In September 2019, The Hillingdon Hospitals NHS Foundation Trust was announced as one of twenty one hospitals to receive a share of £100m funding. This funding allowed us to develop a business case for the redevelopment of the hospital. Since then, we have moved quickly to progress our plans.
When we design our hospital, we are doing so as part of the National Health Service…. as part of the Hillingdon community, including the local authority, CCG, GPs, H4all, Hillingdon Health and Care Partners…. and as part of the wider NW London health and care system and the other acute hospital providers in the area.
Designing a hospital is not a quick or simple process and there are many elements which must be considered at these early stages. This page takes you through the formal business case process and the steps we take to design a hospital.
To be able to access the funding which is required to develop the new hospital, we must follow the process set out by HM Treasury and NHS England/Improvement to show that we have considered all options and selected the best option for the redevelopment of the hospital. The three stages are:
The Strategic Outline Case (SOC) sets out why a change is needed, reviews the options and sets out the preferred way forward.
The Outline Business Case (OBC) demonstrates that the chosen option is affordable and value for money.
The Full Business Case (FBC) is the final stage which provides detail on procurement and delivery.
Designing the hospital
The design of our hospital is driven by what is best for patient care and ensuring the right flow around the hospital.
We start with our Clinical Services Strategy which talks about what Hillingdon Hospital, as an acute hospital, needs to provide to meet future population needs and how this is best achieved. We then look at a number of factors that enable us to decide the right size of the future hospital.
Our clinical cabinet and clinical and operational working groups look at what their area needs to look like in the future, considering questions like;
- How will they deliver care?
- What equipment will they need?
- How can they take advantage of digital development?
Once they have agreed the core principles, they work with specialist health planners to look at how the hospital will flow and which departments need to be near each other. This allows the architects to begin their work, placing the departments and looking at the overall shape of the building. The plan then goes back and forth between the architects, planners and clinicians to address the following questions:
- Does it work?
- Will it deliver for our patients?
- Does it respond to the feedback from our community and staff to help shape the plans?
Right sizing the hospital
Demand projections: To understand how many people are likely to need to use the hospital, we look at data from a number of places.
- Baseline activity data for calendar year 2019 (to avoid the impact of covid)
- Apply ONS population projections by age cohort to reflect demographic change (April 2020 issue)
- Other growth factors including an uplift for maternity to reflect local strategy.
- Apply assumptions to activity volumes to model resource requirements (bed days, theatre hours, clinic hours)
- Apply assumptions about efficiencies to be derived from achieving benchmark
- Apply operations assumptions (sessions per week, utilisation etc) to generate capacity needed
Benchmarking: We review our assumptions against other similar schemes and best practice guidelines.
- NHS Model Hospital metrics
- Experience of other HIP schemes
- Getting it Right First Time (GIRFT) recommendations
- Royal College guidelines where applicable