Agenda item

Jerry Hawker, Senior Responsible Officer and Integrated Care System Executive Director for the Lancashire and South Cumbria New Hospitals Programme, Rebecca Malin, Programme Director for the Lancashire and South Cumbria New Hospitals Programme, and Jane Kenny, Lead Nurse for the Lancashire and South Cumbria New Hospitals Programme attended the meeting and provided an update on the current position of the Lancashire and South Cumbria New Hospitals Programme since they last attended Health Scrutiny Committee on 23 March 2021. A recap of the background and the context was also provided. The key purpose was to share the shortlist of options for new hospital facilities.

Comments and queries from the committee were as follows:

·  On the feasibility of the option to have two new hospitals to replace
Royal Lancaster Infirmary and Royal Preston Hospital (new sites), there had been close engagement with the government during the shortlisting process, but feasibility could not be confirmed at this early stage. However, as the new build option was on the shortlist, it was seen as an indicator of an agreement to continue to pursue and explore those options and there would be more discussion with the government over a six to nine month period regarding capital affordability. It was noted that cost in terms of capital was only seen as one element and a strong part of the development of options was exploring benefits in improving efficiency and productivity, and at a wider socio-economic level. The government had not yet provided a maximum amount of capital, although they had been clear that they were looking for return on investment as the most significant argument that the New Hospitals Programme must deliver to demonstrate value for money for taxpayer's investment. Indicative capital had become less of a focus than demonstrating the return on investment. When the New Hospitals Programme team undertook the shortlist, they maintained options which gave them a broad spectrum of capital revenue potential and there had been significant financial analysis carried forward around return on benefit.

·  If there were two new hospitals built on new sites, services could be maintained and have a short, phased transition across sites. With rebuilding on the existing sites, phasing would become a more critical factor as there would be more costs and considerations to take into account.

·  Assurance was provided that the two hospitals would be built and ran by NHS organisations and the two NHS trusts were committed to operating the services. With regard to the construction of the two hospitals, the New Hospitals Programme were working with the Local Enterprise Partnership to ensure local businesses had the maximum opportunity to be involved in whichever successful option of the building programme went ahead. The programme was also working with the government with a view to enable local companies to be involved in both construction and ancillary services.

·  In terms of the impact on other local hospitals and in particular Chorley and South Ribble Hospital, it was reported that services continued to be invested at that site as recognition that they were significant to the local community.

·  There was not a matrix or formal scoring system used for shortlisting options. The New Hospitals Programme team took guidance and instead used a RAG rating of 'met', 'partially met', or 'did not meet at all' as the mechanism. The team intended to publicly publish further information behind the shortlisting process and key deliberations which enabled the shortlist of options. 

·  It was clarified that a land agent had been appointed, who were undertaking desktop research for land sites which could cater for two new hospitals. The New Hospitals Programme team would update the committee when they had more information. The team were also working with senior officers in local authorities, as they recognised both the link from planning considerations but also the strategic views.

·  The timeline for the New Hospitals Programme to start construction work was 2025, with a view to sites being opened in 2030. It was confirmed this was on track.

·  On public engagement, the New Hospital Programmes team were collecting feedback regarding the shortlist of options and established that engagement would continue as they gained more detail. If there was a requirement to formally consult, a pre-consultation business case would then be developed with an engagement plan. The team with assistance from The Consultation Institute, were committed to continue with the level of engagement and listening.

·  In response to worker housing schemes being developed alongside the new hospital sites, the New Hospitals Programme were aware that they were unable to retain staff due to the condition of their estate. Also, through staff engagement, they knew that parking and punctuality was a large concern, and any new build or refurbishment would complement this.

·  Journey times in terms of distance and time would be an important consideration to narrow the options. As the New Hospitals Programme were designing a hospital which would exist in 2030-2050, a large proportion of their programme of work was investment and development of their approach to population health, investment in community services, and the use of digital technologies so that the hospital would only be attended when residents needed specialist or emergency care.

·  It was acknowledged that accessibility and affordability of transport were factors that would be worked on in partnership with the county council.

·  As next steps, there would be six to nine months of detailed analysis of the shortlist of options, these would then be reviewed again against the critical success factors of deliverability and affordability, to provide a shortlist of options that the New Hospitals Programme team would discuss with the government and either to progress to a full business case or consultation. The team would share with the committee key stages of their journey to their 2025 target.  It was noted that some timelines are under control of the team, however, others would be partially in control of the Department of Health and Social Care.

·  The committee wished to note that they recognised that this investment would impact future generations and that the aims should align with social, economic, and environmental benefits in each of the districts affected, as well as the wider patient community.

Members thanked the Lancashire and South Cumbria New Hospitals Programme team for attending the meeting and for the information provided.

Actions:

·  The New Hospitals Programme team share with the Health Scrutiny Committee detail of key stages on their forward-planning agenda.

Resolved: That;

  i.  The update on the Lancashire and South Cumbria New Hospitals Programme information provided at Appendix A be noted;

  ii.  The feedback from the Health Scrutiny Committee on the shortlist of options be considered;

  iii.  The Lancashire and South Cumbria New Hospitals Programme be asked to return to the Health Scrutiny Committee at its meeting scheduled on 28 June 2022; and

  iv.  In principle the Health Scrutiny Committee agreed to support the option of Two new hospitals to replace Royal Lancaster Infirmary and Royal Preston Hospital (new sites), dependant on future information and detail provided by the Lancashire and South Cumbria New Hospital Programme.