Agenda item - '3T' Development of the Royal Sussex County Hospital

Presentation by Matthew Kershaw, BSUH Chief Executive and Duane Passman, Director of 3Ts, Brighton and Sussex University Hospital Trust.

7.1       The Board considered a presentation from Matthew Kershaw, BSUH Chief Executive and Duane Passman, Director of 3Ts, Brighton and Sussex University Hospital Trust. 

7.2       Mr Passman explained the brief for the 3Ts development.  He reported that the Barry Building which had been completed in 1828 would be replaced.  Neurosciences would be relocated, a level trauma centre would be established, the cancer centre would be enhanced and there would be enhanced facilities for teaching and research. The environment would be to the same standard as the children’s hospital.  

7.3       Members were shown slides of the existing site & plans of the proposed build.  The Stage 1 area required to be decanted was 21% of the RSCH site area.  Decant sites included the former St Marys Hall School and Brighton General Hospital.  The decant period would be from mid 2013 to late 2014. The helipad would be completed between mid 2014 to summer 2015.  Stage 1 would be completed by 2018.  Stage 2 would be completed by 2021.  Stage 3 would be completed by 2022.

7.4       The development would benefit larger numbers of patients each year.  70% of the floor space would be for the people of Brighton & Hove.  Members were shown views of the new hospital.  There was further information on the Brighton and Sussex University Hospitals website.  www.bsuh.nhs.uk

7.5       Robert Brown asked how the hospital would ensure that plans to gear up for the 3T development was not putting services being delivered at risk in terms of effectiveness/quality, particularly given other service pressures at the hospital, and the need to save £30million this year?  Mr Brown stressed that the last letter LINk sent to the hospital stated that they did not consider the Trust to be fit for purpose as a trauma centre.  Could the hospital cope with the pressures?

7.6       Mr Kershaw explained that it was the hospital’s responsibility to ensure services were delivered.  With regard to the £30m Cost Improvement Programme, the treasury had asked the trust to demonstrate how it would remain financially viable during the transition.  Mr Kershaw was pleased to report that the trust had the right plans in place.  There was a need to save £30m as all NHS organisations had to demonstrate financial efficiency and this was what the Trust would do irrespective of the 3Ts development.  The 3Ts was not just about delivering highly specialised services.  Major trauma services were not required by most patients. The majority of people would use the core services on the new site.   

7.7       Mr Passman explained the decant plan.  The overwhelming objective was for services on the site to remain on site and remain fully operational whilst building work was carried out.  He stressed that although the numbers using the trauma centre were not high, the impact of this service was huge.  450 to 500 cases were expected each year.  350-360 a year were treated at the moment.  There was a need to ensure minimum standards were in place.

7.8       Mr Passman stated that the trust had put in place as much as it could in the existing structure to meet standards.  He acknowledged that the works would put the hospital under pressure; however major trauma affected a relatively small number of cases.  

7.9             Tom Scanlon noted that there had been no detail regarding capacity of district general hospital functions.  GPs were concerned that there should be a good district general hospital.  He asked about the level of change currently and at the end of the project with regard to this function. 

7.10         Mr Passman explained that there would still be some physical capacity on the site during the transition, with regard to district general hospital functions.  At the end of the 3Ts, there would be a net extra 100 beds across the trust, some of which would have a district general hospital function. 

7.11         Mr Kershaw explained that there would be no reduction in physical capacity.  However, the trust was looking to improve emergency care and to decrease acute capacity due to better services in the community.   

7.12         Councillor Bowden asked what Plan B would be if the trust were not considered to have a robust plan in place?  Mr Kershaw replied that the trust believed it could deliver and had provided information to the treasury.  If the plan was not approved by the treasury, Mr Kershaw would reply that the trust currently had a building that did not provide for its patients.  Mr Kershaw’s personal view was that the trust had a good case.  The treasury was rightly asking difficult questions, however the evidence the trust was providing was helping the trust make a good case.

7.13         Geraldine Hoban questioned the affordability around the 3Ts development.  She wondered if there was a need to re check the financial assumptions around it.  She stressed the need to ensure the case was robust. Were there plans to reassess the financial assumptions?   

7.14         Mr Kershaw explained that the case for the 3Ts development had received support from a whole range of individuals.  Plans were thorough and he did not want to repeat the process and make a new business case.  The plans were being kept under review.  Mr Kershaw considered it appropriate to work with the new CCGs.  There would be conversations with area teams and financial colleagues in the CCGs. 

7.15         The Chair thanked Mr Kershaw and Mr Passman.  He hoped that there could be further progress reports in the future.  He expected that the Board would have further questions about the shape of services.

7.16         RESOLVED – That the presentation be noted.