Frequently Asked Questions

Following careful review, consideration and discussion, NHS Gloucestershire Clinical Commissioning Group (CCG) and Gloucestershire Care Services NHS Trust (GCS) at their meetings on 25 January, 2018, unanimously approved the preferred option of a new community hospital in the Forest of Dean to replace Dilke Memorial Hospital and Lydney and District Hospital.

The site criteria for the new hospital were also agreed, together with the recommendation to carry out further public engagement on the location.

The public engagement and the Citizens’ Jury will not be considering actual specific sites.

The engagement booklet describes the process that will be followed and what people are being asked as part of the public engagement.

Some of the things that need to be considered are on Page 3 of the booklet and relate to geography, transport and access and demography. It’s essential that the best location for most people in the Forest of Dean is identified before a specific site can be considered.

As mentioned, it’s essential that the best location for most people in the Forest of Dean is identified before a specific site can be considered.

In terms of naming future potential sites, there are obvious commercial sensitivity issues.

The Citizens’ Jury will be made up of 18 people who live in the Forest of Dean. The opportunity to be a member of the Jury has been advertised through local newspapers, websites and posters. You can still apply to be a member of the Jury until 18 June 2018. To apply go to www.citizensjuries.org or call 07983 413 064.

They will consider the recommendation from the Citizen’s Jury, together with feedback received during the period of public engagement, feedback from health and care staff, information about travel and access issues and other information about the local population, before reaching a decision on whether the hospital should be in, or near, Cinderford, Coleford or Lydney.

We are also committed to further public engagement on the full range of services that would be provided in a new hospital. This will inform the design of the building and the business case.

We are asking local people and health and care professionals to consider the options we developed for the future of community hospital facilities in the Forest of Dean.

We would like views on our preferred option of a new community hospital for the Forest of Dean.

If agreed, the new hospital would replace Dilke Memorial Hospital and Lydney and District Hospital when it opens its doors.

Subject to the above, we are also taking the opportunity through this consultation to ask for views on a set of criteria which would be used to help decide where any new hospital would be located and how a recommendation should be made on any preferred location.

The two existing community hospitals are reaching the stage where it is becoming increasingly difficult to provide modern, efficient, effective, high quality care. The main challenges are set out in the consultation booklet and include:

• The ability to maintain some essential services across the two community hospitals is becoming increasingly difficult with healthcare professionals working across different sites and the challenges of recruiting and retaining enough staff with the right skills
• There are significant issues relating to cost of maintenance of the existing hospitals and restricted space for services
• The current physical environment within the hospitals also makes it increasingly difficult to ensure privacy and dignity for all patients and manage infection control
• Too many people from the Forest of Dean have to travel outside the local area to receive care that should be provided more locally, such as endoscopy.

We have been supported in our thinking by the Forest of Dean Community Services Review Reference Group which has comprised of representatives from the local community, who have offered their insight and experience.

We have also worked with our colleagues in the Public Health Team at Gloucestershire County Council, who provide information about the people who live in the county derived from sources such as the Census. We have been supported with information by colleagues at the Forest of Dean District Council, the authority with responsibility for planning housing development in the District.

Yes, we work closely with our colleagues in Wales at the Aneurin Bevan Health Board and with GP practices in places such as Monmouth and Chepstow, to understand the likely use of services in the Forest of Dean by Welsh residents and the 8000+ English residents in the Forest of Dean registered with GPs in Wales.

A new community hospital for local people, fit for modern healthcare resulting in:

• Significantly improved facilities and space for patients and staff
• More consistent, reliable and sustainable community hospital services e.g. staffing levels, opening hours
• A wide range of community hospital services, including beds, accommodation to support outpatient services and urgent care services
• Services and teams working more closely together
• Better working conditions for staff and greater opportunities for training and development.

Following engagement with local partners, the public and healthcare providers as part of the Forest of Dean Health and Care Review, we have concluded that there is a continued need, and wish, for:

• Community hospital beds
• Additional outpatient services
• Appropriate areas for therapy services and treatments
• An urgent care facility
• Diagnostic services, including an endoscopy suite
• Space to support community events working with voluntary and community organisations.

There is work underway in the county to look at how best to develop a network of services and centres to meet urgent care needs in to the future. This work will result in proposals for consultation. However, we are committed to providing an urgent care facility in the Forest of Dean.

Should the preferred option of a new community hospital be agreed following public consultation, we can then begin detailed work on the range of outpatient services that could be available.

A good example would be outpatient services which we cannot currently provide due to the physical restrictions of the buildings e.g. clinic rooms inaccessible to electric wheelchairs.

Should the preferred option of a new community hospital be agreed following public consultation, we would expect to include a higher number of single rooms in a new build as we know that this can significantly improve the patient experience, ensure privacy and dignity for patients and improve infection control arrangements.

This is dependent on the preferred option of a new community hospital being agreed following public consultation. Therefore no decision has been made on the exact number of beds, however it would need to meet the needs of residents in the Forest of Dean and ensure a viable service i.e. evidence suggests at least 24 beds.

Currently, a proportion of the community hospital beds in the Forest of Dean are used by patients who live outside of the district, primarily Gloucester and Cheltenham. We are working to enable their care to be provided more locally. Currently, on average, 21 beds are being used by Forest of Dean residents in the two community hospitals at any one time.

More information can be found here.

Following discussions with local people and healthcare providers as part of the Forest of Dean Health and Care Review, consideration was given to the inclusion of a maternity/birthing unit. This has, however, been discounted on the basis that a clinically safe and sustainable service could not be provided. We will continue to promote home births where appropriate.

At this stage, we don’t have any plans to change services across the two sites. However, irrespective of any decision on the preferred option and consistent with our current approach, this would be kept under review to ensure we can continue to support colleagues to provide safe services.

If the decision is made to invest in a new hospital in the Forest of Dean we have stated that it is our intention to maintain services at both sites until the new hospital is open.

Although this consultation is about community hospitals, it is part of an overall plan for the Forest of Dean, which will see significant new investment in new facilities for general practice (GPs and their teams) and other community based services in the Forest of Dean.

Plans have already been progressed to improve GP premises in Cinderford and Coleford. Depending on the outcome of this consultation, other GP facilities in the Forest of Dean may also need to be prioritised for improvement.

If the preferred option of building a new community hospital is agreed after public consultation, we believe it would take at least four years before the new hospital was ready to open its doors. Therefore, we have an important responsibility to provide the best possible services, facilities and equipment within that period.

Should the preferred option of a new community hospital be agreed after public consultation, we would work closely with our colleagues and community partners, such as the League of Friends of both hospitals, to consider what equipment it would be feasible and appropriate to transfer.

We have recognised that there may be an opportunity to consider co-location with a new hospital development, however at the present time this has not been worked up in any detail and would need to be considered if the decision to invest in a new hospital is made.

Whilst we would be unable to fund public transport to the new hospital, we would work with local transport providers, including community transport (e.g. Dial-a-ride, volunteer driver schemes, etc) to ensure any new site is as accessible as possible. This could include exploring the re-routing of existing bus routes.

Transport matters would be a key consideration in any assessment of potential sites. Should the preferred option of a new community hospital be agreed following public consultation, we believe that one of the key criteria by which potential locations are assessed should be that it is easily accessible by car or public transport.

There are several community transport services in the Forest of Dean. For example, Forest Routes is a Lottery funded community transport partnership in the Forest of Dean. They work to raise awareness of the four community transport providers in the Forest of Dean, to promote their services and to recruit new volunteers to work with them.

Community Transport providers offer reasonably priced fares and a door-to-door service for anyone needing assistance with transport http://forestroutes.org/

Public Bus services are provided by Stagecoach; an example of a Forest of Dean route and timetable can be found on the following website: https://www.stagecoachbus.com/routes/west/30/gloucester-coleford/xsao030.o

Based on experience elsewhere we estimate the minimum investment required for a new hospital able to meet the needs of the Forest of Dean would be approximately £11m.

No. Should the preferred option of a new community hospital be agreed following public consultation, Gloucestershire Care Services NHS Trust would fund the new community hospital using NHS capital funds, and, if a new hospital was not located on the site of one of the two existing hospitals, sale of land would contribute towards the cost of a new hospital.

The freehold of both community hospitals is owned by Gloucestershire Care Services NHS Trust, on behalf of the Secretary of State.

We estimate that it would cost in excess of £20m to rebuild both of the hospitals on their current sites. It is important to note, however, that the proposal that we are recommending through the consultation reflects the fact that it is becoming increasingly difficult to sustain some services across two sites in the Forest of Dean.

Our current estimate is that necessary maintenance over the next 10 years would require a minimum investment of over £4 million, with no prospect that either hospital can become fully compliant with current building regulations. Also, even with significant additional investment, we would still not be able to overcome a range of other challenges (set out in the consultation booklet) such as the increasing difficulty of providing services across two sites.

No decisions have been made. We have developed some criteria which describe the sorts of things that would need to be assessed before recommending a preferred site. The criteria are part of the current public consultation and we are also consulting on the process that would be followed to arrive at a recommendation on a site location. This is all subject to the preferred option of a new community hospital being agreed following public consultation.

We are aware of a number of potential sites across the district. Subject to public consultation and any decision to pursue an option for a new community hospital in the Forest of Dean, there would be a process to assess potential sites options. This is set out in the current public consultation booklet.

As described above no decision has been made on a preferred site. Subject to consultation and any decision to pursue the preferred option of a new community hospital, existing sites, as well as new sites, could be considered.

We are currently consulting on a preferred option of developing a single new community hospital for the Forest of Dean and not on a preferred location. If the preferred option of a new hospital is agreed after public consultation, existing sites, as well as new sites, could be considered as potential locations. Therefore, we cannot confirm at this stage the future of the current community hospital sites.

We do recognise that this is an important matter and would be subject to future discussions with partners and the public depending on the outcome of the current consultation.

We have a proven track record for planning and building new community hospitals in Gloucestershire and if the preferred option is agreed following public consultation, we would ensure that it was built within the time period stated.

We would be committed to any new development being designed with the input of our staff and local communities to reflect the unique heritage and character of the Forest of Dean, with environmental sustainability at the core of the design. Working together, we would hope to secure the best possible hospital that our resources could provide.

The Trust’s policy is to operate a low carbon, sustainable estate that minimises the use of natural resources. We have in recent years managed a number of projects to improve our heating infrastructure, improve heating controls, increase insulation and upgrade lighting as well as renewable energy projects including PV Solar panels. In addition, water efficiency improvements have included water-efficient taps, showers and low-flush toilets.

The exact same principles would apply to any new hospital building with an intent to implement good sustainability standards that equate to the Building Research Establishment Environmental Assessment Method (BREEAM) Excellent standard. To attain this, the Trust needs to demonstrate high levels of sustainability in energy, health and wellbeing, materials used, management, land use and ecology, pollution, transport, waste and water.

The Trust’s new hospitals in Dursley (Vale Hospital) and Moreton-in-Marsh (North Cots Hospital) included extensive planting programmes to enhance biodiversity and dependent upon location, we would aim to adopt a similar approach to any new Forest of Dean hospital.

Clearly the Forest of Dean is a unique environment, however we would also look to ensure the hospital is health promoting – with walking, cycling and healthy lifestyles encouraged whilst working with the local authority to optimise the use of local public transport.

Should a decision be made to build a new community hospital for the Forest of Dean, it will be important to consider carefully a number of factors before making a decision on a preferred site/location.

Within the current consultation booklet, we have taken the opportunity to share some of the criteria we think would be important in making such a decision. In addition to the list in the booklet, we are welcoming views on whether there are other things we should take into account.

Here are some examples of existing “new” community hospitals, run by Gloucestershire Care Services NHS Trust.

North Cotswolds Hospital, Moreton-in-Marsh

Tewkesbury Community Hospital

Tewkesbury Community Hospital

Vale Community Hospital, Dursley

Vale Community Hospital, Dursley

Vale Community Hospital, Dursley