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Transforming our hospitals

West Hertfordshire Hospitals NHS Trust (WHHT) and Herts Valleys Clinical Commissioning Group have been working on plans to secure funding for major redevelopment of hospital sites. 

In autumn 2019 the government confirmed funding for hospital redevelopment in west Hertfordshire. This is a significant milestone in our ambitions to deliver much needed improvements to our local hospitals and is great news for our patients and staff. 

The CCG and WHHT are in close communication with the Department of Health and Social Care and also our regulators, NHS England and NHS Improvement, about the public announcement of funding. The allocation announced is for a sum of £400m.

Our understanding is that the funding is being made available on the basis of the proposals contained in the strategic outline case – for the refurbishment and rebuild of Watford General Hospital, together with some development of the other sites in Hemel Hempstead and St Albans.

The strategic outline case detailed plans to invest approximately £350million across the three sites with a large amount of new build on the main Watford site which sees most patients and those with the highest medical needs. Affordability is a key factor in this plan with regulators and the government directing the hospital trust to develop investment plans that are in line with its annual turnover.

We are still waiting to receive the detail behind the government figure, together with written confirmation. We can then progress to developing more detail around our proposals as part of work to develop an outline business case. 

Follow this link for information about current hospital sites and the services that operate from each.

Hospital transformation plans

In autumn 2017, a plan, called a strategic outline case, to redevelop and refurbish existing acute hospital sites was submitted to NHS regulators. This proposed significant redevelopment of Watford General Hospital as the main A&E hospital providing emergency, critical and planned care and redevelopment of St Albans City Hospital for planned care. Read the strategic outline case here.

This followed a wide-ranging review of various options, including public and stakeholder engagement during 2016.

Find out more about the 2016 review of options here

Alongside this, during 2017 and 2018 the CCG worked with local clinicians, patients, councils and the community to develop complementary plans for new hospital facilities within Hemel Hempstead that could provide urgent, diagnostic and outpatient care.

Timeline to get to this point

2015 to 2016 - Your Care, Your Future

Widespread public engagement on the future of healthcare provision in West Hertfordshire, led by Herts Valleys CCG, leading to the development of a Your Care, Your Future vision. The vision is for more preventative, proactive and integrated care provided as close to home as possible with more options for patients to be seen by specialists in the community rather than needing to go to hospital. This identified that a further piece of work was required to review options for developing future hospital provision and develop a strategic outline case on a way forward. Visit our Your Care, Your Future section for more information.

2016 to 2017 - Development of strategic outline case.

During 2016 West Herts Hospitals Trust and the CCG carried out a wide-ranging review of various options for future hospital redevelopment. Options ranged from building a new hospital on a new site to varying degrees of redevelopment or refurbishment on existing sites. The process included financial and technical analysis and also public and stakeholder engagement. This concluded that redeveloping existing sites would be quicker, more affordable and more deliverable than a new hospital on a greenfield site.

In 2017 a strategic outline case that proposed significant redevelopment of Watford General Hospital as the main A&E hospital providing emergency, critical and planned care and redevelopment of St Albans City Hospital for planned care was approved separately by the WHHT and CCG boards. The hospital trust submitted  the strategic outline case to regulators in autumn 2017. Link to the 2017 strategic outline case.

Find out more about the 2016 review of options here

Alongside this, during 2017 and 2018 the CCG worked with local clinicians, patients, councils and the community to develop complementary plans for new hospital facilities within Hemel Hempstead that could provide urgent, diagnostic and outpatient care.

2018 to 2019 - Refresh of strategic outline case

Autumn 2018: NHS Improvement and NHS England fed back on the strategic outline case. They agreed that investment was needed because of the condition of the buildings. However, they said that the amount of capital investment requested by the trust was too high and asked for the SOC to be 'refreshed'.

In response this feedback from regulators WHHT and the CCG led a process to refresh the strategic outline case which also incorporated consideration of Hemel Hempstead. This was launched with a series of public meetings during October and November in each of the four localities in west Hertfordshire. These meetings were well attended, reaching around 200 residents.

 Presentation and questions and answers from the autumn 2018 meetings

January 2019: NHS Improvement wrote to the WHHT and the CCG clarifying that the hospital plans should be drawn up using the hospital trust’s annual turnover as a maximum threshold for any future investment. This figure is in the region of £350million.

On 29 January a second public event took place. This shared details of how the options for hospital redevelopment were shaping up in view of the NHSI guidance and explained the process for evaluating and shortlisting options.

Presentation and questions and answers from the January 2019 meeting

February 2019: West Herts Hospitals Trust and the CCG convened a stakeholder evaluation panel to examine the options under consideration from various aspects including patient care, accessibility and how they complement other parts of the health and care system locally. This panel had an advisory rather than a decision making role. To represent a range of stakeholder views this panel was made up of clinicians and managers from WHHT, the CCG, other NHS and partner organisations and seven patient and public representatives from across the four west Hertfordshire localities.

You can download the slides from the February panel meeting here and the extra information pack for the hospital options evaluation panel here.

Detailed information was gathered to support the evaluation process and this was also shared with the stakeholder evaluation panel. Follow the links below for further details:

- Demand and capacity information and analysis

- Population, catchment area and travel analysis

- Site options review

- HM Treasury guidance on how to appraise and evaluate policies, projects and programmes

During February scheduled 'private' meetings of the CCG and hospital trust boards each received an update on the investment threshold highlighted in the NHSI letter.  The boards each confirmed a shortlist that took account of the funding threshold. 

March 2019: A third public meeting (on 7 March) shared details of the shortlisted options confirmed by the hospital trust and the CCG boards. It invited people to comment on the shortlisted options in advance of these being examined at the second evaluation panel meeting.

Presentation from the March 2019 meeting

On 13 March the stakeholder evaluation panel met for a second time and scored the shortlisted options. The  Read the slide pack from the March evaluation panel here.

May 2019: The third and final stakeholder evaluation panel meeting received a summary of the outcomes of the economic appraisal alongside the outcomes of the panel's scoring of qualitative scoring for each of the shorlisted options. Read the slide pack from the May evaluation panel here. This also details the key features of the shortlisted options.

During scheduled meetings 'in public' the boards of the CCG and hospital trust again discussed and agreed the shortlist, so allowing the public to be party to this decision.

June 2019: The boards of West Herts Hospitals NHS Trust and the CCG met together on 6 June 2019 to discuss four shortlisted options for hospital redevelopment and to reach a consensus on the emerging preferred way forward for securing major investment in local hospital facilities. Link to board papers for this meeting.

View the board presentation showing indicative plans for each of the four shorlisted options

The boards provided indicative support for the option to retain and redevelop all three existing hospital sites in Watford, St Albans and Hemel Hempstead. Features are as follows:

  • Greatest amount of investment at Watford General Hospital with new clinical buildings housing theatres and critical care as well as women and children’s services and a refurbishment of the Princess Michael of Kent building, allowing significant improvement to inpatient ward accommodation.
  • St Albans City Hospital to be enhanced as a planned surgical facility including a new cancer and surgical centre with diagnostic suite as well as refurbishments to theatres and inpatient beds and the development of a small high dependency unit.
  • Hemel Hempstead Hospital to become a planned medical centre with services, including a newly provided urgent treatment centre, consolidated into redeveloped premises.

June 2019: A public meeting on 13 June updated people on the results of the stakeholder and financial evaluation of the options and on the emerging preferred option that came out of the meeting of the hospital trust and CCG boards.

Presentation from the June 2019 meeting

We filmed the 13 June event in response to requests from people who were not able to attend.

View the event on our YouTube channel here

July 2019: On 11 July the hospital trust board met and approved the strategic outline case detailing a way forward based on option one. The Herts Valleys Clinical Commissioning Group board met later the same day to consider the proposed way forward. The board endorsed the trust board’s decision.Read the papers for the CCG board.

Read the strategic outline case
 

Read the report of public and stakeholder engagement for the strategic outline case

 At the end of July 2019 the SOC was submitted to NHS regulators and central government for consideration.

Answers to frequently asked questions

Throughout the refresh of the strategic outline case we have been answering questions put to us by members of the public and have collated these into a document so that they are available for everyone.

Read responses to frequently asked questions about the refresh of the SOC here

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