Papworth hospital's future in doubt after Treasury intervention Heart and lung hospital's planned Cambridge move caught up in 'NHS politics' that may force partnership with loss-making trust.
The future of the world-renowned Papworth hospital is in doubt because it is being prevented by the Treasury from moving to a new centre of medical excellence in Cambridge.
Instead of consolidating its reputation as a pioneering heart and lung hospital at the forefront of medical innovation, Papworth may instead be forced into a shotgun partnership with the NHS's most loss-making foundation trust.
Stephen Bridge, chief executive of Papworth – scene of the UK's first heart transplant and a host of other medical breakthroughs – told the Guardian that his hospital may become a casualty of "NHS politics" and is "exasperated" at the Treasury's eleventh-hour intervention.
"We could be forever caught up in NHS politics, get bogged down and be left with an uncertain future," said Bridge.
Papworth has had to put on hold its long-planned transfer to a state-of-the-art site outside Cambridge as a result of the Treasury's intervention, despite the move having widespread support in the NHS and academia and from the Department of Health (DH).
The specialist heart and lung hospital may now have to instead move some or all of its services, including cardiac surgery and world-leading transplantation, to Peterborough as part of a rescue plan for Peterborough city hospital.
Peterborough and Stamford NHS Foundation Trust, which runs it, is losing millions of pounds a month, has received £44m in emergency funding from the DH to continue operating and was last year declared "not financially sustainable" by the NHS's economic regulator Monitor.
Papworth, based 12 miles west of Cambridge, has been planning for 10 years to leave its ageing site and relocate to a new £160m, 310-bed hospital in the Cambridge Biomedical Campus, a huge new medical and science park next to the city's Addenbrooke's hospital, which will ultimately employ 30,000 people and be one of the world's biggest centres of research and treatment.
The move is so advanced that Papworth has already appointed construction firm Skanska to build its new facility. The DH approved the move last October and has also arranged £70m in low-interest loans to help Papworth meet the £160m overall cost. The hospital has to borrow the remaining £90m from banks under the private finance initiative (PFI), with that deal needing the Treasury's approval.
But in an unexpected intervention, the Treasury has ordered Monitor to undertake two reviews, which will take several months to complete, before it will approve any move by Papworth.
The first is a review of Papworth's finances – the third such exercise in three years – which it has commissioned despite Papworth being one of the NHS's strongest performers financially and the two previous reviews having raised no concerns.
The other, a short clinical review being undertaken by an independent leading NHS doctor, is examining the "arguments for and against proposals to locate the facility as planned next to Addenbrooke's hospital as well as a clinical review of the feasibility of the utilisation of any excess capacity at Peterborough." The Peterborough hospital, which is struggling to repay a controversial PFI debt, has vacant space which Papworth may help to fill.
The Treasury's move has raised concerns that Papworth's key role in the new biomedical campus, which will see its experts pursue major innovations in treatment for a range of diseases, may be sacrificed because of a desire to improve the finances of Peterborough hospital.
Bridge said he was "disappointed and exasperated" that "the Peterborough option" had been resurrected by the Treasury, even though a report by Monitor last September ruled it out. Patients would benefit from Papworth going to Cambridge because it could then "develop market-leading specialist services for the NHS in one place", the regulator concluded.
Patients may lose out and the Papworth trust's future be in question if some or all its services and 2,000 staff end up going to Peterborough rather than Cambridge, he added.
"Despite providing very detailed financial and clinical evidence as to why Papworth should move to Cambridge, we were informed by the Department of Health [in December] that the we now have to answer these questions, including about why some of our work couldn't move to Peterborough," Bridge said.
"I'm exasperated as only in May last year and again in September last year I was officially told that there was no longer any suggestion that any of Papworth's services should move to Peterborough hospital."
The DH told Papworth about the Treasury-ordered reviews barely two months after health minister Earl Howe had approved the move.
Bridge added: "The clinical reasons for us moving to Cambridge are overwhelming. We do heart and lung transplants and would be next door to Addenbrooke's, which does liver and kidney transplants. We would create a world-leading solid organ transplant centre. "
He is worried that, without final approval soon for the move to Cambridge, Papworth could be targeted under DH plans currently going through parliament to give government-appointed special administrators the power to push through changes at profitable trusts situated near hospitals which have hit major financial problems, such as Peterborough.
NHS England, Cambridge University and major medical charities such as the British Heart Foundation and Cystic Fibrosis Trust strongly back Papworth moving to Cambridge.
Julian Huppert, the Liberal Democrat MP for Cambridge, warned that forcing Papworth to share with Peterborough city hospital was not sensible clinically and would ultimately cost more money.
"The well-known problems of PFI contracts that the last government was so keen on should not cause worse treatment now for another hospital. They should not force Papworth to go to the wrong place simply to patch up other problems. It doesn't make sense to spend more money on a worse outcome simply because of previous problems at Peterborough that are entirely separate," Huppert said.
"Papworth moving to the Addenbrooke's site is the right thing clinically for the patient and the right thing in terms of research and developing new treatments," added Huppert, a scientist.
The Treasury and DH declined to answer questions put to them about their involvement with Papworth and instead issued a joint statement through a government spokesman.
He insisted that "the Department of Health is still considering the [Papworth] trust's business case", even though it signed that off four months ago.
"A joint decision with the Treasury will be made soon. As is normal for major projects such as this one, the Department and the Treasury, drawing on the expertise of Monitor, would expect assurance around the affordability of the scheme and whether it represents value for money for the taxpayer," he added.
Monitor is looking for "assurance" from the reviews that "the proposed future location of Papworth hospital … will be sustainable, is clinically and financially appropriate, and will provide good value for money for the taxpayer." The Guardian
The future of the world-renowned Papworth hospital is in doubt because it is being prevented by the Treasury from moving to a new centre of medical excellence in Cambridge.
Instead of consolidating its reputation as a pioneering heart and lung hospital at the forefront of medical innovation, Papworth may instead be forced into a shotgun partnership with the NHS's most loss-making foundation trust.
Stephen Bridge, chief executive of Papworth – scene of the UK's first heart transplant and a host of other medical breakthroughs – told the Guardian that his hospital may become a casualty of "NHS politics" and is "exasperated" at the Treasury's eleventh-hour intervention.
"We could be forever caught up in NHS politics, get bogged down and be left with an uncertain future," said Bridge.
Papworth has had to put on hold its long-planned transfer to a state-of-the-art site outside Cambridge as a result of the Treasury's intervention, despite the move having widespread support in the NHS and academia and from the Department of Health (DH).
The specialist heart and lung hospital may now have to instead move some or all of its services, including cardiac surgery and world-leading transplantation, to Peterborough as part of a rescue plan for Peterborough city hospital.
Peterborough and Stamford NHS Foundation Trust, which runs it, is losing millions of pounds a month, has received £44m in emergency funding from the DH to continue operating and was last year declared "not financially sustainable" by the NHS's economic regulator Monitor.
Papworth, based 12 miles west of Cambridge, has been planning for 10 years to leave its ageing site and relocate to a new £160m, 310-bed hospital in the Cambridge Biomedical Campus, a huge new medical and science park next to the city's Addenbrooke's hospital, which will ultimately employ 30,000 people and be one of the world's biggest centres of research and treatment.
The move is so advanced that Papworth has already appointed construction firm Skanska to build its new facility. The DH approved the move last October and has also arranged £70m in low-interest loans to help Papworth meet the £160m overall cost. The hospital has to borrow the remaining £90m from banks under the private finance initiative (PFI), with that deal needing the Treasury's approval.
But in an unexpected intervention, the Treasury has ordered Monitor to undertake two reviews, which will take several months to complete, before it will approve any move by Papworth.
The first is a review of Papworth's finances – the third such exercise in three years – which it has commissioned despite Papworth being one of the NHS's strongest performers financially and the two previous reviews having raised no concerns.
The other, a short clinical review being undertaken by an independent leading NHS doctor, is examining the "arguments for and against proposals to locate the facility as planned next to Addenbrooke's hospital as well as a clinical review of the feasibility of the utilisation of any excess capacity at Peterborough." The Peterborough hospital, which is struggling to repay a controversial PFI debt, has vacant space which Papworth may help to fill.
The Treasury's move has raised concerns that Papworth's key role in the new biomedical campus, which will see its experts pursue major innovations in treatment for a range of diseases, may be sacrificed because of a desire to improve the finances of Peterborough hospital.
Bridge said he was "disappointed and exasperated" that "the Peterborough option" had been resurrected by the Treasury, even though a report by Monitor last September ruled it out. Patients would benefit from Papworth going to Cambridge because it could then "develop market-leading specialist services for the NHS in one place", the regulator concluded.
Patients may lose out and the Papworth trust's future be in question if some or all its services and 2,000 staff end up going to Peterborough rather than Cambridge, he added.
"Despite providing very detailed financial and clinical evidence as to why Papworth should move to Cambridge, we were informed by the Department of Health [in December] that the we now have to answer these questions, including about why some of our work couldn't move to Peterborough," Bridge said.
"I'm exasperated as only in May last year and again in September last year I was officially told that there was no longer any suggestion that any of Papworth's services should move to Peterborough hospital."
The DH told Papworth about the Treasury-ordered reviews barely two months after health minister Earl Howe had approved the move.
Bridge added: "The clinical reasons for us moving to Cambridge are overwhelming. We do heart and lung transplants and would be next door to Addenbrooke's, which does liver and kidney transplants. We would create a world-leading solid organ transplant centre. "
He is worried that, without final approval soon for the move to Cambridge, Papworth could be targeted under DH plans currently going through parliament to give government-appointed special administrators the power to push through changes at profitable trusts situated near hospitals which have hit major financial problems, such as Peterborough.
NHS England, Cambridge University and major medical charities such as the British Heart Foundation and Cystic Fibrosis Trust strongly back Papworth moving to Cambridge.
Julian Huppert, the Liberal Democrat MP for Cambridge, warned that forcing Papworth to share with Peterborough city hospital was not sensible clinically and would ultimately cost more money.
"The well-known problems of PFI contracts that the last government was so keen on should not cause worse treatment now for another hospital. They should not force Papworth to go to the wrong place simply to patch up other problems. It doesn't make sense to spend more money on a worse outcome simply because of previous problems at Peterborough that are entirely separate," Huppert said.
"Papworth moving to the Addenbrooke's site is the right thing clinically for the patient and the right thing in terms of research and developing new treatments," added Huppert, a scientist.
The Treasury and DH declined to answer questions put to them about their involvement with Papworth and instead issued a joint statement through a government spokesman.
He insisted that "the Department of Health is still considering the [Papworth] trust's business case", even though it signed that off four months ago.
"A joint decision with the Treasury will be made soon. As is normal for major projects such as this one, the Department and the Treasury, drawing on the expertise of Monitor, would expect assurance around the affordability of the scheme and whether it represents value for money for the taxpayer," he added.
Monitor is looking for "assurance" from the reviews that "the proposed future location of Papworth hospital … will be sustainable, is clinically and financially appropriate, and will provide good value for money for the taxpayer." The Guardian
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