Agenda item

HVCCG Update and Strategic Outline Case


David Evans presented this item.


Cllr Guest asked whether items 6 and 7 were being rolled into one.


David Evans replied that they would be.


David Evans explained that we have had numerous updates regarding the Strategic Outline Case for Watford and St Albans and at the same time we were doing a SOC for the Hemel Hempstead hospital site to decide what would be the solution to the usage of the ageing site and how that might be moved forward.  The case was developed about 18 months ago and was signed off by the West Herts Hospital Trust Board and the CCG. It was them submitted to NHS England and NHS Improvement  It was eventually agreed with both boards that Watford General would be the hospital site to be redeveloped for acute and planned care , St Albans for Surgical procedures, planned care and diagnostics and at the same time we were working on the Hemel Site, and at that time we decided there would need to be a split between the different specialities and speciality focus across all of those sites and you can see from the slides how this broken down.


We have around £300 million to work with and anything that we borrow we must be able to pay – it is usually one year of the Trust’s turnover is around £300-£340 million. There is strong competition from other hospitals nationally – we are definitely in the top 10, we are probably in the top 5 in terms of consideration if our plans get signed off.


Cllr Birnie said £300 million – how does the £65 million deficit at Watford work.


David Evans replied that this figure is capital plus revenue deficit.  Some buildings are condemned so they want have to be maintained.


Cllr Birnie said that this was not an accounting exercise, it is actually money owed


Kathryn Magson corrected the figure saying it is £42 million not 65. It is an ongoing position and the hospital have to borrow against it.  The deficit will improve when the buildings go.   The £300 million will have to be paid back. She continued to explain that as David Evans had said the amount normally lent is the Trust’s turnover she confirmed it would be £300 million and not £260 million.


Cllr Birnie said that it sounded as though Watford is still the site that is being concentrated on and he asked whether the Green Field option would be looked at.


Kathryn Magson confirmed that all the figures would be taken into account.and everything would be worked through as already talked about in the events with the Public, across all four localities.


Cllr Birnie asked if in terms of procedure, would we have to wait until the whole thing is done or would information be fed to us as we go along?


David said they would not be able to do that but there would be a panel supporting decisions and they could update on that.


Cllr England asked a) What is the life of these buildings we are contemplating? and b) What population changes are factored into the SOC?


David Evans answered a) 60/80 years. b)  Met with planning teams and the biggest challenge will not necessarily be how the hospital is built to meet the population growth,  it will be how to manage universal and  primary care services going forward..


Cllr Maddern asked - Could the £300 million be bumped up by selling 3 sites and building a central hospital. The Cllr also asked if the panel was similar to the one that was used for the Hemel Hempstead site.


David Evans replied that the estimated values are Hemel Hempstead £15 million, St Albans £18-20 million and Watford £15 million – this valuation is low because the land can’t be used to build houses immediately as it has been used for acute wards etc.  He added that the panel is different – it is a scoring panel and they have taken applications.


Cllr Hicks remarked that he had seen in the local news that CCG was being fined £1/2 a million a month for not meeting targets and made the point that if they were a private company they would have to convince the government to lend the money and asked how it will affect the Trust.


Kathryn Magson explained that the CCG was fining the Trust as they are failing to deliver on target.  They will continue to support the Trust financially.  She explained that it made no difference to patient care, we are using that money to support patients being seen in other hospitals more quickly.  Patients will get the right care at the right time in the right place.


Cllr Hicks said he found it reassuring that the money was not being lost to patients.


Kathryn Magson said Watford would have to get more operationally efficient. In presenting the SOC they will have to work on a plan which addresses operation inefficiencies.  There has been a spending review in the NHS over the last few months and we expect that some of the money will flow into the key providers as well and that will help. .At the moment they are being paid accurately for the work that they are doing. So although it is different in the private sector the principles are the same.


Kevin Minier said that the SOC is still a high level document, what if it is decided it is not a safe solution for patients, doesn’t provide service and still does not deliver to target.


David Evans replied that in that instance they would not let the plan go forward – that

is what SOC is for. Ring fenced funding etc, they should get through.  It is a once in a lifetime opportunity we have to present and commit to something.