BOARD OFFICIAL NHS Greater Glasgow & Clyde Paper No. 20/29 Meeting: NHS GGC Board Date of Meeting: 2nd June 2020 Purpose of Paper: Approval Classification: Board Official Sponsoring Director: Susanne Millar Chief Officer, Glasgow City HSCP William Edwards Director of eHealth, Paper Title Glasgow North East Health & Care Centre – Outline Business Case Recommendation Approve the Outline Business Case for Glasgow North East Health & Care Centre for submission to Scottish Government Capital Investment Group. Note that the scheme has been assessed as value for money, affordable and achievable. Purpose of Paper This paper is seeking Board approval for submission of the Outline Business Case to the Scottish Government Capital Investment Group. Key Issues to be considered Glasgow North East hub is a significant investment proposal to improve services in the North East of Glasgow and deliver some key strategies set out in the Board’s Moving Forward Together programme. The Initial Agreement for the project was approved by Greater Glasgow Health Board on 26th June 2018 and approved by Scottish Government on 17th October 2018. The OBC has been agreed by the North East hub Executive Steering Group, Glasgow City HSCP Capital Group, the Board’s Capital Planning Group, The Integrated Joint Board and the Board’s Corporate Management Team. 1 BOARD OFFICIAL Plan for Service Delivery within a Tiered Model of Care The North-East Hub is designed to have a major impact on the lives of the people living in North East Glasgow through the delivery of a tiered model of care across the entire health and social care system, encompassing a range of universal, locally delivered community services, as well as traditionally hospital-based and specialist services. The service delivery model includes services for children and adults, across the areas of mental health, addictions, criminal justice, homelessness and health improvement, delivered by a range of public and third sector organisations. The Hub will therefore support a tiered model of care across the entire health and social care system, by enabling health, social care and third sector services to work together to promote early identification of need, early intervention and joined up working to support children, young people, parents/ carers, adults and older people living in the North East. Building on the existing initiatives that work to reduce poverty across the HSCP, the Hub will facilitate connectivity between health and social care services to deliver a “place-based” approach across a range of public and third sector organisations, and will also include GP practices with multi- disciplinary teams, community pharmacists, community spaces, a library and a café. A range of engagement sessions with local residents have been carried out at various sites across the North-East, and elements which are considered important to local residents have informed the design process. Across all services, the model of care being proposed will allow for better integrated services as a result of colocation, and will improve access for families who currently attend multiple appointments and buildings across the North-East. Professionals will also accrue the benefits of colocation, through increased professional dialogue with other services, and a greater understanding of the landscape of services and supports available to families. This will minimise the reliance on traditional ‘signposting’ methods, and allow more proactive matching of families’ specific needs with appropriate sources of support. Service users will also be able to access a range of community resources, library groups and services, and meet other local residents through community café initiatives. It is anticipated that the learning which is emerging from the HSCP response to the COVID-19 pandemic, as well as anticipation of a ‘new normal’ in relation to social distancing, will likely affect service delivery plans and accommodation arrangements within the North-East Hub. Some of the key developments to emerge out of the pandemic relate to increased reliance on digital communication, and agile working, which the Hub will be able to accommodate more effectively than most existing buildings. The current building design and specification will allow a flexible response, based on emerging Scottish Government and public health advice. In addition, the ongoing response to the pandemic, and continued review of the learning, will continue to shape service delivery, to ensure that the HSCP is effectively addressing emerging community needs which arise from the pandemic. Project Development During summer/autumn 2018 a process was undertaken to identify a location for a new facility. The process identified the preferred site as the location of former Parkhead Hospital. A paper outlining the process and conclusion was agreed at the Board’s Finance and Planning Committee on 4th December 2018 and also at the Integration Joint Board meeting on 12th December 2018. 2 BOARD OFFICIAL Scottish Government advised in Spring 2019 that the project would be funded by capital, since the previous Design Build Finance and Maintain (DBFM) procurement route used for hub projects is no longer available. The project is to be delivered through the hub programme and development works and costs have been produced by Hub West Scotland and were submitted to the Board within their Stage 1 submission on 28th February 2020. Since Initial Agreement significant stakeholder engagement has continued and design proposals for a new facility have been developed. During that period a series of additional requirements were identified for inclusion and their incorporation was agreed at the Board’s Capital Planning Group meeting of 2nd July 2019, and agreed at the Corporate Management Team meeting of 12th September 2019, through the Change Control process. The key changes that were approved were: 1. Inclusion of an additional GP practice. 2. Inclusion of additional space to accommodate Eastbank Health Promotion Centre. 3. Inclusion of additional space to support multi-disciplinary team working within GP Practices. 4. Inclusion of Parkhead Public Library, funded by Glasgow City Council The design work for the project has been developed on the principles of the Reference Design project at Eastwood, and building upon lesson learned through it, and the more recently completed projects at Woodside and Gorbals. The project has been developed to achieve net-zero carbon in operation, and will contribute towards the Board’s sustainability targets. The Initial Agreement outlined high-level costs developed in Spring 2018 in advance of a site being selected. The table below highlights the development costs including VAT and fees. IA Approval (SG) October 2018 IA Capital Cost £47,050,000 OBC Date April 2020 Capex Stage 1 (inc VAT) £59,574,000 Optimism Bias £4,766,000 OBC Stage 1 Capital Cost (including VAT & £64,340,000 Optimism Bias) Glasgow City Council contribution (library- £3,018,000 including VAT & Optimism Bias) Scottish Government investment £61,322,000 As shown there has been an increase in costs since Initial Agreement. A number of factors have driven the costs and are outlined below: a) Additional accommodation requirements noted in items 1-4 above b) Glasgow City Council Planning requirement for major developments to meet Gold Standard for sustainability / carbon reduction. c) Abnormal costs associated with site selection, including demolitions, sewer diversion, off-site sewer connection works, additional ventilation requirements and ground conditions. 3 BOARD OFFICIAL d) Addition of an 8% allowance for Optimism Bias to reflect uncertainty around non- project risks including Brexit and Covid-19. The IA did not include this allowance since the project was anticipated to be delivered as a DBFM project at that time. Scottish Government has been kept informed of these changes and the financial consequences throughout the OBC period and is supportive of the changes made. The most recent costs outlined above, were submitted during May 2020 and agreed to be suitable for inclusion in the Outline Business Case. The hub Stage 1 submission has been reviewed by the Board’s external Technical Advisers – Thomas & Adamson, and Legal Advisers – CMS who have confirmed that the submission is compliant and represents value for money. Scottish Future’s Trust’s Key Stage Review (KSR) has been completed with a recommendation to proceed. The current revenue budget available shows a deficit of £630k, this will be included in the IJB’s Medium Term Financial Plan to enable the project to be delivered on a cost neutral basis. This was agreed at the IJB meeting on 13th May 2020. Programme The OBC has been agreed by the North East hub Executive Steering Group, Glasgow City HSCP Capital Group the Board’s Capital Planning Group the Integrated Joint Board and the Board’s Corporate Management Team. The overall programme is currently: OBC approval by NHS GGC Board June 2020 OBC approval by Scottish Government CIG July 2020 FBC approval July 2021 Financial Close August 2021 Construction start September 2021 Completion Dates - Main Building Q1 2024 - Demolition of exist HC and form Car Park Q4 2024 Any Patient Safety /Patient Experience Issues The new facility will improve significantly the quality of environment for patients and service users and facilitate more integrated and effective working across services. Any Financial Implications from this Paper The proposal is dependent upon Scottish Government funding to cover the full