Agenda item

Ms Rachel Benton, Programme Director – Hillingdon Hospital Redevelopment at The Hillingdon Hospitals NHS Foundation Trust (THH), advised that good progress had been made with the three-stage business case process.  Stage one had been completed with approval from Ministers in 2021 and the Stage 2 Outline Business Case had been approved by the Trust in October 2022.  The team was now working with the Treasury regarding next steps with confirmation anticipated in March 2023 (although this timeline might shift).

It was noted that, on 18 January 2023, Hillingdon’s Major Applications Planning Committee approved the Trust’s planning application for the redevelopment.  This would now need to be considered through the Greater London Assembly’s Stage 2 planning process.  The poor condition of the building meant that there had been a significant maintenance backlog as well as issues with overcrowding and ventilation which all had an impact on staff morale as well as retention and recruitment.  The poor layout inside the hospital also led to inefficiencies.  Mr Jason Seez, Deputy Chief Executive, Director of Strategy and Senior Responsible Officer for the Hospital Redevelopment Programme at THH, advised that decant and enabling work would continue through 2023/2024. 

Ms Benton noted that there had been significant underinvestment in Hillingdon Hospital over a number of decades which had driven the need for change.  Temporary buildings had been put in place pre-war that were still in use today and only the first half of a two-stage development planned in the 1960s had been completed.  Professor Abbas Khakoo, Clinical Lead for the Hillingdon Hospital Development at THH, advised that new departments and services had been added on over time wherever the space had been available, so the patient and staff experience was often a chaotic journey.

The new hospital options had all been stress tested with the preferred option being a full new hospital in a single-phase development.  The current hospital would remain open and operational during the build.  It was anticipated that the new hospital development would be funded predominantly through Government central capital with the remainder being met from money raised from the sale of a small amount of land on the east of the hospital site for development. 

With regard to the practicalities of the impact of the build on neighbouring properties, Mr Seez advised that lessons had been learnt from other large developments in the area such as the school.  The executive summary that had been presented to the Planning Committee had been around 200 pages; the full report had included fine detail such as the need to wash the wheels of lorries as they came off the site. 

Members were advised that the design of the building had been informed by the clinical model as well as by patients and the public.  The result had been an eight-storey building with lots of access to natural light and related services located close together.  The emergency department had been positioned on the ground floor and outpatients on the first floor of the new build (linked to the car park via a bridge) as these areas would have high footfall.  Greater access to outdoor spaces had been included in the plans as well as an increase in the number of rooms which would be more flexible.  Areas had also been developed to support staff wellbeing.

Professor Khakoo advised that the single rooms for adults and children would have exactly the same footprint but would be decorated accordingly which meant that they could easily be repurposed if needed.  This meant that it would be easy to build the room units off site and then assemble them once they arrived on site.

Professor Khakoo reiterated the importance of natural light, particularly for areas such as the chemotherapy space.  Children and parents had already been involved in the design of waiting areas and would continue to be involved as the project moved into the 1:50 stage.

The new hospital design would see the Emergency Department located near to specialist services, a new midwife-led maternity unit next to the labour ward and an increase in the number of scanners (increasing from one to three MRI scanners and from two to five CT scanners).  There would also be a doubling of the number of critical care beds (to 20), which would help to care for the increasingly ageing population and digital technology would be used to help with things like wayfinding.  A mobility hub would also be put in place to provide transport options.

Professor Khakoo thanked Members for the help that they had offered in suggesting community groups for the Trust to contact as part of the engagement process.  A number of engagement events had been undertaken with community groups, the public and staff and leaflets had been distributed and feedback had been sought to changes in the design.  This engagement would continue as the development plans progressed. 

Members queried how the new development would support the continued integration of health and social care.  Mr Keith Spencer, Managing Director at Hillingdon Health and Care Partners, advised that he worked on behalf of NHS and voluntary sector partners and had been involved in the development of a comprehensive Out of Hospital Strategy.  The key would be to ensure that measures were put in place to prevent admission in the first place and the good work already undertaken in Hillingdon had resulted in the Borough having the lowest admission rate for over 65s and the lowest number of admissions from care homes. 

Mr Seez noted that, in Autumn 2019, the Health Infrastructure Plan had named 40 hospitals for redevelopment which were then split into four cohorts.  Hillingdon had been included in cohort 3 with seven other hospitals which were known as the pathfinders.  Ms Benton noted that not all of the eight pathfinders had developed their Outline Business Case and that Hillingdon’s had been the most recently approved.

Hillingdon had continued to work with NHS England to highlight the strength of Hillingdon’s case and the strength at place level and as part of the wider integrated system.  NHS London had been supporting strong bids from Whips Cross, Epsom St Hellier and Hillingdon with Hillingdon positioning itself as a Trust that was embracing new ways of working that would be a showpiece for what the NHS could do. 

Ms Benton noted that the new build would improve the Trust’s financial position, supported by cash releasing benefits of £11.5m per annum through increased productivity, which would support in moving to an economically sustainable hospital.  With regard to capital funding, the New Hospitals Programme was taking it through the National Projects Review Group with Treasury input to establish what the total capital allocation will be to then determine Hillingdon’s share of that. 

Insofar as the future of Mount Vernon Hospital was concerned, Mr Seez noted that a range of services were being provided from the site which were likely to get busier over time, with a number of corporate services relocating to the site.  In addition to the £7.5m that had been invested in the Mount Vernon Cancer Centre, other providers had made significant capital investment on the site over the last few years. 

RESOLVED:  That the update on the Hillingdon Hospital redevelopment project be noted.