2015/2020 ESTATES STRATEGY 2 Togeth er we care, we respect, we deliver Contents

1. Executive summary 4 2. Introduction 8 3. The estate strategy process 10 4. Where are we now? 11 • The Trust’s existing estate • Appraisal of the condition & performance of the estate • Backlog costs • Estates key performance indicators 5. Where do we want to be? 28 • The Trust clinical strategy • Drivers for change • Estate key targets for change 6. How do we get there? 30 • Delivering the aims of the estate strategy • The business case process • Key financial assumptions • Stakeholder involvement • Risk • Estates plan 7. Conclusion 33 8. Appendices 34 Appendix 1 – community properties Appendix 2 – residential properties Appendix 3 – trust occupied areas not on the main site

3 1. Executive summary

This report describes the Estates Strategy for Northern Lincolnshire & Goole NHS Foundation Trust for the period 2015 – 2020. The aim of the Strategy is to ensure that the Trust provides safe, secure, high-quality healthcare buildings to support current and future needs.

The Trust recreated its longer term that only through joint working The process adopted for developing strategy during 2014. The changing would services be sustainable in the Estate Strategy has been in NHS environment both locally and the future. accordance with the guidance nationally was the key driver behind and processes described in the • The basis for the strategic the need to recreate the strategic Department of Health document, direction remains robust and vision. developing an Estates Strategy. This the direction is in line with process asks three basic questions in • The strategic direction for the proposals contained within the relation to the Trust Estate: Trust was based upon three key recently published NHS Five Year themes: Forward View. The integration • Where are we now? agenda across providers and • Where do we want to be? i). Quality of Care. Ensure commissioners in particular continued delivery and/or has seen a faster pace during • How do we get there? improvement across the three the latter half of 2015-16 and key aspects of patient safety, provides a strong foundation for clinical effectiveness and patient further progress heading into Where are we now? experience. 2016-17. The Northern Lincolnshire and Goole Hospital NHS Foundation Trust ii). Efficiency. Ensure the services The main priority for the strategy covers a wide geographical area. The delivered are as efficient as is to increase the site utilisation Trust has a total of 878 beds, a gross they can be without impacting by reducing estate and backlog floor area of 143,546 m2. adversely on the quality of care. maintenance costs, whilst improving the environment. It operates out of three main hospital iii). Integration. The Trust Board campus sites and several community reinforced previous findings The delivery of these plans will premises. The Trust delivers District that the local health services require financial investment along General Hospital services on the as currently configured are not with changes in working styles and Grimsby and Scunthorpe sites which sustainable in the medium to challenges to the work for the whole include Emergency Departments long term; under the current organisation. (ED’s) and ITU whereas the smaller NHS payments system and

4 Togeth er we care, we respect, we deliver Goole District Hospital operates a The results of the appraisal are Where do we want to be? lesser portfolio of services and has a summarised in Table 1, the figures Minor Injuries Unit rather than a full included within the table is the The Trust will need to address ED. All three sites provide inpatient, amount of investment required to the current poor condition and day case and outpatient services. bring Trusts estate up to condition performance of the estate and move B; where condition B is defined toward the provision of safe, secure, The first stage of developing as “a facility requiring general appropriately positioned and high- the Estate Strategy included a maintenance investment only”, quality healthcare buildings that are comprehensive appraisal of the which in terms of physical condition used efficiently and effectively for condition and performance of the is “sound, operationally safe and the delivery of modern healthcare existing estate, in accordance with exhibits only minor deterioration” services. However, the Estate Estate Code, covering: and in terms of compliance the Strategy and any future investment • Physical condition; estate “complies with all necessary must be “service and user led” with patients being at the centre of any • Compliance with Fire, Health mandatory fire safety requirements proposed changes. & Safety & other statutory and statutory safety legislation with standards; minor deviations of a non-serious Changes are taking place both • Environmental Management; nature”. The condition is broken within the local health economy down into the six categories listed and nationally to ensure the NHS is • Functional suitability; above and covers the entire estates fit for the future. The NHS recently • Space utilisation; from buildings to road/pathways published its Five Year Forward View • Quality; and and infrastructure such as water and highlighting the challenges faced. • Adaptability gas main pipework; a full breakdown The document does advocate many is detailed in the six facet survey planning themes which are already section commencing on page 13. contained within the Trust’s existing Table 1 – Estate Code Appraisal strategy. The results show in terms of the overall estate:

Appraisal Costs by Sites For : Diana Princess of Wales Hospital,RJL30 20-Feb-15 Site Cost to B Yearly Spend Year 1 Year 2 Year 3 Year 4 Year 5 Years 6-10 Years 10-20 Years 20-30 Years 30+ Diana Princess of Wales £19,483,423 £3,219,423 £9,868,795 £2,514,810 £1,517,014 £612,489 £0 £0 £0 £0 Hospital, RJL30

Appraisal Costs by Sites For : Scunthorpe General Hospital,RJL32 20-Feb-15 Site Cost to B Yearly Spend Year 1 year 2 Year 3 Year 4 Year 5 Years 6-10 Years 10-20 Years 20-30 Years 30+ Scunthor pe General £22,098,788 £2,036,572 £1,342,864 £2,032,851 £997,462 £1,747,249 £0 £0 £0 £0 Hospital, RJL32

Appraisal Costs by Sites For : Goole and District Hospital,RJL31 20-Feb-15 Site Cost to B Yearly Spend Year 1 year 2 Year 3 Year 4 Year 5 Years 6-10 Years 10-20 Years 20-30 Years 30+ Goole and District £2,709,546 £384,164 £182,354 £817,868 £323,012 £1,362,517 £0 £0 £0 £0 Hospital, RJL31

5 A number of key documents set The Trusts recently published To enable delivery of the core out the future strategic direction for Operational Plan for 2015-16 principles above, the Trust refined the Trust and its partners and are reinforced its 5 Year Strategy and and strengthen the following key drivers in shaping this Estates reemphasised the following core strategic enablers;- Strategy. strategic principles; • The Trust continues to develop • Northern Lincolnshire & Goole i). To deliver services efficiently a true patient first workforce NHS FT 5 Year Strategic Direction; without impacting adversely whose services are delivered through a single, engaged and • Healthy Lives Healthy Futures, on the quality of care. The empowered team that has a Options for Future Service Trust has a robust internal 5 voice and strives for uniqueness, Configuration; and year sustainability programme of efficiency improvements, innovation, quality and safety. • Northern Lincolnshire & Goole structured intensively in the early • The IM&T strategy builds upon NHS FT Operational Plan 2015-16 years. This will deliver optimum the innovative culture of system • North Lincolnshire & North East efficiency across the whole of the development the Trust continues Lincolnshire Strategic Estates Trust cost base, and support the to achieve. Harnessing the Review redesign process. strengthening reputation and developing skills base, the ii). Working together across strategic goal is to develop a the health and care spectrum Strategic Direction local IM&T solution which meets provides the greatest The culture created within the Trust the service needs and enables opportunity to control demand, places the quality of care for our the secure sharing of information alleviating the cost pressures patients and their families at the across the patient journey, arising from demand growth. heart of service delivery. The staff removing organisational barriers. Integration improves the quality within the Trust deliver services of care provided by removing • Delivery of truly integrated ensuring continued improvement organizational boundaries, service provision is reliant upon across the three key aspects of enabling clinical teams to work the workforce of Northern patient safety, clinical effectiveness seamlessly across the patient Lincolnshire being able to work and patient experience. journey. as a multi-disciplinary team As part of the Trust 5 Year Strategy, regardless of where the patient the Trust Board reinforced previous The Better Care Fund initiatives is. With prime clinical space at a findings that the local health are a good example of this. premium, maximum utilisation services as currently configured Acute, community, primary and of the estate is key to deliver across Northern Lincolnshire are social teams working together value. The strategy aims to not sustainable in the medium with the individuals and their enable service provision to be to long term, under the current families to deliver a package delivered in the most clinically NHS payments system. However, of care that meets their needs. appropriate locations regardless no compelling case for change This multi-disciplinary approach of organisational ownership. had been made for a radical delivers reduced need for the Whilst the estate is highlighted downgrading, rationalisation or individual to navigate across above as a key enabler, the use centralisation programme of the differing organisations at and quality of the Trust estate runs Trust’s services. The Trust instead differing times reducing follow through each of the above strands identified a programme of clinician- up appointments and avoiding in one form or another, as defined led integration of pathways and admissions where clinically by this strategy. The Trust needs services, with the principal aim of appropriate. to develop innovative and forward controlling net demand growth, iii). Radical transformation where looking solutions that will achieve a through this means limiting needed. The Trust is prepared productive estate and aim to: future cost growth and delivering to act to improve patient care • Improved accessibility to sustainability. This would build on or to deliver more efficient and healthcare for patients; the work already underway across effective services. Both Hyper local providers of primary, secondary, Acute Stroke and ENT services • Disinvest in assets with high community, social and mental health were consulted upon during operating costs, back log care. 2014-15 with the outcomes maintenance requirements; being to consolidate on one site.

6 Togeth er we care, we respect, we deliver • Improve estates asset • Integrate services with the wider The Trust’s vision and plans for performance on all key health community; change over the next five years performance indicators; cannot be achieved without • Release capital from significant change and investment • Promote and facilitate new ways underutilised assets; in the estate. Table 2 below shows of working; • Provide staff accommodation the impact of this investment • Improve utilisation by to support recruitment and and change in terms of the key collaborating with the whole retention; measures of the estate condition and health community and public • Provide modern facilities such as performance as defined in Estate sector; restaurants and retail outlets that code across the three hospital sites. • Dispose of any surplus land; will support 7-day working. (Data for the community estate was not available at the time of writing this strategy)

Table 2 – Impact of Invest Assessment of Current Trust Wide Position Target % of total floor area of buildings falling below standard B Diana, Princess Scunthorpe Goole Trust wide Trust wide of Wales General Hospital Physical Condition 7.74% 20.11% 13.26% 17.69% 13.27%

Functional Suitability 18.41% 9.49% 1.76% 9.02% 6.77%

Space Utilisation 9.24% 5.23% 40% 86.79% 100%

Quality 7.19% 10.67% 6.01% 13.18% 16.48%

Statutory Compliance 36.1% 14.68% 22.72% 34.89% 26.17%

Environmental Performance 55.55% 11.11% 11.11% 2.44% 1.83%

Table 2, above, shows the improvement needed in the key measures of the estate condition and performance as defined in estate code if the trust is to perform with similar NHS Trusts.

How do we get there? • Continual programme of This will be a graphical investment ensuring the core representation of the Trust Capital The Estates Strategy responds to fabric of the Trust estate is Investment requirements and will the challenges and strategic aims as maintained in those areas be modelled to show anticipated described above through a series of where continued utilisation is construction periods pertaining to proposed changes to the estate and confirmed. each scheme. capital investment projects. The key themes applicable to this strategy Integral to the new developments are summarised as;- Strategic Plan and refurbishments is the Trust disposal of surplus land. • Refurbishment / Reconfiguration The strategy described in this / Relocation of business critical report will be delivered through the services to ensure fitness for Strategic Plan which will include a purpose; capital investment programme. • Investments in service developments which support delivery of the sustainability programme;

7 2. Introduction

This report describes an estates Strategy for Northern Lincolnshire & Goole NHS Foundation Trust for the period 2015 – 2020. The Trust covers a wide geographical area with a total of 878 beds, and a gross core site floor area of 143,546 m2. The aims of the Estate Strategy are:

• To support the achievement of functional suitability, quality, a good standard of staff the Trusts Clinical Strategy; adaptability and environmental accommodation. management of the estate; • to provide safe, secure and The plan for of the Estates Strategy quality healthcare facilities which • reduced need for expenditure on will be based on the following key complement and support the backlog maintenance; financial assumptions: provision of sustainable high • Capital receipts received from • Approximately £8.1 million quality care; land disposal; of cash from depreciation is • to ensure the Trust Estates is available per annum. The Trust • staff, patient and visitor used efficiently, coherently will need to invest significantly feedback; and strategically to support above the £8.1m depreciation future clinical and corporate • Patient Led Assessments of the level over 2016/17 and 2017/18 requirements; Care Environment reports; to secure core improvements to the estate, therefore this means • to support the alignment of • increased occupancy of Trust that estates development and Trust Strategies e.g. align with accommodation; improvement will be dependent the Trusts IM&T, Workforce & • Premises Assurance Model (PAM) on the wider funding position Organisational Development completion; and facing the organisation.. and Strategy & Planning etc. • ERIC annual return data • Asset disposal through land These aims will be delivered through: The Estates Strategy cannot be sale may be used to top up this • An improvement in the developed in isolation. The strategy value, though only as part of an condition and performance of is closely aligned to the strategic approved financial plan signed the estate as reported to the direction, enabling robust service off by the Trust Board – there is Department of Health annually; planning as the Trust and wider no automatic process of adding • refurbishment/redevelopment of community move forward. disposal proceeds to the capital programme. At this stage, the the Trusts clinical estate aligned An Estate Strategy should provide most material potential disposal to the Capital Investment plan; the following benefits: receipt would arise from surplus • refurbishment/redevelopment of • Estates development that land at the DPoW site, where the Trusts staff accommodation; supports the Trusts Clinical a project managing disposal is • disposal of property and Strategy; already in place. land surplus to future clinical • a board level commitment to • The Trust has secured loans via requirements; sustainable development and the ITFF specifically to support • redevelopment and relocation carbon reduction initiatives; the investments in estates energy efficiency improvements of the Trusts Retail and Catering • an opportunity to dispose of any and to undertake a programme facilities; and surplus land; of purchase, refurbishment • working in collaboration with the • an opportunity to reduce and expansion of residential wider healthcare community and underutilised areas of the estate; accommodation for staff public sector. across both DGH sites. Project • a means of targeting structures exist to manage both The success measures of the Estates investments to minimise the risk of these projects. Again it should Strategy are: associated with the Estate; be noted that expenditure plans • Improved space utilisation, • an opportunity to recruit remain subject to Trust Board and retain staff by offering sign off, as part of the wider financial plan. 8 Togeth er we care, we respect, we deliver • The Trust has set a total of • Any changes to agreed element of external oversight, £17.2m as an outline planning programmes in year will be from regulators or as part of joint total for the 2015/16 capital authorised through the Strategy working across the local health programme. The schedule & Planning Committee, Trust community, as appropriate. of proposed spending is Resources Committee and where This document builds on the designed to support strategic of significant materiality by the following Estates Strategy 2012 – development priorities. Trust Board. As a guide, the 2015 deliverables; removal or addition of a major • Future capital programme scheme, an overspend of more • Improved utilisation of the Trust resourcing will be derived than 20% of a major scheme’s Estate; through balancing available value, or material transfer of cash with strategic development • Investment in the Trust Estates resources between the main priorities for asset replacement, in order to reduce the backlog elements of the programme risk management, quality maintenance and to maintain (major schemes, Estates improvement, strategic control of the sites services, maintenance, equipment and transformation and business which are rapidly reaching the IM&T) will require Trust Board advantage. The programme will end of useful life; approval. be built in to a wider service • Improve the energy efficiency of and finance plan at least on an • Revenue affordability will be the the Trust building through the annual basis. key driver for determining the Trust Carbon Management and overall capital financing portfolio, Trust Travel Plan. and this may involve some

9 3. The estates strategy process

The estate strategy described in this report has been developed in accordance with the guidance and process described in the Department of Health’s document ‘Developing an Estates strategy’.

The process asks three basic The aim of this strategy is to ensure, The Trust will agree each year questions in relation to the Trust’s in line with the above, that the core an appropriate programme of estate: fabric of the estate is maintained investment balancing available and optimal utilisation is achieved resources with required outcomes. • Where are we now? supporting delivery of high quality The transformation, improvement • Where do we want to be? services and maintenance of the Trust estate will form a key part of this • How do we get there? The Directorate of Planning & programme, but will be part of a Strategy is co-ordinating the work balanced prioritisation process with on developing a long term vision other elements of the programme. Where are we now? of clinical services. This has enabled This initial stage was aimed at a robust and consistent Estates The Trust will seek to maintain developing a comprehensive Strategy. an adequate revenue budget to understanding of how well the allow for ongoing maintenance current estate supports delivery and improvement of the Trust of current services. This was How do we get there? estate, particularly as regards the achieved through an appraisal of This final stage in the process management of key risks. The risk the condition and performance of involved using the information Register will be used as the definitive the estate on accordance with NHS and outputs from the two previous statement of risk used to support Estate Code 2014. stages to develop an Estates Plan the prioritisation and resource that includes a capital investment allocation process. Where do we want to be? programme for modernising the The availability of cash will inevitably estate. A prioritised schedule of play a limiting role in the speed with The Trust submitted it Strategic capital projects, mapped across to which the Trust’s estates objectives Direction in June 2014. The three the Trust Clinical Strategy, will enable can be delivered. This is recognised key themes contained within the clarity of future estate developments by the Trust Board, who have the strategy include; and the Estate Plan to be finalised. task of managing resources. A key consideration at this will the 1. Maintain and/or improve the affordability of the proposed capital quality of care provided; programme in terms of both capital 2. Ensure the Trust is as efficient as and revenue funding. it can be; and

3. Integrate where it is beneficial to do so

10 Togeth er we care, we respect, we deliver 4. Where are we now

The Northern Lincolnshire and Goole Hospital NHS Foundation Trust covers a wide geographical area. The Trust has a total of 878 beds, a gross floor area of 143,546 m2. It operates out of three main hospital sites and several community premises. The Trust delivers District General Hospital services on the Grimsby and Scunthorpe 17 STAFF sites which include A&E and ITU IT whereas the smaller Goole District

65 STAFF Hospital operates a lesser portfolio 5 DISABLED STAFF 19 15 STAFF of services and has a Minor Injuries

WHEELCHAIRS PHARMACY STORE MAC NURSES RESTCOTE 1

TRAINING AND PHOENIX CLUB REPRO DEVELOPMENT GRAPHICS Unit rather than a full A&E. All three GARTH ANDERSON 8 SOUTHHOLME

EASTHOLME INTERNAL AUDIT 2 9 MANUAL HANDLI NG TRAINING 3 ROOMS MEDICAL sites provide inpatient, day case and ELECTRONI CS MEDICAL ILLUSTRATION

OCCUPATIONAL 5 4 HEALTH

WEST ARCH

CLINICAL 6 PSYCHOLOGY outpatient services. EDUCATION & LIBRARY

CHILD & 50 Staff 7 FAMILY 52 STAFF GOVERNANCE ANNEXE

54 STAFF Diana Princess of Wales Hospital, Grimsby DPoW Site Plan – Figure 1 The Trust holds freehold for the site which has 458 beds, a gross floor area of 71,520 m2 and covers a land area of 17.59 hectares. The site has a main road access from Scartho ADMIN A & E BLOCK

DERMATOLOGY Road, with further entrances on OUTPATIENTS X-RAY Second Avenue and Scartho Top. It

BOILER CORONATION BLOCK LINDSEY PATHOLOGY SUITE HOUSE STEPPING STONES has a possible additional entrance WARD 2 Scunthorpe General Hospital HOSPITAL RADIO MODULAR onto Scartho Road via a restricted WARD 5 BUILDING height archway on the older part of

WARDS 16/17

WORKSHOPS BUTERWICK the site but this has not been used HOUSE

SERVICE QUEENS CENTRE TRAINING BUILDING & for some while. A second entrance DEVELOPMENT Reservoir (covered) MENTAL HEALTH

also exists from the site onto Second Croxton House Belton House Hall

IT DEPT Avenue which is gated and is used Elsham House by patients and staff to access the Assisted Living Centre. The Trust is in the process of disposing of 16.16 acres of surplus land to the South side of the hospital, therefore will significantly reduce future expansion opportunities. SGH Site Plan – Figure 2

Scunthorpe General site has extremely limited parking on site. The Trust Hospital, Scunthorpe owns an adjacent plot of land where additional off site staff parking is provided, however some The Trust holds freehold for the site of this is a nature reserve and would be which has 375 beds, a gross floor very unlikely to be available for further area of 48,768 m2 and covers a land development. area of 10.82 hectares. The site has two access roads from Cliff Gardens and two from Church Lane. The 11 The site is within a residential area GDH Site Plan – Figure 3 of Scunthorpe and is surrounded by residential properties therefore is land locked within its current boundaries and has no room for expansion.

Goole and District Hospital, Goole The Trust holds freehold for the site which has 45 beds, a gross floor area of 15,000 m2 and a land area of 6.07 supporting acute or secondary 2. Are the properties efficient, safe, hectares. The site also has a primary care services are located. sustainable, fit for purpose (in care centre onsite and has significant line with Estate Code) and are space for future expansion should it In relation to point 1 above, the they providing value for money? be required. Trust provides Community Services within the North Lincolnshire locality The site has a single entrance and 3. Are the properties appropriately following transfer of a number of a single exit point onto Woodland strategically positioned and services from NHS North Lincolnshire Avenue. aligned to the Trust Clinical in April 2011 as part of the Services Strategy? Transforming Community Services Staff Residence programme. Community services 4. Are properties used or able to be such as dental and therapies are also utilised flexibly and in the most The Trust owns staff residential provided in North east Lincolnshire. efficient manner? accommodation on the Grimsby site, this property providing The majority of the existing 5. Are appropriate agreements in accommodation for members of community estate was inherited place with property owners? staff in training as well as trained as part of the above mentioned 6. Do opportunities exist to staff. Accommodation is provided programme and as such the rationalise the community estate on site in 7 blocks of flats (60 flats), properties occupied for the delivery by surrender or co-location of and 14 semi-detached houses. of services by the Community group vary in size, condition and location services or with other public At Scunthorpe General Hospital and are numerous. sector bodies? the Trust has purchased staff A schedule of community accommodation back from Riverside There are at present five integrated properties, the type of occupancy, Ltd in January 2015. The total stock bases within the North Lincolnshire the Agreement required and their equates to 108 units made up of self- area and this strategy will look to current ownership is shown in contained flats and en-suite rooms. build on these; see question six. Appendix 2. On the Goole site, 6 staff houses are Ownership of community properties, In relation to point 2 above, the provided on site in terrace format. of which the Trust delivers services from (nearing 120 in number), is Trust has interests in a number of A schedule of residential properties mixed, with the Trust occupying properties off the main hospital sites is shown in Appendix 1 space owned or leased by a again under differing ownerships number of organisations including: and with a range of Agreements. Community Premises NHS Property Services Ltd, Local As part of the ongoing project the Authorities, General Practitioners above six questions will be asked in The Trust occupies property within (GP’s) and private landlords. relation to those properties also. the community upon two distinct It is intended to conduct this review basis: At the time of drafting this Strategy a project is underway to consider the over the first half on 2016. 1. Where community clinical following six questions pertinent to A schedule of “offsite” community services or support to such the Community Estate: properties and their current status is services are located; and shown in Appendix 3 1. From which properties do we 2. Where staff delivering or deliver services?

12 Togeth er we care, we respect, we deliver Evaluation of the Table 3: The current size of the estate existing estate: Site Area sq.m (GIA) Diana Princess of Wales Hospital 87,409 The six facet survey A six Facet Property Appraisal was Scunthorpe General Hospital 59,751 carried out on various properties at Northern Lincolnshire and Goole Goole & District Hospital 19,483 NHS Foundation Trust during November and December 2014. The Total 166,643 survey covered the Condition of the The area of the Estate has been utilised to allow for an analysis of overall properties, (including the fabric of condition ratings of the various facets as an overall percentage of the Estate the buildings, fixtures and fittings area. and the electrical and mechanical installations), Statutory Compliance, Space Utilisation, Functional Suitability, Quality of Environment and Environmental Management. The results are presented in tabular form on MICAD spreadsheets with total costs and Risk analyses of the Condition and Statutory costs. The results of these surveys are summarised in the following tables. The current size of the estate (end of March 2015) is summarised in Table 3. 13 Physical Condition The appraisal was carried out addressing each of the main physical elements pertaining to NHS building stock listed in ‘Land and Property Appraisal’ (and previously in Estate Code) as indicated in below. The scope covers all building, M & E elements including infrastructure and external works.

Physical condition Building Mechanical Electrical • Structure • Heating system • Electrical system • External fabric • Steam system • Telecommunications • Roof • Ventilation system • Alarms and detection systems • Internal fabric • Piped medical gases and vacuum • Fixed plant pumps • Internal fittings and fixtures • Building management control • Hot and cold water systems system • External works - grounds and gardens • Lifts and hoists • Drainage and sewerage and • Boilers and calorifiers water supply • Fixed plant and equipment • Fuel storage and distribution

The average overall condition of each element will be assessed against the categories and definitions as detailed in Land and Property Appraisal, summarised below:

A As new (less than two years old) and can be expected to perform adequately to its full normal life. B Sound, operationally safe and exhibits only minor deterioration. B(C) Currently as B but will fall below B within five years. C Operational but major repair or replacement is currently needed to bring up to condition B. D Operationally unsound and in imminent danger of breakdown. Supplementary rating added to C or D to indicate that a full rebuild, relocation or replacement is needed X (i.e. repairs are impractical or too expensive to be tenable).

Overall average building conditions can be summarised as:

A A facility of excellent quality. B A facility requiring general maintenance investment only. C A less than acceptable facility requiring capital investment. D A very Poor facility requiring significant capital investment or replacement.

14 Togeth er we care, we respect, we deliver The results of the physical condition appraisal are summarised below at site level in Tables 4 to 6. Table 4: Diana Princess of Wales Hospital – Physical Condition of the Estate

Physical Condition

A B B(C) C D EstateCode Currently Category & Acceptable Requires Unacceptable New Acceptable Definition Condition Investment Condition (within 5 years)

Area sq.m 0 44,349 36,302 6,736 22

Percentage of the estate (area) in 0% 50.73% 41.53% 7.71% 0.03% each category

Table 5: Scunthorpe General Hospital – Physical Condition of the Estate

Physical Condition

A B B(C) C D EstateCode Currently Category & Acceptable Requires Unacceptable New Acceptable Definition Condition Investment Condition (within 5 years)

Area sq.m 0 40,978 6,759 12,014 0

Percentage of the estate (area) 0% 68.58% 11.31% 20.11% 0% in each category

Table 6: Goole and District Hospital – Physical Condition of the Estate

Physical Condition

A B B(C) C D EstateCode Currently Category & Acceptable Requires Unacceptable New Acceptable Definition Condition Investment Condition (within 5 years)

Area sq.m 0 14,454 2,446 2,583 0

Percentage of the estate (area) 0% 74.19% 12.55% 13.26% 0% in each category

The Appraisal shows that there is only a very small percentage of the estate in an unacceptable condition 0.03% total area at Diana Princess of Wales Hospital site only. The Estate area requiring investment is fairly low as an overall percentage of sites with Scunthorpe General Hospital site requiring the most significant investment on an area percentage of 20.11% of total area, with Goole and District Hospital at 13.26% of total area and Diane Princess of Wales Hospital at only 7.71% of total area.

15 Compliance with Fire and Statutory Safety The Property Appraisal addressed Statutory Requirements; these covered the following:

Statutory requirements Fire Health and safety • Compartmentation • Health and Safety at Work etc. Act and Workplace (including surface temperature of heat-emitting devices) • Fire doors • Electrical services • Means of escape • Asbestos • Alarm and detection systems • Control of Legionellae • Textiles and furniture • Food Hygiene • COSHH • Disability Discrimination Act • Pressurised systems • Work Equipment

Where any of the above Fire and Health and Safety elements do not achieve condition B, cost estimates involved in remedying any deficiencies have been identified.

The average overall compliance of each element will be assessed against the categories and definitions as detailed in Land and Property Appraisal, summarised below:

A Complies fully with current mandatory fire safety requirements and statutory safety legislation. Complies with all necessary mandatory fire safety requirements and statutory safety legislation B with minor deviations of a non-serious nature. Currently as B but will fail below B within five years as a consequence of unabated deterioration B(C) or knowledge of impending fire safety requirements or statutory safety legislation. Contravention of one or more mandatory fire safety requirements and statutory safety C legislation, which falls short of B. D Dangerously below condition A and B.

16 Togeth er we care, we respect, we deliver The results of the statutory appraisals are summarised below at site level in Figures 7 to 12. Table 7: Diana Princess of Wales Hospital – Compliance with Statutory Safety

Statutory Safety

A B C D Estate Code Compliant Non-Compliant Category & Dangerously Fully Compliant With Minor On One Or More Definition Non-Compliant Deviations Standards

Area sq.m 0 65,911 17,244 4,254

Percentage of the estate (area) 0% 75.40% 19.73% 4.87% in each category

Table 8: Diana Princess of Wales Hospital – Compliance with Fire Safety

Fire Safety

A B C D EstateCode Compliant Non-Compliant Category & Dangerously Fully Compliant With Minor On One Or More Definition Non-Compliant Deviations Standards

Area sq.m 0 77,356 7,959 2,094

Percentage of the estate (area) 0% 88.50% 9.10% 2.40% in each category

Table 9: Scunthorpe General Hospital – Compliance with Statutory Safety

Statutory Safety

A B C D EstateCode Compliant Non-Compliant Category & Dangerously Fully Compliant With Minor On One Or More Definition Non-Compliant Deviations Standards

Area sq.m 0 55,717 4,034 0

Percentage of the estate (area) 0% 93.25% 6.75% 0% in each category

17 Table 10: Scunthorpe General Hospital – Compliance with Fire Safety

Fire Safety

A B C D EstateCode Category & Compliant Non-Compliant Dangerously Definition Fully Compliant With Minor On One Or More Non-Compliant Deviations Standards

Area sq.m 0 55,014 4,602 135

Percentage of the estate (area) 0% 92.07% 7.70% 0.23% in each category

Table 11: Goole and District Hospital – Compliance with Statutory Safety

Statutory Safety

A B C D EstateCode Category & Compliant Non-Compliant Dangerously Definition Fully Compliant With Minor On One Or More Non-Compliant Deviations Standards

Area sq.m 0 18,006 1,477 0

Percentage of the estate (area) 0% 92.42% 7.58% 0% in each category

Table 12: Goole and District Hospital – Compliance with Fire Safety

Fire Safety

A B C D EstateCode Category & Compliant Non-Compliant Dangerously Definition Fully Compliant With Minor On One Or More Non-Compliant Deviations Standards

Area sq.m 0 16,533 2,950 0

Percentage of the Estate (area) 0% 84.86% 15.14% 0% in each category

The Appraisal shows that there is only a very small percentage of the Estate with identified issues which are classified as dangerously non-compliant for the Diana Princess of Wales Hospital and Scunthorpe General Hospital.

18 Togeth er we care, we respect, we deliver Backlog Costs Backlog Maintenance and Statutory costs are graded as Low, Moderate, Significant and High Risk. The division of Low, Moderate, Significant and High Risks plus the calculation for Risk Adjusted totals were carried out as per the NHS Estates guide ‘A Risk-Based Methodology for Establishing and Managing Backlog’. The Risk Adjusted totals take into account the perceived ‘Risk’ of the defect in terms of ‘Likelihood’ and ‘Severity’, the estimated cost for rectification and, in the case of Low or Moderate Risks, the estimated remaining life of the building. For Low and Moderate Risks the projected costs are divided by the estimated life expectancy of the building as prescribed in the Guide. The Risk adjusted backlog formula is based on the premise that the eradication of safety-critical backlog will have greater impact on the Risk Adjusted figure than non-critical backlog (and hence will focus attention on reducing ’High’ and ‘Significant’ risk sub-elements). Similarly, the higher the remaining life of each building/block the longer the period in which the lower risk sub-elements can be addressed and therefore the lower the risk adjusted backlog figure. The backlog and risk adjusted backlog are summarised below at site level in Table 13 to 15.

Table 13: Diana Princess of Wales Hospital – Backlog Costs

Backlog Costs Facet Low Moderate Significant High Total Total Risk Risk Risk Risk Risk £ Adjusted £ Physical £ 348,165 3,056,645 2,707,725 2,494,800 8,607,335 5,615,681 Condition % of Total 4% 36% 31% 29% 100% 65%

Compliance with £ 134,506 235,655 264,113 2,302,825 2,937,099 2,606,855 Fire / Statutory % of Total 5% 8% 9% 78% 100% 89% £ 482,671 3,292,300 2,971,838 4,797,625 11,544,434 8,222,535 Total % of Total 4% 28% 26% 42% 100% 71%

Table 14: Scunthorpe General Hospital – Backlog Costs

Backlog Costs Facet Low Moderate Significant High Total Total Risk Risk Risk Risk Risk £ Adjusted £ Physical £ 172,122 4,770,611 4,122,424 5,716,000 14,781,157 10,089,174 Condition % of Total 1% 32% 28% 39% 100% 68% Compliance £ 47,600 756,020 257,885 395,730 1,457,235 689,382 with Fire / Statutory % of Total 3% 52% 18% 27% 100% 47% £ 219,722 5,526,631 4,380,309 6,111,730 16,238,392 10,778,556 Total % of Total 1% 34% 27% 38% 100% 66%

19 Table 15: Goole and District Hospital – Backlog Costs

Backlog Costs Facet Low Moderate Significant High Total Total Risk Risk Risk Risk Risk £ Adjusted £ Physical £ 0 949,874 387,605 622,000 1,959,479 1,042,301 Condition % of Total 0% 48% 20% 32% 100% 53% Compliance £ 0 257,615 217,952 137,500 613,067 364,123 with Fire / Statutory % of Total 0% 42% 36% 22% 100% 59% £ 0 1,207,489 605,557 759,500 2,572,546 1,406,423 Total % of Total 0% 47% 24% 29% 100% 55%

The total backlog cost for all the surveyed Estate is £30,355,372, the appraisal identifies significant high risk backlog costs which results in a relatively high risk adjusted backlog cost of £20,407,514. Significant high risk items have been identified at all sites with a high risk percentage based on block areas of 42% of the site for Diana Princess of Wales Hospital site, 38% for the Scunthorpe General Hospital site and 29% for the Goole and District Hospital site,

Environmental Management Elements for conducting an appraisal of Environmental Management were reported at site level:

Environmental management

Procurement Energy Water Waste Transport performance consumption management management

I). A general overview of the site was gained from an analysis of the relevant Performance Indicator data (i.e. energy usage per unit volume - GJ/100 cubic metres).

ii). The energy performance was compared with published performance bands to determine the category A. B. C. D.

iii). Water consumption, Waste management and Transport management practice and performance was reviewed in terms of Best Practice, Good Practice or Poor Practice; any improvements in environmental management will be considered at site level as appropriate.

iv). Water, Waste and Transport will be categorised as A, B, C and D. The environmental management facet results are summarised below at site level in Tables 16 to 17.

Table 16: Diana Princess of Wales Hospital – Environmental Management

Environmental Management

A B C D EstateCode Category & Excellent Acceptable Improvement Poor Definition Performance Performance Needed Performance

Area sq.m 0 38,848 48,561 0

Percentage of the Estate (area) in 0% 44.44% 55.56% 0% each category

20 Togeth er we care, we respect, we deliver Table 17: Scunthorpe General Hospital – Environmental Management

Environmental Management

A B C D EstateCode Category & Excellent Acceptable Improvement Poor Definition Performance Performance Needed Performance

Area sq.m 6,639 46,473 6,639 0

Percentage of the Estate (area) in 11.11% 77.78% 11.11% 0% each category

Table 18: Goole and District Hospital – Environmental Management

Environmental Management

A B C D EstateCode Category & Excellent Acceptable Improvement Poor Definition Performance Performance Needed Performance

Area sq.m 4,329 12,989 2,165 0

Percentage of the Estate (area) in 22.22% 66.67% 11.11% 0% each category

The appraisal has identified improvements needed for environmental management at all the surveyed sites.

21 Functional Suitability An assessment of Functional Suitability was carried out for each floor. The following factors were considered.

Functional suitability Internal space relationships Support facilities Location • Critical dimensions are suitable • Adequate toilets and bathrooms for the • Distance to key linked facilities not for the function number of users excessive • Observation of dependent • Adequate storage space • Relationship to car parking areas is clear patients by staff and reasonably close • Adequate seating and waiting space • Separate sex bed / cubicle areas • Access to public transport links is good • Provision has been made for disabled and toilet facilities people • Access via vertical or horizontal • Security is maintained for both communication (lifts, stairs) is good staff and patients

The Functional Suitability facet results are summarised below at site level in Table 19 to 21. Table 19: Diana Princess of Wales Hospital – Functional Suitability

Functional Suitability

A B C D EstateCode Satisfactory Not Satisfactory Category & Very Satisfactory No Unacceptable In Minor Change Major Change Definition Change Needed Present Condition Needed Needed

Area sq.m 0 71,314 16,095 0

Percentage of the Estate (area) in 0% 81.59% 18.41% 0% each category

Table 20: Scunthorpe General Hospital – Functional Suitability

Functional Suitability

A B C D EstateCode Satisfactory Not Satisfactory Category & Very Satisfactory No Unacceptable In Minor Change Major Change Definition Change Needed Present Condition Needed Needed

Area sq.m 0 54,082 5,669 0

Percentage of the Estate (area) in 0% 90.51% 9.49% 0% each category

22 Togeth er we care, we respect, we deliver Table 21: Goole and District Hospital – Functional Suitability

Functional Suitability

A B C D EstateCode Satisfactory Not Satisfactory Category & Very Satisfactory No Unacceptable In Minor Change Major Change Definition Change Needed Present Condition Needed Needed

Area sq.m 0 19,141 342 0

Percentage of the Estate (area) in 0% 98.24% 1.76% 0% each category

The appraisal identified large areas of the Estate at all surveyed sites which required minor changes to improve functional suitability, only a small percentage of areas at all the surveyed sites required major changes with the most significant being 18.41% of the total site area for Diana Princess of Wales Hospital site.

23 Space Utilisation The objective of the space utilisation survey was to assess how well the available space is being used in order to satisfy the reasonable demands of the present function and planned requirements. The identification of under-used space and spare capacity may enable substantial revenue savings to be made which can then be reinvested to enhance or extend the service. Space utilisation will be assessed under (a) Current Use and (b) Use Over Time for each floor and be scored A, B, C or D.

Space utilisation Current use Use over time • Empty (E) • Empty for the majority of time (E) • Underused (U) • Underused for long periods (U) • Fully Utilised (F) • Fully used most of the time (F) • Overcrowded (O) • Overcrowded for more than half of the time (O)

The Space Utilisation facet results are summarised below at site level in Tables 22 to 24.

Table 22: Diana Princess of Wales Hospital – Space Utilisation

Space Utilisation

E U F O EstateCode Category & Definition Empty / Not Used Under Utilised Fully Utilised Overcrowded

Area sq.m 7,238 835 64,304 15,032

Percentage of the Estate (area) in 8.28% 0.96% 73.57% 17.20% each category

Table 23: Scunthorpe General Hospital – Space Utilisation

Space Utilisation

E U F O EstateCode Category & Definition Empty / Not Used Under Utilised Fully Utilised Overcrowded

Area sq.m 1,171 1,953 52,331 4,296

Percentage of the Estate (area) in each 1.96% 3.27% 87.58% 7.19% category

24 Togeth er we care, we respect, we deliver Table 24: Goole and District Hospital – Space Utilisation

Space Utilisation

E U F O EstateCode Category & Definition Empty / Not Used Under Utilised Fully Utilised Overcrowded

Area sq.m 2,165 5,628 11,690 0

Percentage of the Estate (area) in 11.11% 28.89% 60.00% 0% each category

The appraisal identified areas which were underutilised at all the surveyed sites areas which were over-utilised were also identified at the Diana Princess of Wales Hospital and Scunthorpe General Hospital sites with 17.20% and 7.19% of the total site area classified as overcrowded for these sites respectively.

25 Quality The Quality Facet comprised a detailed assessment of each of the buildings covering the 28 sub-elements under amenity, comfort engineering and design at each floor.

Quality

Amenity (function) Comfort engineering Design • Attractive main entrance / • Artificial lighting enhances • Colour is creatively and reception area / department overall design therapeutically used for definition and variety • Privacy and dignity issues are • Comfort conditions are achieved addressed in heating • Landscaping is attractive • Confidential conversations can • Comfort conditions are achieved • Planting is optimised for all seasons be held satisfactorily in ventilation • Natural daylight is used to • Toilet facilities are well • Acoustic privacy is achieved optimum effect provided • Noise levels are acceptable • Appropriate finishes are used for • Appropriate storage provision floors, ceilings and walls • Persistent odours are absent has been made • Furniture co-ordinates well with • Disabled users are catered for overall design • Appropriate facilities are • Art and craft work is integrated into provided for children overall design • Seating and waiting areas are • Interior is reassuring and non- sufficient clinical where appropriate • Appropriate safety and • Wherever possible patients and security measures are in place staff have pleasing views from both inside and outside the building • Wayfinding is visible, legible and consistent • First impressions of entrance / reception areas are welcoming • Adequate car parking facilities • Accessible by public and private transport

The Quality facet results are summarised below at site level in Table 25 to 27.

Table 25: Diana Princess of Wales Hospital – Quality of the Estate

Quality

A B C D EstateCode Less Than Category & Acceptable A Very Poor Quality Excellent Quality Acceptable Definition Major Investment Environment Needed

Area sq.m 0 81,127 6,282 0

Percentage of the Estate (area) in 0% 92.81% 7.19% 0% each category

26 Togeth er we care, we respect, we deliver Table 26: Scunthorpe General Hospital – Quality of the Estate

Quality

A B C D EstateCode Less Than Category & Acceptable A Very Poor Quality Excellent Quality Acceptable Definition Major Investment Environment Needed

Area sq.m 0 53,374 6,377 0

Percentage of the Estate (area) in 0% 89.33% 10.67% 0% each category

Table 27: Goole and District Hospital – Quality of the Estate

Quality

A B C D EstateCode Less Than Category & Acceptable A Very Poor Quality Excellent Quality Acceptable Definition Major Investment Environment Needed

Area sq.m 0 18,312 1,171 0

Percentage of the Estate (area) in 0% 93.99% 6.01% 0% each category

The appraisal identified no significantly poor quality environments, all sites had some areas which were recommended for improvements to the quality of the environment.

27 5. Where do we want to be

Clearly, the Trust will need to address the current poor condition and performance of the estate and move towards the provision of safe, secure, high-quality healthcare buildings appropriate for the delivery of modern healthcare services.

However, the Estate Strategy and information technology that maintenance requirements, any proposed investment in the make care closer to home a or short remaining life where estate must be “service led” with the plausible reality these do not meet future service patient at the centre of any proposed requirements; • National initiatives aimed at changes. It is widely recognised that making the NHS more effective • Seek optimum solutions through the specialist nature of healthcare and efficient - The NHS Plan and co-location, integration and services necessitates that buildings the NHS Improvement Plan; shared resources across service must be planned on the basis of “Our NHS, Our Future – Next streams; “form must follow function” if they Stage Review”; NHS Operating are to achieve this aim. • mprove estates asset Framework. performance on all key Changes are taking place both In response to these drivers for performance indicators; within the local health economy and change, the Trust Board has set the across the country to ensure that • Release capital from the disposal following strategic aims; the NHS is in the best possible shape of assets that are no longer to meet future health needs and Focusing on the needs of people required for current and future improve people’s health and well- who use our services: services; being. A number of key documents • Organisational aims: • Develop supporting set out the future strategic direction infrastructure for optimum • Achieve a savings total of £12 to and vision for the Trust and its operational effectiveness; commissioners and have been £15m per year in 2015/16 and influential in shaping this Estate 2016/17, and £6m to £10m in • Develop / procure flexible Strategy: following years. accommodation for locality based services; • The Trust’s Operational Plan For people that use our services and their careers, this means that we will • Integrate services with other • Integrated Business Plans for strive to achieve excellence in all health / social care facilities each of the Directorates and we do, to achieve the best possible wherever possible; Groups. outcomes through the delivery of • Ensure affordable investment high quality, consistent services, The changes to healthcare services plans, based on activity models, with personalised and accessible described within these documents as part of the Service Line model; are part of a wider programme of care. Clearly, in response to these change across the country driven by: aims we need to develop innovative • Develop inherent flexibility in our and forward looking solutions that owned and leased properties, • Changes in people’s health will achieve a productive estate and to enhance our responsiveness needs; aims to: to market changes or activity • Increasing public expectation adjustments, for both positive • Improve access and service user in terms of access to a and negative variations. experience; comprehensive range of high Against the background described • Provide in-patient quality, efficient and effective above, the Trust is undertaking work accommodation that is clinically healthcare services and choice in the following key areas: on how they use services; suitable, effective and meeting or exceeding relevant minimum • Healthy Lives Healthy Futures • Advances in medical and nursing standards; Programme practice that enable patients to be treated in new and different • Minimise risk and promote safety • Developing an active marketing ways; for people who use our services, and communication strategy to our staff and visitors; expand a range of services to • Developments in medical, increase market share. communications and • Disinvest from assets with high operating costs, backlog

28 Togeth er we care, we respect, we deliver Targets for change: decade simply cannot be achieved the mental health and well- without significant change and being of particular groups and The estate strategy will target investment in its estate. communities; improvement in the estate as follows: • The Trust is committed to Model of Service working in this way to benefit • Improvements in the quality all those who need and use of the operational estate over Delivery: the Trust’s services and has time (which can be measured • Collaboration is now central established methods to through reductions in backlog to the way in which the Trust achieve this, from the formal maintenance costs/risks; manages and delivers across arrangements of integration • Improvements in statutory all its service lines. Rigid between Local Authority and compliance and reduction in boundaries between the Trust, Trust partners; risk (which can be measured Local Authority organisations, • Therefore, the Trust will through reductions in non- voluntary, and community continue the emphasis on compliance with statutory agencies are becoming more working collaboratively legislation and incident rates); permeable as the people who and in partnership with a use services require more • Improvements in energy wide range of public bodies, innovative ways of developing performance, utilising the voluntary organisations and the and delivering services. The most Energy Performance Contract independent sector. This should familiar form of collaborative with British Gas and the enable properties to be selected arrangement that the Trust uses renewal of the steam boilers on the basis of strategic fit and is that of partnership. The Trust and associated infrastructure need rather than ownership or has established partnerships at Scunthorpe hospital and the tenancy. Again, the aim being of various forms with those replacement of the existing coal to ensure that the identification with whom it has a shared fired boilers at Goole hospital; of spokes is service led with the commitment to all will ensure the Trust meets patient at the centre of decision improve the mandatory targets for making. NHS organisations in England and compliant with BREEAM Healthcare in carbon emission, water consumption, waste and transport management; • Reductions in the revenue cost of the operational estate over time (which can be measured by mapping trends in overall maintenance costs, utilities costs and the Trust’s income-to-asset value ratio); • Improvements in the use of the estate over time, that is, eliminating under-used and surplus assets (which can be measured by comparing building floor area with total site area and by income-to-asset value ratio); The Trust’s vision and ambitious agenda for change over the next 29 6. How do we get there

This final section will seek to set a series of inter-linking and cross cutting projects intended to move forward the reduction in estates, backlog and costs whilst continually addressing the future needs of the Trust services.

Strategic Planning DPoW - Areas for review • Upgrade of theatres 5 and 6, including the creation of two The Trust has limited capital to lay-up rooms and an additional invest in its estate and services so Projects Proposed: laminar flow in theatre 3. the aim of this strategy is to ensure investment decisions are taken in a • Disposal of surplus land to the • Upgrade of theatres 7 and 8 to context that will achieve the Trust’s Southside of Diana, Princess of complete the theatre upgrade plan Wales Hospital, figure 4; goals and commissioners’ intentions • Creation of an Ophthalmic Suite going forward and which mitigate • Demolition and reconfiguration • Development of an additional risk. The Trust’s Strategy & Planning of the land to the Northside of MRI and CT group set up to consider and make Diana Princess of Wales Hospital, recommendations around the figure 5; • Development of an Assisted services the Trust should invest and Living Centre (ALC) Completed • Construction of new staff divest itself along with recognising 2015 accommodation to support staff new business opportunities. The recruitment and retention; • New Cardiology Day Case Unit output from this forum has been to be sited in the old OPD area; used to make some planning • Re-configure, upgrade and Completed 2015 assumptions that have been used to improve the existing on-site formulate this strategy. catering facilities, to both • Create a Home from Home improve the overall dining facility on ward A1 through Areas for possible development experience for patients, staff and a joint venture with NAVIGO; have been identified via the visitors and the overall profile Completed 2015 strategic planning process; the and attractiveness of the site; Estates Rationalisation project has The above represents a summary of identified areas for development • Conclusion of the the larger schemes and is not listed and contraction. Key backlog reconfiguration of the remaining in any specific order of priority. maintenance issues have also been hospital wards on ‘C’ Floor As previously identified the Trust identified within the outline plan. including the Coronary Care Unit; has areas of its estate that are • Continued upgrade of hot water underutilised. The Grimsby site is by service pipework on A, B and C far the biggest site and lends itself to floors; being reduced. The agreed strategy to reconfigure the Northside of the • Centralisation of Pharmacy site has been a stated intention for a Aseptic Facilities; number of years. Figure 4 – DPOW Southside Figure 5 – DPOW Northside

30 Togeth er we care, we respect, we deliver SGH - Areas for review Figure 6

ADMIN Projects Proposed: A & E BLOCK DERMATOLOGY

OUTPATIENTS X-RAY • Relocation of existing Endoscopy DEMOLITION

BOILER REFURBISHMENT CORONATION BLOCK LINDSEY PATHOLOGY SUITE HOUSE STEPPING STONES Services into vacant Carer Unit WARD 2 Scunthorpe General Hospital HOSPITAL RADIO MODULAR WARD 5 BUILDING • • Reconfiguration of ECC;

WARDS 16/17

WORKSHOPS BUTERWICK • Reconfiguration of theatres HOUSE

SERVICE QUEENS CENTRE TRAINING BUILDING & DEVELOPMENT Reservoir (covered) • Reconfiguration of the Critical MENTAL HEALTH

Croxton House Belton House Hall

IT DEPT

Care facilities Elsham House • Relocate Belton House • Implement Scunthorpe Accommodation Strategy • Optimise use of clinical space; • Re-purpose Coronation block; • Relocate remaining services in Coronation block to fully empty block; Goole - Areas for review • Demolish Belton and Croxton • Redevelopment of Goole site to accommodate output of work on the Goole House. Health Campus Project; • Development of an additional • Review site usage against commissioning intentions; MRI and CT • Expand Community base • Ward refurbishments as prioritised by clinical need • Review the need for the six residential properties currently owned by the Trust • Renewal of the boilers at associated infrastructure • Replacement of the coal fired boilers The above represents a summary of Along with the new developments there is a need to reduce the overall size of the larger schemes and is not listed the estate so the following additional Estates and Facilities lead projects have in any specific order of priority. also been developed.

Figure 7

31 Backlog Maintenance underway to improve the energy Community Properties efficiency of the Trust’s buildings, Investment is a necessity in order to this Energy Performance Contract is On completion of the project alluded reduce the backlog maintenance expected to offer to reduce energy to above with regard to Community and to maintain control of the expenditure by 13% and reduce properties, comprehensive and sites’ services, which are rapidly £375k of backlog maintenance. validated detail will be available to reaching the end of their useful inform strategic decision making life. The Trust is currently planning The Trust also is currently revising to ensure that the Trust delivers for a recurrent £1.5 million capital its Travel Plan that will support the services from flexible properties backlog investment which is below Trust in ensuring that its staff, visitors commensurate in condition and the minimum required to maintain and patients are able to access its strategic location to the needs of the the current estate, however with the services with as little problem as community. estate reductions planned within this possible. Post “Transforming Community strategy this will reduce the current Services” several leased community backlog level and with careful risk Estates Reduction properties have now come under assessment of remaining backlog the remit of this Estates Strategy items it should be possible to The plans and projects identified (Appendix 1). When added to the maintain the current backlog levels. earlier will deliver reduction in the existing Trust community estate Key backlog projects areas currently use of specific areas of the Trust’s (Appendix 3), this provides scope to planned are shown in table 12. estate, leaving these to be disposed rationalise the usage, reduce costs of or demolished which will reduce and improve the environment for estate costs. The specific reductions these services. Table 28 - Backlog Key Themes identified currently are: North East Lincolnshire also has 2015/16 Backlog Item 1. Vacate the Northside and a large portfolio of community £’000 disposal of surplus land at DPoW; estate which is underutilised. Work Water Infrastructure 130 2. Vacate and demolish Belton, is ongoing with commissioners to Fire Compliance 120 Elsham and Croxton House at identify suitable services within Electrical the Trust’s hospital site that could 96 SGH; Infrastructure potentially make the move into H&S Equality Act 3. Develop vacant space at Goole community freeing up Trust estate 90 Compliance to improve utilisation for disposal and increase utilisation Lifts 300 of newer, more functional, efficient and sustainable community estates. Engineering Plant 564 Residential Properties Replacement The Trust owns residential Replacement of Coal 0 accommodation at SGH consisting Financial Planning Fired Boilers of 11 blocks of single bed student The Estates Strategy has listed Upgrade of the 0 accommodation and one bed flats; various projects and rationalisation Steam Plant there are also a small number of schemes that will require financial Theatre Upgrades 550 accommodation which is used investment in order to undertake for on call purposes only whilst the work listed is a brief financial Sustainability at the Goole site the Trust owns 6 assessment of investment required. semi-detached houses within the Estimates have been provided Any new developments both curtilage of the site. where costs are not fully understood, within the main hospital estate or colours indicate years in which At DPoW site the Trust owns 7 community must look to ensure projects plan to be undertaken. residential blocks consisting of both energy sustainability and student one bed rooms and single local sustainability is taken into bedroom flats, there are also account. The Trust has a Sustainable fourteen semi-detached houses Development Management Plan on the DPoW site; the eight semi- that details energy schemes as well detached houses at Juniper Way are as waste schemes to reduce the cost within the land sale boundary and as on the impact on Trust finances. such will be no longer Trust housing An extensive project is currently stock once the land sale is complete.

32 Togeth er we care, we respect, we deliver Table 29 – Financial Investment Element 2015/16 2016/17 2017/18 2018/19 2019/20 Major Schemes 5.5 5.4 5.0 4.0 4.0 Backlog Maintenance 1.7 2.0 2.0 2.0 2.0 Accommodation 1.1 15.6 0.3 0.3 0.0 Energy 5.0 0.2 1.5 0.0 0.0 Total 13.4 23.3 8.8 6.3 6.0

7. Conclusion

The Trust faces changes to its moderate and low risk items. The been allowed to reflect this. Space services at an unprecedented Trust will also address the significant provision is also an issue to some level and unless the estate can be issues identified under Function, areas with total remedial costs at reduced or reconfigured the Trust Quality, Space and Environmental as £722,700 at the Scunthorpe General will be unable to meet these new discussed below during any Capital Hospital site only. demands. The strategy explained in works to address backlog issues and Quality of the environment to many this document is one that has been as part of the wider Health Estate blocks is an issue with a cost of arrived at in conjunction with the review. £189,246 identified for the whole Trust’s Strategic Plan. A significant item identified is a Estate with recommendations The Estate is overall in poor £12,947,439 cost for functional including improvements to condition with a total risk adjusted suitability for the whole Estate. This general appearance and comfort backlog of £16,747,156. The is primarily due to changes in service engineering being common issues. majority of areas will require lifecycle provision, changes in work practices A cost of £35,000 has been identified replacements to some items with a and expansions in teams within for environmental management this total impending backlog (years 1-5) buildings that are simply too small includes site wide improvements of £26,662,394 for the whole Estate. for function or were constructed to management of issues including and designed for another function There are Statutory items that energy, water, transport and waste. which does not provide a suitable require immediate remedial action layout and space for services. Older Total costs for the entire surveyed in the majority of blocks with a estate is often difficult to reconfigure Estate for all 6 facets are £73,251,201 total risk adjusted backlog cost of £ to provide correct layouts and for a 5 year programme. 3,660,360 for the whole Estate. facilities suitable for today’s work As part of this Strategy, statutory methods and services and costs have compliance items will be carried out first, followed by high risk backlog items under physical condition, followed by significant then

33 8. Appendices Appendix 1 - Residential Properties Details of On- Site NLAG Accommodation Properties Net Book Value as at Freehold / Leasehold Expiry Future Plans 31/12/2011 Leasehold Date £k 138 Scartho Road 51,164 Freehold - Retain - office accommodation 140 Scartho Road 150,000 Freehold - Retain - on call accommodation 142 Scartho Road 120,00 Freehold - Retain 144 Scartho Road 105,400 Leasehold 13 May 2024 Retain Croxton Freehold - Demolish Alkbourough Freehold - Retain - Refurbish Edward Jenner Freehold - Retain - Refurbish Saxby Freehold - Retain - Refurbish Keelby Freehold - Retain - Refurbish Elsham Freehold - Demolish 58 Woodland Ave 138,612 Freehold Sale 60 Woodland Ave 119,067 Freehold Sale 62 Woodland Ave 119,067 Freehold Sale 64 Woodland Ave 119,067 Freehold Retain – Long term resident Dr within NLaG 66 Woodland Ave 119,067 Freehold Retain – used for locum Drs 68 Woodland Ave 138,612 Freehold Sale Appendix 2 - Community Estate (Community & Therapies) Status - Type of Occupancy Premises Exclusive or Agreement Required Owner Detail Sessional to Formalise 1 Prince Albert Gardens, Grimsby, DN31 3AG Exclusive Lease 7KS South Park Enterprise College, Sessional Licence 45a Newdown Road, Scunthorpe, DN17 2TX Allerton Primary School, Allerton Drive, Immingham, DN40 2HP Sessional Licence Local Authority NHS Property Ashby Clinic, Collum Lane, Scunthorpe, DN16 2SZ Sessional Licence Services Ltd. NHS Property Ashby Clinic, Collum Lane, Scunthorpe, DN16 2SZ Exclusive Lease Services Ltd. Axholme Academy, Wharf Road, Crowle, DN17 4HU Sessional Licence Axholme Academy Barnard Court, Old Courts Road, Brigg, DN20 8LA Sessional Licence RDaSH NHS FT Barnard Court, Old Courts Road, Brigg, DN20 8LA Exclusive Lease RDaSH NHS FT Barnetby Medical Centre, Victoria Road, Barnetby, DN38 6HZ Sessional Licence GP Barton Children’s Centre, Castledyke West, Barton, DN18 5AP Sessional Licence Local Authority Baysgarth School, Barrow Road, Barton, DN18 6AE Sessional Licence Local Authority Birkwood Medical Centre, Westward Ho, Grimsby, DN34 5BH Sessional Licence GP Bottesford Civic Hall, Bramley Crescent, Bottesford, DN16 3SN Sessional Licence Local Authority Brigg Children’s Centre, Grammar School Road, Brigg, DN20 8AS Sessional Licence Local Authority

34 Togeth er we care, we respect, we deliver Status - Type of Occupancy Premises Exclusive or Agreement Required Owner Detail Sessional to Formalise Broughton Surgery, 27 Brooklands Avenue, Sessional Licence GP Broughton, DN20 0DY Bursar Primary School, Bursar Street, Cleethorpes, DN35 8DS Sessional Licence Local Authority Cambridge Park Academy, Cambridge Road, Grimsby, DN34 5EB Sessional Licence Local Authority Canon Peter Hall School, Pelham Road, Immingham, DN40 1JS Sessional Licence Local Authority Churchview Medical Centre, Cartergate, Grimsby, DN31 1QZ Sessional Licence GP Cleethorpes Primary Care Centre, St Hughs Avenue, NHS Property Exclusive Lease Cleethorpes, DN35 8EB Services Ltd. Congregational Church Hall, Ferry Road West, The Congregational Sessional Licence Scunthorpe, DN15 8QE Church Cromwell Primary Care Centre, Cromwell Road, NHS Property Exclusive Lease Grimsby, DN31 2BH Services Ltd. Cromwell Primary Care Centre, Cromwell Road, NHS Property Sessional Licence Grimsby, DN31 2BH Services Ltd.

Crowle Children’s Centre, Manor Road, Crowle, DN17 4ET Sessional Licence Local Authority

Crowle Community Hub, Chancery Lane, Crowle, DN17 4HN Exclusive Lease Local Authority Duchess House, Queensway Court, Arkwright Way, Exclusive N/A NLaG NHS FT Scunthorpe, DN16 1AL David Ross Edward Heneage Academy, Edward Street, Grimsby, DN32 9HL Sessional Licence Education Trust Epworth Children’s Centre, Birchfield Road, Epworth, DN9 1DL Sessional Licence Local Authority Epworth Leisure Centre, Burnham Road, Sessional Licence Local Authority Epworth, North Lincolnshire, DN9 1BZ Epworth Clinic, Morland Way, Epworth, DN9 1HT Sessional N/A NLaG NHS FT Frederick Gough School, Grange Lane South, Sessional Licence Local Authority Scunthorpe, DN16 3NG Freshney Green Primary Care Centre, Sorrel Road, NHS Property Sessional Licence Grimsby, DN34 4GB Services Ltd. Frodingham Children’s Centre, Rowland Road, Sessional Licence Local Authority Scunthorpe, DN16 1ST Grimsby Leisure Centre, Cromwell Road, Grimsby, DN31 2BH Sessional Licence Local Authority NHS Property Haldenby House, Doncaster Road, Scunthorpe, DN15 7DQ Exclusive Lease Services Ltd. Henderson Avenue Children’s Centre, Sessional Licence Local Authority Henderson Avenue, Scunthorpe, DN15 7RW Henderson Avenue Children’s Centre, Henderson Avenue, Sessional Licence Local Authority Scunthorpe, DN15 7RW Hibaldstow Medical Practice, 11 Church Street, Sessional Licence GP Hibaldstow, DN20 8ED NHS Property Hope Street Clinic, Hope Street, Grimsby, DN32 7QL Exclusive Lease Services Ltd.

35 Status - Type of Occupancy Premises Exclusive or Agreement Required Owner Detail Sessional to Formalise NHS Property Hope Street Clinic, Hope Street, Grimsby, DN32 7QL Sessional Licence Services Ltd. Humberston Park School, St Thomas Close, Grimsby, DN36 4HS Sessional Licence Local Authority Huntcliff School, Redbourne Mere,Kirton Lindsey, DN21 4NN Sessional Licence Local Authority Immingham Children’s Centre, Margaret Street, Sessional Licence Local Authority Immingham, DN40 1LD NHS Property Ironstone Centre, West Street, Scunthorpe, DN15 6EG Exclusive Lease Services Ltd. Keadby Children’s Centre, Station Road, Keadby, DN17 3BN Sessional Licence Local Authority Kirton Children’s Centre, Cornwall Street, Sessional Licence Local Authority Kirton Lindsey, DN21 4PQ Kirton Lindsey Surgery, Traingate, Kirton Lindsey, DN21 4PQ Sessional Licence GP Kirton Lindsey Surgery, Traingate, Kirton Lindsey, DN21 4PQ Exclusive Lease GP Kirton Lindsey Surgery, Traingate, Kirton Lindsey, DN21 4PQ Sessional Licence GP Lindsey Lodge Hospice, Burringham Road, Lindsey Lodge Exclusive Lease Scunthorpe, DN17 2AA Hospice Littlecoates Academy, Harlow Street, Grimsby, DN31 2QX Sessional Licence Local Authority Manor Farm Children’s Centre, Priory Lane, Sessional Licence Local Authority Scunthorpe, DN17 1HE Melior School, Chandos Road, Scunthorpe, DN17 1HA Sessional Licence Local Authority Messingham Family Health Centre, 33 Wendover Road, Sessional Licence GP Scunthorpe, DN17 3SN Monach House, Queensway Court, Arkwright Way, Exclusive N/A NLaG NHS FT Scunthorpe, DN16 1AL Open Door, Albion Street, Grimsby, DN32 7DL Sessional Licence The Big Life Outwood Brumby School, Cemetary Road, Sessional Licence Local Authority Scunthorpe, DN16 1NT Outwood Foxhills School, 2 Foxhills Road, Scunthorpe, DN15 8LJ Sessional Licence Local Authority Parkwood Children’s Centre, Plymouth Road, Exclusive Lease Local Authority Scunthorpe, DN17 1SS Pilgrim Primary Care Centre, Pelham Road, NHS Property Sessional Licence Immingham,DN40 1JW Services Ltd. Providence House, Holydyke, Barton, DN18 5PR Exclusive Lease Local Authority Queensway Children’s Centre, Binbrook Way, Grimsby, DN37 9AT Exclusive Lease Local Authority Resource Centre, Queen Street, Grimsby, DN31 1QG Exclusive Lease Local Authority Reynolds Academy, Machray Place, Cleethorpes, DN35 7LJ Sessional Licence Local Authority Riverside Surgery, Barnard Avenue, Brigg, DN20 8AS Sessional Licence GP Scartho Medical Centre, Springfield Road, Grimsby, DN33 3JF Exclusive Lease GP NHS Property Scartho Medical Centre, Springfield Road, Grimsby, DN33 3JF Sessional Licence Services Ltd. NHS Property Scawby House, Health Place, Wrawby Road, Brigg, DN20 8GS Exclusive Lease Services Ltd. Side By Side Children’s Centre, Enderby Road, Scunthorpe, DN17 Sessional Licence Local Authority 2JL South Axholme Medical Practice, Pinfold Surgery, Station Road, Sessional Licence GP Owston Ferry, DN9 1AW

36 Togeth er we care, we respect, we deliver Status - Type of Occupancy Premises Exclusive or Agreement Required Owner Detail Sessional to Formalise South Axholme School, Burnham Road, Epworth, DN9 1BY Sessional Licence Local Authority St Bedes School, Collum Avenue, Scunthorpe, DN15 7DF Sessional Licence Local Authority St Hughs School, Bushfield Road, Scunthorpe, DN16 1NB Sessional Licence Local Authority St Lawrences School, Doncaster Road, Scunthorpe, DN15 7DF Sessional Licence Local Authority St Lukes Primary School, Grange Lane North, Sessional Licence Local Authority Scunthorpe, DN16 1BN St Nicholas House, Shelford Street, Scunthorpe, DN15 6NU Exclusive Lease RDaSH NHS FT St Nicholas Primary School, Church Lane, Ulceby, DN39 6TB Sessional Licence Local Authority Stirling Medical Centre, Stirling Street,Grimsby,DN31 3AE Sessional Licence GP The Beacon, Solomon Court, Cleethorpes, DN35 9HL Exclusive Lease Care Plus Group The Marshes Medical Practice, Butt Lane, Snaith, DN14 9DY Sessional Licence GP Scunthorpe PODS, Ashby Road, Sessional Licence Local Authority Scunthorpe, North Lincolnshire, DN16 1AA The Vale of Ancholme Academy, Grammar School Road, School Partnership Sessional Licence Brigg, DN20 8BA Trust The Willows Care Home, Willow Drive, Barton, DN18 5HR Exclusive Lease Local Authority Trent View Medical Practice, Chancery Lane, Crowle, DN17 HN Sessional Licence GP Unit 4 Cupola Way, Scunthorpe, DN15 9YJ Exclusive Lease Local Authority Viking Resource Centre,6-8 Fairfield Drive, Barton, DN18 6ER Sessional Licence Local Authority Weeslby View Health Centre, Ladysmith Road, NHS Property Sessional Licence Grimsby, North East Lincolnshire, DN32 9SW Services Ltd. West Common Lane Medical Centre, Dorchester Road, Sessional Licence GP Scunthorpe, DN17 1YH West Street Children’s Centre, West Street, Scunthorpe, DN15 6HS Sessional Licence Local Authority West Town Surgery, 80 High Street, Barton, DN18 5PU Sessional Licence GP Winterton Children’s Centre, West Street, Winterton, DN15 9QG Sessional Licence Local Authority Winterton Medical Practice, Manlake Avenue, Sessional Licence GP Winterton, DN15 9TA Winterton School, Newport Drive, Winterton, DN15 9QD Sessional Licence Local Authority

37 Appendix 3 – Trust occupied areas not on the main site (Central Operations / Diagnostics / Medicine / S&CC / W&C)

Type of Occupancy Status – Exclusive Property & Address Agreement Required Owner Detail or Sessional to Formalise

Alford Group, Alford Village, Lincolnshire Sessional Licence GP Ashby Midwifery Centre, Ashby, Scunthorpe Exclusive Lease Private Landlord Barnard Court, Old Courts Road, Brigg, DN20 8LA Exclusive Lease RDaSH NHS FT Barton Leisure Centre, Brigg Rd, Baysgarth Park, Sessional Licence Local Authority Barton-upon-Humber, DN18 5DT Barton Midwifery Centre, Barton Exclusive N/A NLaG NHS FT Beacon Medical, Cleethorpes Primary Care Centre, Sessional Licence GP St Hughes Avenue, Cleethorpes, DN35 8EB Binbrook GP Practice, Binbrook Sessional Licence GP Boston Pilgrim Hospital, Sibsey Road, Boston, United Lincoln Hospitals Sessional Licence Lincolnshire, PE21 9QS NHS Trust Brigg Leisure Centre, Scawby Road, Brigg, North Sessional Licence Local Authority Lincolnshire, DN20 9JH Broadway, Grimsby Sessional Licence Local Authority Caistor GP Practice, Caistor Sessional Licence GP Central Surgery - King Street, Barton Upon Humber, Sessional Licence GP North Lincolnshire, DN18 5ER Central, Edward Street, Grimsby Sessional Licence GP Centre 4 (Support Group), Wootton Road, 2nd Avenue Resource Sessional Licence Nunsthorpe, Grimsby, DN33 1HE Centre Child Development Centre, Shelford Street, Sessional Licence RDaSH NHS FT Scunthorpe County Hospital Louth High Holme Road, Louth, Sessional Licence NHS Property Services Ltd. Lincolnshire LN11 0EU Cromwell Primary Care Centre, Cromwell Road, Sessional Licence NHS Property Services Ltd. Grimsby, DN31 2BH Crowle Childrens’ Centre,Manor Road, Exclusive Lease Local Authority Crowle, DN17 4ET East Marsh Childrens’ Centre, 203 Victor Street, Sessional Licence Local Authority Grimsby, DN32 7QB Epworth Clinic, Morland Way, Epworth, DN9 1HT Exclusive N/A NLaG NHS FT Epworth Leisure Centre, Burnham Road, Sessional Licence Local Authority Epworth, North Lincolnshire, DN9 1BZ Fairfield School, Mendip Avenue, Sessional Licence Local Authority Grimsby,DN33 3AE Freshney Green Primary Care Centre, Sorrel Road, Sessional Licence NHS Property Services Ltd. Grimsby, DN34 4GB Hawthorn Surgery, Scotten Road, Scotter, Sessional Licence GP Gainsborough, DN21 3SB Health Place, Wrawby Road, Brigg, DN20 8GS Sessional Licence NHS Property Services Ltd. Henderson Avenue Childrens’ Centre, Henderson Exclusive Lease Local Authority Avenue, Scunthorpe, DN15 7RW Highgate, Trinity Road, Cleethorpes Sessional Licence ? TBC Holten Le Clay Medical Practice, Lancaster Gate, Sessional Licence GP Holton-le-Clay, Grimsby, DN36 5YS

38 Togeth er we care, we respect, we deliver Type of Occupancy Status - Exclusive Premises Agreement Required Owner Detail or Sessional to Formalise Humberston Park School, St Thomas Close, Grimsby, Sessional Licence Local Authority DN36 4HS Immingham Childrens’ Centre, Margaret Street, Sessional Licence Local Authority Immingham, DN40 1LD James Street Family Practice, 49 James Street, Louth, Sessional Licence GP Louth, Lincolnshire, LN11 0JN Learning Development Centre, Enderby Road, Sessional Licence Local Authority Scunthorpe, DN17 2JL Lincoln County Hospital, Greetwell Road, United Lincoln Hospitals Sessional Licence Lincoln, LN2 5QY NHS Trust Louth County Hospital, High Holme Road, Sessional Licence NHS Property Services Ltd. Louth, Lincolnshire, LN11 0EU Manby GP, Middlegate, Manby, Louth, LN11 8EB Sessional Licence GP Marisco Medical Practice, Stanley Avenue, Sessional Licence GP Mablethorpe, Lincolnshire, LN12 1DP Market Rasen Surgery, Mill Road, Sessional Licence GP Market Rasen, LN8 3BP Newmarket Medical Practice,153 Newmarket, Sessional Licence GP Louth, LN11 9EH Nunsthorpe & Bradley Childrens’ Centre, Sutcliffe Sessional Licence Local Authority Avenue, Grimsby Pilgrim Primary Care Centre, Pelham Road, Sessional Licence NHS Property Services Ltd. Immingham, DN40 1JW Queensway Childrens Centre, Binbrook Way, Sessional Licence Local Authority Grimsby, DN37 9AT Reynolds Street Childrens’ Centre, Machray Place, Sessional Licence Local Authority Cleethorpes, DN35 7LJ Riverside Childrens’ Centre, Sorrel Road, Sessional Licence Local Authority Grimsby, DN34 9AT Scartho Medical Centre, Springfield Road, Sessional Licence NHS Property Services Ltd. Grimsby, DN33 3JF Scunthorpe PODS, Ashby Road, Sessional Licence Local Authority Scunthorpe, North Lincolnshire, DN16 1AA Snaith GP Centre, Butt Lane, Snaith, Sessional Licence GP Goole, DN14 9DY St Hughs School, Bushfield Road, Sessional Licence Local Authority Scunthorpe, DN16 1NB St Lukes Primary School, Grange Lane North, Sessional Licence Local Authority Scunthorpe, DN16 1BN Taylors Avenue Medical Centre, Taylors Avenue, Sessional Licence GP Cleethorpes, DN35 0LJ The Kidgate Surgery, 32 Queen Street, Sessional Licence GP Louth, LN11 9AU The Marshes Surgery, Station Road, Rawcliffe, Sessional Licence GP Goole, DN14 8QR United Lincolnshire Hospitals, High Holme Road, Sessional Licence NHS Property Services Ltd. Louth, LN11 0EU United Lincolnshire Hospitals, Woldside, Sessional Licence NHS Property Services Ltd. Louth, LN11 0EU Weeslby View Health Centre, Ladysmith Road, Sessional Licence NHS Property Services Ltd. Grimsby, DN32 9SW West Marsh Childrens’ Centre, Macaulay Street, Sessional Licence Local Authority Grimsby, DN31 2ES

39 40 Togeth er we care, we respect, we deliver