Hospital maintenance and staff costs (FOI)

Request

In deciding to build a new hospital, as opposed to maintaining the existing facilities, what were the following calculations;

A

How much would it cost to maintain the current buildings for the next 40 years?

B

How much is earmarked annually to pay the managers for the new hospital?

C

How much is earmarked annually to pay all other staff (medical / maintenance and so on) for the new hospital?

Response

A

The cost for maintaining the current buildings is not held for the next 40 years. Article 3 of the Freedom of Information (Jersey) Law 2011 has been applied.

However, the Head of Hospital Estates, Health and Community Services (HCS), identified a comprehensive maintenance and capital equipment replacement programme required to uphold the safe functioning of Jersey General Hospital to 2033. It was identified that cumulative costs up to 2026 are £51.6m, but that there would be an effective tipping point after 2026, (P.123/2020 page five refers) after which the annual cost of maintenance escalates significantly.

Our Hospital Site Selection: Overdale 

During the development of the Our Hospital Strategic Outline Case (SOC) and Outline Business Case (OBC), the Project team considered whether a “Do Nothing / Business as Usual option”, in which the existing estate would continue to be maintained to the current level, would be a feasible option. The clear advice received by the Project Team from the HCS Executive, the Estates Director and the Clinical Director for the Our Hospital Project was that a “Do Nothing / Business as Usual option” posed significant clinical and operational risks beyond December 2026 such as to make it a non-viable option, in their view. The key identified risks are summarised below:

• six Facet Survey identified issues / general deteriorating condition of the hospital

• difficulty in addressing the building issues without closing areas of the hospital and providing a decant facility

• difficulty in carrying out works whilst operating a hospital simultaneously

• difficulties operating at the existing site including:

• facilities not confirming to modern healthcare standards

• lack of single rooms

• lay out / clinical adjacency issues

• limitations in delivering hot / cold sites – highlighted by the Covid-19 pandemic

• lack of co-location of Mental Health Services

• staff retention / staff recruitment

• limited space to expand at existing facility in order to meet the needs of Jersey’s population or provide additional services.

As a result of the reasons set out above, the Our Hospital Business Case (SOC and OBC) did not consider a Do Nothing / Business as Usual option as part of the Options Appraisal Process as it was concluded that this option would place significant strain on the delivery of services post 2026 and would likely result in the gradual closure of the existing estate. Therefore, no time and resource was spent developing an undeliverable option. However, in the absence of Do Nothing / Baseline, a detailed “Do Minimum / Baseline Comparator Option” was developed which would involve a significant refurbishment of the existing estate and a 60-year lifecycle profile to maintain that estate going forward. Details and costs associated with this option are included in the OBC.

It should also be noted that the Chair of Scrutiny has stated on at least two occasions that the case for a new hospital has been clearly made on clinical and safety grounds and that they did not want that case to be made again for the Our Hospital Project or for us to waste any additional resources to do so.

B

This information is not held in this format (ie the costs for managers). Article 3 of the Freedom of Information (Jersey) Law 2011 applies. Further information can be found in the response to C below.

C

Draft annual budgets for staff expenditure for Health and Community Services are included in the Government Plan 2022-2025.

The new hospital is planned to be operational by the end of 2026, which extends beyond the planning horizon of the current Government Plan. Annual budgets for 2026 onwards have therefore not been set and this information is not held. Article 3 of the Freedom of Information (Jersey) Law 2011 applies.

Existing approved HCS annual budgets include revenue costs for staff. It is considered that there will not be significant variance from current staff costs for a new hospital as current hospital staff will transfer delivery location from the current Jersey General Hospital to Our Hospital.

Work is underway to develop the Workforce Strategy for the new hospital and therefore the exact costs for hospital staff continue to be developed. This is referenced on p124 of the Our Hospital Outline Business Case.

Our Hospital Project: Outline Business Case

It is anticipated that the efficiency of the building will generally lead to efficiencies in the way staff can work in the space. However, the increase in single occupancy inpatient rooms may lead to changes in the staffing requirements for wards.

Article applied

Article 3 - Meaning of “information held by a public authority”

For the purposes of this Law, information is held by a public authority if –

(a) it is held by the authority, otherwise than on behalf of another person; or

(b) it is held by another person on behalf of the authority.