BIG INTERVIEW: Hospital chief executive on £420m redevelopment

Q: This is a huge project. Why was it  needed?
Matthew Kershaw (MK): The simple  answer is to improve patient care. The hospital admitted its first patient to the Barry Building in 1828, more than 20 years before Florence Nightingale started nursing, and if you walk into the main entrance of the Royal Sussex  County Hospital today you are entering  that same building.
More than 185  years after it opened its doors we still have 200 beds in the Barry Building  and its various extensions.
We have fantastic staff trying to deliver 21st century care in 19th century buildings.
Healthcare doesn’t stand still. New treatments and improvements come along constantly.
The space available on the front half of the site is very poorly used by the existing buildings.
We cannot easily deliver the quality of care our patients deserve or adapt services to meet modern requirements in this confusion of outdated buildings.
The only option that makes any sense is to redevelop the whole front of the site so that it can operate as a modern hospital should and the buildings match the care and commitment of the
staff.
It is time our patients and staff got the hospital they deserve and this redevelopment will deliver that.

Q: What will be the next steps now that approval has been granted?
MK: We are currently preparing the hospital site for two temporary buildings to house clinical services.
These buildings, along with the move of  management offices and administration to St Mary’s Hall, which has already  happened, will clear most of the space  required to construct the first redevelopment building.
At the moment visitors to the site will notice hoardings up around two of the entrances to the hospital from Eastern Road.
This is the first part of the temporary buildings preparation work.
There have been other small changes around the site that may have come to readers’ attention including the move of the bus stop on the northern side of Eastern Road. This is to allow access to the site for construction.
At the same time we will continue to work on the Full Business Case for the redevelopment. I don’t want anyone to be confused; the approval of the Outline Business Case that we have just received is the most significant step in securing funding for the redevelopment. It says that the scheme
makes sense clinically and financially and lets us push ahead with our plans.
The word ‘outline’ can be a little misleading too; the business case runs to many hundreds of pages.

Q: What type of disruption will patients face while the building work is carried out?
MK: I think the most important fact to start with is that we will continue to offer all our clinical services throughout the redevelopment.
Two services, Outpatient Physiotherapy and Outpatient Rheumatology will be moving to Brighton General Hospital but all the others will stay on site.
We are entirely rebuilding the front half of the hospital. Over the nine years it will take to complete the redevelopment, different areas of the site will be inaccessible at different times
We are already well into planning how we will help people find their way around during the redevelopment.
Odd as it may sound, having certain parts of the site off limits will actually make it easier for people to navigate round the hospital. Fewer pathways through the site mean less confusion.
Some of our clinical services will move to different buildings. We will make sure that the existing patients of these services will be informed of the changes well ahead of time.
Construction by its very nature does cause disturbance, but there are ways to minimise this for both our patients and our neighbours.
For instance rather than having to drive piles into the ground for the foundations, a process that causes a great deal of noise and vibration, we will be using special screw-in piles that cause a lot less disturbance.
From the earliest planning stages we have been aware that we would have to keep the hospital running while building works were going on. We have looked to other hospital redevelopments that
have managed their levels of disturbance well, such as that at the Royal London, and will be learning from their experience to make sure we keep disturbance to a minimum.

Q: What is the significance of being granted public funding for the project?
MK: As we are all aware the country has been going through a difficult financial time in recent years.
To be granted public money at such a time underlines the importance of the scheme and how badly the hospital needs this redevelopment.
If this was not the case we would not have received the approval or would have been asked to look at a different way to fund the scheme such as a Private Finance Initiative.

Q: Will there be enough car parking spaces? Traffic is already heavy in Eastern Road and people struggle to find spaces at the hospital at the moment.
MK: One of the advantages of building on such a large scale is the possibility of including underground parking.
The new underground car park will be for patients and visitors only, with lifts going up into the reception areas of both the hospital’s new buildings.
The car park will have 390 spaces. This is in line with the calculations that Brighton and Hove City Council use to decide how many car parking spaces new buildings require.
The existing multi-storey car park will be unaffected by the redevelopment and will remain.

Q: Wouldn’t it better to build a new hospital on the edge of the town rather than redevelop the current one?
MK: This is a common question and understandably so.
The last time we had the opportunity to move the hospital was in 1991. At that time the
decision was taken to keep it in its current location and large sums of money were spent on improving it.
These improvements included recladding the Tower Block, building the Millennium Wing, the Renal Centre and, most recently, the Children’s Hospital.
With this level of investment over the past 20 years and particularly with the Children’s Hospital only having opened its doors in 2007, it is not possible to move the hospital.
The hospital also requires quite a large area of land. With the establishment of the South Downs National Park the possible locations for a new hospital effectively dried up.
Even if it did make sense financially to build a new hospital, trying to do so in a national park would have effectively ended any chance of the redevelopment going ahead.

Q: Would it not have been possible to keep the original buildings in some form or another?
MK: Most people are thinking of the Barry Building, the oldest building on site, when they ask this question.
We explored every possibility of keeping the whole building or the facade and none of the options worked.
In the end it came down to a simple question, were we willing to reduce the space for patient care to keep the building?
A building, moreover, that English Heritage did not think was worth listing.
From the hospital’s point of view the answer was ‘no’ and when we explained the situation to local
heritage groups they accepted our reasoning.
We have worked very closely with Brighton and Hove City Council’s Conservation Advisory Group, local heritage organisations and our neighbours to ensure that the front of the Stage 2 Building, that will replace the Barry Building, is in keeping with local architecture and reflects designs in the local area.
The interior of the Chapel in the Barry Building is Grade II listed and will be recreated in the first of the new buildings.
It will be used to show the history of the hospital and the surrounding areas.
The only other items listed on site are two brick piers on either side of Bristol Gate. These
will be moved slightly and repaired as part of the redevelopment.

Q: Are you expecting the helipad to be used a lot? What benefit will it have for patients?
MK: The helipad is vital. Currently the air ambulance has to land in East Brighton Park and patients are then transferred to hospital by a road ambulance.
Evidence shows us that such transfers and delays in getting the most severely injured and unwell
patients to the Emergency Department or Major Trauma Centre puts lives at risk.
Having a landing pad for the air ambulance on site will reduce this risk and give patients the best possible chance of survival and recovery.
Our initial figures suggest that the air ambulance will land between once and twice a week.

Q: How many jobs will the redevelopment create?
MK: At the moment we do not have the final figures for the number of construction or hospital-based jobs that will result from the redevelopment. We do know that the company leading the
construction for us has employed 74% of their construction workforce from within 40 miles of the construction site on previous projects, and will be looking to recruit locally where possible.
We also know that new jobs will be generated within the hospital in both clinical and non-clinical roles.
In addition, a UK Contractors Group report shows that for every £1 spent in construction on a major scheme, such as this redevelopment, £2.74 is generated in the economy
We do intend to maximise the almost £1 billion of economic benefit locally and across Sussex.

Q: How long do you expect it to take for the work to be carried out?
MK: The first new building will open its doors towards the end of 2019. This building will house both general hospital services, such as elderly care wards, and more specialised services
such as Neurosciences and Intensive Care
This first building will be by far the larger of the two and house the majority of the services benefitting from the redevelopment. It will act as the new main entrance for the hospital and have a spacious reception area.
The second new building will be open towards the end of 2022. In the main it will be a new Cancer Centre although a few other services with connections to cancer care will also be accommodated.
It will have its own entrance on to Eastern Road and accessible gardens on its roof.
The entire redevelopment will be completed by construction of a much needed service yard towards the end of 2023.
Overall redevelopment will take nine years, but patients and staff will begin to really see the difference in 2019 when the first new building opens.

Q: What will the redevelopment mean for people in Brighton and Hove and the region?
MK: The redevelopment will replace outdated buildings with brand new hospital facilities and improve the experience of patients, visitors and staff.
Departments will be easier to find and it will be much simpler to navigate around the site. It will be
possible to move through the hospital without having to climb stairs, tackle steep slopes or go outside.
This will be a huge improvement for our patients, particularly those transferred on beds and trolleys between departments.
On average 65% of the beds in the redevelopment will be in single en suite rooms with the rest in single gender four-bed bays.
This will improve privacy and dignity for patients and help with infection control. The wards moving from the Barry and Jubilee buildings, including those for some of our most
elderly, frail and unwell patients, will have almost five times as much space per bed as they do now. Wards and departments in the redevelopment will be more spacious and less cluttered.
We are already the Major Trauma Centre for the region. Redevelopment will allow us to further improve these facilities and bring all the departments required to support trauma care together.
The expansion of some of our more specialised services including the Cancer and Neuroscience centres and Intensive Care will allow more patients to be treated closer to home.
In some cases patients who currently have to travel out of the county for their  treatment will be able to come to our hospital instead.
In planning this redevelopment we are looking not only at what patients need  today but what they may need in the  years and decades to come.
That will  be the real legacy to the people of  Brighton and Hove and Sussex: buildings  of a quality which match the quality of  the care being provided within them  and a hospital they can be proud of  now and in the future.