The collections now held by the George Marshall Medical Museum were nearly done for!

A clipping from the Worcester Evening News on Monday 17 February, 1997.

The ‘Worcester Development Project’ and the transition from institution to community care

For the past few months I have been researching Worcester’s modern medical history (using the Archives at The Hive), with the aim of developing a final topic of discussion based around the NHS and health authorities within Worcester. Within the primary resources I found at The Archives, I found myself drawn to the resources regarding the treatment of mental health. With some more research, I found that a project had been undertaken in the 1970s and 1980s with the express aim of making the transition from the more traditional style mental hospital, Powick, to a new idea of ‘community care’. This became the Worcester Development Project.

The Worcester Development Project was devised in the early 1970s and was initiated by the Department of Health in 1978. It was termed a ‘test-bed’ for a new style of mental health treatment, in an attempt by the government to move away from the previous use of large mental hospitals and move towards a system in which treatment of mental health would be carried out within the community. This was primarily to be done through the closure of Powick Hospital and the establishment of a complex system of replacement units such as day centres, wards attached to general hospitals, and residential hostels[1]. Originally built in 1852, Powick was a large institution that in relation to the national performance of such hospitals, was performing above average; a draft feasibility study compiled by the Department of Health and Social Services in 1969 indicated that only 16% of patients at Powick were classed as long-stay, performing better than the national average[2]. Despite this, the idea of treatment within the community instead of more isolated institutions was growing amongst the government and the public and ultimately, a new system of care was developed with Worcester. 

Previously unaware of the use of Worcester by the authorities as an ‘experiment’ of a new way of treating mental health, the topic intrigued me. The focus of my attention for the remainder of my research will therefore be on the transition from institution to ‘community care’ carried out within Worcester during the Worcester Development Project.

Within this broader area of discussion, I have identified three key areas of research necessary; the reasons for community care and the driving forces behind this, a comparison between the initial plans for the project and the eventual outcome, and thirdly the public reception of ‘community care’ and responses to the Project from a variety of different sources. Through this, I am hoping to find and present an interesting account of the transition from institution to community within Worcester, taking into account different sources with different agendas, focuses and viewpoints.

Powick Hospital from the air, ©Charles Hastings Education Centre

Powick Hospital from the air, ©Charles Hastings Education Centre

[1] P. Hall, R. Gillard, ‘The Worcester Development Project’, International Journal of Social Psychiatry, Volume 28, 1982, pp. 163-172.

[2] Draft Feasibility Study for the Worcester Development Project, June 1969, Archive Reference BA12248/1 (i).


Fern Evans        

My Experience So Far

As way of introduction - I am a second year History and Political Science student at the University of Birmingham. As part of my study programme I was offered the opportunity to work at the Worcester Medical Museums to gain experience and to understand what working with a museum entails, and to complete a research project on any aspect of the National Health Service I liked (a lot more flexibility than I am used to in my university topics). The topic of the NHS was appealing to me, as I personally have family members who are long-time employees of the NHS and thought the opportunity to learn about such a key organisation in such depth was too good to pass up.

So far, I have been getting to grips with the general topic of the NHS, familiarising myself with the history, structure and scope of the organisation. This has meant sifting through the archives about health provision – and later the NHS – in the local area in The Hive which at first felt like it was all written in a different language, as there is so much information ranging from the 1800s all the way to the 2000s. After I gathered my bearings, I found some very interesting areas of the NHS that would be great to study in more detail which I intend to follow up on soon.

One of my favourite findings so far was some information on the changing role of administration within the health sector. Whilst at first I was not immediately drawn to the role of management and administration, an article titled ‘Kindly Technicians’[1] gave a very interesting in-depth account of how the role of NHS managers had changed immediately following the establishment of the NHS in 1948. The article suggests that prior to the NHS, administrators were seen as ‘kindly’ and rarely engaged in conflict with doctors but by the 1960s this role seems to have shifted from one of administration to that of a ‘diplomat’, due to increased conflict between doctors and management which caused administrators within hospitals to dedicate a lot of time to smoothing out these issues.

I found it interesting to think about how the setting up of the NHS actually impacted on the day-to-day running of hospitals. Today, there is perhaps less of a focus on the need for hospital administrators to be ‘kind’, with an increasing use of terms such as ‘targets’ and ‘efficiency’. This is not to say, however, that this is necessarily a failing of the NHS – efficiency is undoubtedly a key quality of any hospital. The more recent efficiency drive that has led to changes in the organisation on an administration level could be due to increased burdens placed on the NHS since its establishment.


Fern Evans



[1] Mark Learmonth, ‘Kindly Technicians: Hospital Administrators Immediately Before the NHS’ Journal of Management in Medicine 12, 1998, pp. 323-330.