Future of the NHS, saviour of the high street? High hopes for health hub in a Barnsley shopping centre | NHS

IIt’s a revolution that could just save the NHS – and the high street. Imagine being able to have your eyes tested, your mole examined or get an appointment with a consultant without going to the local hospital – and maybe go shopping or to the cinema afterwards.

That’s increasingly what Barnsley residents are doing after an unprecedented move of medical services from the district general hospital to a purpose-built outpatient center in the Alhambra Shopping Centre, which is getting a new lease of life thanks to the experience.

Those involved say the initiative – the first of its kind in the NHS – is pioneering and groundbreaking. After a recent visit, Wes Streeting, the health secretary, called it “truly inspiring”. He said: “What we see here in the heart of Barnsley town center is the future of the NHS. »

The outpatient center was created through a collaboration between Barnsley Hospital NHS Trust and the town’s Labor Council. Hundreds of people go there every week to undergo tests or treatments, including minor operations, for example to treat cataracts, blocked tear ducts or ingrown eyelashes. Soon that number will reach 1,000 or more.

It allows patients to access a range of non-urgent services more easily than at the hospital on the outskirts of the city, where parking is limited. Through the additional footfall it generates, it also stimulates footfall in shops, cafes, restaurants and leisure facilities.

“It’s getting your mammogram while your husband walks around Sports Direct, or meeting your friend for coffee after a dermatology appointment where someone examined your rash,” says Michael Brown, the architect who designed the new facility.

The centre, which opened last October and cost £8.8 million, occupies what was once a large branch of variety retailer Wilko on the first floor of the Alhambra, which the council bought to avoid bankruptcy. Since then, the services have gradually left the hospital.

Ophthalmology, optometry and retinal screening came first. Dermatology services began seeing patients there last week and rheumatology and orthotics care opened their doors this week. A total of 121 staff members who previously worked at the hospital – mainly nurses and orderlies but also a few doctors – now work at the new facility.

The trust and council intend to transform the entire first floor of the center into a health and wellbeing hub through their joint ‘Health on the High Street’ plan. The shops – some open, most closed – will be replaced by a private gym, a council-run gourmet cafe and mental health services provided by the local NHS mental health trust.

Barnsley Hospital was encouraged to create the outpatient center by the success of a community diagnostic center (CDC) opening in April 2022 in the shiny, modern Glass Works shopping centre, next to the tired-looking Alhambra. NHS England and Streeting see the growing network of CDCs, which offer blood tests, x-rays and scans in community settings, as a way of helping to reduce the care backlog for 7.25 million people in the service. The hope is that faster, easier access to testing – in convenient locations and not hospitals – will allow treatment to start sooner.

Barnsley CDC already conducts 50,000 to 60,000 tests per year. The association hopes that it and the outpatient care center alone will provide more than 200,000 appointments. The latter should offer 38,000 slots per year for adults suffering from eye diseases, another 4,400 for children with vision problems, 19,500 episodes of care for people suffering from skin diseases, 10,400 for rheumatology and 4,200 for people with foot problems.

The location of the outpatient center is proving popular with patients, partly because it is within walking distance of the bus and train station, says Alan Heathcote, project manager at Barnsley Hospital. “Patient feedback has been very positive. And the themes are consistent: easier access, better location, less walking, shorter waits and no need to fight for hospital parking,” he says. Parking near the Alhambra is plentiful and cheap.

The CDC’s experience so far suggests that providing care in a city center has helped reduce “DNAs” — patients who don’t show up — by 24 percent.

Heathcote said: “For Barnsley Hospital, it’s about much more than moving clinics. We see this as a pioneering model that puts health at the heart of Barnsley town centre. It’s about making care easier to access, more integrated and more relevant to the way people live their lives, whilst also helping to support the wider regeneration of the town.

“We recognize that there is a wider benefit to integrating hospital services into the city centre. This increases footfall [and] supports local businesses.

Each patient attending the CDC spends on average £17.50 during their stay in the city, the trust found. Expected spending for those visiting the Alhambra is slightly lower – £15 per person. But if true, the planned 100,000 appointments could generate £1.5m of extra spending in a city center which, like so many others, needs help to survive the challenges of decay, online shopping and the cost of living crisis.

“Our first priority is always better care and a better patient experience. [but] we are proud that this investment can also contribute to the long-term vitality and renewal of the city centre,” says Heathcote.

The layout, furniture and color palette were designed to not resemble a normal clinical setting, to help reduce patients’ anxiety about receiving care.

When the Guardian visited the facility last week, the dermatology department was about to see its first patients in its new home. They suffer from diseases such as psoriasis, eczema and impetigo. Some receive UV light therapy to relieve their inflammation and itching.

For Lisa Shaw, the department’s head nurse, the outpatient center is a welcome change from her previous base at the hospital two miles away. “It’s very welcoming when you walk in,” she said. “There are better parking spaces than at the hospital, where it is terrible. There are several pharmacies nearby where patients can get prescriptions. [Until now] our hospital services were provided in an old building with a flat roof that always leaked.

Barnsley’s innovation attracts attention. Officials from Bradford NHS Trust visited to see how it works, as did delegations from five councils, the Department of Health, the Department of Housing, Communities and Local Government and even a German city. The Commons health and social care select committee has launched an inquiry into how Streeting’s promise of a network of new “neighborhood health centers” – offering health services under one roof, closer to people’s homes – can move from rhetoric to reality.

Streeting urged the NHS to undertake “three big changes” – from an analogue to a digital service, from hospital to community care and from treatment to prevention – to help it cope with the intense pressures on it. Progress is mixed. But the Barnsley Outpatient Center is an example of this strategy in action, with added economic benefits.

Brown says: “When people look at their town, they look at the high street. If they see closed shops, it’s depressing and gives the impression that ‘my town is not doing well’. Barnsley’s initiative – putting healthcare in a town center shopping center or in empty units – could be a good way for the government to revive northern towns and even help fight reform.”

Radix Big Tent, a centrist think tank, is set to launch a commission of inquiry into how healthcare – both NHS and private – can help save struggling high streets.

“Barnsley NHS Trust potentially provides a model not only for better health, but also for the rebirth of our high streets,” says Ben Rich, its director. “Visitors spending £17.50 in local restaurants, cafes and retailers represents game-changing money for a town like Barnsley and could be a game-changer for other struggling town centers and high streets across the country.”