Admission to new Royal Preston Hospital should be ‘an absolute last resort’, says departing chief

Kevin McGee, chief executive of Lancashire Teaching Hospitals NHS Foundation Trust (LTH), says that he hopes to see a transformation in the way health services are delivered by the time the new hospital opens its doors in around a decade’s time.

The 62-year-old will have long left the NHS behind by that point, after last week announcing that he was retiring from the service after a lifelong career in it, to take up a new post as the director general of health in Gibraltar.

Speaking to the Lancashire Post about the surprise move – after two years at LTH – he said that recent confirmation of funding for the new-build hospital was instrumental in his decision to depart.

“It’s going to require somebody who’s going to be here for a number of years to really take [it] forward…because you’re talking of a period of five years plus in terms of all the planning. That got my mind thinking about when would be an appropriate time to hand over to somebody [else] – and I think it’s an almost perfect breakpoint now.

“So rather than me start it and then hand over to somebody else who would have to pick it up cold, [I decided to leave]. Because it’s not just about a new building – it’s about how you use the new building to really transform and change services across the whole of Lancashire.”

The government announced in May that the NHS in Lancashire and South Cumbria had been successful in its bid for the cash needed to build two entirely new hospitals serving both Preston and Lancaster. However, the previously planned 2030 opening date for the services – were they to be given the green light – was pushed back towards the middle of the decade.

Mr. McGee – who, prior to joining LTH in September 2021, led East Lancashire Hospitals NHS Trust from 2014, before also adding Blackpool Teaching Hospitals NHS Foundation Trust to his duties in 2019 – has long been candid about what he sees as the need for the health service radically to rethink how it operates in order to remain sustainable.

As the Post has previously reported, he has used his position within the Lancashire and South Cumbria Integrated Care System to make the case for shared waiting lists across the area’s hospital trusts so that patients can be seen sooner by being referred to whichever site across the wider patch that has the more immediate capacity to treat them. In 2021, he also warned that financial constraints meant that it was unlikely that the NHS in the region would be able to continue offering all services in all locations.

Looking ahead to the healthcare landscape at the time the new Royal Preston opens, Kevin McGee hopes for a shift in the way the NHS in Lancashire operates – with distinct offerings from different facilities.

“What I would like to see is a world class tertiary [top-tier] hospital that has all the specialist services in one location – [a facility] that can compete with hospitals in Manchester, London, Birmingham and Leeds. Wrapped around that, you’d have world class education, training and research and development that would bring resources and well-paid jobs into Lancashire and South Cumbria.

“You’d then have elective [pre-planned] care that was centralised, say, on three different sites across Lancashire, instead of taking place on a number of different sites.

“But after that, the other services [would] be much more locally-based – [things like] care of the elderly and [treatment of] long-term conditions. Most of the those conditions are better managed and treated in localities [or] in people’s own homes, rather than [by] going into hospital

“The next generation of health and social care [will be designed] to keep people out of hospital much more and keep them resilient in their own communities.

“[There needs to be a] focus on developing health services using digital technology, AI, community-based services and primary care – and then only absolutely as a last resort do [people] come into hospital. But when they do…it’s a world class service.”

He believes that the biggest challenge to the NHS – and healthcare around the world – is the need to recruit and retain staff in what has become a global market. It is a problem with which he expects to be confronted in Gibraltar as he has been in the UK – although LTH has recently achieved a zero percent vacancy rate for registered ward-based nurses after a successful international recruitment campaign.

Mr. McGee acknowledges that the challenging backdrop to his two-year tenure running the Royal Preston and Chorley and South Ribble Hospital has meant that there has been an element of “standing still” during his time in the top job.

He singled out last winter as being “the worst…that the NHS has ever seen” – and of a completely different magnitude to the perennial pressures experienced by the health service at that time of year. However, he stresses that Central Lancashire performed better than many parts of the country during that “brutal” period.

“We kept our services going [and] we cancelled very little work at all,” he said.

His time at LTH also coincided with the national push to make inroads into the backlog of operations and appointments caused by cancellations at the height of the pandemic. The trust met the nationwide target of clearing all two-year waits by last summer and eradicated the “vast majority”of 78-week waits by a second deadline earlier this year – failing to achieve it in full partially as a result of the impact of strike action by junior doctors, according to board papers from a meeting in June.

The trust is also under significant financial pressure, with a savings target for the current financial year of £48.5m.

However, the “firefighting” required to deal with that plethora of day-to-day demands has not smothered much-needed innovations, Kevin McGee claims – citing expanded elective operating capacity and a new ophthalmology unit at Chorley Hospital and improvements to the flow of patients through the Royal Preston’s under-pressure A&E.

He lists one of his proudest achievements as the recent uptick in staff satisfaction, during a time when that measure has been “tumbling” at many other trusts.

“We’ve continued to develop services and we’ve continued to support staff – and [the fact that] we’re in a really good and strong space, in spite of the pressures that the NHS is under, is testimony to the brilliant work of the staff.”

Moreover, those pressures do not dent his genuine optimism for the future of the NHS – and while he may be trading it in for another, slightly different, system in Gibraltar, he would clearly never want the UK to do the same.

“The expectations that are placed on [the NHS] – quite rightly – grow every year. But every year, the NHS manages to cope in the most difficult of circumstances.

“I’ve worked in the NHS for 38 years, I think it’s something very precious and something that we all should fight for and hold on to. I wouldn’t [claim we] do everything perfectly – and there’s a lot that we need to improve.

“But I’d rather have the system that we’ve got in the NHS than other[s] across the world – I think it’s an outstanding system.”