Agenda item

The Chairman welcomed those present to the meeting and noted that no one would dispute the need for a new hospital in Hillingdon.  Mr Jason Seez, Acting Chief Executive Officer at The Hillingdon Hospitals NHS Foundation Trust (THH), introduced the representatives present from THH.  He advised that the CQC would be making an announcement on 9 September 2020 regarding the Trust’s management of infection prevention and control measures.  Mr Seez assured Members that he and his colleagues would be happy to attend a future meeting to discuss this matter fully. 

After many years of trying to get a new hospital in Hillingdon, progress was being made through working in partnership with other stakeholders.  It was anticipated that the proposed new hospital would be completed by 2025 and, as such, momentum needed to be maintained.  Given the significant level of repairs that were needed on the current site, speed was imperative. 

Dr Ian Goodman, Chair of Hillingdon Clinical Commissioning Group (HCCG), advised that, from the organisation’s inception, HCCG had built close relations with Hillingdon Hospital and that it would be important that a whole system holistic approach was taken to building a new hospital that was more convenient for residents.  Progress had already been made with regard to reducing wait times by running paediatric clinics in many GP surgeries, improvements in same day hospital based emergency care and lean discharge planning. 

To reduce the number of patients going to hospital, and deal with them in the community instead, Dr Goodman noted that HCCG had been working with consultants in an advice and guidance capacity.  The Trust had also been working with other acute hospitals to address the backlog of elective care and work was underway with regard to sharing electronic patient records between hospitals. 

Various site options had been considered and narrowed down to two options: the Brunel University site and a new build on the existing Hillingdon Hospital site.  The latter option had been preferred as it could be delivered three years quicker and would cost less.  However, Dr Goodman advised that links with Brunel University would still be strengthened and further opportunities extended. 

Mr Seez believed that a new hospital on the existing site would be achievable by 2025 and that the associated finances could be secured.  It was anticipated that the new hospital would have space for health and social care partners which would reduce disruption to patients.  This would be explored further during the outline business case process.  The THH Board had approved the draft Strategic Outline Case (SOC) which was now being finalised with the regulators before being published in October 2020 – the Committee would be kept updated on the progress of the SOC. 

The regulators would need assurance from the Council that the development had not triggered the need for consultation as there was no substantial variation to the service.  This had also been discussed separately with Healthwatch Hillingdon.  Members agreed that the proposals would not trigger the need for public consultation if significant public engagement were undertaken throughout the process.  Ms Sarah Bellman, Communications and Engagement Lead at THH, advised that any public engagement would be thorough and not just a tick box exercise.  Regular newsletters would be produced which incorporated the feedback captured in a “You Said/We Did” format.  The Committee would also be regularly involved in the process.  Summarising the views of the Members, the Chairman stated that the development as set out would not trigger public consultation but that meaningful and effective engagement would be a must throughout the process.

With regard to the operation of the existing hospital whilst the new hospital was being built, Mr Tahir Ahmed, Executive Director of Estates and Facilities at THH, advised that a decant strategy was already in development.  He noted that improvements to the existing building would need to continue but that the intention would be to decant the west side of the site first so that it was freed up for the new development.  It was anticipated that, in the short term, some of the hospital facilities would improve and that all services would remain fully operational during the project. 

Consideration had been given to decanting some of the services to another site during the development work.  Mr Ahmed advised that THH had been in discussion with a number of hospital contractors very early in the process who had provided buildability advice and identified that there was evidence to support the retention of all services on site during the build.  A complete decant had also been considered and discounted as the provision of temporary facilities would take more time to organise.  Instead, it was proposed that the services provided in the dilapidated estate be moved to modular accommodation on site with a life expectancy of 5-10 years which would exceed the project timelines. 

There were significant concerns expressed over the decant programme, and the notion of building whilst health and medical services were still present on site.  It was a built up area with local residents living very close by and the surrounding roads were already very busy with access, local and University traffic.  Building a new hospital whilst retaining some buildings which were already unfit for purpose and/or moving in temporary buildings appeared to Member to be a high risk operation for hospital users, patients and staff.  Members could not grasp the concept that a total temporary decant to another site would be more costly and time consuming when the benefits of a clear site were apparent.  There were considerable concerns expressed as to the complexities’ and risks involved in such a build with all that entails and maintaining services on the same site.  Member believed that the THH team should reconsider this aspect of the project.

In addition, the development would follow the Considerate Constructors Scheme initiative to reduce the impact on the existing hospital and the residents in the area.  Engagement would also be undertaken with schools and authorities to ensure the least amount of disruption to the local community. 

Sir Neil Mckay, Strategic Advisor to THH, noted that, although the development was a huge opportunity to modernise the hospital, it also needed to be a catalyst for the delivery of care in a more integrated way to include primary care, nursing and residential homes and social care.  This had been supported by the broad mindedness of the clinicians who had clear views about the need to work differently.  To this end, it was suggested that consideration should be given to the inclusion of facilities such as a dementia centre and dental centre in a health and care campus on site.

Dr Abbas Khakoo, Clinical Lead at THH, advised that a number of clinical working groups had been set up to look at the pathways into and out of hospital and it was noted that he had been developing a clinical strategy for future service provision.  Currently, some complementary services were not positioned in close proximity in the existing estate.  As such, consideration would need to be given to their location in the new build.  This would also provide an opportunity for the Trust to work with partners in community care to further reduce the number of patients in hospital and capitalise on the delivery of care in the community by using enhanced diagnostics. 

Concern was expressed regarding the impact of the merger of the eight North West London (NWL) CCGs on the development of a new hospital in Hillingdon.  Dr Goodman advised that there would be minimal impact as HCCG was currently at a more advanced stage than the other seven CCGs with better arrangements in place which was partly due to coterminosity.  He noted that 80-85% of Borough residents would use Hillingdon Hospital in its current state which was higher than other hospitals in neighbouring areas.  In addition, Mr Seez stated that the Integrated Care System and support from the Mayor’s Office was in place to help the development move at pace. 

It was suggested that the proposed timeframe to deliver a new hospital was ambitious and that this had resulted in a limited range and growth of services for the proposed development.  Members were keen that the short timescales did not prevent the Trust from undertaking full and thorough engagement with the diverse range of residents in the Borough.  As different parts of the community had different experiences, Members were keen to hear about plans for engagement with sub sections of the community, such as black pregnant women, to ensure that the planned engagement reflected the diversity of the local population, particularly ethnic minority groups.  Members were asked to forward details of minority groups to THH that could be involved in this engagement activity.

Ms Bellman advised that the Trust was starting to work with residents associations in the Borough and had been using the Nextdoor social networking platform.  In addition, contact was being made with faith groups and patient groups.  Community leaders were also being engaged to reach out to their own communities and encourage feedback. 

With COVID-19 preventing the Trust from undertaking large scale face-to-face engagement, alternative methods of communication would need to be employed.  The COVID-19 pandemic had resulted in more people becoming more familiar with technology and this had meant that more individuals who had not previously engaged in consultation were coming forward with their views.  Members urged caution with the reliance on technology for engagement as there were still a large number of individuals who were not comfortable with it and who would not engage using this medium. 

Mr Seez advised that investment objectives and stakeholder engagement would be key in building a new hospital.  This had been discussed with the regulators who had been happy with the robust process that had taken place to date.  These discussions would need to continue with partners as the project moved forward whilst also being cognisant of the timelines.  The Trust had been securing the best individuals to lead on the different elements of the project to enable to project to move forward quickly. 

It was suggested that the Trust would need early engagement with Hillingdon Planning Department to work through any possible issues.  Given that the site was not the easiest to reach by public transport, it was also suggested that the Trust liaise with Transport for London (TfL) and the Mayor’s Office.  Mr Ahmed advised that the Trust had already engaged with TfL, a transport consultancy and the local authority regarding the Green Travel Plan and had proposed an enhanced bus connection service within the confines of the site.  THH had also already had sizeable engagement with the Council’s planning team and was currently shaping a Planning Performance Agreement (PPA). 

Mr Seez noted that there had been previous moves to secure the development of a new hospital in Hillingdon but that these had failed because attempts had been resourced as a cottage industry and because it had not been as joined up locally as it had needed to be.  The project was now being properly resourced and all system partners (both locally and within NWL) were supportive of the development of a new hospital in Hillingdon. 

The Chairman noted that the Committee would welcome further engagement with the Trust as the project developed, either within scheduled Committee meetings or at specially convened meetings.  On behalf of residents, the Committee warmly welcomed the progress made so far in seeking to achieve a new build of Hillingdon Hospital and wholeheartedly endorsed the need for a new hospital, given the long desire of residents and the Council for a new hospital to be built – Hillingdon residents and other users deserved nothing less.  The Committee looked forward to being able to provide a strongly supportive and constructively critical role at every stage of the process and development of what was envisaged would be a “state of the art” hospital facility to serve Hillingdon’s residents and wider community for the long term future.

RESOLVED:  That:

1.      the Committee supports the development of a new Hillingdon Hospital;

2.      the Committee agrees that there would be no need for a formal public consultation if thorough public engagement was undertaken; and

3.      the presentation be noted.