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Developing hospital services

The future of our local hospital, or ‘acute care’, services is a key element of our Your Care, Your Future vision for a healthier West Hertfordshire. We need to make our hospitals fit for the future to support a growing population and to reflect changing health needs, healthcare advances and new models of care. We must develop buildings to modern care standards and make sure they have the right capacity in the right area to meet changing needs.

Improved facilities that meet modern building standards will result in better medical outcomes and a better experience for patients, a better working environment for staff, improved safety and fewer maintenance-related service disruptions.

Current situation

Hospitals locally are managed by West Hertfordshire Hospitals NHS Trust.

  • Emergency care is centralised at Watford General Hospital, with accident and emergency and inpatient services and an acute admissions unit.
  • St Albans City Hospital is a dedicated centre for elective surgery with supporting outpatient and diagnostic services.
  • Hemel Hempstead Hospital provides a number of services including urgent care, endoscopy, radiology, outpatient clinics and a small number of intermediate care beds.

The Watford General Hospital site needs urgent investment to provide a lasting solution to capacity needs and to ensure that buildings meet modern care standards.

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.

Refresh of the strategic outline case

In late summer 2018 NHS Improvement (NHSI) gave initial feedback on the strategic outline case for the acute hospitals. They made two key points: firstly they acknowledged the need for funding and secondly that public money for hospital redevelopment is limited with strong competition from other hospitals across the country. In response to feedback from regulators West Hertfordshire Hospitals Trust and the CCG are working on a refresh of the SOC that will provide one plan for hospital facilities and services across the whole of west Hertfordshire.

West Herts Hospital Trust and the CCG are using the need to refresh the strategic outline case as an opportunity to examine a range of options for configuration and location of future hospital services. This examination of options must take account of a clear steer from NHS Improvement that West Hertfordshire Hospitals Trust will not be able to borrow a figure in excess of their annual turnover which is approximately £350 million.

Evaluation of options

Evaluation panels met during February and March to examine options from various aspects including service quality, patient experience, accessibility, deliverability and how they complement other parts of the health and care system locally. The panels include patient and public representatives as well as medical experts and health and council managers. This process will help to arrive at a recommended preferred option which will then be subject to further scrutiny and analysis.

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

Download the slide pack from the March evaluation panel here

Detailed information has been gathered to support the evaluation process. This has been shared with the options evaluation panel. Please 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

Engaging with patients and the public

We have committed to running the refresh in an open and transparent way so that the thinking and process to arrive at a preferred option is clear for everyone to see.

Public meetings

A series of public meetings took place during autumn 2018 in Hertsmere, Dacorum, St Albans and Watford. The meetings gave an update on the work being undertaken to refresh the SOC and to answer questions. These meetings were well attended, reaching around 200 residents.

 Read the presentation and questions and answers from the autumn 2018 meetings

The next meeting took place in January 2019. This event shared details of how the options for hospital redevelopment are shaping up and explained the process for evaluating and shortlisting options. We used feedback from the previous meetings to change the format for the question and answer session - rotating questions between different local areas so that everyone had an equal opportunity to contribute and discussions weren't dominated by one perspective.  

Read the presentation and questions and answers from the January 2019 meeting

The most recently meeting in March 2019 shared details of the shortlisted options that are being considered and invited people to comment on these in advance of the options being examined at the second evaluation panel meeting.

Read the presentation from the March 2019 meeting

Fit with wider plans

Acute hospital plans forms part of the proposals within the sustainability and transformation plan for Hertfordshire and West Essex. Members of the sustainability and transformation partnership confirmed their support for the preferred option. However, they said that as the plans developed further they would want to see further assurances that the proposed solution is affordable and would provide the right amount of capacity.

Hospital plans must factor in changes to services that are happening as part of Your Care, Your Future.  In some areas like gynaecology, musculoskeletal services and diabetes some outpatient services are being provided through newly developed community services rather than in hospitals. New community-based services for ear, nose and throat and ophthalmology will be launching early in 2019. The changes will see acute hospitals increasingly focusing on emergency and critical care and patients with more complex health needs.

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