2015/2020 ESTATES STRATEGY 2 Togeth Er We Care, We Respect, We Deliver Contents
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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.