Agenda item

An update document has been provided for the Panel. A representative from the HIP2 team will be present at the meeting to answer questions.

Simon Cook, RUH HIP2 Programme Director introduced this item to the Panel, a summary is set out below.

Health Infrastructure Plan 2 (HIP2)

Second phase announced October 2019 (HIP2) – a rolling five-year programme of investment in health infrastructure, encompassing:

·  capital to build new hospitals,

·  modernise our primary care estate,

·  invest in new diagnostics and technology, and

·  help eradicate critical safety issues in the NHS estate

Invited to bid for up to £450m – A once in a generation opportunity.

Programme Plan Overview

Strategic Outline Case to be submitted by December 2021 following development work on the Strategic Case, Commercial Case, Economic Case, Financial Case and Management Case during the year. We are keen to submit the case sooner if possible to improve the chance of securing the funding for the local system.

A Once in a Generation Opportunity

We are working with our system partners to ensure that the plans we develop will be fit for the future of health and care for our population.

·  HIP2 will introduce the much needed capital investment (up to £450m) to the local economy

·  HIP2 is a catalyst for change across the local health and care system - we are challenged and excited by the need to consider what the future model of care will look like

·  HIP2 is not simply about buildings – it demands an integrated approach to future service delivery

Our HIP2 ambition:

“Achieving better outcomes and experiences for patients and families through flexible integrated care using innovations that work, and supporting ageing well”

Clinical Vision and Model of Care

The following has been developed with input from partners including

the BaNES Integrated Care Alliance:

·  Proactive, preventative care that plans to maintain health and wellbeing, continuously improve clinical outcomes, and reduces healthcare inequalities for our population at all stages of life, supported by the right infrastructure at a health and wellbeing campus

·  A population health approach – supported by data and analytics in a transformed digital and IT infrastructure – to intervene early and prevent deterioration, with patient held data and interaction through apps as the default, improving the experience of healthcare for our population

·  Full integration across the system (primary care, social care) to meet the breadth of needs, based on a stratified model of population health

Investment Objectives

Underpin achievement of our clinical transformation objectives, and hence improve patient outcomes & experience: providing care closer to home through integrated local models of care, reducing health inequalities, contributing to delivery of the Trust Strategy, BSW Strategy and NHS Long-Term Plan commitments by 2030 or earlier.

Provide a feasible solution for resolving operational challenges.

Develop a sustainable estate solution: providing flexible capacity to serve our population for the next 25 years and beyond, adapting to future changes in service delivery; building a Net Carbon Zero estates footprint by 2030.

Critical Success Factors

Enable delivery of excellent patient care incl. care closer to home & reduced health inequalities through integrated local models of care, realising the BSW Strategy and NHS Long-Term Plan commitments.

Maximise broader economic benefit for Bath and North East Somerset.

Demonstrate affordability against the £450m capital allocation, releasing additional funding where possible (e.g. through sale/ development of excess land).

Develop a sustainable estate solution with flexible capacity to serve population into the future and adapt to future changes in service delivery.

Cancer Centre – first HIP2 deliverable

The Cancer Centre will be the first phase of the RUH HIP2 programme:

·  £51m (£42m of HIP2 funding)

·  Subject to final approval, construction mobilisation due to commence in February 2021 – Opening due 2023

·  7,000m2 of new build providing high quality cancer services, improving the experience for both patients and staff

·  Subject to agreement from the national programme, the intention is also to fund an Alongside Midwifery Unit via HIP2

Plans for further engagement

We are working in conjunction with local system comms and engagement teams, developing our plans together and we plan to co-host a lot of the meetings and engagements going forward – this plan is for the system, not just about hospitals.

We are planning a series on online ‘workshops’ for patients and other key stakeholders to discuss different aspects of the proposals. For example, the treatment of long-term conditions, emergency care pathways or the use of new technology. We would welcome Select Committee members involvement in these.

Next steps

·  Deliver a comprehensive engagement plan for local people and stakeholders

·  Work with system partners to further develop the clinical model and vision

·  Develop strategic options for our estates solution

·  Meet with yourselves and other local authorities formally and informally to share more details as they develop and work together to ensure effective engagement with the local population and enable a swift submission of the Strategic Outline Case

The Chair asked for further information as to how the £450m would be allocated following submission and assessment of the Strategic Outline Case.

Simon Cook replied that in order to attempt to gain the maximum amount of funding the Strategic Outline Case will be based on a robust clinical model that is right for the local population and tackles the needs of the estate. He added that to some degree it is a competition and that the case needs to be both compelling and timely.

The Chair commented on the possibility of capturing and reusing anaesthetic gas on site at hospitals asked if the RUH were considering this and were they working with the Council with regard to tackling the Climate Emergency whilst working towards their target of a Net Carbon Zero Estate by 2030.

Simon Cook replied that he was aware of the work surrounding anaesthetic gas. He added that it is an aspiration to achieve Net Carbon Zero across the RUH site, but any new buildings will have that as a requirement when constructed. He said that they were also looking at a potential change in energy supply to the site from steam to electricity.

He stated that work was also ongoing to minimise journeys to the site for appointments that can be delivered at another locality or via a different mechanism.

Councillor Alison Born asked if all of the other HIP2 Trusts within the South West were bidding for the same allocation of £450m.

Simon Cook replied that they were not and that each Trust will have been allocated its own potential amount of funding.

Councillor Alison Born when would the health priorities of the case be identified and what the process behind that would be.

Simon Cook replied that the RUH would not look to determine these in isolation as they are something that would be developed alongside system partners. He added that their work will look to align with the BSW Long Term Plan.

Councillor Alison Born asked if allocation of bed spaces was a factor being considered as part of the Strategic Outline Case.

Simon Cook replied that from a capacity point of view it was about the numbers of staff that are available not just the number of beds that are in place. He said that they will need to consider the issue as part of putting together the business case.

Kevin Burnett asked how much of the potential £450m would be used on backlog maintenance and how much would be for new projects.

Simon Cook replied that a survey was near completion on this matter and that the figure is looking around £50m for backlog maintenance. He added that if a building is deemed not fit for purpose it could be replaced rather than repaired if there were to be financial and clinical benefits.

Kevin Burnett asked how education facilities were to be involved in preventative work.

Simon Cook replied that they are looking to provide education in schools with regards to health and wellbeing.

Kevin Burnett asked for further information relating to the Health & Wellbeing Campus.

Simon Cook replied that there was not a strategic solution in place for this yet. He added that this proposal was a key element for staff to participate in as well as patients as the site could provide them with a space to rest and recover.

Councillor Paul May proposed that the Panel supports fully the investment into the RUH via the Health Infrastructure Plan 2 and their forthcoming Strategic Outline Case.

Councillor Andy Wait seconded the proposal.

The Chair also asked that the Panel receive regular updates via their meetings as to the progress of the Strategic Outline Case until any funding has been secured.

The Panel RESOLVED to agree with the proposals made by both Councillor May and the Chair.