bendigo hospital precinct structure plan health precinct ... · 03 june 2013 bendigo hospital...

03 June 2013

Bendigo Hospital Precinct Structure PlanHealth Precinct Benchmarking / Best Practice ReviewDraft 2

Bendigo Health Hospital


Billard Leece Partnership Health Precinct Benchmarking / Best Practice Review: Bendigo Hospital Precinct Structure Plan Draft 2

Certified by:

......................................................................................................................Principal Consultant

................................................Date

Endorsed by:

......................................................................................................................Consultant

Date


Table of Contents

1.0 Introduction and Background 052.0 Purpose and Objectives 063.0 Methodology 074.0 Identification of Scope 095.0 Inputs 116.0 Summary of Findings 167.0 Conclusions and Recommendations 17

Geelong Hospital Ballarat Hospital

New Bendigo Hospital Wagga Wagga Hospital


Appendices

References

Appendix A Presentation made at Stakeholder Workshop (18 April 2013)Appendix B Media Release from Premier’s Office (5 April 2013)

• Barwon Health Masterplan, Billard Leece Partnership, 2007• Ballarat Health Services Masterplan, Billard Leece Partnership, 2010• Wagga Wagga Base Hospital Masterplan, Billard Leece Partnership, 2012• Bendigo Hospital Masterplan, Billard Leece Partnership, 2011


Bendigo Health Hospital Aerial


Page 05 of 17

In April 2013, Hansen Partnership were selected as the winning tenderer for the Bendigo Hospital Precinct Structure Plan for the City of Greater Bendigo. As part of the consultant brief, a number of technical reports were to be provided to inform this structure plan.

This document forms one of these technical reports. It is prepared by Billard Leece Partnership- Architects and Urban Designers, with inputs from Thinc Health.

Billard Leece Partnership have been responsible for preparation of the Masterplan and Feasibility Study for the new Bendigo Hospital prior to it going to market for delivery under the Public/Private Partnership (PPP) model. They have also masterplanned several other regional hospitals throughout Australia.

Thinc Health is composed of both project direction and management specialists, along with advisory personnel with operational health experience.

Introduction and Background1.0


Page 06 of 17

Purpose and Objectives2.0

The consultant brief for the Health Precinct Benchmarking / Best Practice review included the following information:

PurposeThe redevelopment and day to day running of the Bendigo Hospital will impact and redefine the site, its connections and impacts upon the surrounding precinct and the city of Bendigo generally. While each context is unique, other similar scale urban health precincts can be identified as benchmarks for comparison and learning to appreciate best practice for precinct integration.

The purpose of the Health Precinct Benchmarking is to consider best practice in health precinct planning with regard to integration of a major public asset with its surrounding context. The New Bendigo Hospital will be a ‘campus style’ regional development. Planning for such facilities has historically been very site specific, focussed on ‘operational’ requirements.

This brief requires an assessment of best practice in health precinct planning to ensure lessons can be applied in the Bendigo context to achieve the best precinct integration outcome possible.

ObjectivesThe objectives for the Health Precinct Benchmarking are:

To identify regional hospital precincts including hospital or campus-style as case studies with similarities for the New Bendigo Hospital redevelopment.

To analyse the impacts of other similar hospital redevelopments on surrounding precincts and make recommendations for the New Bendigo Hospital Precinct.


Page 07 of 17

Methodology3.0

The tasks outlined were required to undertake the Health Precinct Benchmarking:

• Identify up to three Australia based health precincts with similarities to the Bendigo Hospital context.

• Derive a set of hospital design best practice principles as a basis for assessing the case studies;

• Analyse the lessons learned from the case studies about best practice and describe how these lessons would apply to the Bendigo Hospital context. Research the following points relating to each case study:

• How was the hospital designed in relation to its surrounds and how has the design approach used been implemented in a practical sense?

• How has the precinct surrounding the hospital changed since the hospital was developed?

• What were the land use planning and urban design challenges which needed to be overcome to ensure effective development of the hospital?

• What is the extent of impacts of the hospital on surrounding residential streets and neighbourhoods and how have such impacts been managed?

• Has the hospital structure and hospital activities benefitted its surrounding neighbourhood?

• How have traffic, transport and parking impacts been dealt with?

• How have connections to open space networks been considered with appropriate lighting, way-finding and signage?

• Are other supporting community facilities co-located or within the health precinct that support both health and greater precinct communities?

• How have the health precinct accommodation demands been catered for?

• Has the hospital benefitted from precinct activities and the local economy?

These tasks were undertaken in a series of steps:

Task TimeframeNomination and analysis of precedents to investigate preliminary best practice principles

Prior to stakeholder workshop

Review of successful tender for the new Bendigo Hospital PPP

Media release from the Premier’s department Friday 5th April 2013

Workshop with key stakeholdersWorkshop held on Thursday 18th April 2013. Copy of the presentation is appended to this report.

Preparation of Draft Report Published Early May 2013

The stakeholder workshop was focussed on both Health and Education, and as such sought active inputs from the healthcare sector, the universities and school sectors, as well as departments of the City of Greater Bendigo.

Following client review of this draft report and other technical reports, a final report is to be published.


Page 08 of 17

Geelong Hospital Aerial Ballarat Hospital Aerial


Page 09 of 17

Identification of Scope4.0

The precedent Health Precincts identified were selected on the basis of relative size of the city/catchment and the rate of population growth of the city, the distance from the GPO (its context within the city), and the level of redevelopment under way, or recently completed. The precincts selected were:

• Geelong Hospital (Barwon Health)• Ballarat Hospital (Ballarat Health Service)• Wagga Wagga Hospital (Murrumbidgee Health Service)

Like Bendigo, none of these precincts are greenfield developments, but rather have grown organically with the surrounding city, the sphere of influence of the hospital impacts the neighbouring uses, and there are a number of synergies have emerged over time between the hospital and surrounds.

Best practice principles were prepared based on common themes identified in the masterplanning of these (and other) health facilities in Australia. They were focussed on the needs of the health services, the hospital workforce, patients and families. As such they sought to review the likely impact of the hospital on its surrounds, and conversely identify what surrounding uses would drive a greater integration between hospital and the precinct. The complimentary uses were broken down into:

• Healthcare Services – such as private hospitals, doctors consulting rooms, and related allied health facilites

• Healthcare support services – such as community health, secondary and tertiary education, and childcare facilities

• Patient Support services – such as carer accommodation, and health related small business

• Daily Living amenities – such as meal, retail and wellbeing (active and passive) amenities

• Transport/connections – such as carparking and public transport links

• Trends about health support services away from the precinct – largely hospital support services (eg food and laundry)

These were presented to the stakeholder workshop for comment, The workshop noted a desire to provide a structured approach to the development of the fringes of the hospital.

Wagga Wagga Hospital Aerial


Page 10 of 17


Page 11 of 17

Inputs5.0

The inputs for reviewing each site have been based on identifying a number of complementary uses for the healthcare facility, i.e. their uses which may have a synergy for one or more of patients, families or staff.

The complementary uses are described by grouping, along with their rationale is as follows:

Healthcare Services

Co-located Private Hospital

• Medical staff can operate both public and private practice (without moving the car)

• Greater critical mass of specialist medical staff on site can make their practice viable

• Possible shared services between public and private hospital to make each financially viable (eg Cancer Services at one or the other, Specialist equipment such as PET, MRI might be shared)

Private Consulting suites (Specialist & GP) in close proximity

• Important for consultants (doctors) to operate in close proximity to the main hospital campus

• Often accommodated in converted housing, or office type buildings• Sometimes accommodated on campus as an incentive for doctors

Other Healthcare

• Private Radiology (aka Imaging) (may have specialist equipment)• Private Pathology• Private Procedure centre (eg endoscopy centre)

Healthcare Support Services

Community Health Centres

• Enable staff connection with main hospital – staff may be based at one but work at both

• Consideration of fleet car parking

Tertiary Education

• University training for health related careers• Potential for dual appointments (Clinical and Education)

TAFE / Secondary

• Training for other roles• Good education facilities can be a magnet for clinicians relocating from

the city

Childcare centre

• Ideally with good walking access to the main hospital campus• Incentives for new parents to return to work / address staffing shortfalls• May be linked to salary packaging for healthcare workers

Patient Support Services

Carer accommodation

• Hotel or motel near to site for families to stay, especially if travelling far within the region

• Ronald McDonald House (or similar)

Health related small business

• Mobility aids• Nursing Agency

Daily living amenities

Meal amenities

• Food options for meal breaks – staff may want to be away from patient families during breaks

• Quality food/coffee nearby – staff/families may want to step off campus for a period

Retail amenities

• Assist with daily living activities eg dry cleaning, medicare, social security, mini-mart

Wellbeing amenities

• Active - Fitness centre / Swimming pool / Tennis centre etc• Passive – parks and gardens nearby• Bicycle and walking tracks – surfaces suitable for all ages eg elderly,

strollers


Page 12 of 17

Ballarat

Urology

Maternal &

Child Health

Centre

Ballarat

Urology

Maternal &

Child Health

Centre

Ballarat Base Hospital Geelong

Hospital

Ballarat

Urology

Maternal &

Child Health

Centre

Wagga Wagga Base Hospital

Ballarat Health Services – All Services / Amenities / Connections Geelong Hospital – All Services / Amenities / Connections

Wagga Wagga Base Hospital – All Services / Amenities / Connections

Private Hospital

Public Hospital


Transport / Carparking

Daily Living Amenities


Other Healthcare


Page 13 of 17

Inputs5.0

Transport/Connections

Carparking

• There is rarely adequate carparking for all staff/visitor needs without high uptake of public transport and/or bicycle use

• Distance from carparks to health facilities can be problematic for the unwell and aged

Links to city centre

• Integrated connections to transport hubs and city centre to support other daily living tasks

Links outside the city

• Location/connection to train station• Location/connection to airport – access for patients and clinicians

Health support services away from the precinct (trends)

Food services

• Frequently off site in an industrial park – servicing multiple facilities - brought in on a scheduled basis

Linen services

• Frequently off site in an industrial park – servicing multiple facilities - brought in on a scheduled basis

Sterilising services

• Can be off site in an industrial park – servicing multiple facilities - brought in on a scheduled basis

Supply services

• Can be off site in an industrial park – servicing multiple facilities - brought in on a scheduled basis

A summary of the complimentary uses have developed at each of the reference sites is tabulated thus

Ballarat Geelong Wagga

Private Hospital

St John of God across the road, connected by aerial bridge

Geelong Private across the road, St John of God, approx 500m along Myers St

Calvary Hospital near to site. Radiotherapy at Calvary

Private Consulting (Specialist)

Generally converted houses skirting the hospital site

Consulting suite buildings co-located with Private Hospitals and as part of Public Hospital

Private Consulting (GP)

Near to Hospital, GP Training in Belmont (Kardinia Health superclinic)

Education

University of Melbourne and Deakin University on site and adjacent site. ACU across the road

Deakin University Clinical School on adjacent site

University of Melbourne

University of New South Wales clinical school on same site. Charles Sturt University (south campus) – 2km

Teaching, Training & Research

Education resource centre on site

On adjacent site (Kitchener House)

Childcare centre None Nearby Nearby

Carer Accommoda-tion

Rotary House colocated with Private Hospital. Medihotel (to cease operation end 13)

Flats on opposite site

Health related small business

Mobility aids - opposite

Meal amenities

Multiple food outlets nearby (eg café, restaurant, fast food)

Multiple food outlets nearby (eg café, restaurant, fast food)

Limited food outlets nearby

Retail Amenities Multiple retail nearby Florist opposite

multiple retail nearby

Florist opposite

24 hr convenience store opposite

Wellbeing amenities Near city centre


Page 14 of 17

New Bendigo Hospital New Bendigo Hospital

New Bendigo Hospital New Bendigo Hospital


Page 15 of 17

Inputs5.0

Ballarat Geelong Wagga

Carparking

Limited in the surrounding area given the collection of intense uses

Limited in the surrounding area given the collection of intense uses

Limited carparking – spills into adjacent streets

Links to City Centre

2 bus routes stop at Hospital entry Bus stop at hospital

Links outside the City

Trains – 1km to station – frequently to Melbourne, daily to Adelaide

Flights - ?? To airport – no regular passenger service

Buses – connections to regional towns and cities

Trains – 3km to station – frequently to Melbourne, daily to Southwest (Warrnambool/Mt Gambier)

Flights- 20km to Avalon multiple to interstate

Buses – connections to regional towns

Trains – 1km to station– twice daily to MEL and SYD

Flights – 10km to airport – multiple to MEL and SYD

Buses – connections to regional towns

The complimentary uses were then mapped over an aerial photograph of each of the reference sites in order to detect patterns in their development relative to the hospital and each other, as well as any other influences.

Further to this exercise, the complementary uses were extrapolated to the Bendigo site in relation to its existing condition, what it understood to be included within the PPP bid, and what gaps/opportunities exist.

Existing PPP-NBH Opportunities

Private HospitalSt John of God several kilometres from site

Silent, but significant patient expansion on site

Private Consulting (Specialist)

Dedicated building and converted houses skirting the hospital site

Silent Yes

Private Consulting (GP) Skirting the site Silent

Education

Monash (Medical) and LaTrobe Universities (Nursing/Allied Health) on site

Silent Accommodation for students

Teaching, Training & Research

180 seat conference facility

Childcare centre Childcare and Wellness centre

Carer accommodation

Existing in Lucan St site

128 serviced apartments and 15 apartments for short stay accommodation

Retail Amenities Limited at present Some retail in the atrium Linkages to the CBD

Wellbeing amenities Wellness centre

Carparking 1300 spaces to be provided

Subject to traffic studies. Removal of hospital carparks on residential blocks surrounding current hospital?

Links to the city centre

Bus routes, cycle trail are well defined Silent

Potential for greater integration with the hospital campus

Links outside the city Helipad on the site



Bendigo Health Hospital – All Services / Amenities / Connections

Private Hospital

Public Hospital


Transport / Carparking

Daily Living Amenities


Other Healthcare


Page 16 of 17

Summary of Findings6.0

Each of the hospital precincts reviewed are highly reliant on the hospital for their existence. In each case, the hospital is the largest individual employer in the city. Notwithstanding this, there is an ongoing tension between these uses and the hospital with relation to infrastructure; particularly carparking is frequently problematic in these precincts due to the consolidated load of all uses, as is the pedestrian environment which often has a reduced priority compared to the provision of carparking space.

Patterns which emerged in the analysis and the correlation to lessons learned include:

Pattern PrinciplePrivate Hospital in the precinct – can ensure long term viability of both the public and private sector. There are not significant patient transfers between the public and private hospital, but it may improve workforce sustainability. The population of the city and the demographics (eg the % of the population with private health cover) will affect the size and number of private hospitals that can be supported in the city

A private hospital partner to be a supported use

Private Consulting/Radiology/Pathology – tend to emerge in one block surrounding the hospital, often opposite the front entry of the hospital and/or near the emergency department (after hours) entry. These can be converted

Ensure good pedestrian links around the hospital, particularly near the main and emergency areas

Education – Good tertiary education facilities on the hospital site. Population of these facilities are primarily younger and may be more likely to use alternative sources of transport (such as cycling)Physical links to secondary education are generally less common

Education providers (office accommodation) may be a complementary use nearby.

Teaching, Training and Research –With a push for higher acuity in regional centres (ie being more self sufficient), there is a parallel need for ongoing professional training on-site.

Encourage community use of the hospital teaching/training facilities –these may be outside peak hospital usage times

Childcare – This may not be satisfactory for all the needs of the neighbourhood, as these places are likely to be primarily for staff of the hospital

100 place childcare centre provided as part of the PPP. Consider council supporting further childcare in the area.

Carer accommodation – These may consist of one or more houses converted for families or purpose built. These are commonly within easy walking distance of the hospital, but outside hospital grounds. Other accommodation options may include hotel, motel or serviced apartment style facilities nearby (these are often on major arterials)

Ensure an ability to consolidate residential properties for this purpose. Safe pedestrian linkages to the hospital main entry are paramount for provision of these facilities.Hotel/motel/serviced apartment developments on major roads within easy walking distance

Retail Amenities – generally these align with major arterials/shopping strips. Generally there is a limited amount of retail which can be supported by the hospital alone.

Some retail outlets may assist in drawing together the hospital precinct with the CBD

Wellbeing amenities – these are most often linked to main arterials/shopping strips. Generally there is a limited amount of retail which can be supported by the hospital alone. Green space is not always

Rosalind park linkages to be encouraged for easy access into/through the park. It is understood that the PPP scheme will deliver good hospital gardens for passive enjoyment. There is potential to link across Barnard St to the existing (and potentially enhanced) active recreation zones eg Tom Flood velodrome, Swimming pools and Tennis courts.

Carparking – provision of adequate carparking frequently dominates discussions about hospital precincts, and many hospitals have ballots for staff spaces, and encourage alternative use of transport (eg bus and bicycle). Hospitals have predictable peak parking times (eg shift changover).

Adjacent uses may have offset peak times (ie outside hospital peaks) enabling a synergy of carpark usage. These may relate to after business hours activities such as sporting or recreation activities, or restaurants. These sorts of uses could be considered in terms of a pooled carpark resource rather than multiple fractured carparking strategies.

Links to the city centre – these are best to be multi-modal – public transport (frequently buses), as well as safe routes for walking and cycling

Bendigo has some good infrastructure, but some links are not well defined. Bus services could be brought all the way into the site (dropping off at the front door), and connections to the CBD could be better marked/defined/give confidence of safety

Links outside the city – fast train infrastructure with regular services to capital cities will make this attractive for commuters, and enable regional centres to stay in-touch”.

Convenient connections between the station precinct and the hospital site.


Page 17 of 17

Conclusions and Recommendations7.0

There is no fixed boundary around a health precinct. A common definition may be a 5 minute walk in any direction from the front door of the hospital (and then allowing for accessible topography) tends to capture the general influence of a hospital on its environs. Beyond this walk, users are likely to drive to a complementary usage. There is a general tension between pedestrian and cars in these precincts – it is important that the ill, and their carers (increasingly more frail and aged) are given easy access to the front door (and emergency department) of the hospital, but this can present conflicts with pedestrian access.

Being a major employer, the influence of the hospital on its surrounds is not always immediately visible but tends to feather out from the centre of the hospital. Hospital users tend to impact many other businesses and types of accommodation.

The New Bendigo Hospital PPP has not yet been viewed in detail by the consultant team, but it reads as being carefully considered in its approach to amenity on the site. The area surrounding the hospital site should acknowledge some of the usage patterns that are likely to emerge around the precinct. If well planned, this may have an improved connectivity to the city, improved amenity around the precinct, and a reduction in tension between vehicular and pedestrian traffic.

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