The route took a mostly direct path from a junction immediately south of Hellingly Station, past Farm and Park House Sidings, stopping places to load and unload produce and supplies from outbuildings of the hospital.
[2] Building materials were transported to the site by a 1+1⁄4 mile (2 km) standard gauge private siding from the goods yard at Hellingly railway station on the Cuckoo Line.
The connection was built by the asylum's builders, Joseph Howe & Company, and was authorised by the London, Brighton and South Coast Railway (LBSCR) on condition that East Sussex Council paid the cost, estimated at £1,700.
Although the railway joined the Cuckoo Line at both the northern and southern ends of the platform, virtually no through trains ran.
On the approach to a level crossing the fireman ran ahead with a red flag, to stop the traffic; he also manually operated the points.
[9] Joseph Howe & Company used an 0-4-0 saddle tank locomotive to transport building materials during the hospital's construction.
[6] The power plant (to generate the electricity for the hospital and railway) was the creation of Messrs Spagnoletti & Co (of London).
James was first employed on the railways, but created his own company building electricity generation plant.
Engineers Robert W. Blackwell & Co provided a small 0-4-0 electric locomotive capable of pulling two loaded coal wagons.
[15] Because service levels depended on patient numbers and the hospital's coal and food requirements, the line never operated to a timetable.
[18] On 22 November 1939, plans were put in place for the restoration of passenger services to allow ambulance trains to reach the hospital, and authorisation was given for their operation.
With a greatly reduced need for goods traffic to the hospital following the conversion of the boilers, it was decided that the railway was not worth the expense of continued maintenance and necessary upgrading, and the line was officially closed on 25 March 1959 following the departure of the last coal wagon.
[22] Traces of the railway can still be seen, including a cast iron pole that supported the overhead wire, the remains of the engine shed (burnt down in 2004), and a short section of track.