Home > Library > Diagnostic and Treatment Centres - DTC: the future of healthcare? >

Case study: Lymington Community Hospital

Sue Howson, PFI Project Director, New Forest PCT

The New Forest PCT operates six community hospitals. It is currently planning a new hospital to replace the existing Lymington hospital, and this new hospital fits the characteristics of a DTC.

The PCT believes it is well placed to run a DTC as it has the ability to see the whole of the healthcare system and is able to match rehabilitation service to diagnostic and treatment procedures. The facility has been planned with partners – particularly acute providers and social services.

The PCT also thought that opting for a DTC would enable it to build under PFI (earlier applications to build a new ‘PFI’ hospital had been unsuccessfull.

The DTC was seen as a chance to ‘start again’, in terms of the services provided and the type of building they would be provided from. Early thinking took in systems and process redesign, as well as new roles for staff. The DTC was to be based around people working as teams rather than individual practitioners. There will be a multi-professional triage team that deals mainly with orthopaedics.

The brief for the building designers, therefore, calls for a structure that can keep people together as teams, with buildings built around the patients and patient pathways. The brief also says that the buildings should have maximum flexibility to allow for change, and advanced use of IT such as EPR and telemedicine.

A series of workshops were held with stakeholders to help in planning the building. These suggested that space should be regarded as ‘a resource not a territory’. There was also a need for good public space, private areas where people could talk to clinical staff or be alone if they need to, social space such as a café and education facilities. There should be ‘natural overflows’ from waiting areas.

It was seen as important that this would not just be a place where people come to get treated, but rather it should be seen as a community facility.

The concept of ‘day and stay’ emerged from thinking about what has been called the ‘pace’ of the building: medical day case needs a slower process than day surgery. The idea is to keep the ‘day’ part away from the ‘stay’ part in the design.

A great deal of attention has also been paid to services and ‘adjacencies’, that is, which services need to be near which. This meant looking carefully at how services within the DTC would relate to each other.

Benefits of the DTC are seen to be that

• it keeps the NHS local
• it identifies and responds to new care pathways
• it integrates primary, community and social care
• it promotes workforce modernisation
• it reduces demand on acute facilities.

< < Previous - Next > >