An overview of the current position of Epsom General Hospital, in relation to the outcome of the Improving Healthcare Together consultation, and the impact of the COVID-19 pandemic on the works being under-taken at Epsom
General Hospital, and on the clinical services being provided to our residents.
Daniel Elkeles: Chief Executive, Epsom & St. Helier University Hospitals NHS Trust
The Panel received a presentation from Daniel Elkeles, Chief Executive, Epsom & St. Helier University Hospitals NHS Trust. The presentation provided an overview of the current position of Epsom General Hospital, in relation to the outcome of the Improving Healthcare Together consultation, the impact of the COVID-19 pandemic on the works being undertaken at Epsom General Hospital, and on the clinical services being provided to residents.
Mr. Elkeles confirmed that £500m had been secured to build a new specialist emergency care hospital, and to refurbish both the Epsom and St Helier hospital sites.
Mr. Elkeles provided the Panel with a timeline summary of the Improving Healthcare Together consultation that resulted in Sutton being the preferred location for the new specialist hospital with Epsom and St Helier retaining 85% of the services.
Merton Council did not agree and had asked the Secretary of State to refer the decision to the Independent Reconfiguration Panel. The Independent Reconfiguration Panel had since agreed with the NHS’s decision and advised that the programme of work continue to proceed.
Mr Elkeles said that the business case was being prepared and would include the following:
· The provision of more beds.
· A redesign of the buildings as to increase the number of single rooms. Mr. Elkeles confirmed it was currently aimed for 70% of the beds to be in single rooms.
· The improvement of travel and access to all sites.
· Plans to ensure the hospital is net-zero carbon neutral.
· To have in place a new Electronic Patient Record system.
· Plans for a specialist renal care facility to operate from one location.
Mr Elkeles gave further details on the hospital’s redesign in respect of the single rooms. He advised that all rooms would be in the line of sight to clinical staff, improve infection control, and offer patients privacy and dignity.
Mr Elkeles spoke about the significant investment at the Epsom and St Helier sites, confirming 6 major construction projects were underway.
The time-line for the programme of work was to be as follows. The final business case to be submitted by 31st December 2020. Final approval was due to be secured in January 2022, with the specialist hospital build in Sutton to commence in February 2022. It was anticipated that the specialist hospital would open in 2025.
Mr Elkeles confirmed that out of the 40 Hospital Trusts due to submit a business case, it is anticipated that Epsom and St Helier University Hospital Trust would be ranked 2nd and that he was therefore confident in the ambitions set out.
The Chairman asked a question about the proposed layout of the single rooms and the visibility of patients. Mr Elkeles confirmed that the focus was on an experience of privacy and dignity for patients, with glass panels that would allow nurses to see in, and windows that would allow patients to look out on a courtyard.
A Councillor asked about the electronic patient record system, asking whether there would be liaison with other agencies such primary care or adult social care, as to promote seamless travel for patient records across services.
Mr Elkeles and Dr Floyd (Medical Director for Surrey Downs Health and Care – also in attendance) confirmed that it was intended that the Hospital would adopt the same system as is already used by Surrey Downs Health and Care and the Mental Health Service across Surrey, thus benefitting from having one common medical record.
A Councillor asked about cost management and the risk of over-spend.
Mr Elkeles advised that the business case methodology included Optimism Bias set at 15% of the overall budget. In addition to this, a pre-determined rate of inflation was predicated over several years as to not under-estimate construction costs. The business case would also need to outline the money required for the Epsom and St Helier refurbishment costs.
A Councillor asked about transport issues, and asked if reassurance could be given that there would be adequate spaces for those with mobility issues.
Mr. Elkeles advised that on the site of the specialist emergency hospital, it was proposed to build a 1,000 space multi-story care park. This would be situated approximately 100 metres from the main building and as such there will also be a drop off point and some allocated disabled parking.
A Councillor asked about the additional beds and whether they would serve the same number of people.
Mr Elkeles confirmed this was the case, however the pandemic had demonstrated that the hospital needed more ITU beds than had been planned for in the original business case. These beds would be in the final design.
The Chairman commented on the plan to provide renal services from a single location and asked for further elaboration on this.
Mr Elkeles advised that historically renal services had been delivered in such a way that meant St Helier provided the clinical care, and St Georges provided renal surgery. This was not ideal for the patient. Renal specialists had requested that all services be delivered in one location. The Trust was subsequently producing an options appraisal for this.
Mr Elkeles advised that renal care is a specialist service and if the business case to deliver it from one location could be made, it was likely to result in better outcomes for the patients, and a better experience overall.