Agenda item

To receive an update on Building Better Berkshire.

Alison Foster, Programme Director, Building Berkshire Together, and Andrew Statham, Director of Strategy, RBH provided an update on Building Berkshire Together.

During the discussion of this item the following points were made:

·       Since 2019 the Royal Berkshire NHS Foundation Trust (RBFT) had been placed on the New Hospital Programme (NHP) as part of the Government commitment to deliver 40 new hospitals by 2030.

·       The Strategic Outline Case had been submitted in December 2020 and had highlighted three possible options –

Ø  Part new build/part refurbishment on existing site – est £785m

Ø  Whole site redevelopment  - est £995m

Ø  New hospital on a new site – est £1.3bn

·       The hospital was part of cohort 4 and would be full adopters of the new approach to building new hospitals (Hospital 2.0), which entailed standardised designs, centralised processes and modern methods of construction.

·       Members were informed that it was anticipated that through economies of scale, there would be a significant reduction in time and cost to build new healthcare facilities.

·       The NHP Team had been progressing the Programme Business Case (PBC) for this approach with HM Treasury.

·       In March 2023 the Secretary of State for Health had announced the total programme budget up to 2030.

·       Some hospitals which had significant issues which needed to be addressed sooner, had been added to the original programme list.  This would potentially have an impact on some other hospitals being delivered by the 2030 deadline.  The impact for scheduling for RBH was not yet fully known.  Alison Foster emphasised that there had to be phasing in the programme to ensure sufficient capacity in the supply of the market.  Consideration of different hospitals were at different stages of the programme.

·       The Trust’s funding envelope had not yet been confirmed in writing, although it was expected imminently.  It was recognised that as part of the New Hospital Programme, it would reflect that some costs would be kept centrally and there would be some expectations on savings on the Trust’s original estimates.

·       Further progress was starting to be seen.  A request had been received to update the Enabling Bid submitted in August 2022, to reflect matters such as current inflation.

·       The Trust had been progressing the Outline Business Case (OBC) with the limited budget available from New Hospital Programme (NHP).  This had included developing the RBFT Clinical Services Strategy (CSS) into a Clinical Model to get to a Clinical Brief which included a Schedule of Accommodation needed for the new hospital.  As part of the OBC process the Trust had progressed Board approval of the Critical Success Factors (CSFs), Investment Objectives (IOs) and long listed options.

·       Considerable engagement using a variety of mediums had been carried out around the long list options to get to a shortlist which could be thoroughly assessed and appraised. 

·       Engagement had included a public survey collecting 3,692 responses.

·       The result of the shortlisting continued to go through a process of validation.  Further input was being sought from stakeholders such as the Berkshire West United Executive.

·       There were two leading options which envisaged a new hospital with services delivered through integrated care pathways.  Members were informed that while the Trust expected that the majority of acute services would be delivered from the new hospital building, the Trust was exploring ways in which integration might be better achieved through the colocation of certain services (including diagnostics) with providers of primary care, community and mental health services at a site away from the main hospital.  In the survey lots of comments had been received around the possibility of the co-location of mental health services.

·       As part of the options development, the Trust has been exploring other potential sites for the new hospital and a recent site search had identified two potential sites which need further investigation.   Both of these were located in the Wokingham Borough

Ø  Thames Valley Park (Brownfield site)

Ø  Thames Valley Science Park (Greenfield site).

          Further work needed to be undertaken to understand the viability and           affordability of these sites.

·       Alison Foster went on to outline immediate next steps which would be taken including the approval of the shortlist and the progressing of the full appraisal process to get to a preferred option and working with the New Hospital Programme on a Minimal Viable Product Hospital 2.0.

·       Regular engagement with the public would be maintained.  Engagement with groups identified through the survey which had been under-represented, would be increased. 

·       With regards to engagement, a Member referred to a recent engagement meeting in the Borough which had not been well attended.  She questioned how the Trust would encourage the public to engage with the process.  Alison Foster indicated that lessons had been learnt from the engagement process through the survey and in person events.  An online event was held each month to provide an update on progress, which was open to all.  These sessions were promoted online.  When more targeted events were carried out the Trust would use knowledge of where good turnout had been achieved previously and why.  Work had been undertaken with Healthwatch to maximise engagement in different areas.

·       The Trust had built on its engagement networks from undertaking engagement events.

·       A Member referred to the chalk mines underneath the current site and the potential difficulties of building upwards as a result.  In addition, parts of the current site were listed buildings.  She felt that Thames Valley Park would be a more appropriate option.  Alison Foster stated that surveys were being undertaken to help understand the issues with the current site, and whether it would be possible to build bigger.  The current site was land locked and surrounded by a conservation area and residential area, meaning that building upwards would be the only possibility.  Planning issues and other issues needed to be further explored.

·       A Member questioned whether Wokingham Hospital would become a rehabilitation hospital, and was informed that consideration was being given as to how existing estates could be used and working in an integrated way.  Andrew Statham reminded the Committee that Wokingham Hospital was run by Berkshire Healthcare Foundation Trust.

·       A Member questioned whether the current site would revert to the ownership of the original family should it no longer be a hospital.  Alison Foster indicated that the site had been gifted for health care purposes and that definition was quite wide.  There were several covenants on the site which would require further investigation.

·       In response to a Member question regarding the closure of Battle Hospital some years ago, Andrew Statham stated that one of the main challenges with the current RBH site was the condition of some of the buildings, particularly the older ones.

·       The Committee questioned whether the Green Park site had been ruled out as an option as it was now part of the wider evacuation zone for the Atomic Weapons Establishment.  Alison Foster indicated that it had not been ruled out but had not scored as highly as other possible options.

·       A Member queried whether two separate sites would be considered and was informed that this was part of considerations.  Other sites were being used for example for out-patients and diagnostics.

·       A Member questioned whether discussions had taken place across BOB regarding any specialisation which might direct some of the discussions around building locations.  Alison Foster stated that investment with the New Hospital Programme had to deliver benefits to a wider system.  However, it was difficult to progress matters until funding had been confirmed.  Sarah Webster added that discussions had taken place with Berkshire West.  In addition, discussions were taking place between the acute hospitals across BOB regarding areas where it made sense to collaborate.  Other neighbouring Integrated Care Boards, Frimley and Hampshire were also being consulted.

·       In response to a Member question regarding the possibility of a teaching hospital, Andrew Statham indicated that a key part of the Trust’s Strategy was how it worked in medical education and actively received students from Oxford and Southampton universities.

RESOLVED:  That the update on Building Berkshire Together be noted and that Alison Foster and Andrew Statham be thanked for their presentation.