Lancashire NHS bosses spoke to local democracy reporter Paul Faulkner about the latest developments in creating brand new hospital facilities for each of the county's two cities.
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00:00 [Music]
00:21 Gerry, you've hosted a delegation from the Department for Health here today at the Royal
00:25 Preston. To put it bluntly, what was the point of that? Because you've already persuaded
00:28 ministers to open the checkbook, haven't you, and build new facilities. So why bring them
00:32 here today?
00:33 Well, it was great to welcome Lord Markham here today and the reason for that was very
00:38 much to make the new hospital programme real for everybody. A chance to see what Hospital
00:44 2.0, as they call it, starts to look like and how it's going to benefit the people of
00:48 Lancashire and South Cumbria. It was also a great opportunity for Lord Markham to speak
00:52 to some patients, some members of public and local politicians to share their views about
00:58 the programme. So it is always a programme that is about continually learning and listening
01:02 to people's views.
01:04 You mentioned Hospital 2.0 there, to use the jargon. Basically, that's a description of
01:08 the design of the hospital, isn't it? It's going to be a very similar design across all
01:12 the new hospitals that are being built. What kind of flexibility locally are you going
01:16 to have in order to create a hospital or hospitals specifically for Preston and Lancaster? Because
01:22 I know you've been put under scrutiny by some councillors who have said that one size really
01:26 doesn't fit all, especially not for a place like Preston where it hosts such specialist
01:30 facilities.
01:31 Yes, and I think it's great to share some of the thinking around this in that for those
01:35 that have been to somewhere like Alder Heyer Hospital in Liverpool, which is a fantastic
01:40 hospital, the new Royal Liverpool, we're always learning from these hospitals, new-build hospitals,
01:46 about how things can be done better for patients and visitors. And part of the national design
01:51 for this is to make sure we capture the best parts of all the hospitals that have been
01:54 built, not just in the UK but internationally. But that said, you can't have a single hospital
02:00 that will meet every area's need. So generally speaking, we're sort of saying that 70 or
02:04 80% of it will be a common standard design, but then we will flex it to the local needs
02:09 of the Lancashire and South Cumbria population, whether that just be the aesthetics of its
02:14 appearance or the design of some of the services themselves. So I think it's a great balance
02:18 between the two.
02:19 As well as the design, of course, the other big question is the location. The last time
02:23 we spoke, you were whittling down a shortlist of sites for both the Royal Preston and a
02:27 new Royal Lancaster infirmary. Has that process got you to a single site for each of those
02:33 places yet, or are you still looking at multiple sites?
02:36 Well I think it's really important to say that the right location for the hospital is
02:39 one that works as well as possible for the people of Lancashire and South Cumbria. But
02:43 that said, there are lots of considerations around the ground type that we have to consider,
02:49 location of utilities. So it's not an easy process and we've got to go through a very
02:53 thorough process. We now have a very short list of options, which we're now working through
02:57 the planning applications. We're also working through very closely with the government to
03:03 enable us to have the capital available to make a purchase. So this is starting to move
03:07 forward quite quickly. I know some people think 2030 is a long way away, but actually
03:11 we're hoping to acquire the land much sooner than that, which will enable us to do some
03:15 early enabling work on the site.
03:17 So you're talking about planning applications there, that sounds very advanced. So is it
03:21 safe to say and to presume that you've got a single site for both Preston and Lancaster
03:25 now in mind?
03:26 I think it's fair to say that we have preferred sites, but that doesn't mean that we won't
03:31 still be exploring other sites depending on whether they're available or not. But clearly
03:35 we're trying to move forward to acquire sites as quickly as we can, because I think that's
03:39 a really strong message to say this is a commitment to build these new hospitals, we have a site.
03:45 Some people aren't convinced are they that this will ever happen? And if a week is a
03:48 long time in politics, then a decade until this new facility opens is an eternity as
03:53 it is in health. Are you personally convinced that this is going to happen in the way that
03:57 you currently envisage it?
03:58 Well, I think that was a key part of Lord Markham being here today was just to give
04:02 that demonstration, not just of this government's commitment to the programme, but that there's
04:07 an awful lot of work going across parties to say that this is a 15, 20, 30 year programme
04:13 of work, not just within the 40 hospitals designed today, but those of the future. So
04:17 I think there's great cross party support for the programme and that gives me a great
04:21 deal of confidence that we will see those two new hospitals built here in Lancashire
04:25 and South Cumbria.
04:26 Kevin, you're at the start of what was always going to be a very long process, building
04:30 a new Royal Preston Hospital, even longer now that the opening date's being pushed back
04:34 to the early 2030s. How do you keep staff's eyes on the prize, if I can put it like that,
04:40 and this fixed point in the future when they'll have this brand new facility, especially given
04:44 the current constraints that they're working in?
04:46 Staff are really excited for the future. I mean, this is a brand new opportunity to get
04:50 a brand new hospital. You don't get this opportunity very often. So our staff are really engaged
04:56 and really excited about this planning. But the planning will take many years. We're talking
05:01 about a capital bill that's well over a billion pounds, you know, really significant investment
05:06 in terms of capital. And to do that, we have to plan for it and we have to start planning
05:10 now. So we can't just think of this as being a building. This is about how do we transform
05:15 services across the whole of Lancashire and South Cumbria for the future. So that will
05:20 require lots of engagement, lots of consultation, engagement of stakeholders in our communities
05:26 and our staff. So the planning really does start now and it's going to take a lot of
05:31 time and a lot of energy to work all that through and work that through. So yes, it's
05:36 a long way off, but actually to get it right, it needs to be a long way off because this
05:41 is a year on year on year process.
05:45 It's not just the current staff that you've got to think about, is it? It's how you recruit
05:48 new staff to the Trust and how can you really be an appealing destination for staff at the
05:54 start of their careers or maybe when they're chasing promotion, when they'd be working
05:58 in facilities that you've acknowledged aren't at their best.
06:01 So you're right, the facilities are not what they should be, but that's not universally
06:06 across the whole of the Preston site. Some of the facilities on the Preston site are
06:10 outstanding, so our critical care unit for instance. But we do know the ward block and
06:15 particularly the front end around A&E are not fit for purpose. But we are continuing
06:20 to invest, so only yesterday we were given £15 million to increase our beds at the front
06:26 door to support flow through A&E. So that's going to allow us to reconfigure the front
06:31 end, reconfigure A&E and support flow and improvements in delivery of services over
06:37 the next couple of years.
06:40 So yes, it's going to be for the future. Yes, the new hospital is not going to be delivered
06:45 for at least 10 years, but we will continue to invest in the current sites of Preston
06:51 and Chorley in the meantime and we will do our best to keep these facilities as good
06:56 as we possibly can.
06:57 What is your vision for the future of the new hospital? I've asked you that question
07:01 before and you always peg it to the future of healthcare, not just the future of that
07:04 hospital building that's a decade away.
07:06 Oh it is. I mean this needs to transform health and social care across Lancashire and South
07:11 Cumbria. So what we need is a really state of the art tertiary hospital with all the
07:16 specialist services in, also providing the local services for central Lancashire. But
07:22 it can also be a hub for the likes of biomedical services, it can be a hub for R&D, research
07:30 and development, education and training and we can start to bring in lots of additional
07:35 jobs, really important jobs into the Lancashire patch. If you think about some of the other
07:40 big hospitals in the North West, say in Liverpool or Manchester, they're able to leverage a
07:45 lot of additional work, a lot of additional income, really important jobs through the
07:51 likes of biomedical research and development etc. We're going to do that for Lancashire.
07:56 You've been in right at the start of this process but you're not going to be able to
08:00 see it through are you because you're retiring in a couple of months but I imagine you'll
08:03 be keeping your eye on it from afar.
08:05 I really will. I mean part of my decision to retire at this point in time was actually
08:11 to allow somebody to come in to see this through for the next few years. So we've worked really
08:15 hard over the last two or three years to get to this point. We've won the arguments that
08:20 says, you know, part of the debate was, well actually all you need is a partial rebuild
08:24 on the Preston site. We said no that's not acceptable, it's not going to deliver the
08:29 services that we require and our populations that require and our communities require.
08:34 We've won those arguments, we've got the capital now for a complete new build. But that new
08:41 work and that new thinking now starts about what the future will hold and it needs somebody
08:46 who's going to be here for five to ten years to see that through. Given my age, I wish
08:51 I was ten years younger, it would have been brilliant. I would have loved to have seen
08:54 this through. What a job to be able to take it from where it is now, to plan those services
09:00 and to deliver those services in a new hospital. What a fantastic job. Unfortunately it needs
09:05 somebody who's a bit younger than me.
09:07 Aaron, your Trust is at the start of what was always going to be a very long process,
09:11 the formation and creation of a new hospital. It's going to be even longer now as the opening
09:16 date's been pushed back to the early 2030s. How do you keep staff focused on that fixed
09:21 point given the constraints that they're working under currently and knowing that a solution
09:25 is so long away?
09:26 Yeah, I think it's important to just recognise how exciting that is for our colleagues. I
09:31 think the announcement of a new hospital for the Royal Lancaster Infirmary has landed incredibly
09:36 well with our teams. So getting out and talking to colleagues and patients in our wards and
09:40 departments, everyone's just really excited about the opportunity to design a new facility.
09:45 The current infirmary, as you'll be aware, is pretty poor actually. It's not a great
09:49 environment for colleagues to work in or patients to be treated in, so the opportunity to design
09:54 and build a new hospital is fantastic. 2030 sounds like a long time away, but when you
09:58 talk about the business case, the design, the development and then obviously getting
10:02 the new facility up and running, I think that's well within the purview of most colleagues'
10:06 careers and they're just really excited about that opportunity.
10:09 So you can carry your current staff with you, but of course you've also got the challenge
10:12 of recruiting, haven't you? And if you're recruiting to a facility that is, as you say,
10:16 not the best, how difficult is that to get the staff that you need?
10:20 Yeah, it's a challenge I think in terms of the NHS at the minute for recruitment. I think
10:24 some of the work we've done in Morecambe Bay about our clinical improvement work and some
10:29 of our digital improvement work, it does draw good colleagues to us to work across our three
10:33 hospital sites. I think now having that notification that the new Royal Lancaster Infirmary is
10:38 available to be built now is a plus for us. It's a further opportunity to recruit good
10:45 colleagues into the system. Obviously we've got the new hospital at Royal Lancaster Infirmary,
10:49 but in our system we've also got the Royal Preston Hospital with its investment that's
10:53 been secured. So for Lancashire and South Cumbria, what we're seeing now is much more
10:57 interest for lots of clinical and non-clinical roles actually to bring colleagues into the
11:00 system, which is a huge benefit to us.
11:03 You've obviously got as well the challenge of investing in the current facility and making
11:07 sure that it can continue to function and function to a standard that patients would
11:11 expect for basically the best part of a decade. How difficult is it to strike that balance?
11:16 Yeah, you're right. It's an issue for us to consider now about how you deploy the limited
11:21 capital investment that we have in our system to best effect. So we'll be making sure that
11:25 our clinical areas in particular get the investment they need over the period to maintain safe
11:30 care, to get good access, to have a good environment for patients to be treated in and recovering,
11:35 and also for our colleagues to enjoy the environment that they work in. Now obviously with the
11:40 new build six and a half years away at 2030, we'll have to take some considered decisions
11:45 about what we invest in and to what level, but we'll be absolutely focused on making
11:49 sure that the services we provide up until that point remain safe, effective and an environment
11:54 that people will want to be cared within.
11:56 And just finally, what is your vision for the new hospital building itself?
11:59 Wow, that's a question. So for me, it has to have all of the good facilities that you'd
12:06 want a 21st century hospital to have. But the things that we generally don't invest
12:12 in as a priority in the NHS, good working environments, good open spaces, making sure
12:18 that we've got single rooms for patients, that we've got some of the rest areas for
12:22 colleagues. So it's a massive opportunity to build what we all know will be a fantastic
12:28 facility for staff and patients. And I know colleagues are really excited about playing
12:32 their part in designing that.
12:33 Difficult to predict this far out from when it will actually be open?
12:36 Yeah, I think the builds normally, three to five years, I think with the build that we've
12:41 put in place. So yeah, we're looking to get started as soon as we're able to release the
12:45 business case and the funds. We know the trajectory now of the timescales we're looking at. And
12:49 like I say, for most colleagues, that's well within the purview of the next phase of their
12:53 careers. And they're all really excited about playing their part in designing that and taking
12:58 the services into the new unit once it's ready.