Wednesday 12 May 2021
'Our hospital modernisation programme is a key strategic priority for HSC this political term. It follows unanimous support from the States of Deliberation in March 2019 to progress a 10-year programme to upgrade Guernsey's only hospital, in support of the Partnership of Purpose. It's all part of a bigger plan to futureproof our health and social care system to cope with an ageing population and ongoing fiscal pressures.
'Without the hospital modernisation there will be ongoing challenges in clinical safety as areas of the PEH are falling behind acceptable modern standards. And crucially, as has been highlighted this week, demand will continue to outstrip capacity.
'Some parts of the PEH date back to the 1940s and this would represent the biggest series of upgrades since. Many areas for treating patients are cramped and unable to accommodate modern day equipment, and ageing facilities are becoming increasingly costly to maintain. It is about ensuring a fit-for-purpose facility going forward. Doing nothing will cost more in the long run due to the known demographic demand.
'We now have an overall plan to complete the proposed upgrades across three phases, with careful sequencing of work to ensure minimal disruption to hospital services and of course we must maintain a fully-functional hospital throughout the modernisation.
'An upgraded Critical Care Unit has been prioritised for Phase 1 as the lack of critical care beds has significant impact on the PEH's efficiency. Many elective procedures can only take place if there is a critical care bed on standby. Construction of Phase 1 has been approved by the States and is due to start this October and be completed within 18 months. The new Critical Care Unit will have the ability to increase from the current 7 beds to 12 beds with an adjacent Theatre Recovery Unit with 10 beds that can swiftly be converted to additional critical care beds to support any future pandemic demands or other emergency situations. The design of the new CCU facility has also considered future demand beyond the scope of this programme and as such allows for an additional 6 beds to be installed as and when needed.
Phases 2 and 3 are still pending States approval but are as important as Phase 1. Only completing this first phase would leave many areas of clinical risk across the hospital and worsening capacity issues. The full programme is all about improving the flow of patients through the hospital with new clinical pathways to improve efficiency and ultimately reduce length of stay in hospital. The modernisaton will also deliver a flexible layout that not only meets current needs but will also be more easily adaptable to future developments within health and social care.
Phase 2 would include a new 21-bay Admissions and Discharge unit which would support day patient procedures as well as accommodating patients during admission and discharge, which reduces pressure on main hospital beds. This second phase would also include an Ambulatory Care Unit by the main entrance which would provide clinical space for outpatient treatments, reducing admissions to medical wards for minor procedures. Similarly, the women's and children's facilities in Phase 2 would have outpatient rooms to avoid admission to main hospital beds for minor treatments.
In Phase 3 a new Orthopaedic Ward would have separate areas for elective procedures and emergency admissions which would help reduce the time a patient is in hospital by ensuring they have the appropriate care for their needs. Currently elective and trauma patients cannot be fully segregated due to the layout of the current facility which is one of the original wards from the 1940's construction.
Also in this final phase, a remodelled Emergency Department would have separate entrances and treatment areas for major medical emergencies compared to minor issues. This coupled with an Overnight Decision unit would help triage and reduce unnecessary admissions from ED into the hospital.
The upgraded hospital would have much more capacity in fit-for-purpose layouts and would also create the best adjacencies between units to improve the flow of patients. Ultimately it would treat patients in the most appropriate way to reduce length of stay in hospital.
