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‘North Hub’ Orthopaedic Elective Cold Site at Cannock Chase Hospital

BCPC System Lead: Dr Jonathan Odum (RWT), COO Lead: Gwen Nuttall (RWT), Project Manager(s): Charlotte Hathaway (RWT) and Leanne Bood (BCPC)

A key component of elective care transformation across the Black Country is centred on establishing additional protected cold-site theatre capacity from which future performance improvement can be made.

In early 2022, the BC system was successful with its submission for Targeted Investment Fund (TIF) resources to establish a cold-site orthopaedics elective ‘North hub’ at Cannock Chase Hospital (CCH).

This proposal will transform orthopaedic elective work within the Black Country by providing additional elective capacity, aligning directly with the GIRFT requirements for High Volume Low Complexity, (HVLC) case capacity and will have a real impact on both the overall waiting list size and the longest waiters.

The ‘North Hub’ would establish three additional theatres and a procedure room at Cannock Chase Hospital that has capacity to run for a minimum of six days a week over a 50-week calendar year. This additional capacity will enable the system to organise and ‘protect’ dedicated elective Orthopaedic surgery, whilst enabling additional theatre capacity for other specialties.

• Following the approval of the Expression of Interest and OBC, the clinical and operational lead engaged with Orthopaedic colleagues from across the system, who were invited to attend an initial ‘away day’ in May 2022. The event was well attended by over 50 delegates who participated in workshop discussions, that focused on identifying an optimal clinical model and how best we might navigate barriers for successful delivery underpinned by activity and finance modelling.
• The Project Governance has been established with task and finish groups progressing work to support delivery of key programmes. The BC ICB has been notified of the potential for service change, which it has reviewed and confirmed, activating the service change assurance process, with patient/stakeholder engagement/consultation to commence shortly.
• Enabling monies to the value of £5m were awarded by NHSE and preparatory works have commenced at Cannock Chase Hospital. This includes the repurposing of offices spaces and the electrical work required to support the new theatres. In addition, Cannock Chase Hospital was awarded national accreditation from GIRFT in March 2023 as part of a pilot scheme to ensure the highest standards in clinical and operational practice.
• More recently, an FBC has been submitted to NHSE and in parallel to each sovereign Trust Board for review and approval. The NHSE has commenced its assessment process which can take up to 14 weeks before confirmation of approval.
• Subject to approval, we will be working towards building and mobilising for opening by late 2024/early 2025 as required by the new timelines from NHSE.
• With respect to the broader strategic picture, it should be recognised that the ‘North Hub’ is a key and important part of the transformation of elective care journey which will over the coming medium term see some of the following:
• Identify the optimal use of ‘vacated capacity’ emanating from the proposed use of North Hub for Orthopaedic activity
• Familiarisation with surgical robots, enabling the development of ‘Centres of Excellence’ for key cancer service areas (e.g. pelvic urology, renal, and gynae-oncology).
• Better resilience in the provision of cancer care e.g. Breast unit consolidation, and plastics
• Improved service resilience through pursuit of the concept of ‘Networked Service Solutions’, encouraging specialties to work closer together as one across multiple sites.
• Participation in the national 26-week pilot ‘Further Faster’ seeking alternative ways in which to manage demand better (e.g. PIFU, Virtual Consultations) in addition to validating waiting lists, and the pursuit of ‘super-clinics’ to rapidly manage patients where possible and reduce the elective demand.
• Aligning additional diagnostic capacity of the CDC’s with high demand elective specialties to ensure patients in need are channelled to the right place as quickly as possible
• Ensuring workforce ad skill mix needs for elective care in the Black Country are planned for enhanced and where present consolidated to deliver optimal care.

Looking Ahead

As we proceed into 23-24 and beyond, the ‘North Hub’ project (subject to approval) will focus its efforts on:

• Assuring the NHSE, BC ICB and sovereign Trust Boards of the merits of the North Hub project, especially in the context of the wider plans for the transformation of elective care in the Black Country.
• Undertake further finance and activity modelling to ensure that optimal service plans are developed
• Progress the NHSE assurance process for service change, navigating the four gateway stages.
• Review the output of patient/public consultation and engagement of stakeholders, ensuring that key responses are fed into the on-going development of the service accommodating/meeting the needs of patients and the public as best as possible.