centre is now accepted as one of the finest teaching hospitals in the world. The hospital was originally opened on Thursday 28th July 1977 by Her Majesty Queen Elizabeth II when along with Prince Philip; she paid a visit to Nottingham as part of her Silver Jubilee celebrations. However, for those who were around at the time and have memories of the event will know what has now become Nottingham’s Medical Metropolis, had, for those who lived in the area, a controversial beginning.

 Having the honour to be the first medical school to be established outside the capital, in the 20th century, and fighting off bids from rival cities, the University Hospital was conceived in July 1964, when a decision was announced in Parliament that Nottingham, the city chosen, was to have a new University Hospital and Medical School.


As it was estimated a site of 42 acres would be required, the initial problem the planners had to face before building work could commence, were issues surrounding the legalities of compulsory purchasing of land and buildings, together with the displacement of people to other areas of Nottingham,  as where the University Hospital was built was once an industrial/housing estate.


Opposition to compulsory purchase land and buildings came in February 1967 when local residents fought the decision to build the access road to the hospital from Derby Road, by launching a petition and car sticker campaign. This culminated one month later when two hundred residents from Wollaton formed a ‘vigilante group’ to oppose the large-scale development about to take place.


No more was the force of collective resistance more keenly felt than by the vice-chairman of the Nottingham Planning Committee, who, apart from sympathising with local residents, was quoted as saying: “I often feel that we the council have the dirty end of the stick. We are told what the plans are by the Ministry and we have no alternative but to enforce them.”


Eventually, after overcoming all the legal technicalities, building of the University Hospital finally got underway in May 1971.


If every thing had gone to plan the whole hospital would have been completed in 1980. Unfortunately, with all the best will in the world, plans never go quite the way they are intended, as it would be a further four years before the building work was finally finished, with the completion of the hospitals South Block.


The Queens Medical Centre because of its sheer size has, from its outset, courted controversy. For example, what took the Q.M.C. so long to become fully operational was due to the fact that during the early part of the 1980’s it had to overcome N.H.S. funding shortages. Indeed, before that, it was reported in the Evening Post on July 7th 1979 that the then North Nottingham M.P. William Whitlock, in a debate in the House of Commons told M.P’s: “the University Hospital was too big.” This was followed three years later in July 1982, when in an Evening Post interview the Rushcliffe M.P. Kenneth Clarke mischievously described the University Hospital as a “monument of folly.” However, in a later article published in the same year, and to refute the comments made by Mr Clarke, the Q.M.C. was described in a survey as: “one of the top ten most productive hospitals in the country.”


With the long lens of time and by reading the above comments made, one can begin to see why when it was built it courted so much controversy. The University Hospitals sole purpose when it was first planed is that all trauma and acute services should be centralized under one roof. This meant transferring all services from smaller hospitals in Nottingham.


Eventually, over time, to familiar cries from staff and patients alike of, “it’s too big” and “it’s too impersonal,”  all services were transferred from old much loved hospitals to this new purpose built building on the western side of the city.


The idea of centralization of services also gives a clue as to what architects and planners were thinking at the time. The 1960’s was a time when Nottingham, like many other towns and cities throughout the U.K., went through a period of slum clearance, when whole districts like St. Ann’s and the Meadows were cleared of all 19th century slum housing.


Apart from building new houses, what appeared to be the answer to overcoming the shortage of housing, as they could be constructed quite quickly, plus they would occupy less building space, and that was to build high-rise flats? Therefore, with high-rise living being the answer, why not build hospitals in a similar way.


The cost of building the University Hospital has been wide and varied. In the mid-1960s during its planning stage, it was estimated that it would cost £15m build, which today would cost an eye watering £223m. Later in 1979, to build the University Hospital it was quoted as £70m, the equivalent price of two Concorde aircrafts. Again, at today’s prices, it would cost a staggering £296m.


Of course, the controversy over the cost didn’t end with the price of two Concorde’s. In the same article published in April 1982 it was estimated that to bring it up to its estimated bed capacity of 1,400 beds a further £6m would have to be spent.


If that was not enough to cope with, this was followed up seven months later on 10 November in an article highlighting settlement cracks appearing in the building, caused by structural movement, thus requiring a further spend of £1.5m in remedial work. In the same article that appeared in 1982, the price to build the Q.M.C. had in three years jumped a further £10m to £80m, which in today’s price would cost a whopping £225m.


To average all the three original prices quoted to build the University Hospital, the final cost would have come to an average of £55m.  Today £55m would be enough, at a rounded cost,  to purchase the current Nottingham University Hospitals NHS Trust, covering both the City and University Hospitals, the just opened £3m Biomedical Research Unit and the £21m Nottingham Radiotherapy Centre at the City Hospital, leaving a surplus of £13m.


One question that has been asked over the years is: “would hospitals like the Q.M.C. ever be built again? The answer would be yes, but at an enormous cost, which in this day and age would prove just as controversial as when the Q.M.C. was first built all those years ago. Indeed, a hospital in similar size to the Q.M.C. was planned to be built in Stockton-On-Tees, only to be cancelled by the current coalition government as the cost was estimated to be £464m.


Having survived politically charged comments and the tectonic plates of earth movement, the Nottingham University Hospital, Queens Medical Centre is today very much an accepted part of Nottingham’s healthcare services.


When thinking of the demands placed on today’s National Health Service, then think of how the old hospitals the Q.M.C. replaced, in today’s day and age. Although we loved the old hospitals and cherish fond memories, hospitals such as the Women’s Hospital on Peel Street, the Children’s Hospital at Forest House and of course the Nottingham General Hospital would not be able to cope with the demands that would be placed on them. Therefore, hospitals like the Q.M.C. and its attached medical school had to happen, without it the world renowned centre for medical excellence that Nottingham is would never have taken place.


Another thought to bear in mind, if the plans to build the Q.M.C. had been conceived ten years later in 1974 rather than 1964, with the same time span of seven years before building work could commence taking it to 1981, maybe the whole project would have been watered down or at worst cancelled, as it would have been deemed too expensive by the government at the time.


So with the benefit of hindsight, those who drew up the plans to build the Q.M.C., unbeknown to them saved Nottingham from many of the changes that have taken place in the N.H.S.


I say this, because if a hospital the size of the Q.M.C. were to be planned in today’s day and age, as already been shown, the whole project would have been cancelled because it would be deemed too expensive.


Finally, as I have shown, the Q.M.C. had to happen. Indeed, from its original plan of 1,400 beds the hospital has since been expanded. So the question I ask: ‘Will the Q.M.C. continue to grow?’ The construction of new buildings on the Q.M.C. campus may have now reached saturation point, but it will continue to grow as it adapts to, and indeed develops, new methods in health care provision fit for a health service of the 21st century.



_______________


HOME ««« Click here Home


The Beginning: How the Queen’s Medical Centre was conceived


 

The Queens Medical Centre, Nottingham's Medical Metropolis was conceived in July 1964, when a decision was announced in Parliament that Nottingham was to have a new University Hospital and Medical School, the first medical school to be established, outside the capital, in the 20th century.


In October, 1965 a Medical School Advisory Committee under the chairmanship of Sir George Pickering, then Regius Professor of medicine of Oxford was formed to advise the University of Nottingham on various aspects relating to the establishment of a medical school.  The committee took evidence from a number of local consultants, and also visited the City and General Hospitals.  The enquiry report declared:

 

It was clearly important to inquire whether the existing hospitals in Nottingham might satisfy the University's need without there being a teaching hospital bill of this purpose.


We visited the City and General Hospitals and we found that we agreed with the opinion of the officers of the Regional Board that while they have an important part to play in the whole arrangements for medical education they would not be suitable as teaching hospitals.


They are too far off from the proposed medical school at the University to allow integration.  To set up a Medical School in such circumstances would be to perpetuate a defect that has made the proper organisation of medical education impossible.

 The hospitals are designed as service hospitals.  They do not have, and cannot have, except at enormous expense, the facilities needed in a University Hospital in the second half of the 20th century.


Alternative sites were considered before they settled for the one off the Derby Road, near the University.  The alternatives included Ruddington, Clifton, Bramcote and University Park.  However, there were legal problems over the acquisition of the site for University Hospital and the Medical School.  This led to a seven-year delay before building started in 1971 -- and the first students were to arrive in 1970.  So it became clear that the existing Nottingham hospitals and their staff would have to be used for all the teaching in the early years.  Thus the City and General Hospital played a crucial role in giving birth to the Medical School.


The Pickering Committee had planned on the basis of Nottingham Medical School having about 132 students a year.  Because of the delay in building University Hospital the Medical School started with an entry of only 48 students a year, of whom 24 were received at the General Hospital and 24 at the City Hospital.  As an insurance against further delay in the building of University Hospital and also to help with the influx of students at the General Hospital, the Trent Wing was opened in 1973.


The establishment of the Queens Medical Centre was an arduous undertaking, with many setbacks along the way.  What you have before you, is a compiled history, from various sources, about those formative years.  In those formative years, nobody could foretell the many snags and pitfalls that were to besiege its construction.  However, since those formative years, the 42 acre site, on the Derby Road, that houses the University Hospital, Queens Medical Centre has since gone on to become one of the National Health Services flagship hospitals of the 21st century.