A plan to build a hospital halfway between Huddersfield and Halifax – providing emergency care for both towns – was debated by health chiefs.

But the proposal to build a new hospital at an equidistant location – possibly Ainley Top – was dropped at an early stage because it was too expensive.

The plan was one of 11 options considered by Huddersfield and Calderdale NHS chiefs behind the Right Care Right Time Right Place proposal.

But this option was discounted, in part, because of PFI commitments stemming from the construction of Calderdale Royal Hospital (CRH), Halifax.

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The plan would involve exiting the PFI contract in 2028 at a cost of approximately £200m – in addition to the £22m the hospitals trust pays in repayments and interest.

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But local NHS chiefs said it was ‘highly unlikely’ funding for this option would be provided.

Hospital and clinical commissioning group (CCG) directors also said the likelihood of finding an alternative use for CRH that satisfied terms of the PFI was ‘low’.

Other discounted options included providing all services at Huddersfield Royal Infirmary (HRI) and finding an alternative use for CRH.

Calderdale Royal Hospital

But this option was, according to health chiefs, ‘not in line’ with clinical guidance and it was uncertain that a standalone HRI would be able to meet the capacity of both Huddersfield and Halifax patients.

Another option, discarded later, was to have Huddersfield Royal Infirmary (HRI) as the centre for emergency care and have CRH as the site for planned care.

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Under Right Care Right Time Right Place, the preferred option for health chiefs will see HRI demolished and replaced with a new hospital.

The new hospital, which will focus on planned care, will have 10 wards and an urgent care centre but crucially, no emergency care centre.

Emergency care will be centralised at an enhanced CRH.

The options:

1) ‘Minimum change’

Minimum change in hospital configuration across two sites but incorporating known changes (such as demographic changes) that will occur in next five years.

Not in line with clinical guidance.

Will not improve standard of care.

Not financially sustainable.

2) All services at CRH

HRI and Acre Mills sites to be sold.

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Not in line with clinical guidance. No guarantee that capacity will be sufficient to serve both Huddersfield and Halifax. Requires extensive reconfiguration and capital investment.

2a) Reduced services at CRH and remaining services transferred to other providers.

Similar problems to option 2.

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3a) All services at HRI and break out of PFI in 2028

Similar problems to option 2 – plus leaving PFI is expected to cost £200m and is not available for 30 years.

3b) All services at HRI and find alternative use for CRH

Problems as above – plus likelihood of securing alternative use that would cover PFI cost is low.

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4a) Emergency care at CRH (the chosen option)

CRH provides all acute and emergency care and high-risk planned care.

Planned care provided at Acre Mills site and HRI is demolished and land sold.

In line with clinical guidance.

Safer and higher quality services with 24-hour consultant-led care.

Undisturbed planned care.

More resilient workforce model.

Capital receipt from sale of HRI site.

4b) Same as 4a but HRI retained and Acre Mills site sold

HRI site is old, expensive to maintain and becoming decreasingly fit for purpose.

5a) Emergency care at HRI

Option 4 in reverse with similar benefits

5b) Emergency care at HRI plus alternative use for some of CRH estate to fit PFI terms

6) A new hospital

Both CRH and HRI would be sold and their services transferred to a new hospital.

In line with clinical guidance.

Safer and higher quality services with 24-hour consultant-led care.

Undisturbed planned care.

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More resilient workforce model.

But requires extensive capital investment and funding ‘highly unlikely’ to be provided.

Plus PFI break expected to cost £200m and is not available for 30 years.

Likelihood of securing alternate use that would cover PFI cost is low.

7) Invest in both sites in their current configuration

Extra investment for HRI and CRH retaining existing services and improving quality of care.

Not in line with clinical guidance.

Unlikely to secure sufficient growth to improve financial position or quality of care.