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Rebecca Malin explains how the shortlist of proposals for the New Hospitals Programme have been developed

Photograph of Rebecca Malin, Programme Director for the Lancashire and South Cumbria New Hospitals Programme

In March 2022, the Lancashire and South Cumbria New Hospitals Programme announced its shortlist of options. Here, Rebecca Malin, Programme Director for the New Hospitals Programme, discusses the merits of the proposals carried forward and the next steps for the programme.

What is on the shortlist of proposals for new hospital facilities?

The shortlist is a narrowed down set of potential options from our previous longlist of proposals for new hospital facilities in our region.

The shortlisted proposals are:

  • A new Royal Lancaster Infirmary on a new site, with partial rebuild / refurbishment of Royal Preston Hospital
  • A new Royal Preston Hospital on a new site, with partial rebuild / refurbishment of Royal Lancaster Infirmary
  • Investment at both Royal Lancaster Infirmary and Royal Preston Hospital, allowing partial rebuilding work on both existing sites
  • Two new hospitals to replace Royal Lancaster Infirmary and Royal Preston Hospital on new sites.

These proposals also include investment in Furness General Hospital, required due to its geographically remote location, its proximity to some of the UK’s major strategic national assets, and its need to meet NHS environmental goals.

In line with NHS guidelines, the shortlisted proposals will be benchmarked against options for no change to, and / or limited investment in, Royal Lancaster Infirmary and Royal Preston Hospital to address the list of tasks that need to be performed to repair or maintain the buildings and keep them in a suitable working condition.

You can read more about the shortlist here.

What options have been discounted, and how was the decision reached on which options to carry forward?

Announcing our shortlist in March 2022 was a real milestone for us as a programme. We had a longlist of ten options, so with the shortlist, several proposals have been discounted after careful consideration.

A completely new build Royal Lancaster Infirmary (RLI) and Royal Preston Hospital (RPH) on the existing sites were both discounted. The reasons they weren’t carried forward is they cost a considerable amount more than a new build on a new site. Also, you can imagine the complexity of phasing different parts of the build, the logistics of moving equipment, the disruption and pressure it would cause to continuity of services, patients, staff and visitors. 

We also discounted the option of a new Royal Preston Hospital on a new site, but with some services being retained on the existing site. Through talking with our clinical and operational colleagues, it just wasn’t clinically viable to continue with that proposal.

Finally, the single new site, which was proposed to be on a new central site to replace Royal Preston Hospital and Royal Lancaster Infirmary, was discontinued despite clinical and operational benefits because there was real concern around health inequalities and access for people from local people. There was also some lack of stakeholder support, including from patients and staff.

How did we arrive at the shortlist?

The draft shortlist was arrived at by a team of experts and stakeholders, including patients, at a workshop that took place in February 2022. This workshop ensured that key stakeholders were involved in decision making, and could challenge and assist to shape the direction of proposals.

Our aim of the day was:

  • To agree the Critical Success Factors against which we would review and narrow down proposals
  • To appraise the longlist of proposals with a view to arriving at a shortlist of options.

The workshop was chaired by the New Hospitals Programme team and was attended by external stakeholders and commissioners, patient and service user representatives, Directors of Finance, economic advisers, Medical Directors, Directors of Estates, Governors and Non Executive Directors, NHP Programme Senior Responsible Officer, Programme Director, Project managers and facilitators. This group worked together to inform what proposals made it onto the shortlist.

How were shortlisting decisions made?

During the workshop, attendees appraised each of the longlisted options against a list of Critical Success Factors. These asked whether each option would:

  1. Improve service delivery and provide access to cutting-edge hospital technologies and deliver the best possible quality of care?
  2. Meet demand needs of the health population and is it flexible and sustainable?
  3. Increase resource capacity and effectiveness, working collaboratively to increase integration in service delivery?
  4. Address health inequalities and meet the health needs of the people of Lancashire and South Cumbria now and in the future?
  5. Deliver value for money i.e. economic, social and environmental?
  6. Be deliverable by potential suppliers i.e. does the construction market have capacity to deliver and do market participants have the necessary capability and experience?
  7. Be potentially affordable i.e. does it make best use of financial resources; does it provide more operationally efficient estate?
  8. Be potentially achievable i.e. is it deliverable within the land area available; is it likely to achieve planning approval; will it minimise disruption to services?

To help inform the attendees’ decision making, we shared evidence and feedback that we’d gathered to identify and quantify the benefits of and possible issues with each option.

A significant part of this evidence was the feedback that we have received from local people, patients, staff and stakeholders, and how this reflected on each of the proposals.

What happened during the workshop?

Attendees worked in small groups to review the evidence presented for each of the longlist of proposals and rate them (as red – does not meet, amber – partially meets or green – meets) against each Critical Success Factor and to use this assessment to recommend whether the proposal should be carried forward onto the shortlist or not.

We then came back together as a single group to discuss any points of difference between the assessments.

The output of the workshop informed the final shortlist, which was approved by regional NHS leaders and endorsed by the Lancashire and South Cumbria Strategic Commissioning Committee on 10 March 2022.

You can read more about the shortlist and the shortlisting process in the New Hospitals Programme update to Strategic Commissioning Committee on 10 March 2022 and 12 May 2022 in the SCC 12 May meeting paper pack.

Read more about Governance and Oversight for the New Hospitals Programme.

How did feedback from service users, members of the public and staff help shape the shortlist?

We’ve done market research interviews and run online surveys and discussions, we’ve held focus groups with under-represented communities, we’ve been out and about in local supermarket car parks and markets listening to local people’s views, we’ve had meetings with local MPs and local authorities – and more – so that we get a real breadth of perspective. Being able to hear what people think about the opportunity for new hospitals in Lancashire and South Cumbria is hugely important to us. We have really appreciated so many people sharing their views on the longlist and what is important to them, and all of that feedback is invaluable.

There are some real consistent themes that are coming through around location, travel, access, and around the use of digital and how we can maximise that to enable care closer to home.

Many clinicians and NHS staff joined the Big Chat online discussion, attended Colleague Summit events and other meetings and briefings to share their thoughts and views on our longlist of proposals and, before that, our Case for Change.

What is next for the New Hospitals Programme?

Now we’ve got the shortlist, we are getting really into the detail of the options, for example what we can do on the existing sites, how we would rebuild, and what would be involved. We need to look at what available land there is in Lancashire and South Cumbria, and also think about the planning considerations, what’s the best use of our resources, and really consider the financial affordability and the return of that investment, as well as how practically deliverable the options are.

Then we continue the work to develop the required business cases. That could be a pre-consultation business case if there is a requirement to consult with local people in a formal public consultation, or it could be straight to a capital business case. It depends on some of the routes and options available. All of that takes us through to agreeing a preferred option prior to starting to build, hopefully in 2025, with new hospital facilities completed in 2030.

Keep up-to-date on all the latest news from the New Hospitals Programme

Read more about the shortlist of proposals for new hospital facilities in our region.

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