My time at Hill End Hospital

The chapel at Hill End, now an Arts Theatre

As well as working in theatre during our second year of nurse training at the QEII, we also did a psychiatric placement. This normally took place in the psychiatric wing of the hospital but I asked for mine to be in Hill End Hospital, so that travelling would be easier for me. Hill End was a large Victorian-built mental institution on the outskirts of St.Albans. It operated from 1899-1995, first under the name of Hertfordshire County Asylum and then later as Hill End (after the NHS had claimed it as its own in 1948). It started with 100 male patients and eventually accommodated over 1200 patients of both sexes by 1939. During the war, like many other mental health institutions, it became the base hospital for an inner city hospital, in this case St.Barts, London. Most of Hill End’s patients were moved to other hospitals to make way for the expected war casualties. After the war it settled down to business again as an NHS Psychiatric Hospital and had a number of well-known in-patients including the comedian Spike Milligan. However, by the 1980’s more and more patients had been moved into community projects or small housing and Hill End was much reduced in size. In 1995 (after the Community Care Act of 1990), Hill End closed completely (it is a now a large housing estate).

I did my placement at Hill End in 1984. Although the hospital numbers had reduced by then compared to its heyday population, it still felt like a thriving and busy hospital. I worked in a male admission ward and remember far less about it than I do about Napsbury (see earlier blog entries) probably because I wasn’t there anywhere near as long. I do remember that the staff smoked on the ward and didn’t wear uniforms (which made it tricky to know who was who at times). There was a television in the day room that the staff watched a lot of until one of the patients hurled it at a window. It didn’t go through because of the wire-protected panes of glass but it didn’t work again either. I also remember the ward domestic running in to say a man had hung himself in the toilets and being kept away until he had been cut down (he did survive). I don’t remember the easy, communal spirit there was at Napsbury probably because the patients were much more acutely ill and tensions in the ward were running high for much of the time. However, the staff were friendly and inclusive and I enjoyed my time there.

Over in the QEII, the other students in my group had a difficult time of it and felt much of the care they witnessed was inappropriate or unsafe. After a top floor window pane was pushed out of its frame by a patient, two students complained to the lead nurse about standards of care and their placement was curtailed very quickly. There was a lot of bad feeling from the ward staff to the remaining students and I was glad not to be there. Whistle-blowing was as difficult then as it is now, although policies now aim to protect staff from any back-lash, it is inevitable that feelings will run high on occasions.

Whilst looking for information on Hill End for this blog I came across an excellent resource called ‘Out of Site, Out of mind’ at http://www.stalbansoutofsightoutofmind.org.uk/page_id__74_path__0p2p21p.aspx
There are numerous comments at the end of the piece about the Adolescent Unit at Hill End which reportedly had appalling standards of care. Many of the contributors personal recollections of the Unit are really shocking and I am saddened to think it was all going on whilst I was there. It was 30 years ago but we still periodically get the same shock horror stories about healthcare in the UK (Winterbourne View, Mid Staffordshire Trust).

My placement at Hill End did not make me wish to return to my original roots in psychiatric nursing. By that time I was completely immersed in general care and looking forward to my return to St.Albans Hospital for my final year.