Annual Report 2006-2007: A Vision for the Future
- A Vision for the Future
- Delivering a Healthy Future
- Review of Acute Services in Hertfordshire
- The West Hertfordshire Surgicentre
- Acute Admissions Unit
- Investing in Your Health: Private Finance Initiative Status
- The Watford Health Campus – a Sustainable Future
- Clinical Assessment and Treatment Services (CATS) and Commissioning Changes
- Practice Based Commissioning
- Health and Safety Policy and Developments
- Energy Policy
A Vision for the Future
In March 2003 – following a 12 month period of engagement and discussion involving doctors, nurses and other clinicians along with a wide range of local people – the NHS in Bedfordshire and Hertfordshire set out its vision for improving local healthcare and creating a health service fit for the 21st century. The vision proposed the separation of planned healthcare from emergency healthcare, the centralisation of specialist and complex health services in fewer hospitals and argued for the
delivery of more healthcare outside of hospital settings. This was published in a document called Investing in Your Health which then became the subject of public consultation.
Most of the assumptions that underpinned Investing in Your Health remain valid today:
- The move to two main hospital sites is strongly supported by doctors, nurses and other clinicians and remains the key to improving the quality of care and maintaining sustainable acute hospital services.
- For many medical conditions the shift of care into the community and out of major hospitals is taking place across the NHS and there is increasing evidence that preventing unnecessary or inappropriate hospital admissions benefits patients.
- In west Hertfordshire the rationale for focusing services on the Watford site remains as strong as ever.
- The separation of planned and emergency surgery will be key to reducing waiting times even more.
But since the Investing in Your Health decisions in 2003 some things have changed as healthcare delivery has evolved or moved on. Patients are spending less time in hospital and more services are now being delivered safely and effectively in the community, closer to where people live.
Delivering a Healthy Future
During 2006, the Trust launched a consultation, known as Delivering a Healthy Future, regarding some interim plans to change services ahead of those proposed in Investing in Your Health. The proposals centred around the centralisation of planned surgery to the St Albans City Hospital or Hemel Hempstead General Hospital site, pending the construction of the Independent Sector Treatment Centre (the Surgicentre) on the Hemel site, and highlighted the Trust’s plans to centralise emergency care to the Watford General Hospital site, as outlined in Investing in Your Health, ahead of the planned timeframe.
Throughout the 100-day consultation process the Trust heard the views, ideas and concerns of patients, residents and other interested parties.
Review of Acute Services in Hertfordshire
In November 2006 the Hertfordshire PCTs launched the pre-consultation phase of a review into acute service in Hertfordshire; part of an Eastern Region-wide review of acute services. The PCT together with West Hertfordshire Hospitals NHS Trust and East and North Hertfordshire NHS Trust are currently consulting on a variety of issues concerning the future of acute healthcare in Hertfordshire.
The main changes proposed for west Hertfordshire involve:
- A new style birthing centre for Hemel Hempstead
- The future of children’s emergency care in west Hertfordshire
- The future of children’s planned day care and day surgery in west Hertfordshire
- The location of the proposed west Hertfordshire surgicentre
The original Investing in Your Health decision to locate acute hospital services for west Hertfordshire at Watford General Hospital is now under development within the context of the Watford Health Campus.
The West Hertfordshire Surgicentre
The local NHS joined the Department of Health's Independent Sector Treatment Centre (ISTC) programme to look at locating a Surgicentre in Hemel Hempsted. The key objectives of the ISTC programme are to provide the NHS with additional resource and capacity, help to drive innovation in service delivery, increase accessibility and offer greater choice to patients. Clinicenta was appointed as the preferred bidder with regard to the local ISTC scheme.
In recent discussions between the Strategic Health Authority, the PCT and Clinicenta it has become clear that the proposed Surgicentre at Hemel Hempstead Hospital would be more expensive than initially expected. As a result, and taking into account other factors, it is therefore intended that the provision of elective care in west Hertfordshire now largely be procured from the NHS.
In 2006, following the Delivering a Healthy Future public consultation, the West Hertfordshire Hospitals NHS Trust Board made an interim decision to locate planned care services at St Albans City Hospital until the new Surgicentre at Hemel Hempstead Hospital was expected to be completed.
However, as the Surgicentre is no longer going to be provided through the ISTC programme, it is sensible and appropriate to review the options of providing a Trust-run elective care centre for west Hertfordshire at either Hemel Hempstead or St Albans, to consult on these options.
Acute Admissions Unit
A major part of planning for the future will be the development of the Acute Admissions Unit on the Watford site. This unit will act to fast track emergency patients (medical, surgical and gynaecology) for assessment, diagnosis and treatment, with an emphasis on discharging patients quickly to the community, avoiding admission or limiting their length of stay in
hospital by ensuring minimal delays for diagnostic tests.
Investing in Your Health: Private Finance Initiative Status
The Trust is developing its Outline Business Case (OBC) to support its application for the redevelopment of Watford General Hospital. Currently, the Trust plans to submit the OBC to the East of England Strategic Health Authority and the Department of Health. The new west Hertfordshire Acute Hospital at Watford sits within the proposed Watford Health Campus.
The Watford Health Campus – a Sustainable Future
The proposal to develop the Watford Health Campus (WHC) continues to go from strength to strength. This unique partnership will see the redevelopment of a 26.5-hectare site in west Watford creating, amongst other facilities, a new acute hospital for west Hertfordshire. The vision is to transform west Watford through creating a unique partnership that will deliver improved healthcare, a more sustainable community, better transport links and enhanced leisure opportunities for west Hertfordshire.
The WHC partnership has prepared a masterplan for the redevelopment of the site which aims to house a new acute hospital for west Hertfordshire, key worker and private housing, business incubator units, and a newly developed football stadium.
The Government’s design advisors, the Commission for Architecture and the Built Environment (CABE) reviewed the project earlier this year and said: “We applaud the key stakeholders for their aspiration…The Masterplan is realistic, robust and well considered,… we are delighted to see that a hospital is being treated as part of a town.” The WHC has huge potential for delivering a new highly sustainable transport infrastructure along with significant improvements in utility consumption. Energy efficiency is becoming an ever more important issue and the WHC will use a combined heat and power plant (Tri-Gen) providing electricity, heat and cooling for the entire site. Water conservation is also high on the environmental agenda for the WHC and innovative measures such as using rainwater from the hospital’s roof to water the football club’s pitch, to flush its toilets and to clean the stands are being designed.
The site's business, leisure and community stakeholders have come together to lead this project. By combining their strengths and pre-existing investment plans, the partners aim to achieve their shared goal of transforming west Watford and better serving west Hertfordshire. The nine organisations behind the Watford Health Campus are:
- East of England Strategic Health Authority
- East of England Development Agency
- Hertfordshire County Council
- Hertfordshire Partnership NHS Trust
- Hertfordshire Prosperity
- Watford Borough Council
- West Hertfordshire Primary Care Trust
- Watford Football Club
- West Hertfordshire Hospitals NHS Trust
Pre-planning consultation took place in May 2007, with a launch sponsored by Claire Ward MP at Portcullis House, Westminster. A planning application for the Masterplan was submitted to Watford Borough Council in July 2007.
Clinical Assessment and Treatment Services (CATS) and Commissioning Changes
On October 2006 the new West Hertfordshire Primary Care Trust came into being, subsuming Watford and Three Rivers PCT, Dacorum PCT, St Albans and Harpenden PCT and Hertsmere PCT.
One of the Government aims is to provide treatment for patients as locally as possible and reduce pressures on secondary care. The concept of primary care-led triage and assessment services has been developed to achieve this aim. Within the NHS in west Hertfordshire a version of this system has been operational for some time whereby physiotherapists reviewed Orthopaedic referrals and sought to manage them without the need for onward transmission.
PCTs within west Hertfordshire sought bids for a number of different specialists, for which the Trust, in partnership with primary care colleagues, was awarded preferred bidder status in the majority of cases.
The new Hertfordshire PCT undertook a review of all CATS proposals at the end of November 2006, following which a number of bids are now being taken forward.
Practice Based Commissioning
The Trust has begun to establish positive relationships with the emerging Practice Based Commissioning Groups being set up across west Hertfordshire. By working with PBC Groups the Trust will be able to ensure that it has a firm understanding of the commissioning intentions of GPs and be able to adapt it’s services to the changing needs of the local community.
Health and Safety Policy and Developments
The Trust Board is committed to ensuring compliance with Health and Safety legislation, and to ensuring the Health, Safety and Welfare of its employees through commitment of resources and the application of best Health and Safety practice. This will be achieved through a sound organisational structure, undertaking effective planning, and addressing the identification of hazards, assessments of risk and appropriate control measures. The duty of establishing the organisation and arrangements to carry out the Trust's Health & Safety Policy is the responsibility of the Chief Executive, and is delegated to the Director of Human Resources.
Energy Policy
The Trust is committed to energy management, which reduces operating costs and helps to protect the global environment. Its Energy Policy sets standards of materials, plant and building fabric, together with target levels of lighting and room temperatures, establishing responsibility of procurer, provider, business centre and service departments in recognising the different age, usage and configuration of spatial environments.The Trust already encourages car share schemes, offering lower-rate parking charges to staff that car share and an inter-site car share scheme is advertised on the intranet.
A Carbon Trust survey has been carried out and a series of energy saving schemes are being proposed on a spend to save basis. The Trust is working towards membership of the EU Emissions Trading Scheme.
The Trust’s estate development plans, including the Watford Health Campus, seek to be as energy efficient as possible.
