Forres Hospital and Health Centre

Full Business Case

Introduction

1. The redevelopment of Leanchoil Hospital in Forres and Forres Health Centre is a major priority for NHS Grampian. The facilities provide a wide range of services for the local population and support the delivery of the Grampian Health Plan in that area.

2. The case for change was confirmed by the Outline Business Case (OBC) for the redevelopment and its approval by the Grampian NHS Board and the Scottish Government during 2008. The case permitted the detailed planning of the integration of the hospital and health centre facilities and the preparation of the Full Business Case which is submitted for Grampian NHS Board approval.

Aim

3. The aim of this paper is to seek the approval of the Full Business Case by the Grampian NHS Board and its subsequent submission to the Scottish Government for final approval.

Discussion

4. The new Hospital and Health Centre in Forres will replace outdated facilities at Forres Health Centre and Leanchoil Hospital. The current facilities have served the NHS and local community well but cannot be upgraded in an economic way to support the delivery of modern healthcare.

5. The new facilities will be provided to modern standards and integrate primary care and hospital care facilities in one building. The new Hospital and Health Centre will also be well located to serve the local population, is consistent with the development plan for Forres.

6. The Full Business Case has been prepared in partnership with a Principal Supply Chain Partner (PSCP) appointed under the terms of the Frameworks Scotland arrangements. The partner, Morrisons, was appointed in March 2009 and a target price of £12.13m has been agreed. This target price is within the budget of £12.15m agreed by NHS Grampian on approval of OBC.

7. In addition to demonstrating innovation in terms of service and building design, the project will also contribute to the Board’s carbon reduction targets by the use of a biomass boiler and the achievement of an Building Research Establishment Environmental Assessment Method (BREEAM) excellent rating.

8. The approval of the FBC is being sought at a challenging time for all public services in relation to both capital and revenue funding. There is currently uncertainty regarding the availability of capital funding within NHS Scotland therefore NHS Grampian is working closely with colleagues in the Scottish Government to review the capital plan for the next three years. The final outcome of this work is expected in December but it is agreed that the Forres proposals are amongst the highest priorities for investment. Given this background the Board is asked to approve the FBC but to provide delegated authority to the Chief Executive to agree the commencement date.

Risks

9. The application of the Frameworks Scotland approach and the involvement of a PSCP reduces the cost risk associated with projects i.e. the target price is the upper limit in terms of cost for NHS Grampian so long as the brief remains unchanged - changes are very unlikely because of the thorough and detailed planning work that has been done involving local clinical staff. The project specific risks are contained within the risk register in the FBC document and financial provision and mitigation actions have been agreed.

10. As indicated above there is currently some uncertainty regarding the availability of capital funding within the NHS in Scotland and its impact on NHS Grampian. Whilst the Forres redevelopment is regarded as a high priority there may be a need to review the start date depending on the Health Directorate position on capital. Given the need to manage this issue it is requested that the final agreement on the start date is delegated to the Chief Executive when the national position is clearer.

Conclusion

11. The redevelopment of the hospital and primary care facilities is a major priority for NHS Grampian. The outline business case was approved by the Scottish Government during 2008 resulting in the preparation of the full business case as submitted to the Grampian NHS Board.

12. The proposals are consistent with Grampian’s Health Plan and implementation will provide significant support for shifting the balance of care in addition to eliminating the risks associated with outdated facilities.

13. The project programme will be managed over the next three months as part of the review of NHS Grampian’s capital programme to ensure that it is consistent with the national position and other priorities.

Recommendations

14. The Board is asked to approve the full business case for the Forres redevelopment for submission to the Scottish Government for final approval

15. Delegate authority for the final agreement on the project programme to the Chief Executive subject to Scottish Government approval.

A Fowlie

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