UNIVERSITY HOSPITALS OF MORECAMBE BAY NHS FOUNDATION TRUST

TRUST BOARD MEETING

To be held on 27 April 2011Agenda No 9a

Report of: / Steven Vaughan, Director of Operations & Performance
Paper Prepared by: / Steven Vaughan
Date of Paper: / 30 March 2011
Subject: / Estate Strategy – Annual Update
Care Quality Commission Standards: / Safety & Suitability of Premises
Assurance Framework Link: / Strategic Objective : 7.5 - Viability and effectiveness of clinical service provision across all sites
Principal Objective
Background Papers: / N/A
Item Considered at Earlier Committees
(pls detail mtgs): / Estate Strategy Updates to Board
Patient & Public Involvement: / Public & Patient Representative of the Facilities Management Division
In case of query, please contact: / Steven Vaughan x46696
Purpose of Paper:
Key Points:
a)This paper provides a brief update on progress regarding the Estates Strategy and sets the Strategic elements for 2011
b)Seeks approval of the Carbon Management Programme, developed in conjunction with the Carbon Trust
The Board is asked to:
  1. Note activities during 2010/11
  2. Approve the Estates Strategy for 2011/12
  3. Approve the Carbon Management Programme

AGENDA ITEM NO 9a

TRUST BOARD MEETING: 27 APRIL 2011

Annual Estate Strategy Update

  1. INTRODUCTION

The Estate Strategy was revised and approved in March 2010 to reflect the clinical strategy adopted by the Trust. The main aspects of the strategy are:

  1. Dealing with backlog maintenance
  2. Immediate schemes supporting service delivery/Integrated Business Plan
  3. Review of current subleases
  4. Development of a Trust wide estate rationalisation plan
  5. Ambulatory Cancer Centre
  6. RLI reconfiguration business case
  7. Sustainable development

The Board has received a progress report, along with a summary paper reporting the annual Estate benchmarking statistics, the Estates Returns Information Collection (ERIC) data.

The Strategy is intended to be service focused demonstrating the Trust’s commitment to :

a. providing accommodation that is:

  1. Functionally suitable for the delivery of high quality healthcare services
  2. Located to provide the highest level of accessibility for patients, visitor and staff; that will be socially inclusive, Disability Discrimination Act and delivers Privacy & Dignity requirements
  3. Designed and maintained to deliver a high quality therapeutic sustainable environment
  4. Well utilised, cost effective and energy/environmentally efficient
  5. Reflect policy, for example delivering estate improvements linked to infection control and our response to changes in mixed sex accommodation guidance

b. providing estate services that are:

  1. Responsive to service needs
  2. Compliant with legal and mandatory guidance
  3. Planned for future needs, e.g. Carbon Reduction Commitment

As part of the annual planning cycle this paper provides a brief progress report and sets out the objectives for the forthcoming financial year.

  1. PROGRESS AGAINST 2010/11 OBJECTIVES
  • Dealing with backlog maintenance

Ongoing activities, plan complete for 2010/11. Outstanding or amended plans re-prioritised within 2011/12 schemes.

  • Immediate schemes supporting service delivery/Integrated Business Plan
  1. Minor schemes
  1. Amendments to Radiology department reception, changing and breast service rooms at Furness General Hospital - in progress
  2. Chemotherapy department at WGH (charitably funded) – building work commenced
  3. Development of cook-chill catering services to support kitchen rationalisation – in progress
  4. Research and Development schemes (started in 2009/10) completed, with staff relocation complete. Buildings scheduled for demolition.
  1. Major schemes
  1. Breast screening – still on hold. Awaiting PCT approval.
  2. Oncology – business case development ongoing (outline been to Hospital Management Team, now with Commissioners)
  3. RLI reconfiguration – statement of case presented to Board, further business case work ongoing
  • Review of current subleases – all occupied areas (on all sites) reviewed, measured and re-costed.
  • Development of a Trust wide estate rationalisation plan to incorporate new service development plans such as Ambulatory Cancer Centre and RLI reconfiguration
  1. Internal Estate rationalisation group has been set up and meeting regularly
  2. Engagement in Quality Innovation, Productivity & Prevention (QIPP) workstreams with other stakeholders continue
  • Sustainable development - Significant progress has been made throughout the year, Carbon Management Programme for approval (Appendix 1)
  • Other activities supporting provision Estate Services

In addition to the activities detailed, which are primarily focussed on buildings, infrastructure and capital expenditure, there are ongoing activities regarding the provision of estate services, for example renegotiation of utility prices, development of new schedules of in year and routine audits covering both estate functions and hotel services, e.g. cleanliness (reported to Infection prevention meeting).

  1. CURRENT ESTATE ASSESSMENT

There only significant change in respect of Trust owned land or buildings during 2010/11 has been the transfer of Dane Garth on the Furness General Hospital site to Cumbria Partnership NHS Foundation Trust. In addition three modular buildings were demolished on the RLI site, as part of the enabling works for the potential site reconfiguration.

The Trust’s estate comprises of four hospital sites. The sites have a total land area of 31.23 hectares and a total building gross internal area (inclusive of all estate support areas, e.g. plant rooms) of 129,321m2

Property / Building Area (m2) / Site Area (hectares) / Tenure
Furness General Hospital / 44,7681 / 14.81 / Freehold
Royal Lancaster Infirmary / 54,9821 / 8.21 / Freehold
Westmorland General Hospital / 26,0471 / 8.10 / Freehold
Queen Victoria Hospital / 3,5241 / 0.11 / Freehold

1 Includes Leased Out Areas

Land and Property appraisal remains unchanged with property being rated as Category B (Sound, operationally safe and exhibits only minor deterioration) or C (Operational but major repair or replacement needed soon).

Backlog Maintenanceis the cost of upgrading assets that are below acceptable standards in terms of their physical condition or do not comply with mandatory fire safety requirements and statutory safety legislation.

As previously reported to the Board, as part of the ERIC summary, the value of reported backlog reduced in the 2010 return from 2009. This table summarises the return.

Risk / 2009 / 2010
£000 / £000
High / 10 / 0
Significant / 5,685 / 4,664
Moderate/Low / 3,479 / 3,182
Total / 9,165 / 7,846
Risk Adjusted / 5,813 / 4,772

The final capital budget will recognise the requirements, and an allocation of c£3m will to cover Statutory, Minor Estates and Major Plant replacement.

  1. OBJECTIVES FOR 2011/12

The Trust aims to develop and improve the Estate to ensure high quality environment for the delivery of patient services. The strategy covers the following aspects:

  1. Dealing with Backlog Maintenance –(ongoing)

Providecapital investment to ensure ongoing management of backlog maintenance, including replacement of estate infrastructure. The backlog maintenance costs will be reported annually through ERIC.

  1. Immediate schemes supporting service delivery/Integrated Business Plan – (ongoing)
  1. Complete current schemes
  2. Develop ad hoc schemes as necessary, prepare business cases and deliver
  1. Review of current subleases –brought forward (Inter-trust trading review expected to be completed end Q1)
  1. Link estate information (costing work completed in 2010/11) to wider inter-trust trading review and agree how to proceed
  2. Complete activities from above.
  1. Maintenance of current estate management plan and development of overarching Trustwide estate rationalisation plan to reflect Trust’s Clinical and Operational plans (Ongoing)

The plan will consist of:

  1. Development control plan for each site
  2. Business cases to cover new build, renovation and/or reconfiguration
  3. Assessment of potential to increase/decrease use of estate by third parties
  4. Acquisition/disposal proposals to support the above
  1. Ambulatory Cancer Centre – brought forward
  1. Open Day Case Chemotherapy facilities at Westmorland General Hospital (first patients expected in June)
  2. Complete business case development and design work associated with proposed Ambulatory Cancer Centre (ongoing work with other stakeholders)
  1. RLI reconfiguration –(implementation to be agreed)
  1. Completereview activities and prepare business case for Board review/approval, including A&E scheme.
  2. If approved, implement appropriate schemes
  1. Sustainable Development - ongoing
  1. Approve Carbon Management Programme (April 2011)
  2. Develop detailed implementation plan of timetabled actions to support introduction of the Carbon Management Programme (Ongoing)

  1. IMPLEMENTATION AND MONITORING

Delivery of the Estate Strategy/Capital plan will be overseen by the Trust’s Capital Group, chaired by the Director of Operations & Performance with financial monitoring from the Capital Expenditure Monitoring Group being reported through the regular financial reporting mechanisms to the Board.

In year progress and any Business Case approval will be brought to the Board or one of its Committees for approval.

  1. CAPITAL EXPENDITURE

The capital programme, as approved as part of the budget for 2011/12, covers maintenance capitalindicatively the split of expenditure will be :

  1. Backlog Maintenance – c£3m
  2. Medical Equipment –c£2m
  3. Information Technology - c£600k

Whilst the capital plan does not allow for development capital in 2011/12, developments could be delivered through other means, including:

  • Achieving a higher surplus than planned;
  • Disposing of existing assets to provide additional cash;
  • Obtaining external financing;
  • Securing investment from PCTs (e.g. to expand the Breast Screening service).

These would all need to be considered in the context of the Board’s commitment to address space problems at the RLI and the PCTs’ requirement to expand and digitise the Breast Screening service.

  1. CONCLUSION

Management of the estate and preparing for its future development are important forsustainable delivery. The Trust’s agenda is developing and this Strategy provides a framework to support delivery of all aspects of this in the forthcoming year.

The strategy will be reviewed/refreshed for 2012/13.

  1. RECOMMENDATION

The Board is asked to

  • NOTE activities in 2010/11
  • APPROVE the strategy for 2011/12
  • APPROVE the Carbon Management Programme

Steven Vaughan

Director of Operations & Performance

30 March 2011

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