Harston Surgery Job No

Harston Surgery Job No. 111637

FBC

Author: A Folan-White Checked by: S Clarke Date: November 2020 Status: For comment

OBC Harston Surgery Job No: 111637 - Date: November 2020

CONTENTS

FBC – Harston Surgery

Appendix No Document Description 1 Letter from Jan Thomas 2 Email from Jonathan Stone 3 Cost Estimator 4 Utilisation schedule 5 Notional Rent Reimbursement Determination Email 26.04.2019 6 Affordability document 7 Planning Approval 8 Site plans and design drawings 9 Alys Turner consultation email 10 Timeline 11 Working Group minutes 12 Confirmation of Section 106 funding 13 Confirmation of funding extension 14 Professional services fee letter 15 Previous Appendices from OBC Options Appraisal Value for money document

Tender Analysis Tender submissions

Project Appraisal Unit

Capital Investment, Property, Equipment & Digital Technology proposals

NHS England Project Appraisal Unit

£1m - £3m Business Justification Template

To be used for Capital Investment, Property & Equipment between £1m and £3m and complex schemes below £1m

Sponsors and authors of documents seeking appropriate authority to fund or proceed with a scheme or project must consider whether the content or strategy to which the document applies at this stage is sensitive or may have commercial implications. If it is considered necessary, the document should be headed and watermarked appropriately.

Document version Version No. Status Issue date Notes control (for use by Business Case sponsors)

Add rows as required.

Last entry should read: ‘Final submission for review and approval’

SCHEME DETAILS Harston Surgery Expansion 1. TITLE OF SCHEME TYPE OF SCHEME New build Yes Note. For £1m - £3m Digital Technology Business Cases, please Improvement Yes use the specific £1m - £3m Digital Technology Business Justification / Equipping Case Template. If other – specify

and explain

Scheme reference number and Reference source of number (organisation).

Please ensure the relevant unique Confirm the Organisation reference (for all Schemes) is used in Harston Surgery issuing the all correspondence and reporting D81058 using appropriate format: e.g. XXX – reference YY - XXX (Org Code – 17 – 001) number.

ANY OTHER APPLICABLE REFERENCE NUMBER

(please clarify source in light blue box on right and insert number and, where necessary, explanantion in white box).

PID reference D81058-18-001 number

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PID APPROVAL AND ANY 8th February 2019 (Letter from Jan Thomas of CAPCCG RELATED CONDITIONS OF Appendix 1). Date th APPROVAL OBC approval e-mail from Jonathan Stone dated 24 September 2020 Appendix 2. (Append approved PID where it will List any None noted support the information provided in conditions this Business Case). Conditions Confirm that PID conditions have are fully met. been fully complied with in this If not, which Business Case. Explain which and and justify why if they have not. why.

Details of The scheme has been developed further to demonstrate scheme accessibility and associated support spaces. change? Details of Costs for the proposed schemes are detailed in this FBC and IDENTIFY ANY SIGNIFICANT cost change? Appendix 3,6 and 14. Increase in costs of £46,126.12 DEROGATION IN THIS Unknown costs have come to light with existing heating, Reason for BUSINESS CASE FROM THE drainage following surveys undertaken after submission of change? APPROVED PID FOR THIS OBC. SCHEME. Who approved the (Significant deviation from the original change? approved PID, includes but are not Date of exclusively funding, cost, deliverables, procurement, client or change? use changes, etc.). Please provide evidence of authority to change.

DCO OFFICE

Lead Harston Surgery 2. SPONSORING NHS Sponsor 1: ORGANISATION(S) Sponsor 2: NHS England, Midlands and East (East) (or other such as GP) Sponsor 3: South Cambs District Council

3. LEAD SPONSOR AND SUPPORTING TEAM FOR THE SCHEME CONTACT DETAILS Title GP Partner Name Dr Chris Gee PROVIDE DETAILS OF LEAD Organisation Harston Surgery OFFICER FOR THE SCHEME Office tel. 01223 870250 Mobile tel. 07711 284924 e-mail [email protected]

Title Director of Finance Name Daryl Cockman PROVIDE DETAILS OF LEAD Organisation NHS England Midlands and East (East) FINANCE OFFICER FOR THE SCHEME Office tel. 0113 825 4932 Mobile tel. 07824 457 93 e-mail [email protected]

Title Head of Primary care Commissioning LEAD COMMISSIONER Name Dawn Jones

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Cambridge and Peterborough Clinical Commissioning Group Organisation (CAPCCG) Office tel. 01480 387137 Mobile tel. 07908 068861 e-mail [email protected]

Where applicable, 4. NHS ENGLAND FUNDING funding Section 106 and Premesies Improvement grant STREAM initiative

Please confirm the NHS England name capital funding stream relevant to this Scheme investment e.g. BAU, etc. reference D81058-18-001 No. (Use standard NHS finance codes) Funding Where capital funding is from a stream special initiative e.g. ETTF, please use the first two rows opposite to Cost Centre denote initiative name and scheme reference number Subjective

Code

5. ANY OTHER PROPOSED A significant level of developer contributions have already been secured through SOURCE OF CAPITAL? section 106 agreements signed between South Cambridgeshire District Council In addition to NHS England capital, and the respective land owners. explain if more than one source of funding is to be accessed, explain: The contributions secured are sufficient to cover most of the cost of the extension a) How it is to be obtained and internal improvements for which approval is being sought with the additional b) Obtained from whom? monies being sought by way of a Premesies improvement Grant c) Type of funding. These monies would allow the creation of accessible toilet spaces, entrance d) Certainty of funding doors and support the installation of ventilation equipment to provide statutory air changes within the minor procedure room. e) Is any element refundable or

provided as a grant? The return of tenders indicates that the total build cost would be f) If yes to e) above, provide details £599,558.13, this would be broken down as below: g) Show amounts in table 1. below The details of these are as follows:

Development Planning ref Amount £ Spend expected restriction Bayercropscience S/2308/06/O £206,499.88 May 2015 Spent May Hauxton 2020 – extension to May 2021 confirmed Cemex Barrington S/2365/14/OL £185,000 2022 10 years from receipt Station Rd S/2148/16/OL £6,000 2021 10 years Foxton from receipt Section 106 £10,000 acrued interest from Hauxton section 106 monies £407,499.88 Premises £192,058.25 Improvement grant / surgery Total £599,558.13

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a) Balance of capital cost is £192,058.25. This will be subject to a premises improvement grant application and surgery contribution (66/34% split £126,758.45 Grant / £65,299.80 surgery contribution) b). This will be subject to a premises improvement grant application c) Premises improvement grant funding d) Funding is guaranteed. e) Yes the £126,758.45 g) Totals are shown in Table 1 above

Please note: Due to when we expect the S106 monies to be released we expect that this improvement will be done in two stages; the first stage to begin as soon as possible will enable use of the Bayercropscience money which needs to be used by May 2021. The second stage is dependent on the funds from the Cemex Barrington development. The S106 states that the funds must be paid to the District Council prior to the occupation of the 100th dwelling on the site. The site is not due to be released until 2021, so it is reasonable to expect that funds will be available for financial year 2022/23. The development of the second stage could be moved back to 2023/24 if the funds were not available at the time. The design takes account of both consulting and administration space for each stage.

The proposals have been developed to provide the option of a phased approach to align with the expected availability of s106 monies:

Phase 1 The main phase of works will construct the two-storey extension and include the internal re-modelling to install the new staircase and provide access to the new accommodation. At ground floor, this extension will ultimately provide 3 No. consulting rooms, however in the intervening period prior to Phase 2, one of these rooms will temporarily provide additional ancillary / administrative accommodation. A net increase of one additional consulting room will therefore be available at the end of phase 1 to accommodate the expected increase in population, and this phase would function as a stand-alone build should there be delays in the release of funding for phase 2.

Phase 2 As additional s106 monies are released, funding will then be available to complete the single storey extension which will provide a refurbished dispensary and additional ancillary / administrative space. This additional space will allow the consulting room constructed in phase 1 to be brought into service and thus further expand the clinical capacity of the surgery to accommodate the increase in population related to the release of the final pot of s106 monies.

Whilst a phased approach is achievable as demonstrated above, a single-phase build would provide efficiencies in cost and a shorter period of disruption for the surgery.

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Table 1. CAPITAL VALUE AND PROPOSED CASH FLOW OF FUNDING: (add additional rows as required) PERIOD Current year [Please enter appropriate Financial 2021-2022 2022-2023 2023-2024 Total 2020-2021 years on right] £’000 £’000 £’000 £’000 £’000 FUNDING SOURCE PHASE 1 PHASE 2

NHS England (Premises £10,000.00 £116,758.45 £126,758.45 Improvement grant) NHS Property Services Community Health

Partnerships / LIFTCo £21,499.88 (includes (S106 currently held) £195,000 £216,499.88 Other £10,000.00 interest) Other (S106 to be received) £6,000.00 £6,000.00 £50,786.00 ** We will approach the developer if any funds can be released earlier Other (S106 to be received as they appear Barrington funds/ NHSE assistance to be ahead of £134,214.00 £185,000.00 programme, due to timings) although we appreciate this is not guaranteed and is not critical to the business case proposed Other Surgery own funding £10,000.00 £55,299.80 £65,299.80

Total £215,000.00 £250,344.13 £134,214.00 £599,558.13

Table 2. BASIC BREAKDOWN OF SCHEME CAPITAL COST: (add additional rows as required) PERIOD [Please enter appropriate Financial Current year 2021-2022 2022-2023 2023-2024 Total years on right] 2020-2021 £’000 £’000 £’000 £’000 ITEM (where applicable, please £’000 specify individual items below) PHASE 1 PHASE 2

£215,000.00 £250,344.13 £465,344.13 Item 1 New consulting rooms £134,214.00 Item 2 Administration spaces £134,214.00 and toilets

Item 3

Item 5

Total £215,000.00 £250,344.13 £134,214.00 £599,558.13

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Table 3. GPIT CAPITAL COSTS FOR NEW BUILD/IMPROVEMENT SCHEMES: (add additional rows as required) PERIOD [Please enter appropriate Financial Current year 2021-2022 2022-2023 2023-2024 Total years on right] 2020-2021 £’000 £’000 £’000 £’000 ITEM ((where applicable, please £’000 specify individual items below) PC’s and AV Item 1 £5,000.00 £10,000.00 £15,000.00 equipment *** Total

Source of Funding

NHS England £5,000.00 £10,000.00 £15,000.00

*** PLEASE NOTE: WE HAVE NOT HEARD BACK FROM ALYS TURNER YET, THESE FIGURES ARE ESTIMATES BASED ON THE NEW WAY OF WORKING SINCE COVID. THERE MAY BE A NEED TO APPLY FOR ADDITIONAL FUNDING IF BEST PRACTICES RESULT IN AN ADDITIONAL NEED

 What is/are the principal strategic driver/s triggering the need for this 6. BRIEF SCHEME OVERVIEW business case (e.g. to enable delivery of relevant commissioning a) What is/are the principal strategic drivers requirements, to comply with NHS policy requirements). triggering the need for this business case (e.g. to enable delivery of relevant a) The principal strategic drivers are as follows: commissioning requirements, to comply with NHS policy requirements, alignment with relevant policy e.g. Five Year Forward View, • The villages served by Harston are experiencing considerable Strategic Transformation Plans and Strategic growth meaning that the surgery is no longer able to respond to Estates Plans. the demands of its patients in terms of patients per GP and the b) Summarise the key dimensions of the size of building, so the additional space will ensure that scheme in terms of both the tangible capital continued primary care services are provided asset to be delivered, and the outputs that will be enabled in service terms as a consequence of the investment. There is a commitment by the CCG, NHS England and District Council Include land and premises ownership issues, to facilitate the expansion of Harston Surgery and developer cross boundary/partnership working and contributions (section 106) have already been secured from a number of impact for service users, etc. sites to fund this.

The principal

• formalise this commitment from the CCG and NHSE with the approval of the Full Business Case and obtain early support from NHS England for a short term financing arrangement in order to deliver phase 2 in the event that the section 106 funding from the Barrington development is delayed beyond 2022, with the intention of reimbursing NHSE once funds are received.

 Summarise the key dimensions of the scheme in terms of both the tangible capital asset to be delivered, and the outputs that will be enabled in service terms because of the investment.

b)The extension to the surgery will accommodate the current and known patient growth from the new build housing developments

The predicted developments in the areas are:

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Village Planning ref Dwellings Barrington S/2365/14/OL 220 + Foxton S/2148/16/OL 22 Hauxton S/2184/16/OL 32 +400 Orwell S/3190/15/OL 49 Shepreth S/3052/16/FL 25 Total 748

The above table does not include the recent growth in the area.

The Development sites for Barrington, Hauxton and Foxton will provide a precicted 1926 additional patients within the next 5 years. This would be in addition to the increase practice population of 9.3% in the last 5 years within the current surgery.

The extension would offer a greater range of services to the community consisting of the following: o More efficient/improved dispensary service o Improved minor illness, minor injuries and urgent medical problem service o HCA’s o Training for student nurses and Registrars o Community Services such as physiotherapy, paramedic, pharmacist, social prescriber, dementia clinic, consultant sessions, mental health sessions o Facilities to work more collaboratively with other organisations o Research participation

The internal accommodation would be an increase of GIA 107 sqm and would consist of the following: - 3 new rooflights - Proposed terrace finishes to roof of new consulting rooms (63m2 total) - New staircase - Reconfiguration of 3 no. WCs (11m2 total) - Reconfigured dispensary layout (30m2 total) - Review and improvements to existing drains

• Due to how the S106 monies are to be received and utilised it will be necessary to manage this expansion over two phases. The second phase of works will be manageable by virtue of the additional areas provided in the first phase which can temporarily be used to offset affected accommodation during the phased works. Prior to the start of phase 2, a full programme and works area plan will be developed in conjunction with the contractor to ensure that disruption is minimised and that the works are safely separated from the operational activities of the surgery. • We will also allow for the medical records storage room to be repurposed in the future, with the digitalistaion of records. Natural light and ventilation are provided to this space via rooflights, and so the area could easily be adapted for administrative use once the records storage has been removed.

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7. PURPOSE a) This is to seek approval of Section 106 monies for £397,499.88 plus a) State clearly what the business £10,000.00 acrued interest to facilitate an extension at Harston justification is in support of: typically Surgery to accommodate an additional 3 no consultant/examination – ‘this is to seek approval of ..... for rooms and support spaces to support the existing and growing £ ….. on ….. in support of …..’ population in relation to the local housing developments Where funding sources are, or b) b) Construction and furniture costs at 34% over the Section 106 monies may be split, such as investment by the premises owner and external will be met by the project/ practice. funding e.g. ETTF, this must be clearly defined and explained here, in the relevant subsequent sections and in the table above.

STRATEGIC CASE

8. STRATEGIC CONTEXT  Provide a summary of the key strategic drivers and service requirements that a) Provide a summary in the context support the case for investment. of underpinning plans and key strategic drivers together with the The strategic drivers that support this case are: service requirements that support the case for investment. E.g. Five • To provide continuation of primary care services to the current patients Year Forward View, GP Forward at Harston Surgery. View, Sustainability & Transformation Plan, Strategic • Provide capacity for the current patients on the waiting list and to make Estates Plan, Devolution and New provision for the future increase in waiting patients because of the Care Models, etc. imminent housing developments locally with a predicted growth of

b) Provide confirmation of the approximately 28% in the next 3 - 5 years. support of all relevant stakeholders. • To provide capacity for future community services including Diabetes

c) Confirm the extent to which the specialist nurse, midwife, dementia support clinic, pharmacist 2 scheme delivers on high priority NHS sessions, mental health service clinic, social prescribers coming on capital investment requirements, e.g. board (contract starts July 2020) and first contact physio too in the next Service transformation and related few months. Counsellor is in place. If we have room and it is clinically infrastructure requirements as beneficial we will happily consider other services using the building identified in the strategic drivers (alcohol worker etc). above, improving patient safety and the patient environment, reducing • The proposed scheme would enable the practice to develop resilience backlog maintenance (% of total); and respond to population growth and provide integrated health care enabling QIPP delivery, etc. and system for patients. other current key work streams. • There is no current PCN amalgamation but definite integration and d) Confirm the support of key common resources including pharmacist, social prescribers, physio and clinicians and the way in which the possibly physician assistants are in discussions to meet the estates scheme supports delivery of local transformation plan. We have also reviewed the space required given commissioning priorities. the COVID pandemic and it is currently unchanged as we still need to e) Confirm that any premises subject deliver consultations whether physically or virtually, we have revisited to the investment will not be the plans however to look at dividing rooms so we would use less space disposed of within 5 years of their for virtual consultations and this could bring forward the community completion. clinics of more counselling and alcohol clinics. f) Include how the investment will • The reduction in surgery visits also reduces car parking which provides deliver the aims of the programme, significant environmental benefits and a reduction in the carbon etc. emissions attributed to the running of the practice and although we have a significant elderly population, where a virtual consultation is appropriate we would use this.

 Provide confirmation of the support of all relevant stakeholders.

b) The project has received support from NHS England, Huntingdon District Council and Cambridge and Peterborough CCG NHS England PAU. £1m to £3m Bus. Just’n. Template –V2.7 13/12/18 Page 8 of 19

 Confirm the extent to which the scheme delivers on high priority NHS capital investment requirements, e.g. improving patient safety and the patient environment, reducing backlog maintenance (% of total); enabling QIPP delivery, etc.

c) The current spaces have been adapted to suit the clinical need as required but do not in the main conform to current Health Building Note (HBN) and Health Technical Memorandums (HTM’s) in terms of clinical space requirements, required environmental conditions and patient accessibility, the increase population growth dictates the need for additional clinica treatment/ consulting spaces and support spaces as proposed.

 Confirm the support of key clinicians and the way in which the scheme supports delivery of local commissioning priorities.

d) The key clinicians and partners within the practice fully support the proposals. As set out in the NHSE approved business case incorporating DH guidance within “Health Building Note 11-01: facilities for Primary and Community Care Services” Harston Surgery should be 420 square metres in size. As Harston Surgery is in the region of 315 square metres it needs somewhere in the order of a 33% increase in floorspace to meet the recommended standards as set out by NHSE The increase in space will ensure that delivery of commissioned and future services are met.

 Confirm that any premises subject to the investment will not be disposed of within 5 years of their completion.

e) The premises will not be disposed of within 5 years. The practice is committed to providing services to the local community

 Include how the investment will deliver the aims of the programme, etc.

f) The investment will allow the practice to provide the facilities and accommodation for the recent and imminent patient growth. As can be seen from the utilisation schedules in appendix 4, the surgery currently is unable to provide many of the community services and clinics that would benefit the local area. The post-extension schedule (also included) shows that the additional rooms provided by this scheme would create space available for services such as physiotherapy, paramedics, social prescriber, dementia clinic, and mental health services, as well as additional GP space for the growing community.

ECONOMIC CASE  Confirm other options considered to achieve the scheme’s objectives. 9. ECONOMIC CASE

a) Confirm the options considered to a) The following options have been previously considered: achieve the scheme’s objectives and provide a summary of the options Long List appraisal process that has resulted in the selection of the preferred Option 1 - Do Nothing -. This would be a retrograde step in our care for option. It is important that a range of patients and the services provided to them, in addition we would not be able to viable options are considered during meet the patient population growth. the appraisal process If the options were/are limited in number, please Option 2 - Do Minimum – even with the no patient growth the existing patient provide clear supporting rationale. services cannot be met within the current spaces as they do not meet current

HBN requirements for consultation rooms so this restricts the services that can

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b) Confirm the scheme benefits – currently be offered. In addition this would still restrict the services that could including financial (cash releasing be more widely offered and non-cash releasing) and non- financial (quantifiable and non- Option 3 – Purchase new larger premises – this proposal was not supported quantifiable) and how the scheme by CCG as it did not comply with their plans for the future of primary care at delivers value for money. Appraisal scale. of options on the basis of the extent to which they deliver non-financial Option 4 – Extend existing accommodation. (Preferred Option) – The benefits can be carried out and addition of 3 No. compliant consulting rooms dedicated to GP’s would meet the presented using a non-financial predicted patient requirements allowing for realistic local growth and allow for benefits analysis employing wider clinical services. weighted benefits criteria and a scoring system to derive non- financial benefits points. Option 5 – Purpose built new build premises – there is no funding available for this option. c) Provide supporting economic appraisal to demonstrate the value for money of the preferred option The long list was discussed with the practice and stakeholders resulting as using a recognised methodology follows: such as the Generic Economic Options 3 and 5 were discounted due to cost and programme as the current Model (GEM) as appropriate. and forecasted population growth cannot be accommodated in the timescales

required to support these options. The practice also cannot provide the Note. To allow reviewers to see and financial contribution required for these options. analyse the underpinning information, please attach supporting Option 1 The recent growth has already had a significant detrimental affect on workings in executable tables (Excel, the practice and this cannot be sustained etc. and NOT pdf or images). Option 2 again did not allow for any future growth or provision of compliant spaces and this would seriously compromise the services being offered at Harston Surgery by possibly reducing patient lists

Short List

It is felt that in this case in order to meet the current and initial known 5 year future growth the only option is Option 4 to extend the existing surgery.

 Provide supporting value for money analysis as appropriate (attach tables to show workings).

b) Please refer to Appendices 2 and 3 within this document.

FINANCIAL CASE Confirm the capital costs of the scheme and anticipated dates of capital 10. FINANCIAL CASE deployment (and any associated disposals) split between 2018/19, 2019/20 a) Confirm the capital costs of the and 2020/21 (as required). scheme and anticipated dates of capital deployment (and any a) We would anticipate the £407,499.88 S106 monies spend between associated disposals) split across financial years (as required). 2020 – 2023 to be attributed as follows:

b) If a lease is proposed, confirm the 2020/2021 - £195,000.00 whole life cost of the lease (see note 6 on the BC Selector Introduction tab 2021/2022 – £78,285.88 for more information).

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c) Confirm the recurrent revenue 2022/2023 – £134,214.00 costs of the scheme. Where these are anything other than revenue Premises improvement grant £126,758.45 neutral or revenue saving, confirm the availability and source of 2020/2021 - £10,000.00 additional revenue.

d) Confirm and demonstrate that the 2021/2022 – £116,758.45 recurrent revenue cost of the scheme is affordable. 2022/2023 – £NIL

Confirm and where necessary e) Surgery funding £65,299.80 explain any non-recurrent (e.g. transitional costs) of the scheme. 2020/2021 - £10,000.00 f) Confirm the availability and source of non-recurrent funds to meet these 2021/2022 – £55,299.80 costs.

g) Provide supporting income and 2022/2023 – £NIL expenditure analysis that sets out clearly the recurrent and non- Please also see Ingleton Woods fees attached, in the appendix which are: recurrent costs of the scheme, the £72,798.00 excluding VAT and £87,357.60 including VAT and not included in sources of funds to meet these the above costs costs, which must demonstrates clearly that the scheme is affordable. Funding

h) Clarify where the assets will A significant level of developer contributions have already been secured through reside in terms of ownership. section 106 agreements signed between the District Council and the respective j) Provide evidence of the proposed land owners. The details of these are as follows: efficiency measures and projected outcomes and how they align with Development Planning ref Amount £ Spend service improvements. expected restriction Bayercropscience S/2308/06/O £206,499.88 With Spent May + £10,000 South 2020 acrued Cambs interest Council Cemex Barrington S/2365/14/OL £185,000 2022 10 years from receipt Station Rd Foxton S/2148/16/OL £6,000 2021 10 years from receipt £407,499.88 + Premises improvement grant

The two contributions that are still to be paid will be subject to indexation meaning that the final sum is higher than that referenced in the section 106 agreement. As such a figure in excess of £400,000 (and possibly up to £430,000) is expected to be received as a result of these 3 developments alone.

The surgery is aware of agreement across NHS England, the CCG and the District Council that Harston Surgery is the only surgery that is to receive the funding secured from these applications. In addition we are advised by the District Council that any developments within the locality may also be required to pay section 106 contributions that will be directed to funding any shortfall at Harston Surgery. Importantly it is the case that (based on the quotes) all of the works may be delivered within the contributions already secured and a proposed application for premises improvement grant.

However as it stands the surgery only has access to the contribution paid in relation to the Bayercropscience site at around £220k (allowing for interest having accrued over the last 3 ½ years). The remaining money will be paid over the coming year (perhaps in 3 years). As such this application also seeks to secure a premises improvement grant and complete the project over two phases as monies are released.

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 If a lease is proposed, confirm the whole life cost of the lease

a) No lease is proposed as the property is mortgaged by the Partners of the practice

 Confirm the recurrent revenue costs of the scheme. Where these are anything other than revenue neutral or revenue saving, confirm the source of additional revenue.

Annual Costs Rates £7,750 Water £700 Gas £3,000 Electric £2,000 Boiler/Heating System Maintenance £350 Intruder Alarm Maintenance £150 Fire System Maintenance £300 Air Con Maintenance £800 Telephone Maintenance and Calls £3,750 Cleaning £8,800 FM £2,616 Total £ 29,416.00

The revenue impact would be an increase of 36% of the current annual cost ongoing £10,590.00. A DV report is currently being undertaken.

Current rent reimbursement is £49,000 based on GF/FF accommodation and parking spaces (E-mail attached – Appendices 4 and 5).

Additional revenue @10% = £4,900

 Confirm and demonstrate that the recurrent revenue cost of the scheme is affordable.

c) The recurrent revenue cost of the scheme is affordable. Additional rent to be received will cover additional incurred costs. (Please refer to Appendix 5)

 Confirm any non-recurrent (e.g. transitional costs) of the scheme.

d) The non-recurrent costs are:

• Legal fees • Stamp duty • IT GP infrastructure • Relocation and removal costs • Design team fees/ project management costs

 Confirm the source of non-recurrent funds to meet these costs.

e) The legal fees, stamp duty, relocation and removal costs will be met by the Project costs/ Practice

IT cost will be met by GP IT

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The design fees and project management costs will be met by NHSE/I subject to relevant caps in terms of percentage of total capital costs.

 Provide supporting income and expenditure analysis that sets out clearly the recurrent and non-recurrent costs of the scheme, the sources of funds to meet these costs, and which demonstrates clearly that the scheme is affordable.

a) Please refer to Appendix 6

 Clarify where the assets will reside in terms of ownership.

b) The assets will be retained by the Practice Partnership.

 Provide evidence of the proposed efficiency measures and projected outcomes and how they align with service improvements.

j) Consultant rooms will reduce current waiting times, and will accommodate the increased patient growth arising from the local housing developments which it is anticipated will be completed in the next 5 years. Refer to Utilisation schedule Appendix 4.

COMMERCIAL CASE  Confirm the commercial arrangements for delivery of the proposed capital 11. COMMERCIAL CASE For new build and refurbishment investment, e.g. procurement approach and proposed contract type (If not projects: using NHS Procure21+ for new build or refurbishment projects explain why not)

a) Confirm the commercial a) The scheme will be self-delivered by the practice via a traditional arrangements for delivery of the proposed capital investment, e.g. procurement route of full tender to the market place and a JCT form of procurement approach and proposed contract appointment contract type. Procure 22, LIFT (Local Improvement Finance Trust)  Confirm when any necessary full planning consent will be achieved. and RHIC (Regional Health Infrastructure Company) are three b) Planning approval has been given 9th March 2020, see appendix 7. DHSC initiatives available to the NHS. If not used for this proposal,  Confirm status of legal documentation and what (if anything) remains to be please explain why an alternative agreed approach to procurement has been used c) The practice does not envisage the appointment of legal advisors

Confirm when any necessary full b)  planning consent will be achieved. For new build and refurbishment projects confirm: i) compliant with DH guidance (HBN & HTM); ii) compliant with eliminating mixed sex Confirm status of any legal c) accommodation; iii) compliant with an approved infection control strategy; iv) in documentation or processes required for the scheme to be alignment with an approved estate strategy, or equivalent; v) intention to delivered in full and what (if undertake BREEAM assessment and target outcome. anything) remains to be agreed, e.g. lease documentation, land d) i) The building will be fully designed to meet the requirements of the ownership (also see g) below, party Department of Health’s, Health Building Notes and Health Technical wall agreements, etc. and if not Memorandums finalised, how and when the risk will ii) Will fully comply with eliminating mixed sex accommodation where be mitigated. possible, the building existing toilet provision will be reviewed in line with d) Confirm: this. i) compliant with DHSC guidance iii) Infection control will be engaged throughout the design process and (HBN & HTM); the agreed strategy will be incorporated in the design and use of the ii) compliant with eliminating mixed sex accommodation; proposed building NHS England PAU. £1m to £3m Bus. Just’n. Template –V2.7 13/12/18 Page 13 of 19

iii) compliant with an approved iv) Aligns with the NHS estates strategy infection control strategy; v) A BREEAM assessment is not required for this project, but iv) in alignment with an approved sustainability/ energy good practice will incorporated where possible. estate strategy, or equivalent; v) intention to undertake BREEAM assessment and target relevant  Confirm any contribution to carbon reduction plan (if applicable). outcome (excellent for new build, very good for refurbishment). e) Sustainability and carbon footprint will be reviewed and incorporated e) Confirm any contribution to carbon within the design and use of the building where possible. reduction plan (if applicable).

f) Where appropriate, attach site  Where appropriate, attach site plans and design drawings for the preferred plans and design drawings for the option. preferred option.

g) Identify the ownership of the land f) Please refer to Appendix 8. All drawings now in tender pack, separate or premises to be modified, the risk document this poses and how the risks are mitigated for the options. g) The land is owned by the Partners of the practice, a site plan is attached For equipping and Digital for information in Appendix 8. Technology expenditure related to building projects h) Consultation is taking place with Alys Turner, Senior Primary care IT (projects which are solely related to Manager. Please refer to correspondence in Appendix 9 Digital Technology should use the specific Digital Technology Business Justification Template). i) To support the new consulting rooms and support areas

h) Describe the scheme: specify what equipment is being purchased j) GP IT funding – please see table 3 awaiting confirmation. and for what site(s)

i) Describe the strategic need for the capital investment and what measurable benefits the capital investment will provide.

j) Indicate where funding is required to support Strategic Estate Plans. For example, if a new build has been agreed and the requirements in this business case also specifically relate to another business case which has delivered or will deliver premises development, please explain and justify the links

 Confirm the arrangements for management and delivery of the capital 12. MANAGEMENT CASE investment scheme a) Confirm the arrangements for management and delivery of the a) The scheme will be self-delivered by the practice scheme  b) Confirm the key risks to delivery Confirm the key risks to delivery and measures to mitigate and manage and measures to mitigate and these risks. manage these risks. b) Planning permission – planning has been approved on 9th March c) Provide a simple timeline with key milestones for the procurement and 2020, please see confirmation letter at appendix 7 delivery of the scheme. Release of Section 106 monies – The staged release of the monies could impact on the preliminary costs associated with the project and the completion times. The construction will be tendered on a phased basis to ensure the practice can meet the costs. The practice would also consider a bridging loan if there was support and assurances from the CCG that the monies would become available.

NHS England PAU. £1m to £3m Bus. Just’n. Template –V2.7 13/12/18 Page 14 of 19

 Provide a simple timeline with key milestones for the procurement and delivery of the scheme.

c) Appendix 10

Option Appraisal 17th January 2019 Procurement Route Confirmed 8th February 2019 OBC/New Project Proposal 1st May 2020 OBC Approval/Stage 1 Approval 24th September 2020 FBC/Final Project Proposal 20th October 2020 FBC Approval/Stage 2 Approval 26th November 2020 Date of procurement 3rd December 2020 Planned start of works 4th January 2021 Estimated completion date 14th May 2021

Phase 2 Date of procurement 4th April 2022 Planned start of works 11th April 2022 Estimated completion date 26th August 2022

Please note: this timeline is a broad example and all dates are liable to change as the project progresses.

13. KEY RISKS Risk Please provide adequate information Mitigation to enable reviewers to understand Planning Permission Granted 9th March 2020 (See the level and likelihood of risk and appendix 7) how it is to be mitigated. Support for the project There has been a lot of support for Please list any risks to delivery, for this project and the practice are keen example if the spend is dependent on to engage further with patients and estates investment etc. the wider community on this. (See appendix 11) Funding The PID has been agreed, section 106 monies have been confirmed as being available (see appendix 12 and 13). If the £206,499.88 on S/2308/06/O is rescinded the practice will not be able to afford the 34% of the new balance.

ENDORSEMENTS AND APPROVALS

14. LETTERS OF APPROVAL / SUPPORT Organisation Enclosed Letter dated Note E-mail dated 25th SPONSOR ORGANISATION James Fisher – South Cambs DC Y April 2019 Letter supporting proceeding to Outline LEAD COMMISSIONER Y 8th February 2018 Business Case (OBC) from Jan Thomas of CAPCCG PROPERTY COMPANY N

NHS England PAU. £1m to £3m Bus. Just’n. Template –V2.7 13/12/18 Page 15 of 19

(NHS Property Services or Community Health Partnerships) 15. PROJECT ENDORSED BY:

Form of Signature.

Note 1. This Word based BJT is circulated electronically in an unlocked format to allow the various fields to be completed and signatures to be added by different organisations. As with any document of this nature, NHS England Information Governance policy and British Standards therefore apply to any attached signatures.

Note 2. Where an Officer uses an electronic signature on behalf of an organisation, the organisation itself is confirming that the signature is valid and the signatory has authority to sign the document in relation to the approval purpose of the signature and consents to their electronic signature on this document being transmitted to others for purposes relating solely to this particular BJT proposal and approval process.

Note 3. In the event of future enquiries by internal or external/auditors or others and to protect the signatory, use of any electronic signature must be capable of being evidenced as having been authorised by the signatory. It is the responsibility of the signatory to ensure that evidence of this authorised use of their electronic signature and the document signed is held on their files for future reference.

Note 4. Conversion of the whole BJT into PDF and inserted for each signature has been used historically by some users, however this results in documents of excessive size and is to be avoided. Subject to consideration of the requirements of notes 1 to 3 above, the responsibility for the authorised use of any signature and format must reside with the signatory, but the optional form embedded below may assist some users on this authorised signature process. The form can be copied and saved separately, quickly completed by signatory through copying and pasting a couple of relevant items from the BJT, signing it, and simply converted to pdf before inserting into the relevant signature box.

T1. Optional signature authorisatio

15. SCHEME OR PROJECT ENDORSED BY: I hereby confirm that I am satisfied the payment of capital as set out in this Business Case is necessary expenditure and offers value for money. I am satisfied that the capital funding Statement requirement set out in this Business case is not replicated in any other NHS capital funding request, e.g. under other parallel capital investment initiatives

SPONSOR ORG 1 Organisation

DIRECTOR/HEAD OF Position FINANCE or APPROPRIATE AUTHORISED OFFICER Name

Signature

Date

I hereby confirm that I am satisfied the payment of capital as set (Where applicable) out in this Business Case is necessary expenditure and offers value for money. I am satisfied that the capital funding Statement SPONSOR ORG 2 requirement set out in this Business case is not replicated in any other NHS capital funding request, e.g. under other parallel DIRECTOR/HEAD OF capital investment initiatives FINANCE or APPROPRIATE AUTHORISED OFFICER Organisation

NHS England PAU. £1m to £3m Bus. Just’n. Template –V2.7 13/12/18 Page 16 of 19

Position

Name

Signature

Date

I hereby confirm that I am satisfied the payment of capital as set out in this Business Case is necessary expenditure and offers value for money. I am satisfied that the capital funding Statement requirement set out in this Business case is not replicated in any other NHS capital funding request, e.g. under other parallel capital investment initiatives (Where applicable) Organisation SPONSOR ORG 3

Position DIRECTOR/HEAD OF FINANCE or APPROPRIATE AUTHORISED OFFICER Name

Signature

Date

DSO OFFICE I hereby confirm that I am satisfied the payment of capital as set out in this Business Case is necessary expenditure and offers Statement value for money. I confirm that all items to be procured are capitalisable in accordance with the current NHS England Capital Accounting Guidance

Area

NHS ENGLAND DCO OFFICE Position DIRECTOR OF FINANCE

Name

Signature

Date

REGIONAL OFFICE I hereby confirm that I am satisfied the payment of capital as set out in this Business Case is necessary expenditure and offers value for money. I also confirm that I am satisfied with the assurance provided by the relevant local DCO office Director of Finance in this Business Case. I confirm that this capital expenditure is funded within the Regional capital budget for the NHS ENGLAND REGIONAL Statement relevant year(s) as outlined in this Business Case. I am assured DIRECTOR OF FINANCE that there is a credible plan in place to order, receive and account for the capital assets in the appropriate financial year in accordance with NHS England Standard Accounting Practice. I recommend that the NHS England Chief Financial Officer approves the proposed investment of capital set out in this Business Case Document.

NHS England PAU. £1m to £3m Bus. Just’n. Template –V2.7 13/12/18 Page 17 of 19

Region

Position NHS England Regional Director Of Finance

Name

Signature

Date

PRIORITISATION (For regional use only)

Statement (Where applicable) As appropriate ETTF OR OTHER NHS Programme ENGLAND PROGRAMME:

REGIONAL HEAD OF Position PRIMARY CARE or PROGRAMME LEAD OR DIRECTOR Name (Depending on value and fund approval arrangements) Signature

Special programme or funding Date initiatives only.

NHS ENGLAND / NHS IMPROVEMENT Joint working initiative.

Statement As appropriate NHS IMPROVEMENT (Where necessary and/or Name appropriate on certain schemes) Position Confirms strategic need for this investment Region

(Signature option added as joint working initiative details are to be Signature agreed) Date

NHS ENGLAND CHIEF FINANCIAL OFFICER

SCHEME NAME

Statement

As appropriate

NHS ENGLAND Name CHIEF FINANCIAL OFFICER

Signature

NHS England PAU. £1m to £3m Bus. Just’n. Template –V2.7 13/12/18 Page 18 of 19

Date

Conditions of approval,

Where applicable.

NHS England PAU. £1m to £3m Bus. Just’n. Template –V2.7 13/12/18 Page 19 of 19 OBC Harston Surgery Job No: 111637 - Date: November 2020

Letter from Jan Thomas

OBC Harston Surgery Job No: 111637 - Date: November 2020

Email from Jonathan Stone

From: STONE, Jonathan (NHS CAMBRIDGESHIRE AND PETERBOROUGH CCG) To: Anni Folan-White; Samantha Clarke Cc: PARKE, David (NHS CAMBRIDGESHIRE AND PETERBOROUGH CCG) Subject: Harston Surgery OBC - Feedback from NHSE CIOG Date: 24 September 2020 14:03:00 Importance: High

CAUTION: This email originated from outside of the business. Do not click links or open attachments unless you recognise the sender and know the content is safe.

Hi both

Just wanted to update on the feedback from CIOG meeting today.

I can bring you good news in that the OBC was supported through to FBC stage, with one minor caveat which is detailed at the bottom of the e-mail.

They did have additional feedback which I have outlined below:

The business case needs some fine tuning and clarification around the planning permission and the FBC will need to demonstrate and evidence that planning permission is granted. There were some queries around whether the works had been tendered yet. I didn’t believe they had been but obviously the full tender process will need to be documented in the FBC along with nomination of a preferred tenderer (and tender evaluation which led to the tender choice) They wanted assurance that the second phase of works would not cause disruption and inconvenience to the Practice and particularly its patients and staff – and this point will need to be addressed and documented in the FBC, with confirmation that the levels of disruption has been considered and forecast and evidence provided that any disruption caused by the second phase would be minimised. It was noted from the proposed plans that the medical records storage room is to be retained and the question was asked that, as a result of the future digitalisation of the medical records and therefore the need of the storage room being redundant, whether there could be an opportunity to refurbish this room and alter its use, providing more capacity

With regards to the “application” for a bridging loan (re the 2nd set fo S106 monies) the feedback was that the NHSE do not provide loans as such. However, given that a “loan” by definition is not what will be required and that it is more a case of some flexibility in payment of invoices they did advise that there could be some flexibility. However in order to provide any further advice a full spend profile would need to be included in the FBC which provides a timeline of all of the expected expenditure for both phases along with the most up to date forecast from the relevant developer in terms of when the trigger point for the 2nd set of S106 might be met.

The minor caveat in terms of supporting the business case is with regards to another aspect of the the spend profile. To provide context, and in confidence, essentially NHSE are “over budget” in terms of their ETTF expenditure for the current financial year and wherever possible they therefore need to carry over ETTF cost pressures into the financial year 21/22. The caveat to approval is therefore that the £36k ETTF ask will be required in 2021/22 rather than 2020/21. I advised that I didn’t think this would be a problem as the scheme is unlikely to be finished before March 31st 2021 and that the S106 from Bayercropscience should cover all invoices up to March 31st – again a spend profile will need to be included in the FBC which confirms this. However, if this is going to cause a problem please let me know and we can look at solutions available.

Finally, with regards to moving to FBC, I have attached the checklist which documents all that is needed at this stage is needed. I’m sure you know, but for the FBC submission, the OBC document is added to/developed rather than a brand new document created.

Given we are already only a few days away from the deadline for the next round of meetings I presume that a proposal to try and get the FBC submitted for final approval in November would be suitable and achievable, and hopefully this fits in with the scheme delivery meeting the Bayercropscience Section 106 expenditure deadline? If so, we would need the FBC ideally by 20th October but at the latest by 27th October for the CCG meeting on 2nd November. The scheme would then be submitted for FBC approval at STP Estates meeting on 9th November and final approval at the CCG’s Primary Care Commissioning Committee on 10th November (where they will formally sign off revenue costs) and then NHSE CIOG on 26th November

Kind Regards,

Jonathan Stone Primary Care Service Improvement Officer Mob: 07814 770145 Email: [email protected]

Cambridgeshire and Peterborough Clinical Commissioning Group (CCG) Base: Civic Suite, Pathfinder House, Huntingdon, Cambs PE29 3TN Head Office: Lockton House, Clarendon Road, Cambridge, CB2 8FH Switchboard: 01223 725400 www.cambridgeshireandpeterboroughccg.nhs.uk

******************************************************************************************************************** This message may contain confidential information. If you are not the intended recipient please inform the sender that you have received the message in error before deleting it. Please do not disclose, copy or distribute information in this e-mail or take any action in relation to its contents. To do so is strictly prohibited and may be unlawful. Thank you for your co-operation. NHSmail is the secure email and directory service available for all NHS staff in England and Scotland. NHSmail is approved for exchanging patient data and other sensitive information with NHSmail and other accredited email services. For more information and to find out how you can switch, https://portal.nhs.net/help/joiningnhsmail OBC Harston Surgery Job No: 111637 - Date: November 2020

Cost Estimator

Project Initiation Document: Estates risk assessment and capital cost estimator Version: May 2018 PAU

1. Programme or project name Harston Surgery

2. Programme/project type Section 106 funding for additonal treatment rooms to support increased population (Insert a brief description)

3. Programme/project: Aims and objectives 1. Provide additional fit for purpose accommodation at Harston Surgery to provide a primary care facility for the local population (Insert a short description of the programme or project 2. Create adaptable accommodation to allow future expansion to include additional community services aims and objectives) 3. Delivery of the project in 2 phases within 18/20 months (Summer 2022)

4. Organisation name Cambridgeshire & Peterborough Clinical Commissioning Group 5. SRO contact details Dawn Jones Name Address Civic Suite, Pathfinder House, Huntingdon, Cambs PE29 3TN

Email [email protected]

Telephone DD 01480 387137, M 07908068861

6. Programme / project manager Chris Gee Name Address Harston Surgery, 11 Church Street, Harston, Cambrdgeshire, CB22 7NP

Email [email protected]

Telephone 01223 870250 7. Names of those who completed this RPA Anni Folan-White and Chris Gee assessment

8. Date RPA completed 21.10.2020

Guidance for compiling the Risk Potential Assessment (RPA)

Purpose of the RPA The Risk Potential Assessment (RPA) provides a standard set of high-level criteria for assessing the risk potential of a proposed programme or project. The RPA imitates the Health OGC Gateway™ review process, by helping to determine whether external project assurance is required. The RPA assessment is an indicator of risk potential and is not an exhaustive risk analysis model.

How to use the RPA An overall risk assessment is required based on consideration of all the elements (below).There is no formula or calculation involved. Provide a short explanatory note to give the reasoning for the overall assessment. Complete the RPA to help with the Project Initiation Document (PID) and project cost estimation process and include it with the PID submission.

It is recommended that the project sponsor, SRO and project manager complete the RPA together to ensure that all known risks at PID stage are best reflected through the RPA.

Please insert  the appropriate box Risk Heading Low End Risk High End Very Low Low Medium High Very High High level of ministerial or political No political interest and unlikely to raise 1. Political interest. Likelihood of interest from PAC or any political interest. * equivalent strategic body or judicial No or very low interest from members of Significant public impact and interest. 2. Public the public. No public service impact or Need for public consultation. High degree interest. No interest from external * of interest from pressure groups or media Little or no exposure of public funds or Significant exposure of public funds, or 3. Financial additional financial burden. * additional financial burden. Other key programmes or projects require Standalone, no interdependencies with 4. Dependencies timely delivery of the programme or other programmes or projects. * project. Requires major changes to business No significant change to the organisation’s practices with high impact on business 5. Business Change business or performance. No impact on the performance. May require significant operation of external bodies. * changes to staff behaviour or performance. External bodies impacted Neutral impact on the primary care Major contributor to delivery of primary 6. Organisational provider achieving strategic targets or care providers key strategic targets or objectives performance indicators. * performance indicators. Major contributor to commissioners 7. Commissioners Neutral impact on commissioners achieving delivery of key strategic targets or objectives strategic targets or performance indicators. * performance indicators. Benefits modest, defined, owned, 8. Benefits Significant benefits expected. Complex measurable and achievable. * Straightforward and stable governance Complex governance arrangements across 9. Governance & structure. Robust control mechanisms in more than one organisation. Control and project management place. * decision-making processes unclear or not Please insert  in the appropriate box to reflect your overall assessment of the project

Overall Risk Assessment Very Low Low Medium High Very High * Additional information to support the RPA

The main risk is providing the accomodation soonest to accompodate the current local housing developments which are currently under construction

②Using known GIAm2 (Or estimated GIAm2 from the 'Space Estimator') i nsert estimated costs / % allowances in unshaded cells to best describes your project and where appropriate, is reflected in the RPA

Your construction cost £m2 based on reliable Oct-20 £ 1,500 £m2 benchmarking

Your estimated accommodation requirement Gross Internal Area m2 209 GIAm2 ③ Allowance guide: Use the following information and %'s to populate the unshaded cells below to develop the cost estimate for the PID

What is the current standard VAT % rate? 20%

The estimated cost for construction of the building only excluding < 50% Extension + Alteration of existing and external work > 80 % New Build Refurbishment Refurbishment 1 Construction Cost Please insert one of the three cost £313,200 £234,900 £187,920 estimates provided here £234,900

Cost Line HEADING DETAIL Refurb New Build (below) LOW Mix HIGH

The project is within existing 15.0% 25% to 35% premises or where a new build the 15% to 25% Site presents challenges e.g. Work associated with preparing the site and dealing with provision of site presents little known challenges contaminated land, flood plain, 2 Abnormal/site work e.g. contaminated land, need for services , draining etc. lack of services demolitions, landscaping, flood control 15.0%

This reflects local market conditions. You can obtain information from If no Location Factor % is known If no Location Factor % is known BCIS NHS Health Service Capital Planning Newsletter on 4 BCIS Location Factor please insert 0 0.0% please insert 0 www.rics.org/bcis

18.0% 18.0% 18.0% To cover all external consultant fees and any in-house fees that may be Little risk indicated in the RPA and New build on complex site and 6 Total Fees capitalised as part of the project minor construction works high risk RPA 13.0%

If no actual cost (£'s) or If no actual cost (£'s) or estimated estimated cost can be given If known. Purchase of land. Land cost + stamp duty etc. (£'s) cost can be given insert TBA and give 7 Cost of land £0 insert TBA and give reasons in reasons in 'Additional Notes' below 'Additional Notes' below

5.0% 7.5% 10.0% Project involves work on new site requiring planning approval Non works cost - statutory Local authority planning application, Design Review requirement, Project involves work on existing and need for environmental 7a transport and travel and environmental impact assessment etc. premises or existing site charges survey and possibly public 10.0% consultation

Group 2 Items that have space and/or building construction and/or engineering services requirements and are fixed within the terms of the 10.0% 12.5% 15.0% building contract. Only basic furniture and equipment Need to provide more specialist to be procured e.g. seating, office equipment e.g.; scanning, x-ray, Group 3 As Group 2 but supplied and fixed under arrangement separate 8 Equipment furniture, exam /treatment couches instrument decontamination from the building contract. etc. units, podiatry / details chairs Group 4 Items supplied under arrangements separate from the building 12.5% contract, possibly with storage implications.

<20% <20% <20% Based on overall risk rating base Based on overall risk rating base on Covers design risk, optimism bias and possible LA planning conditions on your PID RPA self rating and your PID RPA self rating and 9 Risk contingency allowance stakeholder consensus at PID s106 etc. stakeholder consensus at PID stage 15.0% stage

This is an upward adjustment to estimated cost to counteract the <10% <30% tendency for scope o projects to be underestimated at SOC and OBC stage <20% New build, design requirement and will diminish as the scope for project change is reduced as the Existing accommodation and clear at concept stage, little or no 11 Optimism Bias business case progresses to FBC approval when Optimism Bias is expected design and equipping brief design appraisal or stakeholder to be £nil (either 'designed out' or where identified as required added to involvement earlier cost estimates e.g. equipment) 15.0%

-7% to -10% -4% to -6% 0% to - 3% Government Construction Strategy (that seeks to reduce the cost of public Meeting Government expectations Below Government expectation 15 Govt. Construction Strategy sector construction by 15–20% by 2015 for the NHS for the NHS 0.0%

④PID cost estimator Providing brief narrative for each cost element will help with PID appraisal (ensure this is consistent with the main PID)

COST ESTIMATE Ref Cost Heading % Allowance VAT Your additional notes to support this estimate Net Cost Gross Cost 20%

1 Construction cost (m2 GIA x £m2) £234,900 46,980 281,880 This is comparable to recent projects

2 Abnormal / site works (OB3) 15.0% 35,235 7,047 42,282 There is none currently known

3 SUB TOTAL WORKS COSTS 270,135 54,027 324,162 BCIS Location Factor 4 Insert here the date this was 0.0% - - - Not included at this stage will be added at the next stage (adjustment) % obtained 5 SUB TOTAL 270,135 54,027 324,162

6 TOTAL Fees (VAT is excluded) 13.0% 35,118 35,118 Includes full design, OBC and FBC submissions

Land is owned by the practice, overall valuation is included in this (Non Works Cost) - - 7 Land Cost - document 7a Statutory charges etc. (Non Works Cost) 10.0% 27,014 5,403 32,416 LA Planning and Travel plan if required

8 TOTAL Equipment OB2 12.5% 29,363 5,873 35,235 We have no need for specialised equipment

* SUB TOTAL 361,629 65,302 426,931

9 Risk contingency allowance 15.0% 54,244 10,849 65,093

10 TOTAL Non works costs 415,873 76,151 492,024

11 Optimism bias 15.0% 54,244 10,849 65,093

12 SUB TOTAL 470,117 87,000 557,117

13 Inflation adjustments - - - Not at estimating stage 14 TOTAL ESTIMATE PROJECT (Excluding 470,117 87,000 557,117

15 Government Construction Strategy (Cost -% Target) 0.0% - - - Excluded Total PID Cost Estimate 470,117 87,000 557,117

NHS England PAU- April 2017, March 2018, May 2018 Project Initiation Document: Estates risk assessment and capital cost estimator Version: May 2018 PAU

1. Programme or project name Harston Surgery

2. Programme/project type Section 106 funding for additonal treatment rooms to support increased population (Insert a brief description)

4. Organisation name Cambridgeshire & Peterborough Clinical Commissioning Group 5. SRO contact details Dawn Jones Name Address Civic Suite, Pathfinder House, Huntingdon, Cambs PE29 3TN

Email [email protected]

Telephone DD 01480 387137, M 07908068861

6. Programme / project manager Chris Gee Name Address Harston Surgery, 11 Church Street, Harston, Cambrdgeshire, CB22 7NP

Email [email protected]

Telephone 01223 870250 7. Names of those who completed this RPA Anni Folan-White and Chris Gee assessment

8. Date RPA completed 21.10.2020

Guidance for compiling the Risk Potential Assessment (RPA)

It is recommended that the project sponsor, SRO and project manager complete the RPA together to ensure that all known risks at PID stage are best reflected through the RPA.

Overall Risk Assessment Very Low Low Medium High Very High * Additional information to support the RPA

The main risk is providing the accomodation soonest to accompodate the current local housing developments which are currently under construction

Your construction cost £m2 based on reliable Oct-20 £ 2,000 £m2 benchmarking

Your estimated accommodation requirement Gross Internal Area m2 67 GIAm2 ③ Allowance guide: Use the following information and %'s to populate the unshaded cells below to develop the cost estimate for the PID

What is the current standard VAT % rate? 20%

The estimated cost for construction of the building only excluding < 50% Extension + Alteration of existing and external work > 80 % New Build Refurbishment Refurbishment 1 Construction Cost Please insert one of the three cost £134,200 £100,650 £80,520 estimates provided here £100,650

Cost Line HEADING DETAIL Refurb New Build (below) LOW Mix HIGH

④PID cost estimator Providing brief narrative for each cost element will help with PID appraisal (ensure this is consistent with the main PID)

COST ESTIMATE Ref Cost Heading % Allowance VAT Your additional notes to support this estimate Net Cost Gross Cost 20%

1 Construction cost (m2 GIA x £m2) £100,650 20,130 120,780 This is comparable to recent projects

2 Abnormal / site works (OB3) 15.0% 15,098 3,020 18,117 There is none currently known

3 SUB TOTAL WORKS COSTS 115,748 23,150 138,897 BCIS Location Factor 4 Insert here the date this was 0.0% - - - Not included at this stage will be added at the next stage (adjustment) % obtained 5 SUB TOTAL 115,748 23,150 138,897

6 TOTAL Fees (VAT is excluded) 13.0% 15,047 15,047 Includes full design, OBC and FBC submissions

Land is owned by the practice, overall valuation is included in this (Non Works Cost) - - 7 Land Cost - document 7a Statutory charges etc. (Non Works Cost) 10.0% 11,575 2,315 13,890 LA Planning and Travel plan if required

8 TOTAL Equipment OB2 12.5% 12,581 2,516 15,098 We have no need for specialised equipment

* SUB TOTAL 154,951 27,981 182,931

9 Risk contingency allowance 15.0% 23,243 4,649 27,891

10 TOTAL Non works costs 178,193 32,629 210,822

11 Optimism bias 15.0% 23,243 4,649 27,891

12 SUB TOTAL 201,436 37,278 238,714

13 Inflation adjustments - - - Not at estimating stage 14 TOTAL ESTIMATE PROJECT (Excluding 201,436 37,278 238,714

15 Government Construction Strategy (Cost -% Target) 0.0% - - - Excluded Total PID Cost Estimate 201,436 37,278 238,714

NHS England PAU- April 2017, March 2018, May 2018 OBC Harston Surgery Job No: 111637 - Date: November 2020

Utilisation schedule

13. Room Utilisation Schedule (Current)

Room Type/Description 8am - 9am 9am - 10am 10am - 11am 11am - 12pm 12pm - 1pm 1pm - 2pm 2pm - 3pm 3pm - 4pm 4pm - 5pm 5pm - 6pm 6pm - 6.30pm 6.30pm - 7pm 7pm - 7.30pm 7.30pm - 8pm (14)Consultation Room 1 Mon GP GP GP GP GP GP GP GP GP GP Key: Tues GP GP GP GP GP GP GP GP GP GP GP GP GP Consultation Weds GP GP GP GP GP GP GP GP GP GP GP GP1 GP Admin Thurs GP GP GP GP GP GP GP GP GP GP GP N Nurse Fri GP GP GP GP GP GP GP GP GP GP GP NP Prescribing Nurse Sat HCA Healthcare Assistant Sun A Admin (16) Consultation Room 2 Mon GP GP GP GP GP GP GP GP GP GP GP T Training Tues GP GP GP GP GP GP GP GP GP GP GP Com Community provider Weds GP GP GP GP GP GP GP GP GP GP GP M Regular staff meetings Thurs GP GP GP GP GP GP GP GP GP GP GP GPRg GP Registrar Fri GP GP GP GP GP GP GP GP GP GP GP N1 Nurse Admin Sat Sun (17) Consultation Room 3 Mon GP GP GP GP GP GP GP GP GP GP GP Additonal community providers not included, to be fitted in: Tues GP GP GP GP GP GP GP GP GP GP GP Weds GP GP GP GP GP GP GP GP GP GP GP ECHO - monthly clinic Thurs GP GP GP GP GP GP GP GP GP GP GP IAPT - 2 sessions per week Fri GP GP GP GP GP GP GP GP GP GP GP Speech and Language - on request Sat Podiatry - on request Sun AAA clinic - on request (18) Consultation Room 4 Mon GP GP GP GP GP GP GP GP GP GP GP MIND - on request Tues GP GP GP GP GP GP GP GP GP GP GP Weds Com Com Com Com Com Com Com Com Com Com Com Thurs GP GP GP GP GP Com Com Com Com Com Com Fri GP GP GP GP GP Com Com Com Com Com Com Sat Sun (7) Treatment room Mon HCA HCA HCA HCA HCA GP GP GP GP GP GP Tues HCA HCA HCA HCA HCA GP GP GP GP GP GP Weds GP GP GP GP GP GP GP GP GP GP GP Thurs GP GP GP GP GP HCA HCA HCA HCA HCA HCA Fri GP GP GP GP GP HCA HCA HCA HCA HCA HCA Sat Sun (15) Nurses Room Treatment HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA (small) Tues HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA Weds HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA Thurs HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA Fri HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA Sat Sun (8) Medical Lab Mon N N N N N N N N N N N Tues N N N N N N N N N N N Weds N N N N N N N N N N N Thurs N N N N N N N N N N N Fri N N N N N N N N N N N Sat Sun (23) Admin Office Mon A A A A A A A A A A Tues A A A A A A A A A A Weds A A A A A A A A A A Thurs A A A A A A A A A A Fri A A A A A A A A A A Room Type/Description 8am - 9am 9am - 10am 10am - 11am 11am - 12pm 12pm - 1pm 1pm - 2pm 2pm - 3pm 3pm - 4pm 4pm - 5pm 5pm - 6pm 6pm - 6.30pm 6.30pm - 7pm 7pm - 7.30pm 7.30pm - 8pm Sat Sun (4) Office Mon A A A A GP1 M M A A GP1 Notes storage, admin storage Tues A A A A GP1 M M A A GP1 Practice clinical staff admin space Weds A A A A GP1 M M A A GP1 Thurs A A A A GP1 M M A A GP1 Fri A A A A GP1 M M A A GP1 Sat Sun Dispensary Mon Phar Phar Phar Phar Phar Phar Phar Phar Phar Phar Phar Tues Phar Phar Phar Phar Phar Phar Phar Phar Phar Phar Phar Weds Phar Phar Phar Phar Phar Phar Phar Phar Phar Phar Phar Thurs Phar Phar Phar Phar Phar Phar Phar Phar Phar Phar Phar Fri Phar Phar Phar Phar Phar Phar Phar Phar Phar Phar Phar Sat Sun 13. Room Utilisation Schedule (after extension)

Room Type/Description 8am - 9am 9am - 10am 10am - 11am 11am - 12pm 12pm - 1pm 1pm - 2pm 2pm - 3pm 3pm - 4pm 4pm - 5pm 5pm - 6pm 6pm - 6.30pm 6.30pm - 7pm 7pm - 7.30pm 7.30pm - 8pm (14) Consultation Room 1 Mon GPRg GPRg GPRg GPRg GPRg GP1 GP1 GPRg GPRg GPRg GPRg Key: Tues GP GP GP GP GP GP1 GP1 GP GP GP GP GP GP Consultation Weds GP GP GP GP GP GP1 GP1 GP GP GP GP GP1 GP Admin Thurs GPRg GPRg GPRg GPRg GPRg GP1 GP1 GPRg GPRg GPRg GPRg N Nurse Fri GP GP GP GP GP GP1 GP1 GP GP GP GP NP Prescribing Nurse Sat HCA Healthcare Assistant Sun A Admin (13) Consultation Room 2 Mon GP GP GP GP GP GP1 GP1 GP GP GP GP T Training Tues GPRg GPRg GPRg GPRg GPRg GP1 GP1 GPRg GPRg GPRg GPRg Com - Cl Community provider / Clinics Weds GPRg GPRg GPRg GPRg GPRg GP1 GP1 GP GP GP GP M Regular staff meetings Thurs GP GP GP GP GP GP1 GP1 GP GP GP GP GPRg GP Registrar Fri GP GP GP GP GP GP1 GP1 GP GP GP GP N1 Nurse Admin Sat Sun (15) Consultation Room 3 Mon GP GP GP GP GP GP GP GP GP GP GP Additonal community providers not included, to be fitted in: Tues GP GP GP GP GP GP GP GP GP GP GP Weds GP GP GP GP GP GP GP GP GP GP GP ECHO - monthly clinic Thurs GP GP GP GP GP GP GP GP GP GP GP IAPT - 2 sessions per week Fri GP GP GP GP GP GP GP GP GP GP GP Speech and Language - on request Sat Podiatry - on request Sun AAA clinic - on request (16) Consultation Room 4 Mon GP GP GP GP GP GP GP GP GP GP GP MIND - on request Tues GP GP GP GP GP GP GP GP GP GP GP Weds GP GP GP GP GP GP GP GP GP GP GP Thurs GP GP GP GP GP GP GP GP GP GP GP Fri GP GP GP GP GP GP GP GP GP GP GP Sat Sun (28) Consultation Room 5 Mon GP GP GP GP GP GP GP GP GP GP GP Tues GP GP GP GP GP GP GP GP GP GP GP Weds GP GP GP GP GP GP GP GP GP GP GP Thurs GP GP GP GP GP GP GP GP GP GP GP Fri GP GP GP GP GP GP GP GP GP GP GP Sat Sun (7) Consultation Room 6 Mon HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA Tues HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA Weds HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA Thurs HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA Fri HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA Sat Sun (18) Consultation Room 7 Mon HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA Tues HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA Weds HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA Thurs HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA Fri HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA HCA Sat Sun (17) Consultation Room 8 Mon Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Tues Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Weds Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Thurs Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Fri Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Com - Cl Sat Room Type/Description 8am - 9am 9am - 10am 10am - 11am 11am - 12pm 12pm - 1pm 1pm - 2pm 2pm - 3pm 3pm - 4pm 4pm - 5pm 5pm - 6pm 6pm - 6.30pm 6.30pm - 7pm 7pm - 7.30pm 7.30pm - 8pm Sun (8) Dirty Utility Mon N N N N N N N N N N N Tues N N N N N N N N N N N Weds N N N N N N N N N N N Thurs N N N N N N N N N N N Fri N N N N N N N N N N N Sat Sun (4) Office Mon A A A A GP1 M M A A GP1 Tues A A A A GP1 M M A A GP1 Weds A A A A GP1 M M A A GP1 Thurs A A A A GP1 M M A A GP1 Fri A A A A GP1 M M A A GP1 Sat Sun (29) Admin space Mon A A A A A A A A A A Tues A A A A A A A A A A Weds A A A A A A A A A A Thurs A A A A A A A A A A Fri A A A A A A A A A A Sat Sun (3) Dispensary Mon Phar Phar Phar Phar Phar Phar Phar Phar Phar Phar Phar Tues Phar Phar Phar Phar Phar Phar Phar Phar Phar Phar Phar Weds Phar Phar Phar Phar Phar Phar Phar Phar Phar Phar Phar Thurs Phar Phar Phar Phar Phar Phar Phar Phar Phar Phar Phar Fri Phar Phar Phar Phar Phar Phar Phar Phar Phar Phar Phar Sat Sun OBC Harston Surgery Job No: 111637 - Date: November 2020

Notional Rent Reimbursement Determination Email 26.04.2019

From: Anni Folan-White To: Samantha Clarke Subject: FW: BW Healthcare Surveyors - Notional Rent Settlement - Harston Surgery Date: 29 April 2019 18:12:18 Attachments: image001.jpg image002.png image003.png image004.jpg

Anni Folan‑White | MCIBSE CEng MSc BEng (Hons) Partner DD: 01223 965204 | M: 07834 178 514

Ingleton Wood LLP 1a Oakington Business Park Oakington Cambridge, CB24 3DQ T: 01223 965200 www.ingletonwood.co.uk

From: O'LEARY, Gerry (HARSTON SURGERY) Sent: 29 April 2019 18:07 To: Anni Folan-White Subject: FW: BW Healthcare Surveyors - Notional Rent Settlement - Harston Surgery

I didn’t realise it was the notional rent, sorry! See email below I appealed a short while back and received this email this morning informing us that the appeal was successful, and our rent has been increased!

Kind regards

Gerry

From: Will Ellis [mailto:[email protected]] Sent: 26 April 2019 10:14 To: O'LEARY, Gerry (HARSTON SURGERY) Subject: BW Healthcare Surveyors - Notional Rent Settlement - Harston Surgery

Dear Gerry,

I hope you’re well.

We have some great news for the practice. We have now reached an agreement with the District Valuer for an increase in your Notional Rent reimbursement, please see details below;

Original NR: £47,800 pa Revised NR: £49,000 pa Increase: £1,200 pa WEF: 5th October 2018 Fee: £1,020 plus VAT

Please can you confirm acceptance to this agreement so we can arrange for NHS to pay the backdated rent arrears.

Should you have any questions or queries with regards this please don’t hesitate to ask.

Kind Regards

Will

Will Ellis | Director t. 0114 442 0098 e. [email protected]

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Affordability document

Current Harston Surgery Harston extended Net increase/ Total Existing surgery (decrease)% GIA 36 Cost rent/base rent 49,000 53,900 "Development" rent 0 0 Rates 7,750 10,540 Air Con 800 1,088 Gas 3000 4,080 Water rates 700 952 Electricity 2000 2,720 Telephone 3750 5,100 FM and other service charges 2,616 3,558 Cleaning 8,800 11,968 Total costs 29,416 40,006

Funded by: NHS England Core GMS 9,250 12,580

Para 47 Sec 5 CCG Practice 20,166 27,426 Total funding 29,416 40,006 OBC Harston Surgery Job No: 111637 - Date: November 2020

Planning Approval

Our Ref: S/4520/19/FL Portal Ref: PP-08367591

9 March 2020

Mr Peter Griffiths South Cambridgeshire Hall Ingleton Wood Martindales Cambourne Business Park Unit 1A, Oakington Business Park, Cambourne Dry Drayton Road, Cambridge Oakington,, CB23 6EA Cambridge, Cambridgeshire, CB24 3DQ www.scambs.gov.uk | www.cambridge.gov.uk

Dear Mr Griffiths

SOUTH CAMBRIDGESHIRE DISTRICT COUNCIL Application for Planning Permission

Proposal: Two storey rear extension single storey side extension and rearrangment of parking spaces

Site address: 11 Church Street Harston Cambridge CB22 7NP

Your client: Chris Gee / Fraser Allen

Further in the above matter, please find enclosed our formal decision notice relating to your client’s application for planning permission. Please be sure to remind your client that the scheme should be carried out in line with the approved plans. This will avoid the need for any enforcement action.

Making changes to the approved plans

In the event that you wish to change your proposal, please contact your case officer who will advise you on whether the change can be dealt with as a “non-material” or “material” amendment. In either case you will have to complete a form and provide fresh drawings.

Important information regarding conditions

If you have been granted Planning Permission / Listed Building Consent / Advertisement Consent you may wish to get started immediately, however it is always important to carefully read the decision notice in full before any work begins.

The majority of planning decisions have conditions attached. Some conditions request further information that requires approval by the Local Planning Authority before any development takes place (‘pre-commencement’). All conditions are set out on the decision notice.

Greater Cambridge Shared Planning: a strategic partnership between Cambridge City and South Cambridgeshire District Councils Under Section 7 of the Planning (Listed Buildings and Conservation Areas) Act 1990, it is a criminal offence to carry out unauthorised works to a listed building. Under Section 9 of the Act, a person shall be guilty of an offence should they fail to comply with any condition attached to the consent.

How do I discharge the conditions

Please note that the process takes up to eight weeks from the date the Local Planning Authority receives a valid application. Therefore it important to plan ahead and allow plenty of time before work is due to commence.

You need to fill in a form to submit your request to discharge conditions, and accompany the relevant details/samples. You can download the necessary form by using the following link: https://www.greatercambridgeplanning.org

Alternatively you can submit an application to discharge the conditions through the Government’s Planning Portal website: https://www.planningportal.co.uk/applications. Please note, The Planning Portal refers to it as ‘Approval of details reserved by a condition’.

When the required information has been submitted you will receive a reference and an acknowledgement letter. Once the Local Planning Authority is satisfied that the requirement of the condition have been met you will receive a formal notification that the conditions have been discharged.

Appeals against conditions

You should also be aware that the applicant has the right to appeal against any conditions attached to this Notice, please see https://www.gov.uk/planning-inspectorate for details. If you are concerned about any condition you should contact the case officer in the first instance for advice.

We value your feedback

We value your feedback and would like to know your views about the planning process you experienced, including the service you received from us. Your views are important to us and they will help us improve the experience we can offer you. The link below takes you to a survey which will take a couple of minutes to complete. https://forms.scambs.gov.uk/PLANNINGFEEDBACKFORM/launch

Yours sincerely

SJ Kelly Joint Director For Planning & Economic Development For Cambridge & South Cambridgeshire South Cambridgeshire District Council Town & Country Planning Act 1990

Notice of Planning Permission Subject to conditions

Reference S/4520/19/FL Date of Decision 9 March 2020

Mr Peter Griffiths Ingleton Wood Martindales Unit 1A, Oakington Business Park, Dry Drayton Road, Oakington,, Cambridge, Cambridgeshire, CB24 3DQ

The Council hereby GRANTS Planning Permission for:

Two storey rear extension single storey side extension and rearrangment of parking spaces at

11 Church Street Harston Cambridge CB22 7NP

In accordance with your application received on 23 December 2019 and the plans, drawings and documents which form part of the application subject to the conditions set out below.

Conditions

1 The works to which this consent relates shall be started not later than the expiration of three years beginning with the date of this decision notice. (Reason - To ensure that consideration of any future application for works will not be prejudiced by listed building consents which have not been acted upon).

2 The development hereby permitted shall be carried out in accordance with the following approved plans: DS-IWM-ZZ-00-DR-A-0010, HDS-IWM-ZZ-00-DR-A-0060 Rev P1 (Not including the location of the proposed Variable Message Sign (VMS), DS-IWM-ZZ-00-DR-A-0210 Rev P1, DS-IWM-ZZ-00-DR-A-211 Rev P1, DS-IWM- ZZ-00-DR-A-0150 Rev P1, DS-IWM-ZZ-00-DR-A-0153 Rev P1 & DS-IWM-ZZ-00- DR-A-0154 Rev P1. (Reason - To facilitate any future application to the Local Planning Authority under Section 73 of the Town and Country Planning Act 1990).

3 All new and matching materials shall be approved on site by the Local Planning Authority. (Reason - To ensure the use of matching materials).

4 No demolition or construction works shall commence on site until a traffic management plan has been agreed with the Local Planning Authority in consultation with the Highway Authority. The principle areas of concern that should be addressed are:

S/4520/19/FL Page 3 of 8 (i) Movements and control of muck away lorries (all loading and unloading shall be undertaken off the adopted highway) (ii) Contractor parking, for both phases all such parking shall be within the curtilage of the site and not on the street. (iii) Movements and control of all deliveries (all loading and unloading shall be undertaken off the adopted public highway. (iv) Control of dust, mud and debris, in relationship to the functioning of the adopted public highway.

(Reason: In the interests of highway safety in accordance with Policy HQ/1 of the South Cambridgeshire Local Plan 2018 and the Nationall Planning Policy Framework.)

5 Prior to occupation of the development a Travel Plan which shall include monitoring and enforceable implications shall be submitted to and approved in writing by the Local Planning Authority. The provision of the Travel Plan shall be adhered to at all times unless otherwise approved in writing by the Local Planning Authority (Reason: In the interests of sustainable development in accordance with Policy TI/2 of the South Cambridgeshire Local Plan 2018.)

6 Prior to the first use of the air handling units hereby permitted, full details of any cooling plant equipment, ventilation, air conditioning, refrigeration or mechanical extractor systems to be installed as part of the approved development, shall be submitted to and approved in writing by the Local Planning Authority. The submitted details shall include noise measurements and assessments made in accordance to BS4142:2014 and specify measures to control noise from the equipment where relevant. The use of the equipment hereby permitted shall not be commenced until such time as the equipment has been installed in full accordance with the approved details (unless otherwise agreed in writing by the Local Planning Authority). The equipment shall be maintained in accordance with the approved details thereafter. Reason: To ensure nuisance is not caused to local residents in accordance with Policy SC/10 of the South Cambridgeshire Local Plan 2018.)

Plans and drawings

This decision notice relates to the following drawings:

Reference/Document/Drawing Title Date Received

It is important the development is carried out fully in accordance with these plans. If you are an agent, please ensure that your client has a copy of them and that they are also passed to the contractor carrying out the development. A copy of the approved plan(s) is/are kept on the planning application file.

Authorisation Authorised by:

SJ Kelly Joint Director For Planning & Economic Development For Cambridge & South Cambridgeshire

South Cambridgeshire Hall Cambourne Business Park Cambourne Cambridge CB23 6EA

Date the decision was made: 9 March 2020

S/4520/19/FL Page 5 of 8 Working with the applicant

The LPA positively encourages pre-application discussions. Details of this advice service can be found at https://www.greatercambridgeplanning.org. If a proposed development requires revisions to make it acceptable the LPA will provide an opinion as to how this might be achieved. The LPA will work with the applicant to advise on what information is necessary for the submission of an application and what additional information might help to minimise the need for planning conditions. When an application is acceptable, but requires further details, conditions will be used to make a development acceptable. Joint Listed Building and Planning decisions will be issued together. Where applications are refused clear reasons for refusal will identify why a development is unacceptable and will help the applicant to determine whether and how the proposal might be revised to make it acceptable.

In relation to this application, it was considered and the process managed in accordance with paragraphs 186 and 187 of the National Planning Policy Framework.

General Notes

This decision notice does not convey any approval or consent which may be required under any enactment, bye-law, order or regulation other than Section 57 of the Town and Country Planning Act 1990.

Your attention is specifically drawn to the requirements of the Equality Act 2010 and the Equality Act (Disability) regulations 2010, the British Standards Institution BS8300:2009 “Design of Buildings and their approaches to meet the needs of disabled people – Code of Practice” and to Approved Document ‘M’ “Access to and use of buildings”, volumes 1 and 2 of the Building Regulations 2010 and to Approved Document ‘B’ “Fire Safety”, volumes 1 and 2 of the Building Regulations 2010, in request of guidance on means of escape for disabled people. The development should comply with these requirements as applicable

It is an offence under Section 171 of the Highways Act 1980 to temporarily deposit building materials, rubbish or other things on the public highway or make a temporary excavation on it without the written consent of the Highway Authority. The Highway Authority may give its consent subject to such conditions as it thinks fit.

The applicant is reminded that under the Wildlife and Countryside Act 1981(Section 1) (as amended) it is an offence to take, damage or destroy the nest of any wild bird while that nest is in use or being built. Trees and scrub are likely to contain nesting birds between 1 March and 31 August. Trees within the application should be assumed to contain nesting birds between the above dates unless a survey has shown it is absolutely certain that nesting birds are not present.

Appeals to the Secretary of State

The applicant has a right to appeal to the Secretary of State against any conditions of this planning permission, under Section 78 of the Town & Country Planning Act 1990. The appeal must be made on a form which may be obtained from:

The Planning Inspectorate, Temple Quay House, 2 The Square, Temple Quay, Bristol. BS1 6PN Telephone 0303 444 5000 or visit https://www.gov.uk/planning-inspectorate

If an enforcement notice is or has been served relating to the same or substantially the same land and development as in your application and if you want to appeal against your local planning authority’s decision on your application, then you must do so within: 28 days of the date of service of the enforcement notice, OR within 6 months (12 weeks in the case of a householder or minor commercial appeal) of the date of this notice, whichever period expires earlier.

The Secretary of State can allow a longer period for giving notice of an appeal, but he will not normally be prepared to use this power unless there are special circumstances which excuse the delay in giving notice of appeal.

The Secretary of State need not consider an appeal if it seems to him that the Local Planning Authority could not have granted planning permission for the proposed development or could not have granted it without the conditions they imposed, having regard to the statutory requirements, to the provisions of any development order and to any directions given under a development order.

In practice, the Secretary of State does not refuse to consider appeals solely because the Local Planning Authority based their decision on a direction given by him.

Purchase Notices

If the Local Planning Authority or the Secretary of State grants permission subject to conditions the owner may claim that he/she can neither put the land to a reasonably beneficial use in its existing state nor render the land capable of a reasonably beneficial use by the carrying out of any development which has been or would be permitted. In these circumstances the owner may serve a purchase notice on the Council to purchase his interest in the land in accordance with the provisions of Part VI of the Town and Country Planning Act 1990.

Before starting work

It is important that all conditions, particularly pre-commencement conditions, are fully complied with, and where appropriate, discharged prior to the implementation of the development. Failure to discharge such conditions may invalidate the planning permission granted. The development must be carried out fully in accordance with the requirements of any details approved by condition.

Street Naming and Numbering

In order to obtain an official postal address, any new buildings should be formally registered with South Cambridgeshire District Council. Unregistered addresses cannot be passed to Royal Mail for allocation of postcodes.

Applicants can find additional information, a scale of charges and an application form at www.scambs.gov.uk/snn. Alternatively, applicants can contact the Address Management Team: call 08450 450 500 or email [email protected].

Please note new addresses cannot be assigned by the Council until the footings of any new buildings are in place. _ Third Party Rights to challenge a planning decision

Currently there are no third party rights of appeal through the planning system against a decision of a Local Planning Authority. Therefore, if you have concerns about a planning application and permission is granted, you cannot appeal that decision.

Any challenge under current legislation would have to be made outside the planning system through a process called Judicial Review.

A ‘claim for judicial review’ includes a claim to review the lawfulness of a decision, action or failure to act in relation to the exercise of a public function, in this case, a planning decision. The court’s permission to proceed is required in a claim for Judicial Review. A claim for Judicial Review is dealt with by the Administrative Court and if leave to judicially review a planning decision is granted, the Judicial Review will be decided by a judge at the High Court.

S/4520/19/FL Page 7 of 8 An application to Judicial Review a decision must be made within 6 weeks of the decision about which you have a grievance being made. For further information on judicial review and the contact details for the Administrative Courts, please go to http://www.justice.gov.uk/

OBC Harston Surgery Job No: 111637 - Date: November 2020

Site plans and design drawings

OBC Harston Surgery Job No: 111637 - Date: November 2020

Alys Turner consultation email

From: Anni Folan-White To: Samantha Clarke Subject: FW: Harston Surgery Extension Date: 29 April 2019 11:57:06

IT consultation

Anni Folan‑White | MCIBSE CEng MSc BEng (Hons) Partner DD: 01223 965204 | M: 07834 178 514

Ingleton Wood LLP 1a Oakington Business Park Oakington Cambridge, CB24 3DQ T: 01223 965200 www.ingletonwood.co.uk

From: GEE, Chris (HARSTON SURGERY) Sent: 24 April 2019 17:40 To: PrimaryCareIT (NHS CAMBRIDGESHIRE AND PETERBOROUGH CCG) Cc: Anni Folan-White Subject: RE: Harston Surgery Extension

Hi Alys

Thanks for a speedy helpful reply!

S106 from hauxton and Barrington together should cover the build – but of course availability of 1 runs out before the next is available so Anni is conjouring up a phased plan to work out how things might work. Any temp loan from the CCG so we can just get on and sort it seems to be impossible.

Comms cabinet we would envisage can remain where it is, undisturbed; and plans are currently being finalised so we’ll send something when available.

Thanks for the info about the touchscreen- it was an opportunistic question and is unrelated to the build!

Best wishes Chris

From: PrimaryCareIT (NHS CAMBRIDGESHIRE AND PETERBOROUGH CCG) Sent: 24 April 2019 15:52 To: GEE, Chris (HARSTON SURGERY) Cc: Anni Folan-White Subject: RE: Harston Surgery Extension

Hi Chris

As this is at OBC stage we won’t yet provide any IT costing for capital monies, as that is not required until Full Business Case stage.

Btw….I am part of the premises group hence am aware of the PID, etc…..but am sorry for the silence last year.

The outline you describe below, and I recall you telling me about (probably when I last visited a while ago!)

Your developer would need to include any cabling work for the additional rooms/spaces/reconfigured spaces, and link into the current infrastructure so there is end to end setup and tested cabling.

Is the s106 money likely to cover the build, or are you requesting additional capital as well?

Do you current proposed buliding plans available that you can send?

Will the current comms cabinet etc upstairs remain in the same location and be undisturbed by the build?

Re: touchscreens – unless you are talking about an additional screen for the build, then touchscreens replacements is a separate project we are just starting work on, as all practices will need to have W10 touchscreens in place. Will have a spearate conversation with you about that one. I wouldn’t tie that into the build project.

Hope that all helps….?

Kind regards Alys

Sent on behalf of Primary Care IT at Cambridgeshire & Peterborough CCG

Alys Turner Senior Primary Care IT Manager Cambridgeshire and Peterborough Clinical Commissioning Group Lockton House, Clarendon Road, Cambridge. CB2 8FH [email protected] www.cambridgeshireandpeterboroughccg.nhs.uk

This message may contain confidential and privileged information. If you are not the intended recipient please accept our apologies. Please do not disclose copy or distribute information in this email or take any action in reliance on its contents: to do so is strictly prohibited and may be unlawful. Please inform us that this message has gone astray before deleting it. Thank you for your co-operation.

From: GEE, Chris (HARSTON SURGERY) Sent: 24 April 2019 15:34 To: TURNER, Alys (NHS CAMBRIDGESHIRE AND PETERBOROUGH CCG) Cc: PrimaryCareIT (NHS CAMBRIDGESHIRE AND PETERBOROUGH CCG) ; Anni Folan-White Subject: Harston Surgery Extension

Hi Alys/Steve

The email trail below started last year but I never received any response; your message that we needed to involve the IT dept early for any planned surgery improvements had sunk in!

We are now at OBC stage and do need your input; I have copied in Anni who is managing the project and needs to submit the OBC for a May 1st deadline.

The main extension envisaged is an extra 3 consulting rooms (on the garden to meet the carpark) on ground floor, and the upstairs enlarges over this.

Another enlargement at the back of reception relocates the PM office.

So could you please advise whether this might be permissible? Time to access the s106 money to build is tight; so anticipated build date starts in 12 months…

As below – some recabling (access unlikely to be difficult) and 3-4 more pcs are envisaged. If you have any other funding for infrastructure that would be fabulous- are check in screens ever funded by CCG IT?

Best wishes

Chris

From: GEE, Chris (HARSTON SURGERY) Sent: 04 July 2018 15:06 To: PrimaryCareIT (NHS CAMBRIDGESHIRE AND PETERBOROUGH CCG) Subject: FW: IT Funding for extension

Hi Alys/Steve

Can you help please?

BW Chris

From: GEE, Chris (HARSTON SURGERY) Sent: 20 June 2018 17:11 To: TURNER, Alys (NHS CAMBRIDGESHIRE AND PETERBOROUGH CCG) Subject: IT Funding for extension

Hi Alys

A quick question about IT funding and how things work if we were to extend the Surgery?

The PID asks for details of costs and who funds IT infrastructure and GP IT equipment…

The basic plan would be to extend out onto the carpark. We’d lose the smaller nurse room to provide access to 2 GP rooms and a replacement nurse room; net gain of 2 consulting rooms. Upstairs we would need some recabling and probably another PC

So some cabling for 4 areas and 3 pcs – do you need more details or can you offer an estimate and advise whether you have the funds available?

How does this stuff work?!

Best wishes

Chris

Dr Chris Gee GP

Harston Surgery T 01223 870250 F01223 872741 www.harstonsurgery.co.uk

Timeline

ID Task Task Name Duration Start Finish Predecessors 2nd Quarter 3rd Quarter 4th Quarter 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter 1st Quarter 2nd Quarter 3rd Quarter Mode Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug 1 Phase 1 2 Option Appraisal 1 day Thu 17/01/19Thu 17/01/19 3 Procurement Route 1 day Fri 08/02/19 Fri 08/02/19 Confirmed 4 OBC/New Project 8 days Tue Thu Proposal 21/04/20 30/04/20 5 OBC Approval/Stage 1 day Thu Thu 1 Approval 24/09/20 24/09/20 6 FBC/Final Project 19 days Fri 25/09/20 Wed Proposal 21/10/20 7 FBC Approval/Stage 25 days Fri 23/10/20 Thu 2 Approval 26/11/20 8 Date of procurement 6 days Thu 26/11/20Thu 03/12/20 9 Planned start of works0 days Mon 04/01/2Mon 04/01/2 04/01 10 Estimated 95 days Mon Fri 14/05/21 completion date 04/01/21 11 12 Phase 2 13 Date of procurement 6 days Mon 04/04/2Mon 11/04/2 14 Planned start of works0 days Mon 11/04/2Mon 11/04/2 11/04 15 Estimated completion 100 days Mon 11/04/2Fri 26/08/22

Task Summary Inactive Milestone Duration-only Start-only External Milestone Manual Progress Project: Timeline Date: Thu 22/10/20 Split Project Summary Inactive Summary Manual Summary Rollup Finish-only Deadline Milestone Inactive Task Manual Task Manual Summary External Tasks Progress

Page 1 OBC Harston Surgery Job No: 111637 - Date: November 2020

Working Group minutes

UPDATE ON HEALTH PROVISION INITIATIVE A Working Group had been set up following the meeting in April at which 12 villages agreed there was a need for better health provision in the South Cambs/A10 area served by the Harston and Melbourn practices.

Barrington Parish Council had agreed to seek assistance from our M.P. and so Heidi Allen had been contacted, and asked to take the lead. She managed to arrange a meeting with Jan Thomas, Acting Interim Chief Officer at the CCG and Rob Murphy (Acting Director of Planning and Primary Care CCG)) on June 15th. (Jan was apparently the fourth chief Exec in a year!) Other attendees were:- a. County Cllr Sebastian Kindersley b. District Cllr Aidan Van de Weyer c. Parish Cllr Ray Kemp (Barrington) – in place of Cllr R Rhodes-Kemp who was unable to attend. d. Parish Cllr Tony Bearpark (Fowlmere) e. Dr Chris Gee (Harston Practice) f. Valerie Tookey (Clerk to Barrington P.C.) 2. Discussion around:- a. Waiting times to see a G.P.. b. G.P. Recruitment problems c. How to deal with the growth in population d. How to deal with the “ageing” population stretching services e. £42m deficit in the NHS f. Reluctance of the NHS to ask for contributions from S106 funding g. And when do ask for contribution there is difficulty accessing it h. NHS are working through a review of how to meet needs in the long term. i. Agreed need practical support now

Jan Thomas said that a 3 – 5 year strategy needs to be in place. Decisions need to be made about what is being provided that is not needed? A debate needed to be had with local communities. Chris Gee took the view that this should be a national decision similar to the directive that GPs do not prescribe over the counter medicines. Sebastian Kindersley reminded meeting that S106 money is time limited and does seem to disappear because the NHS/CCG do not plan to spend it. Chris Gee confirmed that the Hauxton development money was about to run out, but could now be allocated to be used other than at the Shelford practice. He also said there were a 1000 new patients from Hauxton to add to an already heavily subscribed list. Harston practice could expand, he had plans but could not take out loans to build a health centre. When asked, Chris Gee said he could find G.P.s. Heidi Allen asked who made the decision about the Hauxton monies?. Rob Murphy and Jan Thomas asked to be allowed to look into this.

Heidi Allen summed up meeting:- i) CCG needed blank piece of paper to see what area needs (and when and how could be provided). ii) Be clear where there are pots of 106 money, and if there are any about to expire (need better control and management of this). iii) CCG and NHS need to be better at getting 106 money (similar to the schools formula used). iv) And when they do get funding to have a structure that is as streamlined as possible. v) CCG and NHS need to look at workforce careers.

V Tookey Barrington Parish Council June 2018 OBC Harston Surgery Job No: 111637 - Date: November 2020

Confirmation of Section 106 funding

From: Anni Folan-White To: Samantha Clarke Subject: FW: Harston Surgery Update Date: 11 April 2019 09:01:56

Confirmation of monies – I think I sent this before

Anni Folan‑White | MCIBSE CEng MSc BEng (Hons) Partner DD: 01223 965204 | M: 07834 178 514

Ingleton Wood LLP 1a Oakington Business Park Oakington Cambridge, CB24 3DQ T: 01223 965200 www.ingletonwood.co.uk

From: JONES, Dawn (NHS CAMBRIDGESHIRE AND PETERBOROUGH CCG) Sent: 19 March 2019 10:43 To: Anni Folan-White Cc: O'SHEA, Emma (NHS CAMBRIDGESHIRE AND PETERBOROUGH CCG) ; STONE, Jonathan (NHS CAMBRIDGESHIRE AND PETERBOROUGH CCG) ; UMOREN, Smith (NHS ENGLAND) ; JONES, Dawn (NHS CAMBRIDGESHIRE AND PETERBOROUGH CCG) Subject: FW: Harston Surgery Update

Hi Anni

Confirmation of Section 106 monies from South Cambs DC below.. to support the Harston proposal

Dawn Jones Head of Primary Care Commissioning Cambridgeshire & Peterborough Clinical Commissioning Group

Civic Suite, Pathfinder House, Huntingdon, Cambs PE29 3TN DD: 01480 387137 Fax: 01480 387133 Mobile: 07908068861 E: [email protected].

Head Office: Lockton House, Clarendon Road, Cambridge, CB2 8FH Switchboard: 01223 725400

********************************************************************************************************* This message may contain confidential information. If you are not the intended recipient please inform the sender that you have received the message in error before deleting it. Please do not disclose, copy or distribute information in this e-mail or take any action in reliance on its contents to do so is strictly prohibited and may be unlawful. Thank you for your co- operation.

From: McFarlane Lesley [mailto:[email protected]] Sent: 19 March 2019 10:39 To: JONES, Dawn (NHS CAMBRIDGESHIRE AND PETERBOROUGH CCG) Cc: O'SHEA, Emma (NHS CAMBRIDGESHIRE AND PETERBOROUGH CCG) Subject: RE: Harston Surgery Update

Hi Dawn Sincere apologies for not getting back to you yesterday .. but in answer to your question:

Development Planning ref Amount £ expected Spend restriction Bayercropscience S/2308/06/O £206,499.88 May 2015 Spent May 2020 Hauxton Cemex Barrington S/2365/14/OL £185,000 2022 10 years from receipt Station Rd S/2148/16/OL £6,000 2021 10 years from Foxton receipt

Best wishes.

Lesley McFarlane | Development Officer, Health Specialist

Confirmation of funding extension

From: Anni Folan-White To: Samantha Clarke Subject: FW: Harston surgery Date: 22 July 2020 13:02:40 Attachments: image002.png

Anni Folan‑White | MCIBSE CEng MSc BEng (Hons) Partner DD: 01223 965204 | M: 07834 178 514

Ingleton Wood LLP 1a Oakington Business Park Oakington Cambridge, CB24 3DQ T: 01223 965200 www.ingletonwood.co.uk

From: Peter Griffiths Sent: 22 July 2020 09:27 To: Anni Folan-White Cc: Ian Morrison Subject: FW: Harston surgery

Anni, positive news on Harston Surgery below – the Redrow s.106 monies have extended to April/May next year (so we would need to be in Contract by then).

It would seem ideal to try to achieve tender returns before Christmas for a Jan/Feb start on site? This would mean us preparing our Tender docs from mid-September to end-October.

Would it be helpful to have a catch up to see where we’re at in terms of other approvals to allow this to move forwards?

Regards, Peter

Peter Griffiths | Bsc (Hons) BArch RIBA Director of Architecture DD: 01223 202 064 | M: 07793 758560

Ingleton Wood LLP 1a Oakington Business Park Oakington Cambridge, CB24 3DQ T: 01223 965200 www.ingletonwood.co.uk

From: McFarlane Lesley Sent: 22 July 2020 08:56 To: Peter Griffiths ; PARKE, David (NHS CAMBRIDGESHIRE AND PETERBOROUGH CCG) Subject: FW: Harston surgery

CAUTION: This email originated from outside of the business. Do not click links or open attachments unless you recognise the sender and know the content is safe.

Hi Peter, David Firstly great news that Redrow have agreed to extend the S106 agreement by 12 months. I’ve spoken to our planning department to ascertain what needs to be arranged our side to avoid any further delays as the project progresses. The next step will be to submit it a discharge of conditions application. See the email below listing each of them, Katie suggests that to avoid any delay you should submit an application for conditions 3 and 4 straight away.

I hope this is helpful.

Thanks Lesley

From: Christodoulides Katie Sent: 21 July 2020 16:39 To: Christodoulides Katie Subject: RE: Harston surgery

Hi Lesley,

I have had a look at the consent and the following conditions need discharging:

Condition 3- All new and matching materials shall be approved on site by the Local Planning Authority. (Reason - To ensure the use of matching materials).

Condition 4-No demolition or construction works shall commence on site until a traffic management plan has been agreed with the Local Planning Authority in consultation with the Highway Authority. The principle areas of concern that should be addressed are: (i) Movements and control of muck away lorries (all loading and unloading shall be undertaken off the adopted highway) (ii) Contractor parking, for both phases all such parking shall be within the curtilage of the site and not on the street. (iii) Movements and control of all deliveries (all loading and unloading shall be undertaken off the adopted public highway. (iv) Control of dust, mud and debris, in relationship to the functioning of the adopted public highway. (Reason: In the interests of highway safety in accordance with Policy HQ/1 of the South Cambridgeshire Local Plan 2018 and the Nationall Planning Policy Framework.)

Condition 5- Prior to occupation of the development a Travel Plan which shall include monitoring and enforceable implications shall be submitted to and approved in writing by the Local Planning Authority. The provision of the Travel Plan shall be adhered to at all times unless otherwise approved in writing by the Local Planning Authority (Reason: In the interests of sustainable development in accordance with Policy TI/2 of the South Cambridgeshire Local Plan 2018.)

This condition does not need to be submitted until occupation of the new extension.

Condition 6-Prior to the first use of the air handling units hereby permitted, full details of any cooling plant equipment, ventilation, air conditioning, refrigeration or mechanical extractor systems to be installed as part of the approved development, shall be submitted to and approved in writing by the Local Planning Authority. The submitted details shall include noise measurements and assessments made in accordance to BS4142:2014 and specify measures to control noise from the equipment where relevant. The use of the equipment hereby permitted shall not be commenced until such time as the equipment has been installed in full accordance with the approved details (unless otherwise agreed in writing by the Local Planning Authority). The equipment shall be maintained in accordance with the approved details thereafter. Reason: To ensure nuisance is not caused to local residents in accordance with Policy SC/10 of the South Cambridgeshire Local Plan 2018.)

This condition does not need to be submitted until first use of the air handling units.

I would advise that you submit a discharge of conditions application for conditions 3 and 4 straight away.

Kind Regards

Katie Christodoulides | Principal Planning Officer

m: 07704 018469 | e: [email protected] https://www.scambs.gov.uk/planning/ https://www.cambridge.gov.uk/planning Greater Cambridge Shared Planning: a strategic partnership between Cambridge City and South Cambridgeshire District Councils

Want to work in one of the most exciting and dynamic areas in the Country? Join us here at the Greater Cambridge Shared Planning Service

From: Christodoulides Katie Sent: 21 July 2020 16:22 To: McFarlane Lesley Cc: Fisher James Subject: RE: Harston surgery

Hi Lesley,

Thanks for your email.

Are you able to advise what CCG is?

Have you submitted a new application? I have not dealt with this site since it got approval and have not been allocated a new application.

Kind Regards

Katie

Katie Christodoulides | Principal Planning Officer

Want to work in one of the most exciting and dynamic areas in the Country? Join us here at the Greater Cambridge Shared Planning Service

From: McFarlane Lesley Sent: 21 July 2020 15:24 To: Christodoulides Katie Cc: Fisher James Subject: Harston surgery

Hi Katie

Regards the application to extend Harston Surgery, we had to write to Redrow to ask for an extension to the S106 funding required to deliver this. Last week we finally received confirmation from them agreeing to extend the expiry date by 12 months.

The application now has to go through a series of sign-off processes within the CCG which could take approximately 6 months. Is there anything else I or we need to do, to smooth the way and avoid any possible blockages within the planning process as the application progresses?

Look forward to hearing from you.

Lesley McFarlane | Development Officer, Health Specialist

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This email has been scanned for viruses and malware, and may have been automatically archived OBC Harston Surgery Job No: 111637 - Date: November 2020

Professional services fee letter

Dr Chris Gee Harston Surgery 11 Church Street Harston Cambridge CB22 7NP

Our ref: ME1080b/AFW

18th November 2020

Dear Chris,

RE: Harston Surgery – Proposed Extension

Thank you for the opportunity to quote the above project; we take pleasure in providing our fee proposal below. Following on from the tender submissions we are pleased to confirm our fees based on the preferred tenderer.

1.0 Project

We understand the scheme to be initially the outline business case documentation for the proposed extension at Harston Surgery.

The works will include:

• Review of the existing PID • Provision of spacial estimation • Provision of cost estimate • Spacial layout proposals including general arrangement and elevations

2.0 Fee

Our fee for the overall works will be based on a percentage of the total works. We understand this to currently be £599,558.13 for the PID process and also for the OBC and FBC. Our fees for each discipline and stage are set out in the table below.

Architecture OBC FBC RIBA 5-7 TOTAL % 6.45% £ £11,595.00 £13,539.00 £13,539.00 £38,673.99

Mechanical and Electrical OBC FBC RIBA 5-7 TOTAL % 1.83% £ £3,298.08 £3,837.58 £3,837.58 £10,973.24

Structural OBC FBC RIBA 5-7 TOTAL % 0.82% £ £977.39 £3,909.57 £4,886.96

Cost Estimation OBC FBC RIBA 5-7 TOTAL % 0.90% £ £1,221.51 £4,163.32 £5,384.83

Project Management OBC FBC RIBA 5-7 TOTAL % 0.90% £ £4,163.32 £1,221.51 £5,384.83

Principal Designer OBC FBC RIBA 5-7 TOTAL % 1.25% £ £1,873.62 £1,873.62 £3,747.24 £7,494.48

£72,798.00

Additional Services

Additional Services not covered by any of the above descriptions can be pre-costed where possible and an approximate or fixed fee given or alternatively where relevant, carried out on a time involved basis, for which current time charge rates are:

Page 2 of 3

Position £ / Hour Director/Associate £ 95/hour Senior £ 85/hour Intermediate £ 75/hour Graduate £ 65/hour CAD £ 45/hour

Clarifications

1. VAT is excluded from our Time Charge Rates 2. Our Standard Terms and Conditions would apply to any appointment (enclosed for information) 3. All travel costs and material charges will be invoiced in addition to the above 4. In line with our environmental policy we will issue digital copies only of our documents, hard copies will only be issued by absolute exception

Ingleton Wood is regulated by an integrated practice management system in accordance with RIBA guidelines. In the event that you are unhappy with the services we provide; a copy of the complaints handling procedure is available upon request.

Should you require any further information or any clarification on the above, please do not hesitate to contact us.

I look forward to hearing from you in due course.

Yours sincerely

Anni Folan-White, MSc, BEng (Hons) CEng, CIBSE Partner Ingleton Wood LLP E: [email protected]

Enc: Ingleton Wood Terms of Business

Page 3 of 3

Ingleton Wood LLP: Terms of Business Date: 11/2016

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S:\Resource\IW-Standard Documents\Professional services Terms & Conditions\Terms of Business 11-2016.docx Page 1 of 1 OBC Harston Surgery Job No: 111637 - Date: November 2020

Previous Appendices from OBC • Options Appraisal • Value for money document

Harston Surgery Options appraisal 23-04-19 Criteria Option 1 Option 2 Option 3 Option 4 Option 5 weighting Do nothing Do minimum Purchase new larger Extend existing Purpose built new build accommodation Raw score Weighted Raw score Weighted Raw score Weighted Raw score Weighted Raw score Weighted score score score score score Generic criteria Improved primary care access 17.0 1 17.0 2 34.0 3 51.0 9 170.0 9 153.0 Increased capacity for primary care 18.0 1 18.0 4 72.0 2 36.0 10 180.0 10 180.0

Wider range of services offered 12.0 1 12.0 1 12.0 2 24.0 5 60.0 1 12.0

Increased capacity for training 9.0 1 9.0 5 45.0 9 81.0 10 90.0 9 81.0

Facilitates patient engagement 7.0 10 70.0 10 70.0 7 49.0 10 70.0 10 70.0 Consistent with local estates strategies 7.0 1 7.0 2 14.0 2 14.0 10 70.0 2 14.0

Clear identified need 12.0 1 12.0 5 60.0 5 60.0 10 120.0 10 120.0 Long term sustainability 9.0 4 36.0 5 45.0 5 45.0 10 90.0 8 72.0 Flexible to changing healthcare 9.0 1 9.0 4 36.0 6 54.0 10 90.0 8 72.0 delivery patterns Total 100.0 21 190.0 38 388.0 41 414.0 85 940.0 67 774.0

Rank 5 4 3 1 2 Weighted score as % of preferred 19% 38% 42% 100% 67% Harston Surgery Do nothing Extend Existing surgery Year Year Discount Capital Opp costs HS NPC Capital Opp HS rev NPC No. factor costs current costs costs 0 £'000 70 453 £'000 75 £'000 Total 0 0 70 1,536 453 0 75 2,420 0 2019/20 1.000 0 0 82 0 0 0 105 453 1 2020/21 0.966 82 79 105 101 2 2021/22 0.934 82 77 105 98 3 2022/23 0.902 82 74 105 95 4 2023/24 0.871 82 71 105 91 5 2024/25 0.842 82 69 105 88 6 2025/26 0.814 82 67 105 85 7 2026/27 0.786 82 64 105 83 8 2027/28 0.759 82 62 105 80 9 2028/29 0.734 82 60 105 77 10 2029/30 0.709 82 58 105 74 11 2030/31 0.685 82 56 105 72 12 2031/32 0.662 82 54 105 70 13 2032/33 0.639 82 52 105 67 14 2033/34 0.618 82 51 105 65 15 2034/35 0.597 82 49 105 63 16 2035/36 0.577 82 47 105 61 17 2036/37 0.557 82 46 105 58 18 2037/38 0.538 82 44 105 56 19 2038/39 0.520 82 43 105 55 20 2039/40 0.503 82 41 105 53 21 2040/41 0.486 82 40 105 51 22 2041/42 0.469 82 38 105 49 23 2042/43 0.453 82 37 105 48 24 2043/44 0.438 82 36 105 46 25 2044/45 0.423 82 35 105 44 26 2045/46 0.409 82 34 105 43 27 2046/47 0.395 82 32 105 41 28 2047/48 0.382 82 31 105 40 29 2048/49 0.369 82 30 105 39 30 2049/50 0.356 82 29 105 37 31 2050/51 0.344 82 28 105 36

Notes: Capital costs = cost of buying surgery Capital costs = capital expenditure (excl VAT) Opportunity cost = value of development area HS current = cost rent, rates and other revenue costs ex VAT HS revenue = rates and FM charges (ex VAT) - not rent Lifecycle/maintenance costs included in service charge