Agenda item - Plans for Capital Development of Royal Sussex County Hospital Emergency Department

Report of the Chair of the Health Overview & Scrutiny Committee (to follow).

37.1    This item was presented by Mark Edwards, Chief of Service, Medical Division, and by Dr George Findlay, CEO of University Hospitals Sussex NHS Foundation Trust (UHSx).

37.2    Mr Edwards told members that the Royal Sussex County Hospital (RSCH) Emergency Department (ED) was outdated, with the current configuration not fully meeting service needs. £62 million of capital funding has been allocated to make improvements to ED; some of this work has already been completed, some is in progress and some will start soon. The works will modernise the ED environment, increase ED capacity and substantially increase capacity in the Urgent Treatment Centre (UTC), improve clinical adjacencies of services and improve the environment for staff and patients. Works will be staged as the RSCH needs to continue to provide a full range of services on site at all times during the build.

37.3    A new Surgical Assessment Unit has already been created, and a Medical Assessment Unit is due to open in October 2025. Works on Resuscitation, Majors, and Patient Assessment & Triage (PAT) areas will all begin soon.

37.4    Cllr Cattell asked why ED wasn’t included in the 3Ts development of the RSCH site. Dr Findlay responded that ED was never part of the 3Ts business case. However, the ED improvements now being delivered are only possible because of additional space freed in the hospital by the opening of the Louisa Martindale Building.

37.5    Cllr O’Quinn asked whether the ED changes would improve the environment for people with mental health problems. Mr Edwards responded that the key to better supporting people with mental health issues was for the health and care system to work more effectively to minimise A&E attendance in the first place – for example via better community crisis support and more robust community mental health pathways. The Trust would be happy to come to a later meeting of the HOSC to form part of a system presentation on the work ongoing to reduce the number of people presenting at A&E with mental health problems.

37.6    Cllr O’Quinn asked whether the changes would bring additional scanner capacity. Mr Edwards replied that there would be an increase in CT scanners.

37.7    Cllr Hill asked whether staffing levels would be reviewed at each stage of the works. Dr Findlay agreed that this was important: staffing levels will be regularly reviewed to ensure that there is always a safe level of staffing.

37.8    Cllr Hill asked whether the use of corridor care was improving. Dr Findlay responded that it is – there are still busy days where some patients have to wait in the corridor area, but there are far fewer days when this is required. Mr Edwards added that the last 90 days have seen a significant reduction in corridor use.

37.9    In response to a question from Cllr Hill on a ‘well-led’ developmental review, Dr Findlay replied that reviews are commissioned by the Trust as a tool for learning and improvement.

37.10  In reply to a question from Mo Marsh (Older People’s Council) on mental health and the use of A&E as a Section 136 Place of Safety, Dr Findlay told the committee that there will always be people at A&E who have mental health problems – the challenge is in getting them swiftly into the appropriate services.

37.11  Nora Mzaoui (CVS) asked a question about staffing. Mr Edwards responded that the Trust constantly monitors demand across the RSCH site and will move staff around to meet this demand.

37.12  In response to a question from Ms Mazaoui about access to ED, Dr Findlay responded that there are limitations in terms of the site being on a hill. However, the improvements mean that there is now step-free access to ED via the Louisa Martindale Building.

37.13  Ms Mzaoui asked a question about patient privacy and dignity. Dr Findlay responded that the new works will address this important issue.

37.14  Cllr Wilkinson asked whether the increase in ED capacity will be sufficient to enable the Trust to meet its 4 hour A&E wait target. Mr Edwards responded that the changes will support work to improve performance against the target, particularly in terms of increasing UTC and PAT capacity.

37.15  Geoffrey Bowden (Healthwatch) asked about the increase in programme costs from an original £48M to the current £62M. Dr Findlay responded that this is the result of the inflation of building costs. The Trust has made additional capital commitments to meet this challenge.

37.16  RESOLVED – that the report be noted.