The document provides an overview of opening a new £432 million hospital building at North Bristol NHS Trust. It discusses the decade-long process of designing, building, and planning for the new facility. Key points include: the building was officially opened in May 2014 after months of moving 540 patients and installing over £12 million of equipment; lessons were learned around project and programme governance during the process; and a major change program called "Road to 2014" was implemented to design new models of clinical, workforce, equipment and administrative services for the new hospital.

1. How to open a new hospital Successes and lessons at North Bristol NHS Trust
Ian Triplow
Associate Director of Programme Management Office

2. Overview
This presentation will provide an overview of the learning from the building, commissioning, move and opening of the new £432m Brunel building at Southmead Hospital, North Bristol NHS Trust.
On 28th May 2014, the Brunel building – with 800 beds, 24 operating theatres, over 7000 staff, costing £432m – was declared fully open. This was the culmination of almost a decade of design, building, planning and business transformation at North Bristol NHS Trust, and a final 3 months spent commissioning the new building, installing over £12m of equipment and finally moving all the services (and 540 inpatients) to their new home.
This talk will present a summary of the final report from the move & transformation programme which oversaw the final few months from February to May 2014. This will include an overview of the journey that the organisation went through to build and open the Brunel building, lessons learned along the way, and changes that were made to project and programme governance through its timeline.

3. Background

4. Background - NHS
Since its launch in 1948, the NHS has grown to become the world’s largest publicly funded health service. It is also one of the most efficient, most egalitarian and most comprehensive.
The NHS was born out of a long-held ideal that good healthcare should be available to all, regardless of wealth – a principle that remains at its core.

5. Facts and figures
NHS net expenditure was £109 billion in 2013/14
Planned expenditure for 2013/14 was £113 billion
In the NHS there are currently;
211 clinical commissioning groups (including 152 authorised without conditions)
160 acute trusts (including 101 foundation trusts)
56 mental health trusts (including 41 foundation trusts)
34 community providers (18 NHS trusts and 16 social enterprises)
10 ambulance trusts (including 5 foundation trusts)
c.8,000 GP practices
c2300 hospitals in the UK

6. Background – Acute Hospitals
Formal definition
Acute care may require a stay in a hospital emergency department, ambulatory surgery centre, urgent care centre or other short-term stay facility, along with the assistance of diagnostic services, surgery, or follow-up outpatient care in the community
Informal
It’s a place you wish not to go to but need to know its there for you to keep you healthy from age 0 to 100+
It’s the specialised end of the NHS – specialising in emergency unplanned care – and the follow up through in and outpatient work

8. Bristol and NBT

9. Ref
Trust
Turnover (13/14)
1
North Bristol NHS Trust
£541.2m
2
University Hospitals Bristol FT
£528.2m
3
Royal United Hospital Bath
£233.6m
4
Weston Area Health
£96.8m
2
3
4
1
5
6
7
8
9
Ref
Private providers
5
Care UK (ISTC)
6
Spire
7
Nuffield
8
BMI Bath
9
Circle Bath
Local provider map which identifies the
local Trusts and private sector providers
Bristol Healthcare

10. North Bristol NHS Trust
North Bristol NHS Trust is the largest hospital trust in the South West of England, providing hospital and community healthcare to the residents of Bristol, South Gloucestershire and North Somerset.
We are also a specialist regional centre for a number of services including neurosurgery, renal medicine, plastics, burns, orthopaedics and major trauma.
The Trust provides services to a local catchment population of 905,000
The Trust has a wider catchment population of approximately 3 million for our specialist services

11. Facts and figures
The Trust has a workforce of over 9,000 with a funded establishment in 2013/14 of 7,753 whole time equivalents.
Medical Staff – 928 wte
Nursing, midwives healthcare assistants – 3,085 wte
Scientists and Therapies – 1,299 wte
Ancillary and estates – 885 wte
Administration – 1,395 wte
Managers – 161 wte

12. Frenchay Hospital History
The hospital, situated in the grounds of a Georgian mansion, Frenchay Park, started life as a TB hospital in 1921
In 1931, five purpose-built buildings were constructed to extend the hospital beyond the original house.
Concerns about the possibility of heavy bombing casualties led to the hospital being greatly expanded between 1938 and early 1942.
Although Bristol was severely bombed, the new facilities remained unused
When US forces arrived in 1942, the city handed the new hospital facilities over to the Americans.
Further expansion to the facilities including 27 wards, occurred in late 1942. The Americans used the hospital mainly as training facility for their medical staff.
After D-Day the hospital was used in earnest. Casualties were flown into Filton or arrived by train from the channel ports.
Between 5 August and 31 December 1944 a total of 4,954 patients were discharged from Frenchay.
The National Health Service acquired the hospital in 1948
Over the last 60 years, the hospital facilities have been slowly modernised, but many wartime buildings were still very much in evidence this year

13. New and old together

14. A New Hospital

15. New Facilities
A decision was made in 2005 to create a single acute hospital at Southmead and transform the Frenchay hospital into a community facility
In 2010, Carillion was formally selected to design and build the new hospital and construction work began
Completion of the main building was in March 2014
The Brunel building comprises 114,000 m2 with a capital cost of £432 million
It includes 800 beds, 24 theatres and a full range of services for a population of 400,000 people.

16. Brunel Building Programme
The Brunel Building is a private finance initiative (PFI)
After 10 years of focus on the completion of the new acute hospital at Southmead the Brunel building was handed over to North Bristol Trust on 26th March 2014.
This work was undertaken by the NBT capital planning team with a mix of specialists in building, clinical design, operational pathways and more
The majority of this team were recruited from with the NHS and more specifically NBT

17. Brunel Building – December 2010

18. Brunel Building – June 2011

19. Brunel Building – July 2012

20. Brunel Building – August 2013

21. A new way of working

22. Change programme
A major change programme “Road to 2014” was set up to design and delivery services in new ways of working in time for the new building utilising the new facilities, capability and staffing models that the building allowed
This programme “Building Our Future” was resourced through a mix of project managers internal and external to the NHS – supported with clinical redesign experts

23. What had to change?
The clinical models changed for
Inpatients
Both emergency and elective
Outpatients
Equipment
Storage
Support
The workforce models (and teams) changed for
Wards
Theatres
Administration
Support

24. Gateway Review

25. All into One programme
The Project Assessment Review Team, in December 2013, recognised that the separate components within the overall Move Programme had to be combined single entity, with one critical path and one governance.
In effect the building and the services that were going to be together – now needed to be together
The Trust concentrated on the Move and the building alone
The Move and Transformation Programme was formed – and run at high pace from January 2014 until June 2014

26. Governance Structure
Trust Board
MOVE and Transformation Board
MOVE Delivery Board
Existing Sub- structure
Reporting Workstreams
Single Programme Plan
Brunel Construction
MOVE projects
Facilities Portfolio
IM&T projects
Themes
Directorates
JIGSAW
Service Transfers

27. Summary Reporting – Exception Based
Brunel Construction
MOVE projects
Facilities Portfolio
IM&T projects
Themes
Directorates
JIGSAW
Service Transfers
Single Programme Summary and Highlight report
Risk review
Action Chasing
Programme Overview
Decision Planning
Interdependency Management
Communication
Assumption Management
Upward Reporting
WORKSTREAMS
PMO
INTRANET SITE (WEEKLY)

28. All heading in the same direction

29. Governance - detail
Risk management
Both Move and BAU are managed through the single overview Riskweb system
All Trust risks recorded, now including high-level CCG risks
Weekly check of high risks, daily chasing of mitigating actions
Issue management
Central issues log for Move, daily chasing of mitigating actions
Decision management
All Committee / Executive level and significant decisions logged
Daily system to remind decision makers and record decisions
Centralised daily reporting by PMO on all matters
Single programme plan established with critical tasks for Move identified and tracked

30. Business as Usual incl. Capital Programmes
Governance
All directorates continue to have monthly performance executive review meetings covering the balance reporting of performance / activity / quality / workforce / finances
This continues throughout the Move preparation and into the new hospital
All other capital developments managed through our “Jigsaw Programme”
Integrated Performance Report
The Trust now has integrated performance report covering all executive performance reports to the board in a single format
This has been used over the last 3 months and is used throughout the organisation and board
The report will continue to develop based on evolving issues and areas of focus – with a rotation through other areas as applicable by time in reporting year

31. Training and Orientation
Training – started and ahead of schedule
Compulsory 1 hour session
Prepare staff for working in Brunel
Familiarisation with commonly used equipment
Specific in depth training for specialist areas
Orientation Tours
Opportunity to see the Brunel before occupation
Chance to orientate staff and allow staff to find out how to get to their workplace
Staff can see how wayfinding works

32. Simple Reporting

33. Go/No Go checklist
Last date for Go No Go decision: 30 March 2014RAGReason: Leaflets advising the public of the dates of the move will be issued. General1The building will be handed over in a good state of repair, with all key systems fully functioning (lifts, heating, lighting etc) and free of major defectsGreen2The list of items on the snagging list requiring remedy are acceptable in terms of volume and complexity for operation of the building Green3The fire strategy for Brunel has been approvedAmber4Contingency plans are in place for major incidents to enable business continuityAmber5Critical operational policies are in placeAmberPeople and Services6The order of moves is finalised and all services know the date of their moveGreen7Move plans for each service are in place and understood by the service teamsGreen8All necessary transport arrangements for transferring patients are in place and are in conjunction with the order of moves, and there is written commitment from the service provider to meet the requirementsAmber9Contingency plans are in place in the event of unavailability of planned transportAmber10All staff have been trained to use and orientated to the buildingGreenEquipping & Environments11Any certificates, licenses and approvals necessary in advance of building occupation or use have been issuedAmber12All equipment necessary to run Brunel is ordered, in place (including transferred equipment) and commissioned ready for useAmber13There are sufficient fittings in place to provide a comfortable environment for patientsGreen14The removals company has an agreed and finalised schedule of equipment moves for the full move periodGreen15Contingency plans are in place with the removals company to manage delays, increases in activity etcGreen16All specialist removals companies have an agreed and finalised schedule of transfers for the full move periodGreen

34. Go/No Go checklist
IM&T17All essential IM&T systems are in operation including wireless system, Cerner etcRed18Sufficient hardware (and software) necessary to get services underway within Brunel is in placeAmber19All corporate IM&T systems are amended for the new operation in BrunelGreen20Telephone systems are operationalGreenFacilities Management21The building has had a clinical clean and has been signed off as ready for use by infection controlGreen22The soft FM team are trained to operate in BrunelGreen23The building is stocked through a first fill and ready for operation for all areas - pharmacy and each zone (theatres, critical care, wards etc) Amber24Catering systems and prep areas are cleaned, stocked, tested and ready to feed patients and staffAmber25A process flow is in place to govern safe flow of instrumentation between SSD and BrunelAmber26The service yard is operational with an agreed schedule of deliveries and management processes in placeGreen27A system is in place to move supplies, consumables etc through the building (e.g. AGV)Amber28Parking arrangements for patients and visitors are in placeGreen29Transport arrangements for staff are in placeAmberCommunications30Communications are prepared and processes in place ready to communicate the date of the move to patients and the public (including GPs, patients, general public) GreenOperational31All schedules and staffing rotas are in place for theatres, outpatients and specialist diagnosticsGreen32There is sufficient staffing in place to operate a safe service across all key areas: outpatients, inpatients, theatres, diagnostics, emergency department, critical careAmber33Administrative processes are in place to safely manage patients through the systemsRed34Activity profiles are agreed in the period up to the move to Brunel to minimise risk to moveAmber35All staff are allocated to their area of workGreen36All staff have been trained in how their service will operate in terms of every task in the working dayAmber

35. Highlight Narrative
This week:
 1,026 staff have completed Orientation Tours of the Brunel Building in the first week from
Monday 31 March. Use the button above to book a tour by logging into MLE.
 Outpatient booking: Reporting has been improved and automated to track precisely the
number of patients waiting to be rebooked for new clinics in the Brunel Building. As of 4 April
there were 24,187 patients waiting for a Brunel appointment to be rebooked. Of those: 4,789
are booked into an incorrect clinic and need to be rebooked; 19,122 are waiting to be booked
from a request queue; 253 patients are waiting to be booked from a paper-based pending list
in Renal. The overall number of patients waiting to be rebooked has increased in the last
week. This is likely to be the result of short-term follow-up appointment requests being added
to a request queue rather than booked directly into a Brunel clinic slot.
 Move & Transformation Board worked through the sign-off process for new staff rosters and
for staffing plans for the Move period and beyond the Move.
 The first Clinical Governance Day was held on 3 April for teams to access Theatres, the ED and
other departments for orientation and simulation.
Priorities for next week:
 From 7 April information about Move will be appearing on paper bags used in Pharmacies
around the city.
 From 8 April, a new Frequently Asked Questions page will be available on the NBT intranet and
staff will be able to submit any questions for answers to be published.
 Continued focus on the development of contingency plans for the Move, for Patient
Entertainment and for the Trinity House Outpatient Appointments move.
 Cerner rebuild: The rebuild for outpatients is due to be completed on 10 April and the rebuilds
for Theatres and the Emergency Department are due to complete on 11 April.
 The PMO will be following up to ensure: the completion of all critical Standard Operating
Procedures ready for training; a trajectory of staffing is produced following overseas
recruitment; that the final order for Theatre instrumentation is placed.
Risks and Issues
 There are 142 new FP-10 Prescription printers that have been delivered but do not fit well on
the desks in the new offices. A solution to this – either re-siting the printers, amending the
existing desks or buying different desks – will be worked through.
 There are intermittent issues with the telephones installed in the Brunel Building lifts which
are taking some lifts out of service. The IM&T department are working to fix this and
equipment deliveries and orientation tours are working around the issues.
54 days MOVE Weekly Highlight Report. 4 April 2014
8 weeks
Until Brunel
fully open
Decisions required
Guide to
this report
Decisions
Log
RiskWeb Issues Log
Email
PMO
Progress
Reports
Version 1
Plan
Workstream Lead
Last
Week
RAG
This
Week
RAG
Move Coordination & Planning, People & Services, Equipping & Environments
PFI Timeline Tricia Down Green Green
Move Coordination & Planning Tricia Down Green Green
Communications Tim Bartlett Green Green
Jigsaw - Neuropathology interim move Steve Brown Green Green
Jigsaw - Offsite records Steve Brown Amber Amber
Jigsaw - 'Sherston' Building Projects Steve Brown Green Green
Jigsaw - Other homeless services Steve Brown Green Green
IM&T
IM&T - Infrastructure (e.g. Data Network, Telephony) Mike Brooks Amber Amber
IM&T - Enabling (e.g. Kiosks, Cerner Rebuild) Mike Brooks Red Red
IM&T - Move (e.g. Printer Provision, Switchboard, Jigsaw) Mike Brooks Amber Amber
IM&T - Post-MOVE (Decommissioning, Retained Estate upgrades) Mike Brooks Green Green
Facilities Management
Facilities - NHRP incl buffer store Nicholas Jones Red Amber
Facilities - SSD Paul Jenkins Amber Amber
Facilities - Security Travel & Parking John Smith Red Amber
Facilities - Soft FM Chris Lawson Amber Amber
Facilities - Estates Matt Chick Red Amber
Operational - Themes and Projects
Patient Flow Theme Anne Morris Amber Amber
Rehabilitation Project Anne Morris Red Amber
Outpatients Theme Claire Weatherall Red No RAG
Theatres and Surgery Theme Rosanna James No RAG Red
Centralisation of specialist paediatrics Tasha Swinscoe Amber Amber
Imaging Theme (Formerly Diagnostics) Sharon Nicholson Amber Green
Imaging Day Case Unit Sharon Nicholson Amber Amber
Medical Workforce Theme Chris Burton No RAG Amber
Vascular Service Review Karen Maxfield Green Amber
Patient Care Administration Theme Rob Gittins Amber Amber
Non Medical Clinical Workforce Theme Louise Smith Amber Amber
Breast Centralisation Rosanna James Green Green
Pathology David Gibbs No RAG Amber
Operational - Directorates
Core Clinical Services Directorate Sharon Nicholson Red Amber
Medicine Directorate Anne Morris Amber Amber
Musculoskeletal Directorate Rosanna James Amber Amber
Surgical Services Directorate Rosanna James Amber Red
Neurosciences Directorate Diane Cornish Amber Amber
Renal Directorate Claire Weatherall Amber Amber
Women's and Children's Services Directorate Natasha Swinscoe No Report No Report
Go/No Go Checklist
Last week
RAG
This week
RAG Move Coordination & Planning
1
The building will be handed over in a good state of repair, with all key systems
fully functioning (lifts, heating, lighting etc) and free of major defects
Complete Complete
2
The list of items on the snagging list requiring remedy are acceptable in terms of
volume and complexity for operation of the building
Green Green
3 The fire strategy for Brunel has been approved
Green Complete
4 Contingency plans are in place for critical incidents to enable business continuity
Amber Amber
5 Critical operational policies are in place
Amber Amber
6
Communications are prepared and processes in place ready to communicate the
date of the move to patients and the public (including GPs, patients, general
Green Green
People and Services
7 The order of moves is finalised and all services know the date of their move
Complete Complete
8 Move plans for each service are in place and understood by the service teams
Green Green
9
All necessary transport arrangements for transferring patients are in place and are
in conjunction with the order of moves, and there is written commitment from the
Complete Complete
10 Contingency plans are in place in the event of unavailability of planned transport
Complete Complete
11 All staff who need to have attended compulsory Move training
Green Green
Equipping & Environments
12
Any certificates, licenses and approvals necessary in advance of building
occupation or use have been issued
Green Green
13
All equipment necessary to run Brunel is ordered, in place (including transferred
equipment) and commissioned ready for use
Amber Amber
14
There are sufficient fittings in place to provide a comfortable environment for
patients
Green Green
15
The removals company has an agreed and finalised schedule of equipment moves
for the full move period
Complete Complete
16
Contingency plans are in place with the removals company to manage delays,
increases in activity etc
Green Green
17
All specialist removals companies have an agreed and finalised schedule of
transfers for the full move period
Green Green
IM&T
18
All essential IM&T infrastructure projects are complete: fixed network; wireless
network; phone number strategy; intercoms; multitone paging; AGV comms and
Green Green
19
All essential IM&T Enabling projects are complete: Cerner Rebuild; Non-Cerner
clinical systems rebuild; check-in and patient calling; patient records flow;
Red Red
20
All essential IM&T Move projects are complete: Commissioning; PC Provision;
Printing Provision; Switchboard including double-running
Green Green
21 All corporate IM&T systems are amended for the new operation in Brunel
Green Green
Facilities Management
22
The building has had a clinical clean and has been signed off as ready for use by
infection control
Green Green
23 The soft FM team are trained to operate in Brunel
Green Green
24
The building is stocked through a first fill and ready for operation for all areas -
pharmacy and each zone (theatres, critical care, wards etc)
Amber Amber
25
Catering systems and prep areas are cleaned, stocked, tested and ready to feed
patients and staff
Green Green
26
A process flow is in place to govern safe flow of instrumentation between SSD and
the point of use in Brunel
Amber Amber
27
The service yard is operational with an agreed schedule of deliveries and
management processes in place
Green Green
28 A system is in place to move supplies, consumables etc through the building
Green Amber
29 Parking arrangements for patients and visitors are in place
Green Green
30 Transport arrangements for staff are in place
Amber Amber
Operational
31
All schedules and staffing rotas are in place for theatres, outpatients and specialist
diagnostics
Amber Amber
32
There is sufficient staffing in place to operate a safe service across all key areas:
outpatients, inpatients, theatres, diagnostics, emergency department, critical care
Red Red
33
Administrative processes are in place to safely manage patients through the
systems
Amber Amber
34
Activity profiles are agreed in the period up to the move to Brunel to minimise risk
to move
Green Complete
35 All staff are allocated to their area of work
Green Green
36
All staff have been trained in how their service will operate in terms of every task
in the working day
Amber Amber
37 Completed transfer of paediatric inpatient service to UH Bristol
Green Green
DEC-025 Business Case: Frenchay Disposal Strategic Outline Case 10/04/2014 EAMCPG
DEC-065 Business case: Pathology interim proposals 10/04/2014 EAMCPG
DEC-071 Procurement: Energy procurement for Brunel 10/04/2014 EAMCPG
DEC-072 Procurement: Southmead demolitions tender approval 10/04/2014 EAMCPG
DEC-142 Outline Business Case: Sherston Buildings Project 10/04/2014 EAMCPG
Book a
tour

36. Move Period

37. Manager Checklist - April
Final sign-off from General Managers
To be completed pre-Move for every area
Includes:
Workforce
Training & Orientation
SLAs with Support Services
Workflows, Systems & Processes
Equipment, storage & consumables
Information technology

38. Clinician Checklist - April
Final sign-off from Clinicians
To be completed pre-Move for every clinical area
Includes:
Clinical assessment tools
Documentation
Clinical pathways
Medical records flow
Information flow
Team Processes
SLAs with other services
Clinical rotas
Clinical competencies
Clinical equipment
Training, Orientation and System Test

39. 39
Order of Moves
•Southmead moved first
•Elective
•Logistically more straightforward
•Requirement for rapid decommissioning
•Frenchay followed
•Maintain Emergency Department access
•Clinical dependencies paramount
•Key Partners
•Harrow Green
•SWAST
•RAF

40. 40

41. 41

42. 42
Order of Moves - detail
•Key services always available
•Testing of clinical model possible
•Minimal downtime
•Patients not left isolated
•Allocated access, lifts, routes
•Max 120 patients move in a day MTWTFSSMTWTFSSMTWTF05-May06-May07-May08-May09-May10-May11-May12-May13-May14-May15-May16-May17-May18-May19-May20-May21-May22-May23-MayClinical Equipment ServicesSMDFHYSocial WorkersSMDRheumatology Offices (Beeches)SMDED OfficesMSK OfficesSMDStaff ChangeNEWMedical IllustrationSMDFHYTransport Dept and OfficesSMDAnaesthetic OfficesSMDSurgery and Urology OfficesSMDMedical Offices (incl. other rheum)SMDRenal OfficesSMDImaging OfficeSMDAOC TheatresSMDCPUNEWSeminar RoomsNEWPost RoomSMDK Annexe (Seas Press)SMDC Ward (Resp)SMDD Ward (Resp)SMDElgar 2 (CCU)SMDCardiac TestingSMDRespiratory TestingSMDElgar 4 (C of E)SMDH@NSMDICUSMDCSMs Stage 1SMDBereavement ServicesSMDChewSMDSevern incl. rheum day caseSMDFromeSMDAOC Admissions UnitSMDT WardSMDCarringtonSMDSanctuarySMDFHYBody StoreSMDMain AdmissionsSMDDexa ScannerSMDPhysio and officesSMDSL&HT and officesSMDOT and officesSMDDieteticsSMDK Ward (Inf Dis and Haem)SMDHealth PsychologySMDMalvern (Dementia)SMDElgar 1 (Medicine and CoE))SMDF Ward (Seas Press)SMDSurgery Offices FHYNeuro OfficesFHYImaging OfficesFHYAnaesthetic OfficesFHYCore Clinical OfficesFHYRegistrar of Births and DeathsSMDCashierSMDLeague of FriendsSMDGeneral OP, incl derm, and assoc officesSMDRheum OPSMDAOC OP, Plaster Room and adminSMDG Ward OP and SAASMDAudiology and Cochlear ImplantSMDFHYUrology OPSMDUrodynamicsSMDLithotripsySMDU Ward (Urology)SMDWoodlands (Surgery)SMDTheatres 1,2,3,4 &8, U1&U2SMDNeurosciences OP (Ward 16)FHYSL&HT and officesFHYPhysio and officesFHYOT and officesFHYDieteticsFHYSocial WorkersFHYNeurosciences OP (Ward 20)FHYCSMs Stage 2SMDHealth recordsSMDFHYJ and L Wards (Day Case)SMDDay case Theatres x 2SMDEndoscopySMDEndoscopy DecomtaminationSMDDay Hospital closesFHYPlastics OP, POD, Admin and Skin Ca Nurses (Ward 11)FHYPlastic Dressings ClinicFHYBurns / Plastics OfficesFHYRenal OPSMDVascular TestingSMDFHYCardiac TestingFHYHaematology Day UnitSMDRDU and Day Case UnitSMDNeurophysiologyFHYNeuro Theatres 1,2,3FHYTheatre 7FHYSpinal Theatre 6 or Theatre 5FHYICU - retaining a number of beds at FHY for emergenciesFHYPlastics Trauma ClinicFHYEmergency Dept incl MIU and plain filmSMDFHYWard 105 (MAU)FHYWard 106 (MAU)FHYWard 107 (SAU)FHYWard 103 (CCU)FHYCardiac TestingFHYWard 18 (Neurology and Stroke)FHYWard 19 (Neurology and Stroke)FHYIP therapy equipment within neuroFHYWard 1 (Neurosurgery)FHYWard 2 (Neurosurgery)FHYWard 3 (Neurosurgery)FHYWard 4 (Neurosurgery)FHYWard 12 (Neurology)FHYIP therapy equipment adj to Ward 207FHYWard 201 (Trauma)FHYWard 202 (Trauma)FHYPlaster Room and # clinicFHYWard 104 (Burns and Plastics)FHYWard 204 (Burns and Plastics)FHYWard 203 (Surgery)FHYPlast Theatres 1 and 2FHYBurns TheatreFHYGen Surgery Theatre 8FHYPOA (Ward 5)FHYMSK OfficesFHYHand and Upper Limb CentreFHYWard 13 (Stroke)FHYWard 15 (Stroke)FHYWard 205 (Medicine and C of E)FHYWard 206 (Medicine and C of E)FHYWard 207 (Medicine and C of E)FHYDay case Theatres 1 -4FHYNeuro Physio and OT adj to neurology officesFHYBurden (Neuropsychiatry) to Avonmead and BrunelFHYMacMillan (Pall Care)FHYRetained ICUFHYEndoscopyFHYEndoscopy DecomtaminationFHYWard 30 (Seasonal Pressures) if still openFHYRegistrar of Births and DeathsFHYPharmacyFHYCashierFHYMedicine Offices (incl. rheum)FHYMortuaryFHYBereavement ServicesFHYTheatre 4FHYLaser CentreFHYImmunology OP and HIV (Brecon)SMDCardiac Rehab (offices)SMDFHYDiabetes UnitSMDPOA (Brecon)SMDCSMs Stage 3FHY

43. 43

44. Reflections and Lessons

45. Move Reflections – CEO comments
Moving into the Brunel hospital showed North Bristol NHS Trust at its very best.
Over 500 patients, 24 of whom were critically ill, were successfully and safely moved from Frenchay or Southmead into the new hospital over a two week period.
The values of our staff were fundamental to making this undertaking go so well. But significantly our approach to planning; which was inclusive, honest, when things needed attention, rigorous but not overwhelmingly bureaucratic, with decisions being taken quickly and communicated widely was pivotal in aligning effort, and building confidence as we got nearer to move date.
We had, and have, some brilliant skills and expertise but bringing in outside perspective and skills was a pivotal decision, it showed us willing to be open and to learn, and it helped us provide a single critical path, to ensure objective oversight and a single point of contact when things could fall between individuals or overlap.

46. So what were the lessons?
Communications
In an organisation over multiple sites communication (and rumour control) are key and difficult
Keep it simple
Keep it frequent
1 page highlight is all that is needed
When moving – email isn’t there
Every external group will ask questions
There is never enough reassurance

47. Lessons Continued
Single Change Programme
The need for strong governance with a single SRO and single critical path
That supports – not demands
The benefits of running the Command Centre structure
The lack of concern about hierarchy, meritocracy got things done, not rank
Control with Empowerment
Monitoring and making clear and bound decisions is crucial, as is the recording of these
Gateway reviews (internal and external) are crucial

48. Lessons Continued
Operational Focus
Target Standard Operating Procedures (SOPs) should be bedded in and routine before any physical move
Greater clinical & surgical design involvement would have avoided rumours and distraction
All major cross cutting work should be have an operational and clinical lead (if not the same person) and where identified project support for the life of the work
Ambitious timescales
That a 6 week period from handover to move was a real challenge
You can move a hospital in 2 weeks (just)
People have lives, the impact of 7 day working should not be overlooked - we need to look after all our people

49. Lessons Continued
Resources
Annual Leave control works
The importance of building a strong sense of team, based on continuity – colleagues, programme, suppliers and business – the positive attitudes and cooperative interpersonal skills exhibited have been a real success
There is a difference between subject matter expert and project management
And BOTH are needed
External support when needed should be used

50. Last Thoughts

51. 51

53. 53

55. Fun things that you would never predict
Trainers
Everyone involved in the move needed comfy shoes
But all are healthily now!
Helicopter testing
Start small and increase in size
Big means BIG
Swipe access doors
Great for security
Not so much for tours
The restaurant

56. Serious things we learnt
We did lose beds
Not patients – but beds
Boxes boxes everywhere
100’s
Packing everything
Even the clocks – you can’t spring clean enough
Less meetings is good
And sticking to it

57. Final thoughts
It’s a beautiful building
With outstanding staff
Its here for the population of Bristol
For a long time

58. But don’t come if you don’t need to