The next chapter in the long-running hospital saga is due to start in the next week with the publication of a much-anticipated report to determine what services will go where...
The team behind the ‘New Healthcare Facilities’ programme – the name of this Government’s multi-hospital plan – is expected to release a final draft of a ‘feasibility study’, which will present two options for what should be built where.
It is likely that these options will be based on whether acute services – which is broadly inpatient care – should be at Overdale and ambulatory services – or outpatient care – in Kensington Place / Gloucester Street, or vice versa.
The Government has previously said that it prefers a multi-site option involving Overdale, a cleared site in Kensington Place, parts of the existing Hospital and the former Les Quennevais School in St Brelade.
The options – essentially, what should go at Overdale and what should go in town - have been judged against a set of ‘development’ criteria which has been assessed and approved by a group of senior civil servants providing ‘governance’ over the project.
Pictured: Infrastructure Minister Tom Binet recently defended his review as a "necessary but rapid appraisal of the Our Hospital project".
The feasibility study should also identify where mental health services will be based. Later, the Government will identify what services will run out of the ‘Enid Quenault Health and Wellbeing Centre’ at Les Quennevais, which is expected to be in service for a lot longer than the five years identified in the previous Our Hospital Project.
Once the final draft is published, which is expected to be next week, it will be reviewed by more ‘governance groups’, including the Council of Ministers, before a final edition is produced, scheduled for the end of June.
That final report will state which of the two options has been chosen. The process of selection will be overseen by an independent moderator to make sure it has been carried out fairly and in line with established rules.
The feasibility study is designed to rate the advantages and disadvantages of each site against the clinical services that the Government wants to deliver as part of its New Healthcare Facilities programme, which is believed to have a wider scope than the previous single-site Our Hospital project.
It will include a grading system to illustrate how the two options compare against the criteria. It will also set out the implications for each of the two options when it comes to access, land transactions and other matters.
For instance, it will establish what will happen to Westmount Road, and land and properties around it, for each option. This is important as the realignment of the road was a controversial part of the Our Hospital Project, prompting the Parish of St Helier, which owns land on either side, to refuse to sell it to the Government.
A compulsory purchase order was issued but the process was never completed.
Pictured: The feasibility study is likely to determine the future of Westmount Road, which was earmarked for significant change in the Our Hospital plans.
The feasibility study is likely to be presented to the States Assembly as a ‘Report’ in June. This means it is for information purposes only and will not be debated.
Infrastructure Minister Tom Binet, who is leading the project, has said that he expects the first phase of the New Healthcare Facilities programme – likely to be the development of services at Overdale – to be voted on by the Assembly as part of the 2024-27 Government Plan debate, scheduled for December.
Subsequent phases of the programme, including the building of a new block on former hotels in Kensington Place, will feature in future Government Plans.
In the original timeline for the ‘programme’ – which is the favoured term over ‘project’, in light of the phased approach, which lasts until the end of 2030 – the feasibility study was earmarked for the end of March, but it now coming out at the end of May.
The Government concedes that the original timetable has slipped but argues that this is due to the Healthcare Facilities team giving more time to consulting with clinicians and other stakeholders.
More consultation was a recommendation by Comptroller & Auditor General Lynn Pamment in her recently published follow-up report ‘Learnings from Previous Hospital Projects’ and is also something Scrutiny wants to see.
Ms Pamment also suggested that the feasibility study is not set in stone and should have the flexibility to be continually updated.
It remains to be seen if this study will say how much this latest incarnation of the Hospital project will cost. Its critics, including Deputy Lyndon Farnham, argue it will be more expensive; its supporters say that the £804.5m budget for the previous Our Hospital Project was out of date the moment inflation and interest rates started to climb.
The phased approach will lead to greater control of costs over a longer period of time, the Government argues.
Alongside the feasibility study, another report, called a ‘Strategic Outline Case’, is likely to be published. This document – a requirement of the HM Treasury ‘Green Book’ which establishes how public projects should be run - will set out why a new hospital(s) is needed, something that has been asked many times during previous incarnations.
It means that this document is unlikely to present anything seismically different, albeit this time the plan is to build on multiple sites rather than one.
Meanwhile, the demolition of buildings at Overdale, which already has planning permission, is expected to begin in October, once asbestos has been removed and a contractor has been selected.
This will allow the first phase of the Government’s plan to start next year, subject to Assembly approval in December.
A question Deputy Binet is likely to need to answer is whether past Assembly decisions to support the Our Hospital Project, including the site selection and funding arrangements, need to be formally rescinded.
In 2019, the Assembly rescinded its 2016 decision to redevelop the existing hospital in Gloucester Street, but it remains unclear whether the last incarnation needs to be formally kiboshed, in light of the fact that a hospital will be built at Overdale, albeit one smaller than the single-site scheme.
In her recent report, the C&AG said the States had spent £130.6m on the Future Hospital and Our Hospital projects and been forced to write off £38.6m of it.
She said that there needed to be “clarity on the strategies and ambitions for delivery of Jersey’s health services”, “effective programme management” and “a best practice approach to evaluating, monitoring and reporting on project level financial information and value for money”.
The Government will surely be keen to ensure that, this time, they have got it right.
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