The new hospital will transform the experience of our patients and the working environment for staff. The substantial benefits include:

Improved privacy and dignity – all accommodation will be single-sex, with 40% provided in single rooms. These single rooms will ensure patients with particular needs, including those at highest risk of infection, are treated appropriately.

Personalised care – with day rooms, enhanced washing facilities, en-suite provision, and local temperature control, the new spaces will provide the best environment to offer high standards of compassion and care. The site will benefit from multi-faith facilities in the heart of the hospital and there is a restaurant on the fifth floor, with a varied menu to cater for a range of diets.

Multidisciplinary working through the co-location of services – the hospital’s layout will help teams to work together to provide the best patient care.

Improving care pathways and patient experience – through new ways of working across teams and services, we aim to develop more integrated care pathways and improve patient experience.

Consistently screening all incoming patients – we want to make best use of patients’ first few hours in hospital. During this initial period, this means, for example, carrying out a number of essential assessments consistently for all patients – including nutritional, VTE and MRSA screening, identifying diabetic risk, and involving specialist teams as appropriate, such as our new GP-led homeless people’s service.

Improving theatre management to avoid cancellations – we must ensure that no operations are cancelled unnecessarily on the day of surgery. This will be achieved through a number of measures – including: ensuring our beds are available; staggering the arrival times of elective patients, reorganising our timetable to decompress multiple calls to critical care admission on the same day, relocating pre-assessment to Outpatients so that that process can begin at the time people are listed for surgery; and by completing part one consent before the day of major surgery.

Reducing the length of stay – we want to lower risk for patients, by shortening their length of stay, without increasing readmission rates. This will be achieved in a number of ways – including:

• By moving to nurse-led discharge for all elective work and named emergency procedures, we can shift the timing of discharges to the morning.
• Using the investment in consultant-delivered emergency care, ward rounds and cross-team board rounds, we can get decisions expedited.
• By meeting our minimum standard of no more than 48 hours’ wait for emergency surgery that is not life threatening, we will reduce pre-operative waits.
• By substituting day care for both elective and emergency patients, we can make the most of the Day Case and Short Stay Unit (ACAD) unit.

Integrating services for elderly patients – we want to meet the needs of older people using our hospital, by using our two designated elderly wards effectively and making sure all specialties support our newly enlarged elderly patients’ medical team. This means patients’ acute phase of care will be provided at The Royal London and their longer-term rehabilitation at Mile End. With the designated therapy input to the unit, which began in the summer, we can improve outcomes and support community care.

More effectively managing critical care patients – we want to make best use of the huge investment in critical care made by commissioners. In the new hospital, we will have an integrated critical care unit, with 44 beds from April 2012, and a support programme for level 1 beds through the Critical Care Outreach Team (CCOT), and level 1a and out-posted level 2 beds through the enlarged intensivist team. This will help us to manage acutely ill patients, as well as ensuring that patients stepping down from level 3 beds, or up from resus, can do so rapidly within hours.