New Whipps Cross plans 'grossly underestimate future demand'

Current designs promise flexible wards with between 515 and 600 beds, supported by a “transformed” community health system to reduce demand on the hospital.

In January this year, Dr Rodney P Jones, an expert in hospital demand and capacity, told a multi-council committee that, while the calculations underpinning this design were “impeccable,” there is “always a massive underestimation” when it comes to real-world need.

After the meeting, he emailed the committee to warn again that the models the NHS is relying on to estimate the population’s health needs “grossly underestimate future demand”.

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He added: “Trends in health care demand are vastly complex and follow trajectories (and volatility) which defy current understanding.”

His expert suggestion is that the hospital compile a set of charts tracking trends such as bed occupation, overnight stays and length of stay over the last ten years.

Dr Jones’s comments support concerns voiced by campaigners and councillors about the future hospital’s bed numbers not being in line with a predicted 10% local population growth.

In a written response published in committee papers, the hospital’s redevelopment team say their modelling of demand was independently reviewed by healthcare management consultants Carnall Farrar.

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They added: “Our assumptions for all aspects of the redevelopment – including activity and capacity assumptions – continue to be subject to review and assurance as part of the national business case process.” 

Once the outline business case for the hospital has been submitted to the national hospital programme team, NHS Improvement will conduct an independent review, the new hospital team added.

According to Whipps Cross redevelopment director Alastair Finney, the Treasury has still not approved the budget for the 40 new hospitals promised by 2030.

Only after that, expected in “late spring, early summer,” can a budget for a new Whipps Cross hospital be approved.

A floor plan shows how the administrative area has been redesigned to be converted into a 28-bed ward if needed. Image: Barts Health

Professor of natural science analytics Robert van der Meer, has also voiced concerns about the timing of the design process to committee members.

After the January’s meeting he emailed to say that as the hospital planning progresses there will be less and less opportunity to add more spaces to the hospital, if needed.

He warned: “As the hospital design is further developed and detailed, it is likely that the range of flexibility (e.g. in relation to the range of bed numbers that could be provided) will be irreversibly reduced.”

In response, the hospital redevelopment team maintain that future capacity will not need to go above current needs, between 570 and 580 beds.

They say this is because NHS services in East London will soon “integrate”, with a £32million budget increase to “transform health and care services” in the community.

With improvements to community care, the NHS predicts a 19-20% reduction in urgent hospital admissions and up to 22% fewer planned attendances. The ‘do nothing’ option would see a need for an average of 643 beds by 2028/29.

In their written response to Dr van der Meer’s concerns, the hospital redevelopment team said: “We continue to work with our architect-led design team to make sure we have flexibility in our planning and our design.

“If necessary, with a few alterations, we could physically accommodate 600 beds – against a current bed base of 570-580. “

Draft designs shown to the Local Democracy Reporting Service have added more “flexibility” by making a floor reserved for administrative staff adaptable into a 28-bed ward.

Barts Health, the trust that runs Whipps Cross, have been approached for comment on where the administration office would be temporarily relocated to, but have not responded at the time of publication.

Despite health bosses’ confidence that transforming East London community healthcare will reduce pressure on hospitals, they also recognised that earmarking space for further expansion on the site is “critically important”.

The redevelopment team wrote: “As the strategy for the new hospital has developed, we concluded that it was critically important to retain some space on the site, adjacent to or close to the new hospital, to allow for expansion of the hospital in the future should that prove necessary”.

As the majority of the Whipps Cross hospital site is due to be developed into residential space, the only possible expansion spaces identified are a second multi-storey car park and the service yard behind the hospital.