THE NHS ESTATE IN WALES

Estate Condition and Performance Report 2002-2003 THE NHS ESTATE IN WALES

Estate Condition and Performance Report 2002-2003 CONTENTS

1 INTRODUCTION 5-6

1.1 The Estate and Facilities Performance Management System 1.2 Estate Condition and Performance Reports 1.3 The 2002-2003 Estate Condition and Performance Report

2 EXECUTIVE SUMMARY 7-11

33 EEstateSTATE ProfilePR 4 OFILE- 6 12-14

3.1 Key statistics of the NHS estate in Wales 3.2 The age of the estate 3.3 The Essential and Non-Essential estate 3.4 Expenditure on the NHS estate

44 EEstateSTATE PerformancePERFORMANCE 7 - 20 15-31

4.1 General information 4.2 Physical condition 4.3 Statutory and safety compliance 4.4 Functional suitability 4.5 Space utilisation 4.6 Energy

5E5 EnvNVIRONMENTALironmental Issues 20 - 23 ISSUES 32-36

5.1 Waste 5.2 Transport 5.3 Water usage

6S6 AummaryPPENDICES 24 - 25 37-194

Appendix I Trust Backlog Maintenance Costs Appendices II-XV Summary of Trust Information Appendix XVI Details of Residual and Surplus Hospital Sites Appendix XVII Performance Indicators and Targets Appendix XVIII Comparison of Key Performance Indicators by Trust Type 1 INTRODUCTION 1.1 The Estates and Facilities Performance Management System

1.1.1 This is the second report on the condition of the NHS Estate in Wales to be based on the Estates and Facilities Performance Management System (EFPMS) returns. The system was introduced into Wales in April 2002 under cover of Welsh Health Circular WHC(2001)99 and replaces the Estate Data Returns (EDRs) that used to be submitted annually by NHS Trusts to Welsh Health Estates (WHE).

1.1.2 The system is web-based and is derived from the Estates Returns Information Collection (ERIC) system used by NHS Trusts in England.

1.1.3 The system in Wales is managed by WHE and is designed to facilitate the data input and reporting processes. As a web-based system the EFPMS allows Welsh Trusts to gain access to data submitted by English Trusts, thus enabling them to compare their performance against a much wider database than has been possible until now.

1.2 Estate Condition and Performance Reports

1.2.1 Reports based on the EFPMS are intended primarily to provide the Welsh Assembly Government (WAG) with high level data and information on the condition of the health estate in order to monitor, year on year, performance trends, inform the strategic planning process and assist in the allocation of resources.

The reports are also intended to provide NHS Trusts with information that will enable them to compare their own performance with that of other Trusts as well as against national trends. The reports, therefore, are intended to be a driver in the process of improving the performance and efficiency of the health estate.

1.2.2 In the EFPMS, the NHS in Wales has an all-Wales database that includes comprehensive environmental and facilities data, thus significantly widening the scope of the reports that can be generated from it.

During its first year of operation, the EFPMS included some optional fields, mainly related to facilities data. These fields are now mandatory and, as a consequence, analysis of these topics can be carried out by the Trusts at a local level.

1.2.3 The 2002-03 Estate Condition and Performance Report includes comparisons between Trusts in Wales and Trusts of similar type which are included in the EFPMS dataset. These comparisons are illustrated in the graphs detailed in Appendix XVIII and cover the key performance indicators for all the Trust types in Wales.

1.2.4 This year the EFPMS includes information on all the Trusts’ properties, although the information relating to the non-hospital estate has been aggregated in clearly defined groups.

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 5 INTRODUCTION

It is envisaged that this will allow a more accurate analysis of the condition of the health estate to be carried out.

1.3 The 2002-2003 Estate Condition and Performance Report

1.3.1 This Estate Condition and Performance Report is based on EFPMS returns submitted by Trusts for the financial year 2002-03. It includes data and information relating to all the hospital sites and the remainder of the estate aggregated as follows:

Aggregate 1: Freehold - Diagnostic & Treatment Centres, Health Centres, Clinics, Ambulatory Diagnostic Centres, One Stop Centres and Primary Care Units

Aggregate 2: Freehold – all other sites

Aggregate 3: Leased and fully serviced by the NHS Trust

Aggregate 4: Leased and fully serviced by the Landlord

Aggregate 5: Leased and part serviced by the NHS Trust/Landlord

The aggregate categories were not all applicable to some of the Trusts.

1.3.2 The 2002-03 Estate Condition and Performance Report follows the same format as the 2001-02 report, in so far as the Estate Performance and Energy Performance Reports have been combined into a single report in order to cover the wide range of data contained in the EFPMS. Data relating to the facilities element of the EFPMS has been included in the EFPMS supplementary document and is also available in the EFPMS to be used by the Trusts.

1.3.3 Whilst WHE has not carried out a systematic validation of data submitted by the Trusts, every effort has been made to identify and address anomalies. Responsibility for the accuracy of the data submitted to WHE, however, rests ultimately with the Trusts.

1.3.4 The hospital sites that were in Powys Health Care NHS Trust have now been transferred to the new Powys Local Health Board and for the purposes of this report, and to enable a consistent approach to be taken with regard to the Performance Indicators and targets, the Powys Local Health Board is deemed to have the same status as the other Welsh Trusts.

6 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 2 EXECUTIVE SUMMARY 2.1 Context of the report

This report addresses the condition and performance of the NHS Estate in Wales for the period 2002-03 and, for the first time, includes data and information based on the whole of the health estate rather than hospital sites only.

The report has been compiled by Welsh Health Estates (WHE) based on Estates and Facilities Performance Management System (EFPMS) data submitted by 13 NHS Trusts and Powys Local Health Board, which replaced Powys Health Care NHS Trust in April this year. Due to its uniqueness amongst Trusts, the Welsh Ambulance Services Trust has not been included, though data was submitted and is available in the EFPMS for comparison purposes with other Ambulance Trusts in England.

Data associated with non-hospital sites has been aggregated, based on five categories set down in the EFPMS.

For the first time it has been a mandatory requirement for Trusts to submit hotel services data, including environmental cleanliness, catering, laundry, security and portering. However, since Performance Indicators and targets have yet to be identified, it has been decided not to include information relating to these services. The data, however, has been included in the 2002-03 EFPMS supplementary document.

In April this year three Assembly Regional Offices took on the responsibility for managing the performance of the Local Health Boards and NHS Trusts. Accordingly, the report includes information by region, this year limited to a breakdown of backlog maintenance costs.

The reliability of EFPMS data continues to be a priority matter for WHE. Accordingly, training focused on achieving accurate and consistent data input, based on the correct interpretation of data definitions, is being provided to Trust staff through the EFPMS User Group set up earlier this year.

2.2 Estate profile

The profile of the estate remains largely unchanged, with more than half of it being over 25 years old and approximately a third over 50 years old. The modernisation of the health estate, therefore, continues to be an important priority for both the Welsh Assembly Government and the NHS.

Key to the modernisation process is the development of estate strategies that support service plans, leading to the requirement for new buildings and the rationalisation of old stock. The identification of Essential and Non-Essential buildings, based on whether they have a health use exceeding five years, is designed to encourage Trusts to dispose of stock with a short term future as quickly as possible. Data submitted by Trusts points to the fact that

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 7 EXECUTIVE SUMMARY

265,000m2 of building area have been identified as having a short-term future — an increase of 65,000m2 since last year.

The rationalisation process involves also the disposal of Non-Essential land. According to the data provided, 270ha of land have a short-term future — an increase of 70ha since last year.

It is anticipated that the implementation of Trusts’ estate strategies over the next year will realise a reduction in Non-Essential building area of approximately 60,000m2 with a corresponding reduction in Non-Essential land area of approximately 90ha.

Early disposal of the Non-Essential estate is vital if scarce resources are to be directed where they can be used more effectively. This, combined with a commitment from the Assembly to start to address the shortfall in funding the NHS Estate over the last ten years, will go a long way to revitalise and modernise the estate.

2.3 Estate performance

2.3.1 General

The NHS is committed to meeting a number of targets based on the following National Performance Indicators:

Physical Condition

Statutory and Safety Compliance

Functional Suitability

Space Utilisation

Energy Performance

The targets relate to the Essential estate and will develop over time to reflect national priorities and the quality aspect of the estate. Welsh Health Estates has introduced the following colour banding as a way of visually expressing the extent of the challenge faced by Trusts in achieving the required performance:

Significant effort required to meet the targets

Some effort required to meet the targets

On course to meet the targets

Whilst the report points to some instances of good performance in respect of the intermediate targets set for 2005, it also highlights significant and disappointing shortfalls. Whilst Trusts face a major challenge in meeting some of the 2005 targets, they are reminded that they should not lose sight of the final targets set for 2008. Accordingly it is vital that they should plan now in order to meet the longer-term targets.

8 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 EXECUTIVE SUMMARY

2.3.2 Physical condition and statutory and safety compliance

The report points to a disappointing increase of £34 million in backlog maintenance costs across Wales, from over £431 million in 2001-02 to nearly £465 million in 2002-03. Whilst aggregated sites account for £20 million of the increase and reductions totalling £41 million have been reported against 37 sites, increases totalling £75 million have been reported against 114 sites.

The report, however, also points to the fact that there is scope for major reductions in backlog maintenance through the disposal of sites that are either closed or are scheduled to close. This, combined with the implementation of business cases relating to Prince Charles Hospital and Ysbyty Glan Clwyd, would achieve a reduction in excess of £100 million.

The cost of complying with statutory and safety requirements, including fire safety is estimated to be £180 million, of which £139 million relates to the Essential estate. These include £41 million associated with the Disability Discrimination Act legislation, which should give rise to concern since the legislation is due to come into full force in October 2004.

Whilst seven Trusts have already met the target of 75% of the estate to be in Estatecode category ‘B’ by 2005, significant work needs to be carried out by those that have not.

2.3.3 Functional suitability and space utilisation

Six Trusts have met the interim target of 75% of the estate to be in condition category ‘B’ by 2005 in respect of functional suitability.

In addition, five Trusts have met the interim target of 75% of the estate to be in condition ‘B’ in respect of space utilisation.

Overall, however, there has been some deterioration in performance across Wales. Whilst this is disappointing, it is likely that some of the deterioration is due to improved data reporting rather than actual deterioration.

2.3.4 Energy

The energy returns for 2002-03 show a disappointing increase in primary energy

consumption of 6.15% and a rise in CO2 emissions of 3.9%.

Furthermore, electricity consumption continues to increase, indicating that a focus on

savings in the use of electricity should be given a high priority if CO2 emission targets are to be met.

The above figures, taken in the context of the primary energy usage over the last 13 years, illustrated in Figure 18 of the report, suggest that the NHS has yet to address seriously the need to achieve the all-Wales 15% reduction required by 2010. Last year’s report recognised the need for individual annual targets to be set for each Trust, based on their current performance, and these have been included in the Trust reports found in Appendices II-XV. In future WHE intends to agree with each Trust an overall reduction target to be achieved by that Trust by 2010, together with intermediate targets.

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 9 EXECUTIVE SUMMARY

With regard to Performance Indicators, progress is more encouraging, with ten Trusts being within the target of 65GJ/100m3. Three Trusts, however, are well above the target and a concerted effort will need to be made by these Trusts to improve their performance. Eight Trusts are within or close to the target of 75% of the estate to be in category ‘B’ or above by 2005. Six Trusts, however, are performing well below this target, with three being particularly poor. These will need to concentrate their efforts to meet the 2005 target, with the target fully integrated into their estate strategies.

2.4 Environmental issues

2.4.1 Waste

The submission of data on waste was made mandatory for 2002-03. It is therefore disappointing that, for the second year running, Trusts’ responses have been inconsistent. Furthermore, the reliability of some of the data submitted is questionable. As with last year’s report it has therefore been necessary to estimate some data for all-Wales reporting purposes, and this has precluded an exhaustive analysis with definitive statements on performance.

Data submitted on Clinical Waste suggests the disposal tonnage has risen to approximately 7,000 tonnes, a slight increase since last year. The total cost for disposal has risen to approximately £2.4 million, indicating a 10% increase on last year’s figures. A contributory factor was an 8.5% increase last November in the contracted price for collected waste for Clinical Waste Consortium members.

Domestic/commercial waste data is incomplete and a best estimate of about 13,000 tonnes would indicate a 10% increase on last year’s figures. Disposal costs, however, have doubled, from £0.5 million to £1 million. This huge increase is likely to be due to unreliable data submitted last year.

Disappointingly, only eight Trusts appear to be engaged in any significant waste recovery/recycling initiatives. This should be a cause for concern given the current requirements for waste disposal reduction. Data submitted for individual participating Trusts indicates that they are recovering/recycling between 2% and 8% of their domestic/commercial waste.

There are doubts about the reliability of data reported for all aspects of Special Waste, which unfortunately precludes any observations being made at this time.

2.4.2 Water

Water consumption is similar to last year, though individual Trust performance, based on floor area, varies considerably.

WHE believes that there is considerable scope for Trusts to implement water conservation initiatives. These tend to be very cost effective, often producing payback within one year. Each Trust should assess its performance based on the criteria set out in the recently

10 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 EXECUTIVE SUMMARY

published Watermark report. This will enable Trusts to identify those properties where performance is poor, and investment is likely to have the greatest effect.

2.4.3 Transport

The submission of data on transport was made mandatory for 2002-03. It is therefore disappointing that, for the second year running, inadequate information was provided on fleet vehicles. A full analysis, therefore, cannot be included in the report.

Trust returns suggest that only six Trusts have a Board-approved Green Transport Plan, indicating that there has been no improvement since last year.

However, five Trusts have fleet vehicles operating on ‘green’ fuel(s), an increase of three Trusts since last year.

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 11 3 ESTATE PROFILE

3.1 Key statistics of the NHS estate in Wales

3.1.1 The current portfolio of NHS properties in Wales is diverse, complex and geographically widespread. Hospital buildings range from 17th Century workhouses to modern District General Hospitals incorporating state of the art building technologies and equipment.

The NHS Estate in Wales comprises: A total land area of approximately 1150 hectares; Over 130 hospitals of varying age, construction size and function; Over 250 health centres and clinics; Over 50 mental health units; Approximately 100 ambulance stations; Over 150 miscellaneous properties in the form of offices, housing, storage and distribution warehouses; Over 30 radio mast sites.

The main change since last year has been the closure of Neath General and Port Talbot Hospitals which have been replaced by the new Neath Port Talbot Hospital, procured through the Private Finance Initiative (PFI).

3.2 The age of the estate

3.2.1 Figure 1 shows the age profile of the NHS estate in Wales. The bar chart graphically illustrates the strategic challenges in modernising the estate when more than half of the buildings are over 25 years old and approximately a third of the estate is over 50 years old!

35 31.67

30 28.52

25 21.35 21.40

20 16.5917.40

(%) 14.75 14.78 15

10 6.77 7.10 7.14 5.43 5 3.14 1.77 1.52 0.67

0 Pre 1948 1948 to 1954 1955 to 1964 1965 to 1974 1975 to 1984 1985 to 1994 1995 to 2000 2000 to Present

2002/03 2001/02

FigureFigure 1 1:Age Age profile profile of theof theNHS NHS estate estate in Wales in Wales

12 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 ESTATE PROFILE

Whilst healthcare services of the highest quality can be delivered from aged buildings, it is generally accepted that technological developments driving forward medical and clinical advances and the demands for better patient environments are best satisfied in modern, purpose-built facilities. The modernisation of the estate remains an important priority for both the Assembly and the NHS.

With reference to Figure 1, the age profile of the health estate for the years 1948-1954 and 1955-1964 appears to have worsened since last year. This apparent anomaly is due to the effect of including the Aggregated sites.

3.3 The Essential and Non-Essential estate

3.3.1 The Assembly requires NHS property holding bodies to develop estate strategies that support service plans. This process can lead to the requirement for new buildings and the rationalisation of old stock. If a building, or land, has a health use of more than five years it is categorised as Essential, and five years or less as Non-Essential. It is important for the Service that Non-Essential buildings and land are disposed of as quickly as possible to ensure resources tied up in maintaining these assets are directed to where they can be used more efficiently.

Figures 2 and 3 show the extent of Essential and Non-Essential buildings and land for all NHS Trusts.

350,000

300,000

250,000

200,000

GIA (m²) 150,000

100,000

50,000

0 ansea Velindre Sw Powys LHB Wales Derwen o Morgannwg Cardiff & Vale Br Carmarthenshire Pembrokeshire & North Glamorgan North East Wales Gwent Healthcare Ceredigion & Mid- North West Wales ontypridd & Rhondda P Conwy & Denbighshire Essential Non-Essential

Figure 2: Essential/Non-Essential building area

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 13 ESTATE PROFILE

3.3.2 NHS Trusts with the greatest proportion of Non-Essential estate tend, in the main, to be involved in managing major re-provision schemes. For example, the sale of St. David’s Hospital in Carmarthen will be reflected in a radical readjustment in Pembrokeshire and Derwen NHS Trust’s Essential/Non-Essential profile, with the percentage of Non-Essential Estate decreasing markedly.

80

70

60

50

40

30

Trust Land Area (ha) 20

10

0 ansea Velindre Sw Rhondda Conwy & ontypridd & Powys LHB Wales Derwen P Denbighshire Cardiff & Vale ro Morgannwg mbrokeshire & B Carmarthenshire Pe North Glamorgan North East Wales Gwent Healthcare Ceredigion & Mid- North West Wales

Essential Non-Essential

Figure 3: Essential/Non-Essential land area

3.4 Expenditure on the NHS estate

3.4.1 The NHS Estate is a hugely important resource, which the District Valuer assessed at an Existing Use Value of £1.2 billion in 2001. Its annual running cost is estimated at over £250 million per annum and, in addition, capital is required to maintain, modernise and improve the existing estate and to develop new facilities. Figure 4 shows the capital investment in the NHS, in real terms, since 1992-93 and Backlog Maintenance costs since 1995-96. The figures include capital investment provided for by PFI.

700.00

600.00

500.00

400.00

300.00 £ (Millions)

200.00

100.00

0.00 1992-93 1993-94 1994-95 1995-96 1996-97 1997-98 1998-99 1999-00 2000-01 2001-02 2002-03 FINANCIAL YEAR

Annual net spend Spend required to keep pace with inflation Cumulative shortfall Total Backlog Maintenance

Figure 4: Capital investment in the NHS in Wales

14 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 4 ESTATE PERFORMANCE 4.1 General information

4.1.1 Welsh Health Circular WHC(2002)50 titled ‘Introduction of an Estates Performance Management System’, was issued in April 2002 and provided details of five National Performance Indicators (PIs) and their associated targets. The targets relate to the Essential estate, that is, the estate that is deemed to have a long-term health use of five years or more. They are based on the Estatecode five facets survey, covering physical condition, statutory and safety compliance, energy performance, space utilisation and functional suitability. The PIs and their targets are shown in Figure 5 below.

PERFORMANCE TARGET COMMENTS TARGET DATES Physical Condition ƒ75% of the estate to be 2005 Category ‘B’ applies to buildings that are in category ‘B’ or above sound, operationally safe and exhibit only minor deterioration ƒ90% of the estate to be 2008 in category ‘B’ or above Statutory and Safety Compliance ƒ75% of the estate to be 2005 Category ‘B’ applies to buildings where action in category ‘B’ or above will be needed in the current plan period to comply with relevant guidance and statutory requirements ƒ90% of the estate to be 2008 Category ‘A’ applies to buildings that comply in category ‘A’ with all statutory requirements and relevant guidance Functional Suitability ƒ75% of the estate to be 2005 Category ‘B’ applies to buildings that are in category ‘B’ or above satisfactory and minor changes are needed ƒ90% of the estate to be 2008 in category ‘B’ or above Space Utilisation ƒ75% of the estate to be 2005 Category ‘F’ applies to buildings that are fully in category ‘F’ used ƒ90% of the estate to be 2008 in category ‘F’ Energy Performance ƒ15% reduction in primary 2010 This is a UK Government primary energy energy consumption reduction target ƒ75% of the estate to be 2005 Category ‘B’ applies to buildings with an in category ‘B’ or above energy performance of < 65 GJ/100m³ ƒ90% of the estate to be 2008 in category ‘B’ or above

Figure 5: Table showing National Performance Indicators and Targets

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 15 ESTATE PERFORMANCE

4.1.2 It is envisaged that the PIs and targets will develop over time to reflect national priorities and the quality aspect of the estate.

4.1.3 The PIs and the Trusts’ progress towards the associated targets is discussed in more detail later in this report.

4.1.4 Each PI has been split into three bands of compliance. These have been colour coded as follows:

Significant effort required to meet the targets

Some effort required to meet the targets

On course to meet the Targets

All the Welsh Trusts have been banded according to the above criteria for each of the National PIs.

4.1.5 There is some concern regarding the quality and consistency of data collection and, to address this concern, an EFPMS User Group, with representatives from each Trust, has been set up. It is envisaged that the User Group meetings will be the ‘training ground’ for disseminating good practice in data collection, resulting in improved quality and consistency in reporting.

In addition WHE is liasing with NHS Estates regarding data collection issues and interpretation of data definitions, focusing particularly on backlog maintenance. Accordingly, it is hoped that a supplement to Estatecode will be issued providing guidance on these matters.

4.1.6 The Trusts’ performance for each of the targets has been estimated from the data submitted. This has been weighted in order to obtain an average figure for each Trust as well as an all- Wales figure.

4.2 Physical condition

Backlog maintenance

4.2.1 The results of the analysis of the overall condition of the health estate in Wales show that backlog maintenance costs to bring the estate up to Estatecode condition category ‘B’ have increased by £34 million, from £431 million reported in 2001-02 to £465 million in 2002-03.

This dramatic rise in backlog maintenance costs is mainly due to the aggregated Trust properties, which account for £20 million of the increase and Ysbyty Gwynedd, which accounts for £5.7 million.

4.2.2 The backlog maintenance position for the eight-year period from 1995 is summarised in Figure 6. It should be noted that energy-upgrading costs for 2002-03 are reported as ‘0’.

16 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 ESTATE PERFORMANCE

This is due to the fact that, within the EFPMS, costs for upgrading the energy performance are included in the physical condition costs. Consequently energy upgrading costs cannot be identified separately. A breakdown of the individual Trust costs is detailed in Appendices II-XV.

500

450

400

350

300

250

200

150 Costs (£ Millions) 100

50

0 1995/96 1996/97 1997/98 1998/99 1999/00 2000/01 2001/02 2002/03 Physical Condition 185 180 234 232 219 281 276 284 Statutory & Safety 100 102 98 93 99 154 155 181 Total Backlog Maintenance 285 282 332 325 318 435 431 465 Energy Upgrading (costs included in physical 15 21 17 18 13 22 0 0 condition)

Figure 6: Graph showing trend in backlog maintenance costs 1995-2003

4.2.3 Further examination of the data shows that 37 sites report backlog maintenance reductions totalling £41 million, 20 sites report no change, while 114, which include some aggregated groups, report increases totalling £75 million.

500

16 450

75 400

350

300

250 465 435 431

200 373

Cost (£ Millions) 332 325 318 150 285 282

100

50

0 1995/96 1996/97 1997/98 1998/99 1999/00 2000/01 2001/02 2002/03 2002/03

Total Backlog Maintenance Costs Operational Sites - Trust sites that are fully functional Residual Sites - NAW sites managed by Health Authorities Other Trust Sites - Trust sites that are closed or due for closure

Figure 7: Trend in backlog maintenance costs illustrating the effect of the residual estate

This significant increase is therefore spread across a large number of sites. A detailed breakdown of the backlog maintenance costs by site is included in Appendices II-XV.

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 17 ESTATE PERFORMANCE

4.2.4 It should be noted that the reported backlog maintenance costs include over £91 million associated with sites that are either closed or scheduled to close, while others are part of the residual estate or declared surplus. It can be seen from Figure 7 that the implementation of the disposal programme would dramatically reduce the overall backlog maintenance costs of the NHS by £75 million. For further details relating to these sites refer to Appendix XVI.

4.2.5 In April 2003 the Regional Health Offices were set up in Mid & West Wales, North Wales and South East Wales.

Each Trust is located within one of the Health Regions. The breakdown of the backlog maintenance costs for each Region is detailed in Figures 8 and 9.

Region Physical Cost Stat & Safety Fire Safety DDA Total Backlog Cost / m² to ‘B’ Cost to ‘B’ Cost to ‘B Costs Cost

(£) (£) (£) (£) (£) (£/m²) Mid & West Wales 76,337,557.00 27,392,764.00 7,776,402.00 13,691,542.00 111,506,723.00 219.98 North Wales 56,228,819.00 4,284,480.00 63,225,000.00 6,839,850.00 123,738,299.00 333.96 South East Wales 151,731,023.00 64,374,835.00 13,479,150.00 18,602,852.00 229,585,008.00 271.74 All-Wales Total 284,297,399.00 96,052,079.00 84,480,552.00 39,134,244.00 464,830,030.00 269.89

Figure 8: Backlog maintenance costs by Health Region

Mid & West Wales 24%

South East Wales 49%

North Wales 27%

Figure 9: Percentage of backlog maintenance by Health Region

4.2.6 It can be seen from Figure 9 that almost half the backlog maintenance costs are associated with the South East Wales Region. This Region contains the two largest Trusts in Wales, Cardiff & Vale and Gwent Healthcare, as well as North Glamorgan NHS Trust. Their significance is explained in 4.2.7-4.2.9 below. Although the South East Region accounts for the largest amount of backlog maintenance, its costs are not the highest when viewed on a cost/m2 basis, as can be seen in Figure 8.

4.2.7 In Cardiff & Vale NHS Trust there are large backlog maintenance costs associated with the Cardiff Royal Infirmary (CRI) and Sully Hospitals. Sully is closed and is in the process of being sold, and this will eliminate £8.8 million of the Trust backlog. However, at present no decision has been made with regard to the future use or disposal of the CRI, which accounts for 43% of the Trust’s total backlog maintenance. It is important that early decisions are made regarding the future use or disposal of this building.

18 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 ESTATE PERFORMANCE

4.2.8 The backlog maintenance costs associated with Gwent Healthcare NHS Trust are spread over a larger number of sites, although two, Nevill Hall and Royal Gwent, account for 49% of the Trust total.

4.2.9 With regard to North Glamorgan NHS Trust, a number of business cases for the re- configuration of Trust services are being developed. These also include for asbestos removal and Firecode compliance work at Prince Charles Hospital which, when complete, will virtually eliminate the Trust’s backlog maintenance.

4.2.10 In the North Wales Region 60% of the backlog maintenance costs are associated with Conwy & Denbighshire NHS Trust. This Trust is in a similar position to North Glamorgan, in so far as there are large backlog maintenance costs associated with Ysbyty Glan Clwyd, its largest hospital. This hospital accounts for 87% of the Trust backlog maintenance total and the Trust is also developing business cases for asbestos removal and Firecode compliance work.

4.2.11 The backlog maintenance costs for the Mid and West Wales Region are spread over the six Trusts within the region, with Swansea NHS Trust accounting for £44.65 million or 40% of the Region’s total.

4.2.12 Figure 10 shows backlog maintenance costs by Trust, comparing the figures submitted in 2001-02 and 2002-03.

100,000

90,000

80,000

70,000

60,000

50,000

(£ x 1000) 40,000

30,000

20,000 Total Backlog Maintenance Costs 10,000

0 ansea Velindre Sw ntypridd & Rhondda Conwy & Powys LHB Wales Derwen Po Denbighshire o Morgannwg Cardiff & Vale Br Carmarthenshire Pembrokeshire & North Glamorgan North East Wales Gwent Healthcare Ceredigion & Mid- North West Wales 2002/03 2001/02 Figure 10: Comparison of backlog maintenance costs reported in 2001-2002 and 2002-2003 by Trust

It can be seen from this graph that most Trusts have reported an increase in backlog maintenance costs for 2002-03. The only Trust to report a significant reduction is Bro Morgannwg and this reduction is a direct result of the closure of the Neath General and Port Talbot Hospitals. Detailed analysis of the individual Trust information is included in Appendices II-XV.

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 19 ESTATE PERFORMANCE

Physical condition – targets

4.2.13 Trusts’ progress towards the physical condition target of 75% of the estate to be in category ‘B’ or above by 2005 is illustrated in Figure 11. Additional graphical interpretation of this information is detailed in Appendix XVII. It is clear from the data submitted that there is considerable scope for some of the Trusts to improve the physical condition of their estate.

Trust Physical Condition of Trusts 2002 - 03 2001 - 02 Bro Morgannwg 74.89 76.55 Cardiff & Vale 69.92 77.60 Carmarthenshire 77.16 83.05 Ceredigion & Mid-Wales 88.69 89.07 Conwy & Denbighshire 81.34 80.84 Gwent Healthcare 71.21 54.11 North East Wales 77.76 74.11 North Glamorgan 32.12 27.00 North West Wales 48.04 50.43 Pembrokeshire & Derwen 74.12 64.38 Pontypridd & Rhondda 94.51 99.09 Powys LHB 41.41 47.80 Swansea 75.90 80.00 Velindre 100.00 79.95 All Wales Average 70.24 69.17

Key > 75% 75-65% < 65%

Figure 11: Physical condition of Trusts – percentage of the estate in condition category B or above.

Figure 11 shows that the performance of eight of the fourteen Trusts has deteriorated since last year. One possible explanation for these changes is the poor performance of the aggregated sites and their negative effect on the overall Trust figure. In Bro Morgannwg, for example, 41% of the occupied floor area in one of the aggregated groups is in physical condition category C and D. This accounts for 9% of the Trust’s overall occupied floor area.

The all-Wales average has marginally improved from 69.17% to 70.24%.

4.3 Statutory and safety compliance

4.3.1 Until 1991, health buildings, as Crown Property, had been exempt from some statutory legislation. Since the removal of Crown Immunity from the NHS, all Trusts have to comply with the current Health and Safety Standards and Codes of Practice. Some examples of the main health and safety requirements that Trusts have to comply with include:

20 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 ESTATE PERFORMANCE

Electricity at Work Regulations

Control of legionella

Firecode compliance

Control of Substances Hazardous to Health

Health and Safety at Work

Asbestos

Pressure systems

Disability Discrimination Act (DDA).

This list is not exhaustive and there are many other statutory requirements that Trusts have to comply with in order to protect the safety of their staff, patients and visitors at their sites.

4.3.2 The EFPMS does not itemise all health and safety elements, and as a consequence it is not possible to identify the separate costs for these items. The only health and safety issues that are individually costed are those dealing with fire safety compliance and the DDA.

4.3.3 The cost to comply with the statutory and safety requirements for all the hospitals included in the EFPMS is estimated to be £180 million, of which £139 million relates to the Essential estate.

4.3.4 Trusts will be required to comply fully with the DDA by October 2004. Accordingly 12 out of 14 Trusts have carried out surveys to identify the extent of the work required to achieve compliance. Costs associated with this work are shown in Figure 12.

160.00

140.00

120.00

100.00

80.00

Cost (£/m²) 60.00

40.00

20.00 No survey carried out No survey carried out 0.00 ansea Velindre Sw Rhondda Conwy & ontypridd & Powys LHB Wales Derwen P Denbighshire o Morgannwg Cardiff & Vale Br Carmarthenshire Pembrokeshire & North Glamorgan North East Wales Gwent Healthcare Ceredigion & Mid- North West Wales

DDA Cost / Occupied Floor Area All Wales Average (£25.84/m²)

Figure 12: Comparison of DDA costs / occupied floor area Figure 12 Comparison of DDA costs/occupied floor area

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 21 ESTATE PERFORMANCE

4.3.5 Pontypridd and Rhondda NHS Trust has not completed its survey work and, therefore, has not submitted DDA costs. Cardiff & Vale NHS Trust submitted costs for DDA compliance, but these costs are based on the all-Wales average for 2001-02. In addition, not all the Trusts detailed DDA costs for their aggregated sites.

It has been estimated, using the all-Wales average figure, that the total cost for implementing DDA work in the Trusts is £41 million. The aggregated sites account for £5.90 million of this estimate. In addition, three Trusts have reported a reduction in their DDA costs, with Ceredigion & Mid-Wales reporting the largest reduction of £1.80 million.

The remaining 11 Trusts have reported increased DDA costs.

4.3.6 It can be seen from Figure 12 that the estimated cost/m2 for carrying out the required DDA works varies from £4.00 in North East Wales NHS Trust to £153.94 in Velindre NHS Trust. The all-Wales average is estimated to be £25.84/m2.

4.3.7 The cost of complying with Firecode requirements across Wales is estimated to be £18-20 million, excluding specific remedial works associated with Ysbyty Glan Clwyd and Prince Charles Hospital which total approximately £65 million.

The WAG recognises the importance of implementing a programme of Firecode compliance works across Wales and has therefore agreed to enhance the Trusts’ budgets through the allocation of £6 million specifically targeted at this work. According to information provided by Trusts, significant progress is being made in implementing the programme which is expected to be completed by 2009.

Statutory and safety targets

4.3.8 The percentage of the estate that Trusts consider to be in Estatecode condition category ‘B’ or above for statutory health and safety issues (excluding fire safety) is illustrated in Figure 13. Additional graphical information relating to the performance of the Trusts is included in Appendix XVII. It can be seen that the majority of Trusts appear to be already meeting the target of 75% of the estate to be in category ‘B’ or above by 2005. Trusts, however, will need to continue to work towards the target of 90% by 2008. WHE will be liaising with the Trusts to verify the robustness of the data submitted and ensure consistency across Trusts.

The all-Wales statutory and safety compliance of the Trusts has improved from 70.38% to 74.91%.

22 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 ESTATE PERFORMANCE

Trust Statutory & Safety Compliance of Trusts 2002 - 03 2001 - 02 Bro Morgannwg 72.77 75.78 Cardiff & Vale 69.00 78.19 Carmarthenshire 62.79 61.69 Ceredigion & Mid-Wales 93.61 84.12 Conwy & Denbighshire 96.05 95.67 Gwent Healthcare 75.85 68.20 North East Wales 96.49 95.91 North Glamorgan 36.86 34.65 North West Wales 91.21 91.65 Pembrokeshire & Derwen 86.45 89.41 Pontypridd & Rhondda 89.55 100.00 Powys LHB 39.94 100.00 Swansea 62.42 5.00 Velindre 100.00 64.40 All Wales Average 74.91 70.38

Key > 75% 75-65% < 65%

Figure 13: Statutory & safety compliance of Trusts

4.3.9 In addition to statutory health and safety compliance the EFPMS collects separate data relating to the level of fire safety compliance within each Trust, together with an estimate of the costs required to achieve compliance. These costs are detailed in 4.3.7. Figure 14 below, shows the percentage of Essential building area considered to be in full fire safety compliance.

Trust Fire Safety Compliance of Trusts 2002 - 03 2001 - 02 Bro Morgannwg 90.28 88.70 Cardiff & Vale 68.58 78.19 Carmarthenshire 62.79 62.56 Ceredigion & Mid-Wales 92.02 10.51 Conwy & Denbighshire 62.79 61.26 Gwent Healthcare 91.89 89.49 North East Wales 100.00 96.31 North Glamorgan 28.36 22.97 North West Wales 72.81 65.75 Pembrokeshire & Derwen 87.33 57.37 Pontypridd & Rhondda 100.00 100.00 Powys LHB 50.04 100.00 Swansea 79.90 93.21 Velindre 100.00 47.52 All Wales Average 76.63 76.65

Key > 75% 75-65% < 65%

Figure 14: Fire safety compliance of Trusts

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 23 ESTATE PERFORMANCE

It can be seen from Figure 14 that currently eight Trusts are in the green band, two in the Amber and four in the Red band. Overall, the all-Wales level of compliance is similar to the level reported in the 2001-02 report.

4.4 Functional suitability

4.4.1 Functional suitability is used to determine how effectively a building (or part of a building) supports the delivery of specific Trust services. Key factors which contribute to these assessments are:

Internal space relationships including walking distances, observation of patients by staff, and security;

Support facilities such as the adequate provision of toilets and bathrooms, adequate seating and waiting space, and provision for disabled people;

Location including distance to key linked facilities, access to parking areas, and access to public transport.

4.4.2 The percentage of the estate in Estatecode condition ‘B’ by Trust is shown in Figure 15. Five Trusts are currently in the Red band.

The main area for concern is the large variation in the functional suitability of Conwy & Denbighshire NHS Trust. It can be seen from Figure 15 that Conwy & Denbighshire has reduced its functional suitability from 92.17% in 2001-02 to 57.18% in 2002-03. The reasons for this large reduction need to be investigated.

The all-Wales average for functional suitability has reduced from 77.71% to 72.45%.

Trust Functional Suitability of Trusts 2002 - 03 2001 - 02 Bro Morgannwg 79.43 87.61 Cardiff & Vale 75.60 86.03 Carmarthenshire 80.54 76.32 Ceredigion & Mid-Wales 62.39 61.95 Conwy & Denbighshire 57.18 92.17 Gwent Healthcare 72.09 55.49 North East Wales 94.02 89.82 North Glamorgan 73.21 64.83 North West Wales 46.61 68.15 Pembrokeshire & Derwen 63.29 72.45 Pontypridd & Rhondda 97.69 99.66 Powys LHB 81.39 100.00 Swansea 70.98 78.58 Velindre 64.27 59.00 All Wales Average 72.45 77.71

Key > 75% 75-65% < 65%

Figure 15: Functional suitability of Trusts

24 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 ESTATE PERFORMANCE

4.5 Space utilisation

4.5.1 The space utilisation facet explores how well available space is being used. The objective is to hold no more space than is necessary to satisfy the reasonable demands of the present function and planned requirements.

Getting users to recognise and accept the underutilisation of their particular space is notoriously difficult since this subject touches on territorial issues. Nonetheless the identification of under-used space and spare capacity and meeting national and local targets is a vital part of the process of managing the estate efficiently and effectively.

4.5.2 The current situation is illustrated in Figure 16. This shows that five Trusts are above the all-Wales target, some significantly so.

4.5.3 It can be seen from Figure 16 that five of the Trusts have moved out of the Green band. Of these Trusts, three have moved into the Amber band and two have moved into the Red band.

The reasons for these large variations need to be investigated with the Trusts in question.

Trust Space Utilisation of Trusts 2002 - 03 2001 - 02 Bro Morgannwg 73.94 90.29 Cardiff & Vale 87.86 92.07 Carmarthenshire 80.80 65.83 Ceredigion & Mid-Wales 67.79 67.61 Conwy & Denbighshire 62.78 77.25 Gwent Healthcare 66.41 49.97 North East Wales 87.07 82.08 North Glamorgan 65.86 64.22 North West Wales 75.90 76.24 Pembrokeshire & Derwen 65.32 74.74 Pontypridd & Rhondda 94.94 99.66 Powys LHB 57.21 100.00 Swansea 71.29 94.20 Velindre 70.37 66.00 All Wales Average 75.56 79.29

Key > 75% 75-65% < 65%

Figure 16: Space utilisation of Trusts 4.6 Energy performance

Primary energy

4.6.1 Primary energy consumption for the whole of Wales for the year 2002-03, was 3,915,158GJ. This compares with the figure of 3,688,461GJ for 2001-02, and equates to an increase in primary energy consumption of 6.15%. The figure for 2002-03, represents an increase of 5.87% on the baseline figure of 3,698,000GJ for 1999-00. Primary consumption data is illustrated in Figure 17 overleaf.

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 25 ESTATE PERFORMANCE

Trust 1999 - 00 2001 - 02 2002 - 03 Change Change PRIMARY PRIMARY PRIMARY on on Base Previous Year Year (GJ) (GJ) (GJ) (%) (%) Bro Morgannwg 312,000 321,766 300,767 -6.6 -3.60 Cardiff & Vale 830,000 799,162 834,233 4.39 0.51 Carmarthenshire 193,000 199,237 224,002 12.43 16.06 Ceredigion & Mid-Wales 64,000 58,127 60,206 3.58 -5.93 Conwy & Denbighshire 240,000 224,646 243,957 8.60 1.65 Gwent Healthcare 513,000 548,801 596,542 8.70 16.28 North East Wales 234,000 237,842 243,821 2.51 4.20 North Glamorgan 142,000 133,044 159,594 19.96 12.39 North West Wales 261,000 254,723 283,489 11.29 8.62 Pembrokeshire & Derwen 123,000 135,661 138,188 4.17 12.35 Pontypridd & Rhondda 192,000 191,871 192,993 0.58 0.52 Powys LHB 106,000 98,803 96,814 -2.01 -8.67 Swansea 465,000 457,658 505,118 10.37 8.63 Velindre 23,000 30,119 35,434 17.65 54.06 All Wales Total 3,698,000 3,688,461 3,915,158 6.15 5.87

Figure 17: Table showing primary energy consumption in Gigajoules

4.6.2 Figure 18 shows the trend in primary energy consumption since 1990-91. To show the underlying trend in usage, a multiplying factor of 2.87 has been applied to each year’s electrical consumption. This factor is a measure of the efficiency of electrical generation, which can vary depending on the mix of fuels and method used to produce that electricity. The figure of 2.87 indicates an overall power station efficiency of 35%, and that 2.87kWh of energy has been used to produce 1kWh electricity.

4.50

4.00

3.50

3.00

6 2.50

2.00 GJ*10

1.50

1.00

0.50

0.00

1 2 3 4 5 6 7 8 9 0 1 2 3

9 9 9 9 9 9 9 9 9 0 0 0 0

/ / / / / / / / / / / / /

0 1 2 3 4 5 6 7 8 9 0 1 2

9 9 9 9 9 9 9 9 9 9 0 0 0

Consumption 2010 Target

Figure 18: Bar chart showing primary energy usage 1990-91 to 2002-03

4.6.3 Although there has been an overall increase in primary energy usage across Wales, Figure 17 indicates that some Trusts have reduced their energy usage. To illustrate this the table has been converted into a bar chart shown in Figure 19.

26 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 ESTATE PERFORMANCE

4.6.4 Electrical consumption, which has a disproportionate effect on the primary usage and carbon emission, was approximately 22% of the total energy consumption in the latest year. This does not include electricity generated on site. Electricity consumption shows a continuing increase, indicating that a focus on savings in the use of electricity should be given a high priority. Electricity consumption for 2002-03 is just under 600,000GJ, a rise of 3% on last year’s consumption of 582,740GJ.

Further analysis on an individual Trust basis can be found in Appendices II-XV.

900,000

800,000

700,000

600,000

500,000 GJ 400,000

300,000

200,000

100,000

0 ansea Velindre Sw Rhondda Conwy & Powys LHB Wales Derwen Pontypridd & Denbighshire Cardiff & Vale ro Morgannwg mbrokeshire & B Carmarthenshire Pe North Glamorgan Ceredigion & Mid North East Wales Gwent Healthcare North West Wales

2000 2001 2002 2003

Figure 19: Chart showing primary energy usage over the assessment period

Energy costs

4.6.5 The total cost of energy for hospitals in Wales for 2002-03 was £15.4 million (compared with £14.8 million in 2001-02). Costs for individual fuels were £12.50/GJ for electricity (compared with £12.92/GJ last year), £3.72/GJ for gas (compared with £3.55/GJ last year) and £4.90/GJ for oil (compared with £4.09/GJ last year). The average overall cost was approximately £5.78/GJ compared to £5.64/GJ last year.

Trusts in Wales again reported a wide variation in energy costs. Electricity costs varied between £10.32/GJ and £15.67/GJ, whilst gas costs ranged from £3.11/GJ to £7.57/GJ. The reported cost of oil varied between £4.00/GJ and £6.82/GJ.

Figure 20 overleaf shows the average overall energy cost since1984-85.

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 27 ESTATE PERFORMANCE

£7.00

£6.00

£5.00

£4.00

£3.00

£2.00

£1.00

£0.00 84-85 85-86 86-87 87-88 88-89 89-90 90-91 91-92 92-93 93-94 94-95 95-96 96-97 97-98 98-99 99-00 00-01 01-02 02-03

COST/GJ

Figure 20: Average energy cost

Carbon emissions

4.6.6 Energy consumption causes the production of carbon dioxide (CO2) — the main greenhouse gas and a major contributor to global warming. Reducing the emission of

CO2 is a key government commitment. The 15% national reduction target in primary energy consumption can also be expressed in terms of carbon emissions to the atmosphere. Carbon emissions, therefore, are an important indicator of progress made by Trusts in achieving the energy target for primary energy consumption.

It should be noted, however, that the amount of CO2 produced for a given amount of energy is dependent on the proportion of electrical to fossil fuel of the energy used. More

kg of CO2 is produced per Gigajoule in the use of electricity than gas, oil or coal. Each Gigajoule of electricity used, produces 121kg of CO2 whilst use of a Gigajoule of gas produces only 51kg of CO2.

An overall reduction in energy consumption, therefore, does not automatically result in a corresponding reduction in carbon emissions. It is possible to have an increase in electrical consumption with a reduction in overall total energy usage whilst increasing

CO2 emissions. It is therefore important to look at the production of carbon separately and to track year-on-year changes.

4.6.7 The EFPMS returns show that the NHS in Wales produced 52,469 tonnes of carbon. This figure compares with 50,467 tonnes in 2001-02. The tendency now is to report emissions

in terms of CO2 rather than carbon. Accordingly the emissions for hospitals in Wales are equivalent to 192,248 tonnes of CO2 for 2002-03, and 185,000 tonnes of CO2 for 2001-02. The latest figures allow for the “green” electricity supplied to certain hospitals in North West Wales and the Royal Glamorgan Hospital in Pontypridd & Rhondda.

Figure 21 opposite clearly shows the benefit of “green” tariffs for the Pontypridd &

Rhondda Trust, their CO2 emission per unit of energy use being the lowest in Wales by a considerable margin.

28 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 ESTATE PERFORMANCE

Trust CO2 (Tonnes) kWh Kg CO2/kWh Bro Morgannwg 14,854 56,225,203 0.264 Cardiff and Vale 41,766 160,667,019 0.260 Carmarthenshire 12,283 48,880,082 0.251 Ceredigion 3,428 11,965,696 0.286 Conwy & Denbighshire 12,671 47,764,376 0.265 Gwent Healthcare 29,761 116,240,132 0.256 North East Wales 12,094 45,936,880 0.263 North Glamorgan 7,655 30,587,536 0.250 North West Wales 13,920 57,101,587 0.244 Pembrokeshire & Derwen 6,834 31,128,290 0.220 Pontypridd & Rhondda 6,063 34,719,230 0.175 Powys LHB 4,842 20,613,304 0.235 Swansea 24,444 95,324,942 0.256 Velindre 1,633 5,616,005 0.291 All-Wales Average 192,248 76,277,0283 0.252 Figure 21: Carbon dioxide/kWh ratio

Compared to the 1999-00 base year, when emissions were 185,000 tonnes of CO2, emissions have risen by 3.9%. A reduction in emissions of 35,000 tonnes of CO2 is required in order to meet the 15% target. Reducing imported electricity either by reducing consumption or utilising CHP more effectively, and/or changing to “green” electricity would make a significant contribution to achieving this.

Energy performance - targets

4.6.8 To meet energy performance targets will require a reduction in primary energy consumption to 3.1 million Gigajoules (860 million kWh), from this year’s 3.9 million GJ — a reduction of almost 21%.

It should be noted that the 15% reduction in primary energy is an all-Wales target and Trusts with an existing good energy performance will find it extremely difficult to achieve a saving of this magnitude. During the course of the last year, WHE has discussed individual targets with each Trust. These will now be subject to revision based on the current performance/consumption of the Trusts.

In addition to the primary energy targets, PIs have been set for new and existing buildings. The targets are 35 to 55 GJ/100m3 for new buildings and 55 to 65 GJ/100m3 for existing buildings.

4.6.9 Figures 22 and 23 show the Trusts’ performance against the two energy PI targets. The PIs are calculated on the basis of the Essential estate.

4.6.10 Figure 22 shows all Trusts with PIs more than two GJ/100m3 above the target as red. The amber zone applies to Trusts with PIs at or just above the upper limit of the target. Trusts that are within the PI target are represented in green.

The table shows that Carmarthenshire, Ceredigion, North Glamorgan and Swansea NHS Trusts are well above the target. This leaves ten Trusts that are within the PI target.

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 29 ESTATE PERFORMANCE

Trust Energy Performance Indicators of Trusts 2002 - 03 2001 - 02 Bro Morgannwg 45.49 63.97 Cardiff & Vale 55.71 61.20 Carmarthenshire 74.46 90.24 Ceredigion & Mid-Wales 70.06 64.47 Conwy & Denbighshire 53.55 58.76 Gwent Healthcare 64.74 63.44 North East Wales 62.30 69.51 North Glamorgan 68.74 60.79 North West Wales 51.88 57.90 Pembrokeshire & Derwen 61.39 61.00 Pontypridd & Rhondda 48.07 63.61 Powys LHB 53.62 60.30 Swansea 79.88 70.80 Velindre 21.83 47.20 All Wales Average 58.72 64.05

Key < 65 65-67 > 67 3 3 GJ/100m3 GJ/100m GJ/100m

Figure 22: Energy Performance Indicators of Trusts

4.6.11 The size and type of Trust, together with the age of its properties, are all factors that affect its PI. The overall Trust PI will give a good indication of the Trust’s general performance but a more detailed analysis is required in order to gain a clearer understanding of Trust’s energy performance. This detailed analysis can be found in Appendices II-XV.

4.6.12 The energy consumption of Welsh Trusts, expressed in GJ/100m3, has been compared with other Trusts in the EFPMS dataset. The results are graphically illustrated in Appendix XVIII and show that the performance of Trusts in Wales is in the median range and that there is room for improvement in all categories.

30 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 ESTATE PERFORMANCE

Trust Energy Performance of Trusts % Of Estate in Category B 2002 - 03 2001 - 02 Bro Morgannwg 92.29 90.59 Cardiff & Vale 78.56 73.34 Carmarthenshire 3.08 0.00 Ceredigion & Mid-Wales 11.28 92.66 Conwy & Denbighshire 74.50 95.59 Gwent Healthcare 62.03 53.54 North East Wales 31.17 14.51 North Glamorgan 47.39 100.00 North West Wales 74.46 95.44 Pembrokeshire & Derwen 53.27 100.00 Pontypridd & Rhondda 96.60 27.19 Powys LHB 76.78 52.53 Swansea 5.97 21.65 Velindre 100.00 100.00 All Wales Average 61.47 62.47

Key > 75% 75-65% < 65%

Figure 23: Energy performance of Trusts

4.6.13 It is evident from Figure 23 that seven Trusts are currently struggling to meet the national target of 75% Estatecode Energy Performance category ‘B’ by 2005.

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 31 5 ENVIRONMENTAL ISSUES 5.1 Waste

5.1 This report builds upon the data collected for 2001-02 but, disappointingly, the reliability of some data submitted is still questionable and certain Trusts have been unable to provide full details of the mandatory data required. As with last year’s report it has therefore been necessary to estimate some data for reporting purposes, and this has precluded an exhaustive analysis with definitive statements. Notwithstanding the inadequacies in data, it has been possible to take the reports a stage further and it is anticipated that more rigorous analyses will be possible in the future.

Clinical waste

5.1.1 It is estimated that the NHS in Wales disposed of about 7,000 tonnes of clinical waste during 2002-03, which suggests a slight increase on 2001-02. Specific quantities for clinical waste relating to Gwent Healthcare and Swansea NHS Trusts in Figure 24 below are inaccurate due to the omission of data for Nevill Hall and Singleton Hospitals respectively. The incompleteness and unreliability of many of the returns for 2001-02 and 2002-03 precludes the identification of trends at this time.

2,000

1,800

1,600

1,400

1,200

1,000 tonnes 800

600

400

200

0 Velindre Swansea ff and Vale edigionCer Glamorgan arthenshire Powys LHB Derwen rdi rm h West Wales rt Bro Morgannwg Ca Ca North North Pembrokeshire & Pembrokeshire North East Wales East North Gwent Healthcare No onwy & Denbighshire Pontypridd & Rhondda C

Figure 24: Clinical waste tonnages for NHS Trusts 2002-2003

5.1.2 The total cost for the disposal of clinical waste is estimated to be approximately £2.4m and an overall average disposal cost/tonne of about £340. This indicates an increase of the order of 10% on the previous year, with a contributory factor being a negotiated increase in the contract price for collected waste in November 2002 for the Clinical Waste Consortium members from £296 to £321.

32 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 ENVIRONMENTAL ISSUES

5.1.3 The variation in costs for clinical waste disposal at individual hospital sites has generally smoothed from the previous year but extremes still indicate a range of between £235 and over £770 being reported for sites in Pembrokeshire NHS Trust and North East Wales NHS Trust respectively. Of the Major Acute Hospitals the range reported is between £307 for the Royal Glamorgan Hospital and £377 for the Royal Gwent Hospital. Figure 25 shows the costs/tonne from the data reported for the Major Acute Hospitals.

400.00

350.00

300.00

250.00

200.00 (£)

150.00

100.00

50.00 No data Submitted No data Submitted 0.00 Velindre Morriston Bronglais Nevill Hall Llandough Withybush Prince Philip Royal Gwent Wales Ysbyty Maelor Prince Charles Ysbyty Gwynedd Royal Glamorgan Princess of Wales Singleton Hospital Ysbyty Glan Clwyd West Wales General University Hospital of

Figure 25: Major acute hospitals - clinical waste costs/tonne 2002-2003

Domestic/commercial waste

5.1.4 The data on domestic/commercial waste for 2002-03 is incomplete, as was the case last year. It is estimated, however, that the NHS in Wales is currently disposing of between 12,000 and 13,000 tonnes of waste a year. Although this would indicate an increase of about 10% on the data submitted for 2001-02, costs have risen by 100% from an estimated £0.5m to over £1m. The increase is due to a more realistic average cost per tonne, which this year has been assessed at £85 per tonne compared to the £40 per tonne reported last year.

5.1.5 Individual Trust disposal figures still show a huge disparity in average cost per tonne, ranging from £30 for Ceredigion & Mid Wales NHS Trust to £172 per tonne for Cardiff & Vale NHS Trust. Figure 26 overleaf, shows the disposal tonnages of domestic/ commercial waste by Trust in 2002-03.

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 33 ENVIRONMENTAL ISSUES

2,500

2,000

1, 50 0 Tonnes 1, 000

500

0 Velindre Velindre Velindre Velindre Velindre Velindre Velindre Swansea Swansea Swansea Swansea Swansea Swansea Swansea ff and Vale edigionCer edigionCer Glamorgan Glamorgan Glamorgan Glamorgan arthenshire arthenshire Powys LHB Powys LHB Powys LHB Powys LHB Powys LHB Powys LHB Derwen Derwen Derwen Derwen Derwen rdi rm rm h West Wales h West Wales h West Wales h West Wales h West Wales rt rt rt rt rt Bro Morgannwg Ca Ca Ca North North North North North North North North Pembrokeshire & Pembrokeshire Pembrokeshire & Pembrokeshire Pembrokeshire & Pembrokeshire Pembrokeshire & Pembrokeshire Pembrokeshire & Pembrokeshire North East Wales East North North East Wales East North North East Wales East North North East Wales East North Gwent Healthcare Gwent Healthcare Gwent Healthcare No No No No No onwy & Denbighshire onwy & Denbighshire onwy & Denbighshire Pontypridd & Rhondda Pontypridd & Rhondda Pontypridd & Rhondda Pontypridd & Rhondda Pontypridd & Rhondda Pontypridd & Rhondda C C C

Figure 26: Domestic/commercial waste tonnages for NHS Trusts 2002-2003

Special waste

5.1.6 The unreliability of the data provided for special waste prevents any meaningful comment being made on the quantity generated and its associated costs, although for Clinical Waste Consortium members this is known to be covered by the current charge of £321 from Eurocare in most cases. Accounting for this waste is also due to be influenced by changes associated with the harmonisation of UK legislation with EU requirements during 2004 as well as the changes in definition from ‘special waste’ to ‘hazardous waste’. These changes will also preclude any trends being identified in the short term.

Waste recovery/recycling of domestic/commercial waste

5.1.7 The data submitted for 2002-03 shows that eight Trusts have introduced waste recovery/recycling systems, compared to four Trusts last year. Figure 27 shows the percentage of waste going through a recovery/recycling process by Trust, ranging from just over 8% in Swansea Trust to a modest start being made by Velindre Trust.

5.1.8 It is disappointing to report that that no progress was made by the remaining Trusts.

Waste recovery/recycling will need to be addressed by these Trusts in their Environmental Policy and Strategy if they are to comply with the Environmental Policy for the NHS in Wales.

The introduction of waste recovery/recycling systems also plays an important part in meeting the targets set out for the public sector in ‘Wise about Waste, the National Waste Strategy for Wales’, published by the Welsh Assembly Government, in order to reduce the quantity of waste that is sent to landfill.

34 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 ENVIRONMENTAL ISSUES

9

8

7

6

5

4 Volume %

3

2

1

0 ansea Velindre Sw Ceredigion Powys LHB Derwen ro Morgannwg mbrokeshire & B Cardiff and Vale Carmarthenshire Pe North Glamorgan North East Wales Gwent Healthcare North West Wales ontypridd & Rhondda P Conwy & Denbighshire

Figure 27: Percentage domestic/commercial waste recovered/recycled by Trust 2002-2003

5.2 Transport

5.2.1 The submission of data on transport was made mandatory for 2002-03. It is therefore disappointing that, for the second year running, inadequate information was provided on fleet vehicles. Since five Trusts failed to provide data on fleet vehicles, a full analysis cannot be included in the report.

Trust returns suggest that only six Trusts have a Board-approved Green Transport Plan, indicating that there has been no improvement since last year.

However, five Trusts have fleet vehicles operating on ‘green’ fuel(s), an increase of three Trusts since last year, the percentage ranging between 34% and 100%.

5.3 Water usage

5.3.1 The total water consumption for 2002-03 was just over 2.5 million m3 , similar to last year’s consumption.

5.3.2 On the basis of the returns submitted, the average cost, including sewage charges, is estimated to be £1.93/m3 (£1.72 last year). Figure 28 overleaf, shows Trust consumption for the last three years in relation to floor area.

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 35 ENVIRONMENTAL ISSUES

300

250

200

150 m³/100 m² 100

50

0

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5.3.3 Previous reports have highlighted the importance of benchmarking performance. In this regard WHE and several Trusts in Wales were involved in the UK wide Watermark project. The final Watermark report produced by the Office of Government Commerce was issued in May 2003. The report details water performance benchmarks for a wide variety of healthcare premises. The benchmarks quoted in the report are specific and take into account local conditions such as the presence on site of laundries, swimming pools, physiotherapy pools and other relevant factors. It is recommended that each Trust should rank its premises based on these specific indicators, as the data contained within the EFPMS does not contain sufficient detail to allow calculation of these indicators for inclusion in this report.

36 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 APPENDIX I

Trust Backlog Maintenance Costs

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 37

APPENDIX I

Trust Backlog Maintenance Costs

Trust Physical Cost Stat & Safe Fire Safety Total Total Variation to ‘B’ Cost to ‘B’ Cost to ‘B’ Backlog Backlog Maintenance Maintenance Costs Costs 2002-200 2001-2002 (£) (£) (£) (£) (£) (£) Bro Morgannwg 9,545,458 1,978,966 165,795 11,690,219 25,591,379 -13,901,160 Cardiff & Vale 50,949,489 44,708,308 277,500 95,935,297 85,687,749 10,247,548 Carmarthenshire 6,912,482 4,275,097 3,095,872 14,283,451 11,845,007 2,438,444 Ceredigion & Mid-Wales 5,185,000 1,125,000 477,000 6,787,000 7,274,208 -487,208 Conwy & Denbighshire 11,984,419 416,250 61,852,000 74,252,669 69,540,375 4,712,294 Gwent Healthcare 53,778,000 6,493,840 2,402,000 62,673,840 64,147,353 -1,473,513 North East Wales 25,956,000 2,162,200 348,000 28,466,200 27,115,000 1,351,200 North Glamorgan 42,028,569 9,756,875 10,388,750 62,174,194 48,000,000 14,174,194 North West Wales 18,288,400 1,706,030 1,025,000 21,019,430 14,188,756 6,830,674 Pembrokeshire 13,786,648 3,734,875 764,000 18,285,523 18,808,744 -523,221 Pontypridd & Rhondda 3,915,670 649,462 318,000 4,883,132 4,428,000 455,132 Powys LHB 10,909,000 3,514,144 1,385,000 15,808,144 7,151,500 8,656,644 Swansea 29,998,969 12,764,682 1,888,735 44,652,386 43,191,372 1,461,014 Velindre 1,059,295 2,766,350 92,900 3,918,545 3,855,000 63,545 Totals 284,297,399 96,052,079 84,480,552 464,830,030 430,824,443 34,005.587 Note :- Total Backlog Maintenance = Physical + Statutory & Safety + Fire Safety Costs to 'B'

1000.00

888.13 900.00

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389.95 400.00 Cost / m² (£) / m² Cost

292.47 281.79 300.00 272.44 272.14 270.94 230.91 206.24 200.00 169.91 143.34 110.76 100.00 61.96

0.00 Velindre Swansea Powys LHB Powys Derwen Cardiff & Vale ent Healthcare Bro Morgannwg Carmarthenshire North Glamorgan Pembrokeshire & North East Wales Gw North West Wales Pontypridd & Rhondda Conwy & Denbighshire Ceredigion & Mid-Wales

Backlog Costs / Occupied Floor Area (m²) All Wales Average

Comparison of Trust Backlog Maintenance Costs / Occupied Floor Area

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 39

APPENDIX II

Summary of Trust Information

BRO MORGANNWG

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 41

APPENDIX II

Trust Name: Bro Morgannwg NHS Trust

No of Returns: 9 Individual hospital sites Aggregate 1 – Freehold diagnostic & treatment centres, health centres. Aggregate 2 – Freehold, all other sites. Aggregate 5 – Leased and part serviced by NHS Trust/Landlord.

1.0 Backlog maintenance

1.1 The Trust submitted its returns by the completion date of 30th June 2003. All applicable data fields were completed for the nine hospital sites within the Trust.

1.2 The backlog maintenance figure for the Trust has reduced from £25,591,379 in 2001-02 to £11,690,219 in 2002-03, which equates to a reduction of 54.3%. This is illustrated in Figure 1 below.

However, all sites, with the exceptions of Groeswen (-£43,782) and Maesgwyn (-£11,260), have shown increases.

1.3 The main reason for the large reduction is the opening of the Neath Port Talbot Hospital and the subsequent closures of Neath General and Port Talbot Hospitals.

Hensol is part of the residual estate and is in the process of being sold. It is due to close in March 2004.

As a result of the disposal of Hensol it is anticipated that the Trust’s backlog maintenance figure will reduce to £6,519,819.

Location Physical S & S Fire Safety DDA Backlog Backlog Variation Condition Costs Costs Costs Maintenance Maintenance Costs Costs Costs 2002/03 2001/02

(£) (£) (£) (£) (£) (£) (£) Cimla 938,676 14,778 0 14,490 953,454 206,450 747,004 Glanrhyd 1,383,450 46,000 23,000 23,000 1,452,450 1,263,000 189,450 Groeswen 175,145 23,518 18,170 17,020 216,833 260,615 -43,782 Hensol 3,783,500 1,381,150 5,750 483,000 5,170,400 3,607,100 1,563,300 Llwyneryr 96,761 15,812 74,750 5,750 187,323 162,890 24,433 Maesgwyn 100,114 11,700 0 9,400 111,814 123,074 -11,260 Maesteg 204,090 48,950 1,000 29,415 254,040 132,300 121,740 Neath General N/A N/A N/A N/A N/A 14,316,000 -14,316,000 Port Talbot N/A N/A N/A N/A N/A 3,933,100 -3,933,100 Princess of Wales 1,252,350 350,000 0 0 1,602,350 1,087,000 515,350 Tonna 527,878 46,058 43,125 42,205 617,061 499,850 117,211 Aggregate 1 1,083,494 41,000 0 0 1,124,494 N/A 1,124,494 Aggregate 2 0 0 0 0 0 N/A 0 Aggregate 5 0 0 0 0 0 N/A 0 Trust Totals 9,545,458 1,978,966 165,795 624,280 11,690,219 25,591,379 -13,901,160

Figure 1: Backlog maintenance costs by site

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 43 APPENDIX II

1.4 This is the first year for all the Trust’s sites to be included in the returns. The data for the non-hospital sites has been aggregated into three groups: Aggregate 1, 2 & 5. The inclusion of these Aggregate Groups has added £1,124,496 to the backlog maintenance costs. It should be noted that no backlog maintenance costs were entered for the sites in Aggregate Groups 2 and 5.

1.5 Figures 2-7 graphically illustrate the Trust’s performance against the key all-Wales targets for the Essential estate.

Estimated Trust Conditions 2002-2003

Physical Condition Statutory & Safety Compliance Fire Safety Compliance

C & D C & D C & D 25% 27% 10%

A & B A & B A & B 73% 75% 90%

Figure 2 Figure 3 Figure 4

Energy Performance Functional Suitability Space Utilisation

C & D Unacceptable Unacceptable 8% 20% 26%

Acceptable A & B Acceptable 79% 74% 92%

Figure 5 Figure 6 Figure 7

Essential Building Area Essential Land Area

Non Essential 23% Essential 43%

Essential Non ssential 77% 57%

Figure 8 Figure 9

44 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 EXECUTIVE APPENDIX II

1.6 Figure 8 shows the Essential building area of the Trust. It can be seen from this pie chart that the Essential building area for the Trust is estimated to be 77%. The increase from 56% in 2001-02 is due to the closures of Neath General and Port Talbot Hospitals. It is estimated that when Hensol and Llwyneryr Hospitals close, the Essential building area of the Trust will increase to 97%.

1.7 Figure 9 shows the Essential land area of the Trust. It can be seen from this pie chart that the Essential land area for the Trust is estimated to be 43%. However, it is estimated that when Hensol closes, the Essential land area of the Trust will increase to 100%.

1.8 Figures 10-17 graphically compare Bro Morgannwg Performance Indicators (based on Essential estate) with the other Trusts in Wales.

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Physical Condition A + B (%) All Wales Target (2005)

FigureFigure 10: 10 - -Physical Physical Condition (Categories (Categories A & AB %)& B %)

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Statutory Safety Compliance (Essential) All Wales Target (2005) FigureFigure 11: - 11- Statutory Statutory & SafetySafety Compliance Compliance (Categories (Categories A & B A %) & B %)

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 45 APPENDIX II

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FigureFigure 12: 12 - FireFire Safety Safety Compliance Compliance / Trust / Trust

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Functional Suitability (A + B) All Wales Target (2005)

FigureFigure 13: 13 - FunctionalFunctional Suitability Suitability / Trust / Trust

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Space Utilisation (Fully Used) All Wales Target (2005)

FigureFigure 14: 14 -- Space Space Utilisation Utilisation / Trust / Trust

46 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 APPENDIX II

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Essential Buildings - % All Wales Average

FigureFigure 1515: Essential- Essential Buildings Buildings / Trust / Trust

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Essential Land - % All Wales Average FigureFigure 1616: - Essential- Essential Land Land / Trust / Trust

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% of Estate in condition 'B' or above All Wales Average

FigureFigure 17 – Estatecode17: - Estatecode Category‘B’ 'B' Energy Energy Performance Performance

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 47 APPENDIX II

2.0 Energy performance

2.1 In 2002-03 hospitals in the Trust recorded a net energy consumption of 199,813GJ, a reduction of 11.8% on last year’s figure of 226,601GJ. The main reasons for this reduction are the savings achieved by the closure of Neath General and Port Talbot Hospitals during the course of the year and their replacement by the new Neath Port Talbot Hospital. Figures for each of these three sites refer therefore to a part year only. This has resulted in savings in excess of 20,000GJ. Whether this level of saving can be maintained under normal circumstances remains to be seen. Primary energy is estimated at 300,767GJ, a reduction of 6.6% on last year’s figure of 322,000GJ. Last year’s report suggested that a 5% reduction in primary energy would be reasonable. The Trust has therefore met this target.

It can be seen from Figure 18 that consumption at the Trust’s largest site, the Princess of Wales Hospital, continues to rise substantially, showing a 15% rise following a near 10% increase last year.

2.2 The overall Trust PI is excellent at 41.84 compared with 65.37 last year. Again the closure of the Neath General, which was the worst performer of the Trust’s larger properties, is a key factor, as is the indicator for the new Neath Port Talbot Hospital, which is extremely low, even allowing for it being based on consumption for part of the year only. Another factor for the excellent Trust PI is the performance of the Princess of Wales Hospital, where the PI improvement is directly linked to an increase of 41% in the reported heated volume for the site.

2.3 The improvement in consumption and performance has been due, in the main, to factors other than improved energy efficiency. However, there may be genuine savings accruing from the performance of the new Neath Port Talbot Hospital, though a full year’s data will be required before any meaningful appraisal of performance can be undertaken. However, following consultation with the Trust earlier this year a target reduction in primary energy consumption of 5% was agreed for the year.

Hospital Net Hospital Energy Change on Heated Volume Site PI Consumption Previous Year

3 (GJ) (%) (m ) (GJ/100m3) Cimla 3,661.00 -18.45 6,203 59.02 Glanrhyd 24,698.00 -0.32 41,430 59.61 Groeswen 4,000.00 6.47 3,385 118.17 Hensol 37,223.00 -25.68 86,500 43.03 Llwyneryr 1,557.00 -24.27 3,586 43.42 Maesgwyn 2,861.00 7.60 3,873 73.87 Maesteg 5,818.00 1.08 6,860 84.81 Neath General 11,943.50 -77.67 66,432 17.98 Neath Port Talbot 17,522.58 NA 76,837 22.80 Port Talbot 3,201.46 41.40 21,746 14.72 Princess of Wales* 77,897.44 15.22 146,699 53.10 Tonna 9,430.00 11.28 13,995 67.38 Trust Totals 199,812.98 -11.82 477,546 41.84

Figure 18 Individual hospital energy PIs * Site with CHP installed

48 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 APPENDIX II

3.0 Summary

3.1 Strategic asset investment over many years has put the Trust in a strong position, as it moves towards the interim 2005 estate performance targets.

3.2 Backlog maintenance costs have continued their downward trend with this year’s reduction arising from the opening of the new Neath Port Talbot Hospital and the closure of Neath General and Port Talbot Hospitals. Further improvement will occur with the closure of Hensol in 2004.

3.3 All of the estate performance indicators are good, with fire safety and energy performance already achieving the 2008, 90% compliance target.

3.4 Whilst strategic asset investment will continue to be needed it is difficult to envisage it having the same impact on the estate performance indicators as have decisions over the last decade that have led to the significant relocation of services.

3.5 To improve the Trust’s performance will now require greater focus on more local, operational issues affecting the existing estate. This will need careful planning and targeting of the Trust’s resources, including its discretionary capital. This is a difficult challenge but one that is achievable.

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 49

APPENDIX III

Summary of Trust Information

CARDIFF AND VALE

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 51

APPENDIX III

Trust Name: Cardiff and Vale NHS Trust

No of Returns: 10 Individual hospital sites Aggregate 1 – Freehold diagnostic & treatment centres, health centres. Aggregate 2 – Freehold, all other sites. Aggregate 3 – Leased and fully serviced by the NHS Trust Aggregate 4 – Leased and fully serviced by the Landlord. Aggregate 5 – Leased and part serviced by NHS Trust/Landlord.

1.0 Backlog Maintenance

1.1 The Trust submitted its returns by the completion date of 30th June 2003. All applicable data fields were completed for the ten hospital sites within the Trust.

1.2 The backlog maintenance figure for the Trust has increased from £85,687,749 to £95,935,297, which equates to an increase of 11.95%. All hospital sites have shown increases, with the University Hospital of Wales showing the largest increase of £3,047,759.

The increase in the backlog maintenance figure is largely due to the DDA regulations, since the Trust did not submit any costs for DDA compliance in the 2001-02 EFPMS return, but has included costs totalling £8,407,308 this year.

Location Physical S & S Fire Safety DDA Backlog Backlog Variation Condition Costs Costs Costs Maintenance Maintenance Costs Costs Costs 2002/03 2001/02 (£) (£) (£) (£) (£) (£) (£) Barry 15,000 160,100 0 155,000 175,100 15,000 160,100 CRI 10,531,000 30,746,700 0 709,800 41,277,700 39,566,000 1,711,700 CRI West Wing 2,007,000 181,000 0 149,000 2,188,000 1,897,000 291,000 Lansdowne N/A N/A N/A N/A N/A 3,694,000 -3,694,000 Llandough 3,107,000 1,364,300 0 1,160,800 4,471,300 3,938,749 532,551 Rookwood 1,624,000 395,600 0 277,300 2,019,600 1,315,000 704,600 Royal Hamadryad 2,107,000 580,200 0 76,400 2,687,200 2,442,000 245,200 St David's 0 0 0 0 0 0 0 Sully 5,253,000 3,555,204 0 454,204 8,808,204 7,529,000 1,279,204 UHW 14,422,359 4,111,400 0 3,979,800 18,533,759 15,486,000 3,047,759 Whitchurch 10,003,000 2,843,600 0 836,800 12,846,600 9,805,000 3,041,600 Aggregate 1 1,161,630 344,722 174,500 263,222 1,680,852 N/A 1,680,852 Aggregate 2 139,000 77,512 27,000 66,012 243,512 N/A 243,512 Aggregate 3 579,500 217,118 76,000 148,118 872,618 N/A 872,618 Aggregate 4 0 103,590 0 103,590 103,590 N/A 103,590 Aggregate 5 0 27,262 0 27,262 27,262 N/A 27,262 Trust Totals 50,949,489 44,708,308 277,500 8,407,308 95,935,297 85,687,749 10,247,548

Figure 1: Backlog maintenance costs by site

1.3 Lansdowne Hospital has been closed and the buildings on that site are used as offices. Consequently there is no separate return for this site, and all costs associated with it are included in the Aggregate 2 group.

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 53 APPENDIX III

In addition, Sully Hospital has been closed and is the process of being sold. The backlog maintenance costs for this hospital are estimated to be £8,808,204. Two other hospitals — CRI and Royal Hamadryad — are considered by the Trust to be Non-Essential. The backlog maintenance costs associated with these hospitals is £43,964,900. The total amount of backlog maintenance associated with the non-operational and non-essential hospitals is £52,773,104, which equates to 55% of the Trust total.

1.4 This is the first year for all the Trust’s sites to be included in the returns. The data for the non-hospital sites has been aggregated into five groups: Aggregate 1, 2, 3, 4 and 5. Backlog maintenance costs associated with the Aggregated groups amount to £2,927,834.

Estimated Trust Conditions 2002-2003

Physical Condition Statutory & Safety Compliance Fire Safety Compliance

C & D C & D 30% 31% C & D 31%

A & B A & B A & B 70% 69% 69%

Figure 2 Figure 3 Figure 4

Energy Performance Functional Suitability Space Utilisation

Unacceptable Unacceptable 12% C & D 24% 21%

A & B Acceptable 76% Acceptable 79% 88%

Figure 5 Figure 6 Figure 7

Essential Building Area Essential Land Area

Non Essential 15% Non ssential 42%

Essential

Essential 58% 85%

Figure 8 Figure 9

54 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 APPENDIX III

1.5 Figures 2-7 graphically illustrate the Trust's performance against the key all-Wales targets for the Essential estate.

1.6 Figures 8 and 9 illustrate the amount of Essential building area and land the Trust has in its ownership.

1.7 Figures 10-17 graphically compare Cardiff and Vale PIs (based on Essential estate) with the other Trusts in Wales.

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Physical Condition A + B (%) All Wales Target (2005)

FigureFigure 10: 10 - - Physical ConditionCondition (Categories (Categories A & BA %) & B %)

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Statutory Safety Compliance (Essential) All Wales Target (2005) FigureFigure 11: 11-- Statutory Statutory && SafetySafety Compliance Compliance (Categories (Categories A & B A %) & B %)

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 55 APPENDIX III

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Fire Safety Compliance (Essential) All Wales Average

FigureFigure 12: 12 -- Fire Safety Safety Compliance Compliance / Trust / Trust

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Functional Suitability (A + B) All Wales Target (2005)

FigureFigure 13: 13 -- FunctionalFunctional Suitability Suitability / Trust / Trust

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Space Utilisation (Fully Used) All Wales Target (2005)

FigureFigure 14: 14 - SpaceSpace Utilisation Utilisation / Trust / Trust

56 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 APPENDIX III

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Essential Buildings - % All Wales Average

Figure 15: - Essential Buildings / Trust

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Essential Land - % All Wales Average

FigureFigure 16: 16 - EssentialEssential Land Land / Trust / Trust

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% of Estate in condition 'B' or above All Wales Average Figure 17: - Estatecode ‘B’ Energy Performance Figure 17 - Estatecode Category 'B' Energy Performance

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 57 APPENDIX III

2.0 Energy performance 2.1 In 2002-03 hospitals in the Trust recorded a net energy consumption of 561,930GJ, an increase of 7.8% on last year’s figure of 521,045GJ. This equates to a primary energy consumption of 834,233GJ, an increase of 4.4% on last year’s figure of 799,162GJ.

2.2 The overall Trust PI is excellent, with the indicator at 50.74 GJ/100m3 being lower than the target range 55-65 GJ/100m3. Although the overall Trust PI is excellent, the performance of some sites is poor compared with the Trust as a whole. Furthermore, the Trust’s good PI belies the fact that two of its larger sites — CRI and Sully — appear to be more efficient than they really are due to their large heated volumes and low usage. The PI of last year’s worst performer — Llandough — has improved, though net consumption has increased by more than 15,000GJ. 2.3 Following consultation with the Trust earlier this year, a target reduction in primary energy consumption of 1.5% was agreed for the year. Regarding particular sites, the Trust PIs suggest that there is significant scope for reductions in consumption at Llandough and Rookwood.

Hospital Net Hospital Energy Change on Heated Volume Site PI Consumption Previous Year

(GJ) (%) (m3) (GJ/100m3) Barry 9,196.00 -2.6 20,358 45.17 CRI 18,452.00 -10.1 116,129 15.89 CRI West Wing 10,903.00 -9.3 15,772 69.13 Llandough * 118,819.15 15.1 163,736 72.58 Rookwood 26,169.00 1.8 34,752 75.30 Royal Hamadryad 4,944.00 -21 12,785 38.67 St Davids 12,804.00 N/A 33,887 37.78 Sully 13,157.00 N/A 54,024 24.35 UHW * 297,505.97 7.8 530,417 56.09 Whitchurch * 49,979.84 15.4 125,487 39.83 Trust Totals 561,929.96 7.8 1,107,347 50.74 Figure 18: Individual hospital energy PIs * Site with CHP installed 3.0 Summary

3.1 Whilst the Trust does have a number of relatively new facilities the majority of its estate has serviced the NHS for many years and there are no plans to radically change this core essential estate. This presents particular problems in improving estate performance as it is more difficult to achieve the step gains that can occur with the major relocation of services into new purpose build premises.

3.2 Notwithstanding the challenges facing the Trust it is still disappointing to note that the performance of the estate has deteriorated against most of the key performance indicators and backlog maintenance costs have increased. Whilst the deterioration is marginal, and may be the result, in part, of more accurate measurement, it is still a cause for concern.

3.3 To improve the Trust’s performance will require a concerted effort both strategically and operationally. This will require careful planning and targeting of resources to integrate the strategic service aspirations of the Trust with the operational management of the existing estate.

58 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 APPENDIX IV

Summary of Trust Information

CARMARTHENSHIRE

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 59

APPENDIX IV

Trust Name: Carmarthenshire NHS Trust

No of Returns: 6 Individual hospital sites Aggregate 1 – Freehold diagnostic & treatment centres, health centres. Aggregate 2 – Freehold, all other sites.

1.0 Backlog maintenance

1.1 The Trust submitted its returns by the completion date of 30th June 2003. Data fields relating to the Food Section were not completed in full.

1.2 The backlog maintenance figure for the Trust has increased from £11,845,007 to £14,283,444, which equates to an increase of 20.5%. All hospital sites have shown increases.

West Wales General Hospital has reported the largest increase in backlog maintenance costs, rising by £1,092,640 to £8,795,932.

1.3 Bryntirion Hospital is part of the residual estate and is scheduled to close in July 2004. The backlog maintenance costs for this hospital are currently estimated to be £1,837,980, which is 12.8% of the Trust total.

1.4 This is the first year for all of the Trust’s sites to be included in the returns. The data for the non-hospital sites has been aggregated into two groups: Aggregate 1 and 2. Backlog maintenance costs associated with the Aggregated Groups amount to £430,193, which is 3% of the Trust total.

Location Physical S & S Fire Safety DDA Backlog Backlog Variation Condition Costs Costs Costs Maintenance Maintenance Costs Costs Costs 2002/03 2001/02

(£) (£) (£) (£) (£) (£) (£) Amman Valley Hospital 268,765 69,157 24,720 333,749 362,642 343,789 18,853 Bryntirion Hospital 1,548,914 174,375 114,691 0 1,837,980 1,746,392 91,588 Llandovery Hospital 277,117 121,258 79,856 106,006 478,231 352,695 125,536 Mynydd Mawr Hospital 1,038,911 141,281 143,685 275,122 1,323,877 1,145,554 178,323 Prince Philip Hospital 53,045 795,022 156,529 440,140 1,004,596 553,285 451,311 West Wales General 3,414,614 2,849,403 2,531,915 689,310 8,795,932 7,703,292 1,092,640 Aggregate 1 311,116 123,597 14,503 168,402 449,216 N/A 449,216 Aggregate 2 0 1,004 29,973 8,097 30,977 N/A 30,977 Trust Totals 6,912,482 4,275,097 3,095,872 2,020,826 14,283,451 11,845,007 2,438,444

Figure 1: Backlog maintenance costs by site

1.5 Figures 2-7 overleaf, graphically illustrate the Trust’s performance against the key all-Wales targets for the Essential estate.

1.6 Figures 8 and 9 overleaf, illustrate the amount of Essential building area and land the Trust has in its ownership.

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 61 APPENDIX IV

Estimated Trust Conditions 2002-2003

Physical Condition Statutory & Safety Compliance Fire Safety Compliance

C & D C & D 23% 37% C & D 37%

A & B A & B 63% A & B 63% 77%

Figure 2 Figure 3 Figure 4

Energy Performance Functional Suitability Space Utilisation

Unacceptable Unacceptable A & B 20% 20% 3%

Acceptable Acceptable 80% 80% C & D 97%

Figure 5 Figure 6 Figure 7

Essential Building Area Essential Land Area

Non Essential Non ssential 10% 7%

Essential Essential 90% 93%

Figure 8 Figure 9

1.7 Figures 10-17 graphically compare Carmarthenshire PIs (based on Essential estate), with the other Trusts in Wales.

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Statutory Safety Compliance (Essential) All Wales Target (2005) FigureFigure 11: 11-- Statutory Statutory && Safety Safety Compliance Compliance (Categories (Categories A & B %)A & B %)

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Fire Safety Compliance (Essential) All Wales Average FigureFigure 12: 12 - FireFire Safety Safety Compliance Compliance / Trust / Trust

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Functional Suitability (A + B) All Wales Target (2005)

FigureFigure 13: 13 - - Functional Suitability Suitability / Trust / Trust

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Space Utilisation (Fully Used) All Wales Target (2005) FigureFigure 14: 14 -- SpaceSpace Utilisation Utilisation / Trust / Trust

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Figure 15: - Essential Buildings / Trust

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Essential Land - % All Wales Average

FigureFigure 16: 16 -- EssentialEssential Land Land / Trust / Trust

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FigureFigure 17 –17: Estatecode - Estatecode Category‘B’ Energy 'B' Energy Performance Performance

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2001-2002 65 APPENDIX IV

2.0 Energy performance

2.1 In 2002-03 hospitals in the Trust recorded a net energy consumption of 168,016GJ, an increase of 13.1% on last year’s figure of 148,542GJ. This equates to a primary energy consumption of 224,000GJ, an increase of 12.6% on last year’s figure of 199,000GJ.

2.2 The overall Trust PI is 76.11 GJ/100m3, which is the second highest of all Welsh Trusts, and considerably above the higher target level of 65 GJ/100m3. The overall Trust PI has improved considerably from last year’s figure of 90.38 GJ/100m3 due to an increase in heated volume of 34%.

2.3 Following consultation with the Trust earlier this year, a target reduction in primary energy consumption of 5% was agreed for the year. The PIs for individual hospitals show that there is considerable scope for improvement in energy performance.

Hospital Net Hospital Energy Change on Heated Volume Site PI Consumption Previous Year

(GJ) (%) (m3) (GJ/100m3)

Amman Valley Hospital 4,178.00 9.30 5,282 79.10 Bryntirion Hospital 13,736.00 0.00 15,695 87.52 Llandovery Hospital 1,917.00 1.50 2,192 87.45 Mynydd Mawr Hospital 5,033.00 -6.40 5,992 84.00 Prince Philip Hospital* 61,228.29 12.40 78,360 78.14 West Wales General * 81,924.00 18.30 113,243 72.34 Trust Totals 168,016.29 13.10 220,764 76.11

Figure 18: Individual hospital energy PIs * Site with CHP installed 3.0 Summary 3.1 This year’s data indicates a very similar position to that previously reported and where improvements have been recorded these have tended to be due to more accurate measurement rather than better performance.

3.2 Energy performance is a particular area of concern and the Trust’s PI, at 76.11 GJ/100m3 remains one of the worst of all Welsh Trusts. The rise in backlog maintenance costs of over 20% also requires an explanation. 3.3 As stated last year whilst the interim targets for 2005 may be achievable, the Trust should not underestimate the investment required now in order to meet the more challenging final targets set for 2008. 3.4 To make substantive progress toward the final estate performance targets will require a strategic and operational response particularly in respect of the Prince Phillip and West Wales District General Hospitals. This will require careful planning and targeting of resources to integrate the strategic service aspirations of the Trust with the operational management of the existing estate.

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Summary of Trust Information

CEREDIGION AND MID WALES

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APPENDIX V

Trust Name: Ceredigion & Mid Wales NHS Trust

No of Returns: 4 Individual hospital hites Aggregate 1 – Freehold diagnostic & treatment centres, health centres. Aggregate 4 – Leased and fully serviced by the Landlord.

1.0 Backlog maintenance

1.1 The Trust submitted its returns by the completion date of 30th June 2003. All applicable data fields were completed for the four hospital sites within the Trust.

1.2 The backlog maintenance figure for the Trust has reduced from £7,274,208 to £6,787,000, which equates to a reduction of 6.6%. All hospital sites, with the exception of Tregaron, (+£15,036) have shown reductions. Bronglais General Hospital accounts for £4,650,000 (68.5%) of the total Trust backlog maintenance.

1.3 This is the first year for all of the Trust’s sites to be included in the returns. The data for the non-hospital sites has been aggregated into two groups: Aggregate 1 and 2. Aggregate Group 1 (Freehold, diagnostic & treatment centres, health centres) accounts for £700,000 of the backlog maintenance total.

Location Physical S & S Fire Safety DDA Backlog Backlog Variation Condition Costs Costs Costs Maintenance Maintenance Costs Costs Costs 2002/03 2001/02

(£) (£) (£) (£) (£) (£) (£) Aberaeron Hospital 100,000 40,000 10,000 32,758 150,000 150,000 0 Bronglais General 3,750,000 600,000 300,000 186,130 4,650,000 5,531,000 -881,000 Cardigan & District 355,000 310,000 100,000 128,790 765,000 1,086,244 -321,244 Tregaron Hospital 280,000 175,000 67,000 32,758 522,000 506,964 15,036 Aggregate 1 700,000 0 0 40,000 700,000 N/A 700,000 Aggregate 4 0 0 0 0 0 N/A 0 Trust Totals 5,185,000 1,125,000 477,000 420,436 6,787,000 7,274,208 -487,208

Figure 1: Backlog maintenance costs by site

1.4 Figures 2-7 overleaf, graphically illustrate the Trust’s performance against the key all-Wales targets for the Essential estate.

1.5 Figures 8 and 9 overleaf, illustrate the amount of Essential building area and land the Trust has in its ownership.

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 69 APPENDIX V

Estimated Trust Conditions 2002-2003 Physical Condition Statutory & Safety Compliance Fire Safety Compliance

C & D C & D 6% C & D 11% 8%

A & B A & B A & B 89% 94% 92%

Figure 2 Figure 3 Figure 4

Energy Performance Functional Suitability Space Utilisation

A & B Unacceptable 11% Unacceptable 38% 32%

Acceptable

Acceptable 68% C & D 62% 89%

Figure 5 Figure 6 Figure 7

Essential Building Area Essential Land Area

Non Essential Non Essential 2% 0%

Essential Essential 98% 100%

Figure 8 Figure 9

1.6 Figures 10-17 opposite, graphically compare Ceredigion Pls, (based on Essential estate), with the other Trusts in Wales.

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Physical Condition A + B (%) All Wales Target (2005) FigureFigure 10: 10- Physical- Physical ConditionCondition (Categories (Categories A & A B %)& B %)

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Statutory Safety Compliance (Essential) All Wales Target (2005) FigureFigure 11: -11- Statutory Statutory & SafetySafety Compliance Compliance (Categories (Categories A & B A%) & B %)

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Fire Safety Compliance (Essential) All Wales Average FigureFigure 12: 12 - - Fire SafetySafety Compliance Compliance / Trust / Trust

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Functional Suitability (A + B) All Wales Target (2005) FigureFigure 13: 13 - FunctionalFunctional Suitability Suitability / Trust / Trust

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Space Utilisation (Fully Used) All Wales Target (2005) FigureFigure 14: 14 - SpaceSpace Utilisation Utilisation / Trust / Trust

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Essential Buildings - % All Wales Average FigureFigure 15: 15 - Essential BuildingsBuildings / Trust / Trust

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Essential Land - % All Wales Average

FigureFigure 16: 16 -- Essential Essential Land Land / Trust / Trust

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% of Estate in condition 'B' or above All Wales Average

Figure 17: - Estatecode ‘B’ Energy Performance

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 73 APPENDIX V

2.0 Energy performance

2.1 In 2002-03 hospitals in the Trust recorded a net energy consumption of 43,073GJ, an increase of 3.1% on last year’s figure of 41,776GJ. This equates to a primary energy consumption of 60,205GJ, an increase of 3.6% on last year’s figure of 58,127GJ.

2.2 The overall Trust PI is 65.5 GJ/100m3, which is close to the upper band of the target of 65 GJ/100m3. The individual hospital PIs show that Tregaron Hospital is the worst performer and that Bronglais Hospital, the largest hospital in the Trust, is just outside the 55-65 GJ/100m3 band at 66.84 GJ/100m3.

2.3 Whilst savings at Tregaron would be easy to achieve, the hospital is relatively small compared to Bronglais and smaller percentage savings here would have a greater overall benefit.

2.4 Following consultation with the Trust earlier this year, a target reduction in primary energy consumption of 3% was agreed for the year.

Hospital Net Hospital Energy Change on Heated Volume Site PI Consumption Previous Year

(GJ) (%) (m3) (GJ/100m3) Aberaeron Hospital 608 9.40 1,1514 40.16 Bronglais General 36,069 2.60 53,960 66.84 Cardigan & District 3,065 9.60 5,530 55.42 Tregaron Hospital 3,331 1.40 3,800 87.66 Trust Totals 43,073 3.1 64,804 65.50

Figure 18: Individual hospital energy PIs 3.0 Summary 3.1 The Trust appears to be making steady progress in meeting the interim 2005 estate performance targets although achieving the final 2008 targets presents much more of a challenge. 3.2 The reduction in backlog maintenance costs this year is encouraging and the reduction would have been greater, had it not been for the impact of the Aggregated sites, which have added £700,000 to the backlog maintenance costs. 3.3 The Trust’s energy performance has deteriorated compared to last year. The Trust should carry forward energy saving initiatives, focusing particularly on Bronglais Hospital, where they will have the greatest benefit. 3.4 To significantly improve the Trust’s performance is likely to require the implementation of strategic plans in parallel with tight operational management of the existing estate. In this context it is important that the Trust has a clear estate strategy and fully understands its effect on the key performance indicators.

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Summary of Trust Information

CONWY AND DENBIGHSHIRE

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APPENDIX VI

Trust Name: Conwy & Denbighshire NHS Trust

No of Returns: 19 Individual hospital sites Aggregate 1 – Freehold diagnostic & treatment centres, health centres. Aggregate 2 – Freehold, all other sites. Aggregate 3 – Leased and fully serviced by the NHS Trust

1.0 Backlog maintenance

1.1 The Trust submitted its returns by the completion date of 30th June 2003. Data fields relating to Food, Laundry & Linen Services, Security Services and Portering Services were not completed in full.

1.2 The backlog maintenance figure for the Trust has increased from £69,540,375 to £74,252,669, which equates to an increase of 4.0%. The largest increase is associated with Ysbyty Glan Clwyd, where the backlog maintenance figure has increased by £4,485,387. The total backlog maintenance figure for this hospital is currently estimated to be £64,768,387, which is 87% of the Trust total.

1.3 Three Hospitals have shown a reduction in their backlog maintenance costs, the largest reduction being associated with Abergele Hospital.

Location Physical S & S Fire Safety DDA Backlog Backlog Variation Condition Costs Costs Costs Maintenance Maintenance Costs Costs Costs 2002/03 2001/02

(£) (£) (£) (£) (£) (£) (£) Abergele Hospital 1,330,685 48,000 47,000 329,676 1,425,685 2,860,375 -1,434,690 Ablett Unit 165,300 0 10,000 125,084 175,300 10,000 165,300 Bodnant Psychiatric 178,970 12,750 24,000 59,911 215,720 46,000 169,720 Unit Bryn Hesketh 30,165 0 20,000 40,911 50,165 N/A 50,165 Cedar Court 0 0 20,000 18,205 20,000 5,000 15,000 Colwyn Bay 241,541 66,750 80,000 156,794 388,291 110,500 277,791 Conwy Hospital 890,000 79,000 50,000 102,411 1,019,000 896,500 122,500 Denbigh Community 371,769 2,500 57,000 110,851 431,269 85,500 345,769 Glan Traeth 103,520 0 0 19,098 103,520 0 103,520 Glan Traeth Day 53,092 0 0 19,098 53,092 0 53,092 Gwynfryn Unit 289,000 32,500 50,000 110,156 371,500 334,000 37,500 Hafod MHRC 42,800 0 0 27,605 42,800 17,000 25,800 H M Stanley Hospital 1,790,598 19,000 10,000 333,283 1,819,598 2,838,000 -1,018,402 Llangollen Community 834,750 4,750 85,000 40,679 924,500 302,500 622,000 Nant y Glyn Day 116,440 0 0 27,605 116,440 2,000 114,440 Prestatyn Community 47,370 500 34,000 28,598 81,870 52,000 29,870 Royal Alexandra 790,790 8,000 360,000 316,700 1,158,790 1,690,500 -531,710 Ruthin Community 342,600 750 0 82,021 343,350 7,500 335,850 Ysbyty Glan Clwyd 3,651,387 117,000 61,000,000 2,006,191 64,768,387 60,283,000 4,485,387 Aggregate 1 587,183 20,500 5,000 160,302 612,683 N/A 612,683 Aggregate 2 126,459 4,250 0 76,726. 130,709 N/A 130,709 Aggregate 3 0 0 0 0 0 N/A 0 Trust Totals 11,984,419 416,250 61,852,000 4,191,905 74,252,669 69,540,375 4,712,294

Figure 1: Backlog maintenance costs by site

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 77 APPENDIX VI

1.4 This is the first year for all the Trust’s sites to be included in the returns. The data for the non-hospital sites has been aggregated into three groups: Aggregate 1, 2 and 3. It should be noted that no backlog maintenance costs were entered for Aggregate Group 3.

1.5 Figures 2-7 graphically illustrate the estimation of the Trust performance against the key all-Wales targets for the Essential estate.

1.6 Figures 8 and 9 illustrate the amount of Essential building area and land the Trust has in its ownership.

Estimated Trust Conditions 2002-2003

Physical Condition Statutory & Safety Compliance Fire Safety Compliance

C & D C & D C & D 4% 19% 37%

A & B 63%

A & B A & B 81% 96%

Figure 2 Figure 3 Figure 4

Energy Performance Functional Suitability Space Utilisation

Unacceptable C & D 43% Unacceptable 37% 25%

A & B Acceptable Acceptable 75% 57% 63%

Figure 5 Figure 6 Figure 7

Essential Building Area Essential Land Area

Unacceptable Non Essential 5% 8%

Essential 92% Acceptable 95%

Figure 8 Figure 9

1.7 Figures 10-17 opposite and overleaf, graphically compare Conwy & Denbighshire PIs (based on Essential estate) with the other Trusts in Wales.

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Physical Condition A + B (%) All Wales Target (2005)

FigureFigure 10: 10 - - PhysicalPhysical ConditionCondition (Categories (Categories A & BA %) & B %)

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Statutory Safety Compliance (Essential) All Wales Target (2005)

FigureFigure 11: 11-- Statutory Statutory & Safety Safety Compliance Compliance (Categories (Categories A & B A%) & B %)

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Fire Safety Compliance (Essential) All Wales Average

FigureFigure 12: 12 -- FireFire Safety Safety Compliance Compliance / Trust / Trust

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Functional Suitability (A + B) All Wales Target (2005)

FigureFigure 13: 13 -- Functional Functional Suitability Suitability / Trust / Trust

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Space Utilisation (Fully Used) All Wales Target (2005)

FigureFigure 14:14 - Space- Space Utilisation Utilisation / Trust / Trust

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Essential Buildings - % All Wales Average

Figure 15: - Essential Buildings / Trust

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Essential Land - % All Wales Average FigureFigure 16: 16 - -Essential Essential LandLand / Trust/ Trust

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% of Estate in condition 'B' or above All Wales Average

Figure 17: - Estatecode ‘B’ Energy Performance

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 81 APPENDIX VI

2.0 Energy performance

2.1 In 2002-03 hospitals in the Trust recorded a net energy consumption of 178,584GJ, a reduction of 1.82% on last year’s figure of 181,866GJ. This equates to a primary energy consumption of 243,957GJ, an increase of 8.6% on last year’s figure of 224,646GJ.

2.2 The overall Trust PI is 54.71GJ/100m3, which is lower than the target range of 55-65 GJ/100m3. Last year the PI was 59.19 GJ/100m3.

2.3 Increasing electrical consumption has led to an increase in primary consumption though the net energy consumption is slightly lower than last year. The Trust’s primary energy consumption is 1.65 % above its base year consumption.

2.4 Following consultation with the Trust earlier this year a target reduction in primary energy consumption of 3% was agreed for the year.

Hospital Net Hospital Energy Change on Heated Volume Site PI Consumption Previous Year

(GJ) (%) (m3) (GJ/100m3) Abergele 18,050.00 9.3 25,798 69.97 Ablett Unit 5,334.00 2.8 10,050 53.07 Bodnant 1,655.00 1.3 2,834 58.40 Bryn Hesketh 1,763.00 N/A 2,861 61.62 Cedar Court 858.00 3.0 1,761 48.72 Colwyn Bay 5,489.00 -6.7 13,340 41.15 Conwy 4,932.00 -12.4 8,261 59.70 Denbigh 5,444.00 -28.9 8,261 65.90 Glan Traeth 949.00 32.5 1,393 68.13 Glan Traeth Day Unit 658.00 N/A 1,506 43.69 Gwynfryn 6,355.00 -8.1 9,581 66.33 H M Stanley 780.00 -3.4 2,694 28.95 Hafod MHRC 18,009.00 9.6 23,953 75.18 Llangollen 1,982.00 2.1 2,459 80.60 Nant y Glyn 968.00 27.9 2,324 41.65 Prestatyn 1,631.00 116.3 1,834 88.93 Royal Alexandra 8,681.00 -15.1 20,199 42.98 Ruthin 4,017.00 -4.2 5,817 69.06 Ysbyty Glan Clwyd * 91,028.88 -2.6 181,468 73.83 Trust Totals 178,583.88 -1.82 326,394 54.71 Figure 18: Individual hospital energy PIs * Site with CHP installed 3.0 Summary

3.1 The Trust is currently undertaking a major review of its service delivery models and has already completed the first iteration of this process on its acute services and has developed a number of options for the estate. Work is now being progressed on mental health and community services.

82 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 APPENDIX VI

3.2 However, in advance of the implementation phase of this review, this year’s data does not indicate any general improvement in the Trust’s estates performance although, at an individual site level, there have been some successes.

3.3 Whilst backlog maintenance costs have increased and the performance indicators for functional suitability and space utilisation have deteriorated it is assumed that this is due, in the main, to more accurate measurement. As we move into the third year of the EFPMS it is hoped that such adjustments will not be as significant in future years.

3.4 To improve the Trust’s performance will require a strategic response, as its estate issues, particularly at Ysbyty Glan Clwyd, cannot be addressed solely through better operational management. The Trust does however have a large asset portfolio of smaller hospitals and careful planning and targeting of the Trust’s resources, including its discretionary capital, will be needed to help improve the Trust’s overall estate performance.

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APPENDIX VII

Summary of Trust Information

GWENT HEALTHCARE

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Trust Name: Gwent Healthcare NHS Trust

No of Returns: 22 Individual hospital sites Aggregate 1 – Freehold diagnostic & treatment centres, health centres.

1.0 Backlog maintenance

1.1 The Trust submitted its returns by the completion date of 30th June 2003. Data fields relating to Sterile Services, Water Services, Clinical Waste, Car Parking, Security Services, Portering Services and Postal Services were not completed in full.

1.2 The backlog maintenance figure for the Trust has reduced from £64,147,353 to £62,673,840, which is a reduction of £1,473,513.

Seven hospital sites have reduced their backlog maintenance costs. The largest reduction in costs is associated with Nevill Hall Hospital, which have reduced by £1,214,244.

1.3 This is the first year for all of the Trust’s sites to be included in the returns. The data for the non-hospital sites has been aggregated into one group: Aggregate 1. It should be noted that no backlog maintenance costs were entered for the Aggregate Group.

Location Physical S & S Fire Safety DDA Backlog Backlog Variation Condition Costs Costs Costs Maintenance Maintenance Costs Costs Costs 2002/03 2001/02

(£) (£) (£) (£) (£) (£) (£) Aberbargoed & District 55,000 13,000 3,000 3,850 71,000 80,013 -9,013 Abertillery & District 300,000 17,000 70,000 6,880 387,000 517,240 -130,240 Blaenavon Health Care 165,000 16,340 3,000 8,200 184,340 181,370 2,970 Blaina & District 120,000 16,000 35,000 8,200 171,000 162,680 8,320 Caerphilly Miners 6,400,000 530,000 10,000 22,000 6,940,000 7,539,350 -599,350 Chepstow Community 0 0 10,000 14,808 10,000 10,000 0 County Hospital 3,500,000 450,000 9,000 34,038 3,959,000 3,479,694 479,306 Ebbw Vale Hospital 1,000,000 140,000 50,000 7,000 1,190,000 1,187,540 2,460 Llanfrechfa Grange 1,900,000 230,000 130,000 42,400 2,260,000 1,936,480 323,520 Maindiff Court Hospital 600,000 130,000 70,000 13,640 800,000 754,490 45,510 Monmouth General 45,000 2,500 50,000 3,799 97,500 84,323 13,177 Nevill Hall Hospital 10,500,000 3,500,000 850,000 125,400 14,850,000 16,114,315 -1,264,315 Oakdale Hospital 78,000 54,000 35,000 2,000 167,000 163,530 3,470 Redwood Memorial 50,000 35,000 10,000 1,900 95,000 88,460 6,540 Royal Gwent Hospital 15,000,000 700,000 700,000 178,058 16,400,000 17,614,244 -1,214,244 St Cadoc's Hospital 500,000 53,000 100,000 50,258 653,000 425,648 227,352 St Woolos Hospital 6,000,000 180,000 230,000 58,040 6,410,000 5,815,370 594,630 Talygarn & Ty Siriol 10,000 5,000 5,000 8,067 20,000 5,010 14,990 Tredegar General 340,000 70,000 8,000 7,840 418,000 463,290 -45,290 Ty Sirhowy Unit 15,000 7,000 8,000 3,035 30,000 56,360 -26,360 Ysbytyr Tri Chwm 0 5,000 10,000 6,353 15,000 10,000 5,000 Ystrad Mynach 7,200,000 340,000 6,000 18,000 7,546,000 7,457,946 88,054 Aggregate 1 0 0 0 99,642 0 N/A 0 Trust Totals 53,778,000 6,493,840 2,402,000 723,408 62,673,840 64,147,353.00 -1,473,513 Figure 1: Backlog maintenance cost by site

1.4 Limited information was provided in respect of Chepstow Community Hospital. This is a PFI scheme and it is understood that the Trust had difficulties in obtaining the information required by the EFPMS from the PFI service provider. It is recommended that the PFI service provider be instructed to provide the information requested by the WAG.

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1.5 Figures 2-7 graphically illustrate the Trust’s performance against the key all-Wales targets for the Essential estate.

1.6 Figures 8 and 9, illustrate the amount of Essential building area and land the Trust has in its ownership.

Estimated Trust Conditions 2002-2003

Physical Condition Statutory & Safety Compliance Fire Safety Compliance

C & D C & D C & D 29% 24% 8%

A & B A & B 71% A & B 76% 92%

Figure 2 Figure 3 Figure 4

Energy Performance Functional Suitability Space Utilisation

Unacceptable 34% Unacceptable C & D 28% 38%

A & B 62% Acceptable Acceptable 72% 66%

Figure 5 Figure 6 Figure 7

Essential Building Area Essential Land Area

Non Essential Essential 32% 47%

Esential 68% Non essential 53%

Figure 8 Figure 9

1.7 Figures 10-17 graphically compare Gwent Healthcare PIs (based on Essential estate) with the other Trusts in Wales.

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Physical Condition A + B (%) All Wales Target (2005)

FigureFigure 10: 10- Physical- Physical ConditionCondition (Categories (Categories A & A B %)& B %)

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Statutory Safety Compliance (Essential) All Wales Target (2005)

FigureFigure 11: - 11- Statutory Statutory && SafetySafety Compliance Compliance (Categories (Categories A & BA %) & B %)

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Fire Safety Compliance (Essential) All Wales Average

FigureFigure 12: 12 - - FireFire SafetySafety Compliance Compliance / Trust / Trust

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Functional Suitability (A + B) All Wales Target (2005) FigureFigure 13: 13 -- FunctionalFunctional Suitability Suitability / Trust / Trust

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Space Utilisation (Fully Used) All Wales Target (2005)

FigureFigure 14: 14 - SpaceSpace Utilisation Utilisation / Trust / Trust

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Essential Buildings - % All Wales Average

Figure 15: - Essential Buildings / Trust

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Essential Land - % All Wales Average

FigureFigure 16:16 - -Essential Essential Land Land / Trust / Trust

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% of Estate in condition 'B' or above All Wales Average

FigureFigure 17:17 - -Estatecode Estatecode 'B'‘B’ Energy Energy Performance Performance

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2.0 Energy performance

2.1 In 2002-03 hospitals in the Trust recorded a net energy consumption of 410,055GJ, an increase of 5.6% on last year’s figure of 388,442GJ. This equates to a primary energy consumption of 596,542GJ, an increase of 8.7% on last year’s figure of 548,801GJ.

2.2 The overall Trust PI is 66.26 GJ/100m3, which is slightly higher than the upper band target figure of 65 GJ/100m3. The Trust PI suggests that savings can be made by the Trust, particularly by focusing on several poor performing hospitals including the Royal Gwent Hospital. The figures for this site, it should be noted, are unreliable as some of its energy consumption is calculated by apportionment from the St Woolos Hospital. Consequently, it may be that the quoted consumption for the Royal Gwent is too high and that for St Woolos too low.

2.3 Following discussions with the Trust earlier this year, a target reduction in primary energy consumption of 4% was agreed for the year.

Hospital Net Hospital Energy Change on Heated Volume Site PI Consumption Previous Year

(GJ) (%) (m3) (GJ/100m3) Aberbargoed 2,716.00 11.36 3,850 70.55 Abertillery 5,654.00 -25.34 6,880 82.18 Blaenavon H.C.Unit 1,677.00 10.69 3,316 20.45 Blaina 5,537.00 -15.74 8,200 67.52 Caerphilly 20,374.00 3.58 22,000 92.61 Chepstow 9,467.00 -1.25 14,808 63.93 County 19,582.00 10.61 34,038 57.53 Ebbw Vale 7,095.00 9.76 7,000 101.36 Llanfrechfa Grange 18,811.00 164.14 42,400 125.05 Maindiff Court 8,939.00 14.13 13,640 67.73 Monmouth 2,023.00 8.94 3,799 53.25 Nevill Hall* 80,414.26 1.12 125,400 64.13 Oakdale 922.00 -52.15 2,000 46.10 Redwood 2,162.00 20.04 1,900 113.79 Royal Gwent * 144,293.00 27.64 178,058 81.04 St Cadocs* 24,317.59 63.43 50,258 78.46 St Woolos* 26,182.37 -29.96 58,040 45.11 Talygarn 4,999.00 2.97 8,067 61.97 Tredegar 6,003.00 5.76 7,840 76.57 Ty Sirhowy 676.00 -16.34 3,035 22.27 Ysbytyr Tri Chwm 4,719.00 16.72 6,353 74.28 Ystrad Mynach 13,492.00 -3.03 18,000 74.96 Trust Totals 410,055.22 5.56 618,882 66.26

Figure 18: Individual hospital energy PIs * Site with CHP installed

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3.0 Summary

3.1 With a diverse asset portfolio of 22 hospitals the Trust faces a huge strategic challenge in improving its estates performance. This year the Trust has made improvements in respect of most of the key PIs, although it should be noted that this is mainly the result of the change in categorisation of a number of its hospitals from Essential to Non-Essential, rather than improved performance.

3.2 On a more positive note the stabilisation of backlog maintenance costs is welcome and the Trust will need to make a determined effort to maintain this trend.

3.3 The Trust’s energy performance continues to be an area of concern with increased consumption resulting in a PI above the upper limit of the target range. Individual site PIs show that there is scope for improvement, particularly at the Trust’s largest site, the Royal Gwent Hospital, where savings will make the most significant impact overall.

3.4 Whilst the interim 2005 estate performance targets may be achievable, the scale of the task needed to meet the final 2008 targets will require a greater emphasis on strategic asset management. This will require careful planning and targeting of resources to integrate the strategic service aspirations of the Trust with the operational management of the existing estate. In this context it is important that the Trust has a clear estate strategy and fully understands its effect on the key performance indicators.

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APPENDIX VIII

Summary of Trust Information

NORTH EAST WALES

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Trust Name: North East Wales NHS Trust

No of Returns: 13 Individual hospital sites Aggregate 1 – Freehold diagnostic & treatment centres, health centres. Aggregate 2 – Freehold, all other sites. Aggregate 3 – Leased and fully serviced by the NHS Trust Aggregate 5 – Leased and part serviced by NHS Trust/Landlord.

1.0 Backlog maintenance

1.1 The Trust submitted its returns by the completion date of 30th June 2003. All applicable data fields were completed for the hospital sites within the Trust.

1.2 The backlog maintenance figure for the Trust has increased from £27,115,400 to £28,466,200, which equates to an increase of 5%. The biggest change is associated with Ysbyty Maelor, which has increased by £557,000.

1.3 This is the first year for all the Trust’s sites to be included in the returns. The data for the non-hospital sites has been aggregated into four groups: Aggregate 1, 2, 3 & 5. It should be noted that no backlog maintenance costs were entered for the Aggregate Groups.

Location Physical S & S Fire Safety DDA Backlog Backlog Variation Condition Costs Costs Costs Maintenance Maintenance Costs Costs Costs 2002/03 2001/02

(£) (£) (£) (£) (£) (£) (£) Chirk Community 0 0 0 21,000 0 0 0 Coed Celyn Unit 0 0 0 16,000 0 0 0 Deeside Community 0 0 3,000 21,000 3,000 18,000 -15,000 Dobshill Hospital 2,856,000 368,000 0 6,000 3,224,000 3,070,000 154,000 Flint Community 0 0 0 11,000 0 0 0 Holywell Community 315,000 2,200 0 16,000 317,200 302,000 15,200 Lluesty Hospital 5,250,000 63,000 263,000 5,500 5,576,000 5,310,000 266,000 Llwyn y Groes Unit 0 6,000 0 6,000 6,000 5,000 1,000 Meadowslea Hospital 3,150,000 63,000 21,000 16,000 3,234,000 3,080,000 154,000 Mold Community 0 0 8,000 10,000 8,000 0 8,000 Penley Hospital 2,100,000 105,000 53,000 11,000 2,258,000 2,150,000 108,000 Trevalyn Hospital 2,100,000 53,000 0 15,000 2,153,000 2,050,000 103,000 Ysbyty Maelor 10,185,000 1,502,000 0 263,000 11,687,000 11,130,000 557,000 Aggregate 1 0 0 0 0 0 N/A 0 Aggregate 2 0 0 0 0 0 N/A 0 Aggregate 3 0 0 0 0 0 N/A 0 Aggregate 5 0 0 0 0 0 N/A 0 Trust Totals 25,956,000 2,162,200 348,000 417,500 28,466,200 27,115,000 1,351,200

Figure 1: Backlog maintenance cost by site

1.4 Figures 2-7 overleaf, graphically illustrate the Trust's performance against the key all-Wales targets for the Essential estate.

1.5 Figures 8 and 9 overleaf, illustrate the amount of Essential building area and land the Trust has in its ownership.

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Estimated Trust Conditions 2002-2003

Physical Condition Statutory & Safety Compliance Fire Safety Compliance

C & D C & D 4% C & D 22% 0%

A & B A & B A & B 78% 96% 100%

Figure 2 Figure 3 Figure 4

Energy Performance Functional Suitability Space Utilisation

Unacceptable Unacceptable A & B 6% 13% 31%

Acceptable C & D Acceptable 69% 94% 87%

Figure 5 Figure 6 Figure 7

Essential Building Area Essential Land Area

Non Essential 17% Non Essential 40%

Essential 83% Essential 61%

Figure 8 Figure 9

1.6 Figures 10-17 opposite, graphically compare North East Wales PIs (based on Essential estate) with the other Trusts in Wales.

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Statutory Safety Compliance (Essential) All Wales Target (2005) FigureFigure 11: -11- Statutory Statutory & SafetySafety Compliance Compliance (Categories (Categories A & B A %) & B %)

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Fire Safety Compliance (Essential) All Wales Average

Figure 12: - Fire Safety Compliance / Trust

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Functional Suitability (A + B) All Wales Target (2005) FigureFigure 13: 13 -- Functional Functional Suitability Suitability / Trust / Trust

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Space Utilisation (Fully Used) All Wales Target (2005) FigureFigure 14:14 - -Space Space Utilisation Utilisation / Trust / Trust

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Figure 15: - Essential Buildings / Trust

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Essential Land - % All Wales Average

FigureFigure 16: 16 -- EssentialEssential Land Land / Trust / Trust

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% of Estate in condition 'B' or above All Wales Average

Figure 17: - Estatecode ‘B’ Energy Performance

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2.0 Energy performance

2.1 In 2002-03 hospitals in the Trust recorded a net energy consumption of 165,360 GJ, an increase of 1.6% on last year’s figure of 162,741GJ. This equates to a primary energy consumption of 243,821GJ, an increase of 2.5% on last year’s figure of 237,842 GJ.

2.2 The overall Trust PI is 68.1 GJ/100m3, which is slightly higher than the upper band target figure of 65 GJ/100m3. This suggests that further savings are possible. The individual site PIs point to several sites where savings can be made. These include Ysbyty Maelor — the main acute hospital — which has a PI of 68.74 GJ/100m3, showing a 4.4% improvement on last year’s figure of 71.91 GJ/100m3.

2.3 Following consultation with the Trust earlier this year, a target reduction in primary energy consumption of 4% was agreed for the year.

Hospital Net Hospital Energy Change on Heated Volume Site PI Consumption Previous Year

(GJ) (%) (m3) (GJ/100m3) Chirk 4,041.00 -2.34 6,300 64.14 Coed Celyn 427.00 -2.06 768 55.60 Deeside 5,785.00 1.42 10,100 57.28 Dobshill 6,392.00 17.96 5,808 110.06 Flint 1,920.00 7.87 2,400 80.00 Holywell 2,107.00 22.93 2,500 84.28 Lluesty 7,867.00 8.66 11,200 70.24 Llwyn y Groes 4,014.00 3.21 8,085 49.65 Meadowslea 9,121.00 10.76 7,823 116.59 Mold 5,478.00 -3.23 8,800 62.25 Penley 3,127.00 -24.52 11,354 27.54 Trevalyn 3,282.00 6.77 5,031 65.24 Ysbyty Maelor 111,799.00 3.06 162,652 68.74 Trust Totals 165,360.00 1.60 242,821 68.10

Figure 18: Individual hospital energy PIs

3.0 Summary

3.1 Overall the Trust appears to be making good progress in meeting the interim 2005 estate performance targets although achieving the final 2008 targets present much more of a strategic challenge.

3.2 In respect of the 2005 interim targets, energy performance remains above the upper limit of the target range and needs to be improved. Individual hospital PIs suggests that further improvements are possible.

3.3 Significant work has been undertaken by the Trust on service planning models and how the estate will need to change to respond to these demands. One important outcome from this exercise will be the Trust’s estate strategy and this document needs to clearly set out how progress towards the final 2008 targets will be achieved. It is unlikely that the Trust will be able to meet the estate challenges without the implementation of strategic plans in parallel with tight operational management of the existing estate.

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Summary of Trust Information

NORTH GLAMORGAN

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Trust Name: North Glamorgan NHS Trust

No of Returns: 4 Individual hospital sites Aggregate 1 – Freehold diagnostic & treatment centres, health centres.

1.0 Backlog maintenance

1.1 The Trust submitted its returns by the completion date of 30th June 2003. All applicable data fields were completed for the sites within the Trust.

1.2 The backlog maintenance figure for the Trust has increased from £48,000,000 to £62,174,194. This is an increase of £14,174,194, which equates to an increase of 29.5%.

Prince Charles Hospital accounts for the largest share of the backlog maintenance costs for this Trust and is currently estimated to be £37,970,748, which equates to 61%.

All sites have significantly increased their backlog maintenance costs.

1.3 This is the first year for all the Trust’s sites to be included in the returns. The data for the non-hospital sites has been aggregated into one group: Aggregate 1.

Location Physical S & S Fire Safety DDA Backlog Backlog Variation Condition Costs Costs Costs Maintenance Maintenance Costs Costs Costs 2002/03 2001/02

(£) (£) (£) (£) (£) (£) (£) Aberdare General 6,359,489 2,476,875 670,000 76,875 9,506,364 6,350,000 2,459,489 Mountain Ash General 2,460,000 400,000 750,000 120,000 4,510,000 3,000,000 1,440,000 Prince Charles Hospital 25,670,748 1,300,000 8,200,000 2,050,000 37,970,748 32,500,000 5,470,748 St Tydfil's Hospital 5,738,332 4,100,000 768,750 256,250 7,987,082 6,150,000 1,638,332 Aggregate 1 1,800,000 1,480,000 0 250,000 2,200,000 N/A 2,200,000 Trust Total 42,028,569 9,756,875 10,388,750 2,753,125 62,174,194 48,000,000 14,174,194

Figure 1: Backlog maintenance costs by site

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1.4 Figures 2-7 graphically illustrate the Trust’s performance against the key all-Wales targets for the Essential estate.

Estimated Trust Conditions 2002-2003

Physical Condition Statutory & Safety Compliance Fire Safety Compliance

A & B A & B 28% 32% A & B 37%

C & D 68% C & D C & D 63% 72%

Figure 2 Figure 3 Figure 4

Energy Performance Functional Suitability Space Utilisation

A & B Unacceptable 47% 27% Unacceptable 34%

Acceptable C & D Acceptable 66% 53% 73%

Figure 5 Figure 6 Figure 7

Essential Building Area Essential Land Area

Non essential Non Essential 8% 28%

Essential Essential 92% 72%

Figure 8 Figure 9

1.5 Figures 8 and 9 illustrate the amount of Essential building area and land the Trust has in its ownership.

1.6 Figures 10-17 graphically compare North Glamorgan PIs (based on Essential estate) with the other Trusts in Wales.

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Physical Condition A + B (%) All Wales Target (2005) FigureFigure 10: 10- Physical- Physical Condition Condition (Categories (Categories A & A B &%) B %)

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Statutory Safety Compliance (Essential) All Wales Target (2005) FigureFigure 11: - 11- Statutory Statutory & & Safety ComplianceCompliance (Categories (Categories A & BA %) & B %)

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Fire Safety Compliance (Essential) All Wales Average FigureFigure 12: 12 - -Fire Fire Safety Compliance Compliance / Trust / Trust

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Functional Suitability (A + B) All Wales Target (2005)

FigureFigure 13: 13 -- FunctionalFunctional Suitability Suitability / Trust / Trust

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Space Utilisation (Fully Used) All Wales Target (2005) FigureFigure 14: 14 - SpaceSpace Utilisation Utilisation / Trust / Trust

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Figure 15: - Essential Buildings / Trust

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Essential Land - % All Wales Average FigureFigure 16:16 - -Essential Essential Land Land / Trust / Trust

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Figure 17: - Estatecode ‘B’ Energy Performance

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 109 APPENDIX IX

2.0 Energy performance

2.1 In 2002-03 hospitals in the Trust recorded a net energy consumption of 110,106GJ, an increase of 15.69% on last year’s figure of 95,175GJ. This equates to a primary energy consumption of 159,594GJ, an increase of 19.96% on last year’s figure of 133,044GJ.

2.2 The overall Trust PI is 70.3 GJ/100m3, an increase of 15.6% on last year’s figure of 60.79 GJ/100m3. This is due to increased energy usage at Prince Charles Hospital, which has reported an increase in consumption of almost 27%. Other sites are all within the PI target.

2.3 The key to improving performance is control of consumption at Prince Charles Hospital. However, there may be issues associated with the major projects currently being carried out at the site, which make it difficult to limit energy usage close to its previous level.

2.4 Taking the above issues into account the Trust should aim to achieve a reduction in primary energy consumption of 3% for the year.

Hospital Net Hospital Energy Change on Heated Volume Site PI Consumption Previous Year

(GJ) (%) (m3) (GJ/100m3) Aberdare General 17,766 2.79 27,600 64.37 Mountain Ash General 4,932 -5.97 8,654 56.99 Prince Charles Hospital 68,991 26.78 87,900 78.49 St Tydfil's Hospital 18,417 1.05 32,400 56.84 Trust Totals 110,106 15.69 156,554 70.30

Figure 18: Individual hospital Energy PIs

3.0 Summary 3.1 The Trust has developed an estate strategy that, if implemented, will result in the modernisation or replacement of all of the Trust’s hospital estate. Given the scale and complexity of the work it is unlikely that either the interim or final targets will be achieved within the timescales set out in Welsh Health Circular (2002) 50. On completion of the works, however, all targets will be met and backlog maintenance costs virtually eradicated. 3.2 Notwithstanding the above, it is still disappointing that after three successive years that saw steady reductions in energy consumption, a large increase has been reported during 2002-03 at the Trust’s largest hospital, Prince Charles. The Trust should investigate the reasons for the rise in energy consumption and put measures in place to ensure that energy performance is improved and returned to the level achieved during 2001-02. 3.3 It is clear that to significantly improve the Trust’s performance will require a strategic response, as its estates issues cannot be addressed solely through better operational management. It is noted that the Trust is in discussion with the Welsh Assembly Government and other stakeholders over a number of issues affecting the implementation of its estate strategy.

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Summary of Trust Information

NORTH WEST WALES

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APPENDIX X

Trust Name: North West Wales NHS Trust

No of Returns: 13 Individual Hospital Sites Aggregate 1 – Freehold diagnostic & treatment centres, health centres. Aggregate 2 – Freehold, all other sites. Aggregate 3 – Leased and fully serviced by the NHS Trust Aggregate 4 – Leased and fully serviced by the Landlord. Aggregate 5 – Leased and part serviced by NHS Trust/Landlord.

1.0 Backlog maintenance

1.1 The Trust submitted its returns by the completion date of 30th June 2003. All applicable data fields were completed for the hospital sites within the Trust.

1.2 The backlog maintenance figure for the Trust has increased from £14,188,756 to £21,019,430, which equates to an increase of 48%. Ysbyty Gwynedd accounts for the largest backlog maintenance costs of the Trust and also the largest increase. The backlog maintenance costs for this hospital is currently estimated to be £15,630,480, which is an increase of £5,716,480 (58%), compared with 2001-02.

1.3 This is the first year for all of the Trust’s sites to be included in the returns. The data for the non-hospital sites has been aggregated into five groups: Aggregate 1, 2, 3, 4 and 5. It should be noted that no backlog maintenance costs were entered for Aggregate Group 4.

Location Physical S & S Fire Safety DDA Backlog Backlog Variation Condition Costs Costs Costs Maintenance Maintenance Costs Costs Costs 2002/03 2001/02

(£) (£) (£) (£) (£) (£) (£) Bron-y-garth Hospital 259,000 75,000 0 75,000 334,000 288,000 46,000 Bryn Beryl Hospital 138,000 37,000 0 36,140 175,000 249,000 -74,000 Brynseiont Hospital 784,000 50,000 37,000 50,000 871,000 871,000 0 Bryn-y-Neuadd Hospital 843,000 110,000 302,000 970,000 1,255,000 1,312,000 -57,000 Cefni Hospital 33,000 57,750 0 57,750 90,750 87,750 3,000 Dolgellau & Barmouth 19,400 30,000 0 30,000 49,400 58,000 -8,600 District Hospital Eryri Hospital 491,000 33,000 38,000 33,000 562,000 326,000 236,000 Ffestiniog Memorial 42,000 13,000 0 13,000 55,000 28,000 27,000 Llandudno General 218,000 211,385 63,000 134,385 492,385 804,000 -311,615 Minffordd Hospital 52,000 26,000 0 26,000 78,000 80,000 -2,000 Tywyn & District War 106,000 32,266 0 32,266 138,266 144,266 -6,000 Memorial Hospital Ysbyty Gwynedd 14,580,000 500,480 550,000 350,480 15,630,480 9,914,000 5,716,480 Ysbyty Penrhos Stanley 30,000 26,740 0 26,740 56,740 26,740 30,000 Aggregate 1 567,000 385,000 20,000 285,000 972,000 N/A 972,000 Aggregate 2 25,000 40,000 0 40,000 65,000 N/A 65,000 Aggregate 3 81,000 58,409 5,000 58,409 144,409 N/A 144,409 Aggregate 4 0 0 0 0 0 N/A 0 Aggregate 5 20,000 20,000 10,000 12,275 50,000 N/A 50,000 Totals 18,288,400 1,706,030 1,025,000 2,230,445 21,019,430 14,188,756 6,830,674

Figure 1: Backlog maintenance cost by site

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 113 APPENDIX X

1.4 Figures 2-7 graphically illustrate the Trust’s performance against the key all-Wales targets for the Essential estate.

Estimated Trust Conditions 2002-2003

Physical Condition Statutory & Safety Compliance Fire Safety Compliance

C & D C & D C & D 9% 52% 27%

A & B 48% A & B A & B 91% 73%

Figure 2 Figure 3 Figure 4

Energy Performance Functional Suitability Space Utilisation

C & D 26% Unacceptable Unacceptable 24% 53%

Acceptable 47% A & B Acceptable 74% 76%

Figure 5 Figure 6 Figure 7

Essential Building Area Essential Land Area

Non Essential 12% Non Essential 19%

Essential Essential 88% 81%

Figure 8 Figure 9

1.5 Figures 8 and 9 illustrate the amount of Essential building area and land the Trust has in its ownership.

1.6 Figures 10-17 graphically compare North West Wales PIs (based on Essential estate) with the other Trusts in Wales.

114 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 APPENDIX X

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FigureFigure 10: 10- Physical- Physical ConditionCondition (Categories (Categories A & A B &%) B %)

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FigureFigure 11: - 11- Statutory Statutory & & Safety Compliance Compliance (Categories (Categories A & BA %) & B %)

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Fire Safety Compliance (Essential) All Wales Average

FigureFigure 12: 12 - -Fire Fire SafetySafety Compliance Compliance / Trust / Trust

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 115 APPENDIX X

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Functional Suitability (A + B) All Wales Target (2005) FigureFigure 13: 13 - FunctionalFunctional Suitability Suitability / Trust / Trust

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Space Utilisation (Fully Used) All Wales Target (2005)

FigureFigure 14: 14 -- Space Space Utilisation Utilisation / Trust / Trust

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Essential Buildings - % All Wales Average

Figure 15: - Essential Buildings / Trust

116 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 APPENDIX X

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Essential Land - % All Wales Average FigureFigure 16: 16 - - EssentialEssential LandLand / Trust/ Trust

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Figure 17: - Estatecode ‘B’ Energy Performance

2.0 Energy performance

2.1 In 2002-03 hospitals in the Trust recorded a net energy consumption of 201,183GJ, an increase of 12.3% on last year’s figure of 179,210GJ. This equates to a primary energy consumption of 283,489GJ, a rise of 11.3% on last year’s total of 254,723GJ.

2.2 The overall Trust PI is 61.02 GJ/100m3, which is within the target of 55-65 GJ/100m3. The PI has increased by 4.6% from last year’s figure of 58.34 GJ/100m3; the Trust’s heated volume has increased by 7.3%. An examination of individual site PIs shows that, whilst the overall Trust PI is good, some sites are above the target. This suggests that there is further scope for energy reductions at these sites.

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 117 APPENDIX X

2.3 The rise in consumption is mainly accounted for by the increase of 17,582GJ at Ysbyty Gwynedd. Heated volume at the site has increased by 15% with a comparable rise in energy consumption. Energy efficiency at this hospital is key to the overall performance of the Trust. As the PI for the site is good the scope for improvement may be limited.

2.4 Following consultation with the Trust earlier this year, a target reduction in primary energy consumption of 3% was agreed for the year.

Hospital Net Hospital Energy Change on Heated Volume Site PI Consumption Previous Year

(GJ) (%) (m3) (GJ/100m3) Bron y Garth 3,405.00 -2.41 5,471 62.24 Bryn Beryl 3,131.00 -2.94 5,697 54.96 Bryn Seiont 4,326.00 8.45 5,098 84.86 Bryn y Neuadd 31,739.00 6.56 60,901 52.12 Cefni 4,295.00 7.40 7,065 60.79 Dolgellau 3,982.00 1.35 5,672 70.20 Eryri 6,244.00 -1.08 11,902 52.46 Ffestiniog 1,961.00 41.28 2,403 81.61 Llandudno 16,767.00 3.87 29,470 56.90 Minffordd 2,141.00 -5.14 2,819 75.95 Tywyn 3,503.00 5.61 5,033 69.60 Ysbyty Gwynedd * 111,723.37 18.68 175,967 63.49 Ysbyty Penrhos 7,966.00 10.12 12,193 65.33 Trust Totals 201,183.37 12.26 329,691 61.02

Figure 18: Individual hospital energy PIs * Site with CHP installed

3.0 Summary

3.1 This year’s data shows some deterioration in performance, indicating the possibility that the Trust may have difficulty meeting all of the interim 2005 estate performance targets.

3.2 Of particular concern are the PIs for physical condition and functional suitability, and the substantial increase in backlog maintenance costs, particularly at the Trust’s largest hospital site, Ysbyty Gwynedd. It is assumed that this is due, in the main, to more accurate measurement and as we move into the third year of the EFPMS it is hoped that such adjustments will not be as significant in future years.

3.3 It is also noted that the Trust has increased its energy consumption and the PI has risen. Whilst the overall PI is still within the target range of 55-65GJ/100m3, individual hospital PIs suggests that further improvements can be made at several sites.

3.4 To improve the Trust’s performance will require a strategic response, as its estate issues, particularly at Ysbyty Gwynedd, cannot be addressed solely through better operational management. The Trust does however have a large asset portfolio of smaller hospitals and careful planning and targeting of the Trust’s resources, including its discretionary capital will be needed to help improve the Trust’s overall estate performance.

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Summary of Trust Information

PEMBROKESHIRE AND DERWEN

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APPENDIX XI

Trust Name: Pembrokeshire and Derwen NHS Trust

No of Returns: 5 Individual hospital sites Aggregate 1 – Freehold diagnostic & treatment centres, health centres. Aggregate 3 – Leased and fully serviced by the NHS Trust

1.0 Backlog maintenance

1.1 The Trust did not submit its returns by the completion date of 30th June 2003 and requested additional time to input the data.

Data fields relating to Transport Services, Security Services, Portering Services and Postal Services were not completed in full.

1.2 The backlog maintenance figure for the Trust has reduced from £18,808,744 to £18,285,523. All hospital sites within the Trust, with the exception of South Pembrokeshire (+£294,000), have achieved reductions, with Withybush showing the largest at £3,569,744. Two of the hospitals, Tenby and St David’s, are scheduled to close. The estimated backlog maintenance figure for these hospitals is £388,000 and £8,620,000 respectively.

1.3 This is the first year for all of the Trust’s sites to be included in the returns. The data for the non-hospital sites has been aggregated into two groups: Aggregate 1 and 3.

Location Physical S & S Fire Safety DDA Backlog Backlog Variation Condition Costs Costs Costs Maintenance Maintenance Costs Costs Costs 2002/03 2001/02

(£) (£) (£) (£) (£) (£) (£) Bro Cerwyn & St 125,000 68,000 48,000 125,000 241,000 463,000 -222,000 Brynach Day Hospitals South Pembrokeshire 1,340,000 200,000 30,000 1,000,000 1,570,000 1,276,000 294,000 Hospital St David's Hospital 7,200,000 1,200,000 220,000 1,500,000 8,620,000 10,120,000 -1,500,000 (Carmarthen) Tenby Cottage 250,000 100,000 38,000 500,000 388,000 650,000 -262,000 Hospital Withybush General 1,400,000 1,200,000 130,000 4,100,000 2,730,000 6,299,744 -3,569,744 Aggregate 1 2,850,000 869,000 250,000 1,250,000 3,969,000 N/A 3,969,000 Aggregate 3 621,648 97,875 48,000 185,000 767,523 N/A 767,523 Trust Totals 13,786,648 3,734,875 764,000 8,660,000 18,285,523 18,808,744 -523,221

Figure 1: Backlog maintenance cost by site

1.4 Figures 2-7 graphically illustrate the Trust’s performance against the key all-Wales targets for the Essential estate.

1.5 Figures 8 and 9 illustrate the amount of Essential building area and land the Trust has in its ownership.

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 121 APPENDIX XI

1.4 Figures 2-7 graphically illustrate the Trust’s performance against the key all-Wales targets for the Essential estate.

1.5 Figures 8 and 9 illustrate the amount of Essential building area and land the Trust has in its ownership.

Estimated Trust Conditions 2002-2003

Physical Condition Statutory & Safety Compliance Fire Safety Compliance

C& D C & D C & D 26% 14% 13%

A & B A & B A & B 87% 74% 86%

Figure 2 Figure 3 Figure 4

Energy Performance Functional Suitability Space Utilisation

C& D Unacceptable Unacceptable 35% 47% 37%

Acceptable Acceptable 65% A & B 63% 53%

Figure 5 Figure 6 Figure 7

Essential Building Area Essential Land Area

Non Essential Non 29% Essential 49%

Essential Essential 71% 51%

Figure 8 Figure 9

1.6 Figures 10-17 graphically compare Pembrokeshire & Derwen PIs (based on Essential estate) with the other Trusts in Wales.

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Statutory Safety Compliance (Essential) All Wales Target (2005)

FigureFigure 11: - 11- Statutory Statutory & & Safety ComplianceCompliance (Categories (Categories A & BA %) & B %)

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Fire Safety Compliance (Essential) All Wales Average

FigureFigure 12: 12 - -Fire Fire SafetySafety Compliance Compliance / Trust / Trust

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Functional Suitability (A + B) All Wales Target (2005)

FigureFigure 13: 13 -- Functional Functional Suitability Suitability / Trust / Trust

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Space Utilisation (Fully Used) All Wales Target (2005)

FigureFigure 14:14 - -Space Space Utilisation Utilisation / Trust / Trust

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Essential Buildings - % All Wales Average

FigureFigure 15:15 - -Essential Essential Buildings Buildings / Trust / Trust

124 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 APPENDIX XI

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% of Estate in condition 'B' or above All Wales Average

Figure 17: - Estatecode ‘B’ Energy Performance

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 125 APPENDIX XI

2.0 Energy performance

2.1 In 2002-03 hospitals in the Trust recorded a net energy consumption of 101,868GJ, an increase of 2.4% on last year’s figure of 99,463GJ. This equates to a primary energy consumption of 138,188GJ, an increase of 8.7% on last year’s figure of 127,000GJ. This is indicative of the reduced use of CHP at the Trust’s main site — Withybush Hospital.

2.2 The overall Trust PI is 61.96 GJ/100m3, which is within the target of 55-65 GJ/100m3. Individual hospital PIs show that all the sites, with the exception of Tenby Hospital, have PIs within the target range or below its lower limit.

2.3 Following consultation with the Trust earlier this year, a target reduction in primary energy consumption of 5% was agreed for the year. This takes into account the above factors and may be dependent on the resolution of problems being experienced with the CHP at Withybush.

Hospital Net Hospital Energy Change on Heated Volume Site PI Consumption Previous Year

(GJ) (%) (m3) (GJ/100m3) Bro Cerwyn 1,197.00 19.50 3,460 34.60 South Pembrokeshire 5,294.00 9.30 10,806 48.99 St David's Hospital 44,408.00 4.00 72,100 61.59 Tenby Cottage Hospital 1,512.00 0.00 2,052 73.68 Withybush * 49,457.14 7.90 76,001 65.07 Trust Totals 101,868.14 2.42 164,419 61.96

Figure 18: Individual hospital energy PIs * Site with CHP installed

3.0 Summary 3.1 This year’s data indicates a very similar position to that previously reported and where improvements have been recorded, such as in the reduction in backlog maintenance costs, these have tended to be due to more accurate measurement rather than better performance. 3.2 The disposal of St. David’s and Tenby Hospitals will lead to a substantial decrease in backlog maintenance costs and their purpose built replacements should help the Trust improve its overall estate performance. 3.3 As stated last year whilst the interim targets for 2004 may be achievable, the Trust should not underestimate the investment required now in order to meet the more challenging final targets set for 2008. 3.4 To make substantive progress toward the final estate performance targets will require a strategic and operational response particularly in respect of Withybush General Hospital. This will require careful planning and targeting of resources to integrate the strategic service aspirations of the Trust with the operational management of the existing estate.

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Summary of Trust Information

PONTYPRIDD AND RHONDDA

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APPENDIX XII

Trust Name: Pontypridd and Rhondda NHS Trust

No of Returns: 7 Individual hospital sites Aggregate 1 – Freehold diagnostic & treatment centres, health centres. Aggregate 5 – Leased and part serviced by NHS Trust/Landlord.

1.0 Backlog maintenance

1.1 The Trust submitted its returns by the completion date of 30th June 2003. All applicable data fields were completed for the sites within the Trust.

1.2 The backlog maintenance figure for the Trust has increased from £4,428,000 to £4,883,132, which equates to an increase of 10%. East Glamorgan Mental Health Unit, Llwynypia and Tonteg Hospitals are part of the residual estate and are scheduled to close. The backlog maintenance costs for these hospitals is currently estimated to be £4,361,078, which is 89% of the Trust total.

1.3 This is the first year for all the Trust’s sites to be included in the returns. The data for the non-hospital sites has been aggregated into two groups: Aggregate 1 and 5. It should be noted that no backlog maintenance costs were entered for Aggregate Group 5.

Location Physical S & S Fire Safety DDA Backlog Backlog Variation Condition Costs Costs Costs Maintenance Maintenance Costs Costs Costs 1.4 2002/03 2001/02

(£) (£) (£) (£) (£) (£) (£) Dewi Sant Hospital 201,500 200,500 10,000 0 412,000 110,000 302,000 East Glamorgan MHU 1,204,000 253,000 138,000 0 1,595,000 1,250,000 345,000 Llwynypia Hospital 2,416,818 122,260 125,000 0 2,664,078 2,532,000 132,078 Pontypridd & District 15,952 15,952 0 0 31,904 240,000 -208,096 Royal Glamorgan 0 0 0 0 0 0 0 Tonteg Hospital 51,000 6,000 45,000 0 102,000 296,000 -194,000 Ysbyty George 26,400 26,400 0 0 52,800 0 52,800 Thomas Aggregate 1 0 25,350 0 0 25,350 N/A 25,350 Aggregate 5 0 0 0 0 0 N/A 0 Trust Totals 3,915,670 649,462 318,000 0 4,883,132 4,428,000 455,132

Figure 1: Backlog maintenance cost by site 1.4 Figures 2-7 graphically illustrate the Trust’s performance against the key all-Wales targets for the Essential estate.

1.5 Figure 8 shows the Essential building area of the Trust. It can be seen from the pie chart that the Essential building area is currently estimated to be 75%. However, it is estimated that when East Glamorgan Mental Health Unit, Llywnypia and Tonteg are disposed of, the Essential building area will increase to 99%.

1.6 Figure 9 shows the Essential land area of the Trust. It can be seen from the pie chart that the Essential land area is currently estimated to be 68%. However, it is estimated that when East Glamorgan Mental Health Unit, Llywnypia and Tonteg are disposed of, the Essential land area will increase to 96%.

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Estimated Trust Conditions 2002-2003

Physical Condition Statutory & Safety Compliance Fire Safety Compliance

C & D 5% C & D C & D 10% 0%

A & B A & B A & B 90% 100% 95%

Figure 2 Figure 3 Figure 4

Energy Performance Functional Suitability Space Utilisation

Unacceptable C & D Unacceptable 2% 5% 3%

Acceptable A & B Acceptable 97% 98% 95%

Figure 5 Figure 6 Figure 7

Essential Building Area Essential Land Area

Non Essential Non Essential 24% 31%

Essential 76% Essential 69%

Figure 8 Figure 9

1.7 Figures 10-17 opposite, graphically compare Pontypridd & Rhondda PIs, (based on Essential estate) with the other Trusts in Wales.

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FigureFigure 11: - 11-Statutory Statutory & & SafetySafety ComplianceCompliance (Categories (Categories A & BA %)& B %)

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Fire Safety Compliance (Essential) All Wales Average

FigureFigure 12: 12- -Fire Fire Safety Safety ComplianceCompliance / Trust / Trust

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Functional Suitability (A + B) All Wales Target (2005) FigureFigure 13: 13 - FunctionalFunctional Suitability Suitability / Trust / Trust

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Space Utilisation (Fully Used) All Wales Target (2005) FigureFigure 14: 14 -- Space Space Utilisation Utilisation / Trust / Trust

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Essential Buildings - % All Wales Average Figure 15: - Essential Buildings / Trust

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FigureFigure 16: 16 - EssentialEssential Land Land / Trust / Trust

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Figure 17: - Estatecode ‘B’ Energy Performance

2.0 Energy performance

2.1 In 2002-03 hospitals in the Trust recorded a net energy consumption of 133,189GJ, an increase of 9.9% on last year’s figure of 121,155GJ. This equates to a primary energy consumption of 192,993GJ, an increase of less than 1% on last year’s figure of 191,871GJ. Increased CHP usage at the Royal Glamorgan has limited the rise in primary energy.

2.2 The Trust PI of 47.58GJ/100m3 is low and has dropped considerably since last year, the main reason for the improvement being the revised heated volume at the Royal Glamorgan.

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 133 APPENDIX XII

2.3 The Trust has improved its energy performance but slightly increased its primary energy consumption. The benefits of CHP at the Royal Glamorgan are beginning to show and it is believed that, as the sets are not yet working at optimum capacity, further reductions in primary consumption may be possible. The utility electricity at the Royal Glamorgan is supplied via a “green tariff” thus reducing considerably the Trust’s carbon emissions, which is one of the criteria set for the mandatory 2010 target.

2.4 Following consultation with the Trust earlier this year, a target reduction in primary energy consumption of at least 2% was agreed for the year.

Hospital Net Hospital Energy Change on Heated Volume Site PI Consumption Previous Year

(GJ) (%) (m3) (GJ/100m3) Dewi Sant 7,270.00 -0.40 24,395 29.80 East Glam MHU 10,810.00 2.32 21,000 51.48 Llywnypia 21,784.00 3.56 33,000 66.01 Pontypridd & District 4,452.00 25.80 6,300 70.67 Royal Glamorgan 80,280.57 12.71 161,276 49.78 Tonteg 1,241.00 581.87 5,000 24.82 Ysbyty George Thomas 7,351.00 0.63 12,700 57.88 Trust Totals 133,188.57 9.93 279,907 47.58

Figure 18: - Individual hospital energy Pls

3.0 Summary

3.1 Strategic asset investment over many years has put the Trust in a very strong position to maintain its excellent estate performance. Not only does the Trust have the most modern district general hospital in Wales, the Royal Glamorgan, but also once the new psychiatric unit and second Rhondda Community hospital are completed the Trust will have the most modern hospital portfolio of any Welsh Trust.

3.2 All of the estate’s PIs are excellent although energy performance is worth highlighting. The overall energy PI has improved and is well below the lower limit of the target range, although it should be noted that this is due mainly to a 40% increase in the Trust’s heated volume, rather than improved performance. However, of particular importance is the Trust’s use of “green” electricity at the Royal Glamorgan Hospital that has enabled it to meet the national 2010 target for carbon emissions.

3.3 The challenge facing the Trust will be to maintain this performance and to ensure that backlog maintenance costs, particularly in its new estate are controlled. The Trust will need to focus on more local, operational issues affecting the existing estate. This will need careful planning and targeting of the Trust’s resources, including its discretionary capital.

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Summary of Trust Information

POWYS LOCAL HEALTH BOARD

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APPENDIX XIII

Trust Name: Powys Health Care NHS Trust

No of Returns: 10 Individual hospital sites Aggregate 1 – Freehold diagnostic & treatment centres, health centres.

1.0 Backlog maintenance

1.1 The Local Health Board (LHB) submitted its returns by the completion date of 30th June 2003.

Data fields relating to Water Services, Security Services, Portering Services and Postal Services were not completed in full.

1.2 The backlog maintenance figure for the LHB has increased from £7,151,500 to £15,808,144, which equates to an increase of 121%. All hospital sites have shown increases.

Bronllys Hospital accounts for 32% of the LHB’s backlog maintenance, and the costs are currently estimated to be £5,042,000.

Bronllys Hospital also had the largest increase in backlog maintenance costs of £2,454,500.

1.3 The trend in increased backlog maintenance costs with this LHB is a cause for concern. In 2000–01 the backlog maintenance costs were estimated to be £3,412,000 they now stand at £15,808,144 (+363%). The reason for this escalation in backlog maintenance costs needs to be discussed at the next Annual Strategic Review meeting.

1.4 This is the first year for all of the LHB’s sites to be included in the returns. The data for the non-hospital sites has been aggregated into one group: Aggregate 1.

Location Physical S & S Fire Safety DDA Backlog Backlog Variation Condition Costs Costs Costs Maintenance Maintenance Costs Costs Costs 2002/03 2001/02 (£) (£) (£) (£) (£) (£) (£) Brecon War Memorial 816,000 379,000 159,000 71,000 1,354,000 617,000 737,000 Broddyfi Community 677,000 275,000 143,000 43,000 1,095,000 462,000 633,000 Bronllys Hospital 3,798,000 1,144,000 100,000 80,000 5,042,000 2,587,500 2,454,500 Builth Wells Cottage 475,000 180,000 124,000 37,000 779,000 465,000 314,000 Knighton Hospital 415,000 144 23,000 33,000 438,144 404,000 34,144 Llandrindod Wells 967,000 419,000 206,000 142,000 1,592,000 1,015,000 577,000 Llanidloes & District 430,000 399,000 105,000 36,000 934,000 458,000 476,000 Montgomery County 677,000 333,000 25,000 56,000 1,035,000 433,000 602,000 Victoria Memorial 766,000 154,000 0 0 920,000 0 920,000 Ystradgynlais 766,000 116,000 100,000 31,000 982,000 710,000 272,000 Aggregate 1 1,122,000 115,000 400,000. 142,000 1,637,000 N/A 1,637,000 Trust Totals 10,909,000 3,514,144 1,385,000 671,000 15,808,144 7,151,500 8,656,644

Figure 1: Backlog maintenance costs by site

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1.5 Figures 2-7 graphically illustrate the LHB’s performance against the key all-Wales targets for the Essential estate.

1.6 Figures 8 and 9 illustrate the amount of Essential building area and land the LHB has in its ownership.

Estimated Trust Conditions 2002-2003

Physical Condition Statutory & Safety Compliance Fire Safety Compliance

A & B A & B A & B 40% 41% 50%

C & D C & D C & D 50% 59% 60%

Figure 2 Figure 3 Figure 4

Energy Performance Functional Suitability Space Utilisation

C & D Unacceptable Unacceptable 23% 19% 43%

Acceptable A & B 81% Acceptable 77% 57%

Figure 5 Figure 6 Figure 7

Essential Building Area Essential Land Area

Non Essential 3% Non Essential 17%

Essential Essential 83% 97%

Figure 8 Figure 9

1.7 Figures 10-17 graphically compare Powys LHB PIs (based on Essential estate) with the other Trusts in Wales.

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Physical Condition A + B (%) All Wales Target (2005) FigureFigure 10: - 10 Physical - Physical Condition Condition (Categories A A& B& %) B %)

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Fire Safety Compliance (Essential) All Wales Average

FigureFigure 12: -12 Fire - Fire Safety Safety ComplianceCompliance / Trust/ Trust

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Functional Suitability (A + B) All Wales Target (2005)

FigureFigure 13: 13 - - FunctionalFunctional Suitability Suitability / Trust / Trust

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Space Utilisation (Fully Used) All Wales Target (2005)

FigureFigure 14: 14 -- Space UtilisationUtilisation / Trust / Trust

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Essential Buildings - % All Wales Average FigureFigure 15: 15 - - EssentialEssential Buildings Buildings / Trust / Trust

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Essential Land - % All Wales Average FigureFigure 16: 16 -- EssentialEssential Land Land / Trust / Trust

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% of Estate in condition 'B' or above All Wales Average

Figure 17: - Estatecode ‘B’ Energy Performance

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 141 APPENDIX XIII

2.0 Energy performance

2.1 In 2002-03 hospitals in this LHB recorded a net energy consumption of 74,202GJ, a reduction of 2.7% on last year’s figure of 762,23GJ. This equates to a primary energy consumption of 96,814GJ, a reduction of 2% on last year’s figure of 98,803GJ.

2.2 The overall PI is 51.1 GJ/100m3, which is well below the target of 55-65 GJ/100m3. Individual hospital PIs show that some sites, such as Ystradgynlais and Victoria Memorial are above the target suggesting there are opportunities for energy saving at these hospitals.

2.3 Following discussions with the LHB earlier this year, a target reduction in primary energy consumption of 5% was agreed for the year.

Hospital Net Hospital Energy Change on Heated Volume Site PI Consumption Previous Year

(GJ) (%) (m3) (GJ/100m3) Brecon War Memorial 8,498 -13.34 29,900 28.42 Broddyfi Community 6,824 10.62 12,300 55.48 Bronllys Hospital 20,536 -18.36 37,100 55.35 Builth Wells Cottage 3,235 6.10 4,600 70.33 Knighton Hospital 3,296 31.26 4,600 71.65 Llandrindod Wells 8,320 8.79 13,400 62.09 Llanidloes & District 3,751 -6.71 5,400 69.46 Montgomery County 5,427 23.17 8,500 63.85 Victoria Memorial 6,074 18.49 7,500 80.99 Ystradgynlais 8,241 -1.09 11,600 71.04 Trust Totals 74,202 -2.65 145,159 51.10

Figure 18: Individual hospital energy PIs

3.0 Summary

3.1 Given the variation of data between this and last years’ returns, it is recommended that the figures reported by the Trust be verified. Until there is confidence in the data no meaningful comment can be made in respect of the Trust’s estate performance.

3.2 Particular attention is drawn to the 121% increase in backlog maintenance costs, from nearly £7 million to just over £15.8 million, of which, the aggregated properties account for £1.64 million.

This is the second year where large increases in backlog maintenance costs have been reported. Since 2000-01 the costs have risen by a £12.40 million (365%). This is a worrying trend that needs to be investigated further with the Trust.

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Summary of Trust Information

SWANSEA

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APPENDIX XIV

Trust Name: Swansea NHS Trust

No of Returns: 8 Individual hospital sites Aggregate 1 – Freehold diagnostic & treatment centres, health centres. Aggregate 2 – Freehold, all other sites.

1.0 Backlog maintenance

1.1 The Trust submitted its returns by the completion date of 30th June 2003. Data fields relating to Clinical Waste, Security Services, Portering Services and Postal Services were not completed in full.

1.2 The backlog maintenance figure for the Trust has increased from £43,191,372 to £44,652,386, which equates to an increase of 3.3%. Three of the hospitals, Cefn Coed, Morriston and Singleton, account for £31,235,403 (86%) of the total backlog maintenance figure.

1.3 Of the individual hospital sites only two, Fairwood and Gorseinon have increased their backlog maintenance costs.

1.4 This is the first year for all of the Trust’s sites to be included in the returns. The data for the non-hospital sites has been aggregated into two groups: Aggregate 1 and 2. It is noted that the largest increase in the Trust’s backlog maintenance is associated with the Aggregated groups and this is estimated to be £3,952,383.

Location Physical S & S Fire Safety DDA Backlog Backlog Variation Condition Costs Costs Costs Maintenance Maintenance Costs Costs Costs 2002/03 2001/02 (£) (£) (£) (£) (£) (£) (£) Cefn Coed Hospital 6,517,495 4,065,292 163,805 500,000 10,746,592 11,415,300 -668,708 Fairwood Hospital 0 24,669 11,523 50,000 36,192 10,529 25,663 Garngoch Hospital 196,363 80,814 38,250 30,000 315,427 335,119 -19,692 Gellinudd Hospital 8,156 235 0 30,000 8,391 21,768 -13,377 Gorseinon Hospital 202,095 42,376 661,347 30,000 905,818 364,888 540,930 Hill House Hospital 1,029,628 71,073 64,532 100,000 1,165,233 1,213,665 -48,432 Morriston Hospital 13,321,211 3,280,647 479,377 250,000 17,081,235 18,328,836 -1,247,601 Singleton Hospital 5,117,605 4,917,936 405,574 250,000 10,441,115 11,501,267 -1,060,152 Aggregate 1 3,518,192 218,635 57,092 25,000 3,793,919 N/A 3,793,919 Aggregate 2 88,224 63,005 7,235 30,000 158,464 N/A 158,464 Trust Totals 29,998,969 12,764,682 1,888,735 1,295,000 44,652,386 43,191,372 1,461,014

Figure 1: Backlog maintenance costs by site

1.5 Clydach Hospital is no longer classified as a hospital and, as a consequence, an individual return for this site was not completed. This site is now grouped in Aggregate 1.

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 145 APPENDIX XIV

1.6 Figures 2-7 graphically illustrate the Trust’s performance against the key all-Wales targets for the Essential estate.

Estimated Trust Conditions 2002-2003

Physical Condition Statutory & Safety Compliance Fire Safety Compliance

C & D C & D 38% C & D 24% 20%

A & B A & B 62% 76% A & B 80%

Figure 2 Figure 3 Figure 4

Energy Performance Functional Suitability Space Utilisation

A & B Unacceptable 6% Unacceptable 29% 29%

Acceptable C & D 71% Acceptable 94% 71%

Figure 5 Figure 6 Figure 7

Essential Building Area Essential Land Area

Non Essential Non Essential 0% 0%

Essential Essential 100% 100%

Figure 8 Figure 9

1.7 Figures 8 and 9 illustrate the amount of Essential building area and land the Trust has in its ownership.

1.8 Figures 10-17 graphically compare Swansea PIs (based on Essential estate) with the other Trusts in Wales.

146 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 APPENDIX XIV

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Physical Condition A + B (%) All Wales Target (2005)

Figure 10:Figure - Physical 10 - Physical Condition Condition (Categories (CategoriesA&B%) A & B %)

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Statutory Safety Compliance (Essential) All Wales Target (2005)

Figure 11:Figure - Statutory 11- Statutory & Safety & Safety Compliance Compliance (Categories A A& B& %) B %)

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Fire Safety Compliance (Essential) All Wales Average

FigureFigure 12: - 12Fire - Fire Safety Safety Compliance Compliance / Trust Trust

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 147 APPENDIX XIV

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Space Utilisation (Fully Used) All Wales Target (2005)

FigureFigure 14: 14 -- Space Space Utilisation Utilisation / Trust / Trust

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Essential Buildings - % All Wales Average

Figure 15: - Essential Buildings / Trust

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Essential Land - % All Wales Average FigureFigure 16: 16 -- Essential Essential Land Land / Trust / Trust

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Figure 17: - Estatecode ‘B’ Energy Performance

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 149 APPENDIX XIV

2.0 Energy performance 2.1 In 2002-03 hospitals in the Trust recorded a net energy consumption of 343,142GJ, an increase of 14% on last year’s figure of 300,292GJ. This equates to a primary energy consumption of 505,118GJ, an increase of 10.4% on last year’s figure of 457,658GJ. 2.2 The overall Trust PI is 79.87GJ/100m3, which is considerably higher than the target of 55-65 GJ/100m3, only Gorseinon Hospital having a PI within the target range. The high PI and increased consumption indicate that there are opportunities for reductions to be made. Individual hospital PIs show that of the larger sites the worst performer is Morriston Hospital, with a PI approaching 90GJ/100m3 — a figure considerably higher than the target. This suggests that the focus of the Trust’s drive to reduce energy consumption and to improve its PI needs to be the Morriston Hospital site. 2.3 Following consultation with the Trust earlier this year, a target reduction in primary energy consumption of 1.81% was proposed by the Trust.

Hospital Net Hospital Energy Change on Heated Volume Site PI Consumption Previous Year

(GJ) (%) (m3) (GJ/100m3) Cefn Coed Hospital 52,812 57.19 71,333 74.04 Fairwood Hospital 1,629 48.50 1,651 98.67 Garngoch Hospital 2,808 -1.40 3,791 74.07 Gellinudd Hospital 1,530 -1.23 1,840 83.15 Gorseinon Hospital 5,688 16.03 9,277 61.31 Hill House Hospital 7,282 28.27 10,213 71.30 Morriston Hospital 157,061 4.56 174,736 89.88 Singleton Hospital 114,332 13.87 156,766 72.93 Trust Totals 343,142 14.33 429,607 79.87

Figure 18: Individual hospital energy PIs

3.0 Summary 3.1 This year’s data indicates a very similar overall position to that previously reported and where improvements have been recorded these have tended to be due to more accurate measurement rather than better performance. 3.2 The Trust has increased its energy consumption over the previous year and its overall PI has deteriorated. The poor PIs of individual sites suggest that, whilst there are opportunities for improvement across the Trust, priority should be given to improving energy performance at its largest sites, Morriston, Singleton and Cefn Coed hospitals. 3.3 Whilst the interim targets for 2005 may be achievable, the Trust should not underestimate the investment required now in order to meet the more challenging final targets set for 2008. 3.4 To make substantive progress toward the final estate performance targets will require both a strategic and operational response. This will require careful planning and targeting of resources to integrate the strategic service aspirations of the Trust with the operational management of the existing estate. In this context it is important that the Trust has a clear estate strategy and fully understands its effect on the key performance indicators.

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Summary of Trust Information

VELINDRE

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APPENDIX XV

Trust Name: Velindre NHS Trust

No of Returns: 1 Individual hospital sites Aggregate 1 – Freehold diagnostic & treatment centres, health centres. Aggregate 2 – Freehold, all other sites. Aggregate 5 – Leased and part serviced by NHS Trust/Landlord.

1.0 Backlog maintenance

1.1 The Trust submitted its returns by the completion date of 30th June 2003. Data fields relating to Transport Services were not completed in full.

1.2 The backlog maintenance figure for the Trust has increased from £3,855,000 to £3,9185,000, showing an increase of £63,545 equivalent to 1.6%. It can be seen from Figure 1, that backlog maintenance costs associated with Velindre Hospital have reduced by £198,425.

1.3 This is the first year for all of the Trust’s sites to be included in the returns. The data for the non-hospital sites has been aggregated into three groups: Aggregate 1, 2 and 3. Backlog maintenance for these groups accounts for £261,970 of the Trust’s total.

Location Physical S & S Fire Safety DDA Backlog Backlog Variation Condition Costs Costs Costs Maintenance Maintenance Costs Costs Costs 2002/03 2001/02

(£) (£) (£) (£) (£) (£) (£) Velindre Hospital 949,325 2,664,350 42,900 1,822,796 3,656,575 3,855,000 -198,425 Aggregate 1 11,440 12,000 5,000 357,520 28,440 N/A 28,440 Aggregate 2 20,000 10,000 5,000 1,275,476 35,000 N/A 35,000 Aggregate 5 78,530 80,000 40,000 752,627 198,530 N/A 198,530 Trust Totals 1,059,295 2,766,350 92,900 4,208,419 3,918,545 3,855,000 63,545

Figure 1: Backlog maintenance costs by site

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1.4 Figures 2-7 graphically illustrate the Trust’s performance against the key all-Wales targets for the Essential estate.

Estimated Trust Conditions 2002-2003

Physical Condition Statutory & Safety Compliance Fire Safety Compliance

C & D 0% C & D C & D 0% 0%

A & B A & B A & B 100% 100% 100%

Figure 2 Figure 3 Figure 4

Energy Performance Functional Suitability Space Utilisation

Unacceptable Unacceptable C & D 30% 0% 36%

Acceptable Acceptable A & B 64% 70% 100%

Figure 5 Figure 6 Figure 7

Essential Building Area Essential Land Area

Non

Non Essential Essential 3% 0%

Essential 97% Essential 100%

Figure 8 Figure 9

1.5 Figures 8 and 9 illustrate the amount of Essential building area and land the Trust has in its ownership.

1.6 Figures 10-17 graphically compare Velindre PIs (based on Essential estate) with the other Trusts in Wales.

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Fire Safety Compliance (Essential) All Wales Average FigureFigure 12: 12 -- FireFire Safety Safety Compliance Compliance / Trust / Trust

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Functional Suitability (A + B) All Wales Target (2005) FigureFigure 13: 13 -- FunctionalFunctional Suitability Suitability / Trust / Trust

100

80

60 (%) 40

20

0 ansea North Velindre Wales Gwent Wales Sw North East Healthcare Rhondda Glamorgan Conwy & North West ontypridd & Powys LHB Mid-Wales & Derwen P Ceredigion & Denbighshire o Morgannwg Cardiff & Vale Pembrokeshire Br Carmarthenshire

Space Utilisation (Fully Used) All Wales Target (2005) FigureFigure 14: 14 - SpaceSpace Utilisation Utilisation / Trust / Trust

100

80

60 (%) 40

20

0 ansea North Velindre Wales Gwent Wales Sw North East Healthcare Rhondda Conwy & Glamorgan North West ontypridd & Powys LHB Mid-Wales & Derwen P Ceredigion & Denbighshire o Morgannwg Cardiff & Vale Pembrokeshire Br Carmarthenshire

Essential Buildings - % All Wales Average

Figure 15: - Essential Buildings / Trust

156 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 APPENDIX XV

100

80

60 (%) 40

20

0 ansea North Velindre Wales Gwent Wales Sw North East Healthcare Rhondda Conwy & Glamorgan North West ontypridd & Powys LHB Mid-Wales & Derwen P Ceredigion & Denbighshire o Morgannwg Cardiff & Vale Pembrokeshire Br Carmarthenshire

Essential Land - % All Wales Average FigureFigure 16: 16 -- Essential Essential Land Land / Trust / Trust

100

80

60 (%) 40

20

0 ansea North Velindre Wales Gwent Wales Sw North East Healthcare Rhondda Glamorgan Conwy & North West ontypridd & Powys LHB Mid-Wales & Derwen P Ceredigion & Denbighshire o Morgannwg Cardiff & Vale Pembrokeshire Br Carmarthenshire

% of Estate in condition 'B' or above All Wales Average

Figure 17: - Estatecode ‘B’ Energy Performance

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 157 APPENDIX XV

2.0 Energy performance

2.1 The Velindre Trust has only one main hospital site. In 2002-03 this hospital recorded a net energy consumption of 20,216GJ, an increase of 15% on last year’s figure of 17,579GJ. This includes electricity supplied as local energy from Whitchurch Hospital. The equivalent primary energy consumption is estimated to be 35,434GJ, a rise of 17.6% on last year’s figure of 30,119GJ.

2.2 The overall Trust PI is 60.16GJ/100m3, which is within the target range of 55-65GJ/100m3. The PI would appear to suggest a reasonable but deteriorating energy performance. But as the reliability of historical data is questionable no firm conclusions can be drawn.

2.3 Following consultation with the Trust earlier this year, a target reduction in primary energy consumption of 4% was agreed for the year.

Hospital Net Hospital Energy Change on Heated Volume Site PI Consumption Previous Year

(GJ) (%) (m3) (GJ/100m3) Velindre 20,216 15.00 33,597 60.16

Trust Totals 20,216 15.00 33,597 60.16 Figure 18: Individual hospital energy PI 3.0 Summary

3.1 Overall the Trust appears to be making good progress in meeting the targets set out in the Welsh Health Circular (2002) 50 Introduction of an Estates Performance Management System.

3.2 The Trust’s performance with respect to physical condition, statutory and safety, and fire safety compliance is excellent and this year’s reduction in backlog maintenance is encouraging.

3.3 The Trust will need to focus particularly on improving performance in respect of functional suitability and space utilisation. Whilst the interim targets set for 2005 may be achievable, the Trust should not underestimate the investment required now in order to meet the more challenging final targets set for 2008.

3.2 The returns show a good overall energy PI, but also an increase in consumption. However, the doubt over last year’s data precludes the possibility of making meaningful comparisons.

158 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 APPENDIX XVI

Details of Residual and Surplus Hospital Sites

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 159

APPENDIX XVI

Residual Estate

Hospital Physical Cost to Statutory & Fire Safety Backlog Date of 'B' Safety Cost to 'B' Cost to 'B' Maintenance Closure Cost (£) (£) (£) (£)

Abergele Hospital 1,330,685.00 48,000.00 47,000.00 1,425,685.00 Brynseiont Hospital 78,400.00 50,000.00 37,000.00 165,400.00 Bryntirion Hospital 1,548,914.00 174,375.00 114,691.00 1,837,980.00 July 2004 *Bryn-y-Neuadd Hospital 843,000.00 110,000.00 302,000.00 1,255,000.00 Cardiff Royal Infirmary 10,531,000.00 30,746,700.00 0.00 41,277,700.00 Conwy Hospital 890,000.00 79,000.00 50,000.00 1,019,000.00 End 2003 CRI - West Wing 2,007,000.00 181,000.00 0.00 2,188,000.00 Dobshill Hospital 2,856,000.00 368,000.00 0.00 3,224,000.00 End 2004 Ebbw Vale Hospital 1,000,000.00 140,000.00 50,000.00 1,190,000.00 Hensol Hospital 3,783,500.00 1,381,150.00 5,750.00 5,170,400.00 March 2004 Gwynfryn Unit 289,000.00 32,500.00 50,000.00 371,500.00 2003 Lansdowne Hospital 0.00 0.00 0.00 0.00 Closed * Llanfrechfa Grange Hospital 1,900,000.00 230,000.00 130,000.00 2,260,000.00 Lluesty Hospital 5,250,000.00 63,000.00 263,000.00 5,576,000.00 Meadowslea Hospital 3,150,000.00 63,000.00 21,000.00 3,234,000.00 End 2004 Penley Hospital 2,100,000.00 105,000.00 53,000.00 2,258,000.00 Closed * St Cadoc's Hospital 500,000.00 53,000.00 100,000.00 653,000.00 St David's Hospital 0.00 July 2004 Trevalyn Hospital 2,100,000.00 53.00 0.00 2,100,053.00 End 2004 Sub Total 40,157,499.00 33,824,778.00 1,223,441.00 75,205,718.00

Surplus Trust Property

Hospital Physical Cost to Statutory & Fire Safety Backlog Date of 'B' Safety Cost to 'B' Cost to 'B' Maintenance Closure (£) (£) (£) Cost (£)

Aberaeron Hospital 100,000.00 40,000.00 10,000.00 150,000.00 East Glamorgan MHU 1,204,000.00 253,000.00 138,000.00 1,595,000.00 Early 2004 H M Stanley Hospital 1,789,598.00 19,000.00 10,000.00 1,818,598.00 Mynydd Mawr Hospital 1,038,911.00 141,281.00 143,685.00 1,323,877.00 Royal Hamadryad Hospital 2,107,000.00 580,200.00 0.00 2,687,200.00 Sully Hospital 5,253,000.00 3,555,204.00 0.00 8,808,204.00 Closed Sub Total 11,492,509.00 4,588,685.00 301,685.00 16,382,879.00

Totals 51,650,008.00 38,413,463.00 1,525,126.00 91,588,597.00

* Part of these hospital sites are owned by the Trust.

Bryn-y-Neaudd residual is closed.

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 161

APPENDIX XVII

Performance Indicators and Targets

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 163

APPENDIX XVII

100

90

80

70

60

50 (%) 40

30

20

10

0 ansea Velindre Sw Rhondda Conwy & Powys LHB Wales Derwen Pontypridd & Denbighshire o Morgannwg Cardiff & Vale Br Carmarthenshire Pembrokeshire & North Glamorgan North East Wales Gwent Healthcare Ceredigion & Mid- North West Wales

Physical Condition A + B (%) All Wales Target (2005)

Physical Conditions Categories A & B %

100

90

80

70

60

50 (%) 40

30

20

10

0 ansea Velindre Sw Rhondda Conwy & ontypridd & Powys LHB Wales Derwen P Denbighshire o Morgannwg Cardiff & Vale Br Carmarthenshire Pembrokeshire & North Glamorgan North East Wales Gwent Healthcare Ceredigion & Mid- North West Wales

Statutory Safety Compliance (Essential) All Wales Target (2005)

Statutory & Safety Compliance (Categories A & B %)

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 165 APPENDIX XVII

100

90

80

70

60

50 (%) 40

30

20

10

0 ansea Velindre Sw Rhondda Conwy & ontypridd & Powys LHB Wales Derwen P Denbighshire o Morgannwg Cardiff & Vale Br Carmarthenshire Pembrokeshire & North Glamorgan North East Wales Gwent Healthcare Ceredigion & Mid- North West Wales

Fire Safety Compliance (Essential) All Wales Average

Fire Safety Compliance / Trust

100

90

80

70

60

50 (%) 40

30

20

10

0 ansea Velindre Sw Rhondda Conwy & ontypridd & Powys LHB Wales Derwen P Denbighshire o Morgannwg Cardiff & Vale Br Carmarthenshire Pembrokeshire & North Glamorgan North East Wales Gwent Healthcare Ceredigion & Mid- North West Wales

Functional Suitability (A + B) All Wales Target (2005)

Functional Suitability / Trust

166 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 APPENDIX XVII

100

90

80

70

60

50 (%) 40

30

20

10

0 ansea Velindre Sw Rhondda Conwy & ontypridd & Powys LHB Wales Derwen P Denbighshire Cardiff & Vale ro Morgannwg mbrokeshire & B Carmarthenshire Pe North Glamorgan North East Wales Gwent Healthcare Ceredigion & Mid- North West Wales

Space Utilisation (Fully Used) All Wales Target (2005)

Space Utilisation / Trust

100

90

80

70

60

50 (%) 40

30

20

10

0 ansea Velindre Sw Rhondda Conwy & ontypridd & Powys LHB Wales Derwen P Denbighshire Cardiff & Vale ro Morgannwg mbrokeshire & B Carmarthenshire Pe North Glamorgan North East Wales Gwent Healthcare Ceredigion & Mid- North West Wales

% of Estate in condition 'B' or above All Wales Target (2005)

Estatecode ‘B’ Energy Performance

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 167

APPENDIX XVIII

Comparison of Key Performance Indicators (between NHS Trusts in Wales and NHS Trusts in England) by Trust Type

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 169

APPENDIX XVIII

Physical condition (A & B)

100%

90%

80%

70%

60%

50% (%)

40%

30%

20%

10%

0% RVJ RTF RXP RXC RWY rust rust rust rust T T T T NHS Trust NHS Trust ro Morgannwg NHS Swansea NHS Trust B ontypridd & Rhondda P Conwy & Denbighshire North East Wales NHS Gwent Healthcare NHS North West Wales NHS

LargeLarge Multi Multi Service Service Trust Trust

100%

90%

80%

70%

60%

50% (%)

40%

30%

20%

10%

0% RA7 RR8 RFK RQ6 RTH RTD RM3 RXN RCS RM2 RRK RGT RHQ RHM RW3 RWE Trust Cardiff & Vale NHS

Acute Teaching Trust (Outside London)

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 171 APPENDIX XVIII

100%

90%

80%

70%

60%

50% (%) 40%

30%

20%

10%

0% RAJ RLZ RJR RJN RPL RA2 RK5 RN3 RN7 RTP RC9 RN1 RFS RD7 RNL RD3 RD1 RTK RN5 RBK RVY RBA RPA RDZ RFR RNZ RQ8 RCB RNS RDE RNA RBN RDD RGP RDU REM RMB RMP RGQ RVW RQW RWW Carmarthenshire NHS Trust

Medium Acute Trust Medium Acute Trust

100%

90%

80%

70%

60%

50% (%)

40%

30%

20%

10%

0% RA4 RA3 RE9 RR2 RCD Ceredigion & Mid Wales NHS Trust

Small Multi-Service Trust Small Multi-Service Trust

172 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 APPENDIX XVIII

100%

90%

80%

70%

60%

50% (%)

40%

30%

20%

10%

0% RA9 RR7 RH2 RAS RCF REU RCB RM4 RCC RWJ RMC NHS Trust mbrokeshire & North Glamorgan Pe Derwen NHS Trust

MediumMedium MultiMulti Service Service Trust Trust

100%

90%

80%

70%

60%

50% (%)

40%

30%

20%

10%

0% RT2 RV9 RK7 RP7 RDY RWV Powys LHB

MediumMedium CommunityCommunity Trust Trust

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 173 APPENDIX XVIII

100%

90%

80%

70%

60%

50% (%)

40%

30%

20%

10%

0% RT3 RP6 RET RLU REP RBV RBB RPY RPC REN RBQ RGM Velindre NHS Trust

SpSpecialistecialist Trust Trust

174 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 APPENDIX XVIII

Percentage of PATIENT occupied floor area in Statutory Health and Safety compliance (%)

100%

90%

80%

70%

60%

50% (%)

40%

30%

20%

10%

0% RVJ RTF RXP RXC RWY Trust Trust Conwy & NHS Trust NHS Trust NHS Trust ontypridd & P North East Wales Gwent Healthcare North West Wales Denbighshire NHS Rhondda NHS Trust Swansea NHS Trust Bro Morgannwg NHS

LargeLarge MultiMulti Service Service Trust Trust

100%

90%

80%

70%

60%

50% (%)

40%

30%

20%

10%

0% RFK RR8 RQ6 RTD RTH RCS RM2 RXN RM3 RRK RGT RHQ RHM RW3 RWE rust T Cardiff & Vale NHS

AcuteAcute TeachingTeaching TrustTrust (Outside (Outside London) London)

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 175 APPENDIX XVIII

100%

90%

80%

70%

60%

50% (%) 40%

30%

20%

10%

0% RAJ RA2 RPL RJN RK5 RJR RTK RD3 RTP RD7 RN1 RFS RN3 RN5 RN7 RNL RC9 RD1 RBA RPA RVY RBK RNZ RQ8 RDZ RFR RDE RNA RNS RBN RCB RGP RDD RDU RMP REM RMB RGQ RVW RQW RWW Carmarthenshire NHS Trust

Medium Acute Trust Medium Acute Trust

100%

90%

80%

70%

60%

50% (%)

40%

30%

20%

10%

0% RA3 RA4 RE9 RR2 RCD Ceredigion & Mid Wales NHS Trust

Small Multi-Service Trust

176 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 APPENDIX XVIII

100%

90%

80%

70%

60%

50% (%)

40%

30%

20%

10%

0% RA9 RR7 RH2 RAS RCF RCB REU RM4 RCC RWJ RMC NHS Trust North Glamorgan Pembrokeshire & Derwen NHS Trust

Medium Multi Service Trust Medium Multi Service Trust

100%

90%

80%

70%

60%

50% (%)

40%

30%

20%

10%

0% RT2 RK7 RV9 RP7 RDY RWV Powys LHB

Medium Community Trust Medium Community Trust

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 177 APPENDIX XVIII

100%

90%

80%

70%

60%

50% (%)

40%

30%

20%

10%

0% RT3 RP6 RET RLU REP RBV RBB RPY RPC REN RBQ RGM Velindre NHS Trust

SpSpecialistecialist Trust Trust

178 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 APPENDIX XVIII

Percentage of PATIENT occupied floor area in Statutory Fire Safety compliance (%)

100%

90%

80%

70%

60%

50% (%)

40%

30%

20%

10%

0% RVJ RTF RXP RXC RWY rust T Trust Conwy & NHS Trust NHS Trust NHS Trust ontypridd & P North East Wales Gwent Healthcare North West Wales Denbighshire NHS Rhondda NHS Trust Swansea NHS Trust Bro Morgannwg NHS

Large Multi Service Trust Large Multi Service Trust

100%

90%

80%

70%

60%

50% (%)

40%

30%

20%

10%

0% RR8 RFK RQ6 RTD RTH RCS RM2 RXN RRK RM3 RGT RHQ RHM RW3 RWE Trust Cardiff & Vale NHS

Acute Teaching Trust (Outside London) Acute Teaching Trust (Outside London)

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 179 APPENDIX XVIII

100%

90%

80%

70%

60%

50% (%) 40%

30%

20%

10%

0% RAJ RPL RJN RK5 RJR RA2 RN1 RNL RTP RD7 RD3 RN3 RN5 RN7 RTK RFS RC9 RD1 RPA RVY RBA RBK RNZ RQ8 RDZ RFR RNA RNS RDE RBN RCB RGP RDD RDU RMP RMB REM RGQ RVW RQW RWW Carmarthenshire NHS Trust

Medium Acute Trust Medium Acute Trust

100%

90%

80%

70%

60%

50% (%)

40%

30%

20%

10%

0% RA3 RA4 RE9 RR2 RCD Ceredigion & Mid Wales NHS Trust

Small Multi-Service Trust Small Multi-Service Trust

180 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 APPENDIX XVIII

100%

90%

80%

70%

60%

50% (%)

40%

30%

20%

10%

0% RA9 RR7 RH2 RAS RCF RCB REU RM4 RCC RWJ RMC NHS Trust North Glamorgan Pembrokeshire & Derwen NHS Trust

Medium Multi Service Trust Medium Multi Service Trust

100%

90%

80%

70%

60%

50% (%)

40%

30%

20%

10%

0% RT2 RK7 RV9 RP7 RDY RWV Powys LHB

Medium Community Trust

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 181 APPENDIX XVIII

100%

90%

80%

70%

60%

50% (%)

40%

30%

20%

10%

0% RT3 RP6 RLU RPY RBB RBV REP RPC REN RBQ RGM Velindre NHS Trust

Specialist Trust Specialist Trust

182 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 APPENDIX XVIII

Functional Suitability

100%

90%

80%

70%

60%

50% (%)

40%

30%

20%

10%

0% RVJ RTF RXP RXC RWY Trust Trust Conwy & NHS Trust NHS Trust NHS Trust ontypridd & P North East Wales Gwent Healthcare North West Wales Denbighshire NHS Rhondda NHS Trust Swansea NHS Trust Bro Morgannwg NHS

Large MultiMulti Service Service Trust Trust

100%

90%

80%

70%

60%

50% (%)

40%

30%

20%

10%

0% RA7 RR8 RFK RQ6 RTH RTD RM2 RXN RCS RRK RM3 RGT RHQ RHM RW3 RWE Trust Cardiff & Vale NHS

AcuteAcute Teaching Trust Trust (Outside (Outside London) London)

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 183 APPENDIX XVIII

100%

90%

80%

70%

60%

50% (%) 40%

30%

20%

10%

0% RAJ RA2 RK5 RJR RJN RTP RN7 RD3 RPA RVY RFR RDE RBN RNS RCB RDU RDD RMB RGQ RVW RWW Carmarthenshire NHS Trust

Medium Acute Trust Medium Acute Trust

100%

90%

80%

70%

60%

50% (%) 40%

30%

20%

10%

0% RA4 RA3 RE9 RR2 RCD Ceredigion & Mid Wales NHS Trust

Small Multi-Service Trust Small Multi-Service Trust

184 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 APPENDIX XVIII

100%

90%

80%

70%

60%

50% (%)

40%

30%

20%

10%

0% RA9 RR7 RH2 RAS RCF RM4 RCB REU RCC RWJ RMC NHS Trust North Glamorgan Pembrokeshire & Derwen NHS Trust

Medium Multi Service Trust Medium Multi Service Trust

100%

90%

80%

70%

60%

50% (%)

40%

30%

20%

10%

0% RT2 RP7 RK7 RV9 RDY RWV Powys LHB

Medium Community Trust

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 185 APPENDIX XVIII

100%

90%

80%

70%

60%

50% (%)

40%

30%

20%

10%

0% RT3 RP6 RLU RET RPY RBB RBV REP RPC REN RBQ RGM Velindre NHS Trust

Specialist Trust Specialist Trust

186 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 APPENDIX XVIII

Space Utilisation

100% ...... 90%

80%

70%

60%

50% (%) 40%

30%

20%

10%

0% P S C RVJ RTF RX RX RWY Trust Trust Trust ontypridd & NHS Trust o Morgannwg P Conwy & NHS Trust NHS Trust NHS Trust Rhondda NHS Swansea NH Br North East Wales Gwent Healthcare North West Wales Denbighshire NHS

Large Multi Service Trust

100%

90%

80%

70%

60%

50% (%)

40%

30%

20%

10%

0% RA7 RFK RR8 RTH RTD RQ6 RRK RXN RCS RM3 RM2 RGT RHQ RHM RW3 RWE rust T Cardiff & Vale NHS

Acute Teaching Trust (Outside London) Acute Teaching Trust (Outside London)

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 187 APPENDIX XVIII

100%

90%

80%

70%

60%

50% (%) 40%

30%

20%

10%

0% RAJ RA2 RC9 RN5 RNL RTK RD7 RD1 RN1 RFS RN3 RVY RQ8 RNS RDE RNA RCB RGP RGN RVW RQW Carmarthenshire NHS Trust

Medium Acute Trust Medium Acute Trust

100%

90%

80%

70%

60%

50% (%)

40%

30%

20%

10%

0% RE9 RA4 RA3 RR2 RCD Ceredigion & Mid Wales NHS Trust

Small Multi-Service Trust Small Multi-Service Trust

188 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 APPENDIX XVIII

100%

90%

80%

70%

60%

50% (%)

40%

30%

20%

10%

0% RA9 RR7 RH2 RAS RCF RCB REU RM4 RCC RWJ RMC NHS Trust North Glamorgan Pembrokeshire & Derwen NHS Trust

Medium Multi Service Trust Medium Multi Service Trust

100%

90%

80%

70%

60%

50% (%)

40%

30%

20%

10%

0% RT2 RK7 RV9 RP7 RDY RWV Powys LHB

Medium Community Trust Medium Community Trust

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 189 APPENDIX XVIII

100%

90%

80%

70%

60%

50% (%)

40%

30%

20%

10%

0% RT3 RP6 RLU RET RBB RBV RPY REP RPC REN RBQ RGM Velindre NHS Trust

Specialist Trust

190 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 APPENDIX XVIII

Energy Performance

90

80

70

60 ) 3 50

40 (GJ/100m 30

20

10

0 RVJ RTF RXP RXC RWY Trust Trust Conwy & NHS Trust NHS Trust NHS Trust ontypridd & P North East Wales Gwent Healthcare North West Wales Denbighshire NHS Rhondda NHS Trust Swansea NHS Trust Bro Morgannwg NHS

Large Multi Service Trust Large Multi Service Trust

250

200 )

3 150

100 (GJ/100m

50

0 RA7 RR8 RFK RTH RQ6 RTD RM3 RRK RCS RM2 RXN RGT RHQ RHM RW3 RWE rust T Cardiff & Vale NHS

Acute Teaching Trust (Outside London)

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 191 APPENDIX XVIII

120

100

80 ) 3

60

(GJ/100m 40

20

0 RAJ RPL RA2 RK5 RJN RTK RTP RFS RN3 RC9 RD1 RNL RD3 RN5 RD7 RN1 RVY RN7 RNZ RDZ RFR RBA RPA RQ8 RNA RBN RDE RCB RGP RDD RDU RMB REM RGQ RVW RQW RWW Carmarthenshire NHS Trust

MediumMedium Acute Acute Trust Trust

100

90

80

70

) 60 3

50

(GJ/100m 40

30

20

10

0 RA4 RA3 RE9 RCD Ceredigion & Mid Wales NHS Trust

Small Multi-Service Trust Small Multi-Service Trust

192 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 APPENDIX XVIII

100

90

80

70 )

3 60

50

40 (GJ/100m

30

20

10

0 RA9 RH2 RR7 RAS RCF REU RM4 RCB RCC RWJ RMC NHS Trust North Glamorgan Pembrokeshire & Derwen NHS Trust

Medium Multi Service Trust Medium Multi Service Trust

120

100

80 ) 3

60 (GJ/100m

40

20

0 RT2 RP7 RK7 RV9 RDY RWV Powys LHB

Medium Community Trust Medium Community Trust

WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 193 APPENDIX XVIII

200

180

160

140 )

3 120

100

80 (GJ/100m

60

40

20

0 RT3 RP6 RLU RPY REP REN RPC RBQ RGM Velindre NHS Trust

Specialist Trust

194 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2002-2003 © Copyright Welsh Health Estates 2003

All Rights Reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior permission of the copyright owner.

Cover photographs by Welsh Health Estates.

Designed by Keith James Design Associates.

Printed by Integrated Graphics Limited

Front Cover photographs: 1, Ysbyty Glan Clwyd, Bodelwyddan 1 2, St David’s Hospital, Cardiff 2 PO Box 182, Bevan House, 24-30 Lambourne Crescent, Llanishen Cardiff CF14 5GS

Back Cover photograph: PO Box 182, Tyˆ Bevan, 24-30 Cilgant Lambourne, Llanisien Barry Hospital Caerdydd CF14 5GS