YEARS in the making, Gwent's new Grange University Hospital welcomes its first patients this week.

The hospital is purpose-built to treat the region's sickest and most-seriously injured patients, and will be the centralised critical-care facility for Aneurin Bevan University Health Board (ABUHB).

The location of every department, every theatre, and every piece of equipment, has been decided with one question in mind – how can the hospital diagnose and treat patients as quickly and as safely as possible?

For medical staff, the construction of a new, purpose-built hospital meant key services could finally be placed next to each other – gone are the days of transporting patients, often at their most vulnerable, from one end of a hospital to the other because they required a scan.

This new design is no accident. Leading ABUHB doctors have played a key role in planning the new hospital, helping the architects design a space which benefits staff and patients alike.

Dr Tim Rogerson is a clinical director and consultant in emergency medicine at ABUHB.

Standing in the Grange's A&E department, he said: "The health board was very keen for clinicians to be engaged with the planning process.

"I spent around 100 hours with the architects. Now I walk in here and recognise everything. It means we can deliver care as quickly and safely as possible."


Practical floor plans will "make a massive difference" to the treatment of critically-ill patients, Dr Rogerson said.

The emergency department's CT scanner is located 20 metres away from the resus room, meaning stroke patients, for example, can be scanned within "a matter of minutes" of arriving at the Grange.

This is a potentially life-saving convenience only made possible by the careful planning that went into the layout of the new hospital.

"It's good to be involved in it and to see it come to life," Dr Rogerson said, adding: "We're really proud of what we've achieved with the design."

He added: Finally we're going to come to the Grange and deliver a standard of care we've always been proud of – we've had a good reputation for care but also for the training we do for junior doctors – but now we're going to be able to do that in this amazing clinical space."

In addition to the planning work that has gone into building the Grange, the new hospital will also feature some of the best medical equipment that is available.

Dr Chris Chick, a consultant interventional radiologist at ABUHB, said the health board was "very fortunate" to have new facilities at the Grange, including two cutting-edge 'hybrid' suites that allow patients to receive a range of complex treatments in one room, if needed.

The suites include flexible-arm scanners – the first of their kind in the UK. The scanners help Dr Chick and his team find the sources of bleeding, artery problems, and tumours with more precision than was previously possible.

Of the new suites, Dr Chick said: "They allow us to perform angiograms and even surgery on patients when they're sick.

He added: "The advantage is that [the new scanners] are co-located in theatres, so we can do both operations and interventional radiology (image-guided surgery) in the same place.

"For patients that have trauma [who need] a combination of the two procedures, unlike previously when we had to move you [around] the hospital, we can deliver all that care here."

Dr Chick acknowledged the move to the new hospital would bring some challenges, but said he was relishing the chance for working jointly with other departments – surgery, cardiology, interventional radiology and intensive care will all share the same floor at the Grange.

"Joining those teams together is always really difficult for a health board, and it's always difficult for teams going through a period of change, but we will come out of this with a joint group that is working together to try and get the best outcomes for patients," he said.

"By having that joint approach, it gives us much more flexibility around staffing levels and sustainability of staffing."

Centralising specialist services would also improve care in areas such as paediatrics and obstetrics, Dr Chick added, as the health board moved to consultant-delivered care at the new hospital.

Perhaps the greatest challenge facing the health board this week is managing the ongoing coronavirus crisis while moving key service – including intensive care – to the new hospital.

One of the main reasons the opening of the Grange has been brought forward is to help ABUHB deal with the resurgence of coronavirus in the Gwent region.

"We're not under any illusion that opening early in the middle of a pandemic is a challenge, but it's the right thing to do," Dr Rogerson said.

"The 'fire break' has come at the right time – it's perfectly timed [for the hospital move] because the numbers are plateauing.

"It's very likely the numbers [of cases] will start to climb again, so if we can get the move done...we'll have a chance to get settled."

The Grange will house the health board's intensive care (ITU) units, which are closing at the Royal Gwent and Nevill Hall.

A significant advantage of the ITU facilities at the Grange is that individual patients' rooms can be sealed off, when appropriate, for infection control.

This means Covid-19 patients can be kept on the same ward as other ITU patients with much less risk of coronavirus transmission.

It will also come as a comfort to ITU staff, who will not have to wear the most restrictive items of personal protective equipment (PPE) unless they are treating a coronavirus patient.

Other areas of the Grange will be prepared to deal with coronavirus, too. Dr Rogerson said a separate Covid Assessment Area – away from the emergency department – would be the first port of call for patients arriving at the new hospital.

Any patients suspected to have Covid-19 will be treated in a separate area, away from the main A&E department.

But despite coronavirus and the other challenges surrounding such a major relocation of services, Dr Rogerson said colleagues were raring to go.

"We're looking forward to it," he said. "We're a little bit anxious, but we've been planning this for a long time.

"We're planning a safe model that also delivers really good care. Obviously, like moving house, it's a bit anxious and I know everyone's put in that extra effort.

"But we're really excited to work in a space that we've been waiting for for quite a long time."