Lancaster and Preston could get a new hospital each - but it's 'too soon to rule out' super hospital option
There is no “bottom drawer” plan to merge the Royal Lancaster Infirmary and Royal Preston hospitals as part of a bid for government funding to build new acute NHS facilities in Lancashire.
That was the message to a recent meeting of Lancashire County Council’s health scrutiny committee, which heard concern over the possible creation of a so-called “super hospital” to serve central and northern parts of the county.
However, members were also told that it was too soon to rule out altogether the possibility of a single-site unit replacing the ageing hospitals in Lancashire’s only two cities.
The government last year announced that the county had been selected as one of 40 areas where new facilities could be built over the next decade. The options set out included the construction of new hospitals in both the Lancaster and Preston areas – or one new building to replace the current two.
Phil Woodford, associate director of corporate affairs at University Hospitals Morecambe Bay NHS Foundation Trust – which runs the Royal Lancaster Infirmary – said that Preston and Lancaster had opted to pool a previous allocation of “seed funding“ handed out by the government to draw up initial proposals for new hospital builds.
“We decided…given our closeness, that it would be better value for the taxpayer if we put our money together and instead of commissioning, say, two lots of architects and surveyors, we [tried to] get more bang for our buck.
“It’s really unfortunate that we have got headlines around [a] super hospital. There is no bottom drawer [bid] that says we want a super hospital or to merge the hospitals,” said Mr. Woodford, who added that he was committed to pursuing a “meaningful consultation with the public and all interested people”.
That process is likely to begin before the end of the year when a shortlist of options on which to consult has been drawn up. A longer list of possibilities is set to be presented for approval to NHS England by the middle of next month.
Lancaster Central county councillor Gina Dowding, representing Lancaster City Council on the committee, called for NHS leaders to confirm that a super hospital was not on the table, so that the people of Lancaster and Preston could “relax that…the local A&E and key core services will be available in their communities".
Jerry Hawker, executive director of the Lancashire and South Cumbria new hospitals programme, said that “the full views of the public” would be taken into account, but added: “At this stage, I don’t think we can rule out any option.”
He added: “We have to look at the clinical options [and] the accessibility options, but we also have to look at the affordability of the programme.
“But I can reinforce that we will be taking a very balanced view considering all three of those different considerations and, most importantly, the views of the public in terms of any options that go forward for public consultation.”
Dr.Gerry Skailes, medical director for Lancashire Teaching Hospitals NHS Foundation Trust, which operates the Royal Preston, stressed that “absolutely no decisions have been made” about the location of any new single hospital, nor whether there will ultimately be one or two new buildings built.
“We’re very much in listening mode currently. We’re working through what the possible options will be, but one thing is certain – we need to ensure all our residents have access to…high quality care.
“In terms of the specialist care, there is clear evidence that highly specialist episodes of care have better outcomes if the individuals providing that care are seeing a high volume and maintaining [their] expertise.
“But we also have a significant opportunity here to ensure that [other] elements of patients’ care…are undertaken closer to home for them,” Dr. Skailes said.
Lizzi Collinge, addressing the committee as the county councillor for Lancaster East, said that while residents recognised “the absolute state” of some of the facilities at the Royal Lancaster Infirmary, it was important that services remained accessible to those on public transport, people with with disabilities and relatives of patients having long stays in hospital
She also said that the “knock-on effect” of any future decision to move intensive care away from the city was “really concerning”, because of the impact it would have on other services like maternity.
“If we don’t have [intensive care] in Lancaster, then we don’t have any form of surgical birth – whether that is surgical assistance during birth or [cesarean] section,” County Cllr Collinge said.
Phil Woodford acknowledged that: “For all acute care, if there [are] no back-up emergency services, those consultant-led services can’t exist and everyone has to be blue-lighted away.”
However, Dr. Geoff Jolliffe, clinical chair of Morecambe Bay clinical commissioning group (CCG), said that the region currently had “poor outcomes in health” – and that the new hospitals programme should be “a catalyst” for wider changes.
“We deliver far too much care in hospital, we deliver far too many operations, we deliver far too many services for ill people [without] promoting health and wellbeing,” said Dr. Jolliffe.
Committee member and Morecambe South county councillor Charlie Edwards also called for the current Royal Lancaster site to be put to use as a “community health asset” for public health and ill-health prevention purposes – and not sold off once it is redundant in its current form.
He added: “We need to make sure that the Lancaster and Morecambe community are engaged throughout this process – this is a scary proposition.
“We have got to make sure that the public are with us all the way whatever proposals come forward. We have got to make sure that the services are what we focus on and not the bricks and mortar – that is absolutely key.
“What I’d really like to see come through… is [the alignment of] adult social care with this new hospital project,” County Cllr Edwards said.
Jerry Hawker said that the NHS in the region had a “wider ambition” to focus on prevention, early intervention and more integrated services – and that it needed to go hand-in-hand with the hospital-building programme.