I recently acquired this postcard of the cottage hospital in Tenbury. It wasn’t a hospital that I was familiar with, and it seems to have missed out of the RCHME hospitals survey – perhaps because it lies on the border of two counties, Tenbury itself being in Worcestershire while the hospital lies over the river, and over the county boundary, in the Shropshire parish of Burford. Shropshire was one of the counties that I worked on, but this hospital slipped through the net. It’s a pity, not least because it is still an NHS hospital and the original section is a listed building.

The hospital was established in a converted house in 1869, and originally called St Mary’s Cottage Hospital. The early nineteenth century house was extended westwards around the turn of the century. The extension is probably the part shown on the postcard to the left, with veranda and balcony. In the 20th century the hospital expanded on its east side. It is currently (2024) a community hospital administered by Worcestershire Health and Care NHS Trust.

The original building seems to have been listed because of its interest as a house. It was built around 1835 by Richard Titt, landlord of the Swan Hotel, who died in 1843, aged 86, having been the Swan’s landlord for over 40 years. However, it is also historically important as an early example of a cottage hospital in England, having opened on 1 September 1869. This was only ten years after the very first cottage hospital which opened in 1859: Cranleigh Cottage Hospital, Surrey. It is particularly rare to find a first-generation cottage hospital still using its original building.

The hospital featured in Horace Swete’s Handy Book of Cottage Hospitals published in 1870. Swete described the hospital as a ‘small villa, with garden, coach-house and stable, altered for the purpose’. Patients contributed a small fee towards the cost of their care and treatment, charged at a weekly rate. Mrs Arabella Prescott served as the lady president of the establishment, and it was she who had purchased the house and footed the bill for fitting it up as a hospital, including the provision of linen, dressing-gowns and slippers for the use of the patients.

There was no connection to a mains sewer, so earth closets (or ‘earth commodes’ as Swete termed them), were used throughout the hospital. The floors were waxed and polished ‘with a view to greater cleanliness’, but Swete was critical of this, as it might make the floors slippery: ‘A poor fellow getting out on his crutches for the first time, would find considerable difficulty in walking upon it without falling’.

The hospital had a convalescent ward, and the coach-house was converted into a mortuary chamber, top-lit and fitted with a slate-topped table. The nurse in Swete’s time had formerly been a sister at Middlesborough Cottage Hospital. By 1910 the Tenbury cottage hospital had 9 beds, later extended to 12. An extension was built on the east side of the original house in 1912 named the Elizabeth Wing.

In 1915 the hospital featured in Henry C. Burdett’s How to Become a Nurse which listed the requirements for of various hospitals for trainees. St Mary’s, as it was then still known, took on young women for a month’s trial after a personal interview, which if satisfactory, led to one year’s training. Women had to be between 20 and 22 years of age, between 5ft 2in (1.57m) and 5ft 11in (1.80m) in height, with satisfactory evidence as to character and health. ‘Applicants should be of the upper middle class and Church of England’. Training included lectures by the matron on anatomy, and examinations were held twice yearly. ‘Laundry and text-books provided. Separate bedrooms.’

Although the hospital charged fees for admission and subscriptions from wealthier supporters, fund raising was an essential activity. Church collections were the main source of ad hoc donations. The nearby Swan Hotel hosted an ‘invitation charity ball’ in December 1884, and in 1899 and 1900 a ‘guess the weight of a cake’ competition. The Hotel later instituted an annual ball which took place until the outbreak of the First World War. Nevertheless, by the later 1890s the hospital’s income did not meet its expenditure, causing the hospital to dip into its endowment funds.

St Mary’s survived into the 1920s, but had to close in 1928 in the face of rising costs and staffing difficulties. All was not lost, and in 1931 it was re-orgnised and re-opened as Tenbury and District Hospital, with a further extension to the east opened in 1935 to provide an operating theatre. In the hospitals survey conducted by the Ministry of Health during the war it was described as having 16 beds, maintained by the Tenbury and District Hospital and Nursing Association. Six local general practitioners formed the honorary medical officers alongside a general surgeon from Leominster, an ear and throat surgeon from Kidderminster and a dental surgeon.

Under the NHS the hospital was well supported by the local league of friends. Expansions and modernisation improved facilities, and in 1986 a new outpatients department was built. A Millennium Project provided a further extension .

[Sources: Tenbury and District Civic and Historical Society, Tenbury and the Teme Valley People and Places, 2007: Horace Swete, Handy Book of Cottage Hospitals, 1870, pp.161-2: Report of the Royal Commission on the Poor Laws, 1908: Worcester Journal, 5 Jan. 1843, p.3: Wellington Journal, 27 October 1877, p.8: Tenbury Wells Advertiser, 16 Dec 1884, p.4; 31 Oct. 1899, p.5; 30 Jan. 1900, p.5: Kington Times, 6 July 1935, p.4: Ministry of Health, Hospital Survey. The Hospital Services of the West Midlands Area, 1945.]