How it is being done – the DNRC Programme 2010 The DNRC Programme began in January 2010 with a very small team (the Director and a PA) operating out of the Grosvenor Office in London. Its complex task was simply to achieve the DNRC concept to the fullest possible degree. At its height, the Programme grew to seven people. But it has, and still does, direct experts to achieve the outcome. They range from project managers (Arup), costs consultants (Osbornes), architects (Steffian Bradley and John Simpson) to the people who actually built the Defence facility (Interserve) and many others along the way – perhaps nearly a thousand people. The Programme’s first act was to initiate the feasibility study in January 2010. A pan-Government Project Board was established at very high level and met ten times in the course of the year. The study ranged widely and covered proof of concept, quantification of the benefits in rehabilitation terms, the validity of sharing between Defence and the NHS, possible locations for a new shared facility and costs. At the end of 2010, the feasibility study concluded that the concept of doing something for both Defence and civilians (NHS patients) on the same site was entirely feasible and supported, the rehabilitation benefits were well-defined and the cost of the overall DNRC programme was established at £304 million. That sum assumed that the construction of the Defence establishment on a new site would be privately funded but the operating costs would be met, as now, by the MoD. The opportunity for a civilian facility was that it would share the same overall site and therefore it would be ‘enabled’ by the DNRC Programme, but both the capital and operating costs of the ‘N’ in the DNRC would be sourced elsewhere. The business case was returned to government in late 2010 and the next step was to seek endorsement across the Departments concerned (MoD, DH, DWP notably). More on the detail of the feasibility study and the wider background can be read here. 2011 Meanwhile, in 2011, a fundraising campaign was put in train spearheaded by the Duke whose founding gift was £50 million. By May 2019 the total gift from the Grosvenor family has amounted to over £100 million. In that year the search for a suitable site was concluded and the Stanford Hall Estate near Loughborough was chosen. Also that year it was necessary to put the Programme on a charitable footing and to that end the Black Stork Charity was created with broad charitable objects related to rehabilitation with the Grosvenor office as its registered location. The Charity’s objects can be seen here and have been achieved through the DNRC Programme ever since. The year concluded with the second written Ministerial Statement to Parliament which endorsed the conclusions of the feasibility study and the concept and explained that the next steps would be seeking planning permission on a chosen site, raising the necessary funds and returning to Parliament when construction looked feasible. 2013-15 The Stanford Hall Estate was purchased at the end of 2011 and planning permission was obtained in 2013. In mid-2014 the third Ministerial Statement confirmed that Headley Court would close and move to the new establishment when it was built and that the government would give formal consideration to the national opportunities for a civilian rehab facility (the ’N’ in the DNRC) in 2016. In 2014 a contract was put out to tender to construct the Defence facility. It was formally let to Interserve in 2015 and construction began that autumn. 2016 2016 was the year for evidence gathering to assess the scale of the opportunity to create the first specialist rehab facility for civilians (NHS patients). In the first three months a strategic outline case (SOC) was put together by Nottingham University Hospitals Trust (NUH) which specified a 63-bed facility on the SHRE site, 400 metres from the Defence facility and a concept of sharing with the MoD in relation to expertise and a range of specialist facilities – to mutual advantage. The SOC was followed by a comprehensive study by KPMG into the wider social and economic benefits of provision of specialist rehab facilities. It revealed substantial advantages in terms of the reductions in the cost of care and improvements in the return to work figures. 2016 was also the year when the 6th Duke of Westminster died. On the day of his death work on site stopped at 1100 for a minute’s silence to remember him. Today patients in the Defence establishment pass by a bust of him, and on the high ground in the estate there is a fitting memorial to him overlooking the lake which he had considered an essential element of the healing process. The Grosvenor family was determined to ensure the 6th Duke’s legacy was realised and has remained committed to its achievement. His son, the 7th Duke, explains why this is so in the video below: 2017/18 Construction of the Defence facility continued through 2017 and by June 2018 the 6th Duke’s gift to the nation was ready to be handed over. This occurred on 21 June in the presence of the DNRC Patron, Prince William, with the gift being accepted by the Prime Minister on behalf of the nation. The MoD became the tenants of the new facility shortly afterwards and the first patients were being treated from October onwards with Headley Court closing by the end of the year. 2019 to today Following the evidence gathering in 2016, the question of the opportunity for a civilian rehab capability was put into NHS space in late 2017. In 2018, once the Defence element of the Programme became operational, the development of the 'National' facility on the same site was given emphasis and 2018 therefore saw the consideration of an outline business case by NUH. In the autumn budget of 2018, the Treasury pledged £70 million to cover the construction cost of the patient care element of the NRC (the training and education and R&D elements will require additional funding). In January 2019, NUH was formally appointed the NRC sponsor. Substantial work has been undertaken since then to progress the potential of the NRC and to evidence what it would deliver in clinical and operational terms. The outline and full business cases are being completed with a view to a decision to proceed being clear by end of 2021. The NRC is now also included within the Government's 'New Hospital Programme' (NHP) initiative. The target for the NRC being operational is by the end of 2024. Where is it? The Stanford Hall Estate, Stanford-on-Soar near Loughborough, was selected (from a long list of 68) because of its suitability to work for patients undergoing rehab. Now called ‘The Stanford Hall Rehabilitation Estate’, it was purchased on behalf of the 6th Duke because it: Was rural but without being isolated – the tranquillity of the Estate supports the healing process but the location is not cut off and Loughborough is visible in the distance. At 360 acres it was large enough to be home to both the Defence and, potentially, the civilian (National) facility. It is a little over four times the size of the then existing Defence rehab centre at Headley Court in Surrey. Was in the Midlands – geographically in the heart of the country. Was well-connected – close to strategic transport links by road, rail and air. Would become part of the Midlands seam for Defence medicine – with the Royal Centre for Defence Medicine (RCDM) located at University Hospitals Birmingham NHS Foundation Trust, and the Headquarters of the Surgeon General together with the Joint Medical Group recently established at Lichfield. Was close to Nottingham University Hospitals NHS Trust which has a leading major trauma centre and is in a significant NHS region (the East Midlands) where the scope to deliver benefits through the civilian facility are significant. Could benefit from proximity to Loughborough University, with its expertise in sport science, biomechanics and related disciplines, as well as a network of other Midlands universities. The DNRC programme would align well with the Midlands Engine’s objectives.