Royal Victoria Hospital, Belfast

Coordinates: 54°35′38″N 5°57′11″W / 54.594°N 5.953°W / 54.594; -5.953

Royal Victoria Hospital
Belfast Trust
The hospital, between 1903 and 1914
Geography
Location	Belfast, Northern Ireland, United Kingdom
Organisation
Care system	Health and Social Care in Northern Ireland
Hospital type	District General
Affiliated university	1) Queen's University Belfast 2) University of Ulster
Services
Emergency department	Yes Accident & Emergency
History
Founded	1797; relocated 1799 & 1817; renamed 1847, 1875 & 1899; relocated 1903[1]
Links
Website	Belfast Health and Social Care Trust
Lists	Hospitals in Northern Ireland

The Royal Victoria Hospital (commonly known as "the Royal", the "RVH" or "the Royal Belfast") is a hospital in Belfast, Northern Ireland. The hospital (which provides over 20 percent of the acute-care beds in Northern Ireland and treats half a million patients a year) is undergoing a £74 million refurbishing. This includes an extension to the Royal Belfast Hospital for Sick Children, new wards in the main hospital, a new accident and emergency department and a new maternity unit. The hospital has a Regional Virus Centre, which is one of the four laboratories in the United Kingdom on the WHO list of laboratories able to perform PCR for rapid diagnosis of influenza A (H1N1) virus infection in humans.^[2]

History

Early history

The Royal Victoria Hospital has its origins in a number of successive institutions, beginning in 1797 with The Belfast Fever Hospital and General Dispensary, located in Factory Row (although the dispensary originally opened in 1792). This moved to West Street in 1799, and then to Frederick Street in 1817. In 1847 the hospital separated from the General Dispensary and became the Belfast General Hospital. In 1875 it gained the royal charter,^[3] becoming the Belfast Royal Hospital, and in 1899 it was renamed the Royal Victoria Hospital. In 1903 it moved from Frederick Street to its present (Grosvenor Road) site.^[1]

Grosvenor Road

The first hospital building on this site was designed in 1899 by architects Henman and Cooper of Birmingham.^[4] Completed in 1906, the Royal Victoria Hospital is a landmark in building engineering which claims to be the first air-conditioned public building in the world. Belfast's Sirocco Works factory pioneered the development of air conditioning.

Part of the original ventilation system.

It culminated preparations dating from the mid-1890s to modernise hospital design, with special regard to advances in antiseptic treatment in surgery and the application of plenum ventilation. Notable elements of the original hospital design were in layout and technology. The hospital was built at a time in the UK when there was concern (during a period of relative social responsibility) for having sufficient hospital treatment facilities in (or close to) city centres, when it was recognised there was little available space for expanding existing hospitals or building new institutions.

The Royal Victoria Hospital's design paid less attention to the usual requirements of hospital sites for access to sunshine and fresh air, and traditional pavilion-style hospital design was forsaken. Wards were placed compactly side-by-side, on one level, wall-to-wall, without intervening opening spaces. There were many long, communal wards with large windows at each end, with clerestory windows also providing daylight. Balconies (small for the ward size) were placed at the end of long wards, and there were some accessible outdoor areas. The outdoor access, however, had no integral relationship to the design of the hospital buildings; as the hospital grew, the exterior area available for patients diminished. Today, this area has almost entirely been taken up by roads within the site and parking areas. For ambulatory patients, tiny Dunville Park lies beside the hospital; however, it is unsheltered from traffic noise. Close city-hospital accommodation (with little open space) was not unique in Europe or the British Isles at that time, although it ran counter to the trend of the times.

The design of the Royal Victoria Hospital reacted against that trend at a time when cities were expanding rapidly. Many city hospitals in the UK today differ from those of the Victorian era, in which outdoor access was seen as important for recuperation. (Notably, there has not been any clearly identifiable trend nationally to develop hospitals including open space since that time.) The fresh-air supply in the original R.V.H. was based on the plenum principle (an example of which is the space above a dropped ceiling), which helped control relative humidity.

The Royal Victoria Hospital and its subsidiary hospitals became the Royal Group of Hospitals (or The Royal Hospitals). The Royal Hospitals site has developed over the years to occupy a large area in west Belfast, a walkable distance from the city centre. Most of this site is occupied by the Royal Victoria Hospital itself. The site consists of the original Victorian buildings (some visible from Grosvenor Road) and later, less architecturally-distinguished buildings. The original Victorian designs are a partial adaptation of the English Renaissance style.^[5] The material of the original buildings is typical for Belfast: red brick with Portland stone dressings.

Architecture

Map of the various buildings in the hospital complex.

Tall, long, functional mid-20th-century buildings dominate most of the long Falls Road side of the hospital, and give a plain look to a section of the busy road west of the Grosvenor Road and Springfield Road junction. On this stretch of Falls Road, the mid-20th-century hospital buildings face Saint Paul's Roman Catholic Church, Saint Dominic's Grammar School for Girls and typical, simple, historic terraced housing of Belfast (some converted into small shops and cafés). At the end of this stretch (near Broadway), the Royal Belfast Hospital for Sick Children occupies a smaller historic building of Victorian design.

Recent, typically simple functional buildings are located in the middle of the site bordering the Westlink, largely invisible from the Falls Road and Grosvenor Road. The hospital site stretches near Broadway on the west and downhill to border the Westlink city-link carriageway on the south, where recent functional buildings may be seen.

A slight addition to the main front of the West Belfast site in recent years is new railings (on Falls Road, going west from the junction of Grosvenor and Springfield Roads). The wavy pattern of the railings is reminiscent of the structure of DNA. There are little yellow Xs and Ys detailed for X- and Y-chromosomes, and portraits (laser-cut in sheet steel) chart the progress of a human life from birth to the age of 100.^[6]

Staff and patients

Frank Pantridge, the "father of emergency medicine", was a cardiac consultant at the hospital for over 30 years. During his time at the Royal, Pantridge developed the portable defibrillator, which revolutionised emergency medicine by allowing patients to be treated early by paramedics.^[7]

Social Democratic and Labour Party (SDLP) politician Carmel Hanna worked as a nurse in the hospital. Progressive Unionist Party (PUP) politician David Ervine was admitted on January 7, 2007, and died there the following day. During the Northern Ireland Troubles, the R.V.H. was regarded as one of the best hospitals in the world for the treatment of gunshot wounds. Gunshots to the knee (associated with "punishment" shootings) enabled surgeons at the R.V.H. to gain renown with their treatment of such injuries.^[8][9]

Remodeling

New RVH Hospital (Phase one)

The initial phase of the redevelopment plan provided:

• 400 beds
• Eight new theatres
• 25 bed-intensive care unit (one of the largest in Europe)
• Fracture clinic
• Central investigations unit
• Endocrinology unit
• Pharmacy
• Restaurant, coffee bar, Mace convenience store and vending machines

The new RVH is also linked to the refurbished ”A” Block.

The remodeling was completed ahead of schedule and within budget in autumn 2001 (for outpatient use), first bed occupancy in 2002 and official opening in 2003. The £42 million hospital was officially opened on 2 September 2003 by HRH Prince Charles, 100 years after King Edward VII opened the first RVH on 27 July 1903 with Queen Alexandra. The new 29,000-m² building replaced the red-brick Victorian hospital; it has gained a commendation in the Royal Society of Ulster Architects Design Awards and a commendation in the Irish Landscape Institute Awards of 2002.

Imaging and Central Decontamination Centres (Phase 2A)

The £25 million Imaging Centre is a stand-alone structure located between Block A and the existing Cardiac Theatres on the RVH site. It was completed in March 2007 and opened shortly thereafter. The Central Decontamination Centre opened in May 2006 at a cost of £11 million, and houses one of the largest hospital-instrument-cleaning operations in the UK.

Critical Care Building (Phase 2B)

The £95 million critical-care building on the RVH site will be located next to the existing accident and emergency department and the outpatient centre. The 12-storey Critical Care Centre was given planning permission on 23 March 2007 (Ref Z/2006/2083/F). Within the new critical care building will be an accident and emergency department capable of dealing with up to 80,000 visits a year. Within Accident and Emergency there will be a resuscitation area, and departments for major and minor injuries and conditions. There will also be a helipad located on top of the building with a dedicated lift to allow for the speedy transfer of major trauma cases to the A&E (Accident & Emergency wards). Level three of the new building will have four additional theatres. Levels five, six and seven will be dedicated to intensive care. There is capacity for 16 beds per floor, with two eight-bed wards on each floor. A new education centre will be located on level eight of the building, with varyous-sized lecture theatres and seminar rooms to replace the existing education building. Level nine will house the new regional burn unit; this replaces the existing unit and provides for 12 beds and supporting accommodation. Construction work began in summer 2007 with site-clearance work and piling and basement preparations; it was expected to be completed in late 2011. Work on the 63-metre-high building will also involve extension of the existing Glazed Street – an elevated, two-storey link to the adjacent A-Block and a single-storey underground service duct.

Replacement of outpatient centre and eye, ear, nose and throat buildings (Phase 2C)

The proposed location of phase 2C is the area adjacent to the new imaging centre, between the new Royal Victoria Hospital and the old Victorian corridor running parallel to Grosvenor Road.

New Women’s & Children’s Hospital

The £300 million project will provide 75,000 square metres (810,000 sq ft) of new accommodation (including operating theatres, inpatient wards, outpatient gynaecology and children’s accident and emergency departments).

Accident and emergency department

In November 2013 it was reported that the College of Emergency Medicine considered that issues faced by medics in the Trust's Casualty Department are probably worse than anywhere else in the UK.^[10]

References

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