PEH Phase 2 Walk-through
Benefits of modernising the hospital
- Improved clinical standards and patient safety
- The ability to flex capacity when additional support is needed
- Improve the clinical environment with access to outdoor spaces to support recovery
- Meet current and future medical and surgical demand
- Reducing waiting lists
- Staff recruitment and retention
- Improve infection prevention and control with new single room design
- Reduce the stress and anxiety of patients and relatives
- Promote earlier recovery and the overall experience both before and after discharge
- Increase private revenue and encourage health tourism
- Meet future pandemic situations without having to construct new facilities
We are modernising the Princess Elizabeth Hospital into a future-proofed, fit-for-purpose facility for patients and staff.
The need to deliver a series of hospital upgrades was unanimously supported by the States of Deliberation in March 2019 and subsequently prioritised within the Government Work Plan in 2021. It is an essential part of the ongoing strategy to transform the provision of health and social care services so that it can respond to the Bailiwick's ageing population and increasing demand for services.
The existing Hospital has been shown to provide a poor experience for patients and staff. The current operating model for the PEH imposes a series of constraints on service delivery due to inadequate flexible space. These constraints have the potential to significantly limit the role the services can play in transformation. Without change, this will result in the services becoming increasingly ineffective and a source of public and staff dissatisfaction.
In its current form and size, the Hospital is not able to support parallel work to transform the use of technology and community-based services within the health and care sector. The lack of a flexible structure means that it cannot meet the changing needs of modern health care, either now or in the future. Examples of this, which are resolved by Phase 2 - see below.
We now have an overall plan to complete the proposed upgrades across two phases, with careful sequencing of work to ensure minimal disruption to hospital services throughout - we must maintain a fully-functional hospital while we upgrade it. Phase 1 has been fully approved. Phase 2 will be subject to separate business case approvals.
Rihoy & Son has been appointed to construct Phase 1 of the planned works following a robust tendering process conducted with the local construction industry.
Works on site started in March 2022 and due to be completed in Summer 2024.
Scheduled to be completed over two years, the works will deliver a new purpose-built Critical Care Unit (CCU) with increased capacity from 7 to 12 beds to manage demand and support additional surgery, and a new Post Anaesthesia Recovery Unit (Theatre Recovery) with 10 beds that can be swiftly converted to provide additional critical care beds (to support for example any future pandemic demands or other emergency situations). It will involve the refurbishment and extension of the old Ozanne Ward, extending the footprint of the building.
The new CCU will feature modern single rooms with natural light and a new courtyard facility which is recognised to enhance patient experience and recovery. New staff and relative's facilities will be put in place as part of the Phase 1 works.
Watch the video below for a virtual walk-though of the new CCU:
The new CCU's single room is depicted in the architects' image below, noting that the final plans may be subject to some amendments in terms of finish.
Phase 1 progress photos
(Approved in October 2023)
Phase 2 is due to start in 2025 and will take up to four years to complete. It will involve an extension being built out from the current main entrance. Alongside this new build will be significant refurbishment work of existing internal spaces to update facilities and rearrange and improve the overall layout. To that end, a focal part of Phase 2 will be a new main entrance space spanning all three levels, making it a lot easier for people to visualise the different parts of the hospital and find their way around.
Please use the drop downs below to find out more about what is proposed in Phase 2.
Women's and Children's Wards
- The existing Women's and Children's Department, located on level 3 of the Hospital, is 1,558m2 compared with the proposed new facility of 2,169m2. This increased capacity will offer modern units suitable for all ages and conditions to improve experience and reduce stress for service users. The current facility does not deliver an appropriate clinical service for paediatrics, especially adolescents, or a maternity facility that offers privacy, dignity of confidentiality. These departments are also on level 3, which is above theatres on level 2 and reliant on a lift between floors. This has been identified as the highest risk for HSC and, in the event of an emergency delivery, could delay getting to theatre with potentially fatal consequences to both mother and baby, resulting in extensive litigation costs. The department currently undertakes drills and contingency procedures, but the new hospital design will remove this risk.
- Plans for Phase 2 include:
- A new Children's Ward in single rooms suitable for all ages including adolescents which includes an outpatients / assessment room and appropriate facilities for relatives.
- A new Paediatric Unit with eight single en suite bedrooms suitable for all ages, one isolation room suitable for pandemic support and an outpatient assessment unit at the front end of the ward. All rooms will have overnight accommodation for parents.
- A new Maternity Unit which includes a Pregnancy Assessment Unit, Delivery Rooms, Ante-Partum and Post-Partum Bedrooms (all single en-suite rooms with overnight accommodation for partners), a Still and Newborn Deaths Suite and other facilities for relatives.
- A new Maternity Unit of 11 single rooms comprising of four LDRP (Labour, Delivery, Recovery, and Postpartum) delivery suites; one with a birthing pool, four high dependency rooms, two low dependency rooms and one isolation room suitable for pandemic support. There will also be a modern bereavement suite and an outpatient assessment unit at the front end of the ward. All bedrooms have overnight accommodation for partners
- A new Neonatal Unit including facilities for Transitional Care and Rooming-in.
- A new Newborn Intensive Care Unit (NICU) capable of accommodating three babies.
- Phase 2 plans include four additional new operating theatres including two specified with Ultra Clean Ventilation standards and one dedicated to obstetrics alongside the refurbishment of the current theatres also creating two endoscopy units. The new theatres will have the ability to support robotic surgery in the future.
- An expanded Theatre Suite consisting of four new Theatres and four refurbished Theatres will offer additional capacity for orthopaedic surgery and endoscopy procedures and a dedicated obstetric theatre situated at the end of the Maternity Ward. The new unit will also be able to support emergency cases during the day to reduce on-call costs and pressure.
Admissions and Discharge Unit
- Phase 2 plans include a new Admission / Discharge Unit which will accommodate all the contract day cases and same day admissions as well as provide discharge facilities to support the surgical wards. This unit will also be able to support any future respiratory pandemic.
- A new Admission / Discharge Unit will replace the current Day Patient Unit consisting of 25 bays located adjacent to the Theatre Suite for inpatient and day cases.
- The existing Private Ward is 679m2, whereas the proposed new facility is 1,438m2. This will achieve the bed numbers and facilities required for future income generation and strategy. The current poor facilities and size of the unit do not meet service user expectations or staffing guidance and are consequently under-utilised by private patients. Service users refuse to attend this poor facility and opt instead to go to UK private hospitals resulting in lost private income for HSC. The current facilities are not suitable to accommodate private day patient service user requirements and do not have the flexibility or facility to support Health Tourism.
- Phase 2 plans include a new Private Ward to accommodate day case patients, consultation facilities and enhanced patient and relative amenities including a production kitchen and therapy room.
- The plans are for a new Private Ward comprising of 23 ensuite single rooms, some of which will have balconies suitable for inpatient and day case treatments. There will also be a gym on the ward to assist with recovery and a lounge for relatives that could be used by private patients on the Maternity or Paediatric Wards.
- The current Breast Clinic is a free-standing unit within the carpark of the Hospital. This presents a clinical risk in an emergency as well as hindering patient pathways especially for preoperative biopsies and breast cancer patients due to the lack of adjacency with the Oncology Unit.
- The existing Emergency Department is located on Level 2 of 451m2 and is compared with the proposed new facility of 977m2. It has only one entrance for both the walking wounded and ambulance admissions. This also serves as the entrance for Radiology and the Fracture Clinic meaning there is no privacy and dignity for arriving trauma patients and no safeguarding for bystanders.
- The treatment bays lack privacy, and there is a lack of capacity to meet current and future demands, including new ways of working such as "See and Treat" and "Same Day Emergency Care". It does not provide a safe environment for at risk service users, or the staff treating them. The current department has no space for any future development such as a Clinical Decisions Unit to prevent unnecessary ward admissions.
- Phase 2 plans extend the Emergency Department which creates a dedicated Ambulance Entrance to improve patient dignity and privacy.
- An enhanced Emergency Department consisting of 16 mixed-sized bays to support triage into minor, intermediate or major conditions and separate ambulance and walk-in access. There will be increased resuscitation capacity and a CT scanner within the unit. The new department also contains a four-bedded overnight decision unit to reduce unnecessary admissions.
- The current Fracture Clinic has a small, crowded plaster room and the layout hinders patient flow, contributing to increased waiting times during clinic sessions, which often bring complaints from service users.
- A refurbished Fracture Clinic will allow it to concentrate more on musculo-skeletal issues.
- Plans provide an enhanced Fracture Clinic that will remain in its current location adjacent to the Emergency Department and Radiology but delivers two plaster rooms to support service delivery.
- The existing Orthopaedic Ward is 716m2 compared with the proposed new facility of 1,205m2. The new facility will deliver a service that greatly reduces the risk of post operative infection. It is located within the oldest part of the Hospital and has a section that is still in a Nightingale Ward layout that has been recognised for years as not being suitable for nursing patients. It does not provide separate areas for trauma and elective orthopaedic surgery to prevent transfer of post operative infection, which delay recovery and discharge when they occur. The lack of capacity in the current unit to meet the current and future demand for orthopaedic surgery results in patients being sent off-island and longer waiting lists, which have grown substantially over the last two years.
- Plans include a new 21 bed Orthopaedic Unit with outpatient facilities and a therapy gym. There will be a distinct segregation of elective (clean) and trauma (dirty) care pathways to minimise hospital acquired infections.
- The unit will also contain a dedicated physio gym to enhance recovery and two clinic rooms that can be converted to bedrooms for increased capacity.
- The existing main entrance to the Hospital is dated and is little more than a Porters' Base in a corridor compared with the proposed new facility of 492m2. The current main entrance does not offer any retail facility for staff or service users, and it does not offer a link to other floors of the Hospital, making wayfinding challenging for service users. There is limited space for cars dropping off or parking in this area, meaning that accessing the hospital can be challenging for some service users and staff.
- The proposed new Main Entrance will offer retail facilities and link all three floors of the Hospital together. This will include a large outpatient provision to be able to co-locate all clinics (except Breast and Fracture) held within the PEH into a modern, flexible facility.
- The Hospital currently has four poor quality rooms in which relatives of service users and staff (such as paediatricians/obstetricians) can stay overnight. This offers a poor experience for relatives who are staying in the Hospital to be with very ill or dying patients and hinders staff retention by inconveniencing staff and not providing facilities that they would expect in a modern healthcare environment.
- A new suite of overnight bedrooms for on-call staff and relatives to improve clinical response times out-of-hours, enhance recruitment and retention of staff and provide a more holistic care to families at difficult times.
Sterile Services Department
- The current Sterile Services Department supports the current Operating Theatres demands for surgical instrumentation. There is a separate sterilisation area within the Day Patient Unit which cleans endoscopes. The relocation of the endoscopy room therefore requires changes to the Sterile Services Department to provide one central decontamination unit. Much of the equipment plant within both the current units is at the end of its life, meaning that a complicated phased plant replacement programme would be needed under Business-as-Usual which would not be needed if Phase 2 plans are approved.
- In addition to these clinical issues there are also numerous examples of the engineering plant being at or beyond its life expectancy, decayed fabric not providing weathertight buildings and quantities of asbestos within some parts of the existing estate.
New Outpatients Unit
- Adjacent to the new main entrance, this new unit will provide 'hot desk' clinical space, enabling the centralisation of all out-patient clinics.
- Departments throughout the hospital will operate services from this space.
- This new Outpatients Unit will bring together the majority of outpatient clinics across the PEH (except for cancer services and fracture clinic) into a modern facility that supports a 'one stop shop' and put the patient at the centre of the service.
Clinical Decisions Unit
- A new Clinical Decisions Unit is planned which will support the quicker diagnosis and discharge of more complex patients without blocking inpatient beds.
- The new department also contains a four-bedded overnight decision unit to reduce unnecessary admissions.