Chief Executives Group

Argyll and Bute CHP Committee 14 June 2007 Item 9.2

ARGYLL AND BUTE CHP CAPITAL PLAN 2007/08 – 2011/2012

Report by the Head of Planning, Contracting and Performance & Head of Finance

The CHP Committee is asked to:

 Note the information contained in this paper relating to the CHP’s 5 year capital plan.  Note that this plan was approved by the CHP Management Team at its meeting on 24 May 2007.

1 INTRODUCTION

Each NHS Board has to approve a 5-Year Capital Investment Programme and the attached is the Argyll and Bute CHP contribution to NHS Highlands Capital plan which will be considered by the Board at its June meeting.

The attached paper provides detail on the major capital developments, minor scheme allocations e.g. replacement vehicles, minor estate upgrades etc, medical equipment replacement and property disposals. It also details the financial schedules which capture the capital allocations and all known commitments and proposals over the next 5 years.

The CHP has an allocation of £8.677 million and a current expenditure plan of £6.42 million for 2007/08.

2 NEXT STEPS

The CHP has undertaken an estate condition survey review which was presented at a workshop on 23rd May 2007, where a number of scenarios were developed to inform our ongoing estate and property strategy. The findings of this will inform the final prioritisation and iteration of the plan by the CHP capital planning group in 2007/08.

3. Governance Implications

Policy/Organisational: Meets local delivery plan and corporate objectives and targets

Financial: Aligned with Financial management plan Staff Governance Not applicable Patient Focus & Public Not applicable. Involvement Clinical Not applicable Equality & Diversity Not applicable Impact:

Stephen Whiston George Morrison Head of Planning, Contracting and Performance Head of Finance

4 June 2007

Working with you to make Highland the healthy place to be Argyll and Bute CHP

CAPITAL PLAN 2007/08

CHP Capital Plan Version 0.7 06/05/2018 Page 2 of 15

FIGURE 1 – NHS HIGHLAND – SINGLE PAGE STRATEGY - SPDIER DIAGRAM CEO Objectives - LDP , CHP & Organ Structure , Public Planned Care Engagement / Comms , Planning

Unscheduled Care Diagnostics Developing a Health Promoting Reducing Health Organisation Health Inequalities Access Improvement Access & Waiting Targets Fair to All Projects CEO Objectives - LDP , Planning , CHP Dev & Organ Structure , Health Improvement CEO Objectives - LDP , Planning , Public engagement / Comm 's , Delivering for Health , Clinical Quality , Partnership Framework & Local Delivery Plan

Local Long Term Development Plan Conditions Shifting the Finance Balance of Care Cervical Property Strategy Screening Healthcare Associated Efficiency & E - health Infection Treatment Workforce Governance Patient & Public Planning Expectation

Planned Care Mental Health CEO Objectives - LDP , Planning , CHP & Organ Structure , Corp Team / QIS Standards Leadership , Gov / Board develop , JPIAF Redesign

CHP Capital Plan Version 0.6 06/05/2018 Page 3 of 15 Introduction

1. Argyll and Bute CHP Capital Plan

The Argyll and Bute Capital plan incorporates major capital developments, minor scheme allocations e.g. replacement vehicles, minor estate upgrades etc, medical equipment replacement and property disposals. Appendix 1 details the financial schedules which capture all known commitments and proposals over the next 5 years.

The capital allocation for the CHP is detailed below:

The summary commitments against the capital allocations are shown below:

DRAFT A&B CHP Capital Plan 2007/08 (as at 3 May 2007)

7/8 8/9 9/10 10/11 11/12 Total £'000 £'000 £'000 £'000 £'000 £'000

Available Funding 8,677 5,718 5,718 5,718 5,718 31,549

7/8 8/9 9/10 10/11 11/12 Total Capital Plan £'000 £'000 £'000 £'000 £'000 £'000

Commitments 5,758 4,441 2,177 427 427 13,230 Proposals 1,556 3,760 4,441 6,416 4,916 21,089 Property Sale adjustments [NBVs] (894) 0 0 0 0 (894)

TOTAL 6,420 8,201 6,618 6,843 5,343 33,425 under/(over) commitment 2,257 (2,483) (900) (1,125) 375 (1,876)

The Capital plan has been developed and agreed by the CHP Capital Planning Group chaired by the Head of Finance and the CHP Medical Equipment group chaired by the Clinical Director.

CHP Capital Plan 06/05/2018 When approving capital schemes, the CHP recognises associated revenue costs and plans for them accordingly within the CHP’s revenue financial plan. It can be accepted therefore that any approved capital scheme commitments will have supporting revenue funding identified and allowed for.

There are a number of schemes which are still at proposal stage, particularly so for the later years of the 5 year plan. As these schemes are only at proposal stage, revenue consequences have not yet been identified and allowed for within the revenue plan. However, all proposals will be scrutinised for associated revenue costs and will not be converted to commitments unless supporting revenue funding can be confirmed. It should be noted that with relatively healthy availability of capital funding, this will bring some pressure to bear in terms of affording associated revenue costs.

2. Major Capital Schemes

The purpose of this report is explore in more detail the major capital approved projects with a view to completion within the current financial year 2007/08.

As projectsArgyll and are BUTE completed CHP other– Pen project picture proposals Major Schemes shall be reviewed2007/08 &to 08/09 consider their priority and what capacity is available within the Department, CHP and the rest of NHSDunoon Highland Community for them to Hospital be undertaken, thereafter projects could be redefined as approved and moved forward to being implemented. This project will provide modern purpose built facility to support a fully In orderfunctioning to ensure and project integrated work Community is in line with Casualty approved /PCEC priorities, service taking incorporating account of capacity,ENPs, resource GPs the availabilitySAS and a (bothnew X-raycapital department. and revenue), As statusthe busiest of schemes unit within and their deliverabilitythe CHP thewithin functional timescale, suitability careful of consideration the unit is woefully has been inadequate given to andproject activity in theincorrectly financial sited, year 07/08it will beand relocated 08/09. To to assistthe front this of process, the hospital. projects This have produces been presenteda domino and effect approved which by will the see Capital the community Planning Group,midwifery under unit theand following community headings:-nursing staff/social work and pharmacy relocated into more appropriate accommodation.  Approved – Bid forms indicating capital and recurring funding requirements The submittedproject will and also approved see some by essential Capital Planning engineering Group, and funding infrastructure allocated, work project carriedmanager out and identified. fits within an overall service and site plan for the Cowal locality. Proposed Total project – incorporates cost £3million look forward commitments to 08/09 and 09/10, and also preliminary project information determined, indicative budgetary Bunessaninformation GP practiceidentified, no formal approval sought nor funding allocated and no project manager identified. Located on the Ross of Mull this medical practice (which also covers the Isle Theof schedule Iona) is indetailing urgent approvedneed of modernisation and proposed and projects upgrading. are presented This need in had the annexesbeen recognised1-2 attached. by the SEHD and as such a business case was approved and funded under the Modernisation of Primary care premises imitative and In additionwill provide the Capitalpurpose Planning built facility Group for alsothe whole logs and primary records health “pre-proposal” care team and projects its as a688 horizon patients. scan Total for future cost £1.35 assessment. million

All theMull projects & Iona identifiedProgressive are eitherCare Centrein line with NHS Highland and Argyll and Bute CHP Delivering for Health and Local Delivery plans (ref figure 1 above) and capital andExpected revenue budgets to open or inwill September be reviewed 2009, within thethese new contexts £8 million prior to Mull approval. & Iona As suchProgressive annexe 1 showsCare Centre the level at Craignureof completion is to and replace corresponding Dunaros Residential expenditure Home expectedand Hospital. to be achieved This partnership in 07/08. project includes, Argyll & Bute Council, (Lead organisation), NHS Highland, West Highland Housing Association, Communities Scotland & Mull Progressive Care Group.

The CHP share of the capital and revenue cost has been covered in its CHPfinancial Capital planPlan the new facility will incorporate 12 supported living 06/05/2018accommodation units for older people to allow them to remain on the island as their dependency needs change, 4 GP Acute Beds, 2 Bay Community casualty unit, multi-purpose diagnostic & treatment suite including X-Ray and physiotherapy etc.. CHP Capital Plan 06/05/2018 3. Update of Argyll & Bute CHP Estate Condition survey and Property Strategy

The current Property Strategy for Argyll and Bute premises was completed in June 2000 and is now out of date. A service specification was prepared and tendered in November 2006, detailing the requirements to update the existing current property condition data to inform a forward looking strategy for all the property owned and managed by Argyll & Bute CHP. Specialist consultants – Strategem Management Consultants have been appointed to review and update the CHP’s property condition, statutory compliance & utilisation information.

The CHP property strategy will be developed with input from the full range of clinical, nursing, administrative and management staff, other public sector partners notably Argyll and Bute Council and colleagues from corporate estates and capital planning functions of NHS Highland. It will be based on national guidance, Highland Health Board’s and the CHP’s Delivering for Health Action plan and is consistent with NHS Highland, property strategy action plan approved at the Health Board Meeting in February 2007 (Annexe 3)

The Property Strategy is to follow the guidelines of Health Facilities Scotland, (Formerly Property & Environment Forum) document, “Property Strategy – The Way Forward” first published August 1999 – BHE/99/2 and as emphasised in MEL(1999)44 – Property Management policy and other related matters and in the National Audit Office’s report “Making The Most of The Estate”, February, 1999.

We will then use this information to inform and model a range of service scenarios taking account of - patient activity patterns - within the CHP and outwith to NHSGG&C, the public sector reform agenda and our existing capital plan - in which to develop our CHP estate and property requirements at a workshop on the 23rd May 2007. The outcomes of which will be used to inform the CHPs capital investment plan for the next 5 years.

4. Change in Priorities

As identified early it is possible that in year there will be changes to the status of the schemes regarding progression, completion and or review e.g. the findings of the Estate condition survey as detailed above.

Also the status of the Oban Dental scheme currently in the pre-proposal stage has changed, requiring priority work up and approval to address a pressing service need. In April 2007 the independent dental practice in Oban withdrew from providing an NHS patient service affecting over 2000 patients. The CHP is urgently working up proposals to discuss with the SEHD options to provide an alternative service and associated facilities and what additional resources are required.

These are likely to have an impact on the deliverability on some of the schemes planned for 07/08 and 08/09 as and those in the pre proposal stage. These issues and options are currently being considered and will be brought to the CHPs Capital Planning Group for review.

CHP Capital Plan 06/05/2018  Annexe 1 – CHP Approved Projects 2007/08 – 8th May 2007

% Completet It Propos ion % Spend e Project Project Project ed Financial Financial Year m Project Description Lead Status Budget Start* Year 07/08 07/08 Comments Stephen July 1 Campbeltown Audiology Wilson Approved £40,250 2007 100% £40,250 Stephen May 2 Campbeltown A&E Wilson Approved £335,000 2007 100% £335,000 Bunessan Medical Stephen July 3 Centre (see note below) Wilson Approved £1,350,000 2007 50% £675,000 Stephen Aug 4 Islay Audiology Wilson Approved £40,250 2007 100% £40,250 Stephen May 5 Dunoon Endoscopy Wilson Approved £280,000 2007 100% £280,000 Stephen June 6 Oban Endoscopy Wilson Approved £330,000 2007 100% £330,000 Stephen May 7 LIDGH Car Parking Wilson Approved £60,000 2007 100% £60,000 David June Dependant upon 8 Dunoon Car Parking Ross Approved £30,000 2007 100% £30,000 Community Casualty Unit 9 - Strachur, Southend & Stephen April 12 Furnance & LIDGH DDA Wilson Approved £188,000 2007 100% £188,000 Stephen July 13 Mid Argyll Helipad Wilson Approved £274,000 2007 100% £274,000 David Aug 14 Dunoon Audiology Ross Approved £40,250 2007 100% £40,250 David Aug 15 Rothesay Audiology Ross Approved £40,250 2007 100% £40,250

CHP Capital Plan Version 0.7 06/05/2018 Page 8 of 15 % Completet It Propos ion % Spend e Project Project Project ed Financial Financial Year m Project Description Lead Status Budget Start* Year 07/08 07/08 Comments Subject to incorporation of Vic Infirmary Dental David May changes made proposed 16 Decontamination Ross Approved £78,650 2007 100% £78,650 by Duncan Blues Dunoon 3rd Dental Subject to incorporation of changes made proposed Surgery + David July by Duncan Blues 17 Decontamination Ross Approved £108,550 2007 100% £108,550 Subject to incorporation of Lochgoilhead Dental David July changes made proposed 18 Decontamination Ross Approved £111,800 2007 100% £111,800 by Duncan Blues Subject to incorporation of Furnace Dental Stephen June changes made proposed 19 Decontamination Wilson Approved £71,500 2007 100% £71,500 by Duncan Blues Campbeltown Sunlounge Stephen June Funded from 20 Conversion Wilson Approved £40,000 2007 100% £40,000 Endowments. David May 21 Rothesay Shower Room Ross Approved £20,000 2007 100% £20,000 Islay Hospital Electrical Stephen July 22 Swithgear Wilson Approved £53,000 2007 100% £53,000 CHP management Dunoon Community June team Approved 5 Casualty Unit Proposal £3,070,000 2007 46% £1,412,200 April 07 £2,816,500

Note: * Start dates are provisional and assume the following :- Planning permission and building warrants are in place, Bona Fide tenders received, Acceptance letters issued, Where necessary suitable alternative patient services in place,

CHP Capital Plan Version 0.6 06/05/2018 Page 9 of 15 Annexe 2 – CHP Proposed Projects 2007/08 – 8th May 2007

% Comple tion Proje Financi % Spend ct Proposed al Year Financial Item Project Description Lead Project Status Project Budget Start* 07/08 Year 07/08 Comments Dependant upon Community Casualty Unit. Capital bid to be brought to 1 Dunoon Lifts Proposal £414,000 £0 Capital Planning Group Land purch ase Tighnabruaich MC - +fees 2 Reprovision Proposal only

18 month construction period - capital liability for this year remains to be Mull & Iona Progressive Nov calculated ( Consultant project managers 3 Care Unit Proposal 2007 to produce expenditure profile) Land purch ase Port Appin MC - +fees 4 Reprovision Proposal only Dates assume 12 weeks planning approval period 12 weeks building manufacture time (these may be improved by confirming Oct facility is temporary and by considering 5 Bute Dental Cabin Proposal £227,500 2007 100% £227,500 purchase of pre used buildings) Mid Argyll, Islay & Tiree Sep 6 Dental Decontamination Proposal £300,000 2007 100% £300,000 Subject to approval of Duncan Blues DDA Physical August 7 Compliance Works Proposal £300,000 2007 100% £300,000 £1,241,500 £827,500

CHP Capital Plan Version 0.6 06/05/2018 Page 10 of 15 Annexe 3 – NHS Highland Property Strategy Action Plan

ACTION LED BY TARGET TIMESCALE

Prepare Condition Appraisal Report on Argyll John Swatman – Head of Estates April 2007 & Bute properties

Commission Condition Appraisals on GP John Swatman – Head of Estates June 2007 owned premises David Blair – Head of Capital & Property Planning

CHPs / SSU to develop property General Managers 2007 / 2008 requirements in their Clinical Strategy Delivery Plans.

Establish a Steering Group and review the Elaine Mead – Chief Operating Officer September 2007 vision for Raigmore over the next 20 years. Susan Eddie – SSU General Manager

Work with Wellbeing Alliance partners to David Blair – Head of Capital & Property Planning Ongoing. identify any opportunities for co-location.

Prepare Five-Year Capital Plan to be David Blair – Head of Capital & Property Planning February each year. reviewed annually by the Board.

CHP Capital Plan Version 0.6 06/05/2018 Page 11 of 15 APPENDIX 1 DRAFT A&B CHP Capital Plan 2007/08 (as at 3 May 2007)

7/8 8/9 9/10 10/11 11/12 Total Commitments £'000 £'000 £'000 £'000 £'000 £'000 Project Manager

Campbeltown Hospital - A&E 335 335 John Dreghorn Helensburgh accommodation - phase 2 75 75 David Ross Endoscopy Decontamination - LIDGH 330 330 Moira Newiss Endoscopy Decontamination - Dunoon 280 280 Viv Smith Mull & Iona PCC 1,750 1,750 3,500 Moira Newiss Dunoon DGH Lifts Upgrade 45 45 Viv Smith Bunessan GP Surgery 700 649 1,349 Moira Newiss LIDGH Medical Physics Lab. Upgrade 20 20 Moira Newiss LIDGH car parking 60 60 Moira Newiss Rothesay Victoria Infirmary & HC flooring upgrades 39 39 Viv Smith Dunoon DGH car parking 30 30 Viv Smith DDA compliance works - several sites 188 188 Stephen Wilson Mid Argyll Helipad 274 274 John Dreghorn Dental Decontamination Room - Furnace 72 72 David Ross Dental Decontamination Room - Helensburgh 79 79 David Ross Dental Decontamination Room - Dunoon 109 109 David Ross Dental Decontamination Room - Lochgoilhead 112 112 David Ross Upgrade of Audiology Rooms (4 sites) 161 161 Stephen Wilson Lochgilphead - Purchase of Van 23 23 Jim Dempsey Islay Hospital - Electrical Upgrade 53 53 John Dreghorn Campbeltown Hospital Car Parking 100 100 John Dreghorn MACH Door Hold Backs (capital grant) 52 52 John Dreghorn MACH Nurse Call System Upgrade (capital grant) 16 16 John Dreghorn Rothesay Dental Cabin 293 293 David Ross Dunoon Community Casualty Unit 1,500 1,570 3,070 Viv Smith Minor Allocations (see separate analysis) 77 0 0 0 0 77 George Morrison Medical Equipment (see separate analysis) 353 0 0 0 0 353 Erik Jespersen Mid Argyll PFI 427 427 427 427 427 2,135

Total Commitments 5,758 4,441 2,177 427 427 13,230 CHP Capital Plan Version 0.7 06/05/2018 Page 12 of 15 APPENDIX 1 DRAFT A&B CHP Capital Plan 2007/08 (as at 3 May 2007)

7/8 8/9 Minor Schemes Commitments £'000 £'000 Project Manager Date Approved

LIDGH - Helipad Lighting Upgrade 7 Moira Newiss 10 July 2006 Dunoon DGH Upgrade Medical Vacuum Plant 15 Viv Smith 7 September 2006 Rothesay Victoria Annexe Patient Bathing/Shower Upgrade 20 Viv Smith 7 September 2006 LIDGH - Upgrade of emergency paging system 7 Dave Millward 23 October 2006 Rothesay - Replacement van 10 Jim Dempsey 7 November 2006 LIDGH - Upgrade to Heat recovery system 4 Moira Newiss 1 February 2007 LIDGH - Plumtree Scanner System 14 Moira Newiss 23 March 2007

Total carried-forward 77 0

7/8 8/9 Medical Equipment Commitments £'000 £'000 Project Manager Date Approved Further Comment

LIDGH - X-Ray equipment 100 Moira Newiss 2 November 2006 Dunoon Hospital - X-Ray equipment 100 Viv Smith 2 November 2006 Dunoon Hospital - Dental Chair 25 John Herrick 2 November 2006 Islay Hospital - Sonicaid Team Care Monitor and Printer 7 John Dreghorn 25 April 2007 Lifespan 10 years Argyll & Bute Hospital - Vital Signs Monitor 11 John Dreghorn 25 April 2007 Lifespan 10 years LIDGH - Blood Bank Refrigerator 8 Moira Newiss 25 April 2007 Lifespan 10 years LIDGH - Blood Transfusion Automation System 70 Moira Newiss 25 April 2007 Lifespan to be confirmed LIDGH - Keymed Olympus Gastroscope 32 Moira Newiss 25 April 2007 Lifespan 10 years

Total carried forward 353 0

CHP Capital Plan Version 0.6 06/05/2018 Page 13 of 15 APPENDIX 1 DRAFT A&B CHP Capital Plan 2007/08 (as at 3 May 2007)

7/8 8/9 9/10 10/11 11/12 Total Proposals £'000 £'000 £'000 £'000 £'000 £'000 Project Manager

Dental decontamination rooms ( 3 sites ) 300 300 David Ross Tighnabruiach GP Surgery 634 634 1,268 Viv Smith Inverary GP Surgery 1,275 1,275 John Dreghorn Port Appin GP Surgery 500 750 1,250 Moira Newiss Dunoon Integrated Health Centre 1,500 1,500 3,000 Viv Smith Rothesay OBC 4,000 4,000 8,000 Viv Smith Dental Practice Improvement Grants 0 0 Alex Fraser Primary Medical Services - Premises 98 98 98 98 98 490 Joyce Robinson Primary Medical Services - IT 50 50 50 50 50 250 Sylvia Moran Minor Allocations 223 300 300 300 300 1,423 George Morrison Medical Equipment 115 468 468 468 468 1,987 Erik Jespersen Thomson Court, Rothesay (capital grant) 210 210 Viv Smith PACS radiology system 36 36 Sylvia Moran Dunoon Hospital - Pedestrian Access upgrade 100 100 Viv Smith LIDGH - CT Scanner 500 500 Moira Newiss Oban Dentistry 1,000 1,000 Moira Newiss

Total proposals - not yet committed 1,556 3,760 4,441 6,416 4,916 21,089

CHP Capital Plan Version 0.6 06/05/2018 Page 14 of 15 APPENDIX 1

7/8 8/9 9/10 10/11 11/12 Total £'000 £'000 £'000 £'000 £'000 £'000 Property Sale adjustments (NBVs) Land at Ganavan, Oban (734) (734) Surplus land at Mid Argyll Hospital (part site) *** (150) (150) Surplus land at Tarbert HC (part site) *** (10) (10) Kilcreggan - Former GP surgery site 0 0 Housing Stock Transfer 0 0 Surplus land at Argyll & Bute Hospital 0 0 Land at Kilcreggan 0 0

Total carried-forward to Summary (page 1) (894) 0 0 0 0 (894)

*** Net book values to be verified

CHP Capital Plan Version 0.6 06/05/2018 Page 15 of 15