New hospitals should be ‘as small as possible’ so they are not providing services that could be delivered closer to home, a senior government official has said.
Charlotte Taylor, joint senior responsible owner for the New Hospital Programme (NHP) told delegates on Monday how the scheme will help deliver the government’s three shifts: hospital to community, analogue to digital and treatment to prevention.
Speaking at a Westminster Health Forum event, the Department of Health and Social Care (DHSC) official said this included going ‘digital by default’ by building digital infrastructure into hospital designs, thinking about prevention measures such as infection control, and considering what services needed to be delivered in a hospital and what could be provided closer to people’s homes.
She added: ‘The work we’re doing on demand and capacity is really helping drive the thinking and helping the whole system look a little bit more critically at what do we really really need to do in a hospital, and what are activities that could be delivered in other locations into the community, so the hospitals that we build are the right size, but then, that being said, as small as possible, so that we’re not building in facilities and services that actually should be, could be, [sic] delivered closer to home.’
The government established the NHP in 2020 as part of the then-Conservative government’s commitment to building 40 new hospitals by 2030.
A review conducted by the Labour Government when it came into power led to an updated timeline to deliver the programme, with construction of almost half of the planned new hospitals not due to start until after the original 2030 deadline.
When asked about whether there were examples of community investment helping to support the NHP, Ms Taylor said facilities like CDCs and diagnostic surgical hubs could ‘enable a hospital to be to be smaller when it is rebuilt’.
She added: ‘I think the number of concrete examples at this stage are relatively limited because I think this work is still at the kind of more the planning than the delivery stage.
‘But it’s certainly the case that with CDCs, for example, and [the] sort of new diagnostic surgical hubs developing [sic], and people thinking about those more widely in parts of a holistic approach, those are the sorts of facilities that could enable a hospital to be to be smaller when it is rebuilt.’
However, she added that this ‘needs to be done, not just at trust level, but in a number of cases, at ICB or even regional levels’.
She added: ‘As everyone knows, the kind of patient boundaries are not necessarily sort of firm, and patients may find it more convenient to travel to a community facility in the other direction to their hospital, as it were, even if that’s over the border. So, some greater system join up is needed to really get the benefit of this shift.’
In response to a question about how best practice from the NHP can be spread more widely, she said that thinking about what services need to be delivered within a hospital and how demographic shifts put pressures on those services was ‘absolutely activity that I think all trusts will be doing, not just NHP’.
She added: ‘There’s an ongoing question about how we can, in full time, share the hospital 2.0 standardised designs more widely, so that, for example, hospitals undertaking major refurbishments could start to deliver them in the same approach.
‘We’re not at that point yet, but I think that’s got to be the right direction of travel, so that we don’t just have NHP hospitals that are looking significantly different from the rest of the estate.
‘We’re trying to do the rising tide that lifts all boats sort of approach.’
The National Audit Office (NAO) published an update on the NHP in January, which found that the government’s target to rebuild the seven priority hospitals constructed with Reinforced Autoclaved Aerated Concrete (RAAC) by 2030 will not be achieved.
But the watchdog said that the government’s new delivery timetable was ‘more realistic’ than when it had last reported on the NHP in 2023.
