Agenda item

To receive a verbal presentation.

9.40 a.m. – 10.30 a.m.

 

The Chair, Councillor Jeanette Chamberlain Jones, welcomed Gareth Evans, Project Director and Stephanie O’Donnell, Project Manager, from Betsi Cadwaladr University Health Board (BCUHB) to the meeting to update the Committee on the progress to date with the development of a community hospital/health facility for the north Denbighshire area, on the site of the former Royal Alexandra Hospital, Rhyl.

 

Utilising a PowerPoint presentation they briefed members on the history behind the project and the steps which had been taken to date to bring the Health Board to the position they were currently at of finalising the Outline Business Case (OBC) for submission to the Welsh Government (WG) in early 2017.  During the presentation both representatives outlined the proposed service model that would be developed on the site.  The model under consideration would focus on urgent and same day care, outpatient services near to service-users’ homes, integrated physical and mental health services for older people and would include access to prevention services to improve the well-being of local residents.  The Health Service was planning to deliver these prevention services via a partnership approach with the local authority, community and third sector organisations.

 

Details were given on the proposed service scope at the new facility, which would include:

·       Same day care centre (including minor injuries unit (MIU) and a range of services to support local primary care);

·       Outpatient clinics;

·       Inpatient beds;

·       Therapies and assessment units;

·       Intravenous therapy suite;

·       Diagnostics;

·       Therapy services;

·       Community Dental Services;

·       Child and Adolescent Mental Health Services (CAMHS);

·       Sexual Health Services;

·       Older Persons Mental Health Outpatient Service;

·       Single Point of Access (SPoA)/Integrated Health and Social Care working base; and

·       Community Hub (which would include a café facility, access to the voluntary sector, meeting rooms etc.)

 

An aerial map of the site (the Campus) was shown to members along with the proposed floor plans for each of the three floors which would make up the new building, which would be located on the site of the current Glantraeth Ward building.  The range of services that would be available at the new facility, as well as the proactive approach to delivering intervention services was expected to:

·       reduce the impact on the Accident and Emergency (A&E) Unit at Ysbyty Glan Clwyd;

·       reduce the strain on wards at Ysbyty Glan Clwyd and community hospitals in the wider area, which currently accommodated Denbighshire coastal area residents prior to discharge;

·       create a sustainable same day service that would reduce demand locally on primary care;

·       enhance and improve self-management of health and well-being needs through education, information and the availability of prevention services in conjunction with the local authority and third sector providers;

·       provide facilities that would enable carers to remain on-site and aid the rehabilitation process for the patient;

·       reduce lengthy hospital in-patient stays through rehabilitation e.g. building up the patients’ confidence in undertaking day to day tasks;

·       provide a range of outpatients services as locally as possible and reduce the need for outpatients to travel further afield to access appointments etc.;

·       optimise the use of valuable resources by better integration of multi-agency teams etc.; and

·       improve the recruitment and retention of staff through the fact that they would be based in a brand new, modern facility delivering innovative health services.

 

Responding to members’ questions Health Board representatives:

·       advised that the third and final stage of the process, once the WG approved the OBC, would be to proceed to develop the Full Business Case (FBC) and deliver the project;

·       confirmed that all partners were committed to the project’s delivery;

·       advised that the facility would include provision for a 28 in-patient bed unit (comprising of 22 single en-suite rooms and 6 shorter stay beds for reablement/assessment purposes);

·       explained that a centre of excellence for Community Dental Health Services for Conwy and Denbighshire would be developed on site as part of the project.  However, the Community Dental Services facility would not include an Orthodontic Service;

·       confirmed that the SPoA Service would be based on the campus;

·       advised that they were currently in the process of exploring the feasibility of unadopting  Alexandra Road with a view to incorporating the road into the campus;

·       confirmed that it was the Project Board’s intention to present the OBC to the Health Board at its meeting on 8 December 2016.  BCUHB would then submit the OBC to the WG during January 2017 for its approval.  WG scrutiny of the OBC was expected to take 10 to 12 weeks.  Once that had been approved BCUHB would proceed to the Full Business Case (FBC) stage, which would again take approximately another 10 to 12 weeks.   If the FBC could be approved during the summer of 2017 and planning permission granted (on which a Planning Consultant was currently working with Denbighshire’s Planning Department) it was hoped that work could begin on site in early 2018 with a view to commencing the delivery of services from the new facility in early 2020;

·       confirmed that the facility would have a Minor Injuries Unit (MIU) as part of a larger Same Day Care Centre service, which would deliver a far wider range of service than just minor injuries with a view to supporting the primary care provision in the north Denbighshire area;

·       advised that the open space central courtyard illustrated in the plans was an architectural obligation relating to natural lighting requirements of a building of the size proposed in the plans;

·       acknowledged that the project had not been progressed in recent years, this was due to the structural constraints of the former Royal Alexandra Hospital building due to it being a listed building, and in recent times due to an internal restructuring exercise with BCUHB’s Board.  Nevertheless, considerable strides had been made in recent months.  The Project Manager and the Council’s Corporate Director:  Communities had been instrumental in progressing the project recently;

·       confirmed that the availability of reablement/assessment beds at the new facility would ease bed shortages at Ysbyty Glan Clwyd.  A new process was currently being explored by BCUHB on how to improve and speed up the process for ensuring ‘safe discharges’;

·       advised that, based on current population numbers, Local Development Plan (LDP) population predictions, recognised predicted population growth data, coupled with the reablement agenda a 28 bed in-patient unit was deemed sufficient to meet future demand for in-patent services;

·       explained that the 6 bed reablement/assessment unit could accommodate carers to stay with the patient – this conformed with the emerging reablement philosophy which advocated the important part carers played in the reablement process;

·       confirmed that discussions had already taken place with the Carers Strategy Group with respect of the benefits of having carers/family members stay in hospital with people suffering from dementia, as per the aims of ‘John’s Campaign’;

·       confirmed that the SPoA Service was funded almost entirely from the Intermediate Care Fund (ICF) money given by WG for the purpose of delivering integrated health and social care services with a view to supporting individuals to remain independent for as long as possible;

·       confirmed that the Health Board had a statutory duty to deliver services through the medium of Welsh, and did so wherever possible.  The Board acknowledged the importance to the well-being of dementia patients of having services delivered to them in their first language;

·       advised that GP practices in Rhyl, St. Asaph and other practices in the area along with the Healthy Prestatyn and Rhuddlan Iach facility, were already engaging with the Health Board in relation to the campus’ development.  These GP practices would be expected in due course to attend to their patients at the hospital facility and use the facility for step-up/step-down purposes;

·       advised that as some patients from the Rhyl area were currently admitted to Denbigh Infirmary it was anticipated that once the new in-patient bed unit was open this would ease the pressure on that hospital.  However, as Denbigh Infirmary had specialist respiratory beds, some patients from the Rhyl area would continue to be admitted there;

·       explained that whilst community ophthalmology services would be available on the campus, the main eye hospital service would remain at Abergele Hospital; and

·       explained that all current temporary buildings on the Royal Alexandra Hospital site would be demolished and cleared to make way for additional car parking on the site.  Public transport to the site would also form part of the service development work for the project as would the workforce planning for the facility.  A workforce strategy would be delivered and every attempt would be made to ensure that staffing the new facility would not create a void at other Health or social care locations. 

 

Prior to the conclusion of the discussion members asked Health Board officials to enquire whether funding could be secured to produce a historical booklet on the Royal Alexandra Hospital , similar to the one recently published about the former H M Stanley Hospital in St. Asaph, which had been very well received.

 

The Committee thanked the representatives for attending and for answering their questions.  It was:

 

RESOLVED that subject to the above observations to receive the presentation, note the progress made to date, and support the work underway to deliver the new Community Hospital and Health Facility for the north Denbighshire area in Rhyl.