LOST HOSPITALS OF LONDON

 Defence Medical
Rehabilitation Centre
Headley Court, Epsom, Surrey KT18 6JN
Medical dates:

Medical character:
1950 - current

Rehabilitation (military)

In 1950 RAF Headley Court was officially opened by the Duchess of Kent as a Medical Rehabilitation Unit (MRU) for pilots and aircrew who had been injured during WW2.  Many of the patients had sustained multiple musculoskeletal injuries, sometimes between 10-20 fractures.

Headley Court had originally been an Elizabethan farmhouse.  It had been bought by the Cunliffe family and Lord Cunliffe, then Governor of the Bank of England and Chairman of the London and North Eastern Railway, enlarged it into a mansion.  During WW2 it became the Headquarters of the First Canadian Army in Europe, at first under the command of General McNaughton and then under General Crerar.

After the war, in 1946, the 85-acre Headley Court estate was purchased by the Institute of Chartered Auctioneers and Estate Agents, who presented it to the Royal Air Force, via the Air Ministry, to commemorate the Battle of Britain.

In 1964 the MRU had 100 beds.

In April 1968 the RAF Medical Branch assumed responsibility for medical rehabilitation of personnel in all three fighting services; the MRU became the Joint Services Medical Rehabilitation Unit (JSMRU).  (Today, while it remains under the nominal administration of the Royal Air Force (RAF), it is commanded by the Army and the RAF on a rotational basis).

In 1996 the existing rehabilitation facilities of the Armed Forces were consolidated and the JSMRU became the main rehabilitation centre. (The last military hospital  in the UK - the Royal Hospital Haslar - closed in 1998.)

By 2001 it was part of the Defence Medical Education and Training Agency.  It was renamed the Defence Medical Rehabilitation Centre (DMRC), but is known nationally simply as 'Headley Court'.  Since 2002 it has been the primary rehabilitation centre dealing with seriously injured casualties, while 12 military Regional Rehabilitation Units (today increased to 15) treat those with less severe injuries.

By 2005 some 2,000 service personnel were attending annually for treatment of complex musculoskeletal injuries sustained during sport ot military training.  While 40% of admissions were for chronic low back pain, the Centre was now playing a major part in the rehabilitation of amputees and patients suffering from multiple trauma or from post-traumatic stress disorder.

The Centre had 156 beds, mostly in hostel type accommodation, and was staffed by some 220 medical and healthcare personnel, half of whom were civilian and half from the three services, including Princess Mary's Royal Air Force Nursing Service.  As well as specialist medical officers and nurses, also employed were remedial instructors, physiotherapists, occupational therapists, speech and language therapists, a cognitive therapist, social workers, engineers and administrative support staff.  The Centre had four gyms with cardiovascular and resistance equipment, and a hydrotherapy pool.

While the use of Kevlar vests protecting the torso and the major organs had prevented loss of life, the limbs were still vulnerable to major damage.  The type of warfare currently being fought in Afghanistan (since 2001) has resulted in a surge of troops with catastrophically injured limbs, and the Ministry of Defence has tripled the size of the DMRC.  In 2007 a portable building was attached to a wing of the old mansion house as a temporary ward annexe with 30 beds (the Grade II listed wall and gate had to be carefully dismantled before the building could be craned into position).

The Peter Long Unit has two wards with 66 beds, 20 of which are for patients with brain or spinal cord injury or other neruological condition.  The remaining 46 beds accommodate medical cases or those with multiple injuries who require physical and/or psychological nursing support.  In September 2007 a new wing opened, increasing the bed complement from 170 to 200.

In 2007 the charity Help for Heroes was established, initially to raise funds for a full-size swimming pool after certain members of the local population had objected to amputees using the public facilities in Leatherhead and 'scaring the children'.

The Complex Rehabilitation and Amputee Unit has a contract with a private company for the supply of prosthetic limbs, which are made on site and fitted for each individual patient's needs.  Seven prosthetists and ten technicians are employed in the workshop producing sophisticated artificial limbs.

In February 2008 the first triple amputee was admitted and, since then, about 15 more.  The number of patients who have had above-knee amputations has also increased.  In May 2008, following a warning from the National Audit Office that the RCDM at Selly Oak and the DMRC at Headley Court were reaching capacity just as 4,000 British troops were preparing for a major offensive against the Taliban in Afghanistan, the Defence Secretary, Des Browne, announced that the facilities at Headley Court would be upgraded at a cost of £28m.  A modular 2-storey building would be installed to provide extra staff accommodation of 58 beds.  A larger prosthetics workshop, imaging facilities and a neurological treatment centre would also be provided.


Present status (April 2009)

Headley Court, now part of the Joint Medical Command, is owned by a charitable trust and there is a longstanding history of charitable involvement with the Centre, including groups such as the Royal British Legion, the Army Benevolent Fund, the Soldiers, Sailors, Airmen and Families Association (SSAFA) and, lately, Help for Heroes. The Ministry of Defence also continues to invest in the Centre, and pays for the staff and upkeep of the facilities.

Service personnel wounded in battle overseas are repatriated to be treated at the Royal Centre for Defence Medicine, a military managed ward originally embedded since 2001 in Selly Oak Hospital (it moved to the new Queen Elizabeth Hospital, Birmingham, in 2010).  Once they are stable and their wounds have healed, they are transferred to the  DMRC at Headley Court.

The DMRC aims to help patients achieve independence again and, where possible, to return to active military duty through vocational rehabilitation.  Historically, some 95% of patients were returned to military service but recently, because of the increasingly serious injuries sustained, this has fallen to about 85-90%.  Of the patients with serious brain injuries, between 50 and 65% return to military duty.

In recent years the Centre has more than doubled in size to cope with the numbers of injured military personnel needing its services during the wars in Iraq (2003-2010) and Afghanistan (2001-current).

Update: 2009

In June the Ministry of Defence (MOD) announced that it was considering the possibility of establishing a new rehabilitation centre in the Midlands, nearer to the RCDM in Birmingham, to make it more accessible to patients and their families who come from all over the UK.  A private benefactor had agreed to fund the feasibility study.  This announcement caused great consternation as to the future of Headley Court, although nothing more has been heard of the plan.

In the meantime the new 58-bedded staff accommodation block was erected as well as a Mild Traumatic Brain Injury facility.  Construction work began on a new Rehabilitation Complex.

In July the MOD announced that, for the first time,  regular statistics would now be published online detailing the numbers of military patients treated at the RCDM Selly Oak and the DMRC Headley Court.

Update:  2010


In February Kevan Jones, Minister for Veterans at the MOD, announced that the Peter Long Unit would be extended from 66 to 96 beds.

In June Prince William attended the opening ceremony of the new £11m Rehabilitation Complex.  It had been part funded by Help the Heroes, which provided £8m with the remainder paid by the MOD.

The new Complex contains a 25-metre swimming pool with five lanes; a moveable floor enables the depth of the pool to be increased to 1.8 metres.  The pool also has counter-current swimming jets, a Jacuzzi and an Aqua-jogger.  The refurbished Battle of Britain gymnasium is fitted with a sports-sprung floor and the new gymnasium on the first floor is equipped with a cardiovascular suite with two anti-gravity treadmills.

CENSORED

Headley Court is a sensitive site.  We were requested by the armed sentry not to take photographs.  An Army Security Patrol also complained that we had taken a picture of the public road outside.
References
Hopson JA 1968 RAF medicine - the first 50 years.  British Medical Journal 4 (5622), 48-50.

McCurdie I, Carter N 2001  Armed services may provide model.  British Medical Journal 323 (7322), 1186.

Wynn Parry CB 1964 Rehabilitation in the Royal Air Force.  Journal of the College of General Practitioners 8 (Suppl. 1), 6-13.

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