NATIONAL ESTATE DEVELOPMENT
A ‘massive anchor’ in the local community
Lance McCarthy explained that, like most district general hospitals, The Princess Alexandra Hospital was ‘a massive anchor in the local community’. The hospital serves a population of circa 350,000, with what he dubbed ‘really significant inequalities’. He said: “So, we’ve got parts of our population in the lowest decile in the country, and parts in the highest. We’ve also got massive population growth up the M11 corridor, and our local authorities are – in their local plans – planning on building 53,000 new homes over the next 12 years, with a demographic change to increase our population by about 26 per cent over the next 20.” Having also ‘done a huge amount of work a looking at where we think healthcare is going’ – such as incidence of disease, etc, the Trust CEO said the organisation believed that, in addition to the population increase, there would be an increased demand for diagnostics of around 38 per cent.
The building of a new hospital in Harlow was thus ‘a real opportunity to think really radically, very differently, about how we provide care’. Here Lance McCarthy showed a slide of the current hospital configuration, colour-coded by condition, with the buildings shown in red – the ‘worst part’ of the site – including a concrete tower block housing all the inpatient wards. The buildings shown in purple were also ‘in pretty poor condition’, with those in green – in the best –built in the 1980s, 1990s, or ‘2000s’.
Poor clinical adjacencies
He said: “So, we really need a brand new hospital for all the reasons Natalie and Craig discussed earlier. Our biggest issue is some really poor clinical adjacencies, which makes delivering healthcare really difficult. All our wards are in one place, and our worst accommodations are inpatient capacity, while we have really poor access onto, and through, the site. We have a huge opportunity to do something very different with the new hospital, and we’re really keen for it to be a massive catalyst for change in healthcare delivery, not just within the hospital itself, but within the local system. We have thus developed a 10-year strategy for the hospital, aligned with our 10-year strategy for our local place-based partnership, to consider how we fundamentally re-think and redesign what happens in terms of healthcare, both in the hospital, and in our interactions between it and our primary and community care colleagues. We need to work in a very, very different way.”
Increasing standardisation Lance McCarthy said the Trust already had considerable work under way focusing on increasing standardisation and reducing clinical variation, as well as ‘a huge focus on
24 Health Estate Journal September 2021
This slide, from Lance McCarthy, illustrates the ageing condition of parts of the existing Princess Alexandra Hospital.
prevention to support the inequalities agenda’, plus a shift in secondary care thinking around the prevention agenda, aligned with the ICPs and ICSs. He added: “We’re doing a lot of work on better integrating our services with primary and community services – which is really important to how we meet the ever- increasing demand in terms of demographic growth and ageing population – and the associated impact. We must also ensure we’re not building a hospital replicating the care we’re delivering now. How do we make sure we build the hospital the right size, and that patients are getting the care in the right setting? So, a new hospital – fantastic – but we’ve got to make sure that we have all the primary and community services and integrated care working in conjunction with it, to ensure we stand the best chance of delivering the best care possible for our local population going forward.” Lance McCarthy said the Princess Alexandra Hospital NHS Trust had some ‘big bold ambitions around digital and around sustainability’ as well. He said: “I want the new Princess Alexandra Hospital to be the most digitally enabled and technologically advanced hospital in the country on its completion. ‘Digital’ is a huge opportunity in terms of how does the building work for you, how do you use it as a ‘smart’ building, and how do we get efficiencies for our patients, support them getting care more quickly, and get them discharged more effectively? Equally, how do we support the management of patients in a more community-based setting, with the specialist input based in the hospital so patients aren’t coming into the physical building?”
£14 million in expected efficiencies Lance McCarthy said that the Trust identified about £14 million worth of annual efficiency benefits through both the new building and the use of ‘digital’
and technology. He said: “Roll that out across the NHS and it would have a massive impact on revenue expenditure.” The Trust also had ‘a huge drive around sustainability’; it was aiming to be England’s first ‘all-electric’ district general hospital.
He added: “Our other key ambition is to make sure it doesn’t feel like a traditional hospital. We want it to feel very different – more of a calming space, and we want a genuine community assets. We’re thus engaging with our local population around how they may be able to use some of the hospital facilities, such as our training and education facility, outside traditional hours, so that it starts to be seen to be an asset to the local community, rather than just a place where you go when you’re not well.
Physical and emotional recovery “We’re also,” he added, “doing a lot of work around recovery; not just looking at the provision of secondary care, but at how we support our patients’ physical and emotional recovery, and looking at how we utilise all the spaces around us, so they can be used more recreationally. We are also really keen,” Lance McCarthy said, “to make sure we get the maximum amount of repeatability and flexibility out of Modern Methods of Construction –for ourselves in the short term, but also for the Programme as a whole.”
There was also, he said, ‘a focus on much better holistic care and management of all patients and staff’ – for example ‘by looking at food as medicine’. He explained: We’ve been working closely with a couple of the hospitals in Boston with skyfarms on the roof, and looking into creating a farm on the new hospital’s roof, to provide fresh produce we can then cook for the patients, but also for use by the community to help support and manage the farm, and to use it as an asset for children’s courses over the holidays etc.”
Courtesy of the Princess Alexandra Hospital NHS Trust
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