Paper 17

Ayrshire and Arran NHS Board

Monday 8 October 2018

Asset Disposals

Author: Greg MacKenzie Sponsoring Director: John Wright Property Transaction Manager Director of Corporate Support Services

Recommendation

The Board is asked to declare surplus to Ayrshire and Arran Health Board use.

Summary Due to the age, operating costs, physical condition and the functional suitability of the premises there is no further healthcare use for these buildings. All remaining community services based at Kirklandside Hospital are to be relocated to other sites. The site is of interest to Council within their Local Development Plan, as an enterprise zone and to drive future growth within the locality. East Ayrshire Council have expressed an interest in bying the site.

Key Messages:

 Disposal of the site would help reduce the overall size of the NHS Ayrshire and Arran (NHSA&A) estate, reducing backlog maintenance liability,ongoing maintenance costs and any potential liabilities arising from adverse events on the vacant land.  There is the potential to obtain income from the sale of the land, generating additional funds to enhance and improve patient care.  The sale of the land would bring the site back into use for the benefit of the wider community.

Glossary of Terms AME Anually Managed Expenditure CLO NHS Scotland Central Legal Office EAC East Ayrshire Council IJB Integration Joint Board HSCP Health and Social Care Partnership NHSA&A NHS Ayrshire & Arran PTHB NHS Scotland Property Transactions Handbook

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1. Situation

The East Ayrshire Health and Social Care Partnership agreed at a meeting of the Integration Joint Board on 29 August 2018 that services and staff currently provided from at the Kirklandside site will be transferred to other locations.

2. Background

Kirklandside Hospital opened in 1909 and first treated patients for infectious diseases. From the 1960s this changed to an inpatient facitilty for the frail elderly. Inpatient services have been gradually withdrawn over the past 10 years.

Inpatient services at Rowallan Ward were fully withdrawn in 2016 due to the facilities no longer being fit for purpose. The design and age of the facility was no longer able to support the complex care services required by patients.

In November 2017, the IJB accepted a proposal that NHS Complex Care provision should be replaced with a Housing / Hospital at Home model. As a result, remaining community services will no longer be provided from Kirklandside Hospital. The Stakeholder Reference Group agreed a new ‘blended’ housing model of care which will make services available closer to people’s own homes and communities.

In the interim, 10 in-patient beds have been commissioned at from HSCP for the next 2-3 years to allow East Ayrshire HSCP to carry out a feasibility study and further develop the planned housing option. An architect has been appointed to undertake a detailed design.

3. Assessment

The Kirklandside site also accommodates the Community Rehabilitation Centre (often referred to as the Day Hospital). This is a consultant led multi-disciplinary rehabilitation facility for people over aged 65 with complex care needs. The service promotes optimum level of function through therapeutic programmes such as the Falls Clinic and the Movement Disorder Clinic, treating Parkinson’s disease. The Stakeholder Reference Group agreed on a mobile community model where the service can be delivered in a community rather than a hospital setting.

The Kirklandside Site is a service base for Intermediate Care; Physiotherapy and OT Community Rehabilitation; Community Alarms; Health Promotion; Dietetics and Business Support Services. To declare the site surplus to requirement will require the relocation of some 83 NHS and Council employees, and their respective service bases, from the Kirklandside Hospital Site (see Appendix 1). Plans are being progressed to utilise 4 alternative sites:

a) Some 62 employees and their respective services equipment will move to the former Kirkstyle Primary School which will require minor alterations and the installation of additional network cabling and electrical points to support this move.

b) It is proposed to take the opportunity to co-locate a total of some 21 employees with other senior management at the existing Balmoral Road Office in Kilmarnock.

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c) The Allied Health Professional Service has a Podiatry Team based in the Kirklandside Hospital Site and the proposal for these 4 employees is to relocate to a currently unused office in Treeswoodhead Clinic.

d) The Community Health and Care Service Manager responsible for Intermediate Care and Rehabilitation will be relocated to The Johnnie Walker Bond.

The Kirklandside Hospital site currently has an annual running cost of £228,000, which would be a full year saving, following the demolition of the buildings and clearance of the site. Demolition costs would be met by AME funding from the Scottish Government.

The Board’s ownership extends beyond the current hospital site, with additional land currently unused, but formerly designated for agricultural use. (see Appendix 2)

The backlog maintenance is approximately £2.6M and any future re-use of the buildings would be prohibitively expensive, as the site uses steam heating and is structurally limited, having been constructed as a number of Nightingale Wards.

East Ayrshire Council Planning Department have designated the Kirklandside area as a Future Growth Area, to promote economic development, as an enterprise zone. This limits the potential re-use of the buildings by a third party seeking to purchase the site, which further supports the demolition of the buildings ahead of any sale.

East Ayrshire Council has also expressed an interest in purchasing the site and the District Valuer Service has been appointed, in accordance with the directions within the Scottish Public Finance Manual, for two public bodies seeking to transfer a property.

It is therefore beneficial to the NHS Board to declare the land surplus and dispose of the site. If this can be realised, the income can be reinvested into healthcare and relieve NHSA&A of ongoing security and maintenance costs.

4. Recommendation

The NHS Board is asked to declare Kirklandside Hospital and the adjoinging land surplus to NHSA&A use and to recommend the disposal of the land thereafter, in accordance with PTHB guidance.

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Monitoring Form

Policy/Strategy Implications The NHS A&A Property and Asset Management Strategy sets out the HSCP intention of relocating community away from Kirklandside, linking this within local and national clinical strategies. Workforce Implications Appendix 1 shows the changes to the workforce locations under the plan, who have been consulted about the changes. Financial Implications The land at Kirklanside is not yet on the Asset Disposal Register, but initial asset valuations place an indicative disposal value of £780,000. The savings in operational costs are estimated at around £228,000 in a full year. Consultation (including The site has been recommended to be declared Professional Committees) surplus by the Board’s Corporate Management Team. Further papers have been considered by the Estates, Environment & Sustainability Group and the Capital Programme Management Group. Risk Assessment There is a risk East Ayrshire Council decide not to purchase the land once the valuation reports are received. It would be unlikely a capital receipt can be obtained within the current financial year in those circumstances, as this would mean advertsing the property on the open market. Whilst NHSA&A will make best endeavours to dispose of the site within the timescale, there is a risk that failure to sell the site will have an adverse effect on NHSA&A capital budgets.

There is a high risk of not achieving the disposal value of £750,000, due to abnormal costs. A Property Adviser and Special Adviser (e.g. consulting or structural engineer) will carry out a survey to form a site condition report, which will allow an understanding of the risk of not acheiving the disposal value.

Best Value It is the responsibility of NHSA&A to ensure that all property, sales, are at a price and on other conditions which are the best obtainable at that time having regard to the mandatory requirements of the NHS Scotland Property Transaction Handbook.

The efficient and effective management of transactions will assist NHS A&A to achieve the best outcome for the public interest.

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- Vision and leadership As set out in the NHS Board’s approved Estates Strategy.

- Effective partnerships CLO and Property/Special Advisers, EAC

- Governance and Estates, Environment & Sustainability Group; CPMG; accountability Corporate Management Team.

- Use of resources Professional advisers are procured through quotes/tenders in accordance with procurement guidance and through the Public Contracts Scotland website.

- Performance Estates, Environment & Sustainability Group; CPMG; management Corporate Management Team; Annual Board Financial Audit (Property Transaction Audit).

Compliance with Corporate Compliant with the NHS Board’s approved Estates Objectives Strategy. Single Outcome Agreement Consultation with East Ayrshire Council was carried (SOA) out for the properties. EAC have an ongoing interest in purchasing the Kirklandside site. Impact Assessment A high level Standard Impact Assessment has been carried out on the NHSA&A disposal process. As this is a recurring event, the Standard Impact Assessment applies to all transactions.

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Appendix 1

Location Team/Department Staff numbers New Location Gate House Community Alarms 28 (approximately) Former Kirkstyle Primary School (left) Gate House Nutrition & Dietetics 8 (approximately) Former Kirkstyle Primary School (right) Community food work base Main Block Former Kirkstyle Primary School Person Centred Care 1 The Johnnie Walker Bond Health Improvement 1 Former Kirkstyle Primary School Community Nursing 1 Former Kirkstyle Primary School Older Peoples 1 Former Kirkstyle Primary School Services Addiction Services 1 Former Kirkstyle Primary School ICES Team 8 Balmoral Road ICES 21 Balmoral Road Strategic 1 Former Kirkstyle Primary School Programmes Manager Associated Nursing 1 Former Kirkstyle Primary School Director Prescribing Adviser – 2 Former Kirkstyle Primary School Community Pharmacy Children’s Services 1 Former Kirkstyle Primary School District Nursing 2 Former Kirkstyle Primary School Podiatry 4 Treeswoodhead Clinic Community 4 Former Kirkstyle Primary School Physiotherapy 85

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Appendix 2

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