CF led a consortium to support the States of Guernsey with the modernisation programme for the Princess Elizabeth Hospital by providing detailed activity and capacity modelling, conducted extensive clinical engagement to co-develop design solutions, and supported a rigorous options appraisal process to confirm a preferred, costed option for OBC.

 

  • Validation of the original business case against the Green Book, setting out the rationale for key changes, and recommendations for OBC which have been incorporated
  • Detailed demand and capacity projections until 2048 for the redeveloped hospital with sufficient flexibility to meet future demand
  • Workforce requirements to meet future demand and new care models
  • Financial and economic appraisal to underpin the OBC development
  • A robust options appraisal, arriving at a preferred design option which was endorsed by clinical and managerial staff across PEH and wider stakeholders

Issue:

The Princess Elizabeth Hospital is Guernsey’s only hospital and is comparable to a district general hospital, even though serving much smaller population than its UK equivalents. There are significant clinical risks and estate challenges which provided a strong case for change for the redevelopment programme. The States of Guernsey required support to take the strategic case for the Modernisation programme to the end of RIBA II and provide a strong business case to enable the programme to progress to next stage of development.

Solution:

CF led a consortium (with Currie and Brown providing healthcare planning and cost consultancy services, and IBI providing architectural services) to support the States of Guernsey with the modernisation programme for the Princess Elizabeth Hospital by providing detailed activity and capacity modelling, conducted extensive clinical engagement to co-develop design solutions, and supported a rigorous options appraisal process to confirm a preferred, costed option for OBC.

Methodology:

Strategic case review: Conducted a robust review of the original strategic business case (programme business case), against Treasury Green Book guidance. The review identified areas of compliance as well as critical gaps, which then formed a work plan for OBC development in a summary report.

Care model development: Conducted 3 large system-wide workshops as well as a series of department-level clinical workshops to develop care models, patient pathways and operational policies. The system-wide workshops set the parameters for detailed work at the department level where our experienced facilitators introduced the latest innovation, technology and care models.

Demand and capacity analysis: Projected 30-year future demand for the whole hospital by speciality, taking into consideration the impact of transformation opportunities (e.g. community and digital) and productivity opportunities. The assumptions and outputs were developed and iterated with both clinical representatives (including Medical Director, Chief Nurse, departmental leads) and financial leads to achieve joint sign-off.

Schedule of accommodation: Output of demand and capacity modelling was then taken by C&B healthcare planners to develop a detailed schedule of accommodation at a departmental level. This was done through extensive clinical engagement at a department level.

Options appraisal: Through several rounds of clinical user groups, IBI and C&B developed a long list of design options. CF led the consortium through a structured process, working with stakeholders to agree on hurdle and evaluation criteria, and the application of the criteria using evidence base and extensive stakeholder engagement. The shortlisted options were assessed quantitatively for both capital and revenue costs, to arrive at the option providing the best value for money.

Workforce requirements: Reviewed and quantified workforce requirements for Modernisation programme through workforce modelling as well as clinical engagement. Workforce modelling projected forward workforce requirement by speciality, taking into consideration different demand growth in each speciality. Future workforce requirements and development needs were co-developed with clinicians and operational staff through a dedicated workshop and further iteration, incorporating new care model, training and development requirements as well as productivity opportunities.

Results

The consortium’s work has received universal praise. The preferred option design was endorsed by clinical and managerial staff across PEH and wider stakeholders, who have been closely engaged throughout the process.

Testimonials

“It’s been a very positive experience working with you all. My first encounter with you all was your presentation during the tender process. I thought it was superb, and wondered if I was getting a little carried away so at the break I joined a colleague and asked what he thought. “I feel quite inspired,” he said, so I knew it wasn’t just me. Several of us came away from that presentation believing that we could turn a lot of passionately-held aspirations into a reality with the support of the people we’d just met.

Over the last few months, you’ve lived up to, and exceeded, the expectations you induced that day. I knew there would be issues with our data, but even I didn’t foresee it would all be quite as problematic as it has been. I think almost every week, once you had processed and presented the data, Jude and/or I said something wasn’t right, requiring further work and interrogation of BI, and then repeat work. That has been handled with incredible patience and good humour and has frequently been turned round in 24 hours. The result is that I have confidence in the work you have produced because I see the intelligence and diligence that has gone into it, which is incredibly valuable. It’s been a bit of a high point of my time here at HSC, to be honest. Well done, all of you.”

Keith Davies
Finance Director

 

“CF was commissioned to undertake a robust detailed demand analysis taking into account local demographic and non-demographic growth to ensure correct support for healthcare planning of the programme, they have worked closely with our internal team even at a time giving them support to deliver the necessary data required and have listened to challenge from clinicians and the corporate management and where necessary have revisited their analysis process to ensure the data is accurate.

 I have found CF to be excellent in leading the full consortium, they have ensured professionals reports, presentations, objectives and deliverables are met on time, they have a flexible approach and  have given excellent support to the internal core team, they have been very professional in clarifying and offering assistance when needed for the requirements of the SOC, OBC and FBC process.”

Jan Coleman
Programme Director