Stuart Windsor (Future Hospitals Director, University Hospitals Plymouth NHS Trust), Nicki Collas (Future Hospitals Program Manager, University Hospitals Plymouth NHS Trust) and Amanda Nash (Head of Communications, University Hospitals Plymouth) introduced the Derriford Urgent and Emergency Care Centre item and highlighted the following points:

a)     In December 2022, the business case for Phase 1 was presented to the Joint Investment Committee and was approved. It had now also had approval from the Secretary of State;

b)    The full business case would be submitted in the months following the meeting;

c)     Derriford Hospital was a complex estate, sat in a complex system and so the team had wanted to ensure they were aware of the available opportunities and took an incremental approach to development with a long term plan for the estate as a whole;

d)    Phase One was to address the Urgent Emergency Care building which had received funding from the New Hospitals Programme;

e)     The second phase of work would focus ensuring there was the right capacity for work that needed to be done in the hospital environment whilst taking the opportunity to take services out of the hospital into the community where appropriate;

f)      The third phase would focus on Derriford’s role as a specialist service provider across the peninsula and the importance of ensuring there was the right capacity to deliver services at present and to cope with future changes in demand;

g)     The fourth phase would focus on women’s and maternity services being reconfigured to ensure the right services were in the right place with the right capacity;

h)    The fifth phase would link in closely with phase one and would focus on the creation of an integrated children’s hospital that allowed a flow from the emergency department to paediatric and other children’s’ services;

i)      The final phase would focus on maintenance within the hospital and ensuring the correct bed capacity;

j)      The phases could occur concurrently and would be broken down further to ensure maximisation of funding opportunities;

k)     Crowding was a significant and complex issue which had escalated quickly and formed the basis of the case for change for phase one of development;

l)      Within phase one of the scheme, the opportunity had been taken to remove one of the highest clinical risks around interventional theatre capacity for neurosurgery, by building additional conventional theatre capacity that could be used for both emergency cases and planned cases;

m)   A developer, Willmott Dixon, had been appointed and work was underway to finalise designs and the full business case;

n)    Enabling works were underway and £50 million had been secured from the new hospital programme to being works, which would include the re-routing of underground services and the building of a fracture clinic;

o)    The main contract works would commence in early 2024 and were due to take 2.5-3 years to be completed;

p)    A new walk-in entrance and separate ambulance entrance would be created on level 6;

q)    Level 7 had been designed to have patients diagnosed, treated and returned home within a 24 hour period, and the floor would also have a short stay ward, imaging facilities and smaller emergency department rooms for examinations and consultations;

r)     Level 8 would include four new interventional radiology suites, adjacent patient recovery facilities and would be linked to the existing hospital to improve patient safety;

s)     Level 9’s primary use would be emergency surgery facilities with 5 new operating theatres as well as administrative offices and welfare facilities for staff;

t)     The team were aware of how disruptive schemes like this one could be to both patients and staff and understood the importance of communication with stakeholders both in and out of the hospital, particularly in reference to access;

u)    The team would work with the contractors to undertake work when the hospital was least busy, implementing traffic management and ensuring off-site construction was carried out where possible to minimise the construction on site;

v)     40 new beds had been added to the system through the discharge assessment unit and a number of schemes were underway across the site to increase bed capacity;

w)   Stakeholder engagement had been conducted since 2018 and there was a comprehensive Communications and Engagement Plan which covering phase one of development;

x)    The team were learning from and sharing best practice, and were developing messaging and innovative materials (virtual reality dome to show staff the development) as well as maintaining strong support from MPs and partners;

y)     Engagement was being carried out beyond the Plymouth boundary as the hospital supported people from other areas of Devon as well as areas of Cornwall;

z)     Patient feedback regarding future service provision highlighted increased staffing, mental health provision, community care, access and car parking, and wellbeing of staff and environmental concerns;

aa)  Full works were expected to begin in March 2024 after the approval process and final completion was expected in December 2026.

In response to questions it was reported that:

bb) Considerable stakeholder engagement had been undertaken that had helped shape plans for the new buildings and services that would be delivered;

cc)  There was a process in place to carry out formal consultation, if required where there was significant service change, usually used if a service was being lost, but this was not the case;

dd) The project was bound by planning consent restrictions in terms of the hours that they could work, but the team tried to carry works out around the activity in the hospital and were advised via the network of clinical leads appointed to support the project and services, such as neurophysiology, would be moved away from the construction zone if deemed necessary;

ee)  An updated sustainable transport plan was currently under consultation with staff at Derriford and a new plan was due to be published by the end of 2023;

ff)    The team were working with partners to identify additional off-site parking to support parking for both staff and patients;

gg)  A plan had been produced on how car parking would be handled at certain sites across the full site and there was a plan to construct a further multi-storey car park as part of the next stage of large scale development to ensure no capacity is lost. Car parking provision would be reported as part of the New Hospital Programme updates at future Committee meetings;

hh) A shuttle bus was provided to the hospital from the disabled car park. It was recognised that further action was required to ensure it was running on a more permanent basis, with increased reliability;

ii)     Planning consent had been granted for the building, and security and contractors were in place for the project to be completed by its 2026 deadline;

jj)     While the project was part of the Government’s New Hospital Programme, the new building would be attached to the existing hospital. The total cost of the project was over £150m, and the allocation made to Plymouth would be received following submission of the full business case;

kk)  The movement and creation of services had been based on data around where more capacity was needed on a one, three, five and 10 year basis to ensure improvements were long term.

The Committee agreed:

1.       To recommend that the Chair of H&ASC write a letter of support on behalf of the H&ASC OSC, providing support for the New Hospitals scheme at Derriford;

2.       That the project did not require further public consultation in relation to health service provision however, statutory planning consultation would be required.