NHS leaders charting a future for Bath's main hospital are well placed when funding becomes available but say they will not hold their breath waiting for a £450million cash injection.

Last year the Royal United Hospital was given the "once-in-a-generation" opportunity to bid for the nine-figure sum after Prime Minister Boris Johnson made a manifesto pledge to build 40 new hospitals.

Simon Cook, who leads the health infrastructure programme locally, said this week that figure was a "pre-pandemic number" and now trusts can define what they think they need.

The funding announcement prompted the RUH to start considering a future model of care, and now it has a head start on other trusts.

Mr Cook told Bath and North East Somerset Council scrutiny panel members on March 8: "We don't want to build a white elephant on the hill, we want to be investing in an asset which is going to be a benefit not a burden to future generations.

"We are trying to position ourselves as a health economy to take advantage of any capital funding as and when it becomes available.

"During the pandemic as a nation we've spent enough to build a shiny hospital pretty much in every town but all we've got in exchange for that is masks. There is a massive challenge in terms of finances."

The RUH has been consulting on a new model of care focusing on prevention, wellbeing and a personalised model of care. Mr Cook said that gave it a head start on other trusts and it was not seeking to make "difficult" changes to the estate, adding: "The outpatient model fundamentally hasn't changed since 1947 and actually there's a huge opportunity to change that as we come out of the pandemic.

"That means we have quite a different potential footprint on the RUH site. We're not going to be dragging everyone in to queue up for a 10-minute conversation at the RUH; in the future we're looking to get that out to the community and in some cases avoid the need for those appointments.

"We're not reconfiguring services, we're not moving key parts of services. It's still going to have an A&E, maternity services, critical care, all those really really vital assets.

"We have a track record of being able to deliver, an estate strategy based on that model of care, and we're not proposing a scheme that's going to be unsupportable from a planning point of view with local residents – we're not looking to build a 10-storey ward block on the Combe Park site.

"We're not looking at an all-or-nothing approach where we have to have a billion-pound hospital or nothing at all.

"The scheme's been set out in terms of being able to do it in incremental stages so that as and when funds become available the RUH is well placed to take advantage of those early on."

Mr Cook said the £450million "opening gambit" was a "pre-pandemic number" and now trust leaders can define what they think they need, which will be more than that figure in the long term.

"We're charting a journey where we can do that over 10 to 15 years," he told councillors.

"There are a series of some incremental steps that we've got towards that overall masterplan for the future that the trust has been able to develop. We think that's a realistic and practical way of us moving towards that future state.

"If we wait for all the money to come at once, we'll be holding our breath."