Midland Metropolitan Hospital Final Business Case January 2016 Sandwell and West Birmingham Hospitals NHS Trust Midland Metropolitan Hospital Project
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Midland Metropolitan Hospital Final Business Case January 2016 Sandwell and West Birmingham Hospitals NHS Trust Midland Metropolitan Hospital Project Final Business Case January 2016 Sandwell and West Birmingham Hospitals NHS Trust Midland Metropolitan Hospital Project Final Business Case DOCUMENT CONTROL SHEET VERSION DATE COMMENTS 0.1 8 Jan 2016 Initial draft for CEO comment 1.0 15 Jan 2016 Final version for publication reflecting CEO comments i Sandwell and West Birmingham Hospitals NHS Trust Midland Metropolitan Hospital Project Final Business Case TABLE OF CONTENTS 1 Executive Summary........................................................................................17 1.1 Introduction ......................................................................................................................17 1.2 The Strategic Context......................................................................................................18 1.3 The Case for Change.......................................................................................................23 1.4 The Future Service Requirement ...................................................................................24 1.5 Project Objectives............................................................................................................25 1.6 Economic Case ................................................................................................................26 1.7 The Procurement Route ..................................................................................................28 1.8 Project Scope ...................................................................................................................30 1.9 Procurement Strategy .....................................................................................................30 1.10 The Bidder Solution.........................................................................................................33 1.11 Affordability......................................................................................................................37 1.12 Management Case ...........................................................................................................40 1.13 Risk Management ............................................................................................................42 1.14 Sustainability....................................................................................................................43 1.15 Workforce .........................................................................................................................43 1.16 Consultation, Stakeholder Involvement and Approvals ..............................................46 1.17 Conclusion .......................................................................................................................47 1.18 Addendum post Financial Close ....................................................................................47 2 Introduction.....................................................................................................48 2.1 Purpose of the Final Business Case (FBC)...................................................................48 2.2 Approach to the FBC .......................................................................................................48 2.3 Structure of the FBC........................................................................................................48 ii Sandwell and West Birmingham Hospitals NHS Trust Midland Metropolitan Hospital Project Final Business Case 2.4 Previous Business Case Approvals and Conditions of Approval..............................49 2.5 Key changes to the scheme since OBC approval ........................................................53 2.6 Conclusion .......................................................................................................................57 2.7 Progress since the OBC..................................................................................................57 2.8 Business Case Approvals...............................................................................................57 2.9 Planning Approval ...........................................................................................................57 2.10 Conclusion .......................................................................................................................58 3 Strategic Context ............................................................................................59 3.1 Introduction ......................................................................................................................59 3.2 National Context and Government Policy.....................................................................59 3.3 The NHS Five Year Forward View ..................................................................................61 3.4 Financial Environment ....................................................................................................61 3.5 Local Context and Health Strategy ................................................................................61 3.6 The Local Health and Social Care Economy.................................................................64 3.7 Right Care Right Here (RCRH) Programme ..................................................................68 3.8 The Trust Context ............................................................................................................70 3.9 Conclusion and alignment with national and local agenda ........................................84 4 Case for Change ............................................................................................. 86 4.1 Introduction ......................................................................................................................86 4.2 Poor Health in the Area the Trust Serves......................................................................86 4.3 Major Changes in Primary and Community Care .........................................................87 4.4 Sustaining Top Quality Acute Services.........................................................................88 4.5 Old and Unsuitable Hospital Buildings .........................................................................90 4.6 Care Closer to Home and Patient Choice......................................................................97 4.7 The Conclusion of the Case for Change .......................................................................98 iii Sandwell and West Birmingham Hospitals NHS Trust Midland Metropolitan Hospital Project Final Business Case 5 Future Service Requirements ........................................................................99 5.1 Introduction ......................................................................................................................99 5.2 Right Care Right Here (RCRH) Model of Care...............................................................99 5.3 Trust Service Configuration ...........................................................................................99 5.4 Activity Projections .......................................................................................................102 5.5 Performance assumptions............................................................................................106 5.6 Capacity requirement ....................................................................................................107 5.7 Expansion Strategy .......................................................................................................112 5.8 Summary of Requirements of MMH .............................................................................115 5.9 New Hospital Clinical Requirements ...........................................................................116 5.10 The MMH Service Solution............................................................................................117 5.11 Conclusion .....................................................................................................................120 6 Background to the Option Appraisal ..........................................................121 6.1 Introduction ....................................................................................................................121 6.2 Background: Reconfirmation of Option 4 ...................................................................121 6.3 Identification of the Shortlist of Options .....................................................................122 6.4 Description of the Shortlisted Options........................................................................122 6.5 Conclusion .....................................................................................................................124 7 Benefits Appraisal ........................................................................................125 7.1 Introduction ....................................................................................................................125 7.2 Methodology...................................................................................................................125 7.3 Benefit Criteria ...............................................................................................................125 7.4 Non-Financial Benefit Scores.......................................................................................125