West Hertfordshire Hospitals NHS Trust provides acute healthcare services to a core catchment population of approximately half a million people living in west Hertfordshire and the surrounding area. In addition, the Trust provides a range of more specialist services to a wider population, serving residents of north London, Bedfordshire, Buckinghamshire and east Hertfordshire.
The Trust’s vision
The Trust’s vision is to embody in its hospitals all the principles, values and the sense of service that created the NHS by providing consistently good, safe care in a friendly, listening and informative way, as and when people need and want it and always with dignity and respect.
Pledge to patients
The Trust believes that the needs and experiences of patients are the first and uppermost consideration. The 10-point Heart of Herts. Pledge is designed to commit the Trust to providing the highest possible quality of care to patients and their families.
The Trust is one of the biggest employers in west Hertfordshire, employing around 4,000 people and seeing nearly a million patients each year.
Over the last three years the Trust has dramatically improved its performance. In summary the Trust’s achievements against national targets are:
The Trust operates from three main hospitals:
Watford General Hospital
Watford General Hospital is at the heart of the Trust’s acute emergency services, the core location for inpatient emergency care and for all patients who need the specialist emergency facilities (such as intensive care) of a major district general hospital. It also provides elective care for high risk patients together with a full range of outpatient and diagnostic services. There are 573 beds and 9 theatres (including 1 local theatre). Watford General Hospital is also the focus of the Trust’s women’s and children’s services, including neonatal care. Watford Hospital occupies a 7.4 hectares freehold site to the west of Watford town centre in a low value residential area.
The land and buildings value in existing use is £51.3m and the buildings on the site provide 62,275m2 of accommodation.
Hemel Hempstead Hospital
Hemel Hempstead Hospital has an urgent care centre and offers other local healthcare facilities, such as diagnostic services, including MRI, pathology, and an outpatient service that sees in excess of 100,000 patients per year. In addition, it provides 12 stroke rehabilitation beds. The local Primary Care Trust also operates intermediate care beds on the site. Hemel Hempstead Hospital occupies a 5.3 hectares freehold site on the fringes of Hemel Hempstead town centre.
The land and buildings value in existing use is £24.8m and the buildings on the site provide 20,600m2 of accommodation. However following a radical reconfiguration of the site during 2009 services have been concentrated into 3 main buildings providing 21,013 m2 of operational space.
The site is bounded by private residential accommodation at Maynard Road and Hillfield Road, by the HCA owned “Maynard Road Car Park” to the South and by the HCA owned “Paradise Fields” to the East. There has been 15,758 m2 mothballed.
St Albans City Hospital
St Albans City Hospital is the Trust’s elective care centre. It provides a wide range of elective care (both inpatient low risk surgery and day case) and a wide range of outpatient and diagnostic services with in excess of 70,000 outpatient appointments. It has 40 beds and 6 theatres (including 1 procedure room for ophthalmology) and a Minor Injuries Unit. St Albans City Hospital occupies a 6.1 hectares freehold site on the fringes of St Albans town centre.
The land and buildings value in existing use is approximately £28.3m and the buildings provide in excess of 21000 m2 of accommodation.
The land is bounded on all sides by residential accommodation and open parkland.
The Trust also operates from a small site of 0.15 hectares in St Albans, separate from the main hospital that provides a pharmaceutical packing and assembly service. The buildings on the site provide in excess of 380m2 of accommodation. The Trust is currently working on proposals to dispose of this site. Its value in existing use is approximately £0.3m
On track to become a Foundation Trust
The application process to become a Foundation Trust is extremely rigorous and ensures that the Trust’s governance arrangements, finances and future plans are fit for purpose and robust. Following a successful Board to Board meeting in July 2010, the Strategic Health Authority put the Trust forward to the Department of Health Applications Committee. The Trust is currently waiting for a national decision from HM Treasury on technical issues, before the application can go before the Secretary of State.
In July 2010 the Trust had a Historic Due Diligence (HDD) review by Ernst & Young (E&Y). The HDD review is one of the steps in the process of gaining Foundation Trust status. The feedback was extremely positive with E&Y commending the Trust by stating that the HDD process was amongst the best they had undertaken.
Foundation Trust status means that the Trust will:
The Trust has an engaged and representative membership enabling a better dialogue with people using its services. It has over 6500 members, which is 1500 more than the required 5000 Public Members (1% of the population the Trust serves).
Estate and protected assets
The Trust has protected assets at all three sites and work underway to identify a full schedule of assets at Hemel Hempstead Hospital that would require to be protected within an FT to deliver services. Protected assets are those assets required for providing mandatory goods and services.
The estate at Watford is typical of many district general hospitals in that it has developed and grown over a number of years with the AAU being the most recent addition in 2008/09. Although it remains fit for purpose and able to deliver the Trust’s Clinical Strategy, the clinical adjacencies and patient flows are less than optimal which can lead to negative patient experience in some areas. The Trust is fully aware of the need to invest in the site and has made provision to invest significantly in backlog maintenance, or where affordable, to rebuild. Investment will by necessity focus on the site’s infrastructure; however, funding will also be made available to provide more visible improvements in order to enhance both the patient’s experience and the working environment for staff.
Whilst WHHT is confident that the existing estate at Watford can deliver the clinical strategy underpinned by the LTFM, the Trust is exploring whether partial or full re-development of the site is both feasible and affordable, as clearly redevelopment on any scale will not only significantly reduce backlog maintenance but will also address the fundamental clinical adjacency and patient flow issues, both of which currently constrain full service redesign and efficiency.
The Hemel Hempstead Hospital site has undergone significant change in the last year following the withdrawal of acute services and the centralisation at Watford General Hospital. The Trust has worked in partnership with the PCT to reconfigure the site in order to maximise clinical adjacencies and to significantly reduce its footprint. This reconfiguration has been made possible by an investment of £6.4m which will enable the Trust to save £3.8m per annum on estate and facility costs. This reconfiguration is an interim solution until the PCT build and commission a new Local General Hospital in Hemel Hempstead. The Trust will be disposing of its redundant estate on the site. The Trust has not included the capital receipt for the disposal of the site in the LTFM.
Further information on WHHT can be obtained from the Hospital Trust website