A multi-million pound development at Chesterfield Royal Hospital is set to transform the face of emergency and urgent care for more than 420,000 people who live in the town and across North Derbyshire.

At an expected cost of around £26 million, the ambitious scheme will create a new Urgent and Emergency Department Care Department – at the front of the hospital site where an existing staff car park is sited. With enabling works due to start immediately, the build itself will get off the ground in early summer – and doors are expected to open to patients at the beginning of 2023.

The desire to reinvent emergency services at the Royal has long been under debate. In 2019, after years of discussion with NHS bodies, staff, patients and public engagement, agreement was initially reached on a way-forward that effectively re-designed the existing Emergency Department (and its adjacent areas) to the tune of around £19 million. This four to five-year project would have been carried out in a number of complicated stages, to fit around the continuation of patient care and service provision.

Deputy Chief Executive and Chief Operating Officer at the hospital, Berenice Groves is leading the revised project and explains the change of plan:

“The COVID-19 pandemic stopped our original proposal in its tracks, but it’s given us an opportunity to step-back and re-examine this important development, to make sure we really have ‘got it right’,” she comments.

“In the space of a year, like other hospitals across the country, we have had to work smarter. The pandemic has hastened improvements to our care processes and pathways and it’s become clear, over the last few months, that a new Urgent and Emergency Department Care Department build, outside the confines of the existing available space, offers a better solution in a shorter time-frame. Whilst on paper it might add up to a bigger financial commitment, the additional investment enables an even better environment for our patients to receive the care they need and more improvements to the workplace for our staff. Crucially, it future-proofs emergency and urgent care for everyone and provides much-needed sustainability.”

The latest architect’s plans are still being finalised, but the layout of this new and preferred option will still bring emergency, urgent and primary care services together in one space, although within defined areas. The aim is to get people where they need to be as quickly as possible, so they can be seen by the right clinical expert – whether they need treatment for a minor injury, emergency care for a serious accident, critical care for a life-threatening condition, or medical support for a long-term illness that’s causing concern. For staff, facilities will include changing areas, a staff rest room, office accommodation and an area for training. Throughout the pandemic we’ve learned just how critical these amenities are for staff to take a well-earned break and to continue their education.

The development also encompasses designated zones to care for children and those with a mental health need, as well as allowing for more in-depth assessment of patients who may require additional, but immediate support from other professionals, including therapists, voluntary and social services. There’ll also be improved access to nearby x-ray and imaging services to reduce the length of time patients spend in the department.

The transformation doesn’t stop there. As part of the project a paediatric assessment unit (PAU) will also be constructed, alongside the Royal’s Nightingale Children’s Unit. This additional aspect of the scheme will ensure babies, children and young people with acute illness or injury are assessed, investigated, observed and treated with an expectation of discharge home in 12 hours or less.

Over the next few weeks and months, a number of smaller projects will be carried out that will help the larger scheme to ‘get going’. These include works within the grounds and gardens to prepare the site, as well as other refurbishments within the existing hospital building. At the end of last year, to get ready for an earlier opening date for the Urgent and Emergency Care Department, the Trust opted to finance a pharmacy within its main entrance – which is already giving people easier access to over-the-counter and prescription medications, as well as advice from pharmacy specialists.

Dr Katherine Lendrum, Consultant in Emergency Care – and the Emergency Department’s Clinical Lead – is delighted to see progress taking place. She and the ED team have had input into the new plans and will be involved at every stage of the building programme. Commenting on the decision to adopt a new-build approach she says: “This will make such a difference and the team is incredibly excited to see the revised plans unfold. It’s absolutely the right decision for our patients and our staff. We have an opportunity to apply what we’ve learned throughout the pandemic, to cement the partnerships we’ve developed and to strengthen new ways of working that ensure our patients’ experience is a good one.

“Whatever level of care you need you will immediately be in the right place when you arrive at the door. Then it’s our job to assess you and make sure you see the right expert in the right part of our Emergency or Urgent Care Department as quickly as possible. This could be a GP, Advanced Nurse Practitioner, Therapist or Consultant, but it will be someone with the skills and expertise that you require.”

Over the coming months staff, patients, the public – and other interested parties – will be able to share in the new development as it gets underway, through a series of on-line information events that build on previous engagement and involvement. These will include opportunities to view the plans and a ‘fly-through’ of the new building – to get an idea of what you’d experience as a patient. Financed by the NHS England and Improvement (through the Department of Health) and the Trust, this exciting scheme is one of the biggest recently seen on the Chesterfield Royal Hospital site and will revolutionise this aspect of hospital services that were first opened in 1984.