Agenda item

Mr Jason Seez, Hillingdon Hospital Redevelopment Programme SRO, Deputy Chief Executive and Director of Strategy at The Hillingdon Hospitals NHS Foundation Trust (THH), noted that the Committee had last been provided with an update on the hospital redevelopment at its meeting on 8 September 2020. 

In terms of the process for delivering a new hospital, the Trust needed to follow the HM Treasury’s Green Book business case process to show that all options had been considered and that the best option had been progressed.  This was a three stage process: Strategic Outline Case (SOC); Outline Business Case (OBC); and Full Business Case (FBC).  The SOC had received approval from the Department of Health and Social Care (DoH&SC) and NHS England / Improvement (NHSE/I) Joint Investment Committee on 5 October 2020 (subject to conditions being met in the OBC) and the OBC was currently being worked on.  Designs were being progressed at pace and place-based work was underway with Hillingdon Health and Care Partners (HHCP) and the North West London Integrated Care System (NWL ICS).

Ms Rachel Benton, Programme Director, advised that a team had been put in place to take forward the development of the business case in partnership with the local system.  She noted that investment in new hospitals was managed centrally by the DoH&SC and NHSE/I jointly through the New Hospital Programme team who regularly reviewed the work undertaken on the Hillingdon Hospital development. 

A Schedule of Accommodation had been developed which mapped out the space that would be needed.  This had been discussed at length with partners such as the local authority and the GLA.  The first stage drawings (1:500) showed where the rooms would be in the new development but did not show the detail within each of those rooms (which would be included in the next stage).  It was anticipated that these design layouts would be shared with partners in late May 2021 and feedback would inform the more detailed design layouts (1:200 and 1:50). 

Dr Abbas Khakoo, Clinical Lead for the Hillingdon Hospital redevelopment, advised that the Trust’s Clinical Services Strategy had been signed off by all partners (including Social Care) in April 2020.  Although it was not anticipated that the range of services currently provided would change in the new hospital, there would be a more efficient flow of patients.  The Clinical Services Strategy looked to implement a fully integrated health and care system with a focus on prevention and strengthening primary, community and social care services.  The Strategy also focussed on collaborative working and transformation which would be delivered within the framework of HHCP.  It was anticipated that this would result in more health and social care being provided outside of the hospital setting which would result in better quality emergency and elective care being provided in hospital. 

Over the next year, work would be undertaken to strengthen the care provided by the Hillingdon neighbourhood teams.  The departments at Hillingdon Hospital were currently fragmented with a poor flow of patients and an inefficient set up.  The new hospital would facilitate new models of care by having a better estate and providing more efficient co-location of services. 

Dr Khakoo advised that, under all circumstances, there would be a need for more diagnostic imaging.  As such, there would be an increase in the availability of these services in the new hospital.  With more care being provided outside the hospital setting, there would be a greater need for high dependency and intensive care at the new hospital. 

Ms Caroline Morison, Managing Director at HHCP, advised that providers had already been working together in Hillingdon over the last two years.  This work had resulted in great models of integration around things like paediatric integrated clinics which were being held in primary care settings.  This also provided upskilling, education and training for primary care clinicians.  The Hospital Discharge Team and Care Connections Teams were also identified as examples of good practice. 

Mr Tahir Ahmed, Director of Estates and Facilities, advised that the 1:500 scale design layouts had been agreed by the Trust Board on 6 April 2021 for discussion with Hillingdon Town Planners.  The development of the designs had followed national guidance as well as prescribed methodologies and building requirements and had followed a net zero carbon approach.  When asked about whether the building itself would be carbon neutral, Mr Ahmed advised that the team had looked at recycling but also about designing to cover lifecycle management.  Although hospitals used a lot of power, ventilation, etc, the net zero carbon sustainability agenda was moving at pace so this would be considered for the future. 

Modern methods of construction were being considered to respond to future needs as well as speed up the construction process.  The Planning Performance Agreement had meant that there had been an iterative process of sharing information with the Council’s planning team, receiving feedback and acting upon that.  These meetings had been extended to the GLA. 

The process was now moving into stage 4 of the planning performance engagement.  This stage was expected to complete in the middle of June when a more detailed application would be developed.  It was anticipated that the planning application would be determined around Christmas 2021.  Mr Seez was cognisant that there had previously been unsuccessful attempts to build a new hospital so it would be important to ensure that all stakeholders were in agreement through these early stages of the process so that consultation could be undertaken with confidence.  As such, it was likely that construction would start in 2023 with a completion date some time in 2026. 

Mr David Meikle, Finance and Procurement Lead, advised that the SOC had been agreed subject to a number of conditions.  To this end, work was underway to refine the financial model to ensure that the new hospital was affordable.  In terms of mitigations to improve affordability, it was noted that confirmed land sales would be included and would reduce the overall capital required.  These mitigations would continue to be developed as the Trust moved from 1:500 to 1:200 drawings to ensure that any gaps in the affordability case were closed. 

Ms Sarah Bellman, Communications and Engagement Lead for the redevelopment project, advised that the early stages of engagement had been about raising awareness that the redevelopment was a possibility.  Initially there had been public and staff webinars which had been held online because of the pandemic.  An open recruitment process had been undertaken to establish eight Public Participation Forums, seven of which were aligned with the Clinical Cabinet Working Groups and the eighth being a communications and engagement forum.  Community engagement had also been undertaken with residents’ associations, Healthwatch, schools and faith groups and information had been included in various newsletters.  A microsite had been set up and surveys had been made available there.  As the project progressed, these surveys would become more specific. 

Consideration was now being given to soliciting feedback on what the hospital would look like on the inside and the outside.  In May 2021, there would be information available about the proposed changes to care and how those improvements would be made.  Between June and August 2021, there would be a public exhibition (initially online) where there would likely be more communication and engagement activity undertaken.  Ms Bellman had been liaising with the Council’s Communications Team to look at displaying exhibition information (designs and plans) in libraries, leisure centres and vaccination centres around the Borough.  It was hoped that there would also be some face to face community engagement if the pandemic restrictions allowed.  Ms Bellman would be happy to share the more detailed communication plan with Members of the Committee.

It would be important to engage far and wide with existing users of the hospital as well as future users, staff and other stakeholders to give individuals the opportunity to help shape the plans.  As well as using Facebook, information was also being disseminated through local community forums, in newsletters and in Healthwatch’s shopfront.  Letters would also be sent out to those residents living in the immediate vicinity of the hospital.

Members were happy to see that action was being taken to future-proof the new development by factoring future clinical need into the design to allow it to adapt over time.  Mr Seez confirmed that the new development had a flexible build design with sufficient space to accommodate new physical ways of working.  Mr Ahmed noted that the design enabled adjoining spaces to be converted / joined to adapt to changing needs and that the team had been looking beyond the new building to allow for additional expansion if needed. 

Mr Ahmed advised that a pre-Covid modelling process had been undertaken with regard to car parking requirements for staff and patients on the new development, given that public transport options were limited.  Discussions were currently underway to develop a strategy in relation to parking.  It was hoped that the Green Travel Plan that had been developed would help to reduce the need for cars. 

Ms Morison advised that it would be difficult to quantify the number of services that would be moving off site as partners had been working differently across care settings and partner interactions had developed.  Consideration was being given to working through GPs and in the community and to different ways of communicating.  Community teams had been able to help keep residents in their own homes and NWL was now looking at the initiation of diagnostic hubs in community settings. 

Mr Seez noted that, whilst the new hospital was being built, it was likely that the Trust would need to use the Mount Vernon Hospital site more.  However, he was aware that the Trust would need to go through a similar process with the Mount Vernon Hospital site. 

RESOLVED:  That:

1.    Ms Bellman share the more detailed communication plan with Members of the Committee; and

2.    the presentation and discussion be noted.