About the Case for Change

The Case for Change explains why we need to consider change. 

• It brings together information about our population, the quality of care, demand for services, our workforce and the challenges facing our hospitals
• It helps us understand the problems we need to address. It is not a set of proposals about which services should be provided at which hospitals

We have developed some initial scenarios that look at how we could respond. 

• Developed by clinicians from across our hospitals, these scenarios consider how care might need to develop over the next 10 to 20 years and could form the basis of a clinical strategy
• This includes looking at how our hospitals could work more closely together, what care could be provided closer to people's homes and how we can make the best use of specialist skills and expertise

The Case for Change provides the evidence that has informed our scenarios and will inform the development of our Clinical Strategy. Both need to be informed by the experiences of patients, communities and staff.

There is much to be proud of across our hospitals, but we know that maintaining current arrangements alone will not be enough to meet future healthcare needs. 

Growing demand: People are living longer and often with multiple long-term health conditions. This is increasing demand for healthcare services across Norfolk and Waveney. 

Improving quality and outcomes: We want every patient to receive consistently high-quality care regardless of where they live or which hospital they attend. This doesn’t always happen today. 

Workforce challenges: Some services face workforce pressures that make recruitment, retention and long-term sustainability increasingly difficult. 

Advances in healthcare: New treatments, digital technology and changing models of care mean more services can potentially be delivered differently and, where appropriate, closer to people's homes. 

New hospitals: The replacement hospitals planned for the Queen Elizabeth Hospital King's Lynn (QEH) and James Paget University Hospital (JPUH) provide a significant opportunity to develop services and facilities around the needs of future patients.

Our work reflects the ambitions set out in the NHS 10 Year Health Plan to provide more personalised care, improve outcomes and deliver more services closer to home where appropriate. We are particularly exploring three broad areas. 

Care closer to home: Could more care be safely provided outside traditional hospital settings through stronger partnerships with primary care, community health services, social care and the voluntary sector? 

Services facing pressure: How can services experiencing workforce, demand or sustainability challenges be strengthened for the future? 

Acute and specialist hospital care: How can we make the best use of facilities, expertise and specialist services across Norfolk and Waveney while maintaining safe access to care?

The Norfolk and Waveney University Hospitals Group Board and NHS Norfolk and Suffolk Integrated Care Board have both agreed there is sufficient evidence to support a Case for Change and move to the next stage of work. 

This means further work will now take place to develop and assess a range of potential options for the future.

What has been agreed?

• There is a case for change
• Further work should take place
• A pre-consultation business case (PCBC) should be developed

What has yet to be agreed

• A preferred option
• Changes to hospital services
• Formal public consultation

Current stage: developing and assessing options 

The next stage of work will be led by NHS Norfolk and Suffolk Integrated Care Board through a process known as a Pre-Consultation Business Case (PCBC). 

The PCBC will: 

• develop and assess a range of options 
• include a credible "do minimum" option 
• examine quality, safety, workforce and sustainability impacts 
• assess travel, access and health inequalities 
• consider hospital and community capacity 
• evaluate affordability and deliverability 
• involve patients, staff, partners and local communities 

No options have yet been selected and no preferred option has been identified.

Accordion content

The PCBC will develop and assess a range of possible options for future healthcare provision across Norfolk and Waveney. 

Its findings will be considered by NHS Norfolk and Suffolk Integrated Care Board before any decision is made about whether proposals should move forward. 

If future proposals for significant service change are developed, they would need to go through the appropriate NHS assurance processes, scrutiny and engagement activities and, where required, formal public consultation before any decisions could be taken.