Scrutiny concerned with Business Case for new healthcare facilities
Scrutiny
28 February 2025
A Scrutiny review of the Government’s New Healthcare Facilities Programme (‘NHFP’) has found a lack of clarity and transparency about the decision-making that has informed the NHFP, and an absence of strategic healthcare, workforce and procurement planning. As a result, the panel is concerned that the Island may not be able to afford to build and operate the enlarged healthcare estate that is currently envisaged.The Hospital Review Panel has made a total of 34 key findings and 20 recommendations to make improvements regarding the issues raised during its review, as the NHFP transitions to the Full Business Case stage. The Panel acknowledges the urgent need for new healthcare facilities but believes greater transparency and clarity about decision-making and expenditure will deliver improvements through future phases of the NHFP.
Following the establishment of the Hospital Review Panel in May last year, the Panel has been conducting a review of the Government’s NHFP – continuing the work of the previous Future Hospital Review Panel. The review sought to monitor the progression of the NHFP, address the funding proposals for delivery of Phase One of the NHFP, and consider the intended outcomes of Phase One of the NHFP, the Government’s approach to stakeholder engagement and whether the NHFP meets the health and social care needs of Islanders.
Due to the wide-ranging and technical nature of the review, the Panel also engaged the expertise of external advisers to provide an independent assessment of the Outline Business Case (OBC) for Phase One of the NHFP.
The Hospital Review Panel is concerned about the extent to which the OBC for Phase One of the NHFP is compliant with best practice guidance for business cases and the level of independent oversight and challenge provided to the OBC. The Panel also remain deeply concerned about the future affordability of the NHFP, including the proposed Overdale, Kensington Place and St Saviours Health Village facilities.
Among the recommendations made by the Panel are:
- The Minister for Health and Social Services should quantify the risks associated with withdrawing £5 million per year for refurbishment works of the existing General Hospital in 2026 and 2027.
- The Minister for Health and Social Services should confirm and publish information about the intended uses for the Kensington Place Ambulatory Care facility.
- The Minister for Health and Social Services should develop a detailed workforce model and workforce strategy and confirm the timeframe for the development of a health and care strategy, including its alignment to the NHFP.
- The NHFP Team should produce an updated demand and capacity model to evidence the need for proposed bed capacity at each of the proposed NHFP sites.
- The Minister for Treasury and Resources should strengthen the assurance and oversight processes for the Programme.
- The NHFP team should demonstrate the affordability of the NHFP by confirming the source of funding for the revenue and operational cost increases associated with the NHFP.
“This Scrutiny process has been focused on ensuring that what is being proposed is suitable for the Island’s future healthcare needs and can be delivered affordably and to schedule.
“It is all very well wanting to “get things done”, but we need to know that what is being done is the right thing, and that is what the assurance process is designed to ensure.
“This is the largest capital project the Island has ever embarked on, and the Panel has major concerns that there appears to be an ongoing lack of transparency which means that the Outline Business Case does not meet the expected standard to justify funding decisions of this scale.
“The Panel would urge Ministers and the NHFP Team to respond positively to the Panel’s findings and recommendations to ensure the successful delivery of the NHFP affordably meets the health and social care needs of Islanders.”
The full Scrutiny report can be found on the States Assembly website HERE. More information about the Hospital Review Panel and its terms of reference can be found HERE.
