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

Transcription

1 Board Paper 2017/45 Shetland NHS Board Meeting: Shetland NHS Board Paper Title: Capital Programme 2017/18 Date: 3 October 2017 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 2017/ Purpose To provide the: 2017/18 Capital Programme 10 Year Capital Programme 2.0 Background 2.1 The Capital Management Group (CMG) agreed a Capital programme for 2017/18 at its meeting in December This followed robust risk based prioritisation exercise based on presentations by the Project stake holders and a scoring matrix. 2.2 The Board approved 10 Year Capital Programme assumes an annual Capital allocation of 997k (excluding inflation). Early discussion with Scottish Government indicates that Capital resources in future years may be limited and in particular 2018/19 will be challenging. 3.0 Projects Progress Report 3.1 Progress against the main projects is summarised below: Ambulatory Care Project approved in principle but subject to the approval by SIG (Scottish Investment Group) and a financial allocation from Scottish Government (SG). Initial Appraisal (IA) commenced for submission, to consideration by SIG. SG has indicated budget approval in principle, however capital bids will be subject to a regional consideration and it is recognized that the capital position in 2018/19 and future years is challenging. 1

3 Year k Design Year k Construct Year k Construct Ambulatory Care Project (IA) is under review and an update in conjunction with a consultant Healthcare Planner. Programme as agreed for completion of updated IA with a submission to SIG targeted early Anesthetic Pendants Pendants ordered. Installation programmed for January A detailed programme is being developed for a phased installation (Theatre 1 and Theatre 2) Electrotherapy 50 %Completed Video laryngoscope COMPLETED Additional Clinical Space Scalloway Health Centre Detailed design and phasing approved and tender due to be issued September Emergency Psychiatric Assessment Room (Low Stimulus Room) Project Team has been established. Initial Sketch Scheme revised to reflect Stakeholder input. Detailed design approved - Tender issued September Cold Room Trolley Project Team required to be established with relevant Stakeholders. Order placed, due for delivery October Washer Disinfectors Project Team has been established. Mini Tender from Framework (NP143) has commenced in conjunction with National Procurement and Authorising Engineer. Tender documents due for return September

4 3.1.9 Spend to Save Budget allocation for Transformational Change Projects, requiring Capital Funding. Current allocation 20k for AMD (Out patients Department) Endpoint Infrastructure Detailed briefing commenced Hospital Pager System Scoping commenced Trak Care Infrastructure COMPLETED Server and Storage Capacity Detailed scope completed. Tender due to be issued September Backlog Estate Backlog Minor ongoing works of upgrade, repair and replacement HAI Rolling Program 17/18 Prioritised works agreed with Infection Control. Works commenced (Minor Works Framework). Works due to be completed October 2017 (Theatres and Ward 3) Fire Improvements Rolling Program Fire Committee in conjunction with C S Todd and Scottish Fire and Rescue Service (June 2017) prioritised 17/18 works. Fire Risk Assessments completed by C S Todd and SFRS and Action Plan in place. Works prioritised for 2017/18 (L1 Fire Alarm improvements and Smoke seals to doors) Legionella Rolling Program Water Group in conjunction with Authorising Engineer has prioritised for 17/18 work. Works on going Electrical Rolling Program 17/18 Works will be prioritised on completion of 5 Year Fixed Electrical Testing Report on all NHS Shetland premises. Works have been prioritised from within the 2017/18 budget allocation (Goodlad Crescent and Montfield). 3

5 Windows Replacement Phase 8 EAMS Survey in conjunction with Estates has identified prioritised Window Replacement/Upgrade at GBH. Preliminary investigation works have commenced onsite and are due for completion end of December It is anticipated that these works will alleviate the water ingress by a combination of replacement windows, cills and remedial works to the defective ingoes. Ronas Day room window programmed for replacement during Roof Repairs Various works have been ongoing to the flashing and abutments which appear to have made a significant improvement. However this will be further tested during the winter months. A number of ingress points still remain and these are being investigated locally. Should adverse weather expose a recurrence of the usual water ingress then arrangements are in place with a contractor to carry out an invasive investigation at the earliest opportunity following the incidents DDA Rolling Program On going Steam Pipework Repairs Project Team established in conjunction with Boiler Replacement Project. These works will be enabling works around the water treatment for the new boilers Dampers Rolling Programme GBH Programme has been agreed in principle with the contractor and design team (GBH Ground floor). Each damper is programmed to be treated as an individual project due to the issues in respect of access, service continuity, Infection Control and isolations Boiler Replacement Project Team established. Detailed drawings and specification have been approved and issued September. Boilers will be replaced on a phased basis to ensure no disruption to service continuity Non-Doctor Islands Rolling Programme Minor ongoing works of upgrade and replacement within financial allocation

6 Contingency There is no current contingency within the 2017/18 programme Theatre operating tables (Theatre 1 and Theatre 2) The existing tables have been assessed by Medical Physics, Estates and Theatre Users Group and are considered beyond economic repair. As such, options for replacement have been investigated and the preferred option ordered (MAQUET) Laboratory Managed Service Contract (letter of intent) issued. Installation programme completed. Contract particulars agreed in principle, awaiting financial pricing schedule to be confirmed. Contract documentation finalisation October Food Tenders Milk, Fresh Fish, Butcher Meat, Bread, Groceries and Frozen foods. Tender documentation being prepared to reflect the Procurement Journey and Single Source Supplier and SIC procurement time scales Minor Works Framework (Contractors) Tenders returned and Tender assessment completed - 3 Year Framework in place MRI Feasibility Study Initial Option Appraisal ongoing Scalloway Health Centre Contractor retention not been released until the 'as built drawings' and the Health and Safety file has been handed over Ronas Ward Feasibility Study A Project team has been established and options have been developed within the available space. It is anticipated that the study will be completed during 2017 for consideration by CMG GBH Security Security Manager developing a lock down procedure in conjunction with Police Scotland Security advisor. 5

7 4.0 State of Assets and Facilities Report (SAFR) 4.1 The Annual State of NHS Scotland Assets and Facilities report (for 2016) has been published by the Scottish Government (SG) in August 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. 5.2 An Energy Group has been established and an Energy Policy is being developed. 5.3 A new energy collation and monitoring tool (esight) has been established and data commenced input. 6.0 Property Disposals 6.1 Progress is on going with disposal of the following properties; Burra Nurse's House - due to be re-advertised. 49 Nederdale Sold. 52 Nederdale Sold. Scalloway Health Centre, Harley Street reuse under consideration. 7.0 Property Review (EAMS) 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. 6

8 7.2.1 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 High Risk Backlog has been eliminated following works completed and a review of the High Risk criteria. A further review of the criteria is due (2017/18) to be carried out on the Significant Risk Backlog based on the current criteria. Total Backlog is currently (EAMS) 1.82m In conjunction with the Scottish Futures Trust and Health Facilities Scotland a structural review, including invasive surveys has been carried out in respect of selected of the selected properties from the recommended criteria. The invasive surveys have identified no issues in respect of the Scottish Future Trust review Estates are intending to carry out a full peer review of the Backlog in conjunction with colleagues from NHS Grampian. 8.0 Statutory Compliance Audit and Risk Tool (SCART) SCART is a web based assessment tool which has been developed by Health Facilities Scotland. 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) was issued in January The revised SCART has 36 Sections (Fire, Water, Asbestos etc) each with 4 to 60 individual questions which are applicable to each of our 32 properties. In line with other Boards we are approaching on a zero score basis and have set a target of achieving 70/100 within the next 18 months which reflects the limited resources in staffing and budget availability. 7

9 Estates staff are in the process of completing the SCART tool for the GBH and associated action plan to identify the gaps an associated cost for improvement. In the interim there will be compliance risks which will reduce as we progress with the completion of SCART over time. 9.0 Financial Report To date, there is considered satisfactory expenditure to report against the 2017/18 Capital Programme budget. No issues identified 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 and newly established North Waste Group, North Energy Group and North Sustainability Group 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 HFS are currently reviewing Corporate Greencode Mandatory Public Bodies Duties Climate Change Report Scottish Government has developed a Climate Change Reporting Template. 8

10 NHS Shetland submitted their 2016 return. The 2017/18 submission is due by November 2017 and 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) SDAP being reviewed subject to annual submission to Scottish Government Climate Change Adaptation Plans Health Facility Scotland are developing a Climate Change Assessment Tool. Which is due to be issued during 2017 for use by Boards esight Monthly data submissions for Energy, Waste and Water These are quarterly analysed by Health Facility Scotland in conjunction with NHS Shetland to identify any savings, change in trends and opportunities for reduction in consumption 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 This assessment model is currently being reviewed by HFS and is due to be reissued to Boards during Biodiversity Action Plans 9

11 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 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 EPC updates to be carried out during 2017/ Carbon Management Plan 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 The preparation of an updated Carbon Management Plan is currently out with the staffing levels available within Estates and discussions are ongoing with Zero Waste Scotland with a view to providing assistance Community Empowerment (Scotland) Act In summary this enables requests from certain community bodies to NHS Shetland for the use of land and buildings which are owned or leased by the Board This is new legislation and following training on the applications and implications of this Act a further update will be provided to the Board Guidance is currently being prepared which will be issued in due course to the NHS Shetland website for staff and public. 10

12 12.0 Heritable Asset Registration Programme 12.1 This is a policy requirement of Scottish Ministers for the land register of Scotland to be completed by 2024, including registering all Public land by All of Scotland s land will be registered for the first time which will provide a clear understanding of who owns our land. An efficient, effective and indemnified land registration system is recognised by the World Bank as one of the most important factors in achieving economic development and business growth In relation to NHS owned property, this will be effected by Health Boards working in conjunction with the NHS Central Legal Office (CLO) in order to complete a voluntary registration of those titles transferring from the existing General Register of Sasines onto the Land Register Estates have commenced liaising with CLO to progress this onerous task Year Capital Programme 13.1 The attached appendix illustrates the latest 10 Year Capital Programme agreed by CMG This is based on the medium term projections from IT, Medical Equipment, Capital Projects and Backlog Maintenance and reflects 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 and budgets are forthcoming Fire Report NHS Shetland has reported to SG that no Aluminium Composite materials (ACM) is on our estate. This being the cladding material used on the Grenfell Tower fire. 11

13 15.0 North of Scotland Estates and Facilities Group A North of Scotland regional group has been established for Estates and Facilities to include, NHS Shetland, Orkney, Western Islands, Highland and Grampian, with a view to developing collaborative working. Recommendations The Board is asked to; i. Note the 2017/18 Capital Programme update, and ii. Support the 10 Year Capital Programme agreed by the Capital Management Group. LAWSON BISSET Head of Estates and Facilities 25th September

14 10 Year Capital Programme - (September 2017) Project 17/18 18/19 19/20 20/21 21/22 22/23 23/24 24/25 25/26 27/28 Emergency Psychiatric Assessment Room 50 Cold Room Trolley 2 Washer Disinfectors 200 Anaesthetic Pendants 30 Electrotherapy 12 Video Laryngoscope 13 Additional clinical space Scalloway Heath Centre 35 Spend to Save 30 H & SC Portal 50 Hospital Pager System Trak Care Infrastucture 50 Server and Storage Capacity 30 IT Rolling Replacement 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 Video Endoscope Stack Harmonic Scalpel 0 25 Phacoemulsifier A&E Monitors X-Ray Room Theatre operating tables & transporters 50 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) 500 Ronas Ward 30 Unallocated Yearly Totals: