This option means that a new hospital will use assets on land surrounding the Existing Hospital in addition to the area currently used by the General Hospital. Some of these assets are already owned by the States of Jersey. There will also be some limited acquisition of property adjacent to the General Hospital. The staff and services will then migrate over therefore enabling the Existing Site to be utilised in a different way on a much smaller building footprint. The original plan involved moving different services about within the Existing Site while it was developed, which would have been expensive, lengthy and disruptive.

Large height buildings were considered during 2012, but once building height guidance had been obtained from the Planning Authority, all subsequent designs met this guidance. The reason the project team focused on the extended site option was a result of the insights obtained from States Members that the hospital is a “special case” and a once in a generation decision, which means that some flexibility against planning requirements could be sought within reason.
Warwick Farm was included in the original shortlist but was taken out of the running in 2012 for various issues outlined at no.10 here. While Millbrook Playing Fields was not considered in the screening process as the site was below 20,000 m2 on the ground floor, the consultation revealed that this was a popular potential option. The site has since been assessed, however it failed the screening tests and it is therefore difficult to justify further investigation.
It had also become clear during the engagement period that the views of the public echoed our own concerns regarding the other shortlisted sites. While there was a huge amount of feedback, in essence the general sense was:

1. Town sites were more generally acceptable than out of town sites due to the need for the hospital to remain a “special place” – accessible to all– this also applied to the Overdale Site.

2. Building on the Existing Site (as the plan then stood) was expensive, drawn out and disruptive and was not likely to ever be acceptable for patients or clinicians.

3. Utilising the Waterfront, while acceptable in terms of build result and location, was never likely to be acceptable in terms of the loss of the value of that site for other development.

Given this, the Council of Ministers took the decision to pause and reflect rather than progressing with a full consultation. Since then, there has been on-going work to establish which of the remaining sites would be acceptable. This also included re-assessing alternative sites, including Warwick Farm and Millbrook Playing Fields.

We gained a good understanding from the public what their priorities were for the Future Hospital during the first stage of the public engagement.  At that time we were considering the merits of a number of sites. We then intended to undertake a period of public consultation. Having listened to the public during this engagement period we wanted to ensure that we used it to offer a plan of action to the public that took into account, and attempted to fairly balance, all the concerns that were raised. The conclusion at the end of this period was an understanding that none of the 4 site options would acceptable for various and different reasons – so we needed to suggest an alternative.  This we have now done.
Further comprehensive engagement will now be undertaken with the public and other stakeholders to discuss the preferred option. Ultimately our priority is to ensure we deliver an excellent hospital to Jersey as soon as possible.  Rather than spend further time asking people to weigh up site options that would not be achievable for the reasons the public have already shared with us we will now be recommending the preferred option that we believe will find the right balance between:

The Treasury and Resources Department have obtained provisional funding considerations and options advice. This advice considers how the future hospital might be paid for using existing reserves, internal or external financing options.

Further work will be undertaken to consider proposals for potential funding of the future hospital which would be submitted in conjunction with the Report and Proposition for the preferred site and feasibility study for States Assembly consideration.

Future amendments to the MTFP and appropriate legislation as necessary will be brought forward for approval to facilitate the funding for a new hospital either on a new site or a rebuilt and refurbished hospital on the current site.

If the debate in the States Assembly later in the year is successful, the design feasibility work will begin in earnest to prepare for the build. We would hopefully anticipate ‘breaking ground’ in early 2019.

We have spent money undertaking a robust assessment of a number of the sites on the shortlist. This is industry standard best practice in large capital projects. We have had to do this to exclude the feasibility of alternative options. Therefore, the significant part of the expenditure had to be made, although inevitably some will have been abortive relating to design of specific sites.

We have started to work with clinical and other stakeholders to identify the impact this proposal would have, service by service. For example, some services will move off the General Hospital site in the interim period but return when the hospital is built, others will move and not return. Some will not move at all. The precise balance of these changes is still to be determined but our primary concern is that we will not undertake this proposal unless we are certain that services could be safely re-provided.

A ‘health campus’ brings together in one location a range of healthcare facilities.  Importantly it also creates the possibility of developing a ‘critical mass’ of such facilities in the location in future years.  The Campus has the potential to include not just the Future Hospital but education facilities, voluntary and community bodies, research institutes, private health care facilities, social care organisations, health related retail, exercise and other health lifestyle facilities and events and so on.  The potential combinations are many and varied.  A health campus can be created from scratch with new buildings or can ‘re-purpose’ existing buildings in the area or can, most likely in the Jersey context, be a mixture of new and older buildings.

Healthcare is a growth industry.  The demand for all kinds of health services and products is increasing.  As such the development of a health campus has the potential to contribute to the regeneration of Cheapside.

One of the strongest messages we received during the period of public engagement was the need to provide not just more car parking but also a good amount of ‘drop off’ and ‘pick up’ points as the current places are far from perfect. Whilst the design of the hospital is yet to be confirmed, we will be working with the designers of the new hospital to ensure there are more effective drop off areas. The inclusion of Patriotic Street Car Park in the design will significantly improve overall parking provision with spaces being allocated to hospital patients, visitors and staff.

As the feasibility study progresses we will develop more detail around car parking management, undertake a transport assessment on all types of access and consider the projected growth associated with our aging society to produce a travel plan to meet sustainable transport requirements.

Our first step is always to make contact with all of the owners and occupiers of the properties to explain the project and understand any concerns they may have and how we may improve the scheme for them. We have taken professional advice on the value of acquiring the additional properties in Kensington Place. This will then be the subject of a private negotiation between the owners and the States of Jersey. It is not our intention to use compulsory purchase unless absolutely necessary but these powers may be enacted if a fair value cannot be agreed. We will be working with the owners over the coming months to try to ensure these negotiations are settled as early as possible to give certainty to them and their occupiers so that they can plan for the future.

We have set out the costs of the hospital so far and the costs of site selection on and explained during the public engagement period why it is necessary to invest significantly in developing the right site and feasibility studies for any large building – particularly for a hospital. As the Minister for Health and Social Service has explained publicly, it was necessary to fully test the technical feasibility of all potential sites and the political acceptability of short-listed sites before determining a preferred site. The costs of doing so have not been wasted and will inform the planning application for the preferred site in due course. We will be updating the costs so far to take into account the whole site selection process to the point of the Council of Ministers recommending the preferred site, and will be providing a breakdown of the projected cost of the new hospital in response to public requests when we publicise the costs of the hospital later in the summer.

It is difficult to compare costs to other hospitals in the UK as each Hospital Trust belongs to a network of other hospitals nearby which provide different services. Being on an Island, we provide a general hospital service to ensure we can treat the emergency admissions we have each year as well as providing services that prevent off-island trips for small procedures for Islanders. This is no longer the model adopted in the majority of Trusts in the UK. Therefore, there is no equivalent to compare with on a true like-for-like basis.

Each of the points below were considered by independent quantity surveyors Gleeds Management Services while calculating the estimated costs of site options.

1. As an isolated island, not all the resources we need are immediately available to us in Jersey. While our estimated costs have taken into account utilising local businesses and resources where we can, construction materials we don’t have access to and specialist labour have to be imported. These imported costs affect overall costs significantly and have already been included in our cost estimates.

2. The cost of hospitals in the UK varies too. For example a hospital in Northumbria was benchmarked at having 87% of the UK national average hospital cost compared to London hospitals which can be 125% or higher than the national average. In Jersey, for the reason above, our costs are closer to the London figure.

3. We have to be careful when comparing costs of hospital developments on a like-for-like basis as a hospital opening now will have had its costs fixed several years ago. This means that costs procured for these hospitals will be significantly less as construction demand decreased following the economic downturn. Construction inflation in recent years has increased faster than general inflation so our costs reflect this, and have to predict future tender and construction costs.”