• No decision reached on future of new West Midlands acute hospital
  • Trust “can’t do any more” to get work restarted, says chief executive
  • NHS, government, consultants and bankers continue negotiations
  • Toby Lewis warns extra costs may have to be met by local NHS

An NHS trust badly affected by Carillion’s liquidation can “do no more” to get construction work restarted on its already delayed new £350m hospital, its chief executive has admitted.

The collapse of the engineering giant may push back the completion of the Midland Metropolitan Hospital to 2022 as the NHS, government, bankers and consultants have yet to agree a solution.

Toby lewis

Toby Lewis: ‘It is not in dispute that the Midland Metropolitan Hospital is needed urgently’

The PF2 hospital, to be run by Sandwell and West Birmingham Trust, was planned to open next year but Carillion’s demise has halted the work indefinitely.

Swedish construction firm Skanska has been lined up to take on the building work but cannot proceed without agreement from all the parties involved.

Trust chief executive Toby Lewis told HSJ deadlines for a decision have passed.

“The trust can do no more to bring the position to a conclusion in order to… complete the Midland Metropolitan Hospital as quickly as possible,” he said.

Once open, the hospital would take on the acute services currently provided at the trust’s City and Sandwell General hospitals.

But while arrangements have been developed to maintain services at the trust’s two current sites until 2020, Mr Lewis said options for finishing the Midland Metropolitan take the opening date to as late as 2022.

That would most likely mean “interim service reconfiguration” would be needed between the trust’s existing sites next year.

“This is something partners are working to avoid but as time goes by it is becoming more probable that a slower building route will be chosen, with increased cost and disruption,” Mr Lewis said.

“It is not in dispute that the Midland Metropolitan Hospital is needed urgently,” he added.

The site is “deteriorating” and the rework costs will be “significant”. This has been estimated at around £125m, according to other media.

While this cost will be picked up elsewhere, the trust has had to apply for a “significant” amount of funding from the Department of Health and Social Care to cover the one-off costs incurred by the project’s delay.

Mr Lewis, who previously said the trust should not have to pay for any extra costs, has voiced concern that the trust has been told the funding would come in the form of a loan that would need to be repaid with interest.

In the trust’s latest board papers, Mr Lewis said: “This appears to run counter to the idea that the cost of delay would not be borne by the local NHS.”

He would not say how much money the trust needed from the DHSC or how much the interest would equate to.

Extra money spent on advisers working on behalf of the trust was provided by NHS Improvement until March, the board papers said.

“We are having productive discussions with regulators about additional costs to the trust associated with delay,” Mr Lewis added.

Last year, the trust agreed a deal to transfer its surplus land from City Hospital to the Homes and Communities Agency. It was planned that the trust would move its acute services off the site by December 2019.

Discussions are underway with the agency to delay this process.

The issue has been raised with Theresa May twice in Parliament by John Spellar, the Labour MP for Warley, the constituency where the Midland Metropolitan is located.

Last month, Ms May said the government “recognised” the level of concern and said “we are working to resolve it”.

Knock-on impact on pathology merger

The delayed opening of the Midland Metropolitan may also have a knock-on effect on plans to consolidate pathology in the Black Country.

Four trusts in Wolverhampton, Dudley, Walsall and Sandwell and West Birmingham agreed to merge their pathology services by April 2019.

However, a senior source told HSJ the delays to the Midland Metropolitan have created a “timing issue”.

A new “principle agreement” for the merger has been signed, the source said.

Papers published by the Royal Wolverhampton Trust last month reported chief executive David Loughton saying the region’s sustainability and transformation partnership would focus on the delivery of the “revised pathology service with Dudley and Walsall to date (and possible City/Sandwell) including the capital investment with risks relating to construction capacity availability and cost following the failure of Carillion”.

The business case highlighted the transfer of services from Sandwell and West Birmingham’s two sites to the Midland Metropolitan as one of the risks to the implementation timeline.

Mr Lewis told HSJ the trust is “excited” about the merger and “working with partners to make a success of the venture”.

The Midland Metropolitan delay also means Sandwell and West Birmingham is likely to push back the rollout of its new electronic patient record Unity.

This was planned to take place in August but will be postponed unless a solution to the stalled building work can be found this month.

Rebecca Thomas

Trust can 'do no more' as new Carillion hospital faces further delay