Consider report from Capital Planning Group

Transcription

1 NHS Board Meeting 23 April 2008 Paper 10 NHS BOARD MEETING 23 APRIL 2008 Subject : Capital Programme 2008/09 Purpose : Consider report from Capital Planning Group Recommendation : To approve content of capital programme for 2008/09 1. Background 1.1 The NHS Board meeting held on 13 July 2005 approved the work plan and the long term capital plan for the period 2005/06 to 2012/ In approving the plan, it was recognised that the work plan required to be flexible to deal with other emerging strategic issues, the outcome of the Review of Services Strategy, Review of Mental Health Strategy, and changes to national and local priorities. 1.3 The Capital Planning Group in the intervening period has undertaken further work and the outcome has been reflected in the updated capital plan incorporated in the Finance Strategy issued to the Scottish Government Health Department (SGHD) in March 2008 as part of the Local Delivery Plan. 2. Strategic Aims 2.1 The following strategic issues remain the key aims to be taken into account in formulating the plan : Corporate aims and objectives agreed by NHS Ayrshire and Arran Services redesign for more effective delivery of Clinical Services, as part of the modernisation programme Outcome of completed Review of Services Strategy, Mental Health Strategy and other service strategies for provision of more appropriate services in line with national and local standards and best practice Relevant clinical and other priorities from the Local Delivery Plan, the Joint Futures/Joint Premises agenda and Community Health Partnerships 1

2 Aims from the Information Management and Technology (IM&T) and Property Strategies for more effective and efficient utilisation and best value in service provision 3. Capital Programme for 2008/09 The table below gives the sources and proposed applications of the capital allocation of 37.2m. Thereafter, a brief explanation is given of the various component parts. Available Funding 000 Capital Allocation 21,451 Additional allocation for Electro-Medical 2,207 Equipment Net Brokerage to / (from) SGHD in 2008/09 11,326 Local carry-forward 0 Primary Care Modernisation Community 981 Health Capital Grant Allocation Ophthalmic 480 Services PACS Capital Expenditure reimbursed by 600 SEHD ACT Funding for Education Centre 160 Energy Efficiency Funding balance due 33 Total Funds 37,238 Planned Expenditure 000 Girvan Community Hospital 10,578 North West Ayrshire Resource Centre, 1,307 Largs Formula allocation 5,657 Patna Resource Centre 293 Mossblown Clinic 117 North Ayr Neighbourhood Services Centre 200 capital grant SAC Crosshouse Resource Centre capital 1,795 grant EAC Capital Grants Ophthalmic Services 510 Capital Grants PC Dental Services 152 Decontamination Primary Care Store, Ailsa 200 Energy Efficiency Allocation balance due 33 Ayr Endoscopy Unit Improvements 1,336 Electro-Medical Equipment earmarked 2,207 supplement Lady Margaret Modular Unit 365 Accident & Emergency 1 st floor Alterations, 45 Crosshouse Diagnostic Waiting Times 1,136 2

3 IM&T - Clinical Systems Development 750 Boswell House relocation 107 IM&T Hub, Knockdon, Ailsa 1,070 Review of Services Implementation 2,412 Ayrshire Central Hospital Out-patient 1,000 Department and ADOC alterations Ayrshire Central Kitchen/Dining Room 1,807 improvement Ayrshire Central TSSU 1,500 Extension/Alterations Ayrshire Central TSSU Equipment 400 Replacements Ayrshire Central Horseshoe Building 598 Refurbishment Ayrshire Central Training Centre 2,000 relocation Ailsa Training Centre 382 Ayr Education Centre Extension 84 Revenue to Capital allocation 1,598 Grouped Equipment allocation 600 Capital to Save on Revenue allocation 2,000 Non Value Adding Elements (charged to (4,000) revenue account) Receipts from Asset Sales (1,581) Maternity PFI residual asset valuation 288 Contingency 292 Total Expenditure 37, The 2008/09 capital programme reflects the outcome of the review of progress on projects already approved, business case preparation and other service priorities. 3.2 The funding sources highlighted are firm taking account of allocations notified by the SGHD in March 2008, brokerage of 6.859m deferred from 2006/07 and 4.712m brokerage from 2007/ No capital brokerage with SGHD from 2008/09 to 2009/10, is planned at this point. The Board intends to fully utilise its capital allocation by internally managing any slippage and bringing forward expenditure from 2009/10. This position will be reviewed in-year, once firm expenditure commitments for Girvan Community Hospital have been identified from the tendering process. 3.4 The programme provides a formula capital allocation of 7.9m for replacement/refurbishment projects and to enable a continuation of the phased programme for Infrastructure Improvements/Implications of Disability Discrimination Act. The formula allocation has been reduced by 2.243m to 5.657m to cover the net effect of projects already brought forward from 2008/09 and projects to be brought forward from 2009/10. 3

4 The SGHD has confirmed a supplementary earmarked allocation of 2.207m in 2008/09 for electro medical equipment (EME). This is to supplement existing replacement allocations in the formula allocation to address backlog replacements and new standards. The local access agreement with Kodak provides for Picture Archiving Communication System (PACS) being implemented at Crosshouse and Ayr Hospitals. Under the terms of the national PACS agreement, the SGHD will reimburse each NHS Body the capital costs of the PACS component system and related hardware. NHS Ayrshire and Arran is due to be reimbursed 0.6m for costs incurred in 2007/08. Primary Care Modernisation funding totalling 0.981m from prior years has been carried forward to 2008/09 to progress associated primary care improvements locally. Primary Care Modernisation funding totalling 4.053m for the North Ayr Neighbourhood Services Centre (being commissioned in partnership with South Ayrshire Council), will be carried forward centrally to 2009/10 to enable the capital grant to be effected to South Ayrshire Council in that year. Other specific allocations from SGHD are for capital grants to Ophthalmic Practitioners ( 0.480m) and the balance due ( 0.033m) from Central Energy Efficiency Funding carried forward from 2007/ The balance of the contribution from Additional Costs of Teaching (ACT) funds totalling 0.160m towards the cost of the extension to Medical Education Centre, Ayr has been provided for The following key projects are highlighted together with a brief position statement. 1. Review of Services (RoS) NHS Ayrshire and Arran has carried out a review of its former proposals and submitted its recommendation to the Cabinet Secretary. The recommendation for a phased programme of improvements at Ayr and Crosshouse hospitals has been approved. The capital programme for 2008/09 allows for a start to be made to the work programme. 2. Ayr Endoscopy Unit Extension A Supporting Case for an extension to the Endoscopy Unit at Ayr Hospital was approved in March 2008, to enable work to be completed in 2008/09. This will facilitate a redesign and extension of accommodation to increase capacity and resolve decontamination issues. 4

5 3. Crosshouse Resource Centre NHS Ayrshire and Arran was successful in its bid to SGHD under the Primary and Community Care Modernisation Programme, in relation to the joint development with East Ayrshire Council of a new Crosshouse Resource Centre. Work has commenced to create a new build medical centre, council office, library and learning unit, for completion by summer The NHS Board contribution will be by capital grant to East Ayrshire Council. 4. Ayrshire Central Hospital Redevelopment Programme An Initial Agreement has been submitted to SGHD, for consent to a phased development of a new Community Hospital for North Ayrshire. The 2008/09 capital programme allows for enabling works to commence in line with the master planning process (e.g. new Community Casualty Facility, extension to Out-patient Department, relocation of ADOC/NHS24 services, new Kitchen/Dining Room, Theatre and Sterile Supplies Unit (TSSU) extension, new Area Training Centre and Horseshoe building refurbishment). 5. IM&T Hub, Knockdon, Ailsa Following a review of non-clinical accommodation, it was agreed that a Knowledge Management and e-health Hub including library facilities, would be located at Knockdon, Ailsa. This will allow for close integration with other key IM&T services in Turnberry and for the project to be completed by the end of calendar year Clinical Systems Procurement The Board is pursuing an IM&T Strategy in line with the national plan to support improvements in patient care. This is being implemented on a phased basis over a period of years. The Director of Knowledge Management and e-health is leading various groups to achieve the patient benefits expected from implementation of the strategy. 7. North West Ayrshire Resource Centre, Largs Building work commenced in April 2007 on the extension to Brooksby Day Hospital with completion planned for May The second phase refurbishment of Brooksby House is planned for completion in October

6 8. Girvan Community Hospital The Full Business Case for the new Community Hospital was approved by the then Scottish Executive Health Department in September 2006, using the public procurement route. Following outline planning consent and satisfactory survey results, the associated land purchase has been effected. The application for full planning consent has been approved. Tenders have been sought to enable building work to commence in summer 2008 with completion in autumn Diagnostic Waiting Times Provision has been made for the 1.136m balance of expenditure commitments from the earmarked allocation made by the SGHD in 2007/08, to enable the accommodation alterations at Ayr and Crosshouse to be complete by September Capital to Save on Revenue Projects An allocation of 2.0m has been provided to progress revenue saving projects. The main areas targeted are Energy Initiatives, Shared Site Services and Property Rationalisation measures. The energy initiatives will initially concentrate on improvements at Crosshouse, Ayr/Ailsa campus and Girvan sites. Following an initial meeting with SGHD, it is possible that some additional capital funding could be made by SGHD as a contribution towards local costs. 11. Revenue To Capital Projects In line with the decision taken in 2006/07 on the use of the Revenue allocation to comply with the Treasury ruling on Capital to Revenue Transfers, an allocation of 2.0m has been allowed for revenue funded projects. The first 2.0m of project approvals will therefore require no transfer of funds from revenue (this will reduce revenue funding risks). The 2m allocation has been reduced by 0.402m to 1.598m, for commitments already made (purchase of ransom strip Castlepark, Irvine ( 0.302m), IM&T PACS project VAT adjustment ( 0.100m)). 12. Grouped Equipment An allocation of 0.6m has been provided for the grouping and capitalisation of smaller items of EME and IM&T equipment (individually costing under the 5k threshold), in accordance with the regulations allowed in the Scottish Capital Accounting Manual. 13. Non-Value Adding Elements Provision has been made for non-value adding elements from the capital programme to be recharged against the revenue allocation. This will be externally validated by a review carried out by the appointed Valuers to the Board. 6

7 14. Contingency Provision has been made for contingency of 0.292m to be held for unforeseen items. Any remaining risk will be managed as part of the brokerage process. Any unused elements of the contingency will be allocated against agreed priorities later in the year. 15. Receipts From Asset Sales Income from asset sales totalling 1.581m has been allowed for receipts from the following disposals 1. Former Darvel Health Centre ( 82k), 2. Former Whitletts Clinic, Ayr ( 22k), 3. Wellington Chambers at Ayr ( 77k), 4. Holmhead Hospital site ( 1,300k), and, 5. Former Mossblown Clinic ( 100k). This income has been shown as a deduction against expenditure. 4. Recommendation 4.1 The NHS Board is invited to approve the content of the Capital Programme for 2008/09 as recommended by the Capital Planning Group. Dr Allan Gunning Chairman Capital Planning Group 14 March