NO WAY OF KNOWING WHY WATFORD WAS CHOSEN FOR A NEW HOSPITAL
Audit Office says no documented evidence for final selection of Watford General
The Government’s decision to choose Watford General for a new hospital was made without proper recorded evidence, according to the public spending watchdog.
In scathing comments on the list of sites for development under the New Hospital Programme, a new National Audit Office report says it cannot determine ‘whether there was an evidence-based process for selecting these schemes as opposed to others.’ (page 24)
The NAO says civil servants have admitted that ‘the final selection of [NHP] schemes involved choices and judgements for which no further documentation is available ... there is no basis for us to determine why DHSC selected these schemes (page 22).
The Government’s failure to provide any explanation of why Watford General was chosen for the NHP rather than other sites - including clear new sites within West Hertfordshire - undermines the case for redevelopment there.
New Hospital Campaign Co-ordinator Philip Aylett said today:
“This is a devastating blow for the Trust. Neither they nor the Government have ever produced a shred of objective evidence for choosing Watford General for a new building.
“We now know that the Government’s choice of Watford General for development was based not on reliable evidence but on ‘choices and judgements for which no further documentation is available’. It is absurd that the future of our hospitals for the next 60 years should rely on such feeble, secretive foundations.
“The Trust may claim that they have examined and rejected the case for an alternative to Watford General following the three-year-old ‘Site Feasibility Study’. But that's grossly misleading The SFS study report admitted that its judgements were ‘subjective’. The Government’s own spending rules make clear that investment decisions must only be made on credible objective evidence. This whole process has been riddled with subjectivity - bias - from the start“
The NAO report contains many other criticisms of the NHP process. The New Hospital Campaign will be publishing a fuller analysis of the NAO report in the next few days. Here is the New-hospital-programme-report.
HOSPITALS ANNOUNCEMENT - MAINLY HOT AIR?
The Government got a lot of publicity for the announcement about the New Hospital Programme (NHP), including Watford General, last week.
But what did it mean? Maybe not that much.
The key headline was that many of the NHP schemes will be 'fully funded'. To a normal person, that would mean that the Trusts would know exactly how much money they will be getting. They would also know what buildings they are being allowed to construct.
But Governments with an election in the offing don't follow the normal rules.
In fact 'fully funded' is a misleading term. There is a very long way to go before the funding is secured and a design decided on.
This is what the NHP website says about funding:
All schemes within the New Hospital Programme follow a business case process, including being reviewed and agreed by ministers. Final individual allocations for schemes will only be determined once the Full Business Cases have been reviewed and agreed.
Watford General and the rest have not yet finalised the next stage of their applications - the Outline Business Case. The West Herts Trust have got to adapt their 260-foot tower block design to national standards based mainly on factory-made prefabs. That won't be easy, especially given the small and steeply-sloping Watford General car park site.
The Full Business Case may be many months off and a lot could happen before the Treasury finally agree the money.
Schemes won't start main phase construction until 2025 - after the Election.
Watch this space - a lot could happen in the next two years.
WATFORD GENERAL FUTURE - STILL MORE QUESTIONS THAN ANSWERS
The 25 May relaunch for the New Hospital Programme, including news on Watford General's redevelopment, leaves many vital questions unanswered.
The Trust have failed to gain government approval for their preferred option, and are now in the middle of a rushed redesign to meet the Treasury's demands for a standardised national approach based on 'modular' buildings produced in factories, known as 'Hospital 2.0'. No one has explained exactly what 'Hospital 2.0' means.
Tower blocks will be needed to squeeze 1000 beds onto the current surface car park. How high will they have to be? 16 storeys, maybe more.
Whatever happens at Watford General, the problems of access to a constricted and congested site in a highly built-up area will remain. The impact of building work on patients during construction will be severe.
Meanwhile, there is no detail on the future funding of Hemel Hempstead or St Albans Hospitals.
The fact is that the Vicarage Road site is a very bad place to put an emergency care and specialist hospital.
The NHC response to 25 May announcement is here
The Government press release about the announcement is here
BOTCHED WATFORD GENERAL PLANS MUST BE REVIEWED
A letter demanding an independent review of the West Herts Trust's botched plans for redeveloping Watford General Hospital has been sent to key health decision-makers.
The letter is jointly signed by Sir Mike Penning, the MP for Hemel Hempstead, and Philip Aylett, the Co-ordinator of the New Hospital Campaign. It has gone to Health Secretary Steve Barclay and the Integrated Care Board for Herts and West Essex.
The letter shows that Watford General is not a suitable site for redevelopment. It is extremely congested, inaccessible - and unpopular.
All options for the Vicarage Road site are unaffordable or offer very poor value for money - or both. Taxpayers will lose out if the Trust persist with their plans.
The Campaign believes a completely new emergency care and specialist hospital on a clear and accessible new central site would be the better way forward.
Public confidence in the Trust’s plans for redevelopment at Watford General is in doubt and political support is weak.
The letter calls for a fully independent review. This must allow for a genuine assessment of all options. The Trust should not conduct or even supervise the review, given its history of error and confusion over the project.
The full letter is below:
WHAT'S NEEDED FOR WEST HERTFORDSHIRE
- New state-of-the-art emergency care and specialist hospital, centrally located in the area and offering safe and good quality healthcare
- Working with other hospitals and health services in the area
- On a clear site that’s easy to get to
- Good public transport connections and affordable parking
- Zero carbon, in a green and healing environment
- Future-proof with room to expand
West Hertfordshire Teaching Hospitals NHS Trust insist that the redeveloped emergency care and specialist hospital must be at Watford General. But Watford General is the wrong site for the redeveloped hospital. That’s because new facilities at the Vicarage Road site would be:
- Squeezed into a densely-packed urban area with congested roads and poor public transport links
- Some way down busy roads from major centres of local population such as Hemel Hempstead and St Albans
- On a sloping site with difficult access
- Massively disruptive during many years of construction, as the main work would happen just a few metres from the existing operational hospital
- At the centre of what is planned to be Watford’s largest new housing estate, with up to 1500 flats and houses being built very close by – a recipe for even more disturbance during construction and even worse traffic congestion for ever
This is not a healing environment.
WATFORD'S SHADY NEW HOSPITAL - PATIENTS FACE DARK FUTURE IN THE VICARAGE ROAD TRIPLE TOWERS
TRUST DIAGRAM SHOWS HOW LITTLE LIGHT WILL PENETRATE TO WARDS IN 260-FOOT BUILDING
Patients in Watford General’s planned new tower-block hospital face a gloomy outlook, with many wards in shade for most of the time.
A shocking computer diagram (above), produced by the West Hertfordshire Teaching Hospitals NHS Trust, reveals how the design of the planned 260-foot hospital will severely restrict sunlight and views for patients and staff. The problem will be severe even in June, the sunniest month.
The New Hospital Campaign have accused the new hospital, costing at least £1.1 bn, of being a ‘clinical carbuncle’ which would do nothing for health or wellbeing.
The new facility will suffer from serious defects:
• Deep dark courtyards will be surrounded by monolithic buildings of up to 16 storeys on all four sides;
• The new facility’s three tower blocks, the tallest about 260 feet high, will be just 15 metres apart;
• Blinds in wards will be needed to preserve the privacy and dignity of patients – a recipe for even more shade.
And the layout of the building will make things worse. Squashed on to a plot that is just half the size of the existing hospital, Watford General’s three towers are to face each other in a parallel row. Many wards and other rooms will directly face each other.
Watford General’s closely-packed hospital towers won't meet the minimal spacing standards demanded by Watford Borough Council for ordinary residential buildings.
Philip Aylett, Co-ordinator of the New Hospital Campaign, said today:
“The West Herts Trust seem bent on creating in this Hertfordshire town something usually seen only in dim corners of the City of London, where greed and property prices dictate close packing of office blocks.
"The Trust have abjectly failed to come up with an attractive or effective design. The Trust are creating a clinical carbuncle which will do nothing for health and wellbeing – and the people of West Herts will be stuck with it for 60 years.
“Only for a brief period around noon in the summer will there be much natural light for most patients.
“Terrible for patients and staff. Terrible for the taxpayer.”
HARLOW SHOWS THE WAY - AND SHAMES WATFORD
HARLOW SHOWS THE WAY TO A CLEAR NEW SITE HOSPITAL - AND PUTS WEST HERTS TO SHAME
Harlow's Princess Alexandra Trust are showing how an imaginative NHS body can plan new clear-site hospitals that work for patients.
The Essex team want an efficient new hospital on a human scale - up to seven or eight storeys - in a spacious setting with room to breathe. By contrast West Herts want us to squeeze into a 16-storey, 260-foot monstrosity, surrounded by Watford's biggest new housing estate - the 1500-unit Riverwell.
In this blog, Walking the Tightrope, the Trust explain the thinking behind their choice of a hospital that is in the right environment for healing.
A much better use of public money than Watford's towering infirmary.
TRUST TO REVIEW NEW HOSPITAL SITE OPTIONS
REVIEW OF DECISION TO BUILD AT WATFORD GENERAL AS TRUST BOW TO PRESSURE
Opposition to plans to redevelop Watford General has forced West Herts Trust to agree to review their decision. Amid signs that support for the Trust’s proposals among key local councils is crumbling, the Trust say they will be taking a ‘fresh eyes approach’ to the decision at a Board meeting on 31 May.
The U-turn follows a February meeting at which local health group the New Hospital Campaign (NHC) and others put their case for a new hospital on a clear and accessible central site to Health Secretary Sajid Javid.
In a letter sent today to Phil Townsend, the Trust Board Chair, NHC Co-ordinator Philip Aylett says:
‘I am glad that you and your colleagues are, at last, now apparently prepared to challenge officials to justify their approach.
‘The imminent departures of both the CEO and Deputy CEO, the present hiatus in the New Hospital Programme, the Secretary of State’s consideration of the evidence presented to him by the NHC and, maybe, some of the NHS failings we have heard about recently, all offer the Board a convenient and valuable opportunity to re-set.’
The NHC today sent the Trust their contribution to the review - the detailed submission the Campaign made to the Secretary of State following the meeting with him in February. That recommended that an independent expert body should be commissioned ‘to carry out a full review of options for acute redevelopment in West Hertfordshire. This review should include options for a clear site.’
To read the full press release click here
Click here for the letter sent today to Phil Townsend, West Herts Hospital Trust Chairman
For our full submission to Sajid Javid, Secretary of State for Health, click here
WEST HERTS NEEDS A TRULY NEW HOSPITAL
WHY WATFORD GENERAL WON’T WORK - NHC Update February 2022
This update on hospital redevelopment in West Hertfordshire comes from the New Hospital Campaign (NHC), which is calling on the Government and the NHS to locate a new emergency care hospital for the area on a clear central site.
West Hertfordshire has been promised funding as one of the first of the new hospitals in the Government’s programme, but it’s vital that this investment is made in the right place. An emergency care hospital should be accessible to everyone across West Herts, offering a healing environment and providing value for money.
A hospital on a new site, convenient for all, could provide:
- A good environment for care, with buildings on a human scale, decent landscaping and room to expand as our population grows
- Convenient, easy parking, especially for people with mobility problems
- Planned access by road and public transport from all of the area
- Buildings that help achieve zero carbon, are suited to new technology, and offer single rooms for privacy and infection control
- Speed of construction, as building can go on without interruption or disruption
There are several possibilities for clear new sites, easily accessible from everywhere in the area, but none has yet been properly assessed by the West Hertfordshire Hospitals NHS Trust (West Herts Trust), who continue to insist that new hospital facilities must be located at or around Watford General Hospital.
The NHC case was put to the Health and Social Care Secretary, Sajid Javid, on 7 February, when representatives from the Campaign took part in a delegation led by Sir Mike Penning MP. We look forward to positive results from that meeting.
Refusal to consider alternatives
The West Herts Trust say that redevelopment must take place at and around the increasingly cramped current site of Watford General in Vicarage Road. They constantly manipulate the facts to support this view. They did not, for instance, properly assess the risks of redeveloping at Watford General before the decision was taken to reject all new site options in favour of Watford in October 2020. This was a serious error.
But other trusts are taking a different route
The West Herts Trust’s attitude is baffling: in nearby Harlow the Princess Alexandra Hospital Trust, faced with the same choice of blundering on with redeveloping an existing, cramped town centre site or building anew on a clear ‘out-of-town’ site, have chosen the new site.
The Harlow Trust have analysed the evidence for a hospital on a clear site, and concluded it would be built much faster and more cheaply and give far better results for patients.
The huge flaws in the West Herts Trust’s plans
West Herts NHS Trust stubbornly refuse to admit that
WATFORD GENERAL WON’T WORK.
That refusal to look at alternatives flies in the face of common sense and is – unsurprisingly – creating a number of critical problems.
Lack of space is one of the biggest difficulties for their Watford plans.
The Trust are trying to fit a 1000-bed new hospital facility into a plot that is half the size of the current one. It’s a mystery why the Trust have given up so much of their land. But the answer may lie in the murky depths of the so-called Watford Health Campus, an agreement under which developers and Watford Council have been planning large amounts of residential and other development on and around the current hospital site.
Squeezed into a small space, the Trust have had to plan to build high. The Trust’s current proposals would see demolition of most existing buildings at Watford and the building of three tall towers, the biggest 270 feet high – making it the tallest NHS building outside central London. It would of course look ridiculous among the (mostly) two-storey houses of West Watford. Furthermore, if the unthinkable were to happen, local fire services are not adequately equipped to deal with a fire in a building more than 150 feet high.
The Trust have also known for nearly a year that these towers would break the budget – it would cost over £900m to build and equip the three towers as designed. The money simply isn’t there from the Treasury for what the Trust plan to do.
So the Trust will have to curb their enthusiasm for their towering infirmary. But redeveloping at Watford General in other ways would almost certainly mean having to retain and refurbish the existing buildings - which are in a desperate state.
Over three years ago, an expert survey of the condition of the Watford General buildings concluded:
- Almost all of the buildings were in an unsatisfactory condition and not ‘functionally suitable’
- The site services infrastructure - including electrical, steam heating system and hot water - was at the end of its life
- It would cost at least £240 million to catch up with the maintenance backlog
The situation has got worse since that survey was done – there are over 1000 maintenance call-outs a month at Watford.
But any redeveloped or new facilities at Watford General would suffer other serious problems:
- A poor environment – there will be serious overdevelopment of the constrained site around Watford General, with a total of 1500 flats and houses, a hotel, a school and industrial units either built or planned
- The likely move of the Mount Vernon Cancer Centre to the Watford General site will add further congestion
- The Watford site is mostly steeply sloping, and there are pollution and flooding problems that have not been properly investigated. That makes development expensive and subject to many risks
- The construction noise, dust and pollution just a few metres away will disrupt the lives of patients and staff at the existing Watford hospital for many years - probably for the rest of the decade
- The expense needed to redevelop Watford would deprive the Trust’s other hospitals, at Hemel Hempstead and St Albans, of much-needed investment.
- Already poor access will get worse as car park places are cut and the site’s overdevelopment increases traffic. Greener travel is vital, but the Watford General car park spaces are being reduced immediately – with no funded plans in place for alternative means of transport in the near future
- Travelling to Watford from Hemel Hempstead, St Albans and elsewhere across West Herts is bad enough now – it will only get much worse.
The Trust seem to have run out of Watford redevelopment options that would be good for patients, as well as being both affordable and providing value for money. They are struggling to produce a preferred option - that is months away from being decided.
2022 MUST BE THE YEAR THE TRUST TURN TO PRACTICAL ALTERNATIVES TO THEIR FAILING WATFORD PLANS
There are a number of realistic possible alternatives to the Trust's faltering and delayed plans for Watford. These would see an easily-accessible emergency care hospital on a clear new site, combining with vibrant local hospitals to serve the whole community of West Hertfordshire.
This would not have to re-invent the wheel - there are elements of the Trust's existing plans which could be adapted to fit with an emergency care hospital on a new central, out-of-town site. All that is needed is a rational approach which moves away from the Trust's obsessive determination to redevelop emergency care at Watford General.
The Trust should now reconsider their decision to reject new site options for an emergency care hospital. They need to commission a proper independent study of all the alternatives, this time based on credible evidence.
The New Hospital Campaign is a collaboration between Dacorum Health Action Group, Dacorum Patients Group, and campaigners from Berkhamsted and St. Albans to share ideas and strategies to fight specifically for a new A&E hospital for West Herts in a more central location.
*Journalists and members of the media, please click here for our full press release
NHC meets with Health Secretary Sajid Javid
NHC call on Trust to seek new bids for greenfield sites after Health Secretary meeting
Health Secretary Sajid Javid is to look into the West Herts Trust decision to redevelop Watford General. This heartening progress on the saga came after a face-to-face meeting including NHC campaigners in Mr Javid's House of Commons office.
The Campaign today called on the Trust to look again at all the four new clear greenfield sites wrongly rejected in 2020 - and to invite new bids to make sure patients and taxpayers get the best deal.
NHC Co-ordinator Philip Aylett and building expert Bob Scott were part of a delegation led by Hemel Hempstead MP Mike Penning. Bob pointed out the dire conditions at Watford, with buildings in a bad state of repair and services not fit for purpose. But the Trust's plans for a budget-busting 17-storey triple tower hospital on the severely sloping site won't work either.
Philip explained that Watford General was inaccessible and unpopular, and showed Sajid that the decision to reject all clear new sites was based on flimsy, incomplete and 'subjective' evidence that shouldn't have been used and won't wash with the Treasury. He called on the Trust to carry out a search for new clear greenfield sites that could be better than Watford and offer more than any current greenfield proposals.
To read the full press release issued by Mike Penning click here