Building for the future

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Speaker 1

Building for the future means leading groundbreaking research and putting this into clinical practice to help us deliver exceptional treatment to more patients.

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Speaker 2

CUH has been working in partnership with the University of Cambridge for many years to deliver globally significant genomics research. The immediate impact of that we are now seeing is our ability to deliver specialized and personalized treatments for many of the patients who come to Addenbrooke's Hospital.

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Speaker 3

So here at our Cambridge Genomic Labs, we identify strategies that would offer the best treatment options to our patients that would thereby benefit their conditions.

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Speaker 4

So there was a lady who was referred to us from the pregnancy clinic who had a history of diabetes in a previous pregnancy. And given her history, we thought it be worth just investigating the type of diabetes she had.

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Speaker 5

So we invited her along for genetic screening, and this identified that she had a genetic form of diabetes. And that enabled the correct treatment pathway for both mother and baby.

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Speaker 2

Much of the research carried out at CUH started here many, many years ago, and it gives everybody an enormous sense of satisfaction to see that not only being used to develop new treatments, but also to start the development of big infrastructure projects, such as the development of Cambridge Children's and the Cambridge Cancer Hospital, which hopefully we will see completed within the next few years.

We will work with hospitals across the East of England to provide high quality specialised care for more patients closer to home

Some of our sickest patients require quick and easy access to scarce clinical expertise and equipment. CUH works with other trusts to provide specialised services to more than six million patients across the East of England: delivering integrated clinical pathways with fifteen other hospitals, running regional services and managing regional specialist clinical networks.

Basing specialist services in a smaller number of hospitals nationally can improve safety, quality, and efficiency. However, in a rural geography like the East of England this can also make access to these services very unequal: primary care services based further away from specialist centres can lack the easy connectivity to specialists that can streamline referral pathways, and the time and cost of travelling further is a barrier to some patients. The East of England has the fewest hospital beds and lowest number of clinical staff per patient of any region in the NHS. Consequently many patients go to London or elsewhere for specialist treatment that could be provided within the region.

Specialised commissioning is changing over the coming years to enable closer partnerships between providers. Other sectors of the NHS, particularly mental health, have seized this opportunity to repatriate services provided outside of their region and enable patients to access services closer to home.

By 2025 we want to:

• Improve access to specialised services for patients within the East of England, particularly where patients have long waits or distances to travel
• Reduce the disparity in access between patients within the region, ensuring that pathways of care proactively identify all patients who could benefit and address barriers to access for those who find it difficult
• Improve outcomes for patients through specialised services, particularly where we compare poorly to other regions
• Support trusts across the region to build capacity in specialised services by repatriating some of the £500m that it costs to provide care to patients from the East of England in London hospitals. This will also support other major challenges such as recruitment and financial balance, and opportunities such as spreading research and innovation
• Deepen trust and relationships by working with other trusts in the region, and with commissioners to align with broader strategies to improve care

We will achieve this by:

• Forming the East of England Specialised Provider Collaborative as a partnership of seven trusts, with governance appropriate for the responsibilities that the Collaborative is undertaking
• Engaging closely with specialised commissioners and Integrated Care Boards (ICBs) within the region to align with their priorities for improving services for patients, particularly in cardio-thoracic, cancer, neurology and neurosurgery, paediatrics, burns and plastics, including delegated commissioning responsibility as appropriate
• Implementing practical changes to improve care pathways and increasing capacity for specialised services across the region
• Embedding regional collaboration on specialised services through our planning for new hospitals builds, support for developing the Cambridge Biomedical Campus and ongoing research and innovation activities

We will conduct world-leading research that improves care and drives economic growth

Cambridge is an unparalleled ecosystem of world-class research institutes, laboratories, industry and investors working alongside clinical teams to innovate and improve healthcare. The University of Cambridge has scored top position in the country in clinical medicine, the latest results from the Research Excellence Framework (REF); and our county is home to 470 life sciences companies, employing more than 20,000 people and annually growing turnover by more than 10%.

CUH and the University of Cambridge host a NIHR Biomedical Research Centre (BRC), supporting, delivering and providing leadership in translational research within the NHS locally and nationally. CUH embeds innovative practice and research across our clinical pathways to ensure that our patients have quick access to the latest developments in treatment and care. We are also working to extend research and innovation outside the hospital into primary care, where remote diagnostics offer extraordinary potential to increase early detection of disease.

Pioneering research, and subsequent translation into direct care for patients, wouldn’t be possible without support from across the hospital laboratory space, clinical trial infrastructure, data, skilled teams and study participants. Together they give CUH the resources, skills and capacity to develop new world-class treatments in bioscience and health technology. They also provide the foundations for commercial partnerships that drive economic growth and draw investments into healthcare.

By 2025 we want to:

• Increase the number and breadth of research studies conducted, particularly in areas of high disease burden and clinical need
• Increase the number and diversity of research participants
• Increase the number and diversity of researchers, building on our world leading centre for Nursing, Midwifery and Allied Health Professions (NMAHP) research
• Increase the scale and pace of research positively impacting clinical practice inside and outside the hospital
• Increase the economic value of the life sciences sector and extend the reach further within the East of England

We will achieve this by:

• Fully embedding research and industry partnerships within the new Cambridge Children’s and Cancer Research hospitals, particularly through genomics
• Further extending research outside the hospital through CUH’s clinical pathways, particularly using early diagnosis to improve outcomes and reduce health inequalities
• Growing the impact of the Cambridge Biomedical Campus (CBC) and working with CBC Ltd to deliver the 2050 Vision
• Fostering innovative commercial partnerships through our ‘Open For Business’ framework and Investment Fund
• Developing links between research, education and training to attract and retain talent
• Increasing our capacity to deliver digital innovation and research allied to health and data in the fields of Artificial Intelligence (AI), big data, diagnostics and health inequalities

We will maintain a safe estate and invest in new facilities to improve care for patients locally, regionally, and nationally

CUH has enormous clinical and research capability, but our ability to capitalise on this for the benefit of local, regional and national patients is severely limited by the state of our facilities, most of which are more than fifty years old and not fit for purpose. The East of England is the only region without a dedicated Cancer or Children’s hospital, meaning we are unable to provide the care patients need in appropriate facilities.

To tackle these issues CUH has worked with NHS, academic and industry partners to design a ‘hospital of the future’, called ‘Addenbrooke’s 3’, underpinned by world-leading research, which starts with our Cambridge Cancer Research Hospital (CCRH) and Cambridge Children’s Hospital (CCH) projects.

Alongside our ambitious development plans we are equally committed to maintaining safe, efficient and effective facilities across our current estate.

By 2025 we want to:

• Maximise the use of our Regional Surge Centre (RSC) capacity of 120 beds to reduce waiting times for planned and unplanned care
• Re-provide suitable accommodation for histopathology
• Implement expansions to the Emergency Department
• Commence construction on two new exciting hospital buildings as part of the New Hospitals Programme (NHP):
  • CCRH: Announced by the Prime Minister in October 2020, the 26,000sqm building will bring ‘the bench to the bedside’ and integrate world class cancer research with the latest in digital technology and NHS clinical care, focused on prevention, early detection of disease and novel precision medicine treatments, to dramatically transform our ability to beat cancer, saving millions of pounds of public money and enabling new cancer pathways across the region
  • CCH: Announced by the Secretary of State in December 2018, the 36,000sqm building will deliver a world’s first integrated physical, mental health and research ‘smart’ hospital for children and young people. This hospital will provide care for children and young people in a whole new way to enable earlier diagnosis and intervention, delivering improved lifetime health outcomes and centrally coordinated digitally enabled integrated care across the region
• Reduce the quantum and risk of backlog maintenance in line with available capital resources
• Maintain safety and optimise effective use of our current estate
• Identify and commence planning for future capital developments

We will achieve this by:

• Working with patients, staff, carers, and wider stakeholders across health, mental health, social care, research, and education, as well as with leading architects, engineers and other experts, on the design of all our new hospital buildings and the development of new integrated models of care
• Securing funding through completion of the HM Treasury business case process and our fundraising activities, supported by ACT, Head to Toe and the University of Cambridge fundraising teams
• Investing in an ambitious programme of repairs and maintenance on our current estate
• Enhancing our delivery capability and capacity across the Trust as we move to implementation

We will tackle the climate emergency and enhance environmental sustainability

Climate change is a globally pressing matter that has led to the UK government declaring a ‘climate emergency’. Unless global warming is limited to 1.5˚C, climate change will continue to devastate the environment, the economy and people’s way of life. Higher temperatures also lead to increased rates of respiratory and cardiovascular disease, more injuries resulting from extreme weather events, greater spread of infectious diseases, threats to public health from constrained food and water supply and economic costs crowding out investment in healthcare.

The NHS has committed to halving carbon emissions before 2032 and delivering net zero carbon by 2045. CUH has developed a Green Plan to deliver our commitments, promoting environmental sustainability and playing our part in creating a safer and healthier future for everyone. CUH welcomes innovative practice and research beyond our clinical services, and works in close partnership with researchers and companies seeking to innovate in environmental sustainability. Our staff increasingly highlight their expectation that CUH will play a leading role in this globally significant challenge.

By 2025 we want to:

• Reduce our direct emissions by 10% (from a 2019 baseline) and be on a clear path to halving our carbon emissions before 2032 and reduce to net zero by 2045, in line with national NHS commitments
• Protect our services from the effects of climate change including severe weather
• Provide opportunities for academic and industrial innovation in Cambridge to bring forward technological breakthroughs to tackle climate change
• Be able to demonstrate that we are on a net-zero/zero-waste circular economy trajectory and to help and encourage others to take the same bold steps

We will achieve this by:

• Reducing energy use and decarbonising energy supplies for Trust premises and meeting the NHS Net Zero Building Standard for new buildings and major refurbishments
• Transitioning Trust business miles from fossil fuelled to electric vehicles and continuously improving sustainable travel options for staff, patients and visitors
• Avoiding the emission to atmosphere of high global warming potential anaesthetic-related gases
• Working with our suppliers to develop and procure/provide goods, materials and services that meet our net-zero/zero-waste ambition
• Providing the means for all teams across the Trust to set their services on a net-zero/zero-waste trajectory and embedding carbon and waste reduction as essential aspects of decision-making
• Establishing clinically led multidisciplinary teams to adapt the relevant elements of models of care in ways that reduce carbon emissions and waste

Developing carbon retention and local off-setting practices that account for residual emissions in meeting the net-zero challenge in full

We will use technology and data to improve care

Our hospitals benefit from a very high starting level of digital maturity, which supports the safety and efficiency of our services and improves decision-making. The pandemic has helped us to achieve a culture shift and level of digital transformation within and beyond the hospital that would otherwise have taken years. As we continue to recover our services, we must build on this momentum to reduce waits and make it more convenient to access care.

Digital transformation underpins our ambitious targets for improving efficiency, safety, and quality; can help to tackle health inequalities; and plays a central role in empowering our patients and supporting our staff to work differently to deliver all the commitments across our strategy.

By 2025 we want to:

• Ensure our infrastructure and data environments are secure, sustainable, resilient and fit for the future
• Increase use of digital channels to access care to better manage demand on our services
• Provide a seamless patient journey using digital systems to share medical records both inside the hospital and in collaboration with other health and care providers
• Use insights from our operational analytical data to deliver efficiencies in how we use our current capacity and develop services for the future
• Deliver digitally smart new hospitals, working with industry and academic partners to innovative and deliver improved patient outcomes and efficiency alongside cutting-edge research
  

We will achieve this by:

• Improving our core systems through proactive management of software and underpinning infrastructure by keeping it secure and current, consistent with industry-wide prevailing standards
• Increasing digital leadership expertise across the Trust and developing the digital skills of our workforce through provision of additional, targeted training opportunities
• Investing in supporting staff and patients as we change, implement and adopt new digital solutions
• Maximising the potential of our existing investments and capability by exploiting the use of Epic tools and extending the utilisation of the MyChart patient portal, bringing workflow efficiencies and empowering the patient
• Digitising burdensome manual processes where safe and appropriate to do so, releasing time to care
• Extending our ‘virtual’ offering to establish virtual wards and clinics including telemedicine opportunities for home monitoring
• Developing a ‘Shared Care Record’ across our ICS to provide access to patient medical records beyond the walls of our organisation
• Investing in partnerships and tools to assist with predictive modelling of patient demand and flow
• Establishing a means for academics safely to access our data and use technology to support different models of care pathways
• Innovating through collaboration with partners, research and digital innovation hubs to exploit potential opportunities