'Significant' change to hospital rebuild: What you need to know

The new building housing outpatients/day surgery services will be built on the site currently...
The new building housing outpatients/day surgery services will be built on the site currently occupied by a Wilson Parking building. Photo: Gregor Richardson
All you need to know about the "significant" change to Dunedin Hospital rebuild plans announced today. The Q and A was provided by the New Dunedin Hospital website, which is run by the Ministry of Health.

What’s changed in the approach to building the New Dunedin Hospital?

The staging of the construction has been split into two parts to help relieve pressure at the existing Dunedin Hospital and to also smooth out the building process.

The New Dunedin Hospital will have two main buildings – a large acute/inpatients building and a smaller outpatients/day surgery facility.

Initially it was thought these would be constructed simultaneously but they will now be built separately. The smaller outpatients/day surgery will be built first.

Why are you splitting the construction in two parts?

There are several reasons. One is the need to ensure Dunedin Hospital can function safely and effectively for patients and staff over the next few years. By speeding up the process and building the day surgery/outpatients first, we can move day surgery to this new building. This will both improve services for these patients and free up capacity across the existing hospital.

There is also a recognition of the need for flexibility around the labour force. Even though Dunedin is focusing on training a home-grown workforce, securing enough people to construct New Zealand’s most expensive ever building has always been our major challenge.

The smaller of the two main buildings will need about 350 workers on site at peak, which is a very manageable prospect – about the size of the combined workforce on various University of Otago construction projects now. It can also be part of the training programme for apprentices. These young apprentices will know they will have a unique opportunity to work as qualified tradesmen and tradeswomen on the large, complex inpatients building.

An architect’s rendering of a day surgery/outpatients building. This is a concept image. The...
An architect’s rendering of a day surgery/outpatients building. This is a concept image. The design of the building is yet to begin. Photo: Supplied
What will be in each building?

The outpatients/day surgery building will house fully-equipped day surgery theatres, and outpatient clinics for services such as Ear, Nose and Throat and Ophthalmology, for example.

The acute/inpatients building will have the core acute hospital functions such as Emergency Department, Main Operating Theatres, Intensive Care Unit, Medical Imaging, Cardiac Services, Maternity, Paediatrics and the inpatient wards.

When will they be built?

The site preparation and ground works will begin in the second half of 2020.

The outpatients/day surgery building is planned to open in two stages – with target dates set as November 2023 (day surgery) and November 2024 (outpatient clinics). Importantly, all day surgery will open in November 2023.

The acute/inpatients hospital building will follow and will probably open a decade from now. We will know with more accuracy in the New Year.

Previous opening estimates were July 2026 and February 2027

The construction master programme for the new hospital buildings has been revisited and it has been reconfirmed based on recent developments with the construction sector, and the capacity and capability of major construction companies.

The new building will house day surgery and outpatient services, which are currently housed in...
The new building will house day surgery and outpatient services, which are currently housed in the Dunedin Hospital's ageing clinical services building. Photo: Gregor Richardson
Where will they be built?

At this stage everything points to the day surgery/outpatients building being constructed on the Wilson’s block and the larger inpatients building taking shape on the Cadbury’s block.

We have a good idea of the site layout but need conclusive geotechnical evidence before the final decision is made.

Will a New Zealand contractor be able to build the smaller building?

We hope so.

Have any preliminary geotechnical findings guided the new approach?

No, the key factors are the need to deliver day surgery as soon as possible, and addressing the challenges of construction workforce capacity.

When will the master site plan be released to the public?

Early in 2019, after further geotechnical work is complete.

What type of procedures are typically done in day surgery?

The procedures cover a range of specialties including Gynaecology, Ophthalmology, Orthopaedic Surgery, Plastic Surgery, ENT and Dental.

Why is day surgery capacity so important?

An efficient, well-equipped day surgery service minimises the time patients have to spend in hospital. It is also the best use of hospital resources by allowing patients to go home on the day of their procedure rather than be admitted to a ward.

Why is Dunedin’s day surgery under so much stress?

Dunedin Hospital’s present day surgery facilities have not been upgraded for many years and are therefore unsuitable for a range of modern surgical procedures.

We only have two small day surgery theatres which are no longer fit for purpose to accommodate advancing medical practice. A large number of procedures which should be done in day surgery are therefore carried out in the main operating theatres. This has a ripple effect, putting pressure on the rest of the hospital.

How does improving day surgery help the rest of Dunedin Hospital?

Moving day surgery to a new facility frees up room to enlarge and reconfigure the emergency department and make other changes.

Does this mean you’ll be doing even more refurbishment to an old building – only to last 5-6 years?

This is vital work which will enable Dunedin Hospital to serve the people of Otago and Southland over the next half decade.

How much will that cost?

Southern DHB is working on a business case for additional funding from the Ministry of Health for critical work at Dunedin Hospital.

Will there be any improvement in surgical capacity before this new block is built?

It is hoped that work to improve patient flow and other initiatives under way, including the primary and community strategy, will improve efficiency and ease the pressure on surgical capacity. 

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