Agenda item

Purpose of the item: To seek the committee’s views on the criteria that Frimley Health NHS Foundation Trust will use to evaluate a shortlist of possible sites for a new hospital, and the committee’s feedback on the Trust’s approach to comprehensive engagement with patients, public, and staff.

Witnesses:

Mark Nuti, Cabinet Member for Adults and Health

Sinead Mooney, Cabinet Member for Adults Social Care

Carol Deans - Director of Communications and Engagement Frimley Health NHS Foundation Trust

Kishamer Sidhu, Chief Finance Officer & Executive Lead for New Hospital, Frimley Health NHS Foundation Trust

Emma Boswell, Director of Partnerships and Engagement, Frimley Integrated Care Board Known as NHS Frimley

Key points raised during the discussion:

1. A Member asked why Frimley Health was planning to build a bigger hospital and how modern healthcare standards would better cater for Surrey’s ageing population. The Chief Finance Officer explained that the new hospital would be built to international standards allowing for more space, and the size would be about specifications rather than the quantity of facilities. The Director of Partnerships and Engagement explained that with regards to modern healthcare standards, the commitment to integrated care would be key to the plans of the new hospital and built on ongoing work around integrated care teams, virtual wards, and remote monitoring. This work would need to continue to support the new hospital for the increasing demand and capacity management needs. The Chief Finance Officer explained that part of the aim would be to predict where the future services would need to be, which would involve integration. Three ways that integration would be important and help to provide care in a different way would be with technology; the volume and types of patients changing; and how and what would be treated in the hospital compared to the connected facilities around it, such as virtual wards, community facilities and diagnostics.

2. The Chairman asked how much Frimley was working with NHS Hampshire Hospitals, that would also be building a new hospital and referred to potential conflicts it could cause. The Director of Communications and Engagement confirmed that both Frimley Health NHS Foundation Trust and NHS Frimley were working with Hampshire hospitals and the Royal Berkshire hospital. The Director clarified that Hampshire are considering a reconfiguration of their services between their two hospitals, whereas Frimley Health NHS Foundation Trust are focussing on their site location and would keep services the same with no intention to change the patient flow. The Director of Partnerships and Engagement added that Frimley Health and care system were working in partnership with neighbouring systems, and collaboration between senior responsible officers of the three different builds had been supported by the integrated care system.

3. The Chairman referred to the new rules in the National Planning Policy Framework, which requires large projects to demonstrate a 10% biodiversity net gain, and questioned if Frimley Health NHS Foundation Trust were aware of this new challenge, and of how they would take it into account. The Chief Finance Officer stated that details around this had not been checked but stated that the new rule may indicate a more general issue, as the NHS was already required to change the way they build, to meet energy efficiency and net carbon zero impact standards. The Chief Finance Officer also highlighted the likelihood of having modular builds, which would consider the environmental specification requirements.

4. A Member referred to Frimley Health Foundation Trust’s timeline to build a new hospital and asked whether it would be achievable. The Chief Finance Officer explained that the 2030 hard deadline meant there would be a need for all government machinery to work differently. A key constraint to the timeline would be funds such as with fees to complete the design, engagement, and land acquisition, which were in progress. The Chief Finance Officer highlighted that contractors could be a constraint, particularly due to the scale of the new hospital, and Frimley Health would need to procure them in a different way, which would be done nationally. The Chief Finance Officer added that instead of doing things sequentially, there would be a need to manage different stages of the project in parallel.

5. A Member asked if Frimley’s consultation process would be considering people who were not necessarily part of the hospitals’ normal catchment area but are likely to be related to the new site.The Director of Communications and Engagement explained that Frimley Health and NHS Frimley would cover those people and intend on communicating with people to inform their understanding of who else to communicate with and how to reach them. Ensuring information was widely available and relying on partnerships to help support them with engagement would be key to the work.

6. The Cabinet Member for Health, Wellbeing and Public Health suggested it would be beneficial if plans for the new hospital tied in accommodation for staff, as part of the site investigation process. The Director of Partnerships and Engagement explained that the NHS Frimley had an Integrated Care Partnership on the impact of living and working in a high-cost area. Once the site selection process was complete, it would inform the transformation in how the Frimley Health and Care system supported an effective local workforce, by drawing people in locally, providing effective cost of living wages, with considerations about their housing and the broader issues. The Chief Finance Officer explained there was a need to simultaneously recognise the difficulty in balancing the funding for the hospital build with an accommodation build. The Director of Partnerships and Engagement explained the interest by the Integrated Care Partnership in working together with local authorities, the voluntary sector, and others, to create something broader across their system, with accommodation for staff being one part of that.

7. A Member asked if Frimley had included providers such as chemists in their communications and engagement process. The Director of Communications and Engagement stated that an advantage of the new hospital being a joint piece of work with the Integrated Care Board (ICB) and the Integrated Care System (ICS), is that Frimley would have access to all primary care providers that the ICS covers such as GPs, chemists, pharmacists, and optometrists, and therefore, NHS Frimley would have direct relationships to ensure they would be involved in the process.

8. A Member questioned how confidential the negotiations of the new site were, with consideration of the hospital’s military link and keeping them informed. The Chief Finance Officer explained that he was only aware of the sites being proposed by code names and were not aware of the locations. This was partly because of commerciality, that if the sites were to become public knowledge the price could increase, and to also ensure the chosen site would not be a result of a personal influence. The Chief Finance Officer clarified that there were sites available, and negotiation was taking place. The Member asked if this was normal procedure, and the Chief Finance Officer confirmed it was. The Chief Finance Officer reassured the committee that the military link would be factored into the new hospital’s demographic planning.

9. A Member asked if discussions with utility providers, to understand the ability to provide the required level of electricity, gas, water, and sewerage capacity, could be accumulated in time to estimate the costs and whether Frimley Health NHS Foundation Trust were monitoring this plan. The Chief Finance Officer explained that the provision was part of the hurdle criteria, and Frimley Health NHS Foundation Trust were in conversations with network providers to map out their current plans and how they might be able to change. The Chief Finance Officer explained that costings would change going forward and there was a national support regarding how the cost would conclude for any element of the build.

10. A Member asked what impact the new hospital site would have on their other nine facilities and if those facilities would be involved with the new hospital. The Chief Finance Officer clarified that the new hospital was not about changing services that are provided elsewhere, it would be about re-providing the services Frimley Health NHS Foundation Trust already had on a different site with no service changes built into the land acquisition.

11. A Member asked about what improvements the digital infrastructure would provide to the new hospital and how it would benefit elderly and vulnerable patient groups.The Chief Finance Officer explained that the answer to this would need to be developed, which was partly the reason for the engagement process, to ensure Frimley Health NHS Foundation Trust and NHS Frimley could get everyone’s views on what the future should look like. The Chief Finance Officer provided the example of technology enabling patients to maintain contact with their family by allowing visiting times to be broken down. The new hospital, being designed in a technology-enabled way would facilitate, rather than impede on, improvements.

12. A Member asked how Frimley Health would keep an integrated hospital approach across the various locations. The Chief Finance Officer explained that 25% of Frimley’s activity would take place outside of the hospital site, and they would have an opportunity to think about things in more than just a hospital sense. The Chief Finance Officer highlighted the importance of integrating pathways to ensure that a patient could be moved easily and quickly from one place of care to another. The Director for Partnerships and Engagement referred to some of their broader digital approaches to integration that the new hospital could build on, such as their flagship connected care programme which uses data and insights to identify patients most at risk of things such as hospitalisation, which would be shared back to primary, integrated care teams.

13.  The Chairman asked what was being done to solve the problem of queues to get into the current site’s car park, and how it would be considered in the new hospital’s design.The Chief Finance Officer explained that the hospital programme would need to have a travel plan that would incorporate the ability to get to the new site by car and by other means. Spending money on car parking at the current Frimley site was not deemed the best use of resources and instead, plans were currently being reviewed into ensuring the best use of what they currently had. For example, one of the demolition sites on the current site had been converted into car parking spaces.

14. A Member asked what some of the potential impacts of the new hospital location would have on residents in the most deprived areas of Surrey. The Director of Partnerships and Engagement referred to their five-year shared systems strategy for creating healthier communities, with a single ambition of tackling inequalities. One of the underpinning themes and principles of their work would include being alert to the impact on equality, diversity, and inclusion, and NHS Frimley was expecting to complete an Equality Impact Assessment. Additionally, one of the criteria Frimley Health NHS Foundation Trust and NHS Frimley would be asking people to consider is whether they had health inequalities high enough on the list for selection criteria. The Chief Finance Officer explained that so far, the process had been based largely on the physical side, but there would be two further stages, the Outline Business Case and Full Business Case, that could be inputted on and would capture whether the new site would provide services in a way that helps to reduce health inequalities and not disadvantage groups.

15. In reference to Frimley’s Communication Strategy, a Member asked how Frimley Health would ensure communication with everyone about the process. The Director of Communications and Engagement explained it would be challenge. Frimley Health NHS Foundation Trust’s communication strategy would attempt to get information directly to people in a way that would be easy to share, which is something they continue to work on. Frimley Health NHS Foundation Trust would provide the information in as many formats as possible and would also be relying on partners and others to share information, such as on social media, where there was investment in the targeted boosting of posts to help share information among various groups. There would be a reliance on the media and communicating with people directly and Frimley Health NHS Foundation Trust and NHS Frimley would review all responses to investigate if there were any gaps where certain groups were not engaging.

16.  A Member asked about how disruptive the process of building the new hospital was going to be, how NHS Frimley were managing potential concerns with closing areas of the current hospital and ensuring the public would know where to go for services if they were relocated. The Chief Finance Officer explained that Frimley Health NHS Foundation Trust were spending between £5 million and £8 million, and had already spent £30 million, to ensure buildings retain their integrity and to maintain the provision of services to 2030. The Chief Finance Officer highlighted that there were disaster recovery plans in place with their partners to ensure they would not run unsafe services.

Actions/requests for further information:

1. For future planning, Frimley Park Hospital to provide what a modern hospital room for patients should look like to meet contemporary standards.

2. A Member suggested that Frimley Park take another look at their map to include Ash on it. The Director for Partnerships and Engagement agreed to revisit the map for accuracy purposes.

3. Frimley Park to return to the Committee with an update on progress on the plans for Frimley Park Hospital at its March 2024 meeting.

Resolved:

The Adults and Health Select Committee recommends for Frimley Health NHS Foundation Trust:

1. To ensure that consistent involvement is in place throughout the entirety of all planning stages.

2. To ensure that the caring and compassionate approach remains at the forefront of the patient experience in relation to the increases of health-related technologies in home environments. To be mindful that change can induce fear in vulnerable groups and to ensure the appropriate knowledge is provided regarding the motivations that influence the use of health-related technologies.

3. To ensure that local leaders are kept informed as per setting up a consultative or an advisory group amongst local interested leaders, and that this select committee is kept updated on key discussions / developments.

4. To ensure that the engagement is spread out widely and to engage with Primary Care Networks and local councillors for the area.