Collaboration and community can help our health services through austerity, says NHS director of estates

Date posted:
Tue 06 February 2018

Paul Fitzpatrick, director of estates and facilities at Aintree University Hospital Foundation Trust, has suggested that Liverpool can transform its healthcare delivery by streamlining the city’s care services and encouraging collaboration between them.

His expert insight was heard at Professional Liverpool’s ‘The Challenge of Managing the NHS Estate During Austerity’ event, which drew a large audience of professionals from across the Liverpool City Region and the North West.

NHS services in Merseyside, and throughout the UK, are facing austerity, with Aintree Hospital facing a £7 million deficit. Although, the NHS received a record £124 billion budget this year, in real terms this equates to a 0.3% reduction in NHS funding per person due to population growth and increased demand.

Fitzpatrick told the audience: “Liverpool is not a typical city when it comes to healthcare. It has a lot of specialist trusts, such as women’s, as well as specialist heart and chest and neuro hospitals.

“With multiple trusts, comes different ways of working, meaning that medical procedures and associated building maintenance costs can differ across the hospitals, even though some may be offering the same service.

“At a primary care level, there are currently 93 General Practices spread across 84 buildings, but if we could invest in new buildings to house more of these services in larger hubs, we could benefit from greater economies of scale, deliver a uniform service and reduce building maintenance costs. However, of course, at present, there isn’t the budget to make this a reality.”

While current resources will not allow some services to be rehoused under one roof, hospital reconfiguration has already begun in Liverpool, with multiple hospitals working together to deliver a single, streamlined services across more than one site. For example, The Walton Centre, Aintree and The Royal hospitals will oversee the major trauma and orthopaedic services, while The Royal and The Walton Centre will collaborate on spinal surgery delivery.

To maintain a high level of care despite austerity, the NHS is developing a Neighbourhood Community Care Model, which will aim to give patients better access to local GPs and community health services, as well as moving towards a greater delivery of out of hospital care.  

Once open, the new Royal Liverpool University Hospital will have 100 less beds and capacity for 60,000 fewer outpatients than the existing building. Fitzpatrick explained at the Professional Liverpool event that: The new development is one example of the vision for out of hospital care being essential due to a change in the estate.

“With a reduced bed capacity, more services will therefore be provided out of hospital, meaning more high-quality community buildings will be needed, requiring a cross-department commitment to neighbourhood services. We need to stop spending on old smaller sites and invest in the new, for the long term.”

To raise the funds for such investment, Paul highlighted the possibility of the NHS selling land for development.

“Although the sale of unused land to raise funds is an option for some Trusts, the key thing for me is that it isn’t just new houses that are built, for example.”, Fitzpatrick explained, “Along with those homes, I would hope to see more primary care facilities built, higher education provision, dementia care. It’s about creating real communities, not just gated housing developments which have no real impact on helping to alleviate the strain on our health service.”

Anne King, chair for Professional Liverpool’s health group, who chaired the event, said: “At Professional Liverpool, we’re not just about championing the work done by those in the city’s commercial and financial sectors, we also want to put a spotlight on the outstanding work being undertaken in the public sector too.

“Despite facing an extremely difficult climate, with continued austerity and cuts to services, an increasing number of us depend on our excellent health service and the care it provides. As ever, it was very valuable to hear Paul’s expert insight into the steps being taken to streamline the city’s medical services and encouraging to hear about the focus on collaboration. We look forward to inviting him to more Professional Liverpool events in the future.”  

Paul became director of estates & facilities at Aintree University Hospital NHS Foundation Trust, a department that has a budget of circa £30 million and employs approximately 650 staff.

As part of the Healthy Liverpool Programme team, Paul has been working with many Liverpool Trusts Operational and Strategic Teams on the estates implications in support of the reconfiguration of clinical services across adult acute services and more widely the whole health economy.