AACT’s formal response to the NHS Lothian Strategic Development Framework

Astley Ainslie Community Trust welcomes the publication by NHS Lothian in early April 2022 of their Lothian Strategic Development Framework, and the great detail with which it addresses the many important issues which affect the work of the NHS in this area. The Astley Ainslie Community Trust was set up four years ago to act in accordance with the new laws which allow communities to acquire land and property. The Trust represents a concerned community of members (local) and associate members from farther afield. The Trust holds public sessions to discuss and collect the possibilities and concerns for the site - so that we know what the community wants - and many of them are passionately interested. 

The Scottish Land Fund, the Architectural Heritage Fund Scotland, and individual members of the Trust funded the Feasibility Study on the site. The Trust has in the last few years also engaged with the NHS in green issues for the benefit of patients and staff (with, for example, Tonic Arts) and in public events on the site (such as a nature study day), in which we have been supported by other bodies such as the Cockburn Association and the University of Edinburgh. AACT has now become a charity (reference number SCO51602), which implies access to substantial funding from interested foundations. 

Those interested in a deeper understanding of the issues we are concerned about might review our website and the Feasibility Study, and read the journal, Leaves, published in association with Studies in Photography.

The Astley Ainslie grounds occupy roughly 17 hectares (42 acres), including designed landscapes, policy woodlands, wetland, and plantation woodland. It is the central part of the green corridor reaching out from the City to the South; the biodiversity value of the site in relation to its position in the city is high and it is wonderful land for growing, sheltered, and facing south. There are approximately twenty good buildings on the site, which could be kept for the health of patients, the housing of NHS staff, or adapted to new appropriate uses for more general public benefit. The site of the Astley Ainslie is of exceptional importance for a number of reasons. It is of historic importance - first given to the city by King David and part of the Common Good of the City from that time. It was repurchased by the Trustees of David Ainslie in the 1920s as a convalescent hospital and led the field for twenty years until the NHS took over the hospital and its impressive endowment. The land is public property. It should be dedicated to a continued interest in nature, our health, well-being, and creative pleasures. 

We recognise the tight financial situation that NHS Lothian faces, and fully understand the need to make changes to the way things are run in order to provide services wherever they are needed, most effectively, and with the best use of resources.

We also acknowledge (as stated on page 54) the significant deprivation in the region, leading to health inequalities that must be addressed. The Astley Ainslie Community Trust has concerns over many of the statements in the document. We have used the 5 questions suggested in the document as the framework for our response.

Do you feel the LSDF addresses the issues that are most important. If not, why not?

No, we do not. Whilst the document is comprehensive and far-reaching, but does not offer any detail on the proposed future of the Astley Ainslie site apart from an indicative timeline and a statement (on page 15) that NHS Lothian “would want to influence the ultimate use of the Astley Ainslie site, considering the need for affordable housing that many of our health and care staff need access to.”

We also have concerns that there has been limited time for public consultation, and that the

the document may not have reached a wide public audience.

Have we missed anything really significant in the LSDF? If so, what?

The Astley Ainslie site is of enormous importance and significance both to the local community and Edinburgh as a whole. We feel that the report does not address issues such as health and

wellbeing and biodiversity in any detail. We draw attention to the report “Biodiversity and climate change assessment for the NHS Lothian estate” commissioned by NHS Lothian and published in March 2021. It is clear from this report that the site of the Astley Ainslie is already considered to be one of the most important and valuable current assets of NHS Lothian with regard to both biodiversity and climate change. It is widely agreed that this kind of land has the potential to be managed to improve its contribution to both biodiversity and climate change, with increasing indirect benefits in the long-term to society more widely through: * pollution control

* greenhouse gas mitigation

* the enhancement of biodiversityAstley Ainslie land could have even more directly visible benefits such as:* appropriate housing 

* other social opportunities

We have seen reference to a recent local trial in which activities in open space were prescribed as part of health treatment, which illustrates wider possibilities for the site in terms of its potential value as a social prescribing resource. A large number of our registered members and other supporters have told us how they personally have benefitted from the green aspect and natural environment of the site over the years, whether during long-term convalescence or short-term respite from stressful situations.

What, if any of the proposals set out in the LSDF worry or concern you?

With reference to the statement (on page 15) that NHS Lothian is “considering the need for

affordable housing” Astley Ainslie Community Trust is very aware of the importance of increasing the amount of affordable housing available locally. Appropriately located and innovatively designed affordable housing was a significant aspect covered by the feasibility study that we commissioned on possibilities for the site, which is available here. We think that affordable housing, which is also part of AACT’s vision, is part of the benefit which Astley Ainslie could provide for the community in the future. At the same time, we believe that misjudging its importance relative to other desirable outcomes would have serious effects locally by depriving many people, including those who might come to live there, of opportunities to benefit from substantial open space that they can access conveniently. To this end, we would advocate careful consideration and a clearly delineated footprint for any housing.

What would you suggest that the Lothian Health and Care system could do to alleviate your concerns?

We would like to see Lothian Health Board engaging in better publicised consultation both with the general public and local community groups and third sector stakeholders.

Astley Ainslie Community Trust shares the concern of NHS Lothian that whatever takes place on the site should be for the benefit of the community, which includes the NHS and its staff, but would like to see a broader and longer-term perspective taken. Having recently received approval to operate as a Scottish Charitable Incorporated Organisation, we believe that we can help increase the range of opportunities that can be provided for the community while safeguarding the value of the site for the future on behalf of Edinburgh and Scotland as a whole.

To this end, we have recently written to the chair of the Lothian Health board, inviting him to speak at our forthcoming Annual General Meeting, and give an overview of where the NHS is in progressing plans for the Astley Ainslie site and we look forward to his response.

Is there anything else you would like to tell us before we finalise our strategy?

We note (page 15) that NHS Lothian sees itself as an Anchor Organisation, one with responsibilities to the community which because of its size and influence extend beyond that of providing healthcare. We also note from the Health Foundation website the stated commitment of Anchor Organisations to “work more closely with local partners” and “reduce its environmental impact”.

As a local partner, we welcome the opportunity to engage with the NHS at the highest level over decisions regarding the future of the Astley Ainslie site.

We hope that the NHS will honour that commitment.