Submission - Friends of Our New Hospital re ToR 4 - 20 October 2020

FRIENDS OF OUR NEW HOSPITAL P O Box 442

Jersey JE4 5RE

A Non-Profit Organisation NPO1277 Email: Friends@ournewhospital.org.je

Submission to The Future Hospital Review Scrutiny Panel Terms of Reference Four (TOR 4)

20 October 2020

Introduction

TOR 4. Examine the timeframe in which the decision-making process took place.

The outline plan for the OH was set in the CM's brief to the States of 3rd May 2019[1]. In it, on Page 1, he established three basic criteria:

• "Firstly, establishes the agreed clinical requirements of the new hospital

• Secondly, uses the outcome of this to scope the size and shape of a new hospital to inform the shortlisting of potential locations

• Thirdly, involves a thorough process of island and stakeholder communication and engagement on those locations, alongside technical and financial assessments of deliverability, in order to identify a preferred site for the Government and States Assembly to consider and approve."

He then established a timeline for the completion of the overall OH planing process up to the submission of the Planning Application:

"The proposed timeline is ambitious, but we firmly believe that if we all get behind the process, and there are no further delays, it should still be possible to deliver this within 20 months. It requires us collectively to agree that this is a priority, and to work together, but if we do, we can still deliver a completed hospital in a similar timescale to that of the previous scheme."

Later, on page 4, set out his suggested strategic direction that the following should be considered:

• "How the provision of health care in Jersey links with Guernsey, the United Kingdom, and, if appropriate, elsewhere

• How a more preventative model of health care impacts on any future hospital facility

• Increased digitisation, and how that is changing services and the profile of the future health workforce, and what skills they will need and the implications for the size of a new hospital

• How the new model of health care in Jersey, including Closer to Home and mental health provision, impacts on the size of a new hospital

• New equipment to treat patients and the implications of this for a new hospital."

This does not mean that we go back to the drawing board. But, equally, these matters can and must be considered urgently, if we are to provide a firm foundation for the decisions we need to make, to deliver a new hospital."

The Appointment of the Clinical Director

On 31st July 2019 a media release announced the appointment of Professor Ashok Handa[1] earlier that week as the Clinical Director of the OH Project on a 2-year contract, "starting in August". In fact, he had been appointed by Wednesday 24th July, as reported in the minutes of the POG of that day, and apparently without following the senior appointments procedure, as the advert for the appointment was posted on the States website on 29th July to the frustration of clinicians in the General Hospital who had wished to apply for the post when they saw the appointment advertised locally. A further glitch' arose when it became clear that, at the date of his appointment, he was still employed at the John Radcliffe hospital in Oxford and had to give 3-months' notice of his departure, meaning that he could not start his Jersey appointment until November 2019.

As Professor Handa's job was to put together the Design Brief for the OH (now referred to as the Function Brief) this effectively put the start of that process back, although he did make a visit to Jersey, post appointment, on Thursday 30th July, when he met clinicians in the General Hospital who had also applied for the post only to be disappointed.

On 12th September 2019 the OH Project Team submitted a briefing paper to the States Assembly[2], setting out the detail of the progress to date and, on page 6, the forward programme to March 2021, a progress that has subsequently slipped to September 2021 when a full planning application for the OH is to be submitted.

The Citizen's Panel

A Citizen's Panel was announced in November 2019[3] to establish the sites criteria[4] for the eventual selection of a shortlist of potential OH sites and started its work in March 2020[5].

The Appointment of Mace

On 4th December 2019 there was an announcement of the appointment of the UK consultancy, Mace, to the OH project[6], with the explanation that "Mace, who will run the Project Management Office (PMO), will manage all aspects of the delivery, working with designers and architects, delivery partners and contractors. The company will ensure that the construction and delivery of the hospital runs as efficiently as possible."

What was not mentioned was that Mace had been advisors in a similar capacity of the Future Hospital project and that Richard Bannister, the acting Project Director of the OH project had also been involved with the Future Hospital Project and had been a director of Mace

Planning Guidance

In accordance with the CM's plan, the Planning Minister issued draft Planning Guidance on 12th February 20208, followed by the Supplementary Planning Guidance on 6th June 2020[7].

The Shortlisting of Sites

The Shortlisting of sites was announced on 17th July 2020[8] and the explanatory notes, the Kit of Parts, on 20th July 2020[9].

The detail of what followed publishing of the sites list is set out in the response to TOR 2.

"This Does Not Mean That We Go Back to The Drawing Board"

The above quotation from the CM's paper of 3rd May 2019 is exactly what happened. In it, on page2, he set out the three key things he wanted to achieve:

• The appointment of a new hospital project director, adopting a fresh approach to the project's operational and delivery arrangements, following the rescindment of the previous scheme.

• Consideration of the specifications for the hospital, including undertaking a review of the clinical scope to ensure the future model of healthcare in Jersey fits with the new hospital before we proceed further.

• Commissioning and completing a building and site options appraisal.

• Undertaking a procurement exercise to secure key additional technical support, including earl construction and development advice, as well as appropriate engagement and communications support.

It is assumed that these three, highlighted in red, were in priority order, with the hospital project director  overseeing  the  "considerations  of  the  specifications  for  the  hospital",  followed  by  the "commissioning and completinga sites appraisal".

In fact, what happened was that the Citizens Panel completed their task, thus presumably fulfilling the Planning Guidance requirement for Public Consultation, followed by a site selection process that made no use whatsoever of the Future Hospital process carried out by WS Atkins in 2013[10] and Gleeds Management Services in 2015[11], which thoroughly examined all the potential hospital sites on Jersey based on a 64,000m² new hospital building.

Meanwhile, Professor Handa was pursuing his task and a year after he was appointed the OH Project team announced that the Function Brief was delayed by 10 weeks due to Professor Handa not having

8https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwif64rlx5rsAhU85uAKHWThAtAQFjABegQI ARAC&url=https%3A%2F%2Fwww.gov.je%2FSiteCollectionDocuments%2FPlanning%2520and%2520building%2FAN-

completed his interviews with clinicians to ascertain their clinical requirement's and adjacencies in the OH. That ten weeks ended on Friday 2nd October 2020. Meanwhile the Future Hospital Design Brief[12], from April 2015, setting out the clinical areas seems to have remained untouched, when it could easily have been used as the starting point for the Functional Brief of the OH and saved time.

Summary  

It took the Chief Minister nearly three months to announce the start of the OH Project in his paper of 3rd May 2019. The site selection process effectively began in March 2020 with the start of the Citizens Panel deriving the essential criteria for the OH site, albeit guided by a UK consultant with no prior knowledge of Jersey. A separate panel of civil servants, none of whom are from Jersey, then made the site selection without the completed Functional Brief, despite the clear sequential guidance from the Chief Minister in May 2019.

It is submitted that the timeframe was too extensive and there was no urgency to complete it, leading to  an overly complicated  and  bureaucratic  site  selection  process,  lasting  eighteen months that inevitably led directly to political controversy, which is where we are today.

We would welcome the opportunity to review our submission to you in further detail.

Friends of Our New Hospital

Chair – Brigadier Bruce Willing CBE

Tom Binet – Graham Bisson – Peter Funk – Jean Lelliott – Graeme Phipps