Transcript

opportunity to remind the panel that meetings of this J-HUSC will be conducted in accordance with the standing orders of the host local authority which is Surrey County Council. Welcome to the representatives for Surrey County Council. That's Councillor Mawson who is online on Teams, Councillor Michaela Martin and Councillor Richard Tier, the representatives for Hampshire County Council, Councillor Ros Chad who is also online and is newly joined as in replacement of Councillor Anne Briggs, Councillor Phil North, is due with us very shortly and Councillor Bill Withers and the representatives for Bracknell Forest Council, Councillor Caroline Egglestone and Councillor Tony Virgo. I also welcome the other witnesses, Sally Baker who is the scrutiny officer for Surrey County Council, Hannah Clarke at Democratic Services. Please can everyone ask them to mute? Eddie I think your mic is open. I also welcome the attendees from Frimley Health NHS Foundation Trust, Carol Deans, Director of Communications and Engagement, James Clark, Chief Strategy Officer, Kane Thomas, Interim Program Director and Sam Burrows, Chief Transformation Delivery and Digital Officer and Annie Davies, Associate Director Communications and Engagement. Thank you also to Surrey Heath Borough Council facilitating a meeting in Surrey Heath House and particular thanks to Eddie Scott, Senior Democratic Services Officer. Those attending the meeting for the purposes of repeating the meeting may use social media or mobile devices in silent mode to send electronic messages about the progress of the public parts of the meeting. There is no closed session today. Anyone is permitted to film, record or take photographs of Council meetings with the Chairman's consent. Please liaise with the scrutiny officer listed in the agenda so that the Chairman can grant permission and those attending the meeting may be made aware of any filming taking place. If any member or officer would like to speak during the discussion, they must indicate that the Chairman of the committee by raising their hand or electronic equivalent and when called by the Chairman press the button and again speak clearly and directly into the microphone. So use of mobile devices for recording or filming a meeting is subject to no interruptions, distraction or interference being caused to the public address system or induction loop systems. If there is any disturbance, the Chairman may ask for those to be turned off and you are requested to put your mobile device into silent mode as well please and I've just realised that I've forgotten to do that so I'm going to do that for my one as well. Apologies for absence. We have received the following apologies. Caroline Hutton, Deputy Chief Executive and SRO of the friendly park hostel programme is unable to attend today. Unfortunately she's got Covid but she's set an excellent deputy in her place so I'm really pleased by that so welcome James Clark into that role. And Louise Connolly is attending remotely as is the Hampshire one, Marie Mandel and June Haines. So next question. Next item is declarations of interest. Do any of the members here wish to declare an interest? I will declare one in that I am a community representative to the NHS friendly and Councillor Mawson you've got your hand up as well if you'd like to do your declaration as well. I will declare that I have a family member that works. Councillor Mawson you're very faint I'm afraid but I know that you have a family member who works for the hospital. My wife works for Surrey Heath on the community side. I'm actually working with Radio Freely Park so I don't know if that's important or it's important to me but I just thought I'd declare it. Yeah it's good to note you. I don't think there was an opportunity for interest so thank you. So moving on we have had some members questions so question one was raised by Councillor Alex Crawford from Audershot North division of Hampshire County Council. His question was I would ask what communication there has been with government on the status of the proposal for a new friendly park hospital and the answer to that is the Trust is working closely with national and regional partners to understand more about what if anything the recently announced government review might mean for our new hospital programme. Meanwhile we are in regular communication with the national new hospital programme where there is a set assurance process that we follow when reporting back on our status and progress for a new friendly park hospital. There is an allocated scheme lead from the national team who is our key point of contact and advice, support and challenges our decision making to ensure we are on the right track. There is also a portfolio lead who continuously links in with our senior responsible officer and there are regular programme director calls within the national new hospital programme. The national NHS England team are fully involved and supportive of the need for our new hospital as well. Trust's new hospital SRO raised the importance of a new hospital to address the significant right issues with the Secretary of State for Health when he visited Heatherwood Hospital, another friendly health run hospital in August. The local MPs have also informed us of their recent or planned contact with government ministers since the Chancellor announced the need to review the national programme. Question two, should your friendly JHOS be consulting with MPs for the area such as Alex Baker MP for Aldershot who has NHS services as one of her top priorities? I will answer that directly. Thank you for your question which is very relevant. The members of the JHOS will be, I'm sure, taking every opportunity to work with their MPs to make the need for the new hospital very clear and seek the best possible support for the project. As Chair of the JHOS I have already met with Dr Pinkerton the MP for Surry Keith and we have discussed a common view that it is imperative that the Frimley Park replacement project is successful. I understand that Dr Pinkerton has also discussed the project with the Secretary of State. Following up I have a question from Steve Foster Hampshire County Council which relates to urgent care centres since this isn't directly related to Frimley Park. I'm going to pass over that one and the written reception will form part of the minutes but I think I have no real reason to read it out and deal with it there. And finally, what will the ICB do to work and help fund the bus companies to provide a scheduled and timely bus service from the main centres in Hart, particularly Fleet and Church Crookham to the hospital for staff and patients. This would have sustainability, traffic, parking, employment and social benefit. Will a new location take into account non private car transport from Fleet and CC which I believe is Church Crookham and the answer is NHS Frimley is committed to ensuring the needs of our communities are thoroughly considered in the planning of the new hospital. While NHS does not have the statutory authority to directly fund bus routes we recognise the importance of accessible and sustainable transport options particularly for staff and patients travelling from key areas such as the Fleet and Church Crookham. As a key partner in this initiative we will work closely with the Frimley Health Foundation, Trust and Union Hospital programme team and local government authorities to ensure that transport needs are addressed. This collaboration will focus on ensuring road access, parking and public transport routes are carefully considered and integrated into the planning process for the new hospital site. At this early stage we cannot provide specific details but please be assured that assessments have considered existing bus routes, servicing the preferred sites and issues raised including sustainability, traffic management, parking and social benefits. Finally a question from Councillor Caroline Egglestone. Remind that you are actually able to ask questions in the meeting as well Caroline so please do. But how many of the extra beds will be acute and to which the exact number required in the new hospital is under review with support from the national programme team. It goes on into more detail but I think that basically says it's under review and at the moment nobody knows. As I say the full written answers will come out. If you've got a supplementary on that Caroline please do. I think Councillor Egglestone has the signal that she does now have a supplementary. Ok, right, moving on to the main business thing. What I'm going to do is hand over to the Frimley Park team. I'm sure Carol Deans will marshal them. What we'll do is we'll have the first two items together, follow that by questions and then a short break and then we'll take the second two items to make it a reasonable amount and make it work in probably the best way. So Carol it's over to you. You've got 15 minutes on the first one, 15 minutes on the second one and then up to 20 minutes of questions and answers. Thank you very much Councillor Hogg and actually I'm going to dodge straight over to James because he's going to start with the sort of the context of where we are and lead us through the rest of it. Thank you Carol, thank you chair. So good afternoon everybody and thank you for the words around being the able stand-in. Hopefully you'll think that at the end of the session but let's see. To introduce myself, my name is James Clark. I'm the Chief Strategy Officer for Frimley Health NHS Foundation Trust joined on my side by Carol and Kane and we've also got Sam and Ellie from NHS Frimley around the table as well just so you know who's around at our table. So as the chairman said we're going to cover two main things to start with which you'll see in bullet point one and two on the slide. So the first thing is an update on where we are today, what is our current situation and a reminder of some of the challenges and how we're working through those and then secondly the update on where we are on the progress with the new hospital programme and what is going on with the selection process which Kane will take us through. We're going to cover that as one section. It should last somewhere between 20 and 30 minutes because we think that's a good point to then pause and take any questions on the kind of where we are today and the future for the hospital. So I'll start with where we are today and what we're working through and an update on our current situation at the hospital and we can move one more slide please. So as you are aware the government have announced a full and comprehensive review of the new hospital programme and you know that is being done as we speak. It's worth mentioning that every kind of piece of signal that we've been receiving so far has been around continuing as normal and not to stop anything and we're very much hoping that's still the case. The prime minister's on Wednesday a question was asked to the prime minister around RAC hospitals and will they be a priority as part of the new programme given the recent announcement of the review and the announcement was that RAC is still a priority. So we are carrying on as normal. The other piece to sort of update since you last would have met is a couple of leadership changes that will probably be useful for you to be aware of. Number one Lance McCarthy is our new chief executive. Lance, a very established experienced chief executive has joined from Princess Alexander Trust in Harlow and Lance has been with us for two weeks and no doubt will be keen to introduce himself and meet people around this committee at some point soon. We've also announced a permanent SRO for the programme which is my colleague Caroline Hutton. I think some of you would have met Caroline at the last one of these as she was here and this will be her full-time job so she'll be becoming deputy chief executive and the full-time senior responsible officer for this programme. So she does send her apologies for having COVID and I'm sure no one would want her around the room today. So as I say we're working as we are at the moment just to understand with our national regional partners what if any changes we may need to make as part of the announcement and if we do find out and know anything we'll update you as soon as we know. But our new hospital does remain an absolute priority. It's worth mentioning that obviously we do have to continue to contend with the nutty issue of rack concrete. It makes up 65% of our current building at Frimley Park Hospital and that's around 7,000 plaques that need to be dealt with that are being dealt with on a day-to-day basis as we speak. So if I just go very briefly into RAC for those that may not be so familiar with RAC. What dealing with RAC means is to basically to reinforce it and make sure it's structurally secure for the future. But the work that we're doing you know is likely to sort of last around you know up to about the 2030 point. You know it's not intended to be a permanent solution or fix. And by the end of this year we would have spent nearly £30 million on the reinforcements to make our hospitals safe. As I say addressing some of the dangerous planks and making sure that the building is safe. It's worth bringing that to life a little bit actually because it's not just about you know the disruption that causes and the lack of productivity, inefficiency and disruption to our patients is significant while that's ongoing. If I take the live example of what's going on today and at the moment it's the pediatrics ward is currently being reinforced so all of the ward has had to be closed down. And obviously as you can imagine moving children isn't as simple as just moving them from one place to another because you have to make sure they're moved into an appropriate place. So it ends up becoming a bit of a jigsaw puzzle moving patients around the hospital in order to actually to reinforce and deal with the works. We also have another example would be work that we've had to do on theatres. You know you can't take out all of your theatres at one time so you have to sort of do it in a phased approach. But things like the air handling unit you have you know one air handling unit for all of the theatres so as part of taking two out means you then have to replace the air handling units as well as doing as well as doing the RAC works. So it's a it's not always as simple as just the reinforcement part of doing the work. I think that yeah it's everything you'd say that the current work does have a 10 year lifespan but we know that RAC does continue to deteriorate. We have structural engineers on the site on a bi-weekly basis to continue inspections and are likely to be there for many years to come. It's also worth mentioning and I know there were some questions and interest received beforehand on our new inpatient and diagnostic facility. You may be aware of the the new newly built modular diagnostic and inpatient facility that's being built as we speak a 49 million pound investment in the current site and the plan for that is that that will provide additional bed capacity of 74 inpatient beds and the way that that will be set up is it's set up under I describe sort of modern hospital principles so that's single rooms and bays and that will also have a dedicated breast care diagnostic and outpatient unit. So that will be open in early very early next year and it will be a kind of a one-stop shop for patients to you know and also to help us with our current demand that we're facing in the hospital. The next slide just talks very briefly around some of the other current issues that we are that we're working on and addressing because you know it's all well and good saying we have a new hospital coming in 2030 but that doesn't alleviate the fact that we've got some significant challenges that that frustrate and cause pain points for our patients that we that we're working on. I think the the main one that that I would talk about is travel, parking and access to the site. There isn't a golden bullet to to fix this you know I feel it and see it every day when I'm in the site and if there was you know there was a quick solution or you know finding a you know building a multi-storey car park I'm sure we would we would do it but the way that we've been tackling it is first of all we've got an off-site parking arrangement now arranged in Lion Way so that's about a 10-minute walk to the site and we've relocated our staff parking to Lion Way to open up additional capacity where we can on the site and we're also working collaboratively with partners to make sure that we don't bring patients into the site unnecessarily so actually if patient appointments can be done virtually we can have systems for example a patient initiated follow-up where it can be very much patient-led if they need to speak to to one of their doctors or nursing team. We are building community diagnostics and bringing diagnostics into the community and we'll have more diagnostics facilities opening in coming years and we're continuing to look at what we can do to make transport and travel easier to get our patients into the site because we are aware it is a an absolute pain point for for our patients but it's it's probably worth now me handing over to Sam who's going to talk a little bit about access to healthcare and and and what we're also doing is in the ICB to make it easier for our patients. Yeah thanks very much James good afternoon everybody I'm Sam Burrows the Chief Transformation Delivery and Digital Officer for NHS Frimley. I think given that access to the site and services more generally is clearly an area of interest for everyone in this room I would just take a couple of moments to talk about the work we're doing collectively and in partnership to ensure that we can improve the overall access and performance for our population to our urgent care services. Now when we plan and deliver urgent care services we really try and ensure that they are joined up that patients have got timely access to them and that the care they receive in that location is appropriate. You might often hear this described as right care in the right place at the right time and we have to hold in mind that this isn't just about access to the emergency department so whilst clearly that's of great importance and is a key feature of the current site and will be of the future site as well the access that our patients receive out of hospital is extremely important as well particularly when more than 90% of NHS patient contacts happen outside of a hospital environment which is why we've got a continuing focus for urgent care on a whole range of service developments including how patients can access services with their GP, alternative primary care appointments through the Pharmacy First scheme with local pharmacies, the three urgent care centres we have across our Frimley ICS geography, same-day access hubs which means the patients can access more primary care appointments on the day when they need them and ensure that one-on-one calls are answered promptly and when patients are required to be seen by a different service after speaking with one-on-one that they are sent to the right service and still can be seen quickly as well. We also work very closely with our colleagues at FHFT and with our two ambulance providers in South Central Ambulance Service and Southeast Coast Ambulance Service to ensure that when 999 or ambulance care is required that timely access to those services are available too. How we configure all of those things is something we keep under regular review and we make changes if we think they'll be beneficial to patients as well. Clearly this development for the new hospital for Frimley Park will see us continuing to understand what access is required where as a part of making the new services beneficial as possible for local people. Kane I'm going to hand over to you now. Thank you Sam, good afternoon committee. Just to talk now for a few minutes on the site selection process and the background and some of the stuff we did in 2023 moving towards 2024. So when the trust secured their place on the new hospital programme in May 2023 we set about appointing a land agent to look at a list of long sites. There's a long list of sites that we could choose and evaluate. We moved from that and we set the brief that we set a hurdle criteria, a pass fail hurdle criteria. Was there a landowner out there willing to sell a site? Was the site actually big enough? And were there any obvious planning and programme risks that would inhibit and impede our ability to deliver for 2030? And that allowed us to move from a long list of possible sites to what we deemed a priority list of sites. And then we applied an evaluation criteria of 14 different areas that we were able to do detailed due diligence on and we'll cover those in a bit more detail shortly. And that allowed us to move through the systems site selection process down to what we call preferred sites. And that process is aligned to the HMT Green Book in terms of guidance on managing public money and the business case guidance process. So our options filter framework process from that HMT Green Book aligns with our site selection process. We recently went to the national programme headquarters in Canary Wharf and did a full peer review of our site selection process and that was well received as we continue to go through our due diligence on our sites. We have gone through that during the summer and since our site selection process we've navigated through the general election, the new government review as James has alluded to, and also the possible reform of the national planning policy guidelines as well that those have changed. And we've had to continue our due diligence on our sites in the confidentiality agreements that we are into and also navigating some of the challenges that has been presented to us. So what are we doing now? In terms of the team that we have, we have a large team of professional advisors, subject matter experts, whether they are architects, service engineers, transport engineers, planning consultants, ecologists, economists, lawyers, land agents, quantity surveyors and project managers, all as our expert team, subject matter experts, helping us with the due diligence to make sure that we move at the right pace, find the right site and are able to progress to a detailed design process once we've selected a site. We've been able to develop a key risk schedule in terms of the risks of each site that we're looking at under the banner of preferred sites and also the opportunities of each of those sites. And we spent the summer moving through the detailed area and developed that risk and opportunities schedule. Next slide, please. When I talked about the site selection criteria, this is a slide that may be familiar to committee members who were here in May. This is the evaluation criteria that we've used. We spent a significant amount of time looking at transport in terms of surveys, a detailed transport survey that we've undertaken. We have done on-site surveys in terms of ecology and environmental surveys. We've done flooding analysis. We have done overall program and planner analysis. We've met with what we term tier one contractors who were able to build a hospital of the size that we're looking at and understand the program and aspects in terms of the program that we are working to. We've tested that program with experts in that field. And we've done other surveys in terms of air quality, desktop surveys. We have done substantial utilities diversion works on each of our preferred sites to understand what it is that we would have to do if we chose that site to make it developable for a new hospital. Our new utilities connections that we need, the size of the power, significant size of a power for an all electric hospital. What capacity do we have in the vicinity, in the locality? How are we going to energize a new hospital site the size that we're looking at? And those are the elements of due villages under those banners, the site selection criteria that we worked through during the summer. So in terms of the list that is on the left there, design and implementation in terms of developing the master plan. So we have our preferred sites. What does a master plan look like in terms of the components that are there? We've looked at how patients, visitors and staff would arrive at the hospital, mapping out that where the size and the context of the new hospital in terms of the massing, how high the building would be, how big the building would be, and how it fits into that local context of the locality surrounding that third site. And we've mapped all that into our master plan to give us a far better idea of what a new hospital on our preferred site would look like. We've also had the national programs hospital 2.0 templated design that we've been able to look at and see the impacts that that will create for our new hospital. I would stress that we are not designing the hospital at this moment in time. We are making the master planning for the new hospital in terms of looking at the site and the site location. What we've also been able to do with all of our information in terms of the due diligence is look at that in context of the different sites. The different sites present challenges and those challenges will cost money to overcome in terms of some of the external infrastructure upgrades that we may need to do on some sites. Some of the ecology improvements that we need to do on all sites but on some sites more than others. And we've been able to look at the relative cost value in terms of the cost of developing one site over another site. And that's been a significant piece of work that we've been able to progress during the summer. And all of that has built up that bigger picture in terms of what does the master plan look like on our preferred site and what is the indicative cost of developing one of our preferred sites over the other. What we've also on our evaluation criteria we've also been able to develop during summer is understanding our catchment and the population and how a hospital and one of our preferred sites would impact our population in terms of traveling to the preferred sites, how would they access the site, and what does that mean for our population. And we spend a considerable amount of time during the summer playing that into our site due diligence. And Sam will just talk about that in a little bit more detail from an ICB perspective as well. Yeah thank you Kane. So just a couple of quick words on the equality impact assessment. So under the law, in particular the Public Sector Equalities Treaty and the Health and Care Act, we do have a legal duty to undertake an equality impact assessment to understand and consider the impact that any changes we make to services would have on the population which we serve. Now as a partnership of organizations we do seek to go quite far beyond our legal minimum duties in this space. It is a stated strategic intent for us if you read our ICS strategy which is around healthier communities we published last year. Our two strategic objectives are around reducing health inequalities and improving healthy life expectancy. You cannot do either of those two things or meet your legal obligations unless you understand your population and how the services that you offer and when you change them is going to impact your population. So we use a range of data and intelligence, the joint strategic needs assessments that our local authority partners produce in their public health teams and of course our ongoing dialogue and engagement with local people to build our understanding and to hear their views as well. As we work through the site selection process we will examine all of this and understand the benefits and any mitigations which may be required for any change which is progressed and this will all be produced as part of an integrated impact assessment which will go beyond our basic legal requirements. This work doesn't happen in isolation, it's an ongoing evolving exercise that we'll continue to work with our partners on and that's partners in the broadest sense. So that's the broader public sector, our elected representatives through this committee and other discussions, our staff clearly and of course local people as well. So an area where we've made really good progress in during the summer is working with our local planning authorities to discuss our preferred sites. We've been able under the planning performance agreement to progress through a pre-application process and we presented our master plans to the local planning authorities to talk through the implications of development in hospital on our preferred sites. We've done that under a full confidentiality agreement because in tandem we are also progressing the commercial dialogue with those preferred sites in terms of the legal and commercial aspects of acquiring those sites. It is really important in terms of the confidentiality aspect that we're working under because we have progressed, we have made significant progress, we are moving towards a situation whereby we could form a heads of terms agreement, enter into a contract to acquire a site once we've completed the site selection process. But it is vitally important we maintain that confidentiality given that our sites, our preferred sites, have businesses on them, they're operating and we need to protect those sites and those businesses whilst we work for those commercial negotiations. But we have made significant progress with each of our preferred sites with the local planning authorities. So with the local planning authority we've been able to present our master plan and talk for we've had feedback from the local plan authority on areas of concern, areas of risk, areas of opportunity as well in terms of how we can work together to improve the local infrastructure whilst developing a new hospital as well. And another key area that we've been able to make really good progress in is with the county highways authority. We spent a considerable amount of time doing a transport assessment with our professional team which has been issued to the county highways authority. We've looked at the sustainability of road access and assessment of how the road networks have capacity for future use and move and car movements and active transport movements. We've done some detailed junction modeling on each of our preferred sites and the proposed entrances to see how that junction modeling would stand up to additional transport movements. There are some junctions and areas in the local vicinity of our preferred sites that we already know are at capacity and will need significant infrastructure upgrades whether that be new roundabouts, whether that be footbridges, that element of detail that we've been able to discuss with the county highways authority to inform our due diligence and also to work closely with county highways and our local plan authorities. We've also looked in detail in terms of how we can integrate existing transport networks into where a preferred site would be for the new hospital. So what would we need to do to the local transport networks to not only replicate what we have at Frimley Park but improve as well and take that to a new and for future generations for a fantastic new hospital. And all of that work has happened during the summer with the local plan authorities and county highways authorities as well. So we now know when we move to a detailed planning application the areas of concern that have been raised to us by the LPAs and the county highways, the areas that we need to look at and work with those organizations to make sure that we have a smooth and successful planning application with the correct outcome for all of the selection criteria we've looked at and for the patients and people that we use in the hospital. Next slide please. What still needs to be done? Well, what the the pre-application process has told us is that we need to look more at the ecology and the environmental aspects and we're spending the time now working through those in terms of the the reports that we've had from the local plan authorities to understand better how we would mitigate and improve the ecological environmental impacts of developing a significant size new hospital on any of our preferred sites. We're also taking time to further investigate the catchment analysis that Sam talked about, understanding the impact to our population traveling to the our new hospital sites and how that would allow us to make a decision on what is the right preferred site for us for our new hospital. And those are the key areas that we need to work through. It's vital as I touched upon already that we maintain that confidentiality as we reach this period that we're closing on on the site selection process and conclude that and we need to work for those areas before we can conclude it. So that's all of our content. Obviously open the floor chair to questions. I think just end by saying you know one of the things that we are absolutely committed to and would like to do is continue to work with the HOSC as this develops. You've heard where we are today but you know to talk about you know how we continue to work and keep you updated as as things progress but to you too for any questions. Thank you very much. Thank you. Yeah one of the first things mentioned was the pediatric water. I'm afraid I immediately thoughtably Thomas the Tank Engine catering for me which reached on television. However one of the things that was mentioned was the impact on theatre capacity with the you know protective work going on and at the same time we have a major concern in terms of backlogs. So you know one of the questions I'm going to ask you is what do you think the impact of lack of theatre capacity is having on the backlog and you know what's happening in terms of a recovery to get that backlog back down to where it ought to be? So thank you good question. So our waiting list is too high. You know our waiting list is currently sitting somewhere in the region of 80,000 so it is too high and we acknowledge that. The the there are lots of plans to reduce that and reduce that quickly. The you know the theatre capacity is a problem you know it's you know the the capacity at friendly park hospital is a problem. The the opening of en block will provide 74 additional beds and actually that will help our theatre team significantly because it's not just theatres it's sometimes actually the beds and the flow to get people through their operations. We've obviously also got Heatherwood hospital which if anyone has been to is a elective only site and is a kind of described as an exemplar for for elective care and that operates currently six days a week and we are exploring what we can do to get that seven days a week. Our theatres run about 85 capacity so they are they do run at a high level of capacity but the the Heatherwood provides more opportunities to get our patients into a describe as a cold site so you know they know that their their elective surgery isn't going to get cancelled on the day for an emergency and patient experience that go through that site is particularly it's particularly positive. So so sort of short term is driving Heatherwood harder getting more people through through that seven days a week and the opening of the the additional capacity of the 74 beds will really help at friendly park. Thank you for that. Councillor Richard Tier. Having just had the benefit of a an operation at Heatherwood can I encourage you to make as much use of that facility as you possibly get it really is a marvellous new facility please. Thank you. Councillor Virgo. Thank you children. I suppose we're waiting have you we could cut to the quick really have you found a site I suppose because all these questions are great but it depends on the site so that's my first point. The second point these are perhaps say things but I'm wondering if and maybe this would be ridiculous but park parking is going to be a problem wherever you find I think we all know that but I'm just wondering whether there could be a park and ride from your present site. Now how that would work I don't know because obviously some people would want to go directly to the hospital and how they'd be directed but I think maybe that would just relieve the problem if you don't need urgent care you have to go to the park and ride and get on a bus so that would be the first thing. The other thing I spoke to a nurse actually seeing someone in in primary park by the way they had fantastic service in primary park so that says without you know it's a great hospital and we should be proud of what's going on now let alone the new one but she said in I think it's Queen Elizabeth's hospital in Glasgow they had or they tried single rooms and they found this enormously difficult she said partly because it wasn't very well built that was the first problem but also they they weren't up to that kind of system you know they didn't have enough stuff you know there were all things that happened and communication was the top of that but silly things were there in the design I know you haven't got down to this so forgive me for saying this but silly things like sinks you said because the the hole in the sink which we all know is in the bottom but apparently not in the hospital it's in the it's in the side you know it's in the the top and she said we have more engineers coming to fix the sinks than we do anything else in the hospital I mean just simple things like that the toilet was in the wrong place she said so that you know the toilet was in the middle sorry was in in the side I think she said by a wall it was very difficult to get people up because you can't get to the other side of the people so I just wonder if you thought you know someone's been up and had a look at this or had a conversation with them and would iron those things up I think the rest is I would waffle a challenge because we don't know what the site is so I'd stop that come with those and maybe you say yeah start so I'll tell you can I just pop in there because I've got a couple of questions along with some of which Council Vergos touched on as well because the other suggestion that along with a park and ride you have multiple sites already a very strong suggestion to you that a bus service to move people to where is appropriate would be a good idea and things like take the pressure off A&E by moving people arriving you know that have got minor injuries over to a minor injuries unit is an obvious thing to do but you know there are many you know bits and pieces like that way you may not want them on the main site you may want to move them somewhere else and making it easy to do so is obviously going to be a sensible thing to do and yeah the elephant is the room really is you know how soon do you expect to reveal what site is chosen by when how much longer is this process going to take if I pick up the I'm sure there are of course yeah sure I'll take the I'll take the park and ride and the design and I'll ask Kane to take the new the site selection one if that's okay so first of all council I think an excellent idea park and ride we need to look at it we need to find something we need to find a solution we need to find a better solution than we've got today we can't live with this pain until a new hospital so I'm committed to looking at and trying to find a appropriate solution whether it's bus routes that move patients around whether it's a park and ride whether it's you know finding an appropriate site that's a five-minute walk for people that they can we're you know we will we explore all of those and and continually look to try and ease that pain in terms of the design and Kane you might want to comment on some of the bits but the design for a new hospital does follow a set process which is sort of hospital 2.0 design so we get the design and obviously that that's part of the build of the 40 new government hospitals we'll get a chance to learn I suspect a lot about single wards from our new diagnostic and inpatient block that opens in January because it is a completely new way of working for our team so lots of benefits to patients in terms of things like infection spread quieter you know a better you know more private privacy areas however our nursing teams are you know health professionals and doctors need to work differently because you don't have all the patients in a particular ward so we will learn and we will continue to feed in anything in terms of the design that doesn't work into our into our sort of central central teams that are doing it that the sinks is an interesting one I suspect it's something to do with infection the amount of infection that spreads via hospital sinks but but again if it's not fit for purpose we need we need to get that fed back and and fix it did you want to talk a little bit about the sites yeah thanks James I just covered a few points just embellished what you said in terms of have we found a site yet we found several sites that do have the the ability to have a new hospital site on it we started at a long list and it's not easy to the amount of work that we need to do to find a site within five miles of the existing site that can accommodate a hospital so that process has to go at the right pace we have to get the answer right for the new hospital site so we we have we have a number of sites that we we have gone through that site selection filter and and continuously due due diligence on in terms of the park and ride question that you wouldn't be surprised to hear came up in our discussions with the local plan authorities in terms of the the parking at a new hospital we discussed the possibility of the park and ride and we will look at that further but we haven't started to develop our green travel plan net and a green travel plan for our new hospital will very much inform how we deal with parking on the site whether that be parking accessible parking electric charging points parking whether that be active transportation to the site all of those are being looked at in terms of the the clinical point about single rooms as James said that there is a hospital 2.0 template from the national team that that is single rooms that is 32 bed wards that we've been asked to accommodate in our new hospital it will be as and we touched upon this in the in the last meeting that we attended a committee meeting in May it will be a significant change of culture for everybody involved in terms of the operating policies and and how those wards are managed and we're still working through that but what the national team have done in developing the templated design is take advice from the royal colleges from clinicians to work through to make sure that that design is is compliant is viable and can be implemented on the what was the other point on the capacity in terms of the transport network we have done modeling on each of the sites we know when the network reaches capacity in terms of how we'd manage that in transporting we have detailed isochromes to understand the travel times of patients and staff from various outline locations into a more central location and those journey times and how we could manage that in terms of an active travel plan mr chairman just before we go on can i just have a secondary on the points that we've made um i i suppose i've got to press you on this because we're counselors we're not going to sit here and and be quiet about things um you must have a plan and a date so because there is a building pressure i don't want to make this worse for him there's a building pressure from our side and i'm sure everybody's side what is going on mr virgo um you know and so i know that these things take time but then i can remember and uh correct me if i'm wrong but you said that you've got to start building in 2026 and uh and we are now heading towards 2025 um it's it's close so i just wanted just the chairman made this point but you must have a date by which you've got to come up with a site and i think that's only fair to tell people to work to otherwise we're going to have this constant hassle where are they are you sure you've asked the question have you pressed them on this you know so that's the first point the second point is i want to go back to design because i don't want to stick on this one on time because it's it's not fair um but the point that the nurse made to me and she's a senior nurse up in queen elizabeth hospital in glasgow is that these things were employed on them from marshall street or wherever they the civil service decide to build this thing or design it um and they didn't talk to the staff on the ground and therefore when it was opened uh the staff had to you say adapt but of course they had to adapt actually doing it uh and it seems to me we've really got to talk to staff who are currently in frimley park um about how they want to run this hospital because it's they that run the hospital not us and so i make that point very strongly um and there's just one other point just as i got the floor for a sec um i did ask a question in the last meeting about staff accommodation and it is really important to keep um consultants staff because we know how difficult this is um in a country that's you know that's on its own a bit these days and therefore i think i asked the question um have you in your plan decided to allocate staff accommodation and therefore it's part of the building cost um i think originally um i think um acting ceo said that it was left to the market but i i i just think that would be a disastrous disastrous situation because we want to be assured that staff can stay there can live there in a reasonable way thank you mister thank you chairman okay and apologies i wasn't at the last meeting so and i live in and over so i'm probably not up to the same speed as um most people in this room so apologies if these are some sort of knotty questions um but you mentioned earlier the government reviewing the hospital building program but you've got some good signals from them they're prioritizing rack and you're cracking on um as norm was there a figure previously that the government suggested that they would um finance the new hospital for and if so what was that um and has that changed subsequently now you're doing all your slight selection um and i've got down to to uh or work that up a little bit more and is therefore is there a shortfall from what the government previously committed to what you're working with now uh second question is that and you referred to earlier in terms of the new planning policy framework um part of that of course was also to increase the housing targets most local authorities so we will be assuming um in 10 15 20 years time there'll be a much bigger population in this area than we have at the moment um when the hospital will be built so are you taking that into consideration in terms of your calculations in relation to capacity and then also just to follow up on council vergo's point because the usual sorry i'm not being rude to you individually but the usual nhs response to questions is it takes as long as it takes um but just to back you on that in terms of yeah there needs to be even if you're not going to obviously reveal the site now because of commercial confidentiality some sort of ballpark figure to say where when that's going to take place i mean you're still on just to give people confidence that you're still on target to build the hospital when you are required to build it by thank you jim and you want to start thank you for those questions um so where are we in the site selection process we've come a long way we've done a lot of detailed work are we able to conclude the process yet no when we'll be able to reconclude the process not yet we don't have a definitive date if we had a date we would look to share it as soon as possible we could but there are a number of areas that we're still looking at into the commercial negotiations that the areas that have come out of the pre-op process that we need to look at that mean we need to spend time to get that right so so we aren't able to give a definitive date first half of 2025 second half of 2025 i'm talking about the site selection process concluding at this moment in time and we can't give a date at this moment in time today we'd very much like to but we just have to go through the process in the right place to get that correct answer in terms of the overall delivery and go back to the councilor Virgo's question i sat in front of you in May and said we needed to be start building in early 2026 to achieve that 2030 deadline and that remains the case today but all of the good work that we've done through the summer is telling us that we are still able to achieve that there's nothing telling us that we can't achieve that at this moment in time in terms of the um the we covered the timing it covered the the engagement so we haven't i said during my part of the presentation we were looking at the master plan we weren't at this moment in time in the detailed design of a hospital when we start to look at the detailed design and and doing the mapping the clinical pathways of of where all the departments of the hospital will be designed into we will have a significant engagement exercise with clinicians and all user groups who have been in the hospital to make sure that we listen and take on board their feedback to make sure we get the design correct for the people who are going to use the hospital uh both both from a staff perspective and also patients as well and carol will cover a bit more about engagement further into the presentation in terms of the funding envelope we are still concluding our demand and capacity modeling to tell us exactly the size of the hospital um we were close to concluding that which would have then fed into a funding envelope that would have been confirmed by the national program and then we went into the pre-election period so the pre-election period and obviously the change of government and the review has meant that the trusts are not aware of the funding envelope that hasn't been disclosed but we're working to the brief deliver a new hospital that we've previously given and our inclusion onto the new hospital program we're not aware that figure until until after the review yes we're awaiting the affordability envelope from the review of the new hospital program we will work into a size of a hospital at 130 000 square meters previously and the costs associated with that i think it's a billion pounds it was sent to us it's it's over a billion pounds yes it wasn't confirmed and i'm not quite sure if that was in the public domain and take advice as well but that was uh formally notified and in the public domain but yes it was over a billion but that was several years ago so there will be inflation to consider for that and also an update of how the review of the new hospital program is concluded so we don't have that funding envelope confirmed to us from the new hospital program at this point in time carol have you got the figure that was in the public domain previously yeah so previously in the public domain we talked about i think there were two things that went into public domain one was over a billion and i think i did i do remember very early days there was a figure of 1.3 billion that came out of our very initial strategic outline case to get ourselves onto the program so that was the the broad brush figure that we were talking about so i mean certainly we're still doing as cain said the the size of the hospital might change that figure um upwards and and we we haven't done that bit of a financial output but certainly at one point it's not going to be less than that do you want me to repeat that or do you hear no um we're aware of the the consultation that is out at this moment Simon closes i think in a few weeks time um we're aware of the implications that it could have to the local planning authorities uh and at this moment we're observing it and looking at our demand and capacity model as to the implications that it could have thank you that's helpful could i just stop mr chairman i'm sorry just to this point because i wanted to help counselor north we were told in the last costing that this include roads so it wasn't just for the hospital the 1.5 includes all the road junctions that is correct isn't it if we have to do infrastructure upgrades upgrades to facilitate the new hospital they'll be part of the funding envelope yep okay counselor eggenstone please thank you so i've just got a couple of questions please so obviously when it's announced in the budget on the 30th of october that's when they'll say if hospital can go ahead or not that's when we've been told that it'd be announced so on the 30th of october you might have somewhere that you think is um what you've got planned you've gone and visit these sites if the budget then turns out to be a lot less they just want you to build what you've got but just somewhere else because of the rack have you got the plans for that moving forward or is this all going on what was first agreed with the site with all the extra beds because i'm just thinking what budget may or may not go ahead my second question is will it go to all consultation with a couple of sites like the royal barkshire and also mount fernan have done where you're going to like ask people's feedback on it to make the community feel more involved thank you i'll take the first part of our question so in in terms of um the funding envelope and what it will mean for the new hospital we're continuously planning and looking at different sizes of hospitals the area that we need in terms of the size of the site we're looking at all opportunities but to get that correct in terms of the optimum size of the hospital and size of the area of land that we need to acquire for the hospital as well but in terms of the consultation question i'll defer that to colleagues should i start and then i perhaps pass on to to sam as well so we made a commitment when we came last time about extensive engagement consultation whatever we need to do clearly until we've gone through the the due diligence process that that canes described in some detail around the technical evaluation we're not in a position yet to know quite what we'll be engaging or consulting about so so i guess the commitment from us at this point is yes we will do it what we'll be doing it about um i we're we're looking at a range of options i guess in terms of you know if it's this this is but this is what we'll do and the piece of work that um ellie's going to share with you later on this afternoon is is our stepping tone to that commitment to doing it so regardless of what we're asking um it's about doing it in the right way um as thoroughly as we can and not just around the site itself but throughout the whole of this process because there will be so many opportunities where we need to make sure that we get the views of patients our public our staff um so not just the site but the whole development of the of the hospital itself and how it works and how it runs um is going to be part of that work which is why we want to get the how we do it right and that's why we're bringing that to you today in this very early stages i don't know whether you want to add to that sam i won't add a huge amount more carol i think it's really comprehensive i think the key takeaway from that is clearly there's a dependency on where the site is that helps inform exactly what that exercise looks like but you know genuinely please be rest assured there will be significant and ongoing engagement with local people representatives and staff as well to ensure that we hear the broadest range of views not just on the where but on the how is delivered as well and i just asked another quick question please you mentioned that you have been speaking to local authorities and obviously you're looking at the whole transport and everything it does that include bracknell forest because i know we're a lot smaller and what's the engagement being around that side please yeah i'll just take that one i've actually okay counselor so the answer is a very simple yes so um and actually only yesterday i joined a call with the chief executive of bracknell forest council and actually counterparts from the other barkshire authorities as well and my counterpart from the royal barkshire hospital too you know we're not an island are we at the health economy here we have to make sure that the work that we're doing locally takes into consideration the views of local authorities other public sector partners in the nhs and beyond and of course counselor with us includes our colleagues in north hampshire as well given the work happening there so yeah it's a critical part of what we're doing thank you counselor tia uh thank you thank you um you you spoke earlier about changes to single room wards and that will mean i think some uh maybe some need for additional um labor what's happening in the recruitment and retention space we we haven't spoken about people today we spoke about sites we've spoken about buildings we've spoken about possibilities what's happening on the people front please as if by magic um the chair and vice chair asked us to give a bit of an update on our work with our staff and it did come up as counselor vergo mentioned as well in questions last time so i've got a little little brief bit of presentation to give you at the end of our session if that's all right and i'll pick that specifically up as part of that thank you very much to the nhs team for the q and a so far um i do have one very specific information require that's the weather's ah all right but i'll do this first anyway um i have one very specific information requests for you which is yeah we really could do with a map that shows all of your current sites and what they are what they do in terms of capacity and also a list of all the bits that you're planning because you've mentioned you know the diagnostic center that you've already got presumably is going to be kept but then you you also throw in that you're looking at putting in other diagnostic sites so we need to try to understand what the plan as a whole not just one particular aspect of it and so it's going to be incredibly helpful to house that i mean obviously you can't commit to where exactly any of those are going to be and things like that but you know a general guide of what you're planning what you're looking at strategically on sites is obviously going to be really important to this discussion so and i'm going to include counselors if you'd like to ask them thank you chairman um just like to thank sam on his update and the importance the icb is going to work in in conjunction with this project in having hubs and unit uh urgent trade treatment centers all part and parcel of the build-up of the nhs services up to the opening of that new hospital also the fact it is statutory that a public consultation will happen once a site has has been chosen that's mandatory it's not a question about that so be reassured it'll go out to tom dick and harry and the nurses will be included now um i was we talked about a 30-acre site last time and um from what you've said that that will grow probably to 40 45 acres but you did surprise me in saying that you're looking at preferred sites within a five mile radius of frimley and i find that quite hard to understand that there would be a 40 50 acre site within five miles of frimley i may be wrong but i just find that harder at the moment so we do need clarity on on the size and in the past we have talked about the campus the training facilities the dentistry which all comes under nhs england now to ensure that all aspects are covered there um local planning authorities you talked about actually been dealing with commercial businesses and one could go away with the impression that the site that you're looking at are in commercial business areas which again then starts talking about infrastructure transport support utilities and if you have as much joy as the counties have been working with your utilities i would suggest your timeline for the project has a lot of forward emphasis on it because it's been very difficult for us in in anything with utilities to get them to work together at the same time because the law in this country does not actually demand that but in ireland it does if utilities go in they go in at the same time also if you have to put road structure in then you have to bring it up to be accepted by highways so that's another cross you have to bear the park and ride transportation is has been mentioned and is critical we are covering a lot of the same words coming up due diligence confidentiality and it is getting a bit boring to be honest just say it once or put it on there on the brief that's all we need okay because it makes it very frustrating city that you know you mentioned a five mile area so we'll go away now and we'll look at that five mile area and we'll look and see what 40 50 acres is available and if you're looking at it 10 out of 10 someone else is looking at it um and we do need to get cracking the point about 2030 you know we've already had 10 years in hampshire so you know governments move things very quickly and if you haven't got your plan started you're up against it and you did have to have initially a site recognized by february 24th that was the initial scope and we all knew that was very difficult so it is going to be an interesting time move forward private rooms having just received a granddaughter on tuesday and uh being moved out of a ward because the chair with my son-in-law sitting on it had the curtain on his face and someone sitting the other side due to the lack of space within our current hospitals i think all the key medical things that have come out from covid and and any major disaster is that single rooms are the way ahead and if you look at our future complex need care homes at the moment they've all got it they've all got the right ensuites they've all got the right equipment they've all got a medical safe in there they've all got sensory systems and the doors are open during the day so the patients do see people at night and i say at night because my son-in-law paid a thousand pounds to move into a private room because there was no sleep being obtained in that ward in a maternity ward and anybody who's spent time in a ward in hospital will know sleep and recovery you know which is supposed to be the prime thing is the last thing you get so i would really disregard what's happening up in glasgow i would look at what's happening on the ground in our counties in the south and the success of our future complex need care homes and go and look at them the other thing i would say is that you know we do as a scrutiny committee members go and visit our hospitals we go and look at portsman's for example that i've got an urgent treatment center right next door to it so anybody who goes there and isn't warranted for an a and e goes there and communication is the critical thing that has to happen with this every new hub every new utc and mine injuries unit which is changing the public the last people to know where it is and that map we were talking about chairman is critical to get it out there prior to actually the official location being announced so people actually see what's out there and it shocked me when i looked at hampshire and i'm passing it onto sam to see what's available and you know for the hampshire hospital we've got west barkshire we've got surrey hospital sitting in on the scrutiny committee so every aspect of clinician nursing care and and staff is included in that element and i think that's critical but we're we're sitting on a tightrope and and actually the information you're giving us really is repetitive i've got to say thank you chairman yeah and i'll you know just add to that yeah yeah we do have to actually move the conversation on we cannot keep coming back and saying it's confidential we but we don't know when it's not going to be you know it's not acceptable the public is not acceptable to anybody um you know there must at least be a planned date even if it then slips for one reason or another um so just you know you ever put that out there um i'm going to suggest that what we do now is actually take a 10-minute comfort break and come back to the second session yeah um i absolutely hear what i think we all hear um what you say and and and that frustration and if i might if i might be honest um that's frustration felt by our teams as well and our staff so um we we do feel it each and every day as well um i think the challenge that we have is um yes we're using those words of due diligence and confidentiality and commerciality and they are very real for us um but the reality again is that many of these decisions will be out of our control so cain talked about some of the technical sorry to use the word again but the work that is going on at the moment some of that is requiring people that we don't have control of and not necessarily utilities as as counselor with this mentioned there but but we we can't progress until we get information or go ahead from different areas so we are working as fast as we can but the reason we can't give dates is because the bits that we need are out of our control all we can do is push for them as hard as we possibly can um i have to say that the work that that cain and the team are doing with the local planning authority relevant to the sites that are being um assessed is helping enormously and it is giving us all of that rich information so that when we've finished going through all of that and we are finally able to share um the outcome of it publicly um it will be very very thorough and give a wealth of information that will really be able to get that feedback um from the community so so i we hear we all of us hear that frustration genuinely but and i'm really sorry that we can't give you a date of when that will be but it is because it it's not our it's not our date to create i could i could say to you it'll be whenever but then the information that we need or the authority we need doesn't come and then we just look you know foolish um so i think the important thing for us is that we do want to stay involved and engaged with the just members and i think that there's a there's a balance for us to take around coming back regularly so that we keep that relationship going we progress what we can for example the preparation for consultations and engagement that we need to do whilst at the same time not wasting potentially people's time by coming and not being able to say anything new so that's a real balance that we need to tread with your your guidance i think yeah i think you know we we've all listened we are concerned that you know the state of the building as such you know it isn't going to last much longer despite all of the valiant efforts to prop it up um and so you know we recognize there's a very fixed end date to this um what we you know really can't have is you know that not knowing where what the site is until 2029 by which time you've then got six months to actually build a hospital um so you know you understand that you know we're getting more concerned about the program as a whole uh the fixed nature of the end date um to do something um and the lack of a decision and moving moving forward or even a planned date by which time you will have you know got reached a go no-go point and have to then say okay we're now into emergency planning of doing something yeah we cannot have a situation where we have no hospital um you know it's just unthinkable and so yeah we're getting very concerned is what i would say and can i also add at the last meeting in may you did say by the end of summer that you would be looking to declare what sites you had you've also spoken to our local newspaper the brocknell news and gave them the same which i'm sure you do with other local newspapers to say by the end of summer we then have residents and also other members of our of the council asking us for updates and they've obviously read what they have in the paper and what what you said yourselves and each time we're having to like go back and obviously this is going to add costs as time goes on if there isn't anywhere chosen and if certain hospitals are chosen in october and others have got plans and locations going forward they will be the ones chosen and it won't be friendly and that's what i'm worried about okay i suggest that we leave it there because yeah uh it's obvious that um it's not going to be an easy thing but i think it's something you've really got to think about um we'd like to take you through now a different conversation around how we want to involve people in this project and the engagement co-design proposal was circulated with the papers so i hope you've seen that in advance but i am going to take you to kind of the core elements of that over the next series of slides we'll then hand straight to carol who will be talking through some staff engagement and then we will take questions on both of these elements um we decided to kind of propose a coded co-design element to really speak to best practice in the way of looking at these uh looking at these projects we're committed to working with patients staff volunteers local communities and other stakeholders throughout the life of the project and i'm really committed to involving as many people in all stages of development as we move forward the purpose of co-design is to inform our engagement involvement strategy so that this isn't that this is about the steps to get there and build as sam has spoken about before on our established commitment to equality and accessibility and we need to understand how our communities and key stakeholders would like us to engage with them and involve them in this project so that we can build a strategy that lasts through the life of the program a key element of that is to focus in on some of our kind of protected groups of people and the key kind of recognized groups that we do tend to hear from less and actually we want to make sure we're going out to those people to really hear about their needs for the for the project you can see those groups up there on the slide and i'll draw some of those out so um those who speak english as a second language particularly in our communities we have a strong Nepali population and often people in those communities can sometimes face literacy barriers or language barriers too that's just one of our kind of five system-wide different language groups and we'll be focusing on how we can really get out well into those communities and we're also looking at people with learning difficulties and and additional communication needs unpaid carers is a huge area that we want to really help those people access services and hear from them in a way that's going to help us improve the project and seldom heard communities we mean in this space gypsy roamer traveler communities and particularly military as well that's a key group for us in terms of making sure this facility is still right for them as well and parents and carers with young children another key group that changes throughout the life of this project and young people and we're committed to hearing from these people and we want to find out how best to do that next slide please and health watch you'll all be familiar with health watch they're a strong partner of ours and we want to work with them and we mean the local health watch groups so we have spoken to the different health watches that cover the whole patch this isn't about one particular group in terms of you know Surrey Hampshire and the Berkshire model and and they're going to help us with this piece of work they have excellent links across our and across our geography and they're also really used to hearing from people and you'll see regularly their reports that they feed back to us in terms of improving local NHS services and so the idea will be that they will take a kind of two-prong element to this and we will have lots of in-depth conversations with community group leaders and key representatives of particular groups so that we can really get under the skin of how to do this well when we actually go out in parallel to that we'll also run a public survey which will capture another views from other people so that we can make sure that's a rounded piece of work we think by combining combining the kind of in-depth targeted conversations along with the broader public public input will come out with a real robust and inclusive approach to our engagement moving forward the goals of our co-design are threefold so we want to make sure that we have a really strong strategy for engaging our local people and ensure that we break down some of those barriers that exist I think when we came back to you we came to you the first time we were talking about our initial consultation and you know we had strong numbers over 3,000 people respond but there was you know feedback from those in the room and ourselves that does that reach the broadest group of people so we really want to make sure we get that right when we come out again and we're hoping that this will help improve trust and ownership of the project and also make sure that we're improving accessibility and inclusivity we will have a full report produced and an evaluation summary with the findings of the co-design work which we embed then into the core activities of our program and ensuring that our engagement processes and consultation processes are comprehensive and impactful and we'll make sure those are available for people we hope that you are kind of interested in the co-design approach and we're really interested in your views in terms of the groups that we're looking to connect with and we would like your thoughts and suggestions on how we continue to develop that work ahead of going live in the next in the coming weeks I'm going to go to over to Carol first but then we would like you to kind of think about your thoughts on this piece of work and if you agree that you think it's important for us to do it ahead of the next phases of the program how thank you Ellie clearly talked there about the engagement with our communities and we were really pleased that the committee mentioned at the last meeting about the importance of our staff and it's come up again today and and it's clearly hugely important for us so it's a bit difficult to actually read that slide actually for those in the room but we'll share the slides afterwards but I thought it'd be helpful just to look a little bit about what we know about our staff and those that are likely to be impacted by the new hospitals so you can see there if you can and if not I will read elements of it we've got 14,000 staff across the whole of our NHS trust and just under 6,000 of those work at Brimley Park Hospital some of those are cross sites so they work at Brimley Park Hospital plus others but many of those only work at Brimley Park Hospital and how that breaks down into some of the clinical side of our our workforce you can see there we've got about 1800 that are nurses and midwives we've got just over a thousand that are other clinical support services 850 of the medical and dental staff and three well what is it just under just over 350 are allied health professionals so that's our our therapists our radiographers those sorts of support clinical staff and we've looked already at those in terms of where they live at the moment so 60 percent of those live within a five mile radius and we mentioned that five mile radius each time because that was the search criteria for the new site and it's the the the the the catchment that we are looking at still as as for the new for the new site so so looking at that we got probably about 65 percent of the nurses and midwives live within a five mile catchment a similar amount 63 percent of other clinical services are within five miles interestingly only about 34 percent of our medical and dental workforce are within that five miles and just under 50 percent so 46 percent of the allied health professionals so really important for us to look at where they currently live in relation to that that that current site and the and the the five mile there we've also looked a little bit at the age of our staff now that actually i hadn't initially thought to do that until we did our earlier engagement where when we went and spoke to staff and said you know what what do you think about the new hospital what's your thoughts and they said well we can give you up my ideas but i intend to be retired by then which which was a fair point so so of those that live within a five mile catchment of the current site 77 percent of the 67 to 70 year olds live within five miles so again just just a little bit of a flavor of of understanding our workforce and where they live so colleagues that spoke earlier about the the impact on our staff and and about the accommodation for those those staff so i think it's probably worth noting that at the moment while we do provide accommodation or access to accommodation for our staff that tends to be short-term accommodation and it's not on the current site so staff at the moment are not used to living on the site and in fact actually some of the buildings that we knocked down a couple of years ago because they were completely wrapped were ex-accommodation blocks that were then being used as offices so that that sort of traditional model in the past of having accommodation for staff on site is not is not a model we currently have so while we will be looking at the impact on housing for our staff and our future workforce the the sort of imperative for it to be actually on the hospital site becomes more of potential opportunity which Councillor Withers has mentioned in the past rather than necessity so that's something that i think it's worth bearing in mind in terms of that context so what we've done since we last met is we've now set up a dedicated workforce work stream and the role of that work stream is to really understand more about our staff and what they're going to need and what the impacts will be so they'll be looking at much more detailed work about how our staff travel to the site and actually that probably links in quite nicely with the the earlier questions around travel to the site in general and that piece of work can feed quite nicely into that if we can understand more about how our staff travel to work and how they could travel to work so we'll look at that we're looking at how do we create opportunities for people to identify their needs both now and for the new hospital any concerns or ideas that they might have and a big part of that workforce work stream will actually be looking at what are the future needs of the workforce which again was one of our earlier questions so they will already start to do that work in parallel with the work that's going on around the capacity and demand work that's going on to look at the impact on the workforce and throughout the whole of this transformation process that that sam alluded to as well clearly will always be needing to look at what's the impact on the workforce and that won't just be about the new hospital that will just be about you know the modernization of health care over there over the next five to ten years will will need to be considered as part of this work so lots of really exciting opportunities to involve our staff in that there was mentions well about the impact of the single rooms and that's something that we will be involving our staff in both in terms of informing them what the national team are telling us about why it's important and and the safeguards around it but also making sure that we give staff the opportunity to ask questions raise concerns that we can feed back into the national team so that we make sure that that what we do design and then build is going to be fit for purpose and uses the experience of our nursing and other clinical staff as we do that so really really important to us that that's what we do so a priority for us with everything that we do not just around the new hospital is we really try to have an attitude of staff first we think it's really important that staff hear news from us rather than reading it in the newspapers or or hearing it from the local barber or hairdresser although i know there's a lot of that going on at the moment around where the site is and we just need to make sure that our staff know that they are going to hear it from us first and that they can trust and believe what we're saying so that's really really important to us so we've got a lot of ways that we currently involve our staff that we will continue to continue to use but we've got something just coming up at the moment we ran it a couple ran it last year we've got a road show with we're sort of badging it as a bit of a tour we're going around all of our sites we've got our executive team supporting our corporate teams to go around to all of our sites and speak to our staff about what's going on get their views about a whole range of things of which the new hospital will be very much front and centre of that for us but actually also our new strategy so some of the work that that James is doing and and has come up through some of the conversations about that sort of future view of what the hospital and the trust needs to be looking like will be important that we get our staff involved as well as then our community and yourselves so that's part of what we'll be be looking at doing so we're getting out and about from next week actually and we're using the fact that we've got a new chief executive to also run a whole series of staff briefings next month or this month sorry so that people can meet their new chief exec in person and ask questions there so we're doing a lot of work this month to really just catch people up after the summer break which is which is great and we're even doing sort of twilight shifts so Nick and I have got some 7 pm till 10 pm shifts to do as well as daytime ones to really capture those night staff because we are conscious again in terms of understanding our staff we do have staff who intentionally only work night shifts because that suits them for various reasons so we want to make sure that when we talk about engagement with our staff we're not missing those that that aren't around in sort of office hours that are convenient but we are hearing from all of them to support that when we do the road shows we will also be going out into ward areas so we'll be at key footfall areas and grab people as they go fast they'll know that we're there there so hopefully they can come and see us but we will also be going out to the wards and other clinical areas to try and and catch people and we've done that before and it works really really well and really helps staff to feel involved with us so that's that's what we've got literally coming up at the moment and then just looking to our ongoing engagement so we've got a lot of work that that just as you would expect you know we've got 14,000 staff so we've got a range of different ways of communicating and getting views from our staff whether that be through their management processes so meetings that they have in teams whether it be bespoke things that we put on and some of the things that we'll be looking to enhance and develop will be more in-person events attendance at meetings as well as trying to create and this is a new thing that Nick and I and the team are working on is around named ambassadors so that we can identify people within all of our areas who we can make sure are going to be on the lookout for news and information and will commit to is probably a bit stronger word but but agree to want to help us disseminate that into their areas and feed that back so that's something that we're working on at the moment and before I just stop for questions I just wanted to also say that you'll see that Ellie and I have both presented here about the work that we're doing around communications and engagement whether that be the communities or our staff and we're both really proud that our separate teams because we're separate organisations but our teams are effectively working as one team on everything around communications and engagement whether that be patients public stakeholders or the staff and we're really proud of how that's working and I think that is quite advanced compared to others around the country if I can be so bold and I think it is meaning that we are getting much much better planning and and and commitment to to this area of work thank you thank you and Caroline you're first up with a hand up so off you go thank you I've got a few questions for you so of the 14,000 staff how many agency because one of those questions is obviously will it detract from agency staff and because you're obviously going to do single rooms how are you going to introduce the agency staff to this new way of working when you might have just literally called them in that night and will they still wherever it moves because as you know you only have to move a few miles and it goes from fringe payments to basic payments how are you going to ensure it remains fringe which it is now please and going back to your meetings via health watch are you actually going to do like proper co-production meetings so that you are sitting there with your target audience and asking them what they need to know and designing things around them thank you um should I take the staff bits and actually I will ask because Ellie has been directly working with um with health watch so I know Ellie will be able to answer that one very easily um so in terms of the 14,000 staff um that's our employed staff so so agency would be used to um support that but we are actively working to enhance our recruitment and retention and significantly reduce agency use we've had some real success around reducing agency particularly around nursing um areas and there's some targeted work going on now around our medical workforce so so in terms of the impact on training of agency staff we've got very very clear processes around how we induct agency staff um anyway um and we've got to do a lot of that around our electronic patient record um and the local induction that goes with that so that would absolutely continue and the the impact of digital because actually a digital is is the big part of of how you manage those single rooms um and it's quite hard for our staff even now to envisage what a what a single room um hospital would would work like because they if you think about your wards now where you've got bays and then you've got you know a single room over there and a single room over there it's really hard to imagine working like that but that isn't what it would be like if it's designed in a single way and the the digital stuff that goes into that i've only only beginning to start to understand so i won't try and try and explain that now but so agency we're expecting that to be a reducing an ever-reducing element of our workforce um and the the fringe basic payment i know that's something that has come up in the workforce um work stream i don't have the answer but i will endeavor to find it i don't know whether they know the answer yet but i know it has been flagged in that work stream um by staff managers and unions you won't be surprised any thanks carol um co-production is a national natural extension in the co-design process so yes we are intending to co-produce the ways in which we will be engaging with people when we come out to that point and in some instances we'll have to use representatives of groups but the aim will be where possible we will be having direct conversations with target groups to really get under the skin of how we can best come out and listen to them and hear what they've got to say so uh yes is the other thing thank you okay um you're going to come in with a question here really um which is a bit between everybody um because one of the things that looks very obvious is given the change that's proposed of single rooms there's an implication of more staff being needed who's then got to live somewhere so what discussions have gone on with the local authorities in terms of their local plan requirements for future accommodation um and particularly in the affordable category because NHS salaries whilst recently improved are not world leading in terms of the level of income that you get from the job so it implies certain things about the nature of the accommodation uh and the cost there are so things like social housing affordable housing become to the fore so i really want to understand what's been done with the local authorities there so i my honest answer is um i'm not sure we're there yet because i think we do need to understand what the impact will be on the workforce so that work that the newly formed workforce work stream is looking at is what would that workforce look like um and how would that be made up and what would their needs be i think that's probably the point at which we then take that forward but i think probably um cain and sam may well be able to come in on a little bit more of that from a strategic planning of the of the system yeah i'll let cain come in on the numbers because you're closer to it than i am but um i would just accentuate a point carol made in response to a previous question from council eggleston um you just watched that i've got the word digital in my job title uh do not underestimate uh how impactful the change in use of technology is on the projection required workforce into the future so i mean cain will speak to current assumptions on the relationship between the single room operating model and future required workforce but there is a very significant factor which we have to bear in mind and there's some of it in sorry in fact they're using right now the new sorry and borders facility around using new technology for monitoring of patients in single rooms and the like which does just mitigate a bit of that additional demand for more people but i mean cain i'll let you just add to that as well if you want to thanks come on i can add to that other than it is a little bit early in in the where we are in in the design process for the new hospital we we are looking at it in terms of a size perspective from the master plan at this moment in time but we aren't designing the hospital per se at this moment in time but it is a factor in terms of what the what the national team are telling us in terms of the ward design that it is going to be bigger the amount of single rooms in a it is a 32-bed ward may require additional workforce and we're working through that but that is very much the next phase of the detailed design process okay i'm the sensitivity here is that you know local plans are drawn up by local authorities and they cover quite a long forward period um you know currently sari heath's plan for instance will go beyond 2030 when you're expecting to open the hospital so um you know there's a mismatch there that you do need to think about and i think that's a very uh very good point that's been made about population because um we know the icb's uh renewed ambition strategy is you know even though it came about from april 22 is changing all the time as is the strategy for nhs england but you know if we continue to get immigration dumped on us without any notice that creates many problems in the community apart from health services education services accommodation services job services foreign nurses who need to pass the english exam so instead of being carers you can actually do the job that they've been trained for previously and what contracts have you got abroad like in canada as agencies to provide staff for you which is a current way a lot of the hospitals operate now we talked about carers uh earlier on and of course carers and volunteers are a critical factor i think you've got a thousand volunteers at frimley and they're mainly my age group and and one of the things that that's becoming very current is that both partners of a family today don't give up as much time as they did in the past um and therefore a recruitment retention is going to be difficult you know when you've got 70 year old community nurses out outlasting your 40 to 50 year olds um you know and we had some of that age group come back after covid it that resource is not going to be there in 10 years time one of the things on the communication to me which is critical which we which we did on our care homes of those that we were going to get rid of and the residential homes we were closing down and why was a video of the new not the single bedroom with the single sink with the commode in it but the new type the wider corridors the in-wall cabinets and and lockers you press the wall it comes out you know hampshire introduced alexa into a lot of its patients and facilities we use a japanese machine for helping people to lift so instead of two or three people you only need one or you need two and of course when you take these uh it come uh companies in in other places like japan and you see what they're producing you've then got to adopt it to the european figure because their figure is totally different to us so there are lessons at all the time to be learned and i would suggest that we as a committee would like to see a video on an example of the 2.0 template hospitals that are open in order that we can see the key areas you know the access the egress the land the parking the accessibility for for all types of adults and children learning disabilities wheelchair disabilities ambulance in points out points rather like the central production unit like heatherwood they come in the front they come out the back um it's and then looking at some of the ways these things are operating because all the questions about rooms corridors lifts the size of the lift you need to take two mobile stretcher trolleys you know all all these aspects are critical in in in your time having built construction cities in in dubai i know time is of essence i know only certain countries build lifts what happens in europe apart from england in august september everybody goes on holiday so any orders you've got if you don't get it before the end of 30th july you normally get it for two months so the planning of all your logistics and getting that the flow at the beginning and the flow at the end is going to be critical in your ordering system if you look at the price of steel it's almost this goes up as fast as gold in the last couple years especially since covid and and our own building industry that's trying to get concrete so all those factors it's not easy and uh okay and i know what you're going through and that's why probably on your tail is that uh great plans are thrown out the window by various countries during your planning year so i think communication as you said carol i mean it's it's excellent what you want to do with the staff um and keeping them in the picture the ambassadors is a great thing but i think you know pictures videos and visits you know we would love to go on a visit you won't be paying for it you know our counties would be paid for it we'd go up and see one and have a chat with the staff we mustn't forget that staff annually in all departments have to do refresher training and out of the uh the terrible things that have happened in midriffree and everything in the north and in the midlands the last couple of years so many safeguards and changes have come into being so as as you said medical services adapt on a annual basis so we take that into account so you know i know the icbs are where you're working very closely with us in hampshire because they have to and we have to work with them you know the segregation is gone and and if we are to achieve nhs england's strategy renewed ambition every year is to make sure that the staff as you said an integral part of that chain thank you thanks mr chairman um let me just ask i asked a question before and i think it was covered actually with other members here about a growing population what also worries me intensely i guess i think we discussed that this hospital will only have a hundred extra beds because we at the moment at frimley park as i understand my notes anyway um i think we've got 640 in infirmary park um i do think that is very questionable considering epidemics and the mess certainly the last government got in uh over covid and you know what we do with people and where we send them and you know it was a scramble really to survive more than a strategy uh for going forward which brings me to the last point i guess i don't quite understand the decision making from your good selves have you got autonomy to decide james where the site is or does that have to go through various stages in in in in the department and various gurus have to look at it and approve it and is that half the problem of the delay or can you make decisions here in in primary park i mean if for instance you want another 150 beds because you've considered that is that possible or is it just within your budget or do you have to get special permission for 150 from martian street or whoever um how does this all work please modeling and the size of the hospital i i recognize the 640 figure that you referred to the existing family hospital i i don't recall uh the extra hundred beds point i don't think that's something that that we've communicated is our new hospital have an extra under beds no it was a question i asked and i i i what what you said that you'd get a hundred let me just explain you said that you would have an extra hundred beds in your plan for the hospital you are building so there would be 700 and uh and 40 that's what i think the notes will say in this room so i'm not this you know that's not really the question the question is can you with the information that you have and you're obtaining information all the time can you make that decision here in primary park or is that a decision that is made in in central london the decision in terms of the size of the hospital is the decision that the trust and the icp will form together in terms of the demand and capacity modeling that we're doing into the 2040s in terms of the projections that we're looking at so that that will be a decision that is arrived at collaboratively with the icb in terms of the size of this hospital and the services that that dictates so that is in our gift to make that decision sure that's that's your that's in your view to make the decision but it's not ultimately we will initially we need to we need to approve it together but undoubtedly there will be scrutiny on what we put forward by the treasury by the department of health and others as you'd rightly expect for a nine-figure investment with using public money so the point i wanted to come in and add to what kane said is that whatever the final number that comes out of the demand and capacity work and there will be a number that comes out of it there will be a reliance on transformation to make this viable into the future so simply taking the model of care that we have now overlaying population growth on top of it and saying well that's what we're going to need for the next 30 to 40 years isn't going to be viable and so when we talk about transformation and we talk about much better discharges for patients and get them out of hospital more quickly when they're ready to go which is in their lake to stay so actually you improve your throughput through your bed base which means actually you're getting more beds without having to build more beds more community-based care which means more beds and community facilities and demand mitigation through investments in preventative based care proactive care using digital technology like risk stratification and population segmentation all the things that we're probably in the foothills of technologically rather than at peak maturity on and will make a significant impact on that demand capacity model and therefore what facility you built. Thank you I'm just going to follow up on a couple of those points so obviously you're saying people are going to go into hospital and hopefully come out quicker so one of the questions that was asked to me by one of my fellow councillors was is the pharmacy model then going to be updated because that is the main thing that delays people from leaving hospital so we'd be looking at and also you're saying about them coming back out into the community to basically be cared for closer to home so they have less stay in a hospital when are you talking to the local teams and the local councils to see what space is available to build these facilities because many don't have cottage hospitals near them to be able to take this and obviously then councils have to like talk to what what's needed where the look where the plans can actually be made so when were you looking to do that communication locally so that when you've got this fantastic well I'm sure it'd be fantastic hospital all opened all the local things around are then set up to support that hospital thank you thank you so there's a lot in there I think that's absolutely fine so I think the best way to think about this is a whole potential pathway for a resident or a patient here so ideally we want to prevent people going into hospital in the first place if we can keep them well outside of it and you know it won't be a surprise to anyone in this room we're doing a huge amount of work on that already so one of the unique things about our health and care economy we've got seven thousand people on remote monitoring for example using technology to assess whether they are well because they're at high risk of hospital admission and if they become unwell someone goes out within an hour sometimes to into their home see how they are make them well again keep them away from hospital it's working and that is again embryonic and will be expanded enormously I'm sure over the period of time that we're talking about with this facility and you're right there are too many people who wait too long for medicines before they can go home and all of that needs updating as a model and again technology will make a big difference in that we you know without becoming too futuristic or sci-fi orientated the access to things like artificial intelligence robotics and others for delivering supplies around a large facility like hospital they are actually currently within reach and by the time this facility is opened I'd like to think that we're making the most of those technological opportunities and finally on care closer to home yeah you're right we need to make sure that facilities exist at a local level and that has to be done in partnership with local councils and I'll add one more thing to that though care closer to home doesn't always have to be outside somebody's home and what I think we've shown over the last few years the use of virtual wards which we introduced during the pandemic of which Frimley is the third highest user of national agent it's a fantastic good news story here locally again makes a great difference in ensuring people are kept well they get that out of hospital care they need without actually having to go into a hospital facility so lots and lots of work to do no doubt about it but it's an opportunity as much as a challenge. Thank you I sort of appreciate what you say about hopefully getting people back at home and then getting that care at home I'm sort of thinking where that care can't be there where they can't access things in their own homes they've got stairs that they can't manage obviously we need to be set up locally to be able to offer that to their you know they can walk again just make them comfortable at home thank you. Any more from any of the members to make the point yeah that's all well and good the social care system needs to be sorted out before we can talk about any of that and here we are again with the new government talking about yet another well a royal commission when however many reports we've had in social care previously a decision has got to be made at some point because we've got representatives from both the both counties in this room and we know what the government funding is like in that in that regard that needs to be borne in mind the reality of the situation not just a hope factor yeah and I would also pick up on that people coming out of hospital early means it may well be an impact on primary care and that needs to actually be properly resolved as well and also that you could be in a discharge to assess situation so again you know the you know connection with social care needs to be there it needs to be strong and very effective and all of those processes need to be looked at as part of this. Yeah chair if I could just come in now I think that's a very important point because we all know with the health and well-being boards how much we want to have prevention but if you look at society in our deprived areas the processed foods and in mums that can't cook and all these sort of things two families working it makes prevention very difficult and and of course those that come out from hospital some that go back in quite quickly that's that's another fact of life but it's it's never going to be easy is it to assess truly what the output is going to be like because you you can never tell at the moment we've got covid we've got a similar type of covid but not covid we've got norovirus we've got measles and touchwood we won't get mpox and then we're coming into the winter phase where we got flu jabs and covid jabs coming up and we've now got a vanguard coming up and we've now got a van going around going around giving jabs and I was told today by Simon Bryant that one person is having covid for the first time after four years so it's very hard to ensure that we have prevention purely on flu and and covid so there is a lot of work and obviously we've got to aim for the best haven't we yep and I would concur with that I'm the charity one of the charities that I work with we have you know extensive issues of things like basic things like getting people to learn that fruit and vegetables are things that you can eat and how you turn them into food that goes on a plate it it's as basic as that and that understanding needs to be there that all of these sort of education public health things need to be really strengthened far more than they are so I think we can leave the questions there hopefully before we move on to the recommendations there is one agenda item that accidentally got left off the chairman's briefing which is an important one which is the minutes for the previous meeting and approving them so members can I ask that we approve them okay so that puts that one to bed so I would suggest we move on to the recommendations I've written down a few of them and I'm going to take members through them one at a time and see what their views are on it so the first one is given that the hospital will become untenable at some point we really have to you know think of what if the decision isn't made in a timely way to actually provide the money or set the site or any of the other things that are along the decision path so I think you know there's a strong recommendation that you need a contingency plan with a drop dead date by which at which you will activate it in order to make sure that the population is protected from issues around not being able to operate the current hospital site so yeah members we agreed on that okay second one is that there is a need to feed the provision for accommodation into local housing plans to make sure that it's properly integrated within those plans third that a view of all the friendly health sites and all planned exercise is you know a needed part of the decision-making process that information needs to be made available as early as possible I wouldn't agree with that Mr Chapman we've had private meetings before the formal Josh meeting in Hampshire which are purely confidential and has worked and number four that a committee visit to the inpatient diagnostic and imaging facility happens as soon as possible so we can actually start to get some of the flavor of what the new hospital might look like chair if I can say I think that's two separate things there I think a visit to the diagnostic center is one thing but I think the second one yeah okay and the second piece would be you know we really need educating on what a hospital 2.0 site looks like if there is one that is that we can see I'm not sure that there is but you know if it's in terms of design material and videos and a briefing then that needs to happen if we can see the reality well great but we need to start understanding what it's going to look like next one is the needs modeling really needs to be shared as well so that we have you know a good view of what you are taking into account and the shape of it and what that looks like what the post modeling process is in some detail I think needs to be shared with us and yeah and my last one here was the 2.0 template presentation is needed which I've already covered so there you go and that's you know what I came up with now have the members got any others Councillor Virgo thoughts your your recommendation am I right in saying we are a special case because we can't build high but a lot of hospitals can and so we have that added problem that we need extra space is that is that is that fair as I think there has already been in one of the presentations material about that exactly I'm just thinking of seeing more efficient to build loads than it is to build no no I don't disagree I'm just saying that we you know we go and see something that's got a haunting story or it won't be the same as yeah yeah we need comparable with what we are looking at okay yeah I think that that's a fair very fair point okay is everybody happy with that as the recommendations I think should also don't so could you put your mic on I think you should also we should also note the updates of the various presentations we had today thank them yeah yeah I'm a yeah a big thank you to the agency because I know that it's difficult and I know there's a lot of this and the decision process that you're being forced to go down is as clear as mud at the moment so yeah we really appreciate it thank you very much okay the date of the next meeting is the final item that's on the chairman's notes which is next public meeting has been scheduled for Friday the 18th of October 2024 at the same time same place and I think that brings us there thank you very much everybody thank you very much for your time and all the effort that's gone into this and um yeah I'm sure we're going to be talking some more in between anyway yeah thank you [BLANK_AUDIO]