One of many broken promises made by the former PM & now MP, Boris Johnson, was for forty new hospitals. The manifesto commitment – like others – seems more of a fudge than a pledge. Bits of hospitals are now being counted in the forty, and, we’re told, the work won’t now be finished by 2030.
Meanwhile, not included in those government numbers, 300 miles north of Westminster, the show-piece Emergency Care Hospital at Cramlington in Northumberland could ultimately benefit from an entire new wing …. all for free.
Planning permission has been granted by the County Council for a building that will be integrated with the current complex – and it will be paid for by the site’s original developers.
Why? How? When? You might well ask. What!? You might exclaim.
It follows an out-of-court settlement last October with Lendlease, the company who built the £95m Cramlington facility, which opened in 2015. Legal action was taken by Northumbria Healthcare Foundation Trust against Lendlease after the discovery of an astonishingly large number of structural defects.
The Trust sued for £140mn, but according to one health industry newspaper that claims reliable sources, the final settlement was nearer £100mn Still a massive sum of money – more than the original spend.
The hospital’s defects are believed to include issues relating to the roof, flooring, external walls, pipework, drainage, landscaping and the hospital’s helipad.
The most urgent work – including fire-safety and the roof – has already taken place. But much is still to be done. Money from the settlement is now in the bank. And a thorough investigation has just started to decide how things should proceed.
Included in the Health Trust’s compensation demand was the option for a new building – a whole new wing, three storeys high (amended from four storeys in April of this year), with more than 7,000 square feet of floor-space.
The Trust is now working out if the building is truly necessary. But it looks a cert because patients and equipment will need to be re-located whilst remedial works on the main building take place. Whatever the decision, getting the repairs completed over the next three years will be a massive logistical exercise.
So, if the new wing is built, what happens after the repairs are completed? That will be, according to council documents “subject to separate discussions between the Trust and the local planning authority at the relevant time.”
But at a time when hospitals throughout the land are crying out for replacement or new buildings, it potentially looks like a very big bonus for Northumberland – even if does mean a lot of angst and hassle for patients and staff along the way.
Because of non-disclosure terms included in the out-of-court settlement, Northumbria Healthcare Trust are somewhat cagey about their plans. A spokesperson said “The terms remain confidential, but the Trust can confirm that the settlement allows the Trust to ensure the continued safety of patients, staff and visitors of Northumbria Specialist Emergency Care Hospital.”
The need for repairs just eight years after the hospital was built is unfortunate to say the least. One can just imagine the questions being asked in high places at both the Trust, and the board rooms of the developers and their sub-contractors.
One of the best
However, the outcome can be seen as yet another feather in the cap for Northumbria Healthcare Trust– which is consistently one of the best in the country on a whole host of measures.
Recent accolades and projects include:
- Shortest A&E waits in the country, according to a BBC survey
- Ranked one of the best for maternity care in the country
- National awards for doctors and nurses
- First to launch a home care service to free up hospital beds
- Set up a PPE factory which provided more than two million gowns
- Drone flights for delivering medical equipment
It’s important to the Trust’s Chief Executive, Sir James Mackey, to be top, or near the top, of league tables, and ahead of others when it comes to innovation.
But when the same Government funding model is applied to all Trusts how does that come about? How does Northumbria Healthcare do it?
“This goes back a long way. We’ve spent an awful long time working on clinical and management alignment. It goes back to the 90’s and my predecessor; it’s about making sure you take the right decisions,” said Sir James.
One of those decisions was the Cramlington-based Emergency Care Centre. The idea was to downgrade full accident and emergency units at North Tyneside, Wansbeck and Hexham so they became walk-in minor injury centres and then concentrate all the 999 specialists at Cramlington.
It was a tough decision, and there was a great deal of local controversy with complaints it would mean much greater distances for ambulances, patients and visitors to travel. But Sir James is more convinced than ever that it was the right thing to do with finite resources.
“Cramlington was a very important element of our plans. In order to deliver the standard we wanted we had to come up with something imaginative. It was a difficult and controversial model, but given our geography it was important.”
Northumbria also takes great pride in its relationship with staff. Yes, there are strikes at the moment over national pay rates – which are causing considerable disruption in the battle to reduce waiting lists. But Northumbria largely has a loyal staff and according to a survey last year it had the highest morale of any Trust in the country.
“It is a people business,” said Sir James. “The feeling of belonging to an organisation is really important. You’ve got to get a common purpose about what you do.”
Northumbria try to avoid using agency staff – which racks up the bills in other parts of the country. “We try to be flexible with the way we use staff. It cannot be a selfish endeavour; it’s about getting the balance right.”
So, does Northumbria spread its best practice across the NHS? At a recent public meeting in Hexham, organised by the campaign group Tynedale Transformed, keynote speaker and former transplant surgeon at The Freeman in Newcastle, Professor John Dark, said he felt there was “too much competition and not enough collaboration” in the NHS. Does Sir James agree?
“I think the competition argument is over-played,” he said. “We take patients from other regions; from Newcastle, Yorkshire and Cumbria. The reaction we got to the Cramlington model in Newcastle wasn’t helpful at the time, but that has settled down.
“Today we are meeting regularly to see where we can help each other. It is too easy a narrative to say Trusts are slugging it out with each other. I don’t think that is true.”
However, Sir James will be the first to agree that there’s a long to-do list in the NHS. His ambition for the next year is to get back to, and then beyond, pre-covid levels of service. It’s a tough ask with budgets as tight as ever.
Unsurprisingly, Sir James won’t be drawn into any kind of political discussion. But he, like the rest of us, knows that a new Labour government is more than a possibility. And with Northumbria Healthcare’s Trust’s astute management, along with the likelihood of that new real-estate at Cramlington, we’re entitled to hope – just a bit – that things can only get better.