A hospital fit for the future

Jo's original article appears the August issue of T&A on page 30. She sent this amended article with a slight amendment to para 4 before publication but her email got lost in the ether. Apologies.

I’ve recently had meetings with several of the executive team at the Queen Elizabeth Hospital and while we’re all relieved to hear that our Trust is going to be included as a special RAAC cohort onto the 40 new hospitals programme, we do still need to keep a very close eye on the situation, to ensure that any hospital that is built, is going to be fit for the future – an ever growing population and an aging population.

I think we’re all expecting that a new build will be bigger. We only have to look at the Norfolk and Norwich hospital to see that even though it has 1200 beds it’s still too small for the needs of the community it serves. Plans initially set out that a new QEH would be 38% bigger than the current building. But the new modular build it is likely that we’ll have, which have been labelled Hospital 2.0, are apparently going to be designed so that they do what can only be done in a hospital. This sounds sensible, but in fact the hospital provides the services it currently does because community services and primary care have had their funding cut too. And with the hospital currently running at 97% bed occupancy and with our population set to grow, it's clear that a hospital of approximately 500 beds won't suffice.

While AI, genomics, new therapies and other emerging technologies will impact on what needs to be delivered in a hospital and what can be delivered in the community in places like minor injuries units, cottage hospitals and in primary care, we know that there will be challenges to this down purely to funding and who gets what. If a new hospital is going to be built based on the fact that it won't be delivering everything it currently does, we do need the reassurance that we’ll get still get those NHS services locally, albeit not in the actual district general hospital.

An acute clinical strategy for the three acute hospitals in Norfolk will see pathways that are built on each trust's strengths, which means we won’t get all the levels of our health care needs provided directly BY our hospital but the NHS staff member will be a part of a team employed by, potentially, the James Paget or the NNUH. However, we’ve been assured that it’s the staff member who would travel to deliver the service and not the patient. We do have to travel to access those services only provided by a tertiary care provider and they’re at Addenbrookes or the NNUH. It could see our Trust provide stroke care or frailty care to the whole Norfolk community if that is what we end up specialising in, but again, those in Lowestoft would see a QEH member of staff travel to their centre, not them have to come to the QEH.

It's anticipated that the new hospital will be 100% single rooms because this has proven benefits when it comes to infection control. We therefore must hope that the newly announced workforce strategy has had a positive impact on staffing levels and that staff retention has improved.

There are reports that state that 7 of the 11 of the cohort 4 New Hospitals won't be completed by 2030. I have been reassured that as our hospital is in a special RAAC cohort then we’ll be ok. Indeed, Health Minister Stephen Barclay actually stated that there’s no life beyond 2030 for the RAAC builds.

With the remedial failsafe work still going on, it’ll be another 2 ½ years before all the decant moves and disruption comes to an end. So we have to expect moves and changes for the next few years I’m afraid.

There is still some important work to do and one of those big ticket tasks is to undertake data analysis looking at all the new housing plans in places like West Winch, Hunstanton, South Wootton etc, so all our future growth is built into the updated Strategic Outline Case and we make sure that we do get a hospital fit for our needs. Rest assured, we’ll be watching this space keenly.