Outline Business Case
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OUR HOSPITAL PROJECT Outline Business Case 14 July 2021 CONTENTS CONTENTS ...................................................................................................................................................2 1. INTRODUCTION ...................................................................................................................................9 The Our Hospital Project ................................................................................................................9 The Our Hospital SOC (November 2020) ......................................................................................9 Pre-OBC Approvals ........................................................................................................................9 The Our Hospital OBC ...................................................................................................................9 The Scope of the Our Hospital Project OBC .............................................................................. 10 Green Book (2020) ...................................................................................................................... 11 OBC independent review ............................................................................................................ 11 Purpose of the OBC .................................................................................................................... 11 Full Business Case ..................................................................................................................... 11 2. EXECUTIVE SUMMARY .................................................................................................................... 12 The Strategic Case ..................................................................................................................... 12 Introduction ....................................................................................................................... 12 Work re-confirmed at the OBC Stage ................................................................................. 12 2.1.2.1 Our Hospital Project investment objectives ........................................................................ 12 2.1.2.2 Benefits ............................................................................................................................... 13 Constraints .......................................................................................................................... 14 Dependencies ..................................................................................................................... 15 The Economic Case .................................................................................................................... 15 Purpose of the Economic Case........................................................................................... 15 Work undertaken at the SOC stage and updates to the Case in this OBC ........................ 15 Critical Success Factor and Shortlisted Options ................................................................. 16 Site Evaluation .................................................................................................................... 16 Functional Brief ................................................................................................................... 17 Baseline Comparator Capital Costs .................................................................................... 17 New Build Capital Costs ...................................................................................................... 18 Benefits Appraisal ............................................................................................................... 19 2.2.8.1 Approach taken for qualitative benefits ............................................................................... 19 2.2.8.2 Qualitative Benefit Scoring .................................................................................................. 20 2.2.8.3 Future quantification of benefits .......................................................................................... 20 2.2.8.4 Benefits appraisal conclusion ............................................................................................. 20 2.2.8.5 Risk appraisal ...................................................................................................................... 21 NPC Analysis ...................................................................................................................... 21 Conclusion........................................................................................................................... 21 The Financial Case ..................................................................................................................... 22 Introduction.......................................................................................................................... 22 2 Our Hospital Project financial impact .................................................................................. 22 Affordability.......................................................................................................................... 24 The Commercial Case ................................................................................................................ 24 Introduction.......................................................................................................................... 24 Form of contract .................................................................................................................. 25 Current Status of DDP Contract .......................................................................................... 25 DDP Supply Chain Procurement Strategy (Stage 2 Procurement) .................................... 25 Land transactions associated with the project .................................................................... 25 Build Scheme information ................................................................................................... 25 The Management Case............................................................................................................... 25 Introduction.......................................................................................................................... 26 3. THE STRATEGIC CASE .................................................................................................................... 27 Introduction ................................................................................................................................. 27 Purpose of the Strategic Case ............................................................................................ 27 Work undertaken at the SOC Stage and updates to the Case in this OBC ........................ 27 System and Organisational Overview ......................................................................................... 27 Overview of the Island’s Healthcare System ...................................................................... 27 Population and Demand ...................................................................................................... 30 Structure of HCS ................................................................................................................. 31 Complex care – off island services ..................................................................................... 33 Digital transformation .......................................................................................................... 34 Learning and Development ................................................................................................. 36 Ambulance Services ........................................................................................................... 36 Policy review ....................................................................................................................... 37 Health and care system transformation .............................................................................. 39 Proposed future model of care ............................................................................................ 40 Existing Hospital Estate Overview .............................................................................................. 41 History of the site ................................................................................................................ 41 The Case for Change .................................................................................................................. 43 The current condition of the hospital estate ........................................................................ 44 Mental health services ........................................................................................................ 46 Other healthcare facilities in Jersey .................................................................................... 47 Poor functional suitability and configuration of the site ....................................................... 47 Poor resiliency ..................................................................................................................... 49 The Case for Change: Conclusion .............................................................................................. 49 Our Hospital Project investment objectives ...............................................................................