Developing the options

Working with our staff and local partner organisations we adopted a three-stage approach to the development and appraisal of the options detailed in the Strategic Outline Case.

The first stage involved the identification of a long list of potential options to redevelop the existing Royal Berkshire Hospital by reviewing approaches considered elsewhere across the NHS.

The second stage was informed by emerging themes from internal and external stakeholder engagement and by discussions with NHS England. We reduced the long list of options by appraising them against a series of weighted investment objectives and a group of critical success factors. These included a commitment to high quality, environmentally friendly facilities that meet the patient needs of tomorrow and stimulate economic growth in the local economy.

The third, and final, stage involved the refinement of the second stage options and further input from internal and external stakeholders including our staff, patients, partner organisations and our communities.

This resulted in four options being identified as main redevelopment possibilities along with two further scenarios – the so-called ‘Do Nothing’ and ‘Do Minimum’ options – which were included as baseline options against which the other options could be compared.

What are the options?

Options I and II are the baseline options against which options III to VI can be tested.

Option I would mean the hospital continuing to operate largely as at present. We would seek to maintain basic upkeep of hospital buildings but only the most high-risk elements of backlog building maintenance would be undertaken. This option would not address the growing future demands of local communities, it would not offer a step change improvement in clinical care nor would it help the NHS to address the integration of health and care that will be needed in the coming years.

Option II would also mean the hospital continuing to operate as at present, but we could address the necessary backlog of building maintenance. This option would not, however, address the growing future demands of local communities nor would it deliver a step change improvement in clinical care. In addition, option II – as with option I – would require a significant continuing annual investment to keep our existing buildings up to standard.

Option III involves the development of a new emergency care block at the heart of the present site. This would include an expanded accident and emergency service, an emergency assessment unit, new operating theatres, an intensive care unit and better provision for surgical inpatients. This option does not fully meet the expected future demand needs of local communities, but it does improve the separation of emergency and planned hospital services and it brings other departments, such as A&E and X-ray, closer together.

Option IV builds on option III. It involves the development of an emergency care block and an elective centre for planned hospital care. It also provides for the development of a new women’s and children’s facility and the potential for a local Medical School. In addition, this option offers an opportunity to grow clinical services, better address growing local needs and to serve a wider catchment area. It does not fully meet our ambitions to integrate health and care services, but it goes some way towards this.

Option V involves the building of a substantially new hospital on the present site of the Royal Berkshire Hospital in Reading. The iconic 1830s building on the London Road would be retained but the rest of the site would be redeveloped in phases. This option is designed to support growing demand pressures and would see a greater focus on the integration of hospital services with other health and care services. It could also involve additional clinical specialist centres, a primary care hub, private patient facilities, a medical school and teaching facilities as well as a research centre.

Option VI involves the full relocation and rebuilding of a new hospital. This would enable us to meet all our key investment criteria and elevate our hospital to be one of the best, most efficient and environmentally friendly medical facilities in the UK. While no location has yet been selected a new build hospital would eliminate all the historic building, service and operational challenges we have faced at our current site for over a century. It would also create many new construction jobs.