The NHS in Lancashire and South Cumbria has stated its preference for new hospitals on new sites for both Royal Preston Hospital and Royal Lancaster Infirmary as part of the New Hospitals Programme, which plans to develop cutting-edge facilities, offering the absolute best in modern healthcare and addressing significant problems with the current ageing hospital buildings.

Following on from the announcement of the shortlist of proposals for new hospital facilities in March 2022, the Lancashire and South Cumbria New Hospitals Programme team has carried out a detailed assessment of the shortlisted options.

Each shortlisted proposal has been comprehensively assessed for deliverability, affordability, value for money, and viability, considering feedback from patients, local people and staff:

• A new Royal Lancaster Infirmary on a new site, with partial rebuild / refurbishment of Royal Preston Hospital
• A new Royal Preston Hospital on a new site, with partial rebuild / refurbishment of Royal Lancaster Infirmary
• Investment at both Royal Lancaster Infirmary and Royal Preston Hospital, allowing partial rebuilding work on both existing sites
• Two new hospitals to replace Royal Lancaster Infirmary and Royal Preston Hospital (new sites).

Key elements have been considered to help evaluate each of the shortlisted options. This includes service configuration; what would be required in terms of rooms, beds and other provisions to be able to meet the operational, space and location requirements; and site location options.

This work has resulted in recommendations for preferred options and alternative options for both Royal Preston Hospital and Royal Lancaster Infirmary, subject to endorsement from Lancashire Teaching Hospitals NHS Foundation Trust and University Hospitals of Morecambe Bay NHS Foundation Trust Boards and NHS Lancashire and South Cumbria Integrated Care Board.

Both the preferred and alternative options and different combinations of these are aligned to the published shortlist, and each will need to be considered in the context of capital affordability and benefits including addressing inequalities, clinical outcomes, productivity and wider socio-economic benefits. They will also be considered alongside “business as usual” and “do minimum” options, both standard options required in all business cases.

What could this mean for Royal Preston Hospital?

Lancashire and South Cumbria New Hospitals Programme’s preferred option for Royal Preston Hospital (Lancashire Teaching Hospitals NHS Foundation Trust) is a new state-of-the-art hospital on a new site, with an improved and enhanced urgent and emergency service, increased capacity for specialised services and the opportunity to maximise significant quality and productivity gains.

The Programme’s alternative option for RPH is an improved Royal Preston Hospital on the current site to include a new urgent and emergency care village, together with replacement of some inpatient facilities for non-elective medical and surgical patients, and the replacement of nine theatres and diagnostic facilities. An urgent and emergency care village would contain a range of departments focused on delivering urgent healthcare needs – for example, emergency department (A&E), assessment units, diagnostics and radiology, rapid assessment, same day treatment centre, paediatric care, and ambulance facilities.

A new build Royal Preston Hospital on a new site would bring significant health and care system wide benefits. It would fully address the Case for Change, improve care for patients, improve the work environment for staff, meet environmental commitments, such as Net Zero Carbon, and maximise the wider socio-economic potential. A new build on a new site (which would be within around a 10-mile radius of the current RPH site) offers the best clinical, operational and efficiency benefits and meets the requirements set out by the national New Hospital Programme, such as delivering an environmentally friendly and sustainable hospital, with more single en-suite rooms.

The alternative option would bring a range of improvements, particularly for patients with urgent and emergency needs and would improve clinical adjacencies. However, it only partially addresses the Case for Change and the ambitions of the national New Hospital Programme. For example, it would only partially deliver on environmental and sustainability targets because some of the old buildings and existing gas boilers would remain. As much of the new facilities would provide single en-suite rooms for patients as possible, but this would not be at the scale achievable within a new build. It does not address all of the required backlog maintenance required or tackle issues with the long-term viability of current facilities, such as the much-needed replacement of the ageing ward block, which would therefore still need to be addressed longer term. It also limits opportunities to make service and quality improvements in the future.

What could this mean for Royal Lancaster Infirmary?

Lancashire and South Cumbria New Hospitals Programme’s preferred option for Royal Lancaster Infirmary (University Hospitals of Morecambe Bay NHS Foundation Trust) is a new state-of-the-art hospital on a new site, providing an opportunity to significantly improve patient experience, the quality of services provided, and improve the environment for patients, visitors and staff.

The Programme’s alternative option for RLI is an improved Royal Lancaster Infirmary in the current location to include a new urgent and emergency care village, together with reprovision of critical care, maternity and neonatal, and some inpatient accommodation and diagnostics. An urgent and emergency care village would contain a range of departments focused on delivering urgent healthcare needs – for example, emergency department (A&E), assessment units, diagnostics and radiology, rapid assessment, same day treatment centre, paediatric care, and ambulance facilities.

The preferred option of a new build hospital on a new site would bring significant health and care system wide benefits. It would fully address the Case for Change, improve care for patients, improve the work environment for staff, meet environmental commitments, such as Net Zero Carbon, and maximise the wider socio-economic potential. A new build on a new site (which would be within around a 10-mile radius of the current RLI site) offers the best clinical, operational and efficiency benefits and meets the requirements set out by the national New Hospital Programme, such as delivering an environmentally friendly and sustainable building, with more single en-suite rooms.

The alternative option would bring a range of improvements, particularly for patients needing urgent and emergency care and people accessing maternity services, along with improving clinical adjacencies. However, it only partially addresses the Case for Change and does not address all the required backlog maintenance or the ambitions of the national New Hospital Programme. For example, it would only partially deliver on environmental and sustainability targets because some of the old buildings and existing gas boilers would remain. As much of the new facilities would provide single en-suite rooms for patients as possible, but this would not be at the scale achievable within a new build. It also limits opportunities to make service and quality improvements in the future.

Kevin McGee OBE, Chief Executive of Lancashire Teaching Hospitals NHS Foundation Trust, said:
“Our New Hospitals Programme is progressing at pace, and we are excited by the opportunities it represents for the people of Lancashire and South Cumbria.

Whilst all options would bring much welcome investment and enable significant improvements in patient care, new hospitals on new sites would be truly transformational, giving us the freedom to design our services and facilities around the needs of our patients, rather than the confines of existing sites, future-proofing services for the next generation.”

Aaron Cummins, Chief Executive of University Hospitals of Morecambe Bay NHS Foundation Trust, said:
“The reason I’m so excited, particularly as the Chief Executive at UHMBT, is that this is a once-in-a-generation opportunity, it’s a legacy opportunity to bring new facilities and much needed investment into our patch.

It will also mean that we’re able to resolve quality and safety issues and patient experience issues permanently for our populations.”

Kevin Lavery, Chief Executive of NHS Lancashire and South Cumbria Integrated Care Board, said:
“The New Hospitals Programme gives us a real opportunity to achieve our ambitions for being an exemplar health and care system by transforming the way we work across our hospitals in Lancashire and South Cumbria.

This transformation will enable us to improve quality, safety and patient experience for our whole population and have a positive impact for our NHS staff, who undertake incredible work to support our communities every day.”

Each of the shortlisted proposals for new hospital facilities in Lancashire and South Cumbria also includes investment in Furness General Hospital. This is required due to its geographically remote location, its proximity to some of the UK’s major strategic national assets, and its need to meet NHS environmental goals.

Investment in Furness General Hospital would mean better care and a better experience for patients and staff, particularly for patients who need critical or high dependency care and people receiving emergency care. The number of single rooms would be increased, to create flexible space that could be used to keep patients separated for infection control or could be adapted for other uses, for example to treat patients who need closer levels of monitoring. Digital technologies would be brought in to support a network of care across Lancashire and South Cumbria. This would link up doctors, nurses and other healthcare professionals to work together on treatment for patients.

Next steps

The detail behind each option will continue to be expanded and refined as further work on the shortlist progresses and the required business cases are developed.

Work is underway to assess the viability of potential locations for new hospital builds for both Royal Preston Hospital and Royal Lancaster Infirmary. Following an initial land search, the NHS in Lancashire and South Cumbria is assessing the deliverability of each site, including environmental and planning considerations, capacity for utilities and high-level design, as well as undertaking travel and transport analysis to understand the accessibility of each site. There is still a lot of work to be completed in this area and additional sites may emerge over the coming period. Further information will be shared in due course.

No final decisions have been made and the New Hospitals Programme team will continue to involve patients, local people, staff and wider stakeholders in the development of proposals.

Jerry Hawker, Senior Responsible Officer for Lancashire and South Cumbria New Hospitals Programme, said:
“We are hugely grateful to everyone who has taken the time to share their views on proposals for new hospital facilities. Your feedback has helped inform the process so far. Please continue to get involved and have your say.”

Find out more about how you can get involved at https://newhospitals.info

About the New Hospital Programme

The Lancashire and South Cumbria New Hospitals Programme is part of the Government’s commitment to build 40 new hospitals by 2030. Together with eight existing schemes, this will mean 48 hospitals built in England over the next decade, the biggest hospital building programme in a generation. Find out more on the ‘Improving NHS infrastructure’ website.