Where to build two new hospitals?

Since the May 2023 Government announcement of two new hospitals to replace Royal Lancaster Infirmary and Royal Preston Hospital, a popular question has been ‘where will the new hospitals be located?’.

Jerry Hawker, Senior Responsible Officer for the Lancashire and South Cumbria New Hospitals Programme, explains the complexities around the process of selecting new sites for new hospitals.

What do we know so far?

I hope the news reached you that the Government has announced a record investment of more than £20 billion, ring-fenced for the next phase of the national New Hospital Programme, which brings proposals for new cutting-edge hospital facilities for Lancashire and South Cumbria a step closer. This means that the NHS in Lancashire and South Cumbria is working towards its preference for new hospitals on new sites for both Royal Preston Hospital and Royal Lancaster Infirmary, with investment in improvements to Furness General Hospital.

The existing Royal Preston Hospital and Royal Lancaster Infirmary sites will remain in place and deliver services to our population until new hospital facilities are opened.

Where will the new hospitals be located?

We are aware of how keen people across the region are to know exactly where these new hospitals will be. The short answer is that we do not know yet. If only it was as simple as finding a large enough piece of land that is available, signing a few forms and then getting to work. Building new hospitals in new locations is a monumentally difficult task, with more things to think about than you might imagine. We have certainly learned a number of things along the way.

Building two new hospitals on new sites provides us with a unique opportunity. You can design them to be optimally efficient hospitals with the latest thinking and latest designs, rather than be compromised by designs dating back to the 1970s or even the Victorian times (which is the case with the current Royal Lancaster Infirmary and Royal Preston Hospital sites respectively).

We are looking for a new site for Royal Lancaster Infirmary within around a 10-mile radius of the current Royal Lancaster Infirmary site, and a new site for Royal Preston Hospital within around a 10-mile radius of the current Royal Preston Hospital site. When exploring sites for Royal Preston Hospital, we have to consider accessibility for the whole population of Lancashire and South Cumbria as it is a major trauma centre where people from across the region will travel to for more specialist care.

It is crucial that we are able to find suitable and available sites that are best located for the population and patients that the hospitals provide care for and also for our colleagues who work in those hospitals. It sounds obvious to state, but when you change the location of any building it naturally becomes closer for some people and further away for others. This poses a great challenge, as we want to provide patients with high-quality, next-generation hospital facilities that will improve health outcomes across our population, without inadvertently disadvantaging others. We also need to carefully consider what we can do to minimise the impact of a change in location for those people who are most affected.

What kind of hospital sites have you been looking at?

We have been looking for land which is available, big enough to accommodate a large hospital and everything that would come with this, such as space for parking. We also need to know that the right utilities are or could be in place, such as water supply, electricity, and so on.

How people will physically get to the new hospitals is a huge consideration. Travel and transport analysis is conducted to understand site accessibility, so that we are aware of exactly how potential new locations would affect how people get to the hospitals. This includes everything from looking at the nearby road infrastructure to what this means for people using public transport to attend hospital appointments. Whenever we talk to people about the programme, how people will get to the new hospitals is always one of the first points raised, so we are very aware that this is a key concern for patients, family and carers, and the wider public.

The NHS in Lancashire and South Cumbria has been working in partnership with Town, City, Borough and County councils to assess the deliverability of a number of potential sites, including environmental, planning and highways considerations, capacity for utilities and high-level design. We have also been considering topography (the lay of the land), flight accessibility for air ambulances, properties of soil (to inform what foundations would be needed) and archaeological surveys.

Once we are happy with all of these considerations, the task is to secure the land, which has got to meet the affordability criteria and provide value for money.

All of this is then subject to planning approval with local councils, before submitting the required business cases to NHS England and the Department for Health and Social Care (DHSC) for approval.

Where are you up to with the process of selecting locations for new hospitals?

With all this in mind, we are not yet in a position to share the conclusion of our work on assessing suitable potential sites and inform people across the region of where we recommend two new hospitals should be located.

Further detailed work is underway to assess the viability of potential locations for new hospital builds for both Royal Lancaster Infirmary and Royal Preston Hospital and to develop the required business cases. This work started many months ago, as we planned for all options on our longlist of possible solutions published back in September 2021.

There is still further work to be completed in this area and additional sites may emerge over the coming period.

I can assure you that further information will be shared in due course, and we are aware that people are keen to hear the recommended locations at the conclusion of this stage of work.