Achieving The Seemingly Impossible: Lessons from the Seacole Centre

Dr Katie Lansdell is an Associate Director at PPL with nearly 20 years of experience in the consulting industry, most of which has been spent working on integrated care. As the COVID-19 lockdown started, she was asked to transition the programme she was working into support to develop a new community hospital in response to COVID-19: the NHS Seacole Centre in Surrey.

When I first began learning about project and programme management, we were asked a question – how long does it take to build a house?

We thought about it for a while and came up with a range of answers from a week to several years depending on how complex the design was and whether you counted “building” as including a design phase or not. Then we were shown a time-lapse video of a house being built from a standing start in one day! There were swarms of people running over the site to a carefully choreographed plan. My recent experience with clients during the COVID-19 pandemic has made me think of this again.

Time and time again I’ve heard stories of how we have been able to achieve things that were seen as impossible, whether a mass shift to online consultations or building new hospitals from scratch.

At PPL, I’ve been involved in supporting the development of the NHS Seacole Centre at Headley Court, a community bedded rehabilitation and step-down facility, developed from a decommissioned military rehab centre. The Centre was opened by Matt Hancock, Secretary of State for Health on 4th May 2020, just 35 days after the need for it was confirmed.

As the COVID-19 outbreak started, health and care systems across the country began to look at their capacity to cope with a rising demand for specific types of care.

Initially, a series of Nightingale hospitals were developed for people requiring critical care. Meanwhile, in Surrey, it emerged that there was a need for more bedded step-down care and rehabilitation.

Capacity and demand modelling showed that around 300 beds would be required from April to receive people who no longer needed acute care but could not yet go home. A range of options were explored, and a former military rehabilitation centre was identified as an ideal location to create a new community super-hospital for Surrey and surrounding areas.

We were engaged to support the development of the clinical model and for performance monitoring, just as the UK lockdown began.

We quickly adopted virtual methods of communication and collaboration to develop this at a rapid pace, drawing in clinical expertise in geriatric care, general practice, therapy and social care to develop a model based on accepting people that were still recovering from COVID-19 and had quite high needs.

Creating a new hospital from a standing start is a challenging process that requires thinking through all the support services that are often taken for granted on an established hospital site.

This includes everything from diagnostics, pharmacy, oxygen supply, mortuary, chaplaincy, transport, to how visitors are directed and supported – all of which need to be considered and set up.

In the midst of any crisis, things change.

As the combined teams were working through the above, the modelling work was updated and, due to the success of public health measures to keep the COVID-19 outbreak in check, the need for these beds changed in nature and time.

In addition, the crisis in care homes meant that a real worry was about an increased need for step up care from care homes. This required the clinical model to be revised and those changes quickly agreed by all Integrated Care Partnerships across Surrey.

A business case that secured the necessary funds was written and approved in just a few days.

I believe this was proof in action of our firm belief that it is not the document that holds the value, but the quality of the conversations which have gone into making it. We had had countless conversations with a range of teams working on this over the preceding weeks, which made the development of the business case straightforward.

Since the Centre opened, our involvement has moved into supporting the development of a system-wide Performance Board, with a comprehensive integrated dashboard of information to support it.

This board monitors usage patterns and plans future improvements. It has been a forum for gathering information across the system about the ongoing and changing need for the facility, as well as learning about what is working well in terms of treatment and rehabilitation. It has been genuinely amazing to see the progress made in such a short time and a testament to the hard work and dedication of our clients.

We have all been through some dark times recently, but there are some real positives which we can take forward. One which I will keep with me is never giving up, even when things look impossible.