03 November 2016
The Health and Social Services and Infrastructure Departments have challenged a number of the conclusions arising from the report produced by Concerto for the Future Hospital Scrutiny Sub-Panel.
Suggestions about the lack of an integrated strategy for the future of health and social care in Jersey have been rebutted; the two Departments have also stressed the governance measures in place for the Future Hospital project, and the experience of the project team, after the Concerto Report highlighted these matters.
Minister for Health and Social Services, Senator Andrew Green said “I am very frustrated and concerned that this report contains numerous inaccuracies and draws conclusions and gives opinions based on incomplete information or a clear lack of understanding of the material shared.”
Senator Green said that Concerto had been provided with the integrated strategy for the future of health and social care – ‘Health and Social Services: A New Way Forward’ (P82/2012) – as well as outline business cases containing detail on service models and changes. The report’s author was also given additional detail regarding how the various elements interacted and an update regarding progress on implementing the changes.
“The model for Jersey’s future healthcare has been determined through the P82 strategy already approved by the States Assembly following extensive public and clinical consultation,” he said.
“We’ve made clear that the implementation of P82 is still in progress, but already there have been a large number of positive developments, with more to be introduced in the coming months while we refine the detail of the Future Hospital.
“Neither the summary of key issues nor the main report produced by Concerto have considered the need to have a General Hospital for Jersey providing safe 24-hour emergency care. This requirement creates the conditions for, as a minimal starting point, a safe, sustainable and affordable General Hospital on the Island which will form one part of an integrated health and social care infrastructure.
“In publishing an advisory report with these two key omissions, we hope there is no implicit conclusion that the Island does not need either a General Hospital nor comprehensive 24-hour emergency care services.”
Minister for Infrastructure, Deputy Eddie Noel, said “It is surprising that the sub-panel’s advisor considers there may be issues regarding the governance and experience of those who make up the Future Hospital project team, given that they have still to meet with the majority of team members and therefore cannot make informed conclusions.
“Members of the leadership team have extensive and proven on- and off-Island experience of major successful service transformation and of the development of new acute hospital services and buildings, supplemented by the finest expertise in the field from the UK advisory market in accordance with best practice.
“Similarly, Concerto’s conclusions about the disruption, cost and risk of the preferred site have been drawn without reference to the project delivery team. These conclusions fail to appreciate how the site assessment process assesses value for money, risk and the impact on patients, nor how the safe, sustainable and affordable vision for the Future Hospital underpins the weighting and scoring of the site assessment process.”
Among other issues queried by the two departments are that:
- the report makes no reference to the investments in primary and community services from 2013; this work has made a significant impact on the whole system and formed part of the information provided to the advisor
- comments in the report that the Future Hospital project has been driven by the building and physical requirements, rather than the clinical and service strategy, are not true. In fact, the model of care and service delivery is already being transformed under the Acute Service Strategy, even as plans for the new hospital are being developed and informed by this strategy
- the report infers that Jersey is considering greater use of off-Island provision, whereas the stated plan is to reduce off-Island provision
- contrary to what is said in the report, full consideration has been given to the need for future flexibility in the site design work
- it is recognised that the implementation of the preferred site option for the hospital will require the relocation and movement of staff – this project is underway and being developed, although the details are still being finalised
- it is untrue to say that no modelling has taken place over the projected 60-year lifecycle of the new hospital, and the potential for private practice development in the new hospital has already been investigated
Project team feedback
Senator Green said that in spite of feedback from the project team, the relevant sections of the report had not been rectified.
“We welcome fair challenge from any authoritative source,” he said. “But this review misses the opportunity to be better informed by evidence drawn from key stakeholders – who were not interviewed – and through accessing resources that could have facilitated better insight, conclusions and value for money from the Sub-Panel’s external consultants.
“On behalf of Islanders, both the Health and Social Services, and Infrastructure Departments are very keen to move forward with Scrutiny on this most important project, but I am worried that this report will unnecessarily damage public confidence in the proposed site choice, around which a consensus has been emerging, and which will be subject to a States debate before the end of the year. Any further delay will endanger our goal of a wide range of primary and community-based services, supported by a modern, fit for the future and sustainable hospital.”