FOCUS: So we’re finally getting a new hospital… but can we actually staff it?

After more than a decade of indecision, Jersey’s new hospital cleared a major hurdle last month when planning permission was secured – but critics say there’s one glaring problem: who’s going to staff it?

A scathing report published last week revealed that the hospital plans contain no clear strategy for hiring and retaining staff – despite the island already spending nearly £22 million on agency health workers last year.

With bed capacity set to increase by 32% in the upgraded facility, questions are being raised about whether the Government is building a state-of-the-art facility it simply won’t have the workforce to run.

Express explores the issue in-depth…

An ongoing struggle

New hospitals aside, the matter of Health staffing has been a contentious and challenging issue for many years.

Scores of reports and requests made under the Freedom of Information Law in recent years dating back prior to covid have highlighted an exceptionally high ongoing spend on locum and agency staff.

And in 2023, the government’s own watchdog authored a report emphasising the need for a clear workforce strategy for the current hospital – let alone a future one – noting that the task of recruiting and retain staff had become even more challenging since the covid pandemic.

Two years on, and those staffing struggles are continuing.

Last year, the Government spent £21.7m on agency Health staff – a huge overspend on the £6.8m that was budgeted.

Meanwhile, the stats showed that there was a slight underspend on substantive staff – with £203m spent compared to £218m that was set aside.

Fast-forward to now…

After a period months spent scrutinising every inch of what the government has dubbed Jersey’s New Healthcare Facilities Programme – the lynchpin of which is the acute facility at Overdale, which was recently granted planning approval – Scrutiny politicians last week published a 117-page report expressing deep concerns about numerous aspects of the project.

Chief among those concerns, which were supported by expert UK consultants Currie & Brown, was the cost of delivering the £710m Overale build while maintaining the current hospital to keep it running.

But another key issue highlighted by the Hospital Review Panel, which was chaired by Deputy Jonathan Renouf, was that there is “no information on future workforce requirements” contained in plans for Jersey’s new hospital, according to the panel of politicians in charge of scrutinising the proposals – despite the roughly £22m spent on agency health workers last year.

The panel criticised the lack of detail in the financial model, “particularly in workforce and operational cost projections”.

It said that detailed breakdowns of staff costs, including categories such as nursing, midwifery, and administrative personnel – which are emphasised in NHS England guidance – were “absent” from the Jersey plans.

Increasing bed capacity… but who will staff it?

One of the key issues is that the plan is to provide more beds than the current hospital has – something which certainly makes sense in light of the island’s ageing population but which, the panel argues, needs greater thought in terms of staffing.

“The implications of expanding bed capacity on staffing levels and associated expenses are not addressed,” the report said.

The panel found that there was an increase of around 32% in bed capacity proposed in the New Healthcare Facilities plans, but no change in workforce or clinical costs – other than standard pay inflation – to account for this.

The report said: “Following further discussion with Project Advisors, the future workforce cost projections are based on activity, but there is little evidence to show that this reconciles with the fact that bed capacity, by their very nature, has cost associated with it.

“It would also suggest that the hospital can function with essentially the same level of workforce cost, despite having an increase in bed capacity.”

It added: “The basis on which future workforce costs have been projected is not robust in the context of the proposed increase in bed capacity and we believe that the revenue cost projections require further investigation, in detail.”

Did they really not say anything about staffing?

More than 160 documents formed part of the planning application – many of which were technical in nature, detailing specific height and material requirements.

However, a deep-dive by Express unearthed an estimation that around 400 full-time workers would be needed.

But a document assessing the socioeconomic impact of the new hospital project said that the New Healthcare Facilities team has “indicated there is unlikely to be significant new additional staff requirement at the new hospital”.

“It is assumed the majority of this will be existing staff moving from the temporary facility back to Overdale and subsequently employed at the new hospital,” the document said.

An expert view…

Former consultant gastroenterologist Dr David Ng has repeatedly raised concerns about “the need for more healthcare professionals and duplication of equipment over the multiple sites”.

“The building costs are just one part of the New Healthcare Facilities equation; however, the more significant costs are the running costs,” he said.

“As I have previously stated, these have not been (publicly) considered, which will be many times higher than the building cost.”

He added: “We need to properly fund our health service and not penny-pinch.

“We need to listen to clinicians and support them when they can do their job better and safer with new technologies, rather than frustrate them to the point of resignation.

“Otherwise, we won’t have enough staff to provide healthcare in the New Hospital Facilities. We barely have enough in our single-site crumbling hospital.”

“No information” on workforce requirements

Panel Chair Deputy Jonathan Renouf said the outline business case for the scheme “does not come close to meeting the standard that islanders have a right to expect for the largest capital project in the island’s history”.

No surprise Scrutiny is concerned about the cost of "New Hospitals", same as last Assembly. I warned about not adding running costs to the OBC. I warned about staffing multiple sites. Frontline workers need to "wag" the managers, not the other way around. We know what's need

— David Ng (@JerseyGIdoctor) February 28, 2025

The business case does not include a workforce strategy or workforce model for the new hospital, and there is “no information on future workforce requirements” – such as headcount, roles, or changes to the existing workforce, according to the report.

It continued: “The lack of a workforce strategy means that there is no indication of the extent to which workforce represents a risk to the delivery of the new hospital programme.

“In the absence of information to the contrary, there must be a risk that the workforce will not be sufficient to staff the additional bed capacity.”

What does the government say?

Responding in the hours following the report’s release last week, Health Minister Tom Binet pledged to study its findings “carefully” and respond to them “as soon as possible”.

While he said he would not yet provide a detailed response, he did suggest that the report was likely to cause “unnecessary concern”.

Deputy Binet added: “Everyone knows the new Acute Hospital at Overdale and other healthcare facilities are desperately needed, and having worked with the highly competent delivery team for almost three years, I’m satisfied that sufficient information has been generated in this specific, Jersey context to justify the expenditure, and that the Outline Business Case will be refined to a Full Business Case in the same, appropriate way.”

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