Agenda item

Members to receive a report providing an update on the reconfiguration proposals for University Hospitals Leicester.

Members will also receive a report providing an overview of the planned move of the elective Dermatology service from Leicester Royal Infirmary (LRI) to the St Peter’s Health Centre.

Members received a report providing an update on the reconfiguration proposals for University Hospitals Leicester.

Richard Mitchell, Chief Executive Officer, UHL introduced the report reminding members that funding was initially confirmed for the programme in September 2019 with full consultation taking place thereafter. He went on to provide a recap of the interim reconfiguration project and the delays that had arisen due to the covid pandemic which had led to changes around how prevention of infection was looked at, alongside changes in policy such as achieving carbon net zero and the greater significance of digital transformation.

Richard Mitchell advised that whilst there were some delays UHL had still made progress, and went on to give an overview of the current status of the main reconfiguration programme; impact of the development of the programmatic business by the New Hospital Programme and how that affected the position in terms of the Trust being told of its final capital envelope and delivery programme.

Members were concerned about the uncertainty of the final capital figure. Assurance was given that it had been confirmed in 2019 there would be £450m capital and the ongoing conversation was not questioning whether plans would happen but were about how much more could be added to account for the cost increases that had occurred since.

Members referred to the current economic climate, rising costs and effect of inflation and were disappointed by the lack of clarity about what would happen if there was no subsequent funding uplift to account for rising costs.

Richard Mitchell advised that he had taken on ownership of the reconfiguration plans and collectively the board were making sure that they were building for the best services. He reiterated that conversations were taking place about the increased costs/inflation and how that could be covered. UHL were also looking beyond plans for money coming only from the treasury and were exploring the feasibility of working with long term partners to generate money. It was accepted that the costs base had increased but it was hoped that UHL would receive an increase in funding in a few months. It was emphasised that UHL were committed to delivering, primarily on good health services, and if it became necessary they would revisit plans in terms of design features to reduce costs.

Members discussed the standardised buildings approach and how that impacted on the reconfiguration. It was explained that the standardised approach was similar to what had been seen in education in that there would be an expectation of a standard approach in new buildings however not all of the reconfiguration involved new build and there would be continued flexibility locally in terms of those works.

Members suggested that modern methods of construction should be easier, faster and cheaper to build than 5 years ago, and that logic should be checked when taking forward the next design development.

In terms of steps being taken towards meeting climate/carbon emissions policies there was a greater focus on being carbon net zero and transition to digital, those plans continued to evolve, and the aim was to have a single plan for carbon net zero across the health and care system.

Members asked for a critical pathway to be provided so they could track progress and when things were projected to happen. Richard Mitchell replied that a critical pathway could be provided at a point when matters were less imprecise and there was more certainty about the volume of works and timeline.

Members wanted confidence that at any point in time if something changed the impact would be known because it had been planned through. Members were firm that they wanted to see where things were at now rather than wait another 3 months, even if they were to change in a week as a result of a government  statement.

Members went on to receive a report providing an overview of the planned move of the elective Dermatology service from Leicester Royal Infirmary (LRI) to the St Peter’s Health Centre.

Members noted the move was a temporary transfer of part of the service that would enable expansion of the emergency floor capacity which would help address the challenge of ambulance handover delays and the clinical risk that presented across the community.

It was also noted that:

1.    all patients using dermatology service had been written to about the proposed changes and temporary measures had been put into place to support people with transport.

2.    Although car parking at St Peter’s Health Centre was limited, UHL had identified some on-site parking for patients and staff and were looking to expand that as well as secure some private parking co-located with a similar cost to those around Leicester Royal Infirmary

3.    St Peter’s Health Centre was well served by public transport with 2 main bus routes, the centre was also fully accessible and UHL would continue to work with patients through equality impact assessments to ensure everyone can access services.

Some concerns were expressed that for most people living in Rutland or Leicestershire and reliant on public transport it would not be easy to access the centre and those patients journeys could also take some significant time. Reassurance was sought that those who were from outside the city would be guaranteed parking on site if for other reasons they could not walk from other car parks.

Members noted the difficulties accessing the LRI site with car park areas taken over with building construction sites and the very long vehicle queues to park near the hospital creating a delay of up to an hour which people were not always aware to factor in to their journey time or they faced being significantly late for an appointment.

Members commented that accessibility and getting people on and off sites quickly was important. Members suggested that the outer ring of Leicestershire market towns with community hospitals that were not being used to their maximum extent could be better utilised with more outpatients clinics being held in those hospitals which would ease the issue of patient journeys and traffic into LRI, as well as bring down waiting lists and go towards the carbon net zero aspects too.

Responding to the comments made it was acknowledged that the seven community hospitals were not fully used and UHL were exploring how to increase usage.

As regards disabled patients and those less mobile UHL would ensure access to car parking on site at St Peter’s Health Centre; for others in their own transport, it would be easier to access and less stressful to park in the vicinity than at LRI currently.

It was recognised that car parking at LRI had gotten got worse and there was a mismatch between the volumes of people wanting to park on site. There was messaging about using co-located sites and discussion was ongoing regarding access to other car parking too.

The Chair thanked officers for the report and requested an update at the earliest opportunity about the reconfiguration figure in relation to the cost increase and how any further consultation would be carried out should any changes to the reconfiguration programme be needed.

The Chair also commented in relation to the transfer of level 3 critical care from Leicester General Hospital to other sites and requested that a report be provided to better understand how the clinical benefits of that transfer would be realised.

In relation to the temporary transfer of dermatology services the Chair asked that assurance be provided that the aims of the move had been met, how long it was envisaged the service would operate from St Peter’s and what the subsequent plans would be for that service.

AGREED:

1.    That the contents of the report be noted,

2.    That an update report be provided at the earliest opportunity about the reconfiguration funding uplift/capital envelope and how any further consultation would be carried out should any changes to the reconfiguration programme be needed.

3.    That a critical pathway for the reconfiguration programme be provided so Members can track progress and see when things are projected to happen.

4.    That a detailed report on the planned changes at Leicester General Hospital be brought to a future meeting.

5.    That following the temporary transfer of the Dermatology Service, assurance be provided to Members that the aims of the move have been met, particularly with regard to a reduction in ambulance handover delays.