HSE provides further information on Midlands Hospice plan

The HSE has provided further information to Offaly County Council regarding the proposed Midlands Hospice at Arden Lane, Tullamore, as part of the planning process.

The extensive submission by the HSE, on September 16, comes two months ahead of its deadline to respond to the council's request for further information and addresses a significant number of points raised in observations.

The proposed development consists of a new hospice catering for 20 inpatient beds on a site at Arden Lane, Tullamore, complete with ancillary services, including a Day Therapy Unit and an education centre. 80 car parking spaces including seven accessibility bays, and 15 bicycle stands, also form part of the plans, as does a set down area and one mini-bus parking bay.

Regarding legal ownership of the site, which was raised in a number of observations, the HSE noted that it was not the legal landowner, but stated that the trustees of the Lions Club Tullamore were the legal landowners of the proposed site and will be donating it subject to a grant of permission for the proposed development. It said the trustees had signed a declaration to consent to the application being submitted.

"For the avoidance of doubt, please refer to the signed letters from the Lions Club Tullamore and JD Scanlon & Co. LLP, Solicitors acting on behalf of the Mr James Mathew in the sale of the site to the Lions Club and confirming that the Lions Club Tullamore are the legal beneficial landowners when the application was submitted," the HSE stated in its response, with all documentation available on Offaly County Council's website.

The issue of the proposed development contravening the county development plan was raised in a number of observations on the planning file.

The HSE stated that it is aware that the proposed development is a material contravention of the Tullamore Town Plan/ Local Area Plan within the Offaly County Development Plan 2021-2027 and is subject to a material contravention vote by the local councillors in due course. However, it added that it is not aware of regional and national planning policies that have been breached as part of the proposed development.

The HSE added that the project team had proactively met with councillors and elected representatives to provide comprehensive context and information regarding the development and its critical importance to the Midlands region.

"The applicant strongly disagrees with any assertion that this project does not meet the threshold for exceptional circumstances," the HSE stated, and pointed out that the Arden Lane site had received the full support of the palliative care specialists, the HSE Estates team, and was endorsed by the Health Minister as the preferred location for the Midlands Hospice.

In relation to the issue regarding consent required from the owners of the Pitch & Putt Club for access to the proposed development, the HSE noted that access to the proposed site is via Arden Lane, which it said was a public road that had been taken in charge by Offaly County Council.

"Therefore legal access to the site is in place, and consent from the Pitch & Putt Club is not required to access the site. The HSE would also note that while the boundaries of the folios OY14184F & OY1818F extend across the road, public access and/or a right of way has been established over the several decades," it stated.

Regarding zoning issues raised in a number of observations, the HSE stated that the site is located within a pocket of land zoned for 'Open Space, Amenity and Recreation', and the location was chosen based on the outcome of a rigorous options appraisal exercise conducted by the HSE.

"In line with Department of Health 2004 palliative care design guidelines the Arden Lane sites provides access to a tranquil and quiet environment, access to light and sheltered outdoor space and single floor accommodation. Nature and access to an outdoor environment are key considerations in developing a Level 3 Hospice for patients with lifelimiting and/or terminal illness," it stated.

The HSE added that it believes that the surrounding ‘Open Space, Amenity and Recreation’ land will be sufficient buffer to the hospice development in the future.

In response to the observation from Offaly Hospice Foundation Ltd that the location of the hospice is illogical and contrary to best medical practice, the HSE state that there are 14 specialist palliative care in-patient units in Ireland, and only three of these are co-located with acute hospitals with the other 11 being standalone facilities.

It stated that being located on a standalone site meant the Specialist Palliative Care Team could provide focused, holistic person-centred care in an appropriate environment.

In relation to road widening, the HSE responded that road improvement works to Arden Lane are no longer within the scope of the current planning application. It stated that while road upgrades were seen as beneficial, they weren't considered essential to the project.

It highlighted that other rural hospices operate successfully on local roads without pedestrian paths. It added, however, that it understands the council intends to complete upgrades to enable appropriate access infrastructure, including a footpath and street lighting separately, and that no additional Pitch & Putt land is required for this.

Regarding the requirement for infrastructure upgrades - a point raised in a number of observations - the HSE stated that such works are a common and expected element of building on undeveloped sites.

"The HSE has accounted for these requirements in its overall planning and considers the associated costs to be a justified investment in order to secure a peaceful and appropriate location for the Midlands Hospice," it stated.

In relation to the possibility of the alternative 'Wellwood' site, it said there were a number of challenges with this site, and stated that noise levels at this location were unsuitable for a hospice facility, and there was no direct access between the site the Midlands Regional Hospital Tullamore. Construction of a housing development adjacent to this location had reduced the land available, it stated.

Outlining a number of issues, the HSE response stated: "The Wellwood site poses significant challenges to delivering a hospice environment that meets operational, privacy, and community integration requirements."

In response to issues raised by Condron Concrete regarding the noise, dust and light emissions that its 24-hour facility generates, the HSE stated that a noise impact assessment it had commissioned did not raise any concerns.

The HSE added that it does not believe that the Midlands Hospice will have an adversely effect on the ongoing operation of the plant, its potential future expansion, and/or the Development Plan’s objectives in the surrounding area. It said it believed that the surrounding 'Open Space, Amenity and Recreation' land will be a sufficient buffer to the hospice development in the future.

Addressing a point raised in an observation by Thomas Martin, as trustee of Tullamore Pitch & Putt Club, that “the applicant has instigated a frenzied media and political drive to attempt to pressurise this development through the planning process and to infer the huge public support for this very important facility”, it noted that the HSE specialist palliative care teams delivering palliative care in the region, and who will be responsible for operating the new Midlands Hospice, support the Arden Lane location.

It stated that the Midlands Hospice project was nearly two decades in development and throughout the HSE had maintained ongoing communication with the public, including the six local hospice groups that assist with fundraising. and support the HSE specialist palliative care teams across the region.

"The HSE has been committed to keeping communities regularly informed of the project’s status, milestones, and planning considerations. The HSE, as the applicant, has conducted itself with full transparency and integrity at each and every stage of the process, and remains committed to adhering to all statutory requirements and planning protocols," it stated.

Regarding concerns on contractor parking, the HSE said the contractor will be required to park on-site. It added that the application does not include any works at the west and east end of Arden land and the vehicular connection is not impacted.

The HSE noted in its documentation that ambulance access to Arden Lane will be maintained at all times.

The planning authority had raised queries relating to non-inclusion of hoists into patient en-suite bathrooms, the calculation of OT and physio equipment storage space, mortuary/cold room, numbers of clinical staff attending and space required for them, and the possibility of a children's playroom.

The HSE stated that the decision not to include hoists was made following consultation with hospice colleagues nationwide. It said using tracked hoists to transfer patients over the distance from bed to en-suite bathroom can be perceived as frightening and undignified for many patients, and the majority of in-patients receival all personal care, including hygiene, while remaining in bed.

On the issue of storage space, it had consulted relevant guidelines and operational best practices, and added that the incorporation of dedicated storage spaces provided several key benefits, such as enhanced patient care, operational efficiency and regulatory compliance.

The HSE said the mission of a hospice centres around support and compassionate care, rather than post-mortem services, and an on-site mortuary may be distressing for patients, family and staff. It said the decision had been made not to have a mortuary at the Midlands Hospice, but to have viewing rooms, as this is what is included in hospice design nationally.

In relation to staffing, the HSE said it projected an approximate staff of 73, and the in-patient unit would consist of 20 bedrooms, with the daycare unit expected to open three-four days per week. The building will also allow for 24/7 visitor access.

It gave a detailed breakdown of accommodation required for staff, and said the hospice will include a total of 59 desk spaces. It said from early design stages, the project team had looked to increase the efficiency of the floor area.

The HSE said it had decided to exclude a dedicated children's playroom, following consultations with hospice colleagues nationally, and said feedback highlighted significant challenges related to supervision and management of such spaces.

Instead, the Midlands Hospice will incorporate an alternative provision: a collection of toys located within a communal area, which will be open and easily visible to ensure effective supervision and mitigate any child protection concerns.