The NHS is ever-changing – and so are the challenges we face. At present there are four main issues which need to be tackled by this programme.
Estimates show that the population served by Hampshire Hospitals NHS Foundation Trust could increase by 9.6% over the next decade and by 23% between 2018 and 2050.
But our population is also aging rapidly. The predicted growth in the over 75s in Hampshire between 2017 and 2024 is 35%. And it is well documented that older people require more healthcare.
For example, an 85-year-old man requires, on average, seven times more NHS care than a man in his late 30s.
This trend is particularly noticeable in Basingstoke as the town expanded rapidly in the 1960s and 1970s. The young families who moved there, then, are now reaching older age.
It is critical that our clinical services not only deliver outstanding patient care but that they are sustainable.
This means that we need to know we can provide them consistently and predictably so that people know they can trust and rely on them. It also means that services are able evolve to take advantage of new technology or adapt to a new challenge.
However, to achieve this, some very difficult decisions will need to be made about what services we provide and where.
For example: Hampshire Hospitals often struggles to fully staff two relatively small Emergency Departments at both Royal Hampshire County Hospital (RHCH) and Basingstoke and North Hampshire Hospital (BNHH).
It also has issues delivering maternity and paediatric care across multiple sites and risks losing neo-natal services altogether unless the service is placed on a more long-term sustainable footing.
This programme needs to ensure that these services are delivered reliably and efficiently.
All of the trust’s hospitals require a significant amount of urgent maintenance. The current estimate of the cost to make the improvements needed to bring the buildings up to the standard required to support services as they are delivered at the moment is £73 million; more than three times the national average.
Moreover, in order to keep the buildings functioning for the next 30 years would require over £700m in maintenance spend over that time.
This is simply unaffordable.
The trust is committed to both reducing its carbon footprint and expanding its use of digital technology. Unfortunately the age, condition and design of the current buildings often stops such projects in their tracks or means they deliver less than was intended.
Finally, it is vital that all the different strands of care – community services, mental health, primary care etc – are able to be as joined up as possible. The current estate is a barrier to this becoming a reality due to its design, condition and structure.
For example: The inherent inflexibility of the estate has been exposed during the COVID-19 crisis. The trust has struggled to increase the number of beds available for patients and the ability to adapt wards and areas to treat different kinds of patients has been limited.
NHS staff have done brilliantly at finding workarounds, but this programme needs to ensure that a new hospital can enable us to do even better.
It is obvious from every public survey and the outpouring of appreciation during the COVID-19 crisis that the NHS is one of the most valued, if not the most valued, aspects of British society.
However, the way we currently deliver care and treatment costs more every year and will continue to do so as we try to keep up with technological advances, population growth and the fact that medical advances and lifestyle changes mean that more of us will live much longer than our grandparents had expected to.
This final point is clearly something to celebrate, but it does mean that there are a larger number of frail, elderly people requiring our help than our health system was designed for.
Much of this is driven by the fact that the area has changed significantly in recent years – and is set to do so again in the coming decades; with new housing roughly equivalent to a city the size of Salisbury planned in the Basingstoke area alone!
For example: The local health system struggled financially in 2019/20, with Hampshire Hospitals in particular ending the year in a substantial budget deficit.
This programme needs to address this issue so we can continue to deliver the care that is rightly expected.