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Why the need for development

A. Developments in medical technology

Modern vascular surgery involves both open and endovascular techniques (keyhole surgery controlled under x-ray imaging) and close working with interventional radiology. Most vascular units in the country are now equipped with hybrid theatres to enable this which is not available at Bedford Hospital.

Hybrid theatres incorporate high resolution imaging equipment in a traditional theatre environment, allowing surgeons to switch between the two options as and when required during an operation. The key benefits of these theatres are:

  • Provides the service with facilities to undertake the full range of vascular interventions
  • Patients requiring both an endovascular and an open intervention can have these done during the same operation without the need to return to theatre
  • Improved patient outcomes and shorter operative time
  • Reduced exposure to ionising radiation for staff and patients

B. Trust’s Redevelopment Programme

The major redevelopment programme to build a new Acute Services Block (ASB) at the L&D is well underway and on target for completion in 2024. The ASB provides the Trust with the opportunity to have purpose built facilities and infrastructure for the vascular network.

The redevelopment will see the construction of the five-storey ASB, housing maternity, neonatal, critical care and operating theatres along with a new three-storey New Ward Block (NWB) housing maternity wards. Out of the eight theatre facility, two will be hybrid theatres (one to be predominately used as an interventional radiology facility).

In addition, as the L&D already hosts various services such as the Hyper Acute Stroke Unit (HASU), it makes the site a more natural home for the vascular hub than Bedford Hospital.

C. Developments in service delivery

Over the last few years vascular surgery units have merged to form hub and spoke networks around the country (similar to stroke services), approximately 40 in total. The majority of the hubs are located in the teaching hospitals or large district general hospitals due to the infrastructure requirements of a vascular hub.

Vascular surgery can be a critical or care pathway enabler for a variety of other disciplines for example, trauma, orthopaedics, obstetrics, urology, head and neck surgery, spinal surgery, diabetes, stroke and care of the elderly.

The support infrastructure and services in Bedford Hospital have been designed to cater for a population of around 275,000, whereas Vascular Service aims to deliver care to a population of about a million. In our view, the Vascular Hub is better located at a larger site which is better designed to service a higher acuity of patients and houses other supporting specialties with greater access to 24/7 acute services infrastructure. Resilience for all interconnected departments will be higher at the L&D site due to the relative size.

This relocation will also improve ability to meet national patient access targets and improved clinical outcomes by reducing delays in treatment across the vascular network. It will allow the vascular team to develop relationships with interdependent specialty teams and develop modern, more responsive pathways of care.

A hub at the L&D site would better support 7-day consultant delivered care through a larger scale team, and supports development of robust interventional radiology arrangements and improved rotas.