The proposed move and options
Moorfields and its partners agreed in 2013 that there was a clear opportunity to address issues raised by patients and meet the increasing demand for eye care services, placing patients at the centre of care. Read how we decided that a new build at St Pancras is our preferred way forward.
An opportunity to build for the future
Moorfields and its partners agreed that they wanted to:
- create a partnership between UCL, Moorfields and eye care specialists in the community to design eye care services around the needs of patients, residents and professionals
- bring together eye care, research, and education in one place, and create links to care and social support in other parts of London
- support even closer collaboration between patients, clinicians, students and researchers.
They identified they could do this by either:
- staying at the City Road site making minor modifications to the existing buildings, or
- demolishing some or all of the existing City Road buildings and replacing them, or
- constructing a purpose-built environment at another location.
How we identified the options
The partners and other interested parties drew up a long list of options, which had to meet a set of agreed criteria:
1. Improved patient care and better patient access to ophthalmic clinical care and research.
2. Provision of a facility enabling maximum integration between the partners in the delivery of excellent research, education and clinical care.
3. Location close to other UCL faculties, the Francis Crick Institute and the health science cluster, MedCity, to facilitate collaboration.
4. Creation of more research and education programmes.
A list of 12 possible options which met these criteria was considered. A number of these options were then discounted for not meeting the criteria.
This left the following shortlist of options:
- Do nothing (which would mean no reconfiguration, continued maintenance and little improvement for patients).
- Develop the current site (of which there were seven sub-options, all requiring moving services temporarily during the building phase).
- Do the minimum (part new build and part refurbishment).
- Move from City Road and build a new purpose-built centre (for all the current eye care services at City Road, including A&E and the children’s services in the Richard Desmond Children’s Eye Centre and UCL).
Summary of option advantages and disadvantages
Rebuilding at the current site or rebuilding and refurbishing current facilities has the advantage of continuing to serve patients from the location that people know and find relatively easy to access from Old Street tube station and bus routes. However, there are potential disadvantages compared with the opportunity to build a new centre at another site.
Services would have to leave the current buildings to make way for construction and then move back into the new or refurbished accommodation. This would jeopardise the principle of minimising disruption and maintaining service continuity – a principle that is valued by many people who have expressed their views so far.
Compromise in terms of our ambition
Expanding and adapting the current site offers the potential to improve patient experience, but it only partially achieves the strategic objectives to bring together eye care with research and education. The scope for redesign is limited compared with the opportunity for a purpose-built design.
A more flexible and integrated facility would allow patients to be seen and treated more quickly and efficiently, as well as enabling closer working between clinicians and scientists so they can identify what needs to change and work together to discover new treatments.
Projected cost comparison
Building on land that Moorfields already owns would remove the costs of buying new land. However, with little or no opportunity to gain income from land sales, the projected costs of building and maintaining facilities at City Road over the next 50 years are much greater than the option to build elsewhere.
To examine these advantages and disadvantages further, the partners and others came together again to score the options against further criteria. These covered the benefits and drawbacks of each option and reflected the project vision and objectives – care, research, education, efficiency, flexibility and diversity.
Updated options appraisal 2019
The options appraisal was refreshed as part of this consultation process in early 2019 and, in line with the latest national guidance for business planning, the long list of options was reviewed against updated success criteria. Download a full report of the options review.
The success criteria and options were reviewed at:
- a patient and public workshop which reviewed the critical success factors against which the options were to be appraised
- a commissioner workshop which reviewed the critical success factors, investment objectives, and checked and challenged the options framework
- a combined Moorfields executive, commissioner and patient and public workshop which reviewed the critical success factors and checked and challenged the options framework
- a UCL workshop with representatives from the Institute of Ophthalmology, UCL finance and UCL estates which reviewed the critical success factors
and checked and challenged the options framework.
These workshops concluded that moving to St Pancras and creating a purpose-built integrated centre was still the preferred way forward at this stage.
Why is it important to be in London?
London is the recommended location for the proposed new centre for two main reasons:
- London is the most accessible location for most people, regardless of where they live in England.
- London is the best place to recruit and retain specialists, technicians, researchers and students, which is crucial for the development of future services.
Why a new build at St Pancras is our preferred way forward
Through our property search, seven locations offered potential development opportunities, similar accessibility and the opportunity to improve patients’ experience but did not meet other criteria, such as value for public money. The site at St Pancras meets all the critical success criteria.
Subject to consultation, our preferred way forward is:
- to purchase the land that has become available at the St Pancras Hospital site
- to build a new centre, designed to bring together eye care, research and education
- to provide the highest quality of care and accessibility for patients, carers, staff, innovators and students.
The main advantages of a new build at the St Pancras Hospital site are:
- a purpose-designed centre would achieve our strategic objectives to bring together eye care, research and education for the best possible patient care
- a new design offers the space and flexibility to meet changing patient and service needs in the future
- creating the centre at a new location allows continuation of services at City Road until the proposed new centre is ready, offering greater potential for a smooth transition for patients, carers, staff and students
- a new site has the additional cost of purchasing the land, but by vacating the City Road site, the land can be sold and the proceeds invested in the proposed new centre.
The main disadvantages of a new build at the St Pancras Hospital site, informed by feedback from people who have participated in discussions so far, are:
- changes in transport routes and access for people who have used Moorfields’ services for many years
- potential challenges in getting to the new proposed site via bigger and more complicated rail and underground stations
- potential challenges of a longer route from public transport hubs to the proposed new site.
The following map shows a number of potential sites in London that are in the long list as options 6 to 12.
These sites were identified by a review of the Greater London property market to find available sites that met the criteria set out in the original options appraisal.
Due to the commercial sensitivities relating to these sites, confidential disclosure of this information has been limited to members of the Oriel Board and selected individuals involved in the options evaluation process.
Advantages of options 6-12:
- All locations in options 6-12 allow for a new build, which should be able to meet building requirements.
- A new build allows existing services to continue with the need to decant.
Disadvantages of options 6-12:
- Option 6 and options 8-12 have high land costs.
- Option 7 is unlikely to achieve improvements owing to heritage considerations on the estate and limitations on future flexibility.
- Options 9-12 are distant from the Knowledge Quarter, an area around Kings Cross, the Euston Road and Bloomsbury which is the focal point of one of the greatest knowledge clusters in the world.
The following illustration shows the location of the proposed site for Option 5, the option to relocate to St Pancras. The illustration shows the current St Pancras Hospital site with the blue shaded area indicating the land that is available for the Moorfields’ purchase.
The map shows the local area with mainline rail stations, Euston, King’s Cross and St Pancras, nearby underground stations and other notable establishments in the area, such as RNIB, Guide Dogs and the Francis Crick institute for health research.
The red dotted lines show some of the current access routes to the St Pancras Hospital site, however there would be further work on access as part of the later design and planning stages, with the involvement of patient and public representatives.