Frequently Asked Questions
Q. How has the new hospital design been developed?
A. The specification for the new hospital was issued in summer 2014. It reflected both some important design principles about the look and feel of the building for patients and staff, our commitments about regeneration for the local area, and some requirements about clinical functionality. Design has developed through many hundreds of meetings with clinical staff in the last nine months. That refined design has been tested against our approval criteria, and it has also been independently tested for functionality by experts in the field who had not been involved in developing it.
Q. How does the new hospital design differ from City and Sandwell today?
A. It differs a lot. And of course those two hospitals differ from each other. We have a large number of wards in Midland Met. Overall half the beds are in single bedrooms. Others are in four bedded bays. This reflects patient feedback. The new build has more theatres and key pieces of diagnostic equipment than we have today. Vitally, the departments of the hospital are next to departments with similar or related functions. That adjacency is important to both the speed of care we can provide, and the teamwork we can offer. For instance, imaging is next to A&E. Theatres and intensive care are near to each other. For staff we have meeting rooms and training spaces across the building. It is a hospital designed to be both welcoming and secure. It is built to use light and to create a patient-shaped environment, but also be a decent place to work. That is why we have focused on spaces to meet, to eat, to spend time learning. On the fifth floor we have the main amenity space, which will support visitors who come to our wards (which are in floors above that level). Those coming to the site by car may use the underground car park and take a lift direct to that space. There is a main pedestrian entrance on the ground floor where visitors will be welcome and shown how to get to where they are trying to go. Entrances for A&E, for general arrivals, for deliveries, and for children, are separate.
Q. What about travel and travel times?
A. We have changed visiting times to our wards to make it easier to visit friends and relatives. That is important because it means people are less dependent on traffic and on public transport in peak times. The Trust is working alongside bus companies and the current expectation is that four to five main routes will come onto the site, with a turning circle inside our grounds. There is also a visitors’ underground car park. Pedestrian and cycle entrances are marked across the site. The Trust is working with the Local Authority Highways Teams to make sure that traffic management works for both the NHS and our patients, and for local residents, who are our neighbours. It is important to understand where services will be, and how many common NHS services will remain at City and Sandwell, whilst inpatient emergency care moves to Midland Met.
Q. The new hospital will be built under PFI – should I be worried?
A. No. The new hospital will be built under Private Finance 2. Crucially that means that key services like portering and cleaning will remain within the NHS. The financial model for the new build has been assessed by the Trust, the Treasury and the Department of Health, as well as other NHS bodies. It is affordable, and the cost proportionate to the turnover of the hospital Trust is far lower than some PFI schemes from the early part of the century. Of course, new facilities cost. The existing hospital facilities are over a hundred years old in some cases, and the cost of bringing them consistently to basic statutory standards is over £100m.
Q. The Trust is cutting staff to pay for the new hospital – is that the right decision?
A. The Trust is, categorically, not cutting staff to pay for the new hospital. The Trust is reducing its pay costs, through cutting agency and temporary staffing, and through redeploying staff from some roles into new roles we think we will need in the years ahead. This is difficult and distressing for those involved, and we proceed with care and caution. The new hospital helps us to match our costs to our income, because it reduces duplication between our emergency sites.
Q. Smethwick is further from where I live – why is this a good idea?
A. Emergency care needs expert teams. Travel time matters to care. But time from being ill to being treated matters most. For example, for stroke, services were centralised at Sandwell for people from across Sandwell and the west of Birmingham. For some people their journey to the hospital took longer. But now they can get key treatment and expert assessment once they get to the hospital much faster. And we know that that saves lives. We have also applied the same idea to interventional cardiology, which we plan to centralise at City Hospital. By having one site serving half a million people we can create the specialist teams, seven days a week that will improve outcomes.
It is really important to remember that most care does not need an emergency hospital or a bed. Primary care, including pharmacies, provide nine out of 10 contacts with patients. Now and when Midland Met opens, outpatient care will happen in the Birmingham Treatment Centre, Neptune in Tipton, at Rowley Regis, and in health centres across Birmingham. Planned surgery and diagnostic services will happen in many places, with only the most complex surgery being centralised in the new hospital.
Q. What will be left at Sandwell?
A. Lots of services, and some new ones too. An Urgent Care Centre open seven days a week seeing over 35,000 people with minor and intermediate emergency needs. A major outpatient centre able to offer adult and paediatric consultation in key specialties. A chemotherapy unit for cancer care. And short stay surgery. Our current wards will be refurbished to offer intermediate, longer stay care for people who do not need a busy acute hospital bed. We are exploring whether we can base a GP practice on the site. And Sandwell will be the Trust’s main base, with key ancillary and support services located there. It will be our research and educational hub, and the home for many consultants as well as the Trust’s leadership team.
Q. What will be left at City on Dudley Road?
A. The Birmingham Treatment Centre houses outpatient and short stay surgery. It has a chemotherapy unit. Major imaging services will be based there, as well as key diagnostic functions for common services like respiratory illnesses. The Birmingham and Midland Eye Centre (BMEC) will stay, providing not just specialist care but regional expertise for complex conditions. And in 2014 the Trust invested over £1 million in the intermediate care unit within the Sheldon Block. These three facilities will be the heart of the new services on the site, with other land and buildings sold to help regenerate the local community in line with the plans for the area, consulted upon by Birmingham City Council.
Q. How will urgent care work?
A. A purpose built A&E, with facilities to see other professionals like GPs, will be based at Grove Lane in Midland Met. An urgent care centre will be housed within the current A&E at Sandwell Hospital. The CCG are currently discussing how GP services and out of hours care will develop in the next five years. The Trust recognises the strong preference of local residents to maintain or enhance facilities like the Primary Care Assessment and Treatment Centre at Rowley Regis, but also to make sure that services provided by other organisations are integrated and coordinated, so that one NHS is on offer to local people.
Q. Will Midland Met be big enough?
A. Yes. When we open we will have the facilities we need. Bed use over the last five years has reduced and so the change in beds in hospital is modest. There is a shift from acute beds to intermediate care beds. That is why we have opened two new wards at Rowley Regis in the last two years, as well as investing in Sheldon Block at City Hospital. But in 2030, unless we change the underlying demand for care in our system, by tackling ill health, deprivation and exclusion, the new hospital and the wider system of care in our communities, will struggle to meet need. Prevention and public health must form a big part of all that we do, which is why the Trust has created a public health plan, overseen by the Trust’s Chairman, and why the local CCG has created its own public health team to make sure that long term needs are the heart of their decision making.
Q. Why do we need a new hospital at all?
A. Because we struggle, and in future will struggle more, to provide seven day a week expert team based care for the sickest patients, when we are stretched across two sites. Many years ago the routine size for a major hospital covered a population of 250,000. So in our area we needed two hospitals. Medicine and our thinking about best care has changed. And a minimum of half a million people is now the basis for planning. Midland Met will bring better facilities, but it is not a project about nicer buildings. It is about improving outcomes by providing better care.
Q. Are out of hospital services in place for the new smaller hospital?
A. Firstly, Midland Met is not smaller than our current hospitals. It is sized to cope with expected needs in this decade. Some of our beds, for intermediate care, will be based in Sheldon, Rowley Regis and Sandwell. Secondly, many out of hospital facilities are now in place, which were not present in 2005. Care is being provided through new GP facilities, but also through places like the Portway Leisure Centre. There are a small number of important parts of the area where we still have work to do to make sure facilities are in place, especially in Wednesbury. The Trust has completed the redevelopment of Rowley Regis.
Q. If I want to know more about the new hospital what can I do?
A. Contact the Trust, Sandwell and West Birmingham Hospitals, through our website at swbh.nhs.uk. Ask us a question on twitter @SWBHnhs or email firstname.lastname@example.org.
Q. The new hospital is in Sandwell. How will that work for people who live in Birmingham?
A. The new hospital has an entrance from Dudley Road, but is indeed in Sandwell. Birmingham City Council are a key member of the Right Care, Right Here partnership and are strong supporters of the changes coming with Midland Met. It will be important that the two Local Authorities and the two providers of community health services (SWBH and Birmingham Community Services) work together in the next three years, and make sure that their approaches are the same. Similarly, mental health liaison care is delivered differently in the two Local Authority areas, and the Trust continues to work with both to align services. The Midland Met must mean one service for anyone using it regardless of their home postcode.