Southampton: Hospital sites optimisation

The RSH/WCH project being supported by One Public Estate will see a step-change improvement in the utilisation of land and buildings at both hospitals.


The challenge

A significant proportion of Southampton’s population is aged over 65, with demographic forecasts indicating this will increase sharply during the 2020s. This challenge has been one of several drivers behind the ‘Better care Southampton plan’, developed jointly by Southampton City Council and NHS Southampton City Clinical Commissioning Group (CCG). To facilitate joint working, the council and CCG have also created a £100 million-plus pooled budget, managed by an integrated commissioning unit.

In parallel, the CCG has led a multistakeholder review of the NHS estate across Southampton, a central component of which was to ensure improved use of the two community hospitals – the Royal South Hants Hospital (RSH) and the Western Community Hospital (WCH). Both have unused and under-utilised land and buildings, including the former Department of Psychiatry building at the RSH which has remained empty since 2010.

At the same site, one of the city’s two wards for the physical rehabilitation of older people (43 beds) is in a building that is now well beyond its useful life. Given the demographic trend and the high demand for the existing beds, this will soon be insufficient for the city’s needs. Action must be taken to avoid emergency admissions and to increase capacity of post-acute rehabilitation. Without this, patient care and clinical outcomes would be compromised, in-patients would remain in a ‘queue’ awaiting a rehabilitation bed and A&E waiting times would increase.

The partnership has also identified a need for 400–500 additional ‘housing with care’ units by the mid-2020s.

The vision

The RSH/WCH project being supported by One Public Estate will see a step-change improvement in the utilisation of land and buildings at both hospitals. Key elements of the vision are:

• transfer some elements of the RSH site to the council, creating 150 housing with care units, a 70-bed care home and up to 80 key worker housing units

• improved use of the remaining clinical buildings at the RSH, including an integrated primary and community care hub serving city centre communities

• conversion of a former hospital chapel to a community asset

• vacation of an 1890s ward block, relocating the two older people rehabilitation wards at the RSH to a new ward block at the WCH.

Action taken/planned

The estate optimisation project’s outline business case identified a preferred option for the replacement ward block and was approved by the CCG board and Solent NHS Trust in early 2018.

OPE funding has enabled the CCG and NHS Property Services to engage expert property consultants to advise on alternative uses for RSH land and buildings – a key part of determining the preferred option in the outline business case.

At the time of writing, Southampton City Council and NHS Property Services were seeking to establish a memorandum of understanding setting out a collaborative framework and timetable for the joint development of the RSH site to meet the city’s health and care needs. Under the memorandum, elements of the land at RSH will be acquired by the council at a mutually acceptable market-based valuation. Southampton City Council will then take the lead on progressing the housing with care, nursing home and key worker developments.

For the Western Community Hospital site, a full business case is under development to relocate the 43 rehabilitation beds at the RSH to a purpose-built 50-bed facility, expected to open by 2021.

The Royal South Hants Hospital plan

Outcomes

Expected outcomes of the project include:

• demolition of a redundant former psychiatric unit at the RSH, replacing with 150 units of housing with care, enabling people to remain independent for longer

• acquisition by the city council of other elements of under-utilised land at the RSH to enable the development of a 70-bed care home with nursing

• development of up to 80 units of key worker housing on under-utilised sites at the RSH, addressing difficulties in recruitment and retention

• bringing a wing of the WCH back into use for inpatient care, delivering additional bed capacity for older people’s rehabilitation

• providing a greatly improved environment for patients through development at the WCH – improving clinical quality and patient outcomes by co-locating physical and mental inpatient services.

Next steps

• Finalisation of the memorandum of understanding between Southampton City Council, the CCG and NHS Property Services, followed by design work on the development of the site and transfer of land from NHS ownership to city council ownership. The council will then implement the housing with care and other developments on a timetable to be determined.

• Complete a pre-full business case feasibility study to examine and eliminate key risks to the Western Community Hospital project, then completing the full business case by December 2018.