Appendix E.3
Project Appraisal Unit
Capital Investment, Property, Equipment & Digital Technology proposals
NHS England Project Appraisal Unit Project Initiation Document - Type 1 Clinical Premises Not to be used for NHS England administrative premises - see PID Type 2
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.
Unless building and premises based PIDs are informed by sufficient detail and forward planning this can hinder a prompt and informed decision on PID approval. A PID is the first stage in the process, but there are fundamental issues to be considered before progressing to business case stage. This particular PID type for clinical premises is therefore designed to support authors in considering some of those important issues that need to be covered in the PID to inform local decision making. It is also acknowledged that at PID stage not all of the information asked for may be available. However, all PIDs for this type of proposal must be as complete as possible and, where information is not known, a brief explanation should be provided.
Document version Version No. Status Issue date Notes control For final approval from Dr (for use by PID sponsors) 1 Draft 23/02/2018 Rahmin Add rows as required. For final approval from 2 Draft 26/0218 Last entry should read: SWCLT ‘Final for signatures’ 3 Final for signatures 02/03/2018
New Stretham Surgery to replace existing branch surgery premises and surgery 1. TITLE OF SCHEME premises at Haddenham.
Scheme reference number and source of number (organisation). Reference No.
Please ensure the relevant unique reference (for all Schemes) is used Confirm the in all correspondence and reporting Organisation using an appropriate format: e.g. issuing the XXX – YY - XXX (Org Code – 17 – reference 001) number.
2. DATE OF FORMAL PID Date 02/03/2018 SUBMISSION
3. IS THIS A RESUBMISSION Yes OF AN EARLIER PID? Reference No. This is a NHS supported project. Initial proposal not supported If so, provide details and reference due to size of building. no.
IF YES: Please provide No it will not duplicate funding. Will this resubmission result details OR potentially result in a NHS England PAU. PID Type 1 Clinical Premises VF2 28/06/17 Page 1 of 13 duplicate funding application already covered by another PID, etc.?
Is any element of this PID actually, or potentially funded through any other previous (already approved), parallel (current) or planned (future) application for funds?
4. NHS ENGLAND CAPITAL If applicable, FUNDING STREAM (from any funding Potential ETTF (for IT only) source) initiative name Scheme Please confirm the NHS England TBC capital funding stream relevant to reference No. this investment e.g. BAU, etc. Funding TBC Financial tables should clearly show stream the NHS England commitment.
Where capital funding is from a Cost Centre TBC special initiative e.g. ETTF, please use the first two rows opposite to Subjective TBC denote initiative name and scheme Code reference number Total value of (IT costs) TBC when final building size and facility mix is Please use standard NHS finance NHS England codes when completing this section confirmed. funding. £
Funding Stretham and Wilburton Community Land Trust (CLT) source name Stretham and Wilburton Community Land Trust (SWCLT) is a volunteer-led, democratic organisation set up in October 2012 to develop and own assets for the benefit of the communities in both Stretham and Wilburton. It was granted planning permission in 2014 for a three phase development of 75 new Brief homes. This includes 23 affordable rented homes, 52 for 5. DETAILS OF ANY explanation of market sale and land that has been reserved for a new doctors’ ADDITIONAL CAPITAL funding surgery, workplaces and a new village green. FUNDING SOURCE (where applicable) The subsidiary received from the sale of the market houses Please confirm and briefly explain together with borrowing will fund the construction of the GP ANY additional capital funding surgery. stream relevant to this investment e.g. NHSPS Customer Capital. Is this funding to be used for The additional/alternative funding Construction of the doctor’s surgery building. a specific should be clearly shown in Table 3 purpose? below with relevant totals. Is any element Any borrowing will be from Charity Bank from where SWCLT The implications of the additional of this funding already receives funds. funding must be clearly shown in liable for the Economic and Financial repayment? sections of this PID. If yes, please give details including Amounts and dates to be agreed once final costs known. reason, amounts and dates. Total value of additional 1.5 million funding. £
NHS England PAU. PID Type 1 Clinical Premises VF2 28/06/17 Page 2 of 13 NHS England Midlands & East (East) Region 6. NHS ENGLAND REGION/LOCAL DIRECTOR Swift House, Colchester Road, Chelmsford, Essex. CM2 5PF OF COMMISSIONING and OPERATIONS (DCO) OFFICE DCO West Wing, Victoria House, Capital Park, Fulbourn, Cambridge. CB21 5XB
7a. SPONSORING Organisation Haddenham Surgery ORGANISATION No. 1 AND Title/position Senior Partner LEAD CONTACT Name Dr Amina Rahman Please include a named lead Office tel. 01353 741595 contact for this application who can answer any queries relating to this Mobile tel. PID e-mail [email protected] Organisation Stretham and Wilburton Community Land Trust 7b. SPONSORING ORGANISATION No. 2 Title/position Clerk to Stretham and Wilburton CLT (where applicable) Name Rachel Watts
Please include a named lead Office tel. contact for this application who can 07762 040800 answer any queries relating to this Mobile tel. PID e-mail [email protected] Organisation NHS England (East) 7c. SPONSORING ORGANISATION No. 3 Title/position Head of Estates (where applicable) Name Kerry Harding
01138 249111 Please include a named lead Office tel. contact for this application who can answer any queries relating to this Mobile tel. 07730 380217 PID e-mail [email protected]
Organisation 8. NHS PROPERTY SERVICES OR COMMUNITY HEALTH Title/position PARTNERSHIPS CONTACT Name (where applicable) Office tel.
Please include a named contact as Mobile tel. appropriate e-mail
CCG Cambridge and Peterborough CCG 9. OTHER LOCAL STAKEHOLDERS OR Local Authority East Cambridgeshire District Council TENANTS Peterhouse College Other (1) Please add further lines where required Other (2) Laragh Homes
10. SCHEME DESCRIPTION scope and content Include a brief description of the
scheme, which should include, but GP services in Stretham are currently delivered in an inadequate surgery - a need not be limited to: poor quality 35m2 adapted bungalow where CQC standards are not achievable. scope and content The surgery is only open part-time. the scheme type - new build, refurbishment or a lease objectives and benefits – these may be financial and/or non- financial NHS England PAU. PID Type 1 Clinical Premises VF2 28/06/17 Page 3 of 13 location – address and name of The main Haddenham surgery is cramped and unable to absorb the increased the facility demand from existing patients, let alone from the increasing population (about NHSPS/CHP premises code 300 house starts expected in the next 3 years). where known and available wider stakeholders and their Both buildings are land locked so there is no scope for expansion onsite at either interest e.g. potential occupants location. indicative scheme value for approval purposes A brand new purpose build surgery (630 sq.m. in total over 2 floors) to replace confirm other stakeholders are both the existing Haddenham and Stretham GP’s surgeries is being proposed. It signed up to the general terms, will be leased from the Stretham and Wilburton CLT and located on the Manor costs and implications of the Farm development, off Newmarket Road, Stretham, East Cambridgeshire. proposal. Please see attached site plan and location map. confirm that where details are known, any proposed leases, are This would allow disposal of two GP practice buildings and enable the appropriate and acceptable to all consolation of services into a single fit for purpose centre. participants. if the scheme requires temporary Facilities in the new build include 6 treatment/consulting rooms for GPs, Nurses accommodation and HCA and trainees, a dispensary and private interview room. Improved staff if costs for enabling works are facilities (including a shower), admin space, kitchen and training room are required and, if so, included in provided on the first floor. The training room can be partitioned and will fit out to the overview costs. also serve as a web/tele consulting room.
Externally in addition to pushchair and wheelchair mobility parking spaces, there is a parking area for cancer and other screening vehicles so these services can be provided locally.
objectives and benefits
Patient benefits: The new surgery will result in a full time service for Stretham patients, plus extra services being provided in a purpose build facility. The new surgery would have additional capacity and be able to accommodate the growth in demand from existing patients and the future population. It will enable a wider range of services can be provided to patients, and increase the way patients access GP services by enabling web and telephone based consultations.
More local services allowing better surveillance of vulnerable patients including the elderly at risk of admission. As in most rural practices the most at risk tend to be well known to clinical staff.
Clinical/practice benefits: Good quality treatment facilities allowing more clinical treatment and additional administrative area to facilitate support tasks. This will enable support staff to reduce the administrative burden on GPs.
Staff benefits: The GPs and other staff will benefit from improved facilities and better working environment. The training rooms will enable training of both new and existing staff and assist with recruitment and retention.
Financial benefits: This is a unique opportunity for the NHS and CCG to benefit from a brand new facility with minimal capital funding input.
Having both surgery’s under one roof will generate efficiency savings. Further savings and financial benefits will be generated should the practice merge with neighbouring ones, allowing shared use of facilities and back office services.
wider stakeholders and their interest e.g. potential occupants
Local people and stakeholders
There has been strong support from the District and Parish Councils who have contributed substantial loans to set up the CLT together with Foundation East. Extensive Public consultation has been carried out by the Community Land Trust, consultation with PPG, involvement of East Cambs District Council, NHS England PAU. PID Type 1 Clinical Premises VF2 28/06/17 Page 4 of 13 oversight by Trustees of the CLT and its wider membership by public meetings and newsletters.
General Practice
The new facility will enable more joined up working with other community health providers and closer partnership neighbouring GPs. The larger facilities will means that providers such as midwifery and District Nurse can hold clinics for longer and more regularly than at present.
Community Health Providers
The larger surgery means that patients can not only access a wider range of community health providers, but they won’t have to travel long distances to do so. These services can be offered to patients from near-by surgeries to maximise the benefits.
Voluntary and Community Sector (VCS) organisations
The building will enable VCS organisations such as Citizens Advice and local clubs and community groups to have a presence in the surgery so that they can maximise their support to patients using the services. This will help address wider social issues that can impact on health and reduce isolation, particularly amongst the elderly population.
The indicative scheme value at this stage is £1.5m for construction and fit out costs. The GP practice are requesting that NHS England pay for the IT Infrastructure, estimated to cost £100,000.
This project has the support of NHS England and Cambridgeshire and Peterborough CCG, the Parish and District Councils and Stretham and WIlburton CLT.
Length of lease and rent level to be confirmed in discussion with NHS England.
The scheme will not require temporary accommodation.
11. STRATEGIC NEED Strategic need.
Provide the strategic drivers and Provide the strategic drivers and justification for the scheme. justification for the scheme. Confirm and outline alignment One of the key drivers for this project is the risk of closure of the current with other strategies as Stretham surgery by CQC. Should this occur, the main surgery at Haddenham, appropriate would find it very difficult to cope with the increased demand. There is no possibility of onsite expansion at Haddenham. Patients without access to a car would find it difficult to travel to alternative surgery’s due to poor public transport provision.
The new surgery is required to meet the needs of the growing and increasing elderly population. The inability of the main surgery to absorb the increased demand, or the increased population (about 300 house starts expected in the next 3 years) and that the nearest practices otherwise are more than 5 miles away, and have capacity problems of their own. Local transport links are poor.
The nearest alternative surgery at Sutton is also looking to expand due to capacity issues.
NHS England PAU. PID Type 1 Clinical Premises VF2 28/06/17 Page 5 of 13 There are current planning permissions in the patient boundary area for Haddenham and Stretham for 852 dwellings.
The submission version of East Cambridgeshire District Council Local Plan allocates sites for a further 935 dwellings in the same area.
These figures does not include CLT (Community Land Trust) sites, windfall sites (a site that comes forward on unallocated land for residential development).
This project aligns with the NHS England Five Year Forward View in that it will:
will enable more care delivered locally Will break down the barriers locally in how care is provided between family doctors and hospitals, between physical and mental health, between health and social care. Will support NHS national action on obesity, smoking, alcohol and other major health risks as the practice will be able to hold additional healthy eating, smoking cessation and other public health and prevention focus sessions. Will permit groups of GPs to combine with nurses, other community health services
The Forward View highlights a commitment to invest in the NHS workforce, the training facilities at the new surgery will enable both new and current staff to be training and engage in continuous professional development.
This project will also help reduce pressures NHS budgets as a brand new purpose built facility is being provided at minimal cost to the NHS. This proposal also combines 2 sites into one, reducing revenue costs. Any future merger with neighbouring practices will reduce back office costs and make best use of NHS resources.
This new larger purpose built facility and the services it will allow to be provided are consistent with and will assist with delivery of the Cambridgeshire and Peterborough Health and Care System Sustainability and Transformation Plan and the Cambridgeshire & Peterborough CCG GP Forward View strategy.
The new surgery will be able to host co-located multidisciplinary teams, working across several practices to provide an enhanced level of care to patients with complex needs.
It will have meeting space to allow multidisciplinary case meetings and joined-up working across different groups of care givers from different health and care organisations and the voluntary sector where appropriate.
Additional work to deliver the chronic disease and public health prevention agenda will also be possible as will targeting interventions to specific patients.
The Cambridgeshire & Peterborough CCG GPFV strategy highlights the need to ensure that general practice is sustainable. Haddenham GP Practice is exploring ways of working together with other practices to share the new facilities and explore ways of working at scale. This also includes looking at back office services and opportunities to rationalise overheads and services, and potentially sharing some functions. This will enable a wider range of services to be provided and more efficient working.
The CCG workforce programme’s ambition is to support primary care staff in working safely, through recruitment and retention, leadership development and capacity creation. Working in a new, uncluttered, state of the art, custom built working environment should attract new and help retain existing staff. NHS England PAU. PID Type 1 Clinical Premises VF2 28/06/17 Page 6 of 13 Acknowledging that improving the shape and size of the current and future NHS workforce is critical, the purpose built training facilities at the new surgery will also address workforce shortages and recruitment and retention issues by providing training opportunities will allow the practice to offer training placements to ‘grow its own’ workforce, training new staff and also developing skills of existing staff and embed a culture of learning at the surgery.
The new surgery will have a room fitted out to enable telephone and web based consultations and remote health monitoring as GPs aim to maximise the benefits of modern information technology. This is important in this area where public transport provision is poor and will help the CCG deliver its digital strategy. Providing a safe and efficient facility will assist with implementation of the NHS Getting It Right First Time recommendations.
The new facility will also deliver extended access as part of delivering the General Practice Forward View. It will enable the surgery to meet the requirements for improving access, not only in terms of Timing of appointments, Capacity and ease of access, but also use of digital approaches to support new models of care in general practice
Provision of a brand new surgery at minimal cost the NHS will help to reduce the financial challenges it faces.
12. CONSISTENCY WITH As outlined above this project aligns with the NHS England Five Year Forward SUSTAINABILITY AND View in that it will: TRANSFORMATION PLANS will enable more care delivered locally (STP), COMMISSIONING AND ESTATES PLANS Will break down the barriers in how care is provided between family doctors and hospitals, between physical and mental health, between Confirm alignment with the NHS health and social care. England Five Year Forward View and related implementation Will support NHS national action on obesity, smoking, alcohol and other plans. major health risks as the practice will be able to hold additional healthy Confirm that the proposed eating, smoking cessation and other public health and prevention focus scheme is consistent with the sessions. relevant STP, commissioning, Will permit groups of GPs to combine with nurses, other community clinical and (where appropriate) health services estates and or technology strategies. This new larger purpose built facility and the services it will allow to be provided Confirm whether formal public are consistent with and will assist with delivery of the Cambridgeshire and consultation is required. Peterborough Health and Care System Sustainability and Transformation Confirm whether any planning Plan and the Cambridgeshire & Peterborough CCG GP Forward View permission (including change of strategy. use) is required and its current status. Yes – consultation would be required. This will be conducted with patients, the Confirm that any proposed Haddenham Patient Participation Group and other key stakeholders. property development brief to designers will require and ensure The surgery building already has outline planning permission. compliance with appropriate and relevant NHS guidance, such as The initial plans have been drawn up in accordance with NHS guidance and with BREEAM, Health Building Notes, input from NHS England. This will continue through the design process and common minimum standards for construction of the building. the procurement of built environments in the public sector, etc.
13. ESTIMATED PROJECT DEVELOPMENT COSTS Cost per Stage of Development Funded by Project Sponsor Total incl. VAT £ £ NHS England PAU. PID Type 1 Clinical Premises VF2 28/06/17 Page 7 of 13
Incurred Pre PID PID to Option Appraisal Option Appraisal to OBC OBC to FBC Total
14. CAPITAL COST Capital Total ESTIMATES
(Inc. VAT) The total capital investment for IT infrastructure – in region of £100,000, subject to review This section is anticipated to be very and reshaping. high level (but based on evidence), prior to any formal options Financial tables must clearly show the total NHS England commitment only. appraisal. Benchmarked Table 2. Total Capital requirement inc. VAT for current and future years construction costs can be accessed through Description £ £ £ £ £ the NHS England PAU Current Current PID total Third year Total team. year year Years 1+2 only across (year 1) (year 2) 20[../..] three Please use table 2 (and, 20[../..] 20[../..] years if and where available, Land append any more (generally only detailed ready prepared apply to year 1) tables that are Development considered costs from Table appropriate), to detail 1 above. the capital requirements (generally only to deliver this scheme in apply to year 1) years 1, 2 and year 3 Project where applicable. Management
fees Please use Table 4 to confirm capital funding Enabling works, sources that should where applicable sum to the total in Table Construction 2. Fixed equipment Totals 0 0 0 0 0 Two-site scheme Two-site schemes may potentially occur where, Two-site schemes - see notes on left). say, there is a move from one site to another If this is part of a 2-site scheme, please provide details by year, by site in the following and to achieve this tables to show the total estimated value of the overall project, and these should collectively there may be some sum to the total capital requirement in Table 2, above. level of expenditure on two sites. The total Explanation and description of any two-site scheme covered by this PID scheme costs for both N/A related sites are to be provided in the tables. This does not mean that 2 unrelated sites or schemes can be approved under a single PID.
Please ensure that all proposed costs set out in these tables are for capitalisable CAPITAL FUNDING SOURCES expenditure. The table below will therefore show the full capital cost of the scheme
Table 3. Total Capital requirement inc. VAT for current and future years
NHS England PAU. PID Type 1 Clinical Premises VF2 28/06/17 Page 8 of 13 Please insert the Capital funding £ £ £ £ £ relevant dates in the source Current Current Scheme Third year. Total [square brackets] year year total only across (year 1) (year 2) Years 1+2 20[../..] three 20[../..] 20[../..] years CLT £1.5m £1.5m Other NHS England £100,000 £100,000 £100,000 Totals £1.6m £1.6m
15. REVENUE Length of lease and rent level to be confirmed in discussion with NHS England. AFFORDABILITY / IMPACT Net Recurrent Revenue Impact: £’x’k over the following years. The 17/18 annual costs for Rent, Rates and Water which are all reimbursed to Outline any additional revenue the Practice from NHS England:- costs of capital investment beyond current costs, and other Haddenham Stretham additional costs if applicable e.g. additional rates, energy, FM Rent £37,700.00 £7,100.00 costs and any planned offsetting savings Rates £4,665.28 £2,799.17 Specify funding source for any adverse net revenue impact Water £536.00 (approx.) £213.70 (approx.)
£’x’k Estimated lifecycle costs: The costs for the new surgery will be in line with DP rates. £’x’k Gross Recurrent Revenue Impact
16. PROPOSED N/A PROCUREMENT STRATEGY Land and building to be provided via S106 Agreement by Stretham and Please describe the procurement Wilburton CLT. strategy, who will be leading, and when it is anticipated to complete and capital spend will be incurred. For new build solutions, please confirm if the proposal is likely to be within a LIFT geographical area.
Where available attach a key milestones plan. As a minimum, this should include, as appropriate:
Option Appraisal Procurement Route Confirmed OBC/New Project Proposal OBC Approval/Stage 1 Approval FBC/Final Project Proposal FBC Approval/Stage 2 Approval Date of procurement Planned start of works Estimated completion date
17. CONSIDERATION OF Do nothing OTHER OPTIONS
Describe other options under The key risk with this option is closure of the current Stretham surgery by CQC consideration, including the ‘Do due to it not meeting required standards. Nothing’ Option.
Briefly consider the advantages and Advantages: disadvantages of each option under consideration and identify the one None used for benchmarking to indicate the scheme value in this PID Disadvantages:
NHS England PAU. PID Type 1 Clinical Premises VF2 28/06/17 Page 9 of 13 The inability of the main Haddenham surgery to absorb the increased demand from existing patients, plus the increased population (about 300 house starts expected in the next 3 years). The nearest alternative practice is more than 5 miles away, and has capacity problems of its own. Local transport links are poor. The Practice cannot increase the services it provides. The Practice is unable to expand training offer.
Improve existing buildings
Both practices are privately owned and land locked so there is no scope for expansion.
Advantages:
Retains a surgery presence in both villages.
Disadvantages:
May not be possible to bring Stretham surgery up to the required standard in the existing building. The inability of the main Haddenham surgery to absorb the increased demand from existing patients, plus the increased population (about 300 house starts expected in the next 3 years). The nearest alternative practice is more than 5 miles away, and has capacity problems of its own. Local transport links are poor. The Practice cannot increase the services it provides. The Practice is unable to expand training offer.
New Stretham Surgery only
Advantages:
Retains a surgery presence in both villages. Improved facilities and services in Stretham. This will result on full time service plus extra services being provided in a purpose build facility. The new surgery would have additional capacity and be able to accommodate the growth in patent numbers. Opportunity for NHS England to access a new purpose built facility at no capital cost except IT Infrastructure costs. Fit out will enable web and telephone based consultations.
Disadvantages:
Not financially feasible to run 2 large surgeries so a new Stretham Surgery would not be able to offer the full range of services the Practice wish to provide. NHS England have indicated that they would not support a new Surgery at Stretham of the size being proposed and keep Haddenham Surgery open.
New Surgery at Stretham, shut Haddenham Surgery
Advantages:
Opportunity for NHS England to access a new purpose built facility at no capital cost. The new surgery would have additional capacity and be able to accommodate the growth in patent numbers. NHS England PAU. PID Type 1 Clinical Premises VF2 28/06/17 Page 10 of 13 This option enables the best mix of facilities Widest range of services can be provided to patients Fit out will enable web and telephone based consultations. Facilities will enable merger/partnership work with other local surgeries.
Disadvantages:
Closure of Haddenham Surgery and impact this will have on patients.
18. SITE PLAN Please see attached building plan and location plan.
Where available and for larger schemes (>£1m), please provide a simple site plan to demonstrate the proposal.
19. OTHER ISSUES a No Confirm and provide brief explanation about: Haddenham Surgery GP and Practice Manager, NHS Head of Estates, a) Is the output from One Public Cambridgeshire & Peterborough CCG Head of Primary Care Estate planning known for the b Commissioning and East Cambridgeshire District Council all sit on the relevant locality ? Steering Group for the project and have provided input into the PID. b) Have NHS PS / CHP / or other named party provided input Sutton, the neighbouring surgery, does not have spare capacity and is also c into the PID? looking to expand. c) Is there spare service (or accommodation) capacity in Yes the existing Haddenham and Stretham (branch) surgeries will both neighbouring, cross boundary d areas? close. d) Are any service or accommodation closures anticipated as a result of these e No proposals? e) Will any land be released? f) Is the proposal dependent on reinvestment from disposals? f No g) Where applicable, is the land clearly identifiable and available. h) Is the land in the ownership of g Yes the NHS? i) Are there any known constraints that could h No influence the outcome of this scheme in construction or use? E.g. in a flood zone, listed building, etc.? i No j) Where GP or other organisations will share the facility, are there plans to integrate the common areas, j As the attached plan shows, common areas will be shared. or are the organisations intent on remaining fully separate entities in practical terms? The latter may not be acceptable k Yes – approx. £100,000 TBC at OBC stage. for this PID to be approved k) Has any IT infrastructure been factored into the costs for this l N/A
NHS England PAU. PID Type 1 Clinical Premises VF2 28/06/17 Page 11 of 13 scheme in the tables 2, 3, 4 and 5? If yes, please quantify. The total capital investment for IT infrastructure – in region of £100,000, m l) If not, please confirm source subject to review and reshaping. and certainty of funding for this item. m) In schemes involving GP’s, what is the anticipated value of the GPIT requirement? n NHS England - TBC n) please confirm source and certainty of funding for GPIT.
20. KEY RISKS Risk Mitigation
Please provide adequate Land and building to be provided via information to enable reviewers to S106 Agreement by Stretham and understand the level and likelihood Wilburton CLT, which is a legally of risk and how it is to be mitigated. binding document.
Please list any risks to delivery, for Funding not available from CLT example if the spend is dependent Option to borrow funding from Charity on a practice merger other estates Bank, from where SWCLT already investment, involvement of a 3rd receives funds. party, etc. We have secured early engagement with NHS England and the local CCG Funding not available from NHS both of whom are represented on the England project steering group. Both have indicated support at this stage. Strong project steering group in place. The CLT trustees have a wide and Delays – increase in costs experienced skill set to drive this project forward. The closure of Haddenham Surgery will be addressed at an early stage and in parallel with the construction of the new centre.
Haddenham Surgery not closing Consultation/engagement with patients, the Haddenham Patient Participation Group and other key stakeholders to address objections and other issues relating to the closure.
21. SCHEME OR PROJECT ENDORSED BY: I hereby confirm that I am satisfied the investment of capital as set out in this PID is necessary expenditure and offers value for money. I also confirm that any commitments made in this PID to the covering of revenue will be honoured by the CCG and/or its Statement relevant stakeholders. I am satisfied that the capital funding CCG CHIEF FINANCIAL requirement set out in this PID is not replicated in any other OFFICER NHS capital funding request, e.g. under other parallel capital investment initiatives Organisation Name Signature Date
I hereby confirm that I am satisfied the investment of capital as Statement set out in this PID is necessary expenditure, offers value for NHS ENGLAND DCO money and conforms with relevant policy. DIRECTOR OF DCO COMMISSIONING Name Signature Date
I hereby confirm that I am satisfied the investment of capital as Statement set out in this PID is necessary expenditure and offers value for NHS England PAU. PID Type 1 Clinical Premises VF2 28/06/17 Page 12 of 13 NHS ENGLAND DCO money. I also confirm that I am satisfied with the financial DIRECTOR OF FINANCE commitments made by the CCG in this PID. DCO Name Signature
Date
I hereby confirm that I am satisfied the expenditure of capital as set out in this PID 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 PID in relation to the covering of revenue costs. I confirm Statement that any NHS England capital expenditure assumed in this PID NHS ENGLAND REGIONAL is funded within the Regional capital budget for the relevant DIRECTOR OF FINANCE year(s). I am assured that there is a credible plan in place to account for any assumed NHS England capital expenditure in the appropriate financial year in accordance with NHS England standard accounting practice. Region Name Signature Date PRIORITISATION (For regional use only where applicable)
NHS England PAU. PID Type 1 Clinical Premises VF2 28/06/17 Page 13 of 13