Agenda item

This item presents a briefing paper from Imperial College Healthcare NHS Trust about the delayed refurbishment and rebuilding of Charing Cross, Hammersmith and St Mary's Hospitals.

Michelle Dixon (Director of Engagement and Experience at Imperial College Healthcare NHS Trust) presented the item about the delayed refurbishment and rebuilding of Charing Cross, Hammersmith, and St Mary's Hospitals.

The Chair asked for clarification that the planned rebuild of St Mary’s Hospital in Paddington, and extensive refurbishment and some new build at both Charing Cross Hospital and Hammersmith Hospital had been pushed back beyond the original commitment of 2030. Michelle Dixon said the hospitals were still in the programme and would receive funding for a business case and enabling works (e.g., upgrading a building’s power supply), but the bulk of capital funding would not be committed until after 2030.

The Chair asked if the Trust had received any response to their bid for enabling works made in August 2022. Michelle Dixon said they had not received a response yet.

The Chair asked how much money the Trust was having to spend each year on backlog maintenance. Michelle Dixon said they spent between £7-8m every year on each of the main sites.

The Chair asked for confirmation that if residents saw building works it was maintenance. Michelle Dixon said they could receive money for some enabling works before 2030, but not expansion or refurbishment.

The Chair asked if other hospitals in the core group of forty were slower to complete their business plans, was there scope for the Trust to jump the queue? Michelle Dixon said she anticipated that to be the case. She noted that Charing Cross and Hammersmith could do phased works rather than a complete rebuild. The Trust was hoping to be able to use its land as leverage to get upfront funding before 2030. The Chair asked if there was support from the Government for that. Michelle Dixon said they were speaking to the New Hospitals Programme about it.

Jim Grealy said that residents expected new hospitals to be completed by 2030, but now we learn there is no money guaranteed until 2030 and rebuilds take a long time. He asked when the hospitals would be finished. Michelle Dixon said they were hopeful that the land strategy would enable works to be done before 2030 but if that did not work it would be the late 2030s. She was concerned that the buildings at St Mary’s would not last that long though.

Merril Hammer asked if the Trust were planning to use money from land sales to help pay for the rebuild, would the Trust be refunded for that. And if not, what might that money have been used for if not spent on the rebuild. Michelle Dixon said the money would always be used to offset building costs.

Nadia Taylor asked what the impact on patient services would be during the planned rebuild. Michelle Dixon said the state of the buildings impacted on patients every day. She highlighted the ingenuity of the estates teams in keeping services running.

Councillor Natalia Perez asked about contingencies in case of extreme scenarios like flooding. She also asked if the Trust was exploring land deals for Charing Cross and Hammersmith. Michelle Dixon said they were only looking at a land deal for St Mary’s because it required a complete rebuild. Regarding contingency plans, Michelle Dixon said there were multiple contingency plans in place. If certain areas are offline then they can move things around, or move to a different site, but if there was a critical mass of problems then it could become challenging to manage.

The Chair noted that experts had advised that if the buildings were not upgraded in the next five years, they would become impossible to fix. Residents have complained about the awful condition of the corridors and other spaces at St. Mary’s. He asked for clarification that the Trust would only be getting money for St. Mary’s before 2030 if they raised it themselves and not from the Government. Michelle Dixon said she did not expect any capital from the central funding pot if they could not leverage the land.

The Chair asked what happens to the hospitals and patients in Northwest London if the Trust cannot raise the money. Michelle Dixon said they were hopeful they can get the deal done. They would also continue with contingency planning, but they would have to start thinking about moving services off the site. Building experts have told them that parts of the estate will not be viable much further into the future. It would impact care to the hundreds of thousands of people that are treated at St. Marys.

Toby Lambert said ‘plan B’ was the continued ingenuity of the estates team, but there were limits. They were looking at how to mitigate the problems collectively with the three other nearby hospital trusts. He added that the impact would be sub-optimal and there would be negative impacts on patients and fewer people would be treated if capacity were constrained.

The Chair asked how many people were treated at St. Marys annually. Michelle Dixon said there were around one million contacts across the Trusts, with around 350k at St. Mary’s.

Linda Jackson asked how much the backlog maintenance budget was. Michelle Dixon said it would cost around £105m to get on top of the backlog, but they did not have the full amount, so they prioritised the most essential works each year.

Linda Jackson asked what the St Mary’s rebuild would cost. Michelle Dixon said it would cost between £1.5bn and £1.7bn, taking land sales into account. Linda Jackson noted that at present, the hospital was not receiving either the rebuild cost or the full maintenance costs required.

Merril Hammer asked what the chances were of the programme falling through if the Government changed at the next election. Michelle Dixon said the £20bn for the New Hospitals Programme was already committed in the spending round.

The Chair noted that a floor-by-floor refurbishment of Charing Cross had been announced in 2018 and asked why the Trust was only working on the business case now. Michelle Dixon said there had been other priorities like St. Marys, and business cases took a long time to produce and required additional funding.

The Chair thanked Michelle Dixon for attending.

RESOLVED

1. The briefing note was noted.