NHS Shetland is set to carry out an assessment of the Gilbert Bain Hospital in Lerwick to identify the need for change after board members gave the move their backing on Tuesday morning.
A property report presented to members of the health board highlighted that the “constrained site provides little opportunity for expansion and little or no variation to the layout possible in an attempt to come close to achieving the modern hospital requirements of today”.
While the Gilbert Bain is well maintained, it could cost around £10 million to deal with a maintenance backlog and bring the hospital up to modern standards.
But this “will not deal with the issues of functionality, current location of services within the building, nor the size of the departmental areas, or the patient privacy and dignity issues identified”, NHS Shetland head of estates Lawson Bisset said in his report.
Bisset told Tuesday’s meeting that the report stemmed from months of survey work in collaboration with NHS Grampian.
“We have to do something about the Gilbert Bain Hospital,” he concluded.
“It functions well, however it does not meet the model standards you could expect of a model of this type.”
He said that the assessment will be carried out in consultation with “Shetland PLC” and could take around one year to carry out.
The assessment, which is an early step in what could be fairly lengthy process, could result in a ‘case for change’ being made.
The hospital, on Lerwick’s South Road, was designed and built in the 1950s and 1960s.
The prospect of a new hospital for Lerwick was mooted a number of years ago, but the plans did not come to fruition.
The Scottish Government has indicated that it will contribute the £175,000 needed to carry out a new strategic assessment of the hospital.
The property report states that while there are some newer extensions at the Gilbert Bain, the majority of the hospital is the original 1961 building.
While the physical condition is “generally of a good standard and has been well maintained over the years”, much of the building needs to be renewed.
There is concern, for example, over the hospital’s electrical system, while there are problems with water leaks in the roof and with windows.
There is an acknowledgement that the “current medical, nursing and support staff continue to provide a quality service despite the physical constraints of the building”.
However, the delivery and access space is “very tight, leading to compromised staff and pedestrian access” – while the A&E department is too small.
The wards, meanwhile, are multi-bedded and do not meet the minimum requirements of 100 per cent single rooms with en-suite facilities.
The current bed space does not meet standards imposed in 2008, and to meet these the current wards would have to double in size.
Interim NHS Shetland chief executive Simon Bokor-Ingram said it was important to recognise that the care delivered at the hospital is “excellent”.
He said that any case of for change needs to take into account how healthcare may look like in the next 40 to 50 years.
Councillor Malcolm Bell stressed that the public needs to be reassured about the quality of service from the Gilbert Bain in light of comments that it is not fit for purpose.
“We will be using this building for a considerable amount of time,” he said.
Bell said that despite its “shortcomings”, Shetland’s hospital service was still “light years” ahead of Orkney’s until a new Balfour Hospital become operational in Kirkwall a few months ago.
Bokor-Ingram said the board itself receives assurances from external reviews of the service.
Director of nursing and acute services Kathleen Carolan, meanwhile, said it is “really important that we continue to appropriately invest in the building”.
She pointed to the proposed extension and enhancement of the hospital’s day surgery unit, which has secured £1.3 million in funding from the Scottish Government.
The last word went to NHS Shetland chairman Gary Robinson, who admitted he was “quite cautious” about the plan.
This was because around 12 years ago the health board was in a similar situation but the justification for a new hospital fell short, he said.
“I’m quite insistent this time we go through the steps in the right order,” Robinson said.
“I want to see this done properly because I think the means will justify the end, so to speak.”