Contract partner confirmed for £40m "re-build" of Hereford County Hospital

The job has gone to property, residential, construction and services group Kier.

Revealed by the Hereford Times in January, the plan represents a full overhaul of the hospital’s layout – delivered in a series of phases.

The plan finally sees  off the hospital’s hutted wards after 75 years of life having initially been built as “temporary” accommodation during the Second World War.

Other changes include relocating the endoscopy and day surgery facilities and the building of a new intensive care unit and outpatient theatres.

Richard Beeken, WVT chief executive, said the Kier appointment represented a “landmark moment” for the hospital.

“It is the key stage of a programme of work which will increase our capacity to cope better with the pressures we are experiencing and will certainly give our patients a better experience while in our care.

“We have ambitious plans for the site, and while we are still at an early stage, this appointment demonstrates our clear commitment to deliver safe and effective care in modern and efficient  surroundings.

“We’re delighted to welcome Kier as our partner in this venture. The company has a wealth of experience and knowledge and the appointment will bring huge benefits to local people,” he said.

Kier has extensive experience of partnering with similar projects, having been awarded more than 50 through a scheme called P21+.

 This is a six year national framework started in 2010 for the procurement of construction and design partners to deliver new, upgraded or refurbished healthcare facilities across England.

As one of six “principal supply chain partners” appointed to P21+ by the Department of Health, Kier secured over 140 ProCure21 and P21+ healthcare schemes - worth over £1.3bn - over the past 11 years.

Earlier this year, the WVT board offered support in principle to the five-phase strategy addressing the limited options of the hospital’s present lay-out.

Much of the work timetabled to 2018 is major internal reconfiguration of the hospital which is accepted as having been built too small to cope with demand.

It’s a strategy represents the most significant investment in the hospital since the PFI deal that saw it built.

The NHS has already recognised the trust's current capital programme as amongst the smallest ever submitted.

 Financial constraints mean the trust has not been able to invest adequately in its layout for some time, despite obvious needs.

With its costs covered by a capital investment loan, the new strategy sees the end of the hospital’s hutted wards after 75 years to be replaced with new wards and a clinical block.

Multi-storey car parking and better staff accommodation are also explored.

A capital investment loan (CIL) is the strategy's preferred funding option.

The hospital already faces a number of urgent issues which need to be addressed through investment, including an £11 million backlog of maintenance and underlying shortfalls in the capacity for critical services.

As put to the board, the rebuild and expansion case focuses on:

* Replacing the old hutted wards.

* Extending the hospital’s capacity for inpatients.

* Bringing together services for day surgery and outpatient treatment onto a single site.

It also includes the creation of an already planned midwifery-led unit, and the possible creation of a multi-storey car park, new urgent care centre and internal changes to create a larger emergency department.

An estimated capital cost for all five phases of the work is between £40-50 million.

The hospital’s estate issues date back to 1998 when the then Hereford Hospitals NHS Trust signed a business case for the development of the County Hospital under a PFI deal which became operational in 2002 and expires in 2029.

That business case only dealt with part of the site.

Amongst the drivers of the new business case is the recent Care Quality Commission report that put the trust into special measures with particular concerns identified over the provision of A&E, medical care services and managing patient numbers.

A key test for the strategy was the extent to which identified  works could be carried out through the current PFI contract with Mercia Healthcare Limited.

As outlined, the schedule for the work will be:

PHASE 1

Urgent works in the first year including:

* 16 new inpatient beds on an existing car park near mortuary/pathology.

* A multi-deck inpatient car park with a site identified above the existing Gwyndra Downs car park.

* Decommissioning the “Arkwright” outpatient facility – a hired modular building – to cut cost pressures.

* A midwifery unit – already approved to be funded from charity.

* Internal revamp to improve patient flow.

*  A new base for medical records.

* Options to improve storage capacity across the hospital.

PHASE 2

* A new theatre complex, urgent care centre near A&E and clinical decisions unit.

* A new day/night helipad above the urgent care centre.

* Re-location of the “Spires” restaurant to the main entrance area, freeing space for a pharmacy, equipment decontamination and other activity needing to be near inpatient services.

* A multi-storey staff/patient car park.

* A combined heat and power unit to cut energy costs.

* An administration unit – probably in the present underused Lionel Green building – housing offices from other parts of the site.

PHASE 3

* Creating a wards and clinical block to house current wards well past their useful life as well as a permanent solution to the lack of inpatient capacity.

PHASE 4

* New endoscopy accommodation and the reorganisation of the daycase unit.

PHASE 5

* A number of future development zones identified for different types of development, with an emphasis on staff accommodation and including the possibility of a joint project with the proposed university. There are also cases for more CT and MRI scanning facilities and a combined children’s centre.