and Bosworth Primary Care Trust

Phase II – Hospital redevelopment and service redesign project

I. Introduction

1.1 Since last doing a presentation to the Overview and Scrutiny Committee the project has progressed. This report will highlight some of the key areas of development.

2. Key developments

2.1 The outline business case (OBC)

This was agreed by the Strategic Health Authority (SHA) in October 2005. There were conditions and a request to re-examine the predicted activity figures and to reflect the impact of any changes on affordability. This work has been completed and submitted. However, the SHA are now requesting additional information about planning and workforce development. In view of this the PCT are meeting with the SHA on 3 rd January to ensure that information submitted will result in closure so that a letter of approval can be obtained.

2.2 Planning permission

At the planning meeting on 1 st November the outline application was considered and the Council agreed the recommendation of the Head of Culture and Development. However, members raised concerns about car parking and accessibility to the site. The Highways Authority had raised no objections to the proposal but in view of concerns discussions are ongoing.

2.3 The development of the Batch

Market Harborough and Hinckley scheme are being developed together to go out for the private sector to tender. Advisors have been appointed to assist the process and prepare the invitation to tender documents. There is an enormous amount of work required to meet the project timelines so that we do not delay the process. However, work is progressing well.

2.4 Governance structure

This has been reviewed so there are good two way communication flows between the batch and the locality. The existing Project Board which has been made up of key stakeholders has now become a steering group to the project which will meet three monthly and advise the newly formed Executive Project Group. This latter group will meet monthly. As the PCT move from the development stage of the project into the implementation phase this seemed a logical arrangement. The various local subgroups sit well with the batch workstreams and thus the reporting mechanism up to the Procurement Board and the respective Trust Boards. This is illustrated in the diagram (Appendix 1).

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2.5 Covenants

There are covenants on the packages of land that make up the Hinckley and District Hospital site. However, it has been established that none of these covenants commit to land being used only for Health purposes. Legal advice is being sought about the actual implications of the covenants and if they are still binding.

2.6 Gateway review

This was undertaken in October by an independent team appointed by the Private Finance division of the Department of Health. Its purpose was to scrutinise the project, its robustness and if the proposal within the business case would develop a hospital which was fit for purpose. It is pleasing to be able to report that the review team found the project to be a close strategic fit within the wider health economy with support and buy-in from key stakeholders. They were also impressed that the project was service driven and not just the replacement of old buildings. There were six recommendations. These were around: • Developing new communication structures particularly with the Board • Reviewing the communication strategy for public involvement • Reviewing and developing more robust risk management • Reviewing project governance arrangements • Continuing to assess affordability assumptions • Producing project plans with timelines for each stream of work

An action plan was developed and all areas have now been addressed

2.7 Risk register

This has now been developed in line with Standards for Better Health. Each month a section is reviewed along with new risks. In this way the document remains ’live’

2.8 Clinical strategy

This document forms the foundation of the business case but needs to be reviewed to reflect changes in practice, new government directives and practice based commissioning. To this end an evening meeting has been planned in January involving clinicians at which the document will be discussed and amended.

2.9 Work of the sub-groups

2.9.1 The communication and involvement group are revising the strategy and developing a new action plan so that the PCT can be sure to keep people informed of progress. Over the past few months there have been a number of opportunities to speak to different groups and nearly 800 people have been involved in this process 2.9.2 The design reference and service delivery group have been putting together the documentation required to inform bidders how the building will work, space required and adjacencies of departments. The group is now developing the room data sheets and equipment required. The input from staff has been excellent and their keen involvement, in what is time consuming and detailed work, is to be commended.

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2.9.3 The workforce planning and development group are developing an action plan to identify training needs, recruitment initiatives and reviewing current skill mix and development opportunities. This will be key in ensuring that when the hospital opens, staff are in place and have the skills and competencies to undertake the new ways of working. 2.9.4 The transport group have been tasked with reviewing the Healthy, Green, Travel and Transport Plan. There is considerable public concern over transport issues and this group will be looking at all aspects of transport, access and partnership working with bus, ambulance and voluntary sector transport schemes

2.10 Affordability

Work on affordability and activity has been completed. The project is now in alignment with University Hospitals of Pathway Project and the PCT’s Service Delivery and Development Plan. The project will cost £28 million. A value for money exercise has also been undertaken to compare if there is value in going out to the private sector. This has evaluated favourably.

2.11 Patient and public involvement

There continues to be patient and public representation on the subgroups, which is invaluable in providing opinions on assumptions which might be made.

3. Conclusion

The scheme is developing well and to plan at the time of writing this report.

Wendy Biddington Associate Director Phase II 20.12.05

3 Appendix 1 Governance structure

MRH PCT H & B PCT Board Board

Market Hinckley & Harborough NHS PFI Bosworth

Project Procurement Project Steering Group Board Board Executive Board

Hinckley & Harborough Procurement Project Project Team Team

Specialist Advisory Team

Clinical, Finance & Facilities Procurement design & Governance Management team equipment & Human Design Communication resources Reference/ Workforce Transport & Involvement Service Planning Delivery

Key: Accountability Accountability for procurement process & products Delegated Authority

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