Asset Management Group

Transcription

1 Asset Management Group DRAFT MINUTE of MEETING of the NHS Highland Asset Management Group Anteroom Assynt House Assynt House Beechwood Park Inverness IV2 3BW Tel: Fax: Textphone users can contact us via Typetalk: Tel s.uk Tuesday 28 th February 2017 Present: Alasdair Lawton, Non-Executive Director & Chair - (AL) Alister McNicoll, Deputy Head of ehealth (AM) Carol Marlin, Monitoring Accountant - (CM) Eric Green, Head of Estates (EG) Nick Kenton, Director of Finance (NK) Steven Brown, Section Head Electromedical Equipment Services (SB) Alex Javed, Service Manager - Laboratories & (interim) Radiology (AJ) Michael Foxley, Non-Executive Director (MF) Eileen Anderson, Representative of Area Clinical Forum (EA) In Attendance: David Whyte, Chief Clinical Technologist (DW) George Morrison, Head of Finance A&B (GM) VC (on behalf of Christina West) David Park, Director of Operations, Inner Moray Firth Operational Unit (DP) Sarah Wilson, Estates Project Administrator (minute)(sw) Michelle Fraser, Capital Accountant (MFr) Heather Cameron, Senior Project Manager (HC) Claire Stewart, Procurement Manager (CS) (on behalf of Neil Stewart) Louise MacFarlane, Consultant Dermatologist (LM) Susan Shand, Service Manager Medical Division (SS) Helen Emery, Property Manager (HE) Steve Colligan, Head of Radiotherapy Physics (SC) Welcome/Introductions: Alasdair Lawton welcomed the group & apologies were noted on behalf of; Elspeth Caithness, Mike Hall, Kate Leishman and Bob Summers. 1. MINUTE OF THE MEETING HELD ON TUESDAY 24 th January 2017 The minutes were approved as an accurate record. 1

2 2. MATTERS ARISING 2.1; Belford mobile phones/pagers, Estates have raised a Maximo order for this however no invoices have at present been submitted. 2.2; RNI Dishwasher replacement, DW advised that the dishwasher has been fixed but he has requested that a paper be submitted to procurement for a specification as the current machine is 20 years old. 2.3; Proposed smaller group to scrutinise & approve Business Cases through development paper to be presented moved to February s meeting. Actions; 2.1 AM will investigate and report back at March s meeting. 2.2 DW to update group are March s meeting. 2.3 EG to produce a paper of his suggestion for a smaller approval group at March s meeting. 3. CAPITAL MONITORING Month 10; 7m of the budget has been spent. MFr advised that the low spend is being addressed, meetings are planned to take place leading up to year end with all the Capital budget holders to ensure the entire budget is spent. CM states that the figures for month 10 were correct at the time the report was produced, however with the volume of invoices that have been submitted since then the position will be improved. AM states that although it looks as though ehealth has not spend nearly half their budget he can confirm that this situation has changed and they currently have little over 10K remaining of their allocated budget. HC advised that EG is working toward having the Estates budget allocation accounted for by year end. Time has been set aside this week to try and achieve this. Action; All Capital budget holders to keep updating CM & MFr on their spending to ensure all funds are spent by year end. 4. CAPITAL PLAN No formal confirmation of funding has been received at present from Scottish Government however CM advised Finance are working on the assumption that Formula Capital will remain as last year at 6.6m, and project specific funding for Raigmore Critical Care, Radiotherapy, Badenoch & Strathspey land purchase and the 70% balance of the Smarter offices project. Once technical adjustments and a 500K contingency has been set aside, along with the reinstatement of spend for Estates there is 4.6m available for the rolling programmes. 100K has been allocated for both Dental and Soft Facilities services and 6K for Radiology there is 3.8m for Estates, Medical Equipment and ehealth, which at present this has split evenly 3 ways. 2

3 This should allow Estates to cover continuing red risk as agreed by the Board but is way short of what is required for Medical equipment and ehealth. Schemes over 1.5m have been shown in a different section of the plan as these need to be discussed with and agreed with Scottish Government. Action; CM - Final plan will be presented at March s meeting for approval before submitting to Board on 28 th March RISK MANAGEMENT ehealth TOP 5 RISKS AM informed the group that ehealth are working with Mirian Morrison, Clinical Governance Development Manager, building their risk register. The ehealth teams were provided with templates which have been completed and returned to the Head of ehealth, ehealth Security Officer and AM to compile. The top areas for concern currently are any single points of failure such as a power outage in one of the server rooms due to a lack of power resource, staff browsing the Internet could cause a significant security issue, a cloud based national procurement for a GP system could cause an issue with infrastructure and bandwidth at GP sites and there has been new data protection regulations. The full risk register will be presented at March s meeting. Action; AM to present full risk register at March s meeting 6. RISK MANAGEMENT MEDICAL PHYSICS Electro Medical Equipment Services (EES) are responsible for the management of approximately 27,000 items of medical equipment across NHSH, with an estimated replacement value of 33m. The current Medical Equipment backlog is now 15.3m. To recover this situation, EES have costed a five year risk based programme to identify and prioritise equipment purchases. There is approximately 5.4m of Revenue and 9.9m of Capital medical equipment beyond its scheduled replacement date. NHSH capital equipment is the responsibility of the Asset Management Group and is managed by EES Medical Physics. At present revenue equipment is the responsibility of individual Operational Units which EES has no formal control over. EES have produced a 5 year plan designed to reduce NHSH Medical Equipment backlog to zero by 31 st March This would require planned average investment in both Capital and Revenue Medical Equipment of approximately 5.03M in each of the next 5 financial years. DP asked if it would be possible to separate the risks which would prevent services being available opposed to risks that would cause harm to staff or patients. SB asked the group for clarification on the appointment of a medical equipment sub group. AL thought that it was not within the AMG remit but that it would be prudent to ask the management team for input. Action; DW to highlight risks preventing services and risks causing bodily harm. NK to present the standard terms of reference to the management team. 3

4 7. RAIGMORE ORTHOPAEDIC THEATRES POWER TOOLS Raigmore Orthopaedic Theatres currently owns 18 heavy power tools and also has access to 5 on a long term loan. These tools are used for hip and knee arthroplasty surgery as well as major trauma procedures. The reliability of the Orthopaedic power tools reached a critical point in the summer of 2016 with 11 of the 18 tools being obsolete and half of all tools needing repair, which directly contributed to the cancellation of surgical procedures. KU informed the group that the Theatre Department chose to enter into a hire purchase agreement with Zimmer for 15 power tools along with a 5 year maintenance plan for 115K (with payments spread over 2 years). At this time, they considered this to be a revenue issue. After the order was placed, it was established that this hire purchase would be a finance lease and would therefore impact on capital as well as revenue. In order for Finance to make a technical adjustment to cover this KU requested that the group approve the 87K capital requirement. NK asked if there were any actions that needed to take place to assure that this situation did not reoccur. KU explained that the situation was not carried out maliciously and that lessons have been learned. 8. PHOTOTHERAPY UNIT LAWSON MEMORIAL HOSPITAL Phototherapy (light therapy delivered by specialised cabinet) is a second-line therapeutic intervention used to treat common chronic, debilitating skin conditions such as psoriasis & eczema. Phototherapy is also used in the management of many less common conditions, including cutaneous lymphomas. Small numbers of patients with alopecia & vitiligo, both of which have a hugely negative impact on quality of life, can be treated with prolonged courses of UVB or PUVA. With only one unit at Raigmore, our waiting times are longer than desired, & many patients in remote and rural areas simply cannot travel so far so often because of home or work commitments, or frailty. It inevitably leads to such patients progressing to second-line systemic drugs to control their skin disease. LM advised the group that there are 2 main advantages of being able to offer this treatment distant to Raigmore. Firstly having a second unit out with Raigmore would be more in keeping with the Highland Quality Approach in regards to fair access and secondly it would be a proactive approach to reducing costs. The total cost of the Phototherapy unit and 2 additional items required to provide the service has been quoted as 26,904 plus VAT. This could be offset by the savings made by reducing the number of people requiring second-line systemic drugs. Regarding the issue of the number of patients able to be treated per day that was raised at January s AMG LM advised that the service would start out at 3 mornings per week and would be able to accommodate patients per day. It should be noted that Phototherapy lasts for a maximum of 8 minutes per session, 3 times a week over an eight week course. AL asked who would monitor the savings being made given the claim that there would be revenue saving of 50,000+ per year for only 30,000 expenditure. KU advised that she would be able to liaise with Pharmacy to get the data by drug and then the budget can be withdrawn. AL queried if this was to be part of a roll out across multiple sites in NHSH. SS advised that this proposal is not part of a wider plan but cannot guarantee that other areas may request a similar service in the future. 4

5 CS asked what process was carried out to obtain the quotation. Andrew Hince in Medical Physics obtained the quote and DW advised that having the same machine as the current unit in Raigmore would ensure that dosing was standard. HC enquired if the unit would be able to be relocated if needed. DW advised that the proposed unit is on wheels. 9. ASSET MANAGEMNENT GROUP ATR REPORT The Community Empowerment (Scotland) Act was passed in June The Act places new duties on a range of public sector bodies and provides new rights for community organisations. These include rights for community bodies to request ownership, lease, management or use of publicly owned buildings or land whether or not they are available for sale or deemed surplus to requirements by the owning body. There are a number of implications for NHS Highland including being able to respond to requests from communities for transfer of assets. On receipt of a request, NHS Highland must assess the request its economic, social and environmental benefits and whether it contributes to reducing inequalities. Requests must be granted unless NHS Highland has reasonable grounds to refuse. The Scottish Government s final guidance on Asset Transfer Requests was published in January HE advises the group that there has been an informal application drawn up to allow communities gauge if they have a valid business case. The process is designed to help communities as there is a lot of work that goes into the formal application process. There has been some confusion with community groups thinking that this framework allows them to get something at a discount or free, however that is not the case. NHSH are only able to accept market value. There are some exceptions to this but any case where NHSH is not accepting market value has to go through Scottish Government as it is classed as a gift. This has been through a consultation process however each case will be dealt with on its own merits. There are a few pending cases currently and they should come through the group for approval before going onto the board. HE has said is an essential governance step that should be taken before any asset is handed over to the community. With this framework NHSH have the ability to look at the 5 year financial viability before accepting. This should negate any concerns of inheriting an asset that has not been maintained. MF asks whether market value refers to District valuer s valuation. HE states that NHSH use FG Burnett for open market value. MF enquired if this form had input from other public bodies and HE responded that there was a consultation with them. MF considers that the 5 year business plan may not be appropriate in all cases and that a proportional element needs to be taken into account. NK asked if this would be the process followed by Argyll & Bute. HE advised that as she covers all the property transactions for Highland and Argyll& Bute this was the case. 5

6 CM wanted it noted that NHSH use FG Burnett as they hold the contract having been through the tendering process. 10. CLINICAL ONCOLOGY CT SIMULATOR SC informed the group that Clinical Oncology are requesting approval to replace the CT Simulator and supporting equipment in the Department. The current scanner has reached the age of replacement specified by the Scottish Government. The rolling replacement of radiotherapy equipment is part of the Scottish Government s Cancer Plan and receives ringfenced capital funding from the Scottish Government. The procurement method is via Health Facilities Scotland with the central legal office as there have been issues with the radiotherapy procurement. The intention is to go out to tender and replace this machine in 2017/18. The new machine is to utilise the room that the current machine is occupying. Therefore there will need to be a plan in place so that service is not disrupted. Regarding the funding SC advised that there is 1.1m for the CT scanner and associated supporting equipment and 102K for any building work required. AL asked if all of the cost was being borne centrally. SC confirmed this is the case and the capital charge has been accounted for as part of the Capital Plan. AL enquired as to what the cost implication is to NHSH. SC advised that maintenance would be the only implication. Currently there is an audit contract with a company who comes once a year to service the machine costing around 5K + 20K for spare parts. The downside to this is that we would bear the cost of any spare parts. It is possible that a more inclusive maintenance plan would be beneficial although that would increase the yearly cost. EA asked if this scanner could be used for normal CT scans. SC was unsure if the scanner could accommodate bariatric patients but that in the past it has been looked at as a contingency and could be considered in the future. AM asked if we know when we will know what the revenue costs will be and will it be comparable to the 25K that it is currently costing. SC advises that if a full service contract was taken on it would possibly go slightly higher than the 25K. HC asks if Estates would need to be involved with any room alterations. SC advised that they would consult Estates if any input is required of them. 11. RAIGMORE POT WASHER KU explains that the sterilisation pot washer broke down on 23 rd February and since then The unit is nearly 15 years old and will be beyond it scheduled replacement date in October A quote to repair the machine has come in at 5K and that would not guarantee how long the repair would last. 6

7 NK asked what is happening regarding the sterilisation of pots in the meantime. KU advised that in the short term they are able to manually sterilise using chemicals. It was requested that the group approve the purchase of a new machine for 10.5K.The paperwork is being compiled currently to ensure that once the group has approved there would be minimal lead time. NK enquired if there was a longer term plan for the replacement of catering equipment. KU advises that she will liaise with Crawford Howat and Alistair Wilson to proactively look at catering assets and identify any risks to service. Action; KU to liaise with Crawford Howat and Alistair Wilson regarding catering assets. 12. A.O.C.B DW raised that Medical Physics are slightly over budget as there was a case whereby an alternative ventilator was required by a child in the Fort William area who was not tolerating the current ventilator. This costs under 14K and results in an overspend of 5,448 however the original ventilators would be returned to NHSH. CM to investigate this and report back MF would like it noted that of the 2 VC machines in the Fort William Health Centre (FWHC) there is only 1 working. AM will be notified and asked to consider this. Action; 12.1 CM to investigate the overspend and report finding to the group at March s meeting AM to consider options for the broken VC machine at FWHC. There being no other business the meeting was closed. Date of Next Meeting Tuesday 21 th March 2017 Venue: Ante room Assynt House Agenda items & papers must be submitted by 12 noon on Monday 13 th February