The Norfolk and Norwich Health Care NHS Trust (NNHCT) was established in 1994 (UK Parliament, May 1999, paragraph 7). In January 2001, it was renamed the Norfolk and Norwich University Hospital NHS Trust (NNUHT) after it had been announced that the new Norfolk and Norwich Hospital would be a University teaching hospital (see Annual Accounts, 2000/01, 6 and NNUH website). The creation of a Trust brought a sharp split between the provider (the Trust) and purchaser (District Health Authority) of health services.
In 1994, the Trust was operating two hospitals in Norwich and one in Cromer (NNHCT 1996, 9). The main hospital in Norwich (with 988 beds - NHCT 1994/95, 1) was the Norfolk and Norwich also known as the Brunswick Road hospital or here as the St Stephen's hospital. The St Stephen's hospital was less than a mile from the centre of Norwich. Founded in 1771 (with fewer than 100 beds), it was expanded substantially between 1879 and 1883, to about 220 beds by 1883. By 1938 it had about 400 beds and in 1948 it became the NHS district general hospital. Then, in the late 1960s/early 1970s, there was a further expansion when two tower blocks were built on the site (Cleveland 1948, 7 and 43; Taylor 2000, 42; and NNHCT 1996, 20). The second hospital operated by the Trust in Norwich was the West Norwich (with 219 beds - NNHCT 1994/95, 1), less than two miles from the centre of Norwich. This was a combination of the former Norwich workhouse on the north side of Bowthorpe Road and the former isolation hospital on the south side (NNHCT 1996, 20).
However by the 1980s and into the 1990s, the St Stephen's hospital was recognised to be in acute need of renovation and expansion. There were frequent complaints by workers about the conditions of the buildings, even of sewage spilling out of drains at times of flash flooding (Greenaway et al 2007, 721). The St.Stephen's site was only 16 acres and it had limited parking for cars although access by public transport was easy (Greenaway et al 2007, 721). Thus there was considerable discussion about either the reconstruction of the existing hospitals or the construction of a new one.