Crumbling North Tees Hospital in desperate need of cash

Pieces of the ceiling are falling in, scaffolding is up on the tower block, and leaders are constantly worried about plugging leaks when it rains.

A member of staff had to stand with a hose to keep vital oxygen pipes from freezing this winter during the height of the pandemic.

Virus patients had to be treated in operating theatres due to lack of room.

There are taped up pipes visible to patients when they’re wheeled around the hospital.

Those having endoscopy procedures have to be taken past bins and tugs in the underbelly of the hospital. 

Staff have a breakout space to rest but it’s a good 10 minute walk for many on the west wing – and many have to sit in the corridor for a break. 

It’s too hot in summer, too cold in winter, ward bosses can’t see around corners and pillars to care for patients, and it costs £8m a year just to keep it in its current state.

Stockton needs a new hospital – and it has needed one for some time.

Trust chief executive Julie Gillon has flagged up trouble more than once at the Hardwick site.

She told April’s board meeting how critical care facilities “were not fit for purpose” when it came to preventing or controlling infections, isolation or patients and staff. 

And Ms Gillon told the Local Democracy Reporting Service how politicians were “on the same page” when it came to sorting out the hospital. 

Turning that support into action is now the key. 

False dawns

The hospital was built in phases between 1965 and 1974.

And efforts to replace it have come and gone. 

Early plans for a “super hospital” were first aired in 2003.

But funding for a new £463m hospital at Wynyard was scrapped in 2010. 

Fresh doubts over where the money for a less costly scheme would come from meant the idea was shelved in 2014. 

Investments have come since then to upgrade parts of North Tees – including a £3m covid package to improve accident and emergency earlier this year.

However, the wider hospital is costing more and more each year to maintain – with its annual estate management costs rising more than 40% in the past five years.

Finance director Neil Atkinson revealed an independent review of the building informed the trust how much money it needed to spend just to get it back to 1960s and 1970s standards. 

“This isn’t about taking it into the 21st century – this is just keeping it going and patching it all up,” he said. 

“You can break the report down to red, amber and green risks – but if you take the full cost, it’s about £48m to put everything right.

“The trust doesn’t have £48m to throw at this.”

“Hamstrung”

Mr Atkinson explained the trust had tried to deal with this massive backlog over five years by only honing in on the worst hit parts of the hospital. 

He said: “We spend £5m to £8m every single year patching it up. 

“Fixing the roof, fixing the wiring, fixing all the bits you can’t see behind the walls.

“That’s what we spend every year – and that money we spend is generated by the trust.

“But is this good value for money? All we’re doing is paying money to patch it up – we’re not actually improving it.

“We’re not improving the health and wellbeing of our staff, and we’re not improving patient outcomes.”

The chief executive said this maintenance struggle “hamstrung” the trust and hindered it from putting projects and services together efficiently.  

Ms Gillon added: “You’d make a new build flexible in its intent – so you would be able to flex its purpose. 

“That’s what you find in all the new builds we’ve visited – whether it be Peterborough, or in Scotland.

“When we visited them, we saw that they can repurpose rooms quite easily and re-engineer rooms so you can get that co-adjacency and efficiency of scale of services that we can’t do.”

Outdated design

As an example, Ms Gillon said they would wrap services around the “nucleus” of A&E and have the “ologies” around it to make staffing and consultation with patients more efficient.

“You would get that efficiency of response – you’d stop the admissions and stop the extended lengths of stay,” she added. 

“We’ve optimised efficiency in this organisation despite the estate.”

She added a new hospital would never be designed how North Tees had been in the past – again pointing to how infection prevention control had been hampered by the layout. 

“We work with such an outdated hospital with no real opportunity to manage single rooms,” said Ms Gillon.  

“We still have rooms with four or six people which means we’ve have to limit numbers – and with that comes the issue of diluting staffing.

“We have to put more staffing in to make sure we’re safe, so all of these things which you wouldn’t do in a brand new building, or a refurbished building, we’re hamstrung with.

“There is a huge rationale for us moving towards a new build to allow us to get that efficiency of scale and management.”

The chief officer said hospitals she’d seen in New York had a nurse’s station in the middle with single rooms around the outside – so patients didn’t feel isolated. 

In contrast, she pointed to the North Tees west wing – where walls and pillars often got in the way.

“You’ve got nooks and crannies and side wards miles away from the nurse’s station – all of which mean we have to put additional staff on to ensure the safety and observation of patients,” added Ms Gillon. 

“Constant battle”

Downpours often put teams on high alert when it comes to monitoring the hospital’s many flat roofs.

Ms Gillon said those on call at a weekend always had to deal with a leak somewhere. 

She added: “During the winter, despite some backlog maintenance, we have a lot of flat roofs and windows on the periphery where, if the wind is lashing in a certain direction, you’ll have a leak.

“We rectify these things but it’s a constant battle – it’s too hot in the summer, too cold in the winter and you can’t get a happy balance.

“We haven’t got air conditioning throughout the organisation – and that goes back to the health and wellbeing of staff.

“It’s sweltering in the summer – the only thing we can do is open windows and that’s not always appropriate.”

The struggling state of North Tees comes in the shadow of Teesside stark health inequalities and difficulties. 

Life expectancies can vary by as much as 20 years in different parts of Stockton borough.

Mortality rates in under 75s across Teesside are higher than the national average – as are emergency hospital admissions for COPD (chronic obstructive pulmonary disease). 

Ms Gillon said they wanted to work to tackle the wider health problems on Teesside alongside other bodies. 

She added: “It builds aspiration with the freeport and the investment in Darlington around the Treasury – let’s hope they come and see us.

“There is also the investment in digital infrastructure on the patch.

“What we’re going to see is an aspiration of the population for those social determinants of health – education and employability aspirations – being something we want to work on with partners, as it impacts on the health of individuals in years of life lost.

“The years of life lost in Stockton and Hartlepool through preventable disease are second to none.

“And we know there is going to be a reliance on acute care while we tackle these issues.

“But we also know that if we don’t tackle the social determinants of health, then we’re going to perpetuate the need for more beds. 

“That’s not the game we’re in. We want to build up a health system with our partners.”

£300m cost for new site 

Meanwhile, Mr Atkinson said the trust spent a lot of money during the pandemic last year on oxygen due to the layout and architecture of the hospital.

“We’ve had to move tanks and we’ve had to put new piping in,” he added.

“It’s been expensive and we’re going into millions just to be able to tackle that response to the pandemic.”

So what will it take to get a new hospital to Stockton?

Well, chiefs say it won’t be anywhere near the £460m sum proposed earlier in the century for the “super hospital”.

And an options appraisal is being carried out at the trust at the moment. 

Ms Gillon added: “We’re very mindful we need to afford something at the trust in the future as well. 

“We certainly don’t want to go into the realms of £460m – it’s about £300m is we were to rebuild.

“There is an argument about refurbishing. 

“That’s our least preferred option – only because of the disruption to the operations and patients that would cause.”

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