The PPP Journal - December 2003
West Berkshire Community Hospital
11 December 2003
Catherine Webster, Planning & Commissioning Manager with Newbury & Community Primary Care Trust, contemplates the ways to a first class healthcare facility.
West Berkshire Community Hospital is one of the first hospitals built for the NHS in partnership with the private sector. It is a project that has progressed smoothly to date and is set to be a shining example of what such a partnership can achieve, both in terms of functionality for its patients and staff, and also in architecture and design innovation.
Current hospital provision in Newbury and Thatcham is spread over two sites, with the central services housed in a building, dating back to 1865, in central Newbury. Although this hospital was successfully run for over a century, patient demand and development in medical practices have exhausted the current provision, and a new facility has been required for some time.
A bequest of £4m, made locally, recognised this need and turned the new project into a reality. The majority of the funding came about through the Private Finance Initiative (PFI) with investment infrastructure services and Facilities Management group, Jarvis plc, which brought the total to £16m.
Additionally, the Local Hospital Helpers League executed a rigorous fundraising campaign to raise £1m for the purchase of new digital x-ray equipment, through concerts, antiques events and donations, and sponsorship has been provided by Vodafone and other local organisations based in Newbury.
Despite some initial delays because of the nature of the funding structure, the programme began in July 2002, and is now progressing swiftly and to schedule; completion is expected in February 2004. A five week commissioning period has been allowed to enable a smooth transition and the new hospital is expected to be fully operational in March next year. Post-construction, Jarvis will continue to provide Facilities Management (FM) services (catering, portering, cleaning, security, maintenance and reception facilities) for 30 years, at the end of which, the facility will then be handed back to the NHS.
Unlike the existing facilities, the new West Berkshire Community Hospital is set in an urban setting, offering services to the local rural population.
Key advantages include double the amount of provision for daily patients and substantial growth in the throughput of outpatients from the current level of 28,000 to 40,000. Many patients, who previously had to travel some distance, will now benefit from being treated nearer to home as a result of new services.
Privacy and dignity are central themes of the NHS Plan, and the design and layout of this new facility have taken this into account. For example, the long mixed wards, referred to as 'Nightingale' wards, no longer exist. Instead, the new hospital features a combination of smaller wards and individual bedrooms; one in three patients in the new facility will be accommodated in individual rooms.
Again, to ensure privacy and dignity, the layout of the specialist consultation building in the new hospital has been structured to enable patients to progress to treatment rooms in a manner similar to airport checking-in systems.
A host of other design features have been incorporated with the patients' comfort and wellbeing a priority. These range from a separate waste management centre, positioned to ensure that noise from waste processing does not disturb patients, to balconies, courtyards and roof terraces. In recognition that the natural environment has a positive benefit on patients' recuperation, external landscaping will be extensive, and will include a therapy garden planted with therapeutic plants and herbs.
The central core of the new building is designed as an arcade, its glass roof providing a light and airy ambience. Furthermore, the individual panels in the roof's structure, similar to those used in the acclaimed Eden project in Cornwall, can be adapted to either maximise light or provide shade as is required.
The building will also benefit from an 'intelligent' under floor heating system, which has been developed to measure and respond to changes in temperature automatically, rendering obsolete radiators and their hunger for wall space.
Projects that bring about change often meet with opposition – whether from those content with existing facilities or from those distrustful of much publicised improvements. It was therefore imperative that a comprehensive and consistent internal communications plan was put in place, which would seek to address and allay people's concerns, engender support and enthusiasm, and ease the transition to the new hospital.
Hospital staff were involved in this project from the very beginning, at which point they were shown the architects' drawings and invited to comment. Their involvement has continued at a detailed level. Staff have been updated regularly with an internal staff newsletter and, through a series of site visits, have been able to see the new hospital taking shape.
For the purpose of illustration, Jarvis agreed to complete three sample rooms very early on in the project. The rooms – a typical out-patient examination/consultation room, an office and a five bedded ward – were finished to a representative standard and fitted out as far as was possible. They were open to all staff by prior arrangement. Naturally, this put pressure on the already tight build programme, but achieved huge support and enthusiasm from staff, which has been crucial in driving the programme forward.
The transition has also been aided by the establishment of internal working groups. The Clinical Practice and Change Group ensures that all clinical services are prepared for the move, and determines how they will function in the new hospital, introducing new ways of working to modernise the NHS. It also co-ordinates draft department operational policies which are written by staff – such as a decontamination strategy, occupational therapy and physiotherapy joint operational policy, and a wards operational policy.
A Decommissioning Group, headed by a specifically appointed decommissioning manager, was established to ensure the smooth transition from the old to the new hospital, and supervises suitable disposal (much of it by donation or auction) of that equipment and furniture that will not be required. Additionally, a Land Sales Group will oversee the sale of the Newbury Community Hospital and Sandleford Hospital sites.
The Commissioning team has been working since early August 2003 in focusing on the month's commissioning period following construction completion. Service managers have put together a moving plan, which will identify how their service will pause, pack up, move, unpack and re-start. Stringent health and safety checks will be carried out, and sufficient time will be allowed for the installation of equipment. Staff will also have the opportunity to go and spend time in their department or work area to familiarise and orientate themselves with the new building.
Given the importance of internal communications, a Human Resources Group was formed to supervise recruitment for the new hospital, and to identify training needs of both new and existing members of staff. Jarvis played an important role in communicating with the staff who will transfer through TUPE to work directly for Jarvis. It is essential that TUPE staff are aware of the changes and how these will affect them, and are comfortable with the change process.
The benefit that the new building will bring is unquestionable and the success to date suggests that a smooth transition can be made early next year. However, the desire to improve healthcare in West Berkshire in the long term does not end with this project. Provision has been made within the architectural plans for future extensions on the 24 acre site and decisions on further development will be taken at a later date.
This project shows that, with good planning, broad consultation and open lines of communications, it is possible to deliver a first class healthcare facility that will provide a community with 21st Century services.