• Calderdale and Huddersfield Foundation Trust outlines its “hot” and “cold” site hospital reconfiguration
  • Huddersfield’s A&E to close and emergency care centralised at Calderdale Royal Hospital in Halifax
  • Trust proposes new PFI deal to fund building a planned care hospital in Huddersfield

A foundation trust is proposing procuring a new private finance initiative to fund its controversial “hot” and “cold” site hospital reconfiguration plans.

Calderdale and Huddersfield FT has published its full business case to reconfigure planned and unplanned care services across its patch.

Calderdale Royal Hospital

Emergency care could be centralised at Calderdale Royal Hospital

The controversial plans – which have faced a public backlash – are to close the accident and emergency department at Huddersfield Royal Infirmary and centralise emergency care services at Calderdale Royal Hospital in Halifax.

HRI will be demolished for a 64 bed planned care hospital to be built on the neighbouring Acre Mill site. This would make Huddersfield one of the largest towns in the UK without an A&E department.

The business case said because NHS England and NHS Improvement have made it clear no public money for capital is available, most of the £297.6m reconfiguration will need to be funded through new PFI deals.

It said: “The utilisation of PFI as a financing vehicle allows the trust to access available resource without incurring capital cost against the capital department expenditure limit.

“Continuing with the existing service model does not achieve this as this option is reliant on the Independent Trust Financing Facility as PFI cannot be utilised for backlog maintenance, which would be required during the 10 year period ahead of a new build HRI.”

Following public consultation, Calderdale and Greater Huddersfield clinical commissioning groups agreed in October to have the full business case prepared on the reconfiguration. They will make their final decisions after this is presented to their governing bodies.

However, members of the Calderdale and Kirklees joint health scrutiny committee raised “significant concerns” about the plans and last month referred the proposals to Jeremy Hunt.

The committee said this was because:

  • it was not satisfied with the adequacy of content of the consultation with the joint committee;
  • amended proposals were not consistent with the proposals originally consulted on by the CCGs in 2016; and
  • it considered that the proposals would not be in the interests of the people of Calderdale and Greater Huddersfield, nor in the interests of the health service in the area.

Mr Hunt will decide whether to uphold the CCGs’ decision or overturn it.

The business case, published last week, proposed the new builds on both sites should be funded via a new private finance 2 deal to be procured through the Official Journal of the European Union.

It said the £297.6m costs will be financed through £276.6m of PFI and £21m of Independent Trust Financing Facility funding. The plans will allow the trust to escape its deficit of nearly £14m and achieve financial surplus in by 2024-25.

The document said the reduction in beds from 843 to 738 across the two sites by 2020-21 will be achieved by improving pathways to enable admission avoidance and reduce length of stay.

It is also hoped that centralising emergency care services will help the trust overcome its staffing problems, including 77 whole time equivalent medical and dental vacancies and 187 in nursing. The trust spent £23m on agency staff in 2016-17.