18 10 NEL ELHCP Strategic Estates Plan

Strategic Estates Plan October 2018 CONTENTS executive summary Overview Governance & Partnership Clinical vision Where do we need to be? Capital investment Executive summary How we plan to get there Capital Bids overview How we developed the plan Realising the capital potential of redundant Where are we now estate Where do we need to be One Public Estate The vision for primary care Workstream structure Health and care workforce Financing an improved estate Delivering for digital care and Investment plan: primary and community care health Investment plan: actute care The Projects Progress update Appendices Capital prioritisation framework Executive summary An overview of the East London Health and Care Partnership (ELHCP) London showing CCGs new Housing ELHCP area Havering Zones Barking and Dagenham EAST LONDON 6 HEALTH AND CARE Redbridge Integrated Care 7 Greater London PARTNERSHIP Waltham Forest Partnership Authority Hackney Tower Hamlets Transforming Services Opportunity Havering Newham Together Areas City and Hackney City and Hackney Barking and Dagenham collaboration with 6Redbridge Hackney Council Waltham Forest Tower Hamlets transformation 8 Newham Corporation of London trusts pilots 5 3 boroughs Barts Health 16 Crossrail stations in north Homerton University Hospital • UK’s highest population increase, over east London CCGs NHS Foundation Trust 380k in 15 years, equivalent to a whole Barking Havering Redbridge University Trust (BHRUT) London borough or a town like North East London Reading. Foundation Trust (NELFT) • Home to 16 Crossrail stations (35 mins East London NHS Foundation Harold Wood to Farringdon) Trust (ELFT) • Alternative Funding Organisation hospital (Newham) sites • Health estate GIA = 1,000,000msq 8 • 30% properties pre-date the NHS • £197m backlog maintenance 3 ELHCP Governance and partnership working GOVERNANCE PARTNERSHIP WORKING Our vision, as the 20 founding organisations of the East • Single Accountable Officer and Partnership London Health and Care Partnership, is to measurably lead for north east London improve health and wellbeing outcomes for the people in • Joint Commissioning Committee for all north east London ensuring that sustainable health and seven CCGs established social care services are built around local needs • STP Clinical Senate established Governance structures have been developed over the last 18 months to support this vision. These have been • STP Estates Board established meeting successful in bringing partners together to explore new quarterly operating models • STP Estates Operational Group – has met The NEL (north east London) governance workstream is monthly for the last two years refining the decision-making process with the NEL Joint Commissioning Committee and the ELHCP Executive • Over the last year, all Partners have actively and Assembly. contributed to the ELHCP Estates workstream’s delivery plans The new structure mirrors that of the London Estates Board (LEB) and the London Estates Development Unit • Agreed STP capital prioritisation pipeline (LEDU). All local CCGs/systems have Local Estates • All local CCGs/systems have Local Estates Forums in place. Forums in place Our clinical vision drives our strategy and estates priorities Our challenges Delivering our vision, Estates priorities HEALTH AND WELLBEING our strategy • Estimated population growth of 18% over HEALTH AND WELLBEING next fifteen years HEALTH AND WELLBEING • Developing more fit-for-purpose health • Five out of our eight boroughs are in the • Develop sufficient capacity for population facilities in the community lowest quintile for deprivation in the UK. growth and changes to models of care and • Investment in primary and social care • Health inequalities are high, with many health, support prevention premises and community spaces to support residents challenged by poor physical and • Primary care – more operating ‘at scale’ to larger integrated care teams mental health driven by factors such as provide out-of-hospital care • Elective care networks, including surgical smoking and childhood obesity. • Elective surgery to reflect population growth centres of excellence and change • Shape maternity facilities to meet “Better • Particular challenges from a growing elderly • Maternity care, delivering Better Births population in outer north east London. Births” standards programme • New models of care to reflect changing population needs, specifically services for CARE AND QUALITY CARE AND QUALITY older people • Performance against CQC standards in both • Increased integration across primary and acute and primary care is highly variable. secondary care pathways • Variable performance against key • Increased capacity to provide out-of- CARE AND QUALITY performance targets hospital care • Redevelopment of the Whipps Cross • Poor quality estate in some areas – not • Sustainability of emergency services Hospital site to replace out-of-date and purpose-built, or suitable for modern • Better access to specialised services poor-quality facilities healthcare • Develop new care models for older peoples • Improvement of urgent and emergency care • Substantial backlog maintenance services facilities on a number of hospital sites requirements SUSTAINABILITY SUSTAINABILITY SUSTAINABILITY • Improve utilisation of facilities • Poor utilisation for some sites • Reviewing the location of acute inpatient • Reduce void space mental health services to improve • Void (unused) space in some buildings • Improve productivity and provide more productivity and flexibility • Workforce shortages flexibility for mental health services • Availability of funds for improvement • Need to reduce operational costs 5 Where do we need to be? DESTINATION 2033 DRIVERS FOR CHANGE • Place-based care – fully integrated • Service transformation social care and health services 2018 • Population growth • Primary care ‘at scale’ • Estate utilisation and • Reduced estate voids condition • Improved estate utilisation • Fragmented ownership • Digital innovation • Reduction in non-clinical space • Wide variations in use and condition • Workforce pressures • Improved quality and condition • Fixed core estate • Financial pressures • Exiting non-operational premises • No capacity in some growth • Efficient use of resources areas • High estate and void costs • Inefficient use of space • Opportunities for consolidation Capital investment The capital pipeline for Partnership transformational Prioritising investment projects has been identified and prioritised. All projects in opportunities is a key task. the STP plan have been considered and assessed using criteria that included state of readiness and transformational priorities. The projects are now part of a We cannot deliver all our centralised programme plan which is reviewed monthly projects simultaneously, by the Estates Operational Working Group. and a rational, systematic A thorough prioritisation process was carried out with all approach to prioritisation partners using pass/fail criteria to check the state of will help ensure readiness (e.g. PID in place) and STP ‘alignment. This was requirements are met as followed by a weighted scoring process against four key themes with ten questions and 20 sub-criteria. early as practicable, and that resources are used as Many projects are interdependent upon each other and effectively as possible. these interdependencies, along with the state of readiness, impacted on where they ranked in the prioritisation. See Appendix slides for methodology/framework applied Detailed prioritisation list of all projects available upon requested. 7 Purpose Infrastructure is a key enabler to facilitate the delivery of the East London Health and Care Partnership (ELHCP) vision. This plan gives a strategic overview of the current estate and its challenges. It charts the way forward to deliver the estate required to enable the ELCHP vision. This is a system wide estates plan, designed to begin the development of an estate-based response to the main STP transformation themes. The ELHCP Strategic Estates Plan (SEP) does not replace or duplicate existing organisations’ estates strategies/plans across the footprint. It focuses on common themes, identifying where collaboration is either desirable – helping to achieve economies of scale, to share scarce resources or to share best practice; or Our plan provides a framework for essential. Where we need it, we must plan prioritising investment to maximise for buildings that make data-sharing and co- the benefits of estate-enabled location work. transformation. 8 How we have developed this plan This plan summarises the Over the past year, the partners have been meeting to existing challenges and sets produce the ‘Estates’ section out the interim conclusions of of the STP. the work to date. Our discussions and this plan, More importantly, it is a ‘living’ build upon the work of our Local Estates Forums (LEFs) plan that partners will develop to produce Strategic Estates into a robust strategy which Plans (SEPs), and providers’ reflects the full transformation own work to deliver cost implications of the Sustainable improvement and innovation. Transformation Plan (STP). 9 The partners The Partners agree to work together to collectively to improve the information we hold and share about our respective estate, and to improve our estate management performance. There are strong interdependencies between the new models of care in the STP and estates efficiencies that cannot be delivered separately. We continue working together to pursue opportunities

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