Date: December 2016 Author: Lawson Bisset Job Title: Head of Estates, Facilities & Medical Physics Decision / Action required by meeting:

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Board Paper 2016/57 Shetland NHS Board Meeting: Shetland NHS Board Paper Title: Capital Programme 2016/17 Date: December 2016 Author: Lawson Bisset Job Title: Head of Estates, Facilities & Medical

1 Board Paper 2016/57 Shetland NHS Board Meeting: Shetland NHS Board Paper Title: Capital Programme 2016/17 Date: December 2016 Author: Lawson Bisset Job Title: Head of Estates, Facilities & Medical Physics Decision / Action required by meeting: The Board are asked to: Note the 2016/17 Capital Programme and update. Note the 10 year Capital Programme High Level Summary: The paper sets out the Capital projects prioritised and agreed by the Capital Management Group (CMG) and provides a short update on progress with the schemes and key issues. Key Issues for attention of meeting: No specific issues of concern to raise; Impact of item / issues on: Patient Safety: Staffing/Workforce: Finance/Resource: Shetland Partnership / Joint Working Equality & Diversity: Legal Issues: Specific projects within the Capital Programme support improved patient safety and quality of service. Estates &Facilities staff will be impacted by the requirement of statutory reporting & compliance within limited workforce resources. Within existing identified resources / budget. Ongoing work with SIC supports efficiencies within the Estates & Facilities services. No specific issues identified. No specific issues identified. Previously considered by: Committee/Group: Capital Management Group.

2 Shetland NHS Board CAPITAL PROGRAMME 2016/ Purpose To provide the: 2016/17 Capital Programme and update 10 Year Capital Programme 2.0 Background 2.1 The Capital Management Group (CMG) has approved a revised Capital Programme for 2016/ The Board has approved a 10 Year Capital Programme on the assumption that the allocation is 997k (plus uplift) per annum. 3.0 Projects Progress Report 3.1 Progress against the main projects is summarised below: Ambulatory Care Initial option appraisals have been carried out in conjunction with the stakeholders. The preferred options have been developed in conjunction with the architectural consultants and a preferred option agreed. An initial Standard Business Case has been presented to Strategy and Redesign and agreed in principle. A funding package has been discussed with Scottish Government and agreed in principle. An Initial Agreement is currently being prepared for presentation to the Board and for the Scottish Government Capital Investment Group for consideration and approval as part of the required Business Case process (Scottish Capital Investment Manual - SCIM). 1

3 Year k - Design Year k Construct Year k - Construct Resus Storage Works will be carried out in conjunction with the Emergency Psychiatric Assessment Room (EPAR) project (17/18) GBH Lifts On going backlog upgrade GBH Servery Replacement of servery equipment Mental Health Staff Accommodation Improvements to Drugs and Alcohol, CAHMS and Adult Mental Health Accommodation. Project Team has been established and options are being developed. Risk assessment completed. Drugs and Alcohol Accommodation has been identified as being on the Critical Path. CAHMS are due to be relocated by mid December. Option Appraisals are being developed for consideration to provide relevant accommodation for SMRS and Psychological Services Emergency Psychiatric Assessment Room (EPAR) Project Team has been established and the general arrangement layout, design and specifications have been approved by all the relevant Stakeholders. Project in abeyance till 2017/18 in order for consideration of the Mental Health Action Plan review Ronas Therapy Kitchen Creation of therapy kitchen on rehabilitation unit (Ronas Ward) In abeyance Lerwick Health Centre Security Provision of a Security system to LHC (including Mental Health) Detail provision ongoing. Installation due for completion end of November Contingency No allocated contingency Medrex Scanners Scanners for EPR Project. Project Team option appraisal ongoing. 2

4 Medrex EDM Electronic Document Management Systems for EPR. Briefing commenced VC Expansion Increase provision of VC to support Tele-appointment Programme. Developing brief and investigating options Switch Power Redundancy Improve power redundancy of switches to protect from outages and surges - GBH and LHC. Procurement commenced Hospital Pager System Replace/upgrade existing Multitone infrastructure. Brief being developed Storage Refresh Data Storage Refresh. Procurement commenced Print Management System Secure printing and print management. Briefing commenced Thin Client Expansion Improved remote access to systems. Briefing commenced. Reactive Backlog Estates Backlog Minor ongoing works of upgrade, repair and replacement HAI Rolling Program Allocation to address infection control issues identified and prioritised in conjunction with Infection Control Team. Theatre works complete Fire Improvements Rolling Program The 2016/17 allocation has been prioritised following annual desktop inspection from CS Todd, and an annual inspection on site from Scottish Fire and Rescue Services (June 2016) Legionella Rolling Program Works ongoing prioritised based on Risk Assessments. 3

5 Authorised Person training and Competent Person training completed by the Authorising Engineer Electrical Rolling Program 5 yearly statutory testing commenced Windows Replacement Works prioritised based on Risk assessments Roof Repairs Various ongoing roof repairs DDA Rolling Program DDA improvements Air Conditioning Replacement of defective air conditioning units Heating/Energy GBH Improvements to achieve controllability and energy targets HAI Flooring Replacement flooring at Health Centres. Programme of works completed Ventilation Rolling Program Phase 1 Rolling programme of Damper installations. Briefing to be carried out in 16/17. Works due 17/ Anaesthetic Machines COMPLETED Suction Unit Procurement commenced Pressure Care System Patient warming unit. Briefing commenced Warming Unit Patient warming unit. Briefing commenced Drill Chiropody COMPLETED. 4

6 Plaster saw/extraction COMPLETED Audiometer Procurement commenced Scopes Procurement commenced Endoscopes Procurement commenced Humidifier COMPLETED Drill charger COMPLETED Doppler Pocket Foetal heart beat monitor. Procurement commenced Laboratory Managed Service Contract (letter of intent) issued. Installation programme ongoing Food Tenders The statutory tendering process (in consultation with National Procurement), based on Scottish Government Procurement Journey 1 has commenced Ward 1 Curtain Tacking COMPLETED. 4.0 State of Assets and Facilities Report (SAFR) 4.1 The Annual State of NHS Scotland Assets and Facilities report (for 2015) has been published by the Scottish Government (SG) in August A report will be presented to the Board following this SAFR issue in due course. 5

7 5.0 Energy Audit 5.1 Energy and CO 2 reduction targets and savings for NHS Scotland are being reconsidered with new targets to reflect each local NHS Board s achievable targets, reflect limited capital resources and the Chief Executive s accelerated programme. External Utilities billing Audit has been commissioned in line with the Accelerated Shared Services programme. 5.2 An Energy Group has been established. 6.0 Property Disposals 6.1 Progress is on going with disposal of the following properties; Brevik House sale completed on Friday Burra Nurse's House - offer withdrawn, due to be re-advertised. 49 Nederdale Sold. 52 Nederdale Currently advertised. Residents decanted. Scalloway Health Centre, Harley Street - ongoing. 7.0 Property Review 7.1 A review of the Property Performance of all the NHS Shetland premises has been completed. 7.2 An updated Property Conditions Survey of the Health Centres has been carried out by external consultants (CAPITA) as part of the Phase 7 Surveys through Health Facility Scotland The survey information has been imported into the national EAMS (Estates Asset Management System). The survey information will enable discussions in respect of the ongoing Service Strategy development. 8.0 Statutory Compliance Audit and Risk Tool (SCART) SCART is a web based assessment tool which has been developed by Health Facilities Scotland. 6

8 The purpose of SCART is to enable Boards to measure their levels of compliance with a range of aspects of estates legal and best practice compliance and produce a score. An updated SCART version (evidence based) is due for issue in December 2016 following which an updated annual scoring will be carried out and a report presented to the Board for consideration. Estates have completed training in the new version and initial scoring is encouraging. However it is anticipated that compliance risks will remain within NHS Shetland Estate due to a lack of resources Financial Report To date there is a satisfactory expenditure to report against the 2016/17 Capital Programme expenditure Environmental and Sustainability An Environmental and Sustainability Group has been established. The group addresses the following deliverables. This group liaises with relevant colleagues in Shetland Island Council Corporate Greencode Environmental Legal Compliance Corporate Greencode is an NHS Scotland online tool that includes a list of environmental legislation applicable to NHS Shetland. Each item of legislation is to be assessed using a simple Red / Amber / Green basis A review of Corporate Greencode status was carried out by external Consultants in February The Action Plan has been updated in conjunction with Health Facility Scotland Actions will be prioritised and incorporated into the 2017/18 Estates Backlog Rolling programme, within existing staffing resources and budget availability Mandatory Public Bodies Duties Climate Change Report Scottish Government has developed a Climate Change Reporting 7

9 Template The template was a voluntary submission by November 2015 which was submitted by NHS Shetland. The mandatory annual submission is due by November NHS Shetland submitted their 2015 return and feedback from SG was positive. The 2015/16 submission highlights another reporting pressure on staff resources within Estates Sustainable Development Action Plan (SDAP) This SDAP sets out NHS Shetland s contribution to the Scottish Government s sustainable development aims and objectives, and how these are being integrated into the delivery of core business. In addition, it is consistent with NHS Shetland s Property and Asset Management Strategy (PAMS) , approved by NHS Shetland Board SDAP being reviewed subject to annual submission to Scottish Government Climate Change Adaptation Plans Sustainability and Environmental Manager, liaising with Health Facility Scotland, has carried out an initial risk assessment carried out using the Climate Change Assessment Tool. This is being reviewed prior to presentation to the Board esight Monthly data submissions for Energy, Waste and Water These are quarterly analysed by Health Facility Scotland Good Corporate Citizenship Assessment Model An annual self assessment is required. This has been challenging for all Boards however renewed impetus from Scottish Government requires to be addressed Biodiversity Action Plans NHS Shetland have previously submitted a plan (in conjunction with Health Improvement) in line with the Scottish Government deadline. This requires to be reviewed and update every three years. 8

10 The plan should address site based improvements to enhance wildlife and Greenspace planning and management, to increase active use of the outdoor estate for patients, visitors, staff and community Energy Performance Certificates This is now required for all NHS sites with a gross internal floor area of 250m2 or above. Previously 1000m2 or above Carbon Management Plans The NHS Shetland current plan was prepared in 2012 and while this is only a voluntary requirement, initial discussions have been carried out with SIC to prepare a joint plan in due course subject to resources Year Capital Programme 13.1 The table below illustrates the latest CMG approved 10 Year Capital Programme This is based on the medium term projections from IT, Medical Equipment, Capital Projects and Backlog Maintenance and reflects the reduction in the 2016/17 programme and the anticipation that this funding level will be projected over future years The 10 Year programme will require to be adjusted as future year aspirations/needs are forthcoming. 9

11 10 Year Capital Programme - Revision E (November 2016) 10 Year (all values k) Project 16/17 17/18 18/19 19/20 20/21 21/22 22/23 23/24 24/25 25/26 A&E Trolleys 40 0 Resus Storage 0 5 GBH Lifts 12 Mental Health Staff Accommodation 40 Emergency Psychiatric Assessment Room Mortuary Trolley 0 6 Ronas Therapy Kitchen 0 4 Lerwick Health Centre Security 10 Servery 30 0 Washer Disinfectors Contingency 18 Clinical Portal Phone Systems Medrex Scanner 40 IT Rolling Replacement Anaesthetic Machines 180 Suction Unit 28 Endoscopes Anaesthetic Monitors 0 80 Mobile X-Ray 0 80 Renal Dialysis Phototherapy 0 25 Ultrasound Scanners OCT Scanner 0 50 Image Intensifier Ward 3 Monitors 0 100

12 Video Endoscope Stack Project 16/17 17/18 18/19 19/20 20/21 21/22 22/23 23/24 24/25 25/26 Harmonic Scalpel 0 25 Phacoemulsifier A&E Monitors X-Ray Room Med Equip Rolling Replacement Capital Projects (non-specific)(unallocated) Estates Backlog Maintenance Allocation Unallocated Ambulatory Care (allocated in principle) X-Ray Room 2 Fluoroscopy 800 Acute ward Redesign GBH Feasibility CT Scanner (CG Funded 1.2m) 1200 Unallocated Yearly Totals:

13 14.0 Recommendations The Board is asked to; i. Note the revised 2016/17 Capital Programme and update, and ii. Support the revised 10 Year Capital Programme agreed by the Capital Management Group. LAWSON BISSET Head of Estates and Facilities 22 nd November

Shetland NHS Board. Board Paper 2017/03

Shetland NHS Board. Board Paper 2017/03 Board Paper 2017/03 Shetland NHS Board Meeting: Shetland NHS Board Paper Title: Capital Programme 2016/17 and 2017/18 Date: January 2017 Author: Lawson Bisset Job Title: Head of Estates, Facilities & Medical