National Paediatric Hospital Project

Transcription

1 National Paediatric Hospital Project Planning Application Draft Tallaght Hospital Capacity Study August 2015

2 Introduction This draft study has been prepared as a capacity assessment on the instruction of the NPHDB in conjunction with the host hospital in order to understand broadly the parameters for development at the Tallaght Hospital Campus, Dublin 24. Tallaght Hospital was recognised as a suitable location for a satellite centre as part of the National Paediatric Hospital Project. This was based on a number of criteria against which the site was considered including inter alia: planning and development considerations; paediatric population density; level of deprivation experienced by the population; accessibility; clinical advantages; site suitability; and, cost 1. On the basis of the review and analysis, the Minister for Health decided in 2014 that two satellite centres, as part of the National Paediatric Hospital Project, should be developed and to proceed with the construction of the two centres at Tallaght Hospital and Connolly Hospital in tandem with the new children s hospital at St. James s campus. This draft study demonstrates that the proposed development of a satellite centre as part of the NPHP can be accommodated on the hospital campus while protecting the potential of the campus to flexibly accommodate emerging healthcare requirements which will be required on the campus in the future. Therefore the satellite centre at the proposed location does not compromise the existing operation of the hospital or affect future developments. The subject campus area is circa 13.8ha and is located immediately north of Tallaght Town Centre in south west Dublin. The study does not purport to be a detailed plan but rather an exercise which draws on existing information pertaining to the site to identify: The existing site plan and the surrounding context (see figure 2) The guiding planning framework provided by the South County Dublin Development Plan (SDCDP) and the Tallaght Town Centre Local Area Plan, 2006 Areas within the campus that may be developed This draft study builds on the foundations set down in the Tallaght Hospital Development Control Plan It provides a framework to guide proposals and future planning applications for the Hospital campus with the drawings and development scales only indicative of what may be realised in the future. While the study provides guidance from which detailed proposals could emerge it may also be the case that a more forensic analysis results in alternative expansion plans in the coming years. This document relies on matters of fact in relation to the campus such as established access points, topography, hospital street/adjacencies, existing parking areas, green areas etc. to highlight zones that could be appropriate in the future for development. Background The Tallaght Campus The campus was constructed in the mid-1990s and is situated northwest of Tallaght village, just south / southeast of the townland boundary between Cookstown and Tallaght. At a macro level the physical context of the campus includes the hospital buildings, ancillary accommodation and parking areas all set in the urbanised landscape surrounding the Tallaght Town Centre to the south. The Tallaght Hospital provides a range of services primarily to the people of south west Dublin, north Wicklow and parts of Co. Kildare. In addition, it has many national and international responsibilities. It is recognised as a significant contributor to teaching and provides its communities with specialities in: Medicine Accident and Emergency Gynaecology Surgery National Urology Centre Psychiatric Unit Intensive and Coronary Care Elective Orthopaedic Age Related Healthcare Out-Patients Department Cardiology Neurology Nephrology Regional Dialysis Centre Trauma Child Health Services Purpose of the Draft Study This draft study provides outline development zones and represents a planning context for the existing Tallaght Hospital Development Control Plan The purpose of the study is not to consider the campus afresh but to bring together known facts in one concise document which can be referred to as a platform for future development and a framework for current proposals. A set of principles and development parameters are identified that can be considered as development proposals come forward. This will allow contextualization at an early stage in the feasibility of schemes which will then in turn refine proposals through the design process. There is a need to appreciate that clinical requirements and medical practices are continuously evolving. Therefore, the built environment on the Tallaght Campus needs to be flexible in terms of development considerations such as area, form, height and access in particular. The study seeks to provide a focus for future expansion while ensuring that building solutions allow for hospital facilities that meet the clinical requirements. A core purpose of this draft study is to identify sites that can take different development typologies which in some instances may not be buildings (e.g. parking) and in other cases may be essential back up facilities (e.g. FM). Therefore, this document takes a zonal approach to identifying sites within the campus and in the main avoids prescribing detail that can only be arrived at following a detailed feasibility/design process. However, for the purposes of including the most up to date information more detail on certain portions of land is included as the nature and form of development is more certain. An example of such detail would be the satellite centre proposed as part of the National Paediatric Hospital Project which has been through a comprehensive feasibility exercise and full design process including consultations with user groups. Children s Hospital Satellite Centres Further to the above, the Model of Care for the children s hospital satellite centres serves to promote and guarantee the provision of high quality, safe clinical care to every child, every time he/she attends the new children s hospital satellite centres. This is based on current best practice and evidence. The new children s hospital at St. James s Hospital campus has two separate but linked responsibilities. It will provide tertiary / quaternary (highly specialised, small volume) services on an all-island basis and secondary paediatric care (higher volume but less severe and less complicated conditions) to the GDA (counties Dublin, Wicklow, Kildare and parts of Meath). National and international evidence shows that children with complex, rare and life-threatening conditions do best by centralising highly specialised 1 Information provided by the National Paediatric Hospital Development Board, June 2015

3 and complex tertiary / quaternary services. Secondary care, by its nature less complex and requiring less specialised equipment and staff, would ideally be delivered as close to the child s home as possible. The two new satellite centres (one of which is proposed for Tallaght) will form part of a hub and spoke model in which they will work alongside the new children s hospital at St. James s Hospital campus and provide the following services: Secondary general paediatric care closer to home to children and young people in the GDA Safe urgent care to the children and young people of the GDA. A safe, local secondary paediatric service which will meet the local community s needs and which will reduce inconvenience for children, young people and their families. The projected clinical activity for emergency/urgent care department visits for the new children s hospital at St. James s Hospital campus in 2020 is circa. 126,340. Most large specialist children s hospitals would see between circa. 50,000 90,000 children in their emergency departments annually. The provision of urgent care in the two new children s hospital satellite centres addresses this issue by providing urgent care to approximately 25,900 children in each of the two satellite centres to meet the needs of the local population. The Emergency Department in the new children s hospital on the campus at St James s Hospital is designed to treat 74,540 children. Therefore, the Government decision identified the need for two satellite centres to be located at Tallaght and Connolly campuses. west of the site are residential lands zoned A to protect and/or improve residential amenity with adjacent open space zoned F to preserve and provide for open space and recreational amenities. Buildings The hospital buildings are planned around a central hospital street that runs through the site from north to south and range in height from single storey to four storeys (total floor area in the region of 44,000sq.m). As shown in Figure 2 (included as Appendix 1) the following buildings are located on the overall campus: Education Centre Haemodialysis and Nephrology Multi-Storey Car Park Cardio Vascular Risk in Young Diagnostic and X-Ray Department Accident & Emergency Dept. Catering Children s Wards Operation Human Resources Out Patients Mortuary SSACU ICU HSSD Buildings in the immediate vicinity of the planned satellite centre include: the Ward s block; the Medical Oncology Day Centre; the Psychiatric Unit; the Diabetic Unit; the Geriatric Unit; the Atrium; Endoscopy; and Administration. Description of Site and Surroundings and Contextual Analysis In order to appreciate the nature and extent of the subject lands there is a need to understand the campus wide context within which the zones of potential development can locate. This frames a current position and ensures that the unique characteristics of the campus are captured. Planning Context The campus is accessible from Belgard Square North to the south, with Cookstown Way and the LUAS red line bounding the campus to the west. The internal hospital road runs proximate to the eastern boundary to the east of the existing hospital complex, connecting with and providing access from the industrial estate at Fourth Avenue to the east. As shown in figure 1, Under the SDCDP the subject site is zoned CT To protect, improve and provide for the future development of the County Town of Tallaght. Hospital as a land use is Permitted in Principle under this zoning. The subject site also contains the following Local Objective, IN to provide for a post primary school or other institution. Figure 1: Extract from SDCDP Maps, 2010 The campus is bound to the north by lands zoned EP1 with the objective, to facilitate opportunities for intensive employment uses complemented by mixed-use development based on a principle of street networks and in accordance with approved plans, to the east and south are lands zoned CT To protect, improve and provide for the future development of the County Town of Tallaght and to the Figure 2: Existing Site Context (prepared by Coady Partnership Architects) Access and Parking The campus is well connected having access to high capacity roads such as the Belgard Road, Cookstown Way and the N81 in the immediate vicinity and further afield, the N7 and the M50, ensuring

4 Car and Pedestrians Car,Luas, Bus and Pedestrians Car and Pedestrians good access for patients. The principle access point is at the south east of the campus via a roundabout on Belgard Square North while there is a secondary access at the east of the campus via Fourth Avenue. Utilisation of an internal one way perimeter road services the campus from within and is reasonably efficient in terms of traffic management. There are approximately 1,730 car parking spaces within the campus with approximately 1,340 of these being provided for staff use. The spaces are located in eight surface staff car parks throughout the campus with the remaining located in a public multi-storey car park in the north east of the campus. The parking areas are strategically located around the perimeter of the campus and highly accessible for users. A further 300 car parking spaces for staff use are currently being rented off campus at an adjoining building. The campus is well served by public transport. A number of local buses service the hospital and three Luas red line stops are located in the immediate vicinity. The nearest Luas stop (Hospital) is located to the south west of the campus along Cookstown Way. Given the relative urbanised nature of the surrounding area the hospital provides good access for those travelling by more sustainable modes such as walking and cycling. Figure 3 below (included as Appendix 2) illustrates the key aspects of access and parking at the campus. perimeter. At the time of construction of the hospital earth berms were created in order to help define a boundary for the campus. This has resulted in a campus that is self-contained but accessible to the surrounding area through structured access points. The lowest point at the campus is at the main entrance via the roundabout on Belgard Square North with the level rising by approximately 3m at the western boundary. The boundary of the campus is heavily landscaped with trees and planting located along the perimeter. Small grassed areas and planting are located throughout the campus. Surrounding context The surrounding area has a physical typology that comprises of a mix of development types. The hospital campus is located immediately north of the Tallaght Town Centre with the connecting land comprised primarily of residential apartment blocks with ground floor commercial use. A mixed-use office and residential development which fronts Belgard Square North is located to the south east of the campus. To the west of the campus, across Cookstown Way, are housing estates comprised of low density two storey dwellings with adjacent public open space. To the north and east of the site are industrial lands that are primarily made up of two storey industrial units. Linkages The campus has good vehicle and pedestrian linkage with the Tallaght Town Centre via Belgard Square West to the south. To the east of the campus there are vehicle and pedestrian linkages to the Cookstown Road and the Town Centre expansion zone via Fourth Avenue. The full completion of Cookstown Road, as set out in the South County Dublin Development Plan, will further enhance linkages to this growth area. Figures 3 and 4 illustrate the campus linkages and position strategically in the wider Tallaght Town Centre, Town Centre Expansion Area and public transport network. L Expansion Area Hospital L Car, Bus and L Town Centre Figure 3: Existing Site Features (Prepared by Coady Partnership Architects) Car, Luas, Bus and Pedestrians Topography, Open Space and Landscaping The internal topography of the site is generally flat with a noticeable level change occurring along the Figure 4: Strategic Linkages

5 Policy and Strategic Plan Context The following section sets out some of the policies of relevance to development at the Hospital. It will begin by providing a high level overview of relevant national policy before focusing upon policies contained within the adopted and emerging plans. National Policy Overview (NDP AND NSS) The National Development Plan (NDP), and the National Spatial Strategy (NSS), both recognise hospitals as important infrastructure, encouraging and providing for the development of same. National Model of Care for Paediatric Healthcare in Ireland, 2010 Informed by the extensive research into international best practice, trends in paediatric healthcare and contemporary changes in healthcare the decision was made to develop the hub and spoke model of a main National Tertiary Hospital with satellite centres, also referred to as Urgent Care Centres. The satellite centres were identified as having a crucial role as projected patient numbers to the three Dublin Hospitals by 2021 of 120,000 2 would have been well in excess of the internationally accepted manageable figure for a single department of 80,000 patients. This configuration improves geographic access to urgent care for a significant number of children in the Greater Dublin Area (GDA), supports primary and community care paediatrics, reduces outpatient attendance on the main children s hospital site and significantly reduces emergency department attendance at same. Disability Act, 2005 The Disability Act puts in place a framework that sets out to make significant improvements to the lives of people with disabilities. It is designed to increase the participation of people with disabilities in our society by supporting the provision of disability specific services and by improving access to mainstream public services. It puts in place significant obligations on public bodies to make buildings and services accessible to people with disabilities. The National Clinical Programme for Paediatrics and Neonatology, 2011 The National Clinical Programme for Paediatrics and Neonatology was established in 2011 as a joint clinical initiative between the Health Service Executive (HSE) and the Faculty of Paediatrics, RCPI. The overall aim of the programme is to ensure high quality care is provided to children throughout Ireland, from the point of first contact. Smarter Travel A Sustainable Transport Future: A New Transport Policy for Ireland, This document published by the now Department of Transport, Tourism and Sport sets out the vision of a sustainable transport future in It identifies measures aiming to increase the share of the population walking, cycling and using public transport by Through this framework, the Government aims to reduce the car-based share of total commuting trips from the current average of 65% to 45%. Regional Planning Guidelines for the Greater Dublin Area, The Regional Planning Guidelines for the Greater Dublin Area recognise the role of hospitals stating that like the provision of educational facilities, healthcare is not a social service provided directly by Local Authorities, however, the provision of healthcare facilities must be taken into account in planning terms. In this regard the RPGs support close consultation between the HSE and Planning Authorities in the 2 Updated figure now 126,340 by 2020 development management process with Policy SIR4 stating that planning authorities should work with the health services with regard to provision for community based primary care centres and hospital care in key population centres, supporting their integration into new and existing communities. South Dublin County Council Development Plan, The zoning of the site is covered above within the section Planning Context. In addition the SDCDP sets out a number of policies pertaining to the campus and these are outlined below: The site is within the Baldonnel Casement Aerodrome identified on the SDCDP maps as Approach Areas Variable Height Restrictions. The SDCDP recognises Tallaght Town Centre as providing a range of uses and states that the Regional Hospital is well established in the Town. In this regard the future development of Tallaght is supported by a number of policies including inter alia Policy TDL6: Public Transport in Tallaght, Policy TDL7: Tallaght County Town and Policy TDL10: Tallaght Education City and Innovation City. Tallaght Town Centre is considered to be the most appropriate location for an Intellectual Development Zone capability of promoting innovation. In this regard Policy EE9 on Economic Clusters states, It is the policy of the Council to promote innovative economic sectors and encourage business clusters that exploit links with one another and/or third level and medical institutions. With regard to heights of new building the Plan states that in the development of a diverse urban environment common to the traditional town, a variety of building heights is appropriate. In determining building height the SDCDP provides the following guidance for consideration including inter alia: the height of surrounding development; a cohesive streetscape; perimeter blocks should be three to five storeys; locational factors; proportionality in relation to the street and open space; and, airport height controls. The car parking standard relating to the Hospital land use is classed as to be determined by Planning Authority. With regard to sites such as the Tallaght Hospital Campus which are located in the Town Centre and proximate to public transport, Policy T34 states, It is the policy of the Council that in areas well served by public transport or alternative means of access the car parking standards provided in the Development Plan shall be taken to be the maximum provision required. In relation to MMPs the SDCDP states that these are required for larger sized developments which are likely to result in more than 500 employees and which will generate significant trip demand. For new hospital developments secure covered cycle parking facilities incorporating frame locking facilities and bicycle parking located close to entrances is required. South Dublin County Council Development Plan, The abovementioned plan is currently at Draft stage and its provisions have not been included in this document as they have not been fully adopted by way of approval from elected officials. The Plan is due for adoption in Tallaght Town Centre Local Area Plan, 2006 The LAP sets out a number of key development control considerations for the Tallaght Hospital Campus and are detailed below:

6 Table 1: Development Control Considerations Land Use Density Plot Ratio and Building Height Layout Transport Car Parking Access and Permeability Site Analysis Energy Efficiency With regard to the hospital the LAP states that land uses should be primarily associated with the Hospital. With regard to institutional lands it is also an objective of the LAP to ensure access to all such areas is maximised, and major spaces are linked via amenable pedestrian routes. In this regard the LAP encourages the construction of plazas and squares at various locations including entrances to major destinations such as inter alia the hospital. The LAP states that medium density areas are located within sections of Tallaght Hospital. It notes that these areas are not as well served by public transport and facilities as the higher density areas. However, sufficient levels of service are available and/or can be built upon to sustain more intensive levels of development than currently exist. While the LAP applies plot ratio and building height thresholds to the Tallaght Town Centre Area the Tallaght hospital campus lands are not included and deemed subject to a detailed Masterplan/Conservation Plan on both accounts. An indicative masterplan layout of the hospital site is contained in the LAP and contains the following: Some mixed use non-hospital related development along Belgard Square may be desirable to encourage the development of a more active street frontage. The area should be made significantly more permeable to vehicles and pedestrians. East/West pedestrian access across the southern and northern extremities of the site would provide direct access to the LUAS, Hospital and Cookstown Stations. That any major redevelopment should seek to build up existing structures in preference to the further sprawl of low lying buildings. That a new public square should be provided adjacent to the main hospital entrance. There are opportunities for gateway buildings at the existing entrance point off Belgard Square and on the corner of Cookstown Way. It is an objective of the LAP to facilitate the expansion of the public transport network including inter alia an improved QBC network both within and at key access points to the Town Centre along routes such as Belgard Square North. Access to the Tallaght hospital Campus by public transport may also be improved through the LAP s implementation measures, specifically identifying opportunities for interchange including park and ride, bus stops, taxi ranks, bicycle parking etc. where appropriate, in conjunction with major development proposals in the Town Centre. The Belgard and Cookstown Luas stops may be particularly suitable for park and ride. While the LAP applies specific car parking parameters for certain land uses it does not specify for the land use hospital. Where specific uses are not identified the parking parameters as set out in the South Dublin County Development Plan are applied. Improvements in accessibility and permeability are required to ensure that the Hospital becomes a more integrated part of the Town Centre. The Masterplan states that this can be achieved by creating additional entrance points and new streets and spaces that are fronted by development that is more responsive to the public domain i.e. a new public square and direct access to LUAS. In addition the Masterplan states that such alterations would also enable public transport (buses) to operate through the hospital site in the future. The LAP states that the layout and orientation of development should be guided by factors such as the nature of surrounding development, natural features, accessibility, sunlight patterns and climate, which are to be identified by the process of Site Analysis. The LAP states that such Site Analysis should include references to inter alia, land use, scale of surrounding buildings, key frontages, pedestrian links and public and private space and be submitted with applications for new developments on sites over 500m2 as part of the Design Statement. The LAP states that all new development within the Town Centre should seek to be as energy efficient as possible by utilising renewable energy sources and passive solar design techniques. In this regard, it is a requirement that this process be documented via the Design Statement to confirm that best practise methods have been followed with respect to Energy Efficiency and accompanied by Shadow Diagrams to demonstrate solar access levels and the impacts of any overshadowing on surrounding lands It was proposed to develop these buildings at the southern end of the campus opening it up to Cookstown Way. The re-alignment of the main access road in order to reduce the curve and move it further west. The creation of a defined front and rear to the campus. It is anticipated that the front of the campus will be for the use of public and pedestrian traffic and the rear will be focussed on goods and staff traffic. The DCP is somewhat dated in that it does not reflect current government policy as it is now no longer intended to locate a maternity hospital at the Tallaght hospital campus. The development of a satellite centre at Tallaght hospital as part of the National Paediatric Hospital Project differs in certain respects from the ambulatory and urgent care centre allowed for in the DCP. Furthermore, the DCP does not reflect current thinking and the emerging clinical requirements anticipated in the context of the new Midlands Hospital Group of which Tallaght Hospital is a member. Capacity Outline The following section sets out some design principles and parameters for future redevelopment at the site, many of which are indicative and subject to future detailed feasibility. In addition, there will need to be a degree of flexibility capable of accommodating changing clinical requirements. Each development parcel can be considered in the context of underlying design principles and the identification of opportunities in Figure 5 is not exhaustive. Development Opportunities Scale and Location The hospital campus has been considered in terms of future development opportunities. Figure 5 below (included as Appendix 3) shows development zones within the campus that may be considered for development. Tallaght Hospital Development Control Plan, A Development Control Plan (DCP) was approved by the Board of the Hospital in The DCP includes a site analysis and sets out the options for the development of the campus, the main points of which are summarised as follows: The development of a single building solution to accommodate the proposed ambulatory and urgent care centres and maternity hospital. These were seen as the only major stand alone developments likely to be initiated on the campus during the period of the development control. Figure 5: Development Opportunity Sites (Prepared by Coady Partnership Architects)

7 In Table 2, below, we consider the potential capacity for each site in the context of the existing planning framework. In this regard it should be noted that the Tallaght Town Centre LAP does not prescribe the same level of detail for the campus as it does for adjacent plots. This is not surprising as the complex operations of a hospital campus should not be dictated in a general planning masterplan as its scope is not sufficient to understand clinical requirements. However, in order to create a general framework the following were considered: the current use of the site; its area; the possible development opportunity use (where appropriate); and, the range of scale that may be acceptable on the lands. Table 2: Development Opportunities Location and Capacity Development Area Capacity Range Plot Ratio Minimum Plot Ratio Maximum Site Area Comment Development Scale 1 Cardio Vascular ha Possible Infill / Densification 1,100sq.m 5,500sq.m 2 Car Park ha Opportunity Site 1,350sq.m 6,750sq.m 3 Mortuary ha Possible Densification 1,000sq.m 4* Accident & Emergency 5,000sq.m Proposed Renal Development - 5* Out Patients Proposed ICU - 6 Surface Car Park ha Opportunity Site 1,100sq.m 7* National Paediatric Hospital Project Site 5,500sq.m Proposed Satellite Site - 8 Surface Car Park ha Opportunity Site 3,750sq.m 18, 750sq.m 9 Front Site / Heli-pad ha Gateway Location 7,850sq.m 10 Human Resources / SSACU 39,250sq.m ha Possible Infill / Densification 2,500sq.m 12,500sq.m * Development scales to be determined through completion of detailed design and feasibility which is currently ongoing. Please see individual applications for finalised figures. Connectivity There should be clear connections with existing routes and areas. This will provide people with the maximum choice in how they make their journey, taking into consideration all modes of movement. Permeability Permeability should be maximised (where appropriate) and encourage pedestrian and cycle movement. Surface Treatment Select surface treatment of a high quality that contributes to the quality of the urban character. The urban environment should be clearly legible for all users. Traffic calming Roads should be designed to encourage drivers to drive with caution. Calming measures should suit the local context and take consideration of pedestrians, cyclists, public transport, service and emergency vehicles. The location of buildings should be considered in terms of controlling the flow of traffic. Safety Routes should be safe and encourage movement. Open Space Strategy The following design principles can be incorporated into the overall development of the campus on a case by case basis: Visibility Enable people to have views into and across spaces. Orientation South facing where possible and practicable, with adequate shelter and seating where appropriate. Interface Carefully consider the manner in which public spaces and the built environment interact i.e. the urban space edge. Activity Introduce activity where appropriate to the hospital campus setting. Form Ensure well designed space of varied typology that takes account of disability access, the need for surveillance and health and safety. Surface Treatment Select surface treatment that encourages movement and avoids abrupt level changes, slippery surfacing etc. to ensure flow through space is not interrupted. Design Principles The following provides a broad framework of design principles that can be incorporated into the overall development of the campus. Detailed design of a specific site is ultimately where a development succeeds and this should be looked at separately on a case by case basis: Development Opportunities Guidance on Best Practice Access and Movement Access and movement is an integral part of the urban fabric and the success of same can be seen in both its functional performance and the contribution it makes to the quality and character of the area. The following criteria can be incorporated into the overall development of the campus on a case by case basis: 3 Tallaght LAP identifies the site as subject to detailed Masterplan with no specific plot ratios given. Plot ratios outlined above are the minimum and maximum for the entire LAP lands. 4 Plot ratio selected for the purposes of calculating general development scale and subject to detailed analysis as part of development schemes. 5 Building heights may vary and are subject to detailed design Context and Integration Development should take consideration of the site context and complement the existing urban fabric but also allow for distinctiveness where necessary. An approach should be taken that is flexible enough to respond to future changes. Functional Efficiency The inter-relationship between buildings, streets and open spaces should be looked at in terms of a coherent unit. Creating a Sense of Place Distinctiveness and identity should be strengthened. Places should be designed to be safe, comfortable, varied, attractive and stimulating for people. Connections Places need to be easy to get to and integrate adequately with the surrounding context. Environmental Harmony Development should seek to be energy efficient and ecologically sensitive.

8 Appendix 1 Existing Site Context

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10 Appendix 2 Existing Site Features

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12 Appendix 3 Future Development Opportunities

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