Estate Strategy

estate strategy

january 2008

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

Table of Contents

Executive Summary ii

1 Introduction 1.1 The Estate Strategy 1 1.2 The Trust 2

2 The Current Estate 2.1 The Estate 3 2.2 The Current Service Profile 4 2.3 Property Schedule with Values 5 2.4 Estate Occupancy Costs 8 2.5 Results of 6-Facet Survey 9 2.5.1 Physical Condition 12 2.5.2 Functional Suitability 13 2.5.3 Space Utilisation 14 2.5.4 Quality 15 2.5.5 Compliance 16 2.5.6 Energy Performance 17 2.6 Environmental Impact Assessment 18 2.7 Risk Adjusted Backlog Report 20 2.8 Summary of Priorities 22

3 Aspirations for the Estate 3.1 Summary of the Service Strategy 23 3.2 Environnmental Strategy 25 3.3 Performance Criteria 26 3.3.1 Space Efficiency 27 3.3.2 Asset Productivity 28 3.3.3 Asset Deployment 28 3.3.4 Estate Quality 29 3.3.5 Cost of Occupancy 29

4 Options and Implementation 4.1 Implications of Service Startegy For the Estate 30 4.2 Proposals for Delivering the Estate Strategy 4.2.1 Site Rationalisation 31 4.2.2 Improvement and developments 32 4.3 Implications of Local Authority Development Strategies 33 4.3.1 Efficient Use of the Site 33 4.3.2 Design and Layout Measures 33 4.4 Capital Investment Programme 34 4.5 Summary Disposal And Proceeds of Sale 35 4.6 Risk Management Strategy 35 4.7 Energy Strategy 37 4.8 Access to Hospital Services 38 4.9 Transport and Travel Planning 38

Appendix 1 Site Development Plan S01 41 Appendix 2 Site Development Plan S02 42 Appendix 3 Site Boundary and Location of Blocks 43 Appendix 4 Key to 6-Facet Survey Summary Table 45 Appendix 5 Moderate and Low Risk Backlog Maintenance Jobs 47 Appendix 6 Performance Indicator Percentile Groupings 51

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

Executive Summary

The Ipswich Hospital NHS Trust estate is based on a 46 acre site to the north east of Ipswich. The site has developed over the last 50 years and has a diverse mixture of estate buildings both in terms of design and quality that reflects the above time period.

The Trust is seeking to reduce its estate portfolio operational foot print in order to become more cost effective in the delivery of its services and improve the quality and clinical effectiveness of its remaining estate.

The Trust has initiated a rationalisation of the estate portfolio with the closure of older parts of the estate at the north of the site with a view to progressively migrating the predominance of clinical services to the south of the site. The key projects to deliver this Strategy are detailed below -

• Closure of the Hayward Unit (Bucklesham Ward and Hintlesham Ward). • Closure of Bealings Ward. • Closure of Orford Ward. • Closure of Westerfield Ward. • Closure of Staff Development Centre. • Relocation of support office and functions. • Closure of the old Laundry building.

A number of ward closures have been actioned by relocation to South End wards. The closure of the above areas has facilitated the ability to progress discussions to Outline Business Case stage with the Suffolk Mental Health Partnership Trust to relocate services on to the Ipswich Hospital site.

The Trust has identified a range of other key projects that will need to be delivered over the next 10 years. The key projects are detailed below -

• Review of the maternity block, which is currently housed in a 1960s tower block that has many challenging features in respect of fire compliance and clinical functionality. • Refurbishment of the majority of the Trust’s acute wards, which are currently located within a Nucleus style development constructed in the early 1980s. ii

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

• Extension to the orthopaedic and fracture clinic. • Development of the old laundry site to a GP surgery centre (possible sale or lease) or other healthcare related use. • Refurbishment of doctors’ accommodation. • Closure of range of support buildings at north of the site with potential relocation into other parts of the Estate. • Demolition of Minsmere House site on ‘hand back’ from Suffolk Mental Health Partnership Trust. • Development of transport services and public access infrastructure. • Progressive refurbishment of outpatient clinics. • Development of schemes to support the Trust’s Service Strategy

The Trust has developed the £26 million Garrett Anderson Treatment Centre under the private finance initiative, which has been designed to give patients more space, dignity and privacy. The unit will consist of a new critical care centre, emergency centre, day surgery suite (4 theatres) and a 40 bed ward. This scheme is scheduled to become operational early 2008 and under pins the relocation and modernisation of services on the site.

The attached drawing number DEV 1016 S01 Rev. A – Appendix 1 and DEV 1016 S02 Rev. A Appendix 2 shows the current site development plan for the site. The Trust has carried out a 6 Facet Survey of the site which takes into account the following elements: Physical Condition Functional Suitability Space Utilisation Quality Compliance with Fire and Health & Safety Energy Performance

The 6 Facet Survey has informed the Strategy in respect of Risk Adjusted Backlog, Fire Compliance and Disability Access issues and development of Performance Indicators.

iii

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

1 Introduction

1.1 The Estate Strategy The NHS Plan (2002) set out the key objectives and the direction for NHS service delivery over a ten year period. To deliver a modern NHS, fit for the 21 st century, buildings and equipment are required that are in the right place, in the right condition, of the right type and which will be able to respond to future service needs.

The purpose of the Estate Strategy is be an informative document which provides information on the current estates portfolio, a framework for development which will underpin the Trust’s Service Strategy, and to support business cases for future service developments.

The Estates Strategy will be an important factor in the delivery of the Trust’s medium to long term Service Strategy. It will therefore need to be developed and amended as the Trust’s other strategies are evolved.

This document is broadly divided into three sections.

The first contains information upon which the strategy will be based. This includes the current property portfolio with values, occupancy costs, the results of a 6-facet survey as outlined in the NHS Estates document EstateCode, an Environmental Impact analysis, a review of the Trust’s Risk Adjusted Backlog, and a summary of priorities.

The second section lays out the Trust’s aspirations with regard to the estate, and contains a summary of the service strategy, an environmental startegy, and performance critera which compare current information and future plans.

The final section suggests the best startegy for achieving the aspirations laid out in the preceding section

Appendices contain information referenced in the Estate Strategy document.

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

1.2 The Trust The Ipswich Hospital NHS Trust is a National Health Service Trust providing hospital- based health care to more than 350,000 people who live in and around Ipswich and east Suffolk.

The Secretary of State for health approved Trust status for The Ipswich Hospital in April1993. It is one of the largest general hospitals in the East of England Strategic Health Authority.

The Trust is located on the north-eastern outskirts of Ipswich as shown .

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

2 The Current Estate

2.1 The Estate The Trust occupies an 18.50 hectare site on the north-eastern outskirts of Ipswich. Much of the external area is taken up by over 2000 parking spaces which are provided for patients, staff, and visitors.

Accommodation is provided on the Heath Road site in 94 blocks made up of a variety of building types and age. Together these blocks have a gross internal area 0f 90,679 sq metres. There is also a link road and car parking at Pearson Road. See site plans Appendix 3.

Figure 1 demonstrates the by percentage internal area by year built. (This does not include the Garrett Anderson Development)

Age Profile by Internal Area

2005 - Present 1% 1995-2004 pre-1965 4% 7% 1985-1994 19%

1965-1974 38%

1975-1984 31%

Figure 1

The target in the NHS Plan is for 40% of the total value of the NHS estate to be less than fifteen years old by 2010. The Figure 2 shows that, at present, the Trust has only 5% of its buidings’ value in that categry. However, the Trust is scheduled to commission the Garrett Anderson Centre development in early 2008 and close older parts of the estate. This will have a significant impact on this figure and it is estimated that it will be around 30% by value.

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

The current age profile by value is shown below. It underlines the fact that the bulk of the estate was constructed between 1965 and 1994.

Age Profile by Value 2005 - Present 2% pre-1965 1995-2004 6% 3%

1985-1994 27% 1965-1974 32%

1975-1984 30%

Figure 2

2.2 The Current Service Profile

The Trust service areas are as follows: • Emergency care • Elective care • Long term conditions • Maternity and Child Health • Cancer care • Care of older people • Specialised and tertiary services • Education, training, research and development • Income generating services.

The Trust has developed a Draft Service Strategy “Our Passion Your Care” . The Estate Strategy will require development and review as the service strategy is evolved.

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

2.3 Property Schedule With Values

The Trust property portfolio is allocated block asset numbers and this schedule shown in Table 1 along with Net Book Values at 31/03/2007. Block locations are shown on the plan in Appendix 3.

The total net book value of Buildings and External Works is £ 76,291,933.62. Total value of land at 31/03/2007 was £29,376,148.89.

Table 1 Net Book Block Name Value at Number 31/03/2007 01 Nucleus 1 17,771,383.92 02 Education Centre 1,427,589.44 03 Outpatients & Pathology 9,405,278.62 04 ENT & Speech Therapy 735,947.16 05 X-Ray Store 67,023.45 06 Pathology Store 60,552.66 07 Gas Store & Pharmacy Store 28,324.41 08 Estate & Facilities 566,784.14 09 Generator Sub Station 188,306.42 11 Hospital Street 286,399.35 12 Medical Secretaries 566,803.61 13 Integrated Discharge Planning Team 295,676.69 14 Maternity Block 5,718,992.27 15 Antenatal Clinic 910,102.01 16 Nurse Changing 61,479.64 18 Staff Bungalows 142,620.55 19 Doctors Home 608,305.58 20 ex Call Centre Portakabins 24,236.70 21 Decant Portakabins 56,483.68 22 North Comms Room 740,527.39 23 Minsmere House 311,887.71 24 Orford & Westerfield Wards 1,140,581.27 25 Plant Room 121,600.80 26 Staff Development 48,335.35 27 Hayward Unit 1,573,156.44 29 Staff Changing 132,953.40

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

Net Book Block Name Value at Number 31/03/2007 30 Bealings Ward 363,052.20 31 Chiropody 6,375.41 32 Chapel 125,583.85 33 Corridor & North Offices 390,341.61 34 Kitchen & Staff Restaurant 3,434,588.24 36 NHS Supplies Stores & Med Recs 517,826.39 39 Estate & Facilities (Carps Wrkshop) 16,837.44 40 ex PHLS garage 14,207.34 41 ERICA & Drug Information 132,747.52 42 Store (Generator) 17,163.30 44 Portakabin (Fume Cabinet) 15,852.11 45 Ethics Portakabin 15,852.11 46 Cancer Information Centre 208,780.32 48 North Offices & Computer Suite 2,229,576.42 49 Rigby Ward 1,159,662.77 50 Portakabin 1459 7,131.92 51 Portakabin 1370 9,437.84 52 Portakabin 1460 9,437.84 53 Creche 266,577.26 54 Tank Tower 106,213.21 55 Generator 25,609.54 56 Boilerhouse 1,333,916.96 58 Old Stores 455,698.72 59 Laundry 1,626,327.14 62 Planning & Information 242,778.71 63 Estate & Facilities Portakabins 23,459.41 67 Oil Tanks 71,881.10 68 Gas House (1) 26,867.89 70 Gas House (2) 7,052.47 71 Ambulance Station 503,885.51 72 Mortuary & Telephone Exchange 998,148.94 73 Nucleus 2 2,339,548.38 74 Diabetes Centre 251,869.74 75 Diabetes Centre Extension 603,114.75 76 Junior Doctors Home 1,185,872.44 80 Nucleus 3 8,801,030.49 81 Oncology 6,728,975.92

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

Net Book Block Name Value at Number 31/03/2007 82 Sexual Health & Trust HQ 820,864.04 84 Pathology Extension 1,902,680.37 85 Neurology Portakabin 4,170.12 87 Renal Unit 852,626.26 88 Portakabin (OPD & Amb) 31,674.49 89 Pump House 14,964.76 90 Waste Disposal Compound 22,866.82 91 Police Portakabin 21,135.42 92 Gas Bottle Store 10,468.63 94 V.I.E. Plant 38,385.69 95 Linac Rooms - Oncology 691,829.72 96 Parentcraft Block 145,397.01 External Works 12,241,638.34 Total 76,291,933.62

These blocks are leased or under construction 57 Incinerator 79 Garrett Anderson 97 Framlingham Ward 98 Ophthalmic Day Theatres

These blocks are below the capital asset threshold 35 Store 37 Estate & Facilities (Painters) 38 Estate & Facilities (Builders Store) 43 Headway Shed 47 Renal Portakabin 64 Trade Union Portakabin 77 Estate & Facilities Store 83 Orthopaedic Portakabins 86 Gas House (Laundry) 93 Pharmacy Bin Store

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

2.4 Estate Occupancy Costs

The Trust’s estate occupancy costs are shown in Table 2. This table shows the actual cost in the year 2006/2007 and the cost per square metre by cost element. Note that maintenance costs include equipment. Table 2 Estate Occupancy Costs

based on site average annual cost per square metre (ERIC 2006/07) 90,679 sq ft 01/04/2007 Cost Cost per sq m Business Rates £ 905,316.00 £ 9.98

Capital Charges BIF & Land - 3.5% Return £ 4,062,862.68 £ 44.80 Capital Charges BIF - Depreciation £ 3,843,225.08 £ 42.38

Total Capital Charges £ 87.19

Electricity £ 887,551.00 £ 9.79 Gas £ 193,006.00 £ 2.13 Water £ 100,600.00 £ 1.11 Oil £ - £ - Sewage £ 135,915.00 £ 1.50

Total Utilities £ 14.52

Maintenance - non EME Repairs £ 1,350,706.00 £ 14.90 Maintenance - non EME Planned £ 578,874.00 £ 6.38 EME - Repairs £ 483,582.75 £ 5.33 EME - Planned £ 161,194.25 £ 1.78

Total Maintenance £ 28.39

Property Insurance £ (est) 25,000.00 £ 0.28

Waste Disposal £ 103,000.00 £ 1.14

TOTAL £ 12,830,832.77 £ 141.50

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

2.5 Results of 6-Facet Surveys To provide a baseline for developing the Estate Strategy, the NHS Estates document Estate Code stresses the need for Trusts to be aware of the condition of their Estate in each of 6 facets. These are, • Physical Condition • Functional Suitability • Space Utilisation • Quality • Compliance with Fire and Health & Safety, both Statutory and non-Statutory. • Environmental Performance

A summary of the 6-facet survey results for each block is shown in Table 3.

A key to the categories can be found in Appendix 4.

Summary of 6-Facet Survey by Block Table 3

Block Year Gross Heated Name Function Number Built Internal Area Volume Quality Quality Compliance Compliance Space Utilisation Utilisation Space Physical Condition Condition Physical Energy Performance Performance Energy Functional Suitability Suitability Functional

sq m cu m Wards, A&E, Theatres, HSDU, 01 Nucleus 1 Clinics etc 1984 18,094.59 36,946.13 C B F C B B Nurse Education, 02 Education Centre PGME 1979 3,064.38 6,275.70 C B F C B B Clinics, Diagnostic Imaging, Retail Units,Pharmacy, Offices, Day 03 Outpatients & Pathology Unit,Laboratories 1972 12,897.23 28,036.32 C B O C B C 04 ENT & Speech Therapy Clinics 1982 758.61 1,707.36 B B F B B C 05 X-Ray Store Storage 1981 128.20 512.80 D(X) B F C B B 06 Pathology Store Storage 1972 139.53 325.99 B B F B B B 07 Gas Store & Pharmacy Store Storage 1972 68.02 151.73 B B F B B C Workshops, 08 Estate & Facilities Offices, Stores 1984 744.87 2,286.65 B B O C B C Standby Generator, Sub- 09 Generator Sub Station station 1972 174.84 426.50 C B F B B C Loading Bays, 11 Hospital Street Corridors 1980 365.33 853.08 C B F B B C 12 Medical Secretaries Offices 1983 591.35 1,345.06 B B F C C C 13 Integrated Discharge Planning Team Offices 1983 327.16 745.22 B B F C C C

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

Maternity and Gynae Wards, Day Unit, Theatres, Neo- 14 Maternity Block Natal Unit 1971 8,153.29 17,406.61 C B F C C C 15 Antenatal Clinic Clinics 1971 1,173.19 2,543.42 B B F B B C 16 Salt Store Store 1976 115.29 247.90 B B F B B C Staff 18 Staff Bungalows Accomodation 1965 281.19 641.76 C B F C B C Staff Accomodation, 19 Doctors Home Offices 1930 967.28 2,714.15 C B F D B C 20 ex Call Centre Portakabins Offices 1982 117.62 277.12 D(X) A E C B C 21 Decant Portakabins Offices 2004 137.96 328.10 C(X) A U C B C 22 North Comms Room Computer Suite 2006 63.40 150.36 A A F A A C Suffolk Mental 23 Minsmere House Health Partnership 1971 1,994.77 4,493.71 D(X) B F D C C 24 Orford & Westerfield Wards Elderly Wards 1968 1,559.51 3,446.31 D B F C B C 25 Plant Room Plant Room 1968 142.31 333.48 D A F C B C Seminar/Meeting 26 Staff Development Rooms 1969 339.06 816.08 C B E D B C Ward, Day 27 Hayward Unit Hospital, Re-Hab. 1979 2,307.96 5,168.53 C B E B B C 29 Staff Changing Changing Area 1968 273.67 644.11 D B F C B C 30 Bealings Ward Elderly Wards 1968 435.75 1,033.53 D B E B B C 31 Chiropody Clinics 1972 61.79 145.46 C(X) B F D B C 32 Chapel Chapel 1968 144.81 337.61 B A F B B C 33 Corridor & North Offices Offices, Corridor 1968 686.43 1,126.27 C B F B B C Kitchens, 34 Kitchen & Staff Restaurant Restaurant 1968 2,052.05 6,533.11 C A F B B C 35 Store Storage 1968 26.64 63.94 B A F B C B Supplies Stores, 36 NHS Supplies Stores & Med Recs Medical Records 1957 933.34 3,635.96 C C F C B C 37 Estate & Facilities (Painters) Workshop,Storage 1957 28.49 67.46 B A F C C B 38 Estate & Facilities (Builders Store) Storage 1957 18.03 43.08 C(X) A F C C B Workshops, 39 Estate & Facilities (Carps Wrkshop) Offices 1957 139.26 324.86 C A F C C C 40 ex PHLS garage Storage 1957 33.60 78.55 C(X) A F C C B 41 ERICA Offices 1950 312.54 731.29 C(X) A F C B C 42 Store (Generator) Generator 1950 31.41 75.38 B A F B B C 43 Headway Shed Workshop 1998 19.68 N/A B A F B B N/A 44 Portakabin (Fume Cabinet) EME 1982 12.48 29.95 D(X) D(X) E D D C 45 Ethics Portakabin Office 1982 21.84 52.10 B A U C B C 46 Cancer Information Centre Information Centre 2004 100.00 236.02 B A F A A C 47 Renal Portakabin Offices 2004 27.35 37.10 B A F C B C Storage, Workshops, Computer Suite, Offices, Corridors, 48 North Offices & Computer Suite Clinics 1910 1,033.28 6,181.73 C B O C B C 49 Rigby Block Clinics 1898 903.45 2,018.33 C C F B B C 50 Portakabin 1459 Offices 2005 27.35 65.64 B A F B B C

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

51 Portakabin 1370 Offices 2005 15.80 37.92 B A F B B C 52 Portakabin 1460 Offices 2005 27.35 65.64 B A F B B C 53 Creche Nursery 1980 634.19 1,484.88 C A F B B C 54 Tank Tower Water Tower 1965 144.00 1,584.00 C A F B N/A B Standby 55 Generator Generator 1995 30.52 90.39 B A F B B B 56 Boilerhouse Boiler House 1965 785.95 3,895.08 B A F B B B 57 Incinerator Incinerator 1995 7,814.41 N/A A N/A N/A N/A B 58 Old Stores Storage 1898 1,396.04 3,580.63 D(X) A F C C C 59 Laundry Storage 1965 2,020.41 9,682.61 C(X) A U D B C Standby Generator, Oil 60 North Generator (Comms Room) Tank 2006 38.70 N/A A A F B A N/A 62 Planning & Information Offices 1920 232.33 569.87 B A F B B C Workshops, 63 Estate & Facilities Portakabins Offices 1985 121.91 286.33 C A F C B C 64 Trade Union Portakabin Office 1965 29.30 69.98 C A U C B C 67 Oil Tanks Compound 1965 - N/A D(X) B N/A D C N/A 68 Gas House (1) Gas Sub-Station 1965 54.00 108.00 B A F B C A 70 Gas House (2) Gas Sub-Station 1938 24.25 47.20 B A F B C A Ambulance 71 Ambulance Station Station 1979 917.90 4,466.18 B A F B N/A C Mortuary and 72 Mortuary & Telephone Exchange Switchboard 1972 729.73 1,650.72 C B O C C C 73 Nucleus 2 Wards, Clinics 1985 2,131.63 4,904.92 B B F C B B 74 Diabetes Centre Clinics 1985 281.14 649.27 B A F B B B 75 Diabetes Centre Extension Clinics 2006 331.00 759.22 A A F B B B Staff 76 Junior Doctors Home Accomodation 1985 1,111.17 2,209.16 C A F C B C 77 Estate & Facilities Store Storage 1965 28.23 67.75 D(X) A F C B A Wards, Theatres, 79 Garrett Anderson Critical Care 2008 9,100.40 N/A A A N/A A N/A N/A Wards, Theatres, 80 Nucleus 3 Clinics 1988 7,269.87 15,071.28 B B F B B B Wards, Clinics, Treatment, 81 Oncology Workshops 1991 4,508.06 8,925.82 B A F B B B 82 Sexual Health & Trust HQ Clinic, Offices 1991 637.85 1,446.70 B A F B B B 83 Orthopaedic Portakabins Offices 2004 37.50 135.84 B A F B B C 84 Pathology Extension Laboratories 1992 1,484.55 3,009.70 B A F B B B 85 Neurology Portakabin Offices 1985 55.83 127.51 B A F B B C 86 Gas House (Laundry) Gas Sub-Station 1992 7.77 15.54 B A F B C A 87 Renal Unit Clinics, Offices 1998 629.53 1,432.13 B A F B B B 88 Portakabin (OPD & Amb) Offices 1996 46.32 110.59 B A F B B C 89 Pump House Plant Room 1996 17.62 44.05 B A F B B A 90 Waste Disposal Compound Compound 1996 9.33 22.39 B A F B B C 91 Police Portakabin Offices 1996 27.56 64.39 B A F B B B

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

92 Gas Bottle Store Storage 1998 12.01 24.02 B A F B B A 93 Pharmacy Bin Store Storage 2001 21.44 51.34 B A F B B A 94 V.I.E. Plant Plant 2001 44.04 N/A A A F B A N/A 95 Linac Rooms - Oncology Clinics 2001 450.36 924.60 B A F B B B 96 Parentcraft Block Offices 2003 104.00 242.88 B A U B B B 97 Framlingham Ward Ward 2003 801.05 1,842.31 B A F B B B 98 Ophthalmic Day Theatres Theatres 2004 426.52 984.96 B A F B B B 98,807.34 220,141.76

The graphs below show the distribution of categories by percentage area for each facet.

2.5.1 Physical Condition

Buildings are rated on the condition of the building elements, and electrical and mechanical systems.

Physical Condition

D A 6% 10%

B 26%

C 58%

Figure 3 A As new and can be expected to perform adequately over expected life B Sound, operationally safe and exhibits only minor deterioration Operational but major repair or replacement will be needed soon, that is, within three years C for building elements and one year for engineering elements D Runs a serious risk of imminent breakdown

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

2.5.2 Functional Suitability

Each block is assessed in terms of its internal space relationships, support facilities and location.

Functional Suitability

C D 2% 0% A 30%

B 68%

Figure 4 A Very satisfactory, no change needed B Satisfactory, minor change needed C Not satisfactory, major change needed D Unacceptable in its present condition

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

2.5.3 Space Utilisation

Each block is rated as to how intensively the space is used, does usage vary over time, and how does available space compare with national guidance.

Space Utilisation

O E U 3% 4% 17%

F 76%

Figure 5 E Empty F Fully Used U Under used O Over crowded

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

2.5.4 Quality

The quality of each block has been assessed in terms of amenity, comfort engineering, and design.

D Quality 5% A 9%

B C 33% 53%

Figure 6 A Excellent Quality B A facility requiring general maintenance investment only C A less than acceptable facility requiring capital investment D A very poor facility requiring major capital investment or replacement

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

2.5.5 Statutory and non-Statutory Fire and Health & Safety Compliance

Assessment has been made to rate compliance with current Fire, and Health & Safety regulations and recommendations

Compliance D A C 0% 14% 10%

B 76%

Figure 7 A Excellent Quality B A facility requiring general maintenance investment only C A less than acceptable facility requiring capital investment D A very poor facility requiring major capital investment or replacement

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

2.5.6 Energy Performance

Energy usage for each block has been analysed per unit volume.

Energy Performance

D A 0% 0% B 44%

C 56%

Figure 8 A 35-55 GJ per 100cu m B 56-65 GJ per 100cu m C 66-75 GJ per 100cu m D 76-100 GJ per 100cu m

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

2.6 Environmental Impact Assessment

The following information is taken from the Trust’s submission to the Department of Health using the NHS Environment Assessment Tool (NEAT). This software is a tool designed to assess the impact of healthcare facilities on the environment.

As can be seen in Table 4 the weighted scores give the Trust a total score of 54.46 which gives a GOOD rating and only just falls short of being VERY GOOD.

Table 4 Trust (RGQ) IPSWICH HOSPITAL NHS TRUST Site (RGQ01) THE IPSWICH HOSPITAL NHS TRUST Generated Date 18/01/2008 16:40

Total Score 54.46 Rating Good

Weighted Section Score Weighting Score Management 30.30% 15 4.55 Energy 45.45% 15 6.82 Transport 90.91% 10 9.09 Water 46.15% 5 2.31 Materials 100.00% 5 5.00 Landuse and Ecology 33.33% 10 3.33 Pollution 44.44% 10 4.44 Internal Environment 66.67% 15 10.00 Social 60.00% 10 6.00 Operational waste 58.33% 5 2.92

Thresholds % Rating 0 Fail more than 25 Pass more than 40 Good more than 55 Very Good more than 70 Excellent

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

Figure 9 is a graphical representation of the table showing the element scores. The red section shows the current score and the blue section is the improvement possible.

Figure 9

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

2.7 Risk Adjusted Backlog

In 2004 NHS Estates issued two documents, Best practice advice: Establishing and managing backlog and A risk-based methodology for establishing and managing backlog .

The methodology involves assessing the site to find all jobs classed as Backlog Maintenance. Then, finding the risk score from the consequence and liklihood scores. The result is then ranked as either High, Significant, Moderate and Low. Finally the cost to repair is estimated and applied.

To get an overall risk adjusted figure for Backlog Maintenance the following formula is applied to each block,

(Cost of moderate and low ranked jobs/Remaining life of block) + cost of High and Significant ranked Jobs.

The adjusted figures for each block are totalled to give an overall Risk Adjusted Backlog Cost.

The High and Significant Risk ranked jobs are listed in Table 5. These jobs are sorted by Risk. Moderate and Low ranked are in Appendix 5.

The risk adjusted backlog figures will change and be amended as parts of the estate are closed, due to the opening of the Garrett Anderson Centre, and work in progress jobs are completed. Also indexation will be applied to the estimated cost. Table 5

Job Block Rem Conseq Prob. Risk Estimated Building Background Risk Rank ID No Life Score Score Score Cost E098 +E103 REPL MAIN ELEC DIST + HIGH 134 Nucleus 1 03 22 GENERATOR 5 4 20 177,650.00 E065 NURSE CALL HAYWARD BUCLESHAM HIGH 128 Nucleus 1 27 25 HINTLESHAM 5 4 20 17,765.00

HIGH 157 Nucleus 1 30 32 E021 REPL N CALL 5 4 20 8,882.50

HIGH 132 Nucleus 1 54 30 E097 REPL GENERATOR 5 4 20 44,412.50

M126 & M141 OIL HIGH 155 Nucleus 1 56 31 STORAGE TANKS 5 4 20 57,475.00

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

Job Block Rem Conseq Prob. Risk Estimated Building Background Risk Rank ID No Life Score Score Score Cost

SIGNIFICANT 38 Nucleus 1 14 28 4 4 16 2,090,000.00

SIGNIFICANT 158 Nucleus 1 99 26 Electrical Infrastructure 4 4 16 1,828,750.00

B102 REPLACEMENT SIGNIFICANT 36 Nucleus 1 02 24 ROOF 3 4 12 106,590.00 M130 PHYSIO P/RM - CONTROLS COVERTED SIGNIFICANT 133 Nucleus 1 03 22 TO BMS 4 3 12 5,329.50

SIGNIFICANT 37 Nucleus 1 14 28 M127 OP LIGHTS FIXING 4 3 12 4,441.25

M011 RENEW MAIN SIGNIFICANT 156 Nucleus 1 14 28 PLENUM DUCTWORK 4 3 12 10,659.00

SIGNIFICANT 129 Nucleus 1 24 27 B088 FELT ROOF 3 4 12 106,590.00

Education B092 HAYWARD FELT SIGNIFICANT 160 Centre 27 25 ROOF 3 4 12 26,647.50

B087 PERSONNEL FELT SIGNIFICANT 29 OPD 33 22 ROOF 3 4 12 75,501.25

B032 RECORD STORE SIGNIFICANT 88 OPD 48 15 ROOF 3 4 12 1,045.00

SIGNIFICANT 25 OPD 48 15 B026 CORR ROOF 3 4 12 17,765.00

SIGNIFICANT 80 OPD 56 31 B097 TANK COMPOUND 4 3 12 8,882.50

SIGNIFICANT 30 OPD 58 9 B093 AREA 3 4 12 106,590.00

SIGNIFICANT 31 OPD 71 30 B085 ROAD REPAIRS 3 4 12 44,412.50

SIGNIFICANT 79 OPD 73 22 E086 REPL CHILLERS 4 3 12 97,707.50

E094 ADDL SKTS AT SIGNIFICANT 28 OPD 99 26 BEDSIDE 3 4 12 48,853.75

SIGNIFICANT 162 OPD 99 26 M091 MACERATORS 3 4 12 72,888.75

The totals and Risk Adjusted figures are below,

Risk Rank Total

HIGH 306,185.00

SIGNIFICANT 4,652,653.50

MODERATE 1,150,832.38

LOW 2,081,963.95 Grand Total 8,191,634.83

Calculated Risk Adjusted Backlog £5,253,455

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

2.8 Summary of Priorities

The 6- facet analysis suggests the following aims,

Physical Condition : Eliminate condition D Reduce condition C to lerss than 40%

Functional Suitability Eliminate condition C & D

Space Utilisation Eliminate all over crowded areas Reduce under-used areas to less than 10%

Quality Eliminate category D Reduce category C to less than 40%

Compliance Reduce category C to less than 5%

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

3 Aspirations For the Estate

3.1 Summary of the Service Strategy

The Trust has developed a draft Service Strategy “Our Passion Your Care” which is the product of our work in the last two years. It is the result of planning partnerships both within the Trust and with Suffolk Primary Care Trust and others who commission our services.

The draft service strategy is based on: • Proposals originally put forward in the Service Development Plan produced in April-June 2006 • The Trust’s current work programme • Further proposals put forward by the Chief Executive

It recaps on vision and values, sets out the strategic goals and summarises the services we propose to offer in order to play our part in improving the health and well-being of the population we serve.

Two big questions • Does this draft service strategy offer the right services to meet the health needs of our population? • Does this draft strategy define the service you want to provide?

Summary of proposals for each of the service areas

Emergency care Our population needs the full range of emergency services. We will change the way we provide these services and provide faster, more effective treatment, avoiding emergency admissions.

Elective care We will be there for people who need treatment that only a hospital can provide. We will compete with the independent sector in terms of reliability and efficiency, and beat them on outcomes. 80% of surgery will be on a day case or 23 hour stay basis, and no

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

operations will be cancelled on or near the day for non-clinical reasons.

Long term conditions We will reach out and work in partnership with GPs and others in primary care to care for people with long term conditions. Our support will help people to have a better quality of life, keep hospital visits to a minimum and avoid having to stay in hospital. Maternity and child health We will provide safe, high quality maternity services that offer choice in childbirth, and outstanding specialist child health services.

Cancer care We have a reputation for providing cutting edge treatments. We will continue to develop our specialist services for the population of east Suffolk and north and mid Essex. We will make the most of advancing technology and our network links to other hospitals to ensure the best outcomes for patients.

Care of older people We will be a beacon of excellence for the care of older people in hospital. The way we provide services will change to a model based on dependency rather than specialty and we will maintain high standards of care and dignity, wherever in the hospital the older person is being cared for.

Specialised and tertiary services Maintaining comprehensive emergency services gives us the opportunity to develop specialist elective services. We will take this opportunity and stand out above other providers, working in partnership with Essex Rivers, our neighbouring hospital in Colchester, to achieve economies of scale and long-term viability.

Education, training, research & development Investment in progress has always been an important part of Ipswich Hospital and this has attracted staff of the highest calibre. We aim to attain teaching hospital status and provide staff with greater opportunities for training and development.

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Income generating services We already provide a range of income generating services, but it is estimated that we have the potential to increase our commercial income by £2 million per annum. We will forge links with the local business community and take a more expert approach to our commercial and fundraising portfolio.

3.2 Environmental Strategy

In accordance with the Trust Environmental Policy:

The Ipswich Hospital NHS Trust recognises that as an integral part of its community, it has a duty to ensure that its activities do not adversely affect the environment.

In recognition of the commitment to this environmental policy the Trust will:

• Ensure waste is minimised and where possible recycled;

• Operate within the conditions of current legislation, and fulfil its duty of care to all staff and others affected by its work;

• Educate and inform staff to enable them to be environmentally aware;

• Seek to achieve the standards of ISO 14001 and operate within the limits of the Environmental Management System;

• Use every available means to prevent pollution of the environment by emission to the air, and water;

• Develop and maintain an emergency plan to minimise the effect of environmental incidents;

• Use energy and resources in the most efficient way and see to reduce consumption by good management and investment in energy saving technology.

It is the objective of the Trust to introduce an accredited Environmental Standard (EMS) such as ISO 14001 by 2010, and significantly improve all aspects of environmental management.

In conjunction, the Trust will improve the NEAT performance achieving a “Very Good” rating by 2010 and “Excellent” by 2012.

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

3.3 Performance Criteria

The Performance Indicators (Pis) listed in table 6 are designed to allow informed judgement on the efficiency and condition of the Estate. All are based on indicators that are expressed as ratios of the Trust’s building and land areas. A simple traffic light exercise classifies performance management information into three categories. Green - no or very limited problems Amber – some problems Red – serious concerns The figures are produced by The Information Centre for Health and Social Care from a variety of sources.

The Trust’s Pis are listed in table 6. The national PI percentile groupings can be found in Appendix 6.

As can be seen the Trust has 3 Pis in the red category, 2 concerning Backlog and 1 equipment deployment. Groupings: Trust Cluster & Type: Top – Acute

Table 6 IPSWICH HOSPITAL NHS TRUST - 2006/2007 Trust PI SUMMARY PI Space Efficiency Income £10/m² 201 Activity/100m² 100 Asset Value £10/m² 137 Occupancy Cost £/m² 152 Asset Productivity Asset Value £10/m² 137 Capital Charges £/m² 107 Total Backlog £/m² 90 Rent & Rates £/10m² 107 Asset Deployment Land £/m² 324 Building £10/m² 97 Equipment £/m² 68 Capital Charges £/m² 107 Estate Quality Asset Value £10/m² 137 Depreciation £/m² 60 Critical Backlog £/m² 55 Risk Adjusted Backlog £/m² 58 Cost of Occupancy Rent & Rates £/10m² 107 Energy/Utility £/10m² 119 Maintenance Costs £/10m² 220 Capital Charges £/m² 107

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

3.3.1 Space Efficiency

This PI relates the estate and its annual occupancy cost to the output of the Trust.

It indicates that the Trust is generally using floor space with reasonabe efficiency when compared with similar NHS Trusts.

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

3.3.2 Asset Productivity This PI demonstrates the actual cost of owning/renting assets. It suggests the Trust is performing well when compared to comparable Trusts.

3.3.3 Asset Deployment This PI aims to compare the makeup of the asset base. Apart from under investment in Equipment the Trust is performing well.

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

3.3.4 Estate Quality

This PI gives a balanced view of the overall condition of the estate relative to value and age. It suggests the Trust needs to invest to reduce its Backlog Maintenance.

3.3.5 Cost of Occupancy

This PI identifies the profile of occupancy costs (revenue). Here the Trust is again performing well.

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

4 Options & Implementation

4.1 Implications of Service Strategy For The Estate

The Trust has undertaken a review of its estate and assets and has used this information to contribute to a strategic review of future requirements. This review has been informed by the Trust Draft Service Strategy and the Board Seminar Day held in December 2007. This Estate Strategy will be updated further when the following items of work are completed –

• The capacity planning exercise has been completed.

• The market analysis exercise has been completed.

• The completion of the Trusts application for Foundation Trust Status.

• Redesign of Emergency Care services.

• The Trusts Service Strategy has been completed and agreed with the SHA and PCT.

The Strategy that has been developed is based upon –

• The Draft Service Strategy – Our Passion, Your Care

• Taking Control Report

• Board Seminar Day

• The Suffolk Mental Health Outline Business Case for Modernisation of Mental Health Inpatient Facilities in Suffolk

• 6-Facet Survey

The potentialproposals for the site have been mapped on site development plans in Appendices 1 and 2.

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

4.2 Proposals for delivering the Estate Strategy

4.2.1 Site Rationalisation

The Trust is seeking to rationalise the estate portfolio by the closure of older parts of the estate at the north of the site with a view to progressively migrating clinical services where possible to the south of the site. The key projects to deliver the Strategy are detailed below –

• Closure of the Hayward Unit (Bucklesham and Hintlesham Wards). • Closure of Bealings Ward. • Closure of Orford Ward. • Closure of Westerfield Ward. • Closure of Staff Development. • Relocation of support office and functions. • Closure of the old Laundry building. • Location of the Suffolk Mental Health Partnership Trust (SMHPT) in to 4 wards on the Ipswich Hospital site (2 wards already accommodated on the Hospital site within Minsmere House). The provision of the new mental health services on the site would be accommodated in an area that is being vacated as part of the site rationalisation programme.

• Demolition of the Minsmere House site upon completion of the new Suffolk Mental Health Partnership development of 4 wards. With a potential use for car parking or redevelopment.

• The closure of the existing laundry site to provide a potential redevelopment site for GP surgery or other health related development.

• To review and rationalise the remainder of the building stock at the north of the site (excluding Oncology and Headway developments) with a view to migrating to other locations on the site.

• To review the boiler house with a view to developing a new energy centre.

• To develop a scheme to replace the nursery located adjacent to car park K with a view to developing car park K to a multistorey car park to support the future rationalisation and redevelopment of the site.

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4.2.2 Improvement and developments

The Trust has identified a range of other site issues that will need to be resolved over the next 10 years. This list will be progressively refined and developed based on the finalisation of the Service Strategy and appropriate business case developments.

• Review of the maternity block, which is currently housed in a 1960s tower block, that has many challenging features in respect of fire compliance and clinical functionality.

• Electrical Infrastructure.

• Maternity Block centralised Central Delivery Suite.

• Maternity Block Regulatory Reform Fire Order improvements.

• Refurbishment of the majority of the Trust’s acute wards, which are currently located within a Nucleus style development constructed in the early 1980s.

• Development of cytotoxic outpatient department.

• Extension to the orthopaedic and fracture clinic.

• Relocation of the Podiatric Foot Clinic from the North of the site.

• Development of the old laundry site to a GP surgery centre (possible sale or lease).

• Refurbishment of doctors’ accommodation.

• Closure of range of support buildings at north of the site with potential relocation in the maternity block.

• Demolition of Minsmere House site on ‘hand back’ from Suffolk Mental Health Partnership Trust.

• Provision of Emergency Department CT Scanner Suite.

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

• Development of transport services and public access infrastructure.

• Progressive refurbishment of outpatient clinics.

• Improvements to access for disabled.

• Maternity and childrens services reprovision.

4.3 Implications of Local Authority Development Strategies

The aims of the Estate Strategy will need to be reflected in the Borough Council’s Local Development Framework (LDF) which will contain planning policies guiding new development and growth over the period up to 2021.

The Council has recently published its preferred Core Strategy and Site Allocations and Options Documents for consultation purposes, both of which form part of the LDF. Consequently, the Trust will be participating in the review of this planning policy exercise to ensure the development interests of the Hospital site including the Estates Strategy are properly represented and reflected in the policies and proposals of the LDF. The final version of the Council’s LDF will form part of the Statutory Development Plan for the Borough and will be used as a basis to determine planning applications.

4.3.1 Efficient Use of the Site

A condition survey feasibility exercise is being undertaken to determine which buildings should be retained and refurbished and others that have come to the end of there existing life and require redevelopment. Redevelopment options will include the potential to fully utilise building footprints to make the most efficient use of available space. Similarly, new development on existing open areas will be designed to optimise the footprint of each area and allow for additional storeys where appropriate.

4.3.2 Design and Layout Measures

All new development will be designed to a high standard in order to produce modern state of the art health care facilities within the context of an overall health campus. The masterplan exercise will

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

develop the opportunities to create a more prestigious and attractive built and landscaped presence to the main Heath Road frontage in particular, which will complement the scale and quality of design created by the recent Garrett Anderson development. Current Government guidance on planning and energy conservation and climate change will also be taken into account.

Further design issues include designing an effective layout between the Hospital Campus buildings themselves and their relationship with adjoining residential development, with the aim of creating suitable and compatible land use relationships.

4.4 Capital Investment Programme

The Trust recognises the need to invest in the Estate and will develop a capital programme that will address backlog and compliance issues, as well as meeting the needs of the Trust’s Service Strategy.

The current anticipated capital investment program is shown in Table 7. Table 7

08/09 09/10 10/11 11/12 12/13 13/14 14/15 15/16 16/17 17/18 Possible £000' Scheme Funding s £000's £000's £000's £000's £000's £000's £000's £000's £000's Total Source

Backlog Trust 200 200 200 200 200 200 200 200 200 200 Maintenance Capital N/A Trust 25 25 25 25 25 25 25 25 25 25 Energy N/A Capital

Health & Trust 200 200 200 200 200 200 200 200 200 200 Safety Capital N/A Trust Security 20 20 20 20 20 20 20 20 20 20 N/A Capital

Electrical Trust 2,569 1,052 Infrastructure Capital 3,621 Maternity block - Trust 900 350 33 Centralised Capital Delivery Suite 1,283

Year Total 3,914 1,847 478 445 445 445 445 445 445 445

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

4.5 Summary Disposal And Proceeds of Sale

The Trust is reviewing options in respect of the opportunities to release land for either sale or lease. The Site Development Plan identifies that the majority of the site is required for health related services. The migration of other health service functions on to the site develops a Health Campus approach.

4.6 Risk Management Strategy

The Trust has a published Risk Management Strategy which has been ratified by the Trust Board. It states that:

“The Ipswich Hospital NHS Trust is committed to ensuring the safety of patients, staff and the public through an integrated approach to managing risk, regardless of whether the risk is clinical, corporate or financial.”

The management of non-clinical risk is part of the remit of the E&F and follows the principles described above.

Health and Safety, fire safety and security are all included in this non-clinical function and follow well established risk management principles.

Risk assessments are completed for all E&F activities and functions and identified risks are reduced to the lowest level as far as is reasonably practicable.

Specific funding is provided to address non-clinical risks found, but where unacceptable risks are identified which are beyond the ability or resources of the E&F Directorate these are assessed using the Trust Risk Classification Matrix and submitted for inclusion on the Trust Risk Register and as process commenced to develop business cases to resolve.

Fire safety in any healthcare premises has always been given a high priority and the recent introduction of the Regulatory Reform (Fire Safety) Order 2005 (RRO) has reinforced this view.

The Trust is reviewing all existing fire safety risk assessments and is commissioning corrective measures and modifications which will bring all Trust premises to the required standards of fire safety that meet the needs of

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

current requirements defined within Firecode and required by the Regulatory Reform (Fire Safety) Order 2005 (RRO)

The Suffolk Fire and Rescue Service are being consulted to ensure an integrated approach that will give confidence that the risk of fire is minimised and the Trust meets its statutory obligations.

4.7 Energy Strategy

The Trust current annual energy consumption is approximately 221429 GJ costing in excess of £700,000 and therefore warrants action to improve our overall energy performance.

There are currently two energy efficiency targets applying to the NHS:

• to achieve energy usage of between 35-55 Gigajoules per 100 cubic metres for all new buildings – equivalent to up to one and a half times the energy usage of a domestic house – and 55-65 GJ/100 cubic metres for all existing buildings – equivalent to that of 1.5-2 domestic houses; • to reduce primary energy consumption and reduce carbon emissions by 15 per cent from 2000 to 2010.

The Trust will introduce measures to seek to achieve the reductions in energy use as described above for all buildings in the Trust portfolio.

All new building will be commissioned to achieve energy use of between 35 and 55 GJ per 100 CuM and the average energy use of existing buildings will be between 55 and 65 GJ per 100 CuM. By 2010

Present Position – at January 2000

Energy Use per 100 CuM heated volume

The ERIC return data for 2000 is as follows:

Electricity Gas Steam Total GJ Heated Vol GJ/100 CuM 39232 79268 75500 194000 256010 75.78

Target Position for 2010

Electricity Gas Steam Total GJ Heated Vol GJ/100 CuM 48500 34000 76560 159060 246265 64.59

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

Carbon Emissions

At January 2000

Electricity Gas Steam Total Tonnes CO2 39232 79268 75500 6539 4193 5192 15925 Tonnes CO2

Target Position for 2010

Electricity Gas Steam Total Tonnes CO2 48500 34000 76560 8084 1746 5105 13349 Tonnes CO2

This would be a reduction of 16% against a target of 15%

The following actions will be taken to progress the delivery of the Energy Targets.

• Review existing Energy Policy and reissue • Consolidate all data on TEAM energy management software • Transfer to TEAM Sigma software when available. This upgrade will give a greater ability to identify energy waste • Maximise the use of waste heat from the incinerator • Seek, subject to best value, a green electrical energy supplier • Increase sub-metering to increase the ability to identify waste • Set targets / benchmark • Continue with and develop energy awareness campaigns to encourage savings in overall consumption • Invest in energy saving schemes • Increase resources towards energy management

Update – at December 2007

Electricity Gas Steam Total GJ Heated Vol GJ/100 CuM 50289 28956 66279 145524 246265 64.0

Electricity Gas Steam Total Tonnes CO2 50289 34000 66279 8382 3463 5265 17110 Tonnes CO2

These tables show that the Trust is on target to achieve the target regarding GJ/heated volume.

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

The CO2 emissions target is a much greater challenge, however, and will require a significant reduction in electricity consumption before 2010 a review of activities to achieve the CO2 emissions will be commissioned.

4.8 Access to Hospital Services

The Trust is committed to the provision of an estate which gives equal access to all persons and complies with the requirements of the Disability and Discrimination Act 2005 (DDA). Significant work has been carried out for a number of years on improvements to pedestrian and wheelchair access and in 2005 a Strategic Access Review was commissioned using Professor Keith Bright, a specialist consultant to identify any areas of non-compliance or significant risk.

An action plan was developed to address the main areas of concern identified in the report and a number of projects have been completed to date.

The Trust will continue to invest in improvements to access to hospital services and carry out regular monitoring of progress against the plan.

4.9 Transport and Travel Planning

The Estates Strategy and related Masterplan for the Heath Road site, will be supported by a revised Travel Plan to help manage traffic demand. Travel Plan’s are encouraged by Government planning and transport policy driven by the following overall objectives:

• To promote more sustainable transport choices for visitors and employees

• To promote accessibility by public transport and

• To reduce the need for travel, especially by car.

More recent Government Guidance on ‘Planning and Climate Change’ (December 2007) places an even greater emphasis on conserving energy and resources and promotion of ‘greener’ forms of travel.

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However, given the nature of the use of the site including its A&E role, the continued essential operational requirements of the Hospital will need to be met. This will necessitate the provision of sufficient on site car parking provision to meet the requirements of patients, visitors and essential staff. Also, as the Hospital is a significant generator of travel, viable and efficient transportation facilities are required, which provide for a variety of alternative transport modes in addition to essential car users needs, all of which need to be planned for.

The Trust published a Travel Plan in 2005, and following the construction of the Garrett Anderson Centre and deferment of the associated multi storey car park, the associated Travel Plan measures are being reviewed. Consequently, a revised set of measures are being drawn up and guided by the following broad aim:

To provide for the essential operational needs of the Hospital including the provision of safe and sustainable transport to, from and within the site, whilst seeking to reduce the reliance on car borne trips as a mode of travel

The emerging revised Travel Plan measures include the following proposals which the Trust is developing and considering further:

Travel Plan Coordinator – Introducing a new position, if possible, shared with other Trusts in order to coordinate and facilitate the preparation, implementation and review of associated travel plan measures.

Car Park Management – Including the provision of an on site designated contractors parking area during construction periods, re-allocation of designated parking zones, phased visiting hours, improved on site directional signs, introduction of a car sharing scheme and further parking capacity for longer term development. The intention will be to seek to balance car and non car usage with the aim of achieving a target percentage modal shift in favour of non car patronage.

Public Transport – including further improved bus access and circulation within the site, links to a wider number of bus routes including Park & Ride

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services, links with ‘Real Time’ information systems and staff bus ticket subsidy.

Cycling & Motor Cycling – including the provision of further covered parking and changing facilities, extended and improved cycle routes through the site, a bicycle loan scheme and interest free loans on motor cycles (up to 125cc).

Walking – including a 15 - 20 minute walking permit allocation system.

Monitor & Review - Regular review of initiatives, targets and requirements will be undertaken.

Feedback on the revised Travel Plan provisions including targets will be discussed further through the Transport Strategy user Group. In addition, the Trust is in liaison with the Council over related measures and the revised Travel Plan will be formally submitted for planning approval in February 2008.

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

Appendix 3 Site Boundary and Location of Blocks

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

Appendix 3 Site Boundary and Location of Blocks

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

Appendix 4 Key to 6-Facet Survey Summary Table

As recommended in Estatecode Section 4, in order to produce an Estate Strategy document it is necessary to know the quality of the current Estate. This can be demonstrated by rating each of the 6 facets.

Facet 1 Physical Condition

Rate each of theses elements, Buildings Mechanical Systems Electrical Systems

As new and can be expected to perform adequately over A expected life B Sound, operationally safe and exhibits only minor deterioration Operational but major repair or replacement will be needed C soon, that is, within three years for building elements and one year for engineering elements D Runs a serious risk of imminent breakdown Added to C Impossible to improve without replacement X or D

Facet 2 Functional Suitability

Assessed on the basis of three elements.

Internal Space Relationships -Walking Distance, Observation by staff, separate sex, Security Support Facilities – toilets, bathrooms, storage, seating, disabled provision Location – Distance from linked facilities, car parking reasonably close, and access to public transport, lifts and stairs

A Very satisfactory, no change needed B Satisfactory, minor change needed C Not satisfactory, major change needed D Unacceptable in its present condition Added to C Supplementary rating added to D to indicate only a total rebuild X or D will suffice

Facet 3 Space Utilisation

Rate according to questions: - How intensively is the space being used? How does usage vary over time (working day or week)? How does available space compare with national guidance?

E Empty U Under-used F Fully used O Overcrowded

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

Appendix 4 Key to 6-Facet Survey Summary Table

Facet 4 Quality

Based on three elements:-

Amenity – privacy, dignity, comfort, working conditions, signposting Comfort Engineering – well lit, adequate heating and cooling, noise, odour Design – attractive design, well furnished, art, plants, landscaping

A Excellent quality B A facility requiring general maintenance investment only C A less than acceptable facility requiring capital investment D A very poor facility requiring major capital investment or replacement

Facet 5 Fire and Health & Safety/Statutory & non-statutory compliance

Assess each of Fire and Health & safety for each block.

Building complies with all statutory requirements and relevant A guidance Building where action will be needed in the current plan period B to comply with relevant guidance and statutory requirements C A building which falls short of B Areas which are dangerously below B standard (subject to D adverse external inspections) Added to C or D to show that structural improvements are X either impractical or too expensive to be tenable

Facet 6 Environmental Management

At present this means Energy Performance only – Will include Water Consumption, Waste Management, and transport Management.

Rank each block based on the following: –

A 35-55 GJ per 100 cubic metres B 56-65 C 66-75 D 76-100 Added to C or D indicates improvement to a B performance is either X impossible or uneconomic.

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

Appendix 5 Moderate and Low Risk Backlog Maintenance Jobs

Cons Block Rem Likely Risk ID Building Background q Risk Rank TOTAL No Life Score Score Score

E055 REPLACE MODERATE 164 OPD 03 22 HV RING MAINS 5 2 10 31,088.75

E013 REPL HV MODERATE 27 OPD 56 31 GEAR 5 2 10 26,647.50

E053 REPL HV MODERATE 89 OPD 59 25 RINGMAIN 5 2 10 53,295.00 M123 CYLINDER MANAGEMENT & COMPLIANCE MODERATE WITH EURO 84 OPD 99 26 REGS 5 2 10 11,756.25 M134 ISOLATING VVALVES FOR MODERATE 163 OPD 01 23 LEGIONELLA 3 3 9 8,882.50 M026 ACCESS TO EXTRACT MODERATE 85 OPD 01 23 FANS 3 3 9 10,450.00

B061 SHOWER MODERATE 81 OPD 01 23 ROOMS 3 3 9 26,647.50 M019 OPD MATY VENT IN HV MODERATE 165 OPD 03 22 ROOMS 3 3 9 - E106 UPGR LOCAL MODERATE 82 OPD 03 22 DISBOARDS 3 3 9 -

E107 UPGRADE MODERATE 26 OPD 03 22 LIGHTING 3 3 9 17,765.00 M004 HYDRO POOL MODERATE PIPEWORK & 161 OPD 03 22 CHLORINE 3 3 9 21,788.25 E091 OPD XRAY UPGRADE LV MODERATE 87 OPD 03 22 DISTRIBUTION 3 3 9 35,530.00

B072 ROOF MODERATE 83 OPD 03 22 REPAIRS 3 3 9 42,636.00

B100 REPL MODERATE 24 OPD 03 22 VINYL FLOORS 3 3 9 88,825.00

M146 STORAGE MODERATE 166 XRAY Store 08 28 CISTERN 3 3 9 3,553.00

E024 UPG N MODERATE 153 E&F 14 28 CALL SYS 3 3 9 53,295.00

E105 UPG LOC MODERATE 140 MED SECS 30 32 DISBOARDS 3 3 9 8,882.50 E104 UPGRADE CATERING MODERATE 200 Maternity Block 34 22 DISTRIBUTION 3 3 9 -

E009 FIRE MODERATE 120 Maternity Block 41 18 ALARM 3 3 9 4,441.25 E100 UPG TRANSFORMER MODERATE FEEDER PILLAR 115 Maternity Block 48 15 ETC 3 3 9 22,206.25 E080 DIAB FOOT CLIN OOFSPACE MODERATE 41 Maternity Block 49 28 - LIGHTING 3 3 9 444.13

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Cons Block Rem Likely Risk ID Building Background q Risk Rank TOTAL No Life Score Score Score E084 STAFF HEALTH MODERATE ROOFSPACE 119 Maternity Block 49 28 LIGHTING 3 3 9 4,441.25 E102 REPL GENERATOR (EX MODERATE 44 Maternity Block 56 31 NORTH) 3 3 9 13,323.75

E089 REPL LV MODERATE 118 Maternity Block 58 9 GEAR 3 3 9 10,659.00

E085 REPL MODERATE 168 Maternity Block 73 22 INTERCOM 3 3 9 5,329.50 M039 CLEAN DIRTY EXTRACT MODERATE 71 Maternity Block 80 26 SYSTEMS 3 3 9 54,340.00 M136 VENT FOR MODULAR MODERATE 147 Maternity Block 81 41 BOILERS 3 3 9 -

M101 ADDL GAS MODERATE 39 Maternity Block 99 26 OUTLETS 3 3 9 2,403.50

M148 LIFTING MODERATE 167 Maternity Block 99 26 BEAM 3 3 9 5,329.50 E050 CORRIDORS MODERATE ADDL SOCKETS 42 Maternity Block 99 26 & RCDS 3 3 9 8,882.50 E079 ALARMS FOR S/BY MODERATE 40 Maternity Block 99 26 GENBERATORS 3 3 9 8,882.50

B070 FIRE MODERATE 195 STAFF BUNGALOWS 99 26 DOORS 3 3 9 8,882.50

M121 ADDL 4 MODERATE 146 MINSMERE HOUSE 99 26 BAR OUTLETS 3 3 9 13,062.50 M135 DHWS CALORIFIER MODERATE 182 WESTERFIELD/ORFORD 99 26 LEGIONELLA 3 3 9 17,765.00 E090 INST ADDL WESTERFIELD SOCKETS ALL MODERATE 127 /ORFORD 99 26 WARDS 35 3 3 9 25,550.25

WESTERFIELD M149 ROOF MODERATE 181 /ORFORD 99 26 EDGE 3 3 9 44,412.50 E095 N CALL HANDSET MODERATE 152 GERI PLANT RM 99 26 REPLACEMENT 3 3 9 71,060.00 M119 ADDL OXYGEN MODERATE 66 HAYWARD 99 26 OUTLETS 3 3 9 72,888.75 M122 ADDL VACUUM MODERATE 185 HAYWARD 99 26 OUTLETS 3 3 9 79,942.50

B098 ROAD MODERATE 184 HAYWARD 99 26 REPAIRS 3 3 9 88,825.00 M088 COMPLIANCE MODERATE WITH HTM2025 45 BEALINGS 99 26 THEATRE VENT 3 3 9 146,718.00 B008 FOUNDATION LOW 148 JNR DR'S HOME 05 50 SUBSIDENCE 2 2 4 25,315.13

E070 LIFT SHAFT LOW 139 NUCLEUS 2 14 28 LIGHTING 2 2 4 4,441.25

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Cons Block Rem Likely Risk ID Building Background q Risk Rank TOTAL No Life Score Score Score M077 RENEW CONDENSE LOW 137 NUCLEUS 2 14 28 MAIN 2 2 4 6,792.50 E020 LIFTS - CONTROL SYS & LOW 138 NUCLEUS 2 14 28 CARS 2 2 4 177,650.00 B054 REPAIR WINDOWS LOW 136 NUCLEUS 2 18 23 DOORS 2 2 4 -

M074 SERVICES LOW 150 ONCOLOGY 23 6 DUCT 2 2 4 15,413.75 M025 FRENGER CEILING LOW 114 ONCOLOGY 24 27 HEATING 2 2 4 21,945.00

B025 FRENGER LOW 113 ONCOLOGY 24 27 CEILING TILES 2 2 4 71,060.00 E045 ALTERATIONS LOW TO ELECTRICAL 112 ONCOLOGY 34 22 MAINS 2 2 4 - M133 PHOTOTHERAPY LOW 201 SITE 48 15 HEAT PUMPS 2 2 4 888.25 M043 INSULATION LOW UNDERGROUND 61 SITE 48 15 STEAM MAIN 2 2 4 2,612.50

B033 EXT LOW 99 SITE 48 15 DOORS 2 2 4 5,329.50 E056 UPGRADE HEATING LOW 104 SITE 74 27 CONTROLS 2 2 4 - M128 INSTALL BOOSTER PUMP LOW ON RETURN TO 100 SITE 76 31 OPD 2 2 4 1,306.25 M078 UPGRADE HWS SEC LOW 110 SITE 76 31 CIRCULATION 2 2 4 7,733.00 M040 CONDENSE LOW 58 SITE 80 26 RETURN P/RM 8 2 2 4 1,045.00 M013 WATER PENETRATION LOW 59 SITE 81 41 IN VENT SYS 2 2 4 5,329.50

M007 HIGH LOW 175 SITE 81 41 ROOM TEMPS 2 2 4 54,653.50 M061 GLASS TRAPS ON LOW 102 SITE 99 26 HUMIDIFIERS 2 2 4 1,567.50

B077 LOW 107 SITE 99 26 FOOTPATHS 2 2 4 9,770.75

M021 UPGRADE LOW 60 SITE 99 26 LAGGING 2 2 4 38,665.00

E038 EARTH LOW 111 SITE 99 26 BONDING 2 2 4 39,971.25

M033 RELAG LOW 62 SITE 01 23 VENT DUCTS 1 2 2 10,450.00 E078 LIGHTING TO ROOF LOW 101 SITE 03 22 WALKWAYS 2 1 2 3,553.00

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

Cons Block Rem Likely Risk ID Building Background q Risk Rank TOTAL No Life Score Score Score

B006 EXT MAINT LOW 103 SITE 03 22 TO WINDOWS 1 2 2 16,432.63

B022 DOOR LOW 179 SITE 14 28 LOCKS 1 2 2 2,612.50

B050 EXT LOW 97 SITE 27 25 SRTRUCTURE 1 2 2 2,612.50

E008 ELECT LOW 108 SITE 41 18 INST 1 2 2 17,765.00

B024 DOOR LOW 174 SITE 48 15 LOCKS 1 2 2 1,332.38

B040 LIGHTING LOW 109 SITE 99 26 BARRIERS 1 2 2 2,612.50

LOW 105 SITE 99 26 B017 VERGES 1 2 2 8,882.50

B083 EXTERNAL LOW 94 SITE 99 26 DEC 1 2 2 142,120.00 M100 HANDRAILS LOW 63 SITE 03 22 UNDERCROFT 1 1 1 9,300.50 M035 PHYSIO VENT OT LOW 96 SITE 03 22 KITCHEN 1 1 1 26,647.50

E012 PATH FAN LOW 106 SITE 03 22 COIL 1 1 1 44,412.50 E025 UPG OVERBED LOW 95 SITE 14 28 LIGHTING 1 1 1 13,323.75

E023 UPGRADE LOW 176 SITE 14 28 LIGHTING 1 1 1 26,647.50 E006 24/12 HEATING LOW 91 SITE 36 26 CONTROLS E6 1 1 1 4,890.60 E035 OLD CORR REM LOW REDUNDANT 50 SITE 48 15 SERVICES 1 1 1 4,441.25

M062 REM LOW 173 SITE 58 9 STORAGE TANK 1 1 1 15,988.50 E040 CHILLER TIME TEMP LOW 172 SITE 73 22 CONTROLS 1 1 1 3,997.13

M027 CHAMP LOW 178 SITE 80 26 HEATING 1 1 1 8,882.50

M037 STEAM LOW 93 SITE 99 26 METERS 1 1 1 110,770.00

THE IPSWICH HOSPITAL NHS TRUST ESTATE STRATEGY January 2008

Appendix 6 Performance Indicator Percentile Groupings

33% 34% 33%

Space Efficiency 188 189 and 215 216 82 83 and 96 97 133 134 and 170 171 148 149 and 195 196 Asset Productivity

133 134 and 170 171 93 94 and 131 132 61 62 and 152 153 107 108 and 161 162 Asset Deployment

242 243 and 423 424 91 92 and 113 114 132 133 and 170 171 93 94 and 131 132 Estate Quality

133 134 and 170 171 58 59 and 78 79 14 15 and 46 47 16 17 and 57 58 Cost of Occupancy

107 108 and 161 162 172 173 and 194 195 214 215 and 256 257 93 94 and 131 132