Agenda item

To consider a report by the Programme Manager from Betsi Cadwaladr University Health Board (copy attached) which updates the Committee on progress and plans for the development of the Royal Alexandra Hospital site and seek members’ feedback on the proposals.

 

10:10am – 11:00am

 

The Lead Member for Health and Social Care and the Corporate Director: Social Services & Education (CDSSE) presented the Royal Alexandra Hospital (RAH) Development report (previously circulated) alongside Betsi Cadwaladr University Health Board (BCUHB) Integrated Health Community Director for Conwy & Denbighshire, Gareth Evans. The report shared progress and plans for the development of the RAH site in Rhyl. 

 

It was emphasised that whilst the RAH project was led by the Health Board the Council was working very closely with Health Service colleagues on the project, with the Lead Member and Corporate Director dedicating some considerable time and effort into realising the development.  The proposal was to deliver new services alongside relocated and expanded supporting services from a new clinical building. The project would also aim to refurbish the existing RAH building as a support centre with some clinical, patient-facing services remaining in situ, e.g., Child & Adolescent Mental Health Services (CAMHS) and Physiotherapy.

 

The BCUHB Integrated Health Community Director guided the Committee through a presentation highlighting the background and summary of the work undertaken to date on the RAH project, including its scope, key dates, programme governance structure, and collaborative working opportunities.

 

BCUHB aspired to develop the site, which had a long history.  Whilst a business case had been submitted in 2021 but, due to inflationary costs caused by factors outside of the control of the Health Board, such as the pandemic and geo-political matters, insufficient capital was available to fund the scale of work outlined in that business case. Consequently, an Option Appraisal for a lower-cost development was agreed upon with the Welsh Government in July 2024. It was then agreed to progress the scope through innovative procurement of design, detailed in an Addendum to the 2021 full business case (FBC), which was submitted to WG. 

 

Due to financial constraints, the scope of the work had to be re-evaluated. This entailed a design which prioritised the delivery of new services in a new, smaller clinical building. The project also required the Health Board to prioritise the refurbishment of the existing Grade II Listed RAH building as a support centre. In addition, with a view to alleviating pressures at Ysbyty Glan Clwyd (YGC) and support the local population, the Health Board was expected to provide the following services in the new building:

 

·                A new Minor Injuries and Ailments unit

·                Some “Care Closer to Home” beds

·                Increased opportunities for collaborative working with partners at the site

 

Under the revised plans the new clinical building would accommodate the following:

·                A new Minor Injuries and Minor Ailments Unit (MIAU) taking demand away from Ysbyty Glan Clwyd and serving people closer to home

·                approximately 14 community beds (number subject to design constraints), which would enable Health and Social care to meet the needs of local people

·                A relocated and expanded Radiology service and an expanded Community dental service.

 

The existing building would be refurbished to include:

·                repairs to the floor structure and external fabric

·                refurbishment of current unoccupied areas

·                new electrical and heating infrastructure

·                co-location of the Third Sector adjacent to the Community Team; and

·                the potential repatriation and expansion of sexual health, audiology, and orthotics services (subject to design and funding limits).

 

The Committee were advised of the indicative key dates for the project’s development and delivery  –

 

·       Jan – April 2025: Procurement (this phase was currently in progress)

·       March - August 2025 – submission of planning application for the site

·       May 2025:  Approval by BCUHBoard of new build design, then submission to Welsh Government (WG)

·       July 2025: Approval by BCUHBoard for existing building, then submission to WG

·       August 2025:  design and cost update for the existing building (RIBA 3)

·       Quarter 1 2026: commencement of the new build phase

·       Quarter 2 2026: commencement of the work on existing building construction

 

The Committee were also informed of the ongoing stakeholder engagement taking place.

 

·       Continual “Bite Sized Health” engagement events

·       Rhyl White Rose Centre events in 2025

·       Developing the work on the wider economic benefits to the community with stakeholders in local government and the Voluntary Sector

·       Continuation of staff engagement events

·       Return to the Equalities Stakeholder Group

·       A Clinical Reference Group had recently been established.

 

Following the introduction, in response to members’ questions, the Lead Member, Council, and BCUHB officers:

 

·       confirmed that the new designs were being finalised, once they were finished, planning permission would be sought.

·       Advised that there had been good, positive dialogue with Welsh Government (WG) and the other local stakeholders on the project and its funding.  The North Wales Regional Partnership Board (NWRPB) had endorsed the partnership element of the funding and included it within their 10-year Capital Investment Plan.  Health Board officials and relevant Denbighshire County Council (DCC) officers had been involved in discussions with WG ministers at the highest level with respect of the project.

·       The proposed14 beds were intended to prevent people from needing to attend the acute hospital.  They were very much viewed as a step up/step down provision which would be a key feature of future health and social care provision, complementing other aspects of the prevention work e.g. Community Resource Team (CRT) and other community-based services.  

·       clarified that approximately 20% of funding within the project would come from regional partners, via the NWRPB.  The remainder would be sourced from WG via capital funding streams.

·       Advised that whilst car parking facilities were yet to be finalised, all partners were confident that satisfactory solutions would be included in the final plans.

·       Confirmed that the wards closed in 2012 were closed on fire safety grounds which would be too costly to upgrade to meet modern-day standards.

 

A number of committee members expressed the view that there was a need to reinstate community hospitals as the needs within the community were continuously increasing and causing severe pressures on acute hospitals, such as YGC.

 

The committee emphasised that the length of time the process to redevelop the hospital was taking was frustrating, especially for local members who had been elected members since the inception of the proposal for the RAH development.  The Lead Member for Health and Social Care advised that she understood members' frustrations on the matter.  However, the project had been re-scoped to accommodate budget constraints, more capital funding had recently been promised by UK Government to the WG for health projects therefore there was every reason to feel more optimistic about this particular project and be forward thinking for the future.

 

BCUHB Integrated Health Community Director responded to members’ concerns that the matter may fall foul of political processes ahead of the 2026 Senedd election, stating that the project had been ongoing through multiple electoral cycles. The WG had shown its commitment to the project by setting aside funding for it, subject to the conclusion of the scoping and design planning stages.  It was earmarked as one of its major capital investment projects.  The project, once completed, would reap huge benefits for the local community.

 

The Chair thanked BCUHB’s Integrated Health Community Director for Conwy and Denbighshire for attending the meeting and giving the presentation, and in conjunction with the Lead Member for Health & Social Care and the Corporate Director of Social Services & Education, for answering members' questions.  

 

After an in-depth discussion, the Committee:

 

Resolved:  -

 

(i)   to note the scope of the work, the timescale, and potential available funding for the purpose of developing the Royal Alexandra Hospital;

(ii)  that the feedback and observations provided during the discussion be considered as part of the service provision planning for the development; and

(iii)                  that a further progress report on the Royal Alexandra Hospital Development be presented to the Committee at its September 2025 meeting.