A new Queen Elizabeth Hospital

A new QEH for King’s Lynn and West Norfolk would deliver a sea change in health and care for our local communities in Norfolk, Cambridgeshire, and Lincolnshire.

The simple truth is that our buildings are in a desperate state and have reached the end of their life. We now have 3,433 steel and timber support props in 56 areas of the hospital. We now have more than six times more props than beds and we are the most propped hospital in the country.

A new hospital that is fit for the future will enable us to provide outstanding care in world-class facilities and meet the demands of our growing and ageing population. We want to become the best rural District General Hospital for patient and staff experience and a new hospital is central to achieving this ambition.

We are taking proactive steps to maximise safety at our hospital. This includes a rolling programme of onsite surveys and maintenance as well as receiving £20.6m emergency national capital investment in facilities for 2021/22 that will modernise QEH, including the installation of failsafes (to reduce the risk of RAAC plank failures) which will improve the safety and delivery of some services. The final element of our approach is doing what is necessary to have a fit for the future hospital that our patients and staff deserve.

In the longer-term we are determined to attract significant national capital funding to bring a new hospital to King's Lynn and West Norfolk, which is nothing less than our patients and staff deserve.

If we manage to secure the funding and are confirmed as one of the Government’s eight new hospital schemes, it will take a number of years to go through the necessary planning and approvals process and build the hospital. The very earliest we would expect the new hospital to open its doors would be 2029.

As a RAAC (reinforced autoclaved aerated concrete) hospital, QEH will continue to need significant annual investment and it will be crucial that we continue to invest in our hospital during this time to make sure we provide the best care and experience we can for our patients, their families and staff.

Why we urgently need a new hospital in King's Lynn and West Norfolk

Strategic Outline Case for a new Queen Elizabeth Hospital is complete

The Strategic Outline Case (SOC) for a new Queen Elizabeth Hospital was completed on 7 June and has been fully supported by our Board of Directors and full spectrum of external stakeholders and partners across Norfolk and Waveney, Lincolnshire and Cambridgeshire, following extensive engagement. This is an important milestone as we continue our work to secure the funding we desperately need for a new hospital.

The SOC sets out associated indicative costs and details of how the development of our preferred new hospital scheme would be managed with clear timescales for completion.

We have a strong and well-known Case for Change driven by four key areas:

The current hospital has reached end of life (national experts say the current hospital has a 2030 deadline) due to Reinforced Autoclaved Aerated Concrete (RAAC)
Improvements recommended in patient and staff surveys - as well as in CQC inspection reports and described in the Trust’s risk register - relating to RAAC and the operational impact on the running of and people’s experience of the hospital
Challenges in workforce retention and satisfaction relating to our estate and RAAC
The current hospital can no longer meet current or future forecast increases in demand

The SOC focuses on ensuring that QEH is best placed to continue to fulfil its role in the area while improving clinical outcomes and patient, visitor and staff experience in a hospital that is fit for many decades to come.

It sets out our preferred new hospital scheme for a single-phase new build on our existing hospital site which will cost £862m. This is the only solution that will bring a new hospital to King’s Lynn and West Norfolk ahead of the 2030 deadline and is the option that brings least disruption to patients and staff during the build and construction period. It also provides best value for money and return on investment.

Our preferred new hospital scheme was identified and agreed by the Trust Board in December 2021. It is consistent with our preferred Expression of Interest (EOI) which was submitted to the Department of Health and Social Care in September 2021 in a bid to become one of Government’s eight further new hospital schemes. It was also the number one scheme chosen by NHS England and NHS Improvement for the East of England.

Our preferred new hospital scheme will help to ensure that there is always a District General Hospital in King’s Lynn and West Norfolk, delivering core services to our population. The new hospital would provide a once in a generation opportunity to transform and modernise healthcare, recognising regional historic under-investment in health and care in this part of the region. Consistent with our Clinical Strategy, it would enable QEH to become a centre of excellence for frailty and stroke, day surgery and regional anaesthesia, research and innovation, and same day emergency care.

The SOC is now ready for submission to the Trust’s regulator and national New Hospital Programme team for review and consideration, pending an announcement about the outcome of the Expressions of Interest process for the Government’s eight further new hospital schemes and confirmation that QEH will be added to the list.

We are now working to develop an outline and full business case. Enabling works for a new hospital need to begin in 2025, with the doors to open on a new QEH in 2029.

We expect to find out soon if we have made the longlist for the Government’s eight further new hospital schemes, with a final decision expected later in the year.

New Hospital – Trust Board agrees preferred way forward

Work has been progressing on the development of our Strategic Outline Case (SOC) for a new hospital. This sets out a robust case for change, and a preferred way forward with associated indicative costs, including how the development would be managed and delivered with clear timescales for completion.

During Winter 2021, we held two workshops with a range of internal and external stakeholders, including Heads of Service and Divisional Leadership Teams, Governors, Non-Executive Directors and Healthwatch Norfolk, patient, staff and partner representation, to review the options for a potential new hospital and to assess all options using clear success criteria informed by local and national measures.

The Trust, with support and input from a range of external stakeholders, formally reviewed and assessed the following shortlist of possible options identified for a potential new hospital:

a single-phase new build hospital on the existing QEH site, expected to be operational in 2029
a multi-phase development (part new-build, part refurbishment), expected to be operational in 2033 (at the earliest)
considering whether a new hospital would be built on the existing hospital site or elsewhere.

At the Trust Board Meeting on 7 December 2021, the Board approved the preferred option of a single-phase full new build on the existing QEH site based on the technical detail and information presented to them following the completion of these detailed assessments.

This is consistent with our preferred Expression of Interest (EOI) which we submitted to the Department of Health and Social Care in September 2021 alongside an alternative EOI for a multi-phase development (part new-build and part refurbishment) in a bid to become one of eight further new hospital schemes.

Whilst a multi-phase development would provide a scalable option that still delivers some of the benefits and would be a vast improvement on our current estate, a single-phase new build would cost less and deliver much greater benefits. It is also the only solution that meets our deadline, based on national expert opinion, of replacing our hospital by 2030.

This is because our hospital is a RAAC (Reinforced Autoclaved Aerated Concrete) hospital, which was built in 1980 and designed to last 30 years. RAAC is a lightweight form of concrete used to manufacture pre-cast planks which have been used to build QEH. These planks are now more than 40 years old and have reached the end of their life.

The Government is committed to eradicating RAAC in hospitals by 2035. Our deadline at QEH, based on national expert opinion, is 2030.

The Trust’s Expressions of Interest have been reviewed and considered by the NHS regionally ahead of a decision nationally by the Department of Health and Social Care. We remain confident we have a very strong case. We expect to find out soon if we have been selected to go through to the next stage of the assessment process for the Government’s New Hospital Programme. A final decision on the further eight new hospital schemes is expected later in the year.

Work now continues to complete the SOC which remains on track to be completed and considered by the Board in June this year.

Proposed site development 'masterplan' for a new hospital on current site

The proposed site development ‘masterplan’ for a new hospital that would be built on the current site (our preferred option) can be seen in the image below:

QEH Site Masterplan