Leaking ceilings and sinking floors: at St Helier hospital where staff fear for patient safety

SHelier Hospital is older than the NHS itself. A once beautiful modernist building that admitted its first patients in 1941 is now in disrepair. The white paint is crumbling on every corner of the previously glossy exterior and the ultra-modern balconies are fenced off due to modern safety regulations.

A more pressing concern for staff are the structural issues that make their already challenging work much more difficult. Large windows built for optimal ventilation flow are held together with tape to prevent them from spilling onto staff and patients. Corridor floors sink into the ground and ooze mud, and elevators are so often out of service that ambulances are used to take the most vulnerable patients from the side exits to the wards to the main hospital building or intensive care unit.

Pauline Swift, a consultant nephrologist, says the state of the building has reached a crisis point. She remembers how that morning – a cold October morning – a nurse had tried to close a window in a kidney dialysis treatment room and the window fell off in her hand. “Someone ordered extra blankets because it was so cold because of the broken windows,” she said. “It’s a brilliant little unit, but do you really want to care for your patients in this environment? None of us do that.”

Ceiling tiles at St Helier Hospital have disintegrated due to water damage. Photo: Jill Mead/The Guardian

St Helier in Sutton is one of thousands of hospitals in a state of disrepair, according to a Guardian investigation. A third of NHS sites in England require repairs to prevent serious and/or catastrophic failure, major disruption to clinical services or serious injury or prosecution.

The NHS is just one part of the public domain that has fallen into disrepair. A Guardian project has found that more than 1.5 million students study in schools that need major renovations or renovations, or that require extensive repairs. Two in five courthouses are considered to be in poor condition, while thousands of prisoners are held in buildings considered inhumane.

The problems at St Helier are obvious even to the untrained eye: all over the building there are buckets under gaping holes in the ceiling. The ceiling tiles that used to be there have disintegrated due to water damage. You see a large piece of tarpaulin protruding from under a hole in the ceiling of a hallway and landing in a bucket below.

A few days after James Blythe started working at the hospital, a renal unit had to be closed because ceiling tiles collapsed on patients’ heads. Photo: Jill Mead/The Guardian

“I would say that throughout the winter, as I walk around the hospital, I can probably go to three or four places where I will find some sort of device that is used to prevent water from escaping from a roof,” says James Blythe. the chief executive of Epsom and St Helier hospitals.

In February 2022, three days after Blythe started his role at the hospital, a busy renal unit had to be closed and demolished because it was deemed too dangerous for patients. “It dropped so much that ceiling tiles were falling on patients’ heads,” he says.

The Epsom and St Helier University Hospitals NHS trust says it has spent almost £60 million improving its estates over the past five years and has had to cancel 600 operations directly because of the problems.

“The majority of our capital budget goes to backup maintenance… It means we can’t really invest in anything new, we mostly do repairs and mandatory upgrades,” says Blythe.

Tarpaulin under pipes on the ceiling of a corridor at St Helier Hospital. Photo: Jill Mead/The Guardian

Epsom and St Helier University NHS Trust was one of 40 places promised a new hospital under Boris Johnson’s new hospitals programme. The trust was promised a brand new specialist urgent care hospital in Sutton and significant investment in Epsom and St Helier hospitals to modernize facilities. In September, the chancellor, Rachel Reeves, reviewed the plan, but the trust has not yet received clarity on whether it will receive what was promised.

One of the hospital’s intensive care units (ITU) has recently received a state-of-the-art upgrade: with good ventilation, heat regulation and a digital control system that can be accurately monitored. But other wards in the ITU were not so lucky and staff are left to decide which ward should treat vulnerable patients.

Epsom and St Helier University NHS Trust was one of 40 places promised a new hospital under Boris Johnson’s hospitals programme. Photo: Jill Mead/The Guardian

Jane Camilleri, head of intensive care nursing, treats the hospital’s sickest patients on the ITU wards day in and day out. She says the building’s problems are a “constant juggle.”

“There are only certain types of patients that we can accommodate here because the air exchange is not sufficient. So you will have to have patients with airborne infections next to the door, because you have the right air exchange,” she says.

The ITU in St Helier does not meet NHS regulations in terms of bed space, air exchange and ventilation. But without funding it is considered impossible to meet these demands. Like elsewhere in the hospital, the ITU team has little choice but to continue to do the best for their patients in appalling conditions.