Government must be "left in no doubt' that Preston and Lancaster hospitals need replacing

Lancashire needs to create a “slam dunk” case to convince the government to stump up the £1bn it will take to replace the Royal Preston Hospital and Royal Lancaster Infirmary.
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That is according to the woman leading the charge to ensure the county secures its share of the cash pledged by ministers to build dozens of new hospitals across the country over the next decade.

Rebecca Malin told a meeting of Lancashire and South Cumbria’s joint committee of clinical commissioning groups (JCCGs) that the condition of the two ageing buildings was “holding back” healthcare in the region – and even putting off potential new staff.

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“When people come for interviews and look around our sites, we get feedback on the state of our facilities, the lack of access to new and modern technologies and on car parking.

The Royal Preston and Royal Lancaster hospitals are in line for replacement - and in need of it, according to NHS leaders in LancashireThe Royal Preston and Royal Lancaster hospitals are in line for replacement - and in need of it, according to NHS leaders in Lancashire
The Royal Preston and Royal Lancaster hospitals are in line for replacement - and in need of it, according to NHS leaders in Lancashire

“The current condition of our estate at Preston and Lancaster…means our services are fragmented,” added Ms. Malin, who is the programme director for the region’s new hospitals project.

The government announced late last year that the Royal Preston and Royal Lancaster could be replaced either with two new facilities or one so-called “super hospital”, plus three urgent care hubs located elsewhere in Central and Northern Lancashire.

However, before any decisions are taken, the region will have to construct a “case for change” document as ambitious as the new hospitals it wants to build.

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A long list of options for the overhaul of hospital services in the area will have to be drawn up by mid-May, for approval by NHS England ahead, of a full-scale public consultation due to take place before the end of the year.

“We need to tell a story – we need to make this a real slam dunk case for change, so that when someone picks it up, they are in no doubt as to why Lancashire and South Cumbria need new hospitals,” Ms. Malin said.

However, she told a separate meeting of the region’s integrated care system (ICS) that whatever shape the proposals ultimately take, they will be the “biggest and the most complex” of the 40 new hospital projects earmarked by the department for health and social care (DHSC).

It is understood that use of digital technology and an ambition to create net zero carbon facilities will be deemed by the DHSC as essential elements of any bid.

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Ian Cherry, non-executive member of the Greater Preston CCG, also warned at the ICS meeting of the “competitive” nature of the process, which would pitch Lancashire and South Cumbria against other parts of the country, because “there isn’t enough money to go round” under the £3.7bn government plans.

Notwithstanding the complexity of creating a convincing case, the chief executive of University Hospitals of Morecambe Bay NHS Foundation Trust, Aaron Cummins, said there was a need for the proposal to “keep things as simple as we can” – in order to make it an “easy” decision for ministers to make the requested investment in the region.

That moment of truth will come when a subsequent business case – building on the case for change and the outcome of the public consultation – is submitted in March 2022.

The work to get to that point will be led by clinicians, 25 of whom have so far been appointed to the new hospitals programme board. JCCCG members were told that evidence shows health service transformation plans are “far more successful and sustainable” as a result of clinical involvement.

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A series of workshops, involving staff and patient representatives, have already been held – and there will be an ongoing push to raise awareness and generate “excitement” about the plans amongst the workforce and the public.

Although focused on the Preston and Lancaster sites, the new hospitals programme will involve all NHS organisations in the Lancashire and South Cumbria region as part of wider work to improve healthcare provision across the patch.

The future of the accident and emergency unit at Chorley and South Ribble Hospital is also now likely to be determined as part of the process, after a separate planned consultation into the facility was scrapped last month following the intervention of the health secretary.

Commenting on a draft version of the case for change at the ICS meeting, Graham Burgess, lay chair of Blackburn with Darwen CCG, cautioned that the final document needed to reflect issues with access to services in all corners of the county – and also propose solutions as well as identifying problems.

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Rebecca Malin told the JCCCGs gathering that the document should not focus solely on “everything that’s wrong”.

“We want to build on what’s right – we’ve got a great population and a great workforce, but with new hospitals, it could be even better,” she said.

In a statement, ICS chief officer Dr. Amanda Doyle said that Lancashire and South Cumbria were being offered “an incredibly exciting opportunity to build brand new hospital facilities and help local people live longer and healthier lives”.

She added: “I want to emphasise that no decisions have yet been made about the shape or location of new hospital buildings. Collaboration with local people will be a fundamental part of our process.

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“Over the coming months, we will be carrying out extensive engagement with our communities to explore how the new funding could best be used to provide the health services of the future. Working together, we can make sure that the proposals we submit to government are people-focused, inclusive of all, and offer the best possible quality of care and experience.”

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