FINAL approval was granted this week for the ambitious and long-awaited £485 million redevelopment of the Royal Sussex County Hospital in Brighton. Health reporter Siobhan Ryan explains what it means to you and the care you receive.

Q: Why does the Royal Sussex County Hospital need to be rebuilt?

A: The buildings at the front of the hospital, the Barry and Jubilee buildings, were built almost 200 years ago. The wards are cramped and inadequately designed for 21st century healthcare. The layout also makes it difficult to control infection and provide safe and dignified care. The Barry Building, which was completed in 1828, came into service 20 years before Florence Nightingale started nursing and needs replacing. The redevelopment will also support the hospital’s role as a major trauma centre for Sussex and the south east.

Q: Who is paying for the rebuild?

A: The £485 million cost is being publicly funded through Treasury funds.

Q: Why is this such a significant turning point for the hospital?

A: The money allocated is the biggest publicly funded NHS development in recent years and will transform the Royal Sussex, putting it on the map as a regional centre for the south east as well providing services for patients across Sussex.

Q: What will be happening?

A: The old Barry and Jubilee buildings will be pulled down and replaced with two state of the art buildings. The cancer centre will be expanded, an underground car park will be created and a helicopter pad installed.

Q: How long has this redevelopment been planned for?

A: Brighton and Sussex University Hospitals NHS Trust first started drawing up definitive plans in 2008 and in May 2009 The Argus revealed the first images of what the new hospital would look like.

Over the following two years the plans were altered and adapted 27 times after behind the scenes discussions with council planners, councillors, residents, heritage and conservation groups, environmentalists and the trust’s own staff. But it was not until September 2011 that a planning application for the redevelopment was submitted to Brighton and Hove City Council. Permission was granted in January 2012. Since then the trust has been working with local, regional, national and Government authorities to make sure it met all the requirements for the development. The Treasury approved funding the scheme in principle about a year-and-a-half ago and gave the final approval this week.

Q: The rebuild will take place in the centre of a built-up residential area. Why can’t the hospital be relocated somewhere else instead?

A: The Royal Sussex has been at its current site for almost 200 years and the residential area has built up around it. Moving to a new site and building a new hospital from scratch would be more than double the cost involved in redeveloping the existing site. Following a review of hospital services in 1991, a decision was taken by the then Government to keep the hospital where it is and develop services instead of moving to a new location.

Q: Why has it taken until now to replace the Barry and Jubilee buildings?

A: Following the 1991 decision, the trust had to look at all areas of the hospital grounds and prioritise what needed to be done, including making sure the Thomas Kemp Tower was fit for purpose. It initially looked towards the back of the site, where there were fewer patient services and provided room for the new Millennium Wing and the brand new Royal Alexandra Children’s Hospital, which opened in 2007. Once this was complete, attention turned to the main buildings at the front.

Q: How long will the redevelopment take?

Work will start in earnest in January and will be carried out in three stages. Stage one will involve pulling down and replacing the main Barry building and will include inpatient and outpatient services, expanded services for neurosciences and bring together facilities for neurology, stroke and the emergency department’s major trauma centre. This will be completed at the end of 2019.

Stage two will see an expanded cancer care unit and new facilities for Brighton and Sussex Medical School and will finish in 2023.

The final, stage three, a new service yard for the hospital, will complete the programme in 2024.

Q: How will the construction work affect patients and visitors?

A: All services will remain open during the construction. Most of the south east quarter of the hospital, with the exception of the Cancer Centre, will be closed off for construction of stage one. This will channel more people through the main entrance of the hospital. Access to the back half of the site will be via this route and those going to the Thomas Kemp Tower from here will have a longer journey.

Physiotherapy outpatients, rheumatology outpatients, nuclear medicine, the HIV ward, the clinical infection service ward and the cancer ward will be in new locations. The hospital signs will reflect this. Some other journeys to and from existing departments will be longer because the most direct routes will be unavailable.

Q: What changes will patients experience once the redevelopment is complete?

A: There will be new modern buildings that provide plenty of space and improved facilities.

Neuroscience facilities will be expanded to provide 72 bed and the number of intensive care beds at the hospital will increase from 31 to 55.

The Sussex Cancer Centre will be expanded to provide 45 inpatient beds, 44 chemotherapy treatment couches and six radiotherapy bunkers.

The number of beds at the hospital will increase by 100 and there will be four new operating theatres.

The major trauma centre, which deals with critically injured patients, will have new facilities, including a helipad at the top of the Thomas Kemp tower.

The elderly care and general medicine wards will have more than four times as much space per bed than they currently do.

There will be a combined stroke and acquired brain injury service, offering better care and much improved rehabilitation facilities for patients. The service will have a dedicated rehabilitation courtyard/garden area.

Q: Will the redevelopment help with the backlog of patients often left waiting in A&E?

A: The redevelopment will establish an emergency floor taking up part of the stage one building, the Thomas Kemp Tower and the existing emergency department. This will give the department more space. Extra bed capacity will also help ease pressure.

Q: How much disruption and noise will there be?

A: There is always a certain level of disturbance associated with major construction works. For inpatients this will mainly consist of noise from the site. The hospital will be doing partial off site construction to minimise the disturbance. If it becomes necessary acoustic screening materials will be used. Patients may also be transferred to different wards if there are thought to be risk from the construction activities. This will only affect a small number of patients. On site the construction team will use dust suppression and will wash down vehicles before they leave the site to minimise dust and dirt interfering with the rest of the hospital and its neighbours.

Q: Why is a helipad needed?

A: Allowing the air ambulance to land at the hospital itself will mean shorter transfer times for patients. The helipad will be located on the highest point of the hospital to minimise the noise for patients, staff and local residents. The hospital is expecting about 360 major trauma cases a year, of which one or two a week will need the air ambulance.

The helipad is also useful if seriously ill patients who need rapid transfers between hospitals.

Q: Will there be improved car parking facilities on site?

Yes. The number of spaces will rise by 297 from just over 500 to more than 800. There will also be an underground car park with lifts that open directly into the reception areas of the new two new buildings. Spaces will be allocated for patients, visitors and staff and there will be disabled facilities and places for patients needing to come in regularly for treatment like dialysis.

Q: How many jobs will be created?

At its peak approximately 450 people will be employed on site during the construction phase. Extra staff will also be needed at the hospital once the work is finished and these numbers are still being finalised but the current estimate is the equivalent of about 98 full-time jobs. Some of these will be part time positions.

Q: Will the re-build help reduce cases of MRSA, c-diff and other hospital acquired infections?

A: The new development will make vital improvements to the hospital infrastructure which will mean efforts to continue preventing and controlling infection and providing safe and dignified care are no longer be hindered by sub-standard buildings.