West Herts Hospitals NHS Trust must submit redevelopment scheme capped at £400million

The West Hertfordshire Hospitals NHS Trust manages hospitals in Watford, Hemel Hempstead and St Albans
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The West Hertfordshire Hospitals NHS Trust has not given up on plans for a new hospital, but will have to submit outline costings to the Department for Health and Social Care (DHSC).

The DHSC wrote to trusts, including West Hertfordshire, last week informing them they needed to submit redevelopment schemes capped at £400million, alongside the trusts' preferred and more costly options, and a 'phased approach' to delivery of the preferred option.

Although final costs have not been confirmed yet, most of the pathfinder trusts have previously estimated that their schemes will cost significantly more than £400m.

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These include Manchester University (£600m), Princess Alexandra (£600m), West Hertfordshire (£590m), Epsom and St Helier (£511m), Leicester (£500m), and Leeds (£500m).

Prime Minister Boris Johnson's New Hospital Programme aims to 'deliver 48 new hospitals across England by 2030'.

The New Hospital Programme stated in its letter to trusts that there was a “clear expectation” that the “40 new hospitals” programme is delivered within a “finite and carefully controlled budget envelope” to ensure best value for taxpayers’ money.

This means a “decision to increase the funding allocated to any given scheme will require trade-offs elsewhere”, the letter stated.

However, it acknowledged that the £400m budget option “may not represent your preferred way forward or may have a higher forecast total cost over the longer-term”, but it added that “this approach will ensure that in-budget options are fully considered along with other shortlisted options”.

West Hertfordshire Hospitals NHS Trust has been working on plans to improve its facilities and secured planning permission last week for a near-total rebuild of its hospital in Watford.

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The trust initially planned for a £350 million development, which was then upped to £400m in 2019. Last year, the trust received a letter from the DHSC which indicated there may be up to £540 million to spend in Watford, along with £50 million at St Albans City and Hemel Hempstead hospitals.

Hospital trusts will find out exactly how much they have to spend when a full business case has been approved.

The trust’s acute redevelopment programme director, Duane Passman, said: “At this early stage, we are working with the New Hospital Programme to ensure value for money and no expectations have been set about maximum costs.

“All of the options we are working on are based on retaining our current three hospital sites and will be publicly available when our OBC is completed later this year or in early 2022.

“Our outline planning application for the Watford site has just been approved by the local council.

"Our vision is for each hospital to have a clearly defined purpose and to maintain a range of local services.

“Emergency, inpatient and complex care will remain at Watford General; Hemel Hempstead Hospital will be the site for planned medical care and long term conditions and St Albans City Hospital will provide planned surgery and cancer care. Urgent care services and some outpatient services will be provided at all three sites.

"Diagnostic facilities will be significantly upgraded at all three hospitals and the latest digital technology will be incorporated.

“There is also strong clinical support for this model.”

The Department of Health and Social Care and NHS England and NHS Improvement joint central programme team are working closely with all NHS trusts involved to plan how and when new hospitals will be built across the decade to make sure we meet our target with this delivery programme.

This includes considering how the trusts phase the whole hospital building programme so they can work with similarly developed trusts to maximise the benefits for other schemes.

A Department of Health and Social Care spokesperson said: “We remain on track to deliver 40 new hospitals across England by 2030 to transform services for local communities, backed by an initial £3.7 billion.

"Together with eight existing schemes, this will mean 48 hospitals by the end of the decade.

“This is the biggest hospital building programme in a generation so we are working closely with the NHS Trusts involved to plan how and when new hospitals will be built across the decade, so new services for patients and staff open on time and within budget.

“As part of our plans to build back better, all the hospitals will prioritise sustainability, digital technology and the latest construction methods to see them built as quickly as possible, to the highest standards.”

Calls to build a new hospital on a brand new site that campaigners felt would be more accessible for patients in Dacorum and St Albans were rejected by the Trust.

Spokesperson for HertsValleysHospital.co.uk Steve Day said: “The wheels have well and truly come off the bus. The trust is now in the almost impossible situation of having to dust off their previous plan to refurbish the Princess Michael of Kent building to meet the £400m cap.

"Their aspirations to spend £590m (or more) had already been reigned back despite them proceeding with the planning application and design work. A refurb to the Princess Michael of Kent building is both impractical and unrealistic.

“The opportunity now for the trust and Department of Health is to take stock of what is affordable and deliverable as opposed to the previous decision that inappropriately ruled out building on clear sites and took no account of cost.

"Most importantly, the public can get on board with a centrally located hospital supported by facilities in each of the three main towns."

In a joint statement of support Elected Mayor of Watford, Peter Taylor, and the town's MP Dean Russell, said: "Watford needs new and better hospital buildings and we are closer than we have ever been to achieving this, not just for Watford residents, but for the entire population of West Hertfordshire.

"We are confident that the Trust’s years of hard work and detailed examination of the facts, finances and feedback behind their proposal will deliver the best solution for hospital services across its three sites.

"Now is the time to get behind the Trust as they put their case to the government’s New Hospital Programme to get the funding needed.

"Attempts to deflect this focus with rehashing old arguments about alternative sites that we know have been shown to be unrealistic and unaffordable is doing a huge disservice to the Trust and, more importantly, to local people who deserve to see the transformational plans delivered as soon as possible.

"We don’t need another site, we just need the funding.

"We will both be writing to the New Hospital Programme to reiterate our support for the Trust’s plans."