The star ng point. What is the Na onal clinical rehabilita on facility? Where will it be located?

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1 The star ng point What is the Na onal clinical rehabilita on facility? The Na onal clinical rehabilita on facility (the Na onal facility ) will operate as a specialist rehabilita on centre for the civilian popula on of the East Midlands who have undergone significant traumas, have long term condi ons or life threatening injuries. The Na onal facility will provide: A regional clinical facility offering specialist clinical rehabilita on to people across the Midlands; A na onal programme of research and development; and A na onal centre for training and educa on. The Na onal facility is part of the Defence & Na onal Rehabilita on Centre (DNRC) programme which was the ini a ve of the late 6th Duke of Westminster, Gerald Grosvenor. It seeks to provide 21st century clinical rehabilita on for the armed forces and poten ally the na on. It is envisaged that the NHS will operate the Na onal facility. This combina on of the two elements, Defence and Na onal, on the same site has the poten al to be game-changing in the field of clinical rehabilita on. With construc on of the Defence Establishment nearing comple on, work is now focused on unlocking the full poten al of the Na onal facility. Where will it be located? The Na onal facility will be located within the Stanford Hall Rehabilita on Estate, to the west of the Defence Establishment. This se ng provides an opportunity for shared facili es, including the spectacular parkland which will make an important contribu on to the overall healing environment. Both developments have been designed within a co-ordinated overall masterplan for the site. However, due to different funding streams and occupiers, the Defence Establishment (which will be occupied and operated by the MoD) has been developed first. It has always been envisaged that, with the Defence Establishment in place, there is something from which the Na onal facility can benefit by sharing exper se and facili es when it also comes on stream. The Na onal facility affords a unique opportunity to co-locate a state-of-the art rehabilita on centre in close proximity to the Defence Establishment. We seek your views on the design, layout and landscaping of the Na onal facility.

2 Why is the Na onal facility needed? The Na onal facility will provide voca onal clinical rehabilita on facili es for the civilian popula on in a way that does not exist at present. It is for people who have suffered serious injuries or diseases and who would benefit from specialist clinical rehabilita on programmes. For such pa ents, access is required to specialists and equipment that can help to restore or enhance their func onal ability. The Na onal facility will provide this access, maximising a pa ent s chance of regaining his or her independence, returning to work, managing daily ac vi es, and improving their quality of life. Rehabilita on for people who are unable to work in civilian life is a major policy area within Government. The opportunity to co-locate and share exper se across Defence and civilian medicine in a single loca on such as the Stanford Hall Rehabilita on Estate is unique. The UK has lower levels of rehabilita on consultants compared to other countries in Europe: In the East Midlands, there are only 81 rehabilita on beds for a popula on of 4.6 million people, a shor all of 189 against the Bri sh Society for Rehabilita on Medicine (BSRM) standards. UK return to work rates for civilians who have suffered major trauma are significantly behind other countries, and the military: What are the benefits of co-loca ng with the Defence Establishment? From the outset, Government has recognised the opportunity that crea ng a new Defence Establishment represents in terms of doing something for the na on as well. The unique value of the DNRC idea comes from co-loca ng a Defence and a Na onal facility on the same site, sharing best-prac ce and exper se, learning from each other and enabling good quality research. Co-loca on and the integra on of these two facili es working as one single and comprehensive facility for clinical rehabilita on will enable the DNRC to achieve far more than the sum of its parts. Combining excellence in clinical medicine with the right physical environment and the right loca on will create a facility which has the poten al to deliver remarkable outcomes for the people who receive treatment there. Whilst both developments have progressed at different mescales, the inten on is that they will complement each other in terms of best prac ce, research and training. They will share facili es where appropriate. SHARED FACILITIES AT THE STANFORD HALL REHABILITATION ESTATE HYDROTHERAPY POOL This can form a central part of rehabilita on, and few East Midlands rehabilita on pa ents currently have access to these facili es. SPECIALIST MEDICAL EQUIPMENT Access to diagnos c equipment, such as the gait lab, which enables movement to be assessed in detail. SPECIALIST RESEARCH FACILITIES Access to the Computer Assisted Rehabilita on Environment (CAREN) - which can be used for both treatment and research. LECTURE THEATRE For collabora ve training and educa on events. There is a lack of these much-needed specialist rehabilita on facili es in the NHS. Without these facili es, many pa ents who have experienced major trauma also experience significant deteriora on in their mental health, as they find themselves unable to return to aspects of their former life, including work. This has major social, psychological and economic costs for the na on. There is a stark contrast between the civilian return to work rates and those in the military, where 85% return to military du es. SHARING KNOWLEDGE Unique opportunity for knowledge sharing and research collabora ons between staff. The Na onal facility will benefit the civilian popula on by providing specialist clinical rehabilita on treatment and research and training facili es required to develop this field of medicine in one loca on.

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4 How has the design evolved? An ini al building concept was drawn up for the outline planning stage, to provide an early idea of how a modern rehabilita on centre might look. Since the outline planning applica on was submi ed in 2013, the ini al concept has been developed by undertaking a more in-depth analysis of the site, as well as consul ng the NHS, East Midlands Universi es and other stakeholders, including Rushcliffe Borough Council. The design has taken precedents from worldwide, exemplary rehabilita on facili es, reflec ng best prac ce in 21st century healthcare design. The design remains true to the original principles at outline planning stage, and embodies a modern and contemporary feel suitable for an inspira onal 21st century healthcare facility. The key design drivers informing the design are highlighted below: Natural light and ven la on The building is made up a series of building bars running north to south. The areas between the bars will benefit from floor to ceiling glazing, allowing a sense of space and landscape to flow through the building and connect it to its surroundings. The ward accommoda on is posi oned above the bars and runs east to west so that all bedrooms enjoy the same expansive views across the parkland to the south. Pu ng nature at the heart of the building The areas between the bars creates a series of small gardens throughout the building, providing connec on to nature within every part of the building. These areas also offer a range of outdoor spaces for dining, sea ng, relaxa on or therapy. Flexible and func onal space The layout of the Na onal facility has been planned to accommodate clinical, research, educa on and training ac vi es and all necessary support func ons, whilst being sufficiently loose fit and flexible to allow internal modifica ons as the building s requirements are further developed. The design of the building has evolved whilst remaining true to the original design principles from the outline planning applica on; crea ng a modern and contemporary healthcare facility.

5 What will the Na onal facility look like? Crea ng a welcoming entrance The entrance to the building sits between the two tallest bars. A welcoming canopy will lead from the pa ent and visitor drop-off point to the main recep on and the communal hub of the facility. Within the car park area an avenue of trees, aligning with the bars and canopy, will guide pedestrians and car park users to the main recep on. Opening out to the landscape The building and garden court spaces open out to the broader parkland landscape, providing views and encouraging access to promote physical ac vity and therapeu c rehabilita on. The design of the upper floors has been considered to allow all pa ent bedrooms to have access to the expansive views across the parkland. Crea ng a sustainable building Natural light and ven la on will be maximised by keeping the building depths to a minimum. This in turn will reduce the reliance on mechanical hea ng and cooling systems which will reduce power usage. Incorpora on of roof mounted solar panels will generate power for the facility. Green roofs over the building s bars will improve air quality, provide insula on and manage water run-off during heavy downpours. Materials and Finishes Contemporary materials and finishes that relate to the local context are being explored for use throughout the building. The material that the building s bars is to be clad in, is reminiscent of the natural local blue lias stone a heavy earthy material. The upper floors spanning over the bars will be clad in a more modern lightweight material such as zinc. Areas of mber panelling will introduce so er, warmer highlights. So ening the visual impact The upper floors follow a very subtle fluctua ng line in order to so en the visual impact of an otherwise large building in open countryside. This has the added benefit of avoiding long, straight corridors, which would make the space feel rather ins tu onal for pa ents who could be living here for several months. The design of the building seeks to bring nature, light and landscape into the heart of the facility.

6 How will the Na onal facility fit into the landscape? The healing power of nature The healing power of natural landscapes has been a key driver behind the loca on choice for the Defence and Na onal Rehabilita on Centre. The Stanford Hall Estate was chosen for the quality of its natural environment, much of which is Grade II Registered Park and Garden, and is expected to enhance the speed and quality of rehabilita on. In recent years, much medical research has provided evidence for the links between the importance of views and access to nature in improving recovery rates and clinical outcomes, reducing reliance on pain medica on and generally improving both pa ent and staff wellbeing. The Avenue A contemporary interpretation of a traditional estate avenue, with dense up-lit clusters of birch woodland and fern planting lining the pedestrian connection to the reception area. Long views through the building towards the estate parkland connect the proposed development with the existing context. Healing Courts - Therapy Gardens Calm and multi-sensory courts adjacent to the recreation, occupational therapy and dining areas. Textural planting, water features, decorative lighting and subtle ramps and level changes allow patients and visitors to rest, relax and interact with a multisensory space, whilst also offering simple rehabilitative functions. The Estate A plateau landscape composed of a contemporary mix of seasonal grasses echoing the open grasslands of the estate, with parkland trees and artwork framing views. A contemporary haha wall replaces the existing hedge and defines the boundary, whilst allowing uninterrupted views of the wider landscape. Healing Courts - Physio Garden The physio garden offers a more interactive and challenging setting for rehabilitation. These spaces will feature a wider range of material features including sand and gravel, stepping stones, planting, water features and more complex level changes to offer more physical interactivity. The Meadow & Woodland Trails The meadow seamlessly blends with the existing parkland. Open grassland with parkland trees characterise the space and set the scene of the building within the wider landscape. It is envisaged that walking and cycling trails will allow visitors and patients to explore the parkland and woodland setting. The landscape design is based on the concept of the healing landscape where contact with nature improves clinical outcomes. As a result, the design of the Na onal facility seeks to capitalise on its beau ful natural se ng within the wider Stanford Hall Rehabilita on Estate, as well as improve and enhance the immediate landscape of the site. Existing native woodland Transition into dense wooded avenues with frequent clearings revealing species-rich understory planting As the clearings widen, multi-sensory drifts of colourful perennials define the spaces adjacent to the building Closer to the wider parkland, naturalistic perennial grasses and ornamental trees become more dominant At the parkland edge, spacious drifts of wildflowers and naturalistic grasses are punctuated by occasional specimen trees A Ha-ha defines a seamless boundary, allowing views to extend into the wider landscape The landscape is fully integrated into the building s design. A series of spaces between the bars will house a variety of gardens and outdoor spaces for therapy and leisure purposes. These gardens will support socialisa on, quiet contempla on and physical therapy ac vity. Woodland Rehabilitation Centre Parkland An example of what the Avenue might look like The Na onal facility landscape design is centred on the idea of a healing landscape, encouraging connec ons to the spectacular parkland se ng of the Stanford Hall Rehabilita on Estate.

7 How shall I get to the Na onal facility? Where will visitors & users park? A 150-space car park (with disabled spaces) will be located to the north of the Na onal facility building, as per the maximum number set by the outline planning applica on. How will visitors, pa ents, staff get to the Na onal facility? All users of the Na onal facility will get to the building using a dedicated new road separate from the Defence Establishment, which will sweep through the Lings Spinney woodland to the north of the site, before opening up to a landscaped car park and the Na onal facility beyond. The road allows for two opposite lanes of traffic and a combined footpath/ cycleway. Access to this road will be via a new priority T-junc on off Melton Road, located approximately 100m to the east of the junc on with Loughborough Road. Further tree plan ng will occur to screen the access road from Melton Road and the wider parkland. Can people travel by public transport to the Na onal facility? The Na onal facility is located approximately 700m from the bus stop at the southern end of Loughborough Road, just before the junc on with Melton Road. This bus stop is serviced by bus route 1 (running between No ngham and Loughborough via East Leake every mins) and bus route 05 (running through East Leake, Normanton on Soar to Ratcliffe on Soar, once daily). A footpath leading from this bus stop to the Na onal facility entrance has already been built as part of the wider works for the DNRC project. It will take approximately 7-10 minutes to walk from the bus stop to the Na onal facility. Access details have already been approved Access details to the Na onal facility have already been approved as part of the hybrid planning applica on for the DNRC. Details of access are not an outstanding Reserved Ma er but are included here for informa on purposes. How will we reduce car travel to the facility? A Travel Plan will be prepared in due course. The purpose of a Travel Plan is to promote and encourage sustainable modes of travel to and from the site. The Travel Plan will be agreed in consulta on with Rushcliffe Borough Council and the Highways Authority No nghamshire County Council. How will the Na onal facility be serviced? Service vehicles will use the same access road as all other users. They will then travel along the northern edge of the car park to a dedicated servicing area at the western edge of the building. This building wing will screen the back of house area. How will users access the Defence Establishment? To maximise the benefits of the co-loca on of the two facili es, users of the Na onal facility will be able to access the Defence Establishment by following a path at the eastern edge of the Na onal site to join a path across the park leading to the Defence Establishment. Pa ent transfer will be by small electric vehicles. How will pedestrians & cyclists get to the Na onal facility? The new road will include a dual footpath and cycleway. Cycle storage areas will also be provided, including cycle spaces for disabled cyclists. So and diffused external ligh ng will be provided along the access road to allow safe use for both vehicular and pedestrian traffic during the evening whilst being sympathe c to the rural se ng and minimising impact on wildlife. Access details to the Na onal facility have already been approved as part of the hybrid planning applica on, but are included here for informa on purposes.

8 Next steps and keeping you informed Now that you have seen the proposed development for the Na onal facility, we would like your views. Please provide your views on the feedback form available. You can also provide your views through the following methods: onal nconsulta FREEPOST - Send Le ers to: Arup No ngham, City Gate West, Tollhouse Hill, No ngham NG1 5AT The deadline for feedback to be received by is Sunday 1st July What will we do with your views? We will review all views received and where appropriate, develop the design in response to these comments. We will produce a Statement of Consulta on that will accompany the Reserved Ma ers applica on and provide a summary of the feedback received from the public exhibi on events and how these views have been considered. How can I stay up to date with the project? Informa on on the Na onal facility, including the progression of the planning applica on when submi ed, is available via: onal twi er.com/dnrcofficial facebook.com/dnrcofficial/ Once the Reserved Ma ers applica on is submi ed in October 2018, details of the applica on will also be available on the planning pages of Rushcliffe Borough Council s website. This will be linked through the DNRC website. What happens next? NOW TO JULY 2018 Receive views from public exhibi ons. JULY SEPTEMBER 2018 Outline Design finalisa on. Prepara on of materials for Reserved Ma ers planning applica on. OCTOBER 2018 Submission of Reserved Ma ers planning applica on to Rushcliffe Borough Council(RBC). OCTOBER 2018 JANUARY 2019 RBC consider planning applica on. RBC led statutory consulta on on applica on. JANUARY 2019 Expected decision date for Reserved Ma ers applica on ONWARDS Detailed design development for the Na onal facility. Start of construc on of the Na onal facility. Discharge of planning condi ons. Now that you have seen the proposed development for the Na onal facility, we would like your views.

9 Casey Margery Liam Who will use the Na onal facility? Pa ent Journeys A wide range of pa ents requiring specialist rehabilita ve care could access the Na onal facility. The stories opposite illustrate how pa ents will experience the healing environment at the Na onal facility. A single mum in her thir es with two school age kids. She works three days a week in HR and lives in Stapleford. A climbing club member, Casey fell whilst on a trip to the Peak District. The result was the loss of a lower leg and a severe head injury. It was all a bit of a blur With my head injury, the first day of my treatment has been a bit of a blur I am finding it hard to concentrate and I know there is a long road to recovery ahead of me. Ge ng my brain to learn how to work my body again seems impossible, let alone using a prosthe c leg! My ex and my sister are looking a er the kids, but it s difficult they tend to be a bit noisy in the ward. All I can do is lie here, miss them, and worry. My first impressions I ve just found out I ve got a place at the new specialist rehab centre on the Stanford Hall Rehabilita on Estate. They are going to put me through an intensive programme of rehabilita on which will improve my overall chances of recovery. I look out of the pa ent transport as we sweep through beau ful woodland before arriving at the entrance to a very modern, impressive looking building. My spirits are li ed straight away because I love being outside and its been weeks since I ve had proper fresh air. My rehab starts My first appointment is with the specialist and my employer s occupa onal health advisor - it s great to know what I can achieve with the support that s available even if it s going to take me quite a while to get back to work. My rehab starts off quite slowly, as I s ll have a lot of trouble focussing and get red very easily, but it soon ramps up to a full nine to five schedule. Shared facili es Once I m healed enough, fi ngs for my prosthe c leg start. These are done at the centre, but the same specialist company also supports the military centre and has a workshop there. I m helping research I m asked if I will sign up for a research study comparing soldiers and normal people like me, who have prosthe c limbs, as well as head injuries. They ll track our progress through all stages of rehab, and learn what works best. I m happy to be involved. Visitors My sister brings the kids several mes a week. They love playing in the park - it s an amazing set up with loads of trails through the beau ful parkland, and there s even pitch and pu! By the end of my rehab, we re racing each other on the hand cycle track, which is great fun. Next steps in my rehab The day I take my first unaided steps on my new leg is a great feeling. There is s ll a long way to go. There is s ll a long way to go, but thanks to the specialist care here, I got there much more quickly than I might have done otherwise. Margery is in her mid-six es and has MS. She has been gradually losing some movement and feeling in her arms and legs. She is re red but has been helping to look a er her grandchildren most days of the week. Her worsening condi on is star ng to affect her ability to drive. She is widowed and lives in Loughborough. I d resigned myself to the MS I thought that nothing could be done about the problems with my arms and legs, but I m told that I m suitable for a spell of intensive rehab at the new specialist centre at the Stanford Hall Rehabilita on Estate. This should hopefully improve my symptoms, even if I will always have MS. I m so pleased, because I can t help with the kids any longer and my daughter was thinking of stopping work because of the cost of childcare. My first impressions When I arrive, I m pushed through the main entrance in my wheelchair, where I can see straight across recep on and out to the garden where pa ents are enjoying the sunshine and plan ng vegetables in raised beds. I ve been pre y much stuck in my house for months so I can t wait to get out there! The main space around recep on is a hive of ac vity with pa ents and staff moving between the treatment areas or stopping for a chat and visitors having a coffee at the café. My rehab starts My first appointment is an assessment and discussion of my aims. This was a real change up to now I ve just done whatever the doctors told me! I d got really weak from si ng around at home so treatment feels pre y full on. However, with gentle encouragement from the team of specialists, I s ck at it, and can gradually see it star ng to make a difference. Making friends As I start to become more mobile, I make some friends who I meet every day in the café or the gardens when the weather is nice. It feels great to talk to people who are in the same situa on as me; I was very lonely before, and to be honest, I felt a bit depressed. Mee ng the soldiers I also get trips several mes a week across the park to the military centre where we use the hydrotherapy pool, which I really enjoy. I also like mee ng the soldiers, but I think they are on their best behaviour for us! Next steps in my rehab By the end of my treatment, my movement is greatly improved and I will be able to get out and about a lot more and help with the kids again. My MS is s ll there, of course, but with support from the community rehab services, I can stay ac ve for much longer. Liam is in his early twen es, lives in No ngham and works on a contract basis in a car workshop. He was in a motorbike accident on the M1 and sustained mul ple injuries including abdominal injuries, head trauma, a pelvic fracture, and a broken arm and leg. Saving my life was only the start The Trauma team saved my life a er the bike crash but I m now out of intensive care and on a normal 4-bed ward and star ng to get frustrated. I can t move from the bed without a hoist, feed or wash myself, or go to the toilet normally, and I only get to see the physio once or twice a day. My girlfriend has stopped visi ng because I ve been so angry, and they ve already filled my job. My first impressions Good news I ve got a place at the new specialist rehab centre on the Stanford Hall Rehabilita on Estate, where they are going to put me through an intensive 2-3 month programme of rehab. This place is something else its brand new! I get my own room which has an amazing view out across the park. I m so relieved to have privacy while I learn how to look a er myself again. My rehab starts My first appointment is an assessment and discussion of my aims, including what kind of work I could do. It feels good to finally understand my path to recovery. Together we agree a plan; the schedule is intense - nine to five every day but I m excited not to be lying around in my room most of the day. My treatment is really hard work; I spend a lot of me in the special gyms with the rehab specialists pushing me all the way. But I can see it slowly star ng to make a difference. And its not just working in the gyms; I also start an e-learning course that will give me more job op ons. Learning to walk again As I become more mobile, I m taken on a short journey across the park to the military centre on a golf buggy. I m assessed at the gait lab this looks at exactly how I m moving so the specialists can help me to walk normally again. Over the next weeks, I visit the military centre several mes to use the Computer Aided Rehab Environment (CAREN); basically like a big computer game that I move around in. It helps me get used to the kind of things I never thought about before, such as walking down the street. All is forgiven I ve been using the free wi-fi to FaceTime my girlfriend. I was able to show her the views and persuade her to come and visit me; it s one bus ride from No ngham. I take her out for a meal at the café overlooking the park and she s so happy that I am calmer being here is helping me feel more posi ve about my future again. As she leaves, she jokes to me to enjoy my country retreat. I laugh but it does kind of feel like that! Next steps in my rehab At the end of my treatment, I am discharged home, but my rehab journey is far from over I ll s ll have local outpa ent sessions for quite some me. But thanks to my me at the specialist rehab centre, I am now able to get around and more or less look a er myself. I also have some new skills and know what types of job I want to get when I am ready.