‘Risk to intensive care’ at hospital where DHSC delayed rebuild

Out-of-date air handling units in several operating theatres and the intensive care unit at North Devon District Hospital in Barnstaple are at risk of failure, which would have a huge impact on Royal Devon University Hospitals Foundation Trust’s operational performances and finances.

The hospital, which is the most remote district general hospital in England, was included in the government’s “40 new hospitals” pledge in 2019 for redevelopment between 2025 and 2030.

However, last May, ministers delayed eight projects – including NDDH – until 2031 at the earliest, in order to prioritise other hospitals with extensive RAAC. No reason was given for the trust’s project being postponed.

The unexpected delay, coupled with concerns over the estate and – subsequently – the sustainability of all acute services within, have prompted RDUH chiefs to submit an “alternative phased plan” to NHS England and the government.

The plan has been developed to “avoid critical equipment failure alongside mitigating future growth in demand for a hospital already operating at close to capacity”, according to a report in RDUH’s January board papers.

In the event of the air handling units failing, the trust would have to spend up to £32m on modular or mobile theatres and/or intensive care facilities, while fixing them.

These mobile units would be redundant once the new hospital building was completed, and the infrastructure failure would also cause a “significant… productivity and operational impact”.

Additionally, the trust said it had “significant concern” about the current planned delay’s impact on the sustainability of “key services” at the hospital.

NDDH has long struggled with recruitment due to its isolated location, and chiefs said the construction of a new hospital was a “key enabler to support recruitment”.

The report said: “There is a risk that a delay in the replacement of key infrastructure could affect the retention of existing staff and the sustainability of clinical services. In turn this acts [as] a major blocker to further recruitment of key workforce.

“Demand and capacity analysis also originally identified that NDDH will become short of theatre, ICU and inpatient bed capacity by 2028, but it is now clear that some patient services are already exceeding capacity.”

RDUH’s board, therefore, wants NHP to allow the trust to work on an outline business case for its alternative plan which would allow an earlier start date (2027) if “other schemes slip”.

The alternative plan’s cost “works within the trust’s £660m indicative funding envelope to the North Devon scheme”, the trust told HSJ.

Its board has escalated its concerns to NHSE’s regional team and is set to meet with NHP chiefs next week.

NHP did not respond to HSJ’s questions.

In 2018, Torbay and South Devon FT experienced air handling units failing in three theatres, which caused a 20 per cent loss of inpatient surgical capacity.