Our Case for Change and Clinical Strategy
Planning hospital care for future generations across Norfolk and Waveney
Our hospitals are an important part of our communities. Every day, thousands of people rely on the care provided by our staff at the Norfolk and Norwich University Hospital, The Queen Elizabeth Hospital and James Paget University Hospital.
We want to make sure we can continue providing the best possible care, not just today but for generations to come.
To do that, we need to think differently about how hospital care is provided.
We’re developing a new Clinical Strategy that looks at what care people will need in future, how our hospitals can work better together and how we can make the most of the opportunities ahead.
We know there has been considerable discussion about what this work could mean for individual hospitals and services. We understand why people have questions and concerns.
We don’t yet have all the answers. Clinical teams are exploring different approaches, but no decisions have been made about future changes to services. Some services may need to work differently in future, and we want to be open about that possibility.
This section explains why we’re undertaking this work, where we are now, how decisions will be made and how you can get involved.
Why do we need to think differently?
Healthcare is changing, and our hospitals need to change with it.
There are several reasons we’re looking at how we provide care.
More people need our care
Our population is growing and getting older. More people are living with complex health conditions, increasing demand for hospital services.
We want to improve the care we provide
Care across our hospitals isn’t consistently as good as we want it to be. We need to address differences in quality and improve outcomes and experiences for patients.
Some services are under pressure
Recruiting and retaining specialist staff can be difficult. We need to consider how to make the best use of our clinical teams and ensure services can provide safe, high-quality care in future.
Healthcare is changing
Advances in treatment and technology mean more care can potentially be provided outside traditional hospital settings, helping people receive appropriate care closer to home.
We have a once-in-a-generation opportunity
Major investment in new hospitals at The Queen Elizabeth Hospital and James Paget gives us an opportunity to plan buildings and services around the healthcare people will need in future.
Doing nothing isn’t a realistic option. But how we respond to these challenges has not been decided.
What are the Case for Change and Clinical Strategy?
These are two connected but different parts of the work.
The Case for Change explains why we need to consider change.
It brings together information about our population, the quality of care, demand for services, our workforce and the challenges facing our hospitals.
It helps us understand the problems we need to address. It is not a set of proposals about which services should be provided at which hospitals.
The Clinical Strategy looks at how we could respond.
Led by clinicians from across our hospitals, it will consider how care might need to develop over the next 10 to 20 years.
This includes looking at how our hospitals could work more closely together, what care could be provided closer to people’s homes and how we can make the best use of specialist skills and expertise.
The Case for Change provides the evidence that informs the Clinical Strategy. Both need to be informed by the experiences of patients, communities and staff.
What are we looking at?
There are three broad areas we want to understand better.
Care closer to home
Where it is safe and appropriate, could more care be delivered outside hospital settings in partnership with primary care, community services, social care and the voluntary sector?
Services facing pressure
How can we strengthen services that are experiencing workforce, demand or sustainability challenges so they can continue to provide safe, high-quality care?
Acute and specialist hospital care
How can we make best use of our expertise and resources across the Group to provide the hospital and specialist services our communities need?
Importantly, this work is about understanding opportunities
Where are we now?
Current stage: exploring ideas
An idea isn’t a decision
More than 80 of our doctors, nurses and health care professions are examining evidence and exploring different approaches to future care. This is an important part of developing the strategy, but it does not mean that a particular approach has been agreed.
Our journey:
1. Understand the challenges
Work undertaken and continuing
Gather evidence about current services, population needs and the reasons change may be necessary.
2. Explore ideas
Current focus
Consider different ways of addressing the challenges, informed by clinical evidence and people’s experiences
3. Develop and test potential options
Examine potential approaches in more detail, including their benefits, risks and practical implications.
4. Develop proposals
Determine whether any potential approaches should be taken forward as proposals.
5. Follow the appropriate NHS process
This may include formal public consultation if significant service changes are proposed and consultation is required.
6. Make decisions
Consider the evidence, the outcomes of involvement and any required consultation before decisions are reached with our partners and NHS Norfolk and Suffolk Integrated Care Board who commission and pay for the services our hospitals provide <link>.
Listening, involving people and providing updates will continue throughout this work.
What will we consider?
Any potential future approaches will need to be examined carefully.
That means looking at more than the way services are currently organised. We need to understand what different approaches could mean for patient safety, quality of care, access, travel, health inequalities, workforce, patient experience and the impact on other services.
There may be difficult choices and different views about what matters most. We want to understand those views as part of developing and testing potential approaches.
The principles guiding our work
As we develop our Clinical Strategy, there are five important principles guiding how we approach the work and the decisions that may follow.
- Safe care for patients comes first
Our starting point is improving the quality, safety and experience of care. We want people across Norfolk and Waveney to have access to high-quality healthcare that meets their needs, now and in the future.
- Led by clinicians and informed by evidence
Doctors, nurses and healthcare professionals from across our hospitals are leading the development of the strategy. Their experience, alongside clinical evidence and information about our population, will help us understand the challenges and explore different ways of providing care.
- Listening to patients, staff and communities
Clinical evidence is only part of the picture. We also need to understand what matters to the people who use and deliver our services. We will involve people as the work develops and explain how their experiences and views are informing our thinking.
- Looking at the whole picture
There are no simple answers. We need to consider quality and safety alongside access to care, travel, health inequalities, workforce, patient experience and affordability. We will also consider how changes to one service could affect others.
- Being open about the process
We will explain what we know, what we’re exploring and what remains undecided. We won’t rule possibilities in or out before the necessary work has been completed. Any potential changes will need to be properly assessed, with further involvement and the appropriate NHS processes followed before decisions are made.
Our aim is to find the best way forward, not start with an answer.
What does this mean for our new hospitals?
The new hospitals planned for The Queen Elizabeth Hospital and James Paget are a significant opportunity to improve healthcare.
Developing the Clinical Strategy and planning the new hospitals need to work together.
We need to understand what care people need in future as our population changes and medicine advances so that our new buildings can support the right services and ways of working.
The Clinical Strategy covers all three hospitals, including the Norfolk and Norwich University Hospital. It is not simply a programme about new buildings.
Have your say
Being treated close to home? Seeing the right specialist? How far do you need to travel? Feeling safe and confident in your care?
Healthwatch Norfolk is independently gathering people’s experiences and views to help inform the development of our Clinical Strategy.
This is not a formal consultation on proposals to change services. It is an opportunity to contribute while the strategy is being developed.
The survey closes on 6 November 2026.
We will continue to share updates as the work develops, including what people are telling us and how that feedback is being considered.