Worcestershire Oncology Project Radiotherapy Feasibility Review

Worcestershire Acute Hospitals NHS Trust & University Hospitals Coventry and Warwickshire Hospitals NHS Trust

Worcestershire Oncology Project

Radiotherapy Feasibility Review

110511 Radiotherapy Feasibility Report_v1.1 i 11/05/2011 Version 1.1 11th May 2011 Worcestershire Oncology Project

Radiotherapy Feasibility Review

DOCUMENT CONTROL SHEET

Version Date File Name Status Version 1.0 9th May 2011 110509 Radiotherapy Final draft issued to Radiotherapy Feasibility Workstream for meeting on 11th May Report_v1.0 2011 Version 1.1 11th May 2011 110511 Radiotherapy Updated for conclusions as agreed at Feasibility Radiotherapy Workstream meeting on Report_V1.1 11th May 2011. Submitted to Project Team for approval on 13th May 2011

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Table of Contents 1. Executive Summary ...... 1 1.1 Introduction & Background ...... 1 1.1.1 Introduction ...... 1 1.1.2 Background ...... 1 1.1.3 Programme of Work to Develop Oncology Services ...... 1 1.1.4 Programme of Work for the Radiotherapy Workstream ...... 2 1.2 Requirements for a Radiotherapy Facility ...... 2 1.2.1 Linear Accelerators ...... 2 1.2.2 Overall Facility Requirements ...... 3 1.2.3 Schedule of Accommodation ...... 3 1.3 Site Selection ...... 3 1.4 Identifying the Long‐list of Options ...... 4 1.5 Shortlisted Options ...... 4 1.5.1 Building Design ...... 4 1.5.2 Location of Options on WRH and AH Sites ...... 6 1.5.3 The Options ...... 712 1.6 Non Financial Evaluation ...... 13 1.6.1 Selecting the Evaluation Criteria ...... 13 1.6.2 Weighting of the Options ...... 13 1.6.3 Scoring the Options ...... 14 1.6.4 Results of the Non Financial Evaluation ...... 15 1.6.5 Sensitivity Analyses ...... 16 1.7 Financial Appraisal ...... 16 1.7.1 Capital Costs ...... 16 1.7.2 Lifecycle Costs ...... 17 1.7.3 Revenue Costs ...... 17 1.7.4 Economic Appraisal ...... 19 1.7.5 Sensitivity Analysis ...... 20 1.8 Overall Appraisal Results ...... 21 1.8.1 Results ...... 21 1.9 Conclusions ...... 22

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2. Introduction & Background ...... 23 2.1 Introduction ...... 23 2.2 Background ...... 23 2.3 Programme of Work to Develop Oncology Services ...... 24 2.4 Programme of Work for the Radiotherapy Feasibility Review ..... 25

3. The Requirements for a Radiotherapy Facility ...... 26 3.1 Site selection ...... 26 3.2 Service Brief ...... 26 3.3 Linear Accelerators ...... 27 3.4 Overall Facility Requirements ...... 28 3.5 Schedule of Accommodation ...... 29

4. Identifying the Longlist of Options ...... 30

5. Shortlisted Options ...... 31 5.1 Building Design ...... 31 5.2 Location of Options on WRH and AH Sites ...... 33 5.3 The Options ...... 34

6. Non Financial Evaluation ...... 40 6.1 Selecting the Evaluation Criteria ...... 40 6.2 Weighting of the Options ...... 42 6.3 Scoring the Options ...... 42 6.4 Results of the Non Financial Evaluation ...... 43

7. Financial Appraisal ...... 45 7.1 Capital Costs ...... 45 7.2 Lifecycle Costs ...... 46 7.3 Revenue Costs ...... 47 7.4 Economic Appraisal ...... 48

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8. Overall Appraisal Results ...... 51 8.1 Results ...... 51

9. Conclusions ...... 53

Appendix A Clinical Services & Activity Brief ...... 54 Appendix B Non Financial Evaluation Panel Membership ...... 55 Appendix C Information Provided to Evaluation Panel ...... 56 Appendix D Non Financial Appraisal Results ...... 57 Appendix E Capital Costs ...... 58 Appendix F Patient flow and travel time analysis ...... 59 Appendix G Revenue Costs ...... 60 Appendix H Economic Analysis ...... 61

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Table of Tables

Table 1. Projected Fractions / Linear Accelerator Requirements ...... 27 Table 2. Non Financial Evaluation Criteria ...... 40 Table 3. Criteria Weighting ...... 42 Table 4. Non Financial Evaluation ‐ Weighed Scores and Results ...... 43 Table 5. Non Financial Evaluation Results – By Stakeholder Group ...... 44 Table 6. Capital Costs ...... 45 Table 7: Building and Engineering Asset Component Lives ...... 46 Table 8. Revenue Cost Analysis ...... 48 Table 9. Economic Analysis Results ...... 49 Table 10. Sensitivity Analysis – Capital Costs ...... 49 Table 11. Sensitivity Analysis – Revenue Costs ...... 50 Table 12. Overall Appraisal Results ...... 51 Table 13. Sensitivity Analysis – Combined Results ...... 51

Table of Figures

Figure 1. Radiotherapy Facility Schematic – Options A, D, E, F & G ...... 31 Figure 2. Radiotherapy Facility Schematic – Option C ...... 32 Figure 3. Site Options – Worcestershire Royal Hospital Site ...... 33 Figure 4. Site Options – Alexandra Hospital ...... 33 Figure 5. Option A – A&E Car Park (WRH) ...... 34 Figure 6. Option C – The Workshops (WRH) ...... 35 Figure 7. Option D – Spetchley Land (WRH) ...... 36 Figure 8. Option E – Rear of Site (AH) ...... 37 Figure 9. Option F – Adjacent to PGMC (AH) ...... 38 Figure 10. Front of Site (AH) ...... 39

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1. EXECUTIVE SUMMARY

1.1 Introduction & Background

1.1.1 Introduction In February 2011, Worcestershire Acute Hospitals NHS Trust (“the Trust”) appointed University Hospitals Coventry and Warwickshire NHS Trust (“UHCW”) to be its Strategic Partner for the development of non‐surgical Oncology services for the population of Worcestershire. As part of the formal programme of work that has been established by the Strategic Partnering Board, a Feasibility Study was commissioned to look at the feasibility of developing a Radiotherapy facility on either the Worcestershire Royal Hospital (WRH) or Alexandra Hospital, Redditch (AH) sites. This report documents the work and results of that study.

1.1.2 Background The need for developing non‐surgical Oncology services for Worcestershire arises from the inherent tension between the Trust’s current organisation of cancer services and the increasingly county‐wide nature of site‐specific cancer services and other general services (for example, emergency admissions). This tension gives rise to a range of operational problems which can lead to delays, inadequate communication and potential errors, and patients having to travel further for treatment. To help address this, WAHT undertook a formal OJEU procurement to appoint a strategic partner with whom the Trust would develop local non‐surgical Oncology services, resulting in UHCW being selected as the Strategic Partner in February 2011. Since then, a formal programme of work has been established to help improve the safety, quality and accessibility of cancer services for Worcestershire residents, with potentially positive impacts on other health economies, thus providing a ‘once in a lifetime’ opportunity to provide better cancer services for Worcestershire.

1.1.3 Programme of Work to Develop Oncology Services As stated above, a formal programme of work has been established to secure a number of identified benefits. A project structure has been developed to oversee the work to help deliver these, which includes an overarching Project Team and a number of underpinning workstreams to deliver specific areas of work, including Radiotherapy. This report forms part of work within the remit of the Radiotherapy Workstream.

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1.1.4 Programme of Work for the Radiotherapy Workstream The Radiotherapy Workstream was specifically tasked to undertake the following work in relation to the feasibility review:

■ Develop a clinical, service and activity brief for the new facility;

■ Identify all of the available site options;

■ Develop the physical solutions for each option, to the level of detail needed for the preparation of capital cost estimates and timescales;

■ Undertake a non‐financial appraisal of the options;

■ Undertake a financial appraisal of the options, including an affordability assessment; and

■ Undertake an economic and value for money appraisal of the options.

It was agreed that the study would not include a detailed quantitative assessment of the capital funding options for the new facility, which will be undertaken as part of the Outline Business Case preparation instead.

1.1.4.1 Design & Technical Team To help assist this programme of work, external support was commissioned as follows:

■ Strategic Healthcare Planning LLP ‐ healthcare planning and design;

■ Holbrow Brookes LLP ‐ capital costs; and

■ Provex Consultancy ‐ finance and options appraisal support.

1.2 Requirements for a Radiotherapy Facility The Radiotherapy workstream developed and agreed the requirements for a Radiotherapy facility to underpin the options to be developed for siting a facility on either the WRH or AH sites, as summarised in the Clinical Services & Activity brief attached at Appendix A.

1.2.1 Linear Accelerators To help quantify the number of linear accelerators that will be required, the Clinical Services & Activity Brief used the disease incidence data in the Draft NHS Worcestershire Cancer Strategy 2009‐2013 as a starting point, and assumed that 95% of the fractions for the adult Worcestershire population will be delivered on the identified site (as assumed in the Trust’s service specification used for the OJEU procurement and referenced above). The modelling assumptions then assumed a mix of the model issued by the National Radiotherapy Advisory Group (NRAG) for Trust’s to project future required levels of fractions, and a cancer site specific model developed by UHCW, to identify (a) the number of fractions that will need to be delivered; and (b) the resultant number of linear accelerators that will be required. The results of this analysis (detailed in Table 1 in Section 3.3) indicated that WAHT will need 3 linear accelerators by 2015/16, moving to 4 by 2016/17.

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1.2.2 Overall Facility Requirements In addition to the modelling work outlined above, the following requirements have been determined for a Radiotherapy Oncology service to be delivered from a single site for the population of Worcestershire:

■ Five linear accelerator bunkers;

■ Three dual energy linear accelerators equipped for arc therapy and cone‐beam CTs for IGRT;

■ All linear accelerators to be capable of delivering both photons and electrons, and equipped with portal image devices;

■ One CT together with virtual simulation software;

■ A DXR treatment machine housed in a linear accelerator bunker for the treatment of surface tumours (maximum energy 300kV) which will optimise use of the linear accelerator facilities and simplify the provision of an additional linear accelerator when this is required;

■ Comprehensive support facilities, including a mould room, dedicated treatment planning facilities and simulation suite; and

■ ‘Undeveloped space’ to facilitate the provision of an appropriately positioned additional simulation suite which will be required when 4 linear accelerators are operational.

1.2.3 Schedule of Accommodation The above requirements have been translated into a schedule of accommodation totalling a gross internal area of 3,215m2. The schedule is appended to the Clinical Services & Activity Brief at Appendix A. Each of the options includes an allowance for 37 car parking spaces for the new facility.

1.3 Site Selection In 2009, prior to this study, the Trust undertook an option appraisal exercise to determine how best to move forward with the provision and location of Oncology services in the future, which in part, included looking at the options to locate Radiotherapy services on a combination of either one or two sites. Three sites were considered, namely the WRH in Worcester; AH in Redditch; and an unspecified ‘central Worcestershire’ location (such as Bromsgrove or Droitwich). Following a formal evaluation, the final report, Oncology Care for Worcestershire – Options Appraisal (April 2009), recommended that the Trust pursues a single‐provider for a single‐ site Radiotherapy facility and inpatient Oncology services for Worcestershire, located at either WRH or the AH.

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Given that NHS Worcestershire and that the Trust had previously undertaken this robust and transparent evaluation and made a clear decision about the potential sites for Radiotherapy services, it was agreed that this feasibility review would not revisit this issue, and the options underpinning this review would be developed on thet basis tha Radiotherapy services would be located on either the WRH or AH sites as previously agreed. 1.4 Identifying the Long‐list of Options Representatives from the Design & Technical Team reviewed both the WRH and AH sites, and identified a long list of 7 potentially feasible options for a new build as follows:

■ Option A – On the A&E car park at WRH;

■ Option B – On the Aconbury East building at WRH;

■ Option C – On the workshops at WRH;

■ Option D – On the Spetchley Land adjacent to WRH;

■ Option E – Rear of the AH site;

■ Option F – On the bank adjacent to the PGMC at AH; and

■ Option G – Front of the AH site.

Whilst other options would be possible, the implications in terms of disruption, timescale and deliverability were such that they were not viewed as viable. Upon further consideration, the Radiotherapy Workstream also discounted Option B (on the Aconbury East building at WRH) on the grounds that the site constraints would result in a design that would be deep and long, and thus not optimal in terms of shape and available daylight. Additionally, the location meant that this would be the most disruptive solution from the long list in terms of impact on existing operations. On this basis, the remaining 6 options were further developed as described below and in more detail in Section 5.

1.5 Shortlisted Options

1.5.1 Building Design A design for a Radiotherapy facility that can deliver the agreed requirements was developed, to give an indication of the overall size and shape of the facility required. The developed design provides all of the clinical accommodation that necessitates a patient interface at the ground floor, with staff and support facilities located on a first floor. However, due to the site constraints around Option C, an alternative design was developed for this option only, which placed some of the clinical accommodation on the first floor (i.e. the Mould Room, Radiotherapy Physics and workshops) alongside the staff support facilities. The two designs are illustrated below:

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Radiotherapy Facility Schematic – Options A, D, E, F & G

Radiotherapy Facility Schematic – Option C

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1.5.2 Location of Options on WRH and AH Sites The physical location of the different options on each of the identified sites is illustrated below:

Site Options – Worcestershire Royal Hospital Site

Site Options – Alexandra Hospital

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1.5.3 The Options

1.5.3.1 Option A – A&E Car Park (WRH) As stated previously, this option proposes to locate the new Radiotherapy Centre on the existing A&E Car Park at the Worcester Royal Hospital as illustrated below:

Option A – A&E Car Park (WRH)

The key points in relation to this option are:

■ The ground floor of the new building will be linked to level 2 of the existing hospital;

■ The building occupies the majority of the available site therefore the ability to extend outwards in the future is limited, although there may be potential to extend upwards;

■ The proposed vehicular entrance and patient drop‐off is achieved through the retention of the existing car‐park entrance with a new exit point on to the adjacent mini‐island;

■ There will be provision for a disabled car‐parking zone in this area with the majority of car parking provided elsewhere;

■ A separate service entrance will be provided to the rear of the facility;

■ In order to make the site available for construction, it will be necessary to re‐provide the existing car parking that is displaced by the development, and it is proposed that this is achieved by the acquisition of adjacent land currently owned by the Berkeley and Spetchley Estate;

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■ Access for construction traffic will need to be via the hospital roadway system. It is proposed that the constructional techniques incorporated in the building will be such that off‐site fabrication is maximised to minimise the time in which disruption could occur;

■ Timescales for enabling works, construction and commissioning of the building are estimated to be 22 months.

1.5.3.2 Option C – The Workshops (WRH) The option illustrated below proposes to locate the new facility on the site currently occupied by the workshops and crèche:

Option C – The Workshops (WRH)

The key points relating to this option are:

■ The facility accommodates the majority of the clinical accommodation on one floor level with the balance being provided at an upper level together with staff and support facilities;

■ It is not possible to realistically link this new building with the existing hospital, therefore any transfers or inpatient activity will need to be undertaken by ambulance;

■ The facility occupies all of the site therefore the ability to extend in response to future needs is limited without the removal of other existing buildings for example, the mortuary;

■ Access for ambulance services will be via the hospital road adjacent to A&E with visitors approaching from the opposite end of the site;

■ This option enables a separate service entrance to be provided to the rear of the building;

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■ Discrete car parking areas can be provided for visitors and staff with a disable zone adjacent to the main entrance;

■ This option requires enabling works to be carried out to create the space required for the new building i.e. the re‐provision of a crèche and the Catalyst Lend Lease offices and workshop. It is proposed that these be accommodated in the ground floor of Aconbury East when space has been created following the redistribution of functions to currently vacant space within the building;

■ The proposed site can be accessed for construction traffic from the Newtown Road and therefore not cause disruption to the main hospital.

■ Timescales for enabling works, construction and commissioning of the building are estimated to be 25 months.

1.5.5.3 Option D – Spetchley Land (WRH) This option proposes to build the new facility on adjacent land currently in the ownership of the Berkeley and Spetchley Estate, as illustrated below:

Option D – Spetchley Land (WRH)

■ The proposed site is separate from the main hospital. Since this option is based on new land to be acquired, the Trust has the opportunity of purchasing sufficient land to enable the building to be extended to respond to future service growth or change;

■ Access to the site is expected to be from the main highway and anticipated to be provided by the developer of the overall Berkeley & Spetchley Estate land as part of the land acquisition;

■ As the new building is separate from the main hospital any patient transfers will need to be by ambulance;

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■ Access to the existing hospital site will be provided through the existing staff car park;

■ Access to the site for the builder will be from the main highway and therefore construction traffic will not disrupt the activities of the main hospital.

■ The total timescales for construction and commissioning are estimated to be 18 months (15 for construction, 3 for commissioning).

1.1.5.4 Option E – Rear of Site (AH) This option proposes to build the new Radiotherapy Centre on land recently acquired at the rear of the site as illustrated below:

Option E – Rear of Site (AH)

■ Due to the ground levels and the slope of the site, the first floor of the new building will be at the same level as the ground floor of the existing hospital. A link corridor will therefore provide the necessary clinical access to associate functions;

■ There is sufficient available land to enable the building to be extended in response to service change;

■ Vehicular access to the facility will be via the existing hospital roadway that is scheduled to be extended to service the proposed site. Access will also be provided via the existing hospital main entrance;

■ Access for construction traffic will need to be via the hospital roadway system. It is proposed however, that the constructional techniques incorporated in the building be such that off‐site fabrication is maximised to minimise the time in which disruption could occur;

■ Access being provided via the main entrance will require the existing Rehabilitation services to be displaced; and

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■ Timescales for the enabling works, construction and commissioning are 18 months (15 for enabling and construction work which can be undertaken in parallel, and 3 months for commissioning).

1.1.5.5 Option F – Adjacent to PGMC (AH) This option locates the new facility on the top of the bank adjacent to the PGMC as illustrated below:

Option F – Adjacent to PGMC (AH)

■ Due to the ground levels and the slope of the site the ground floor of the new building will be at the same level as the first floor of the existing hospital. A link corridor will therefore provide the necessary clinical access to associated functions, for example Radiology, outpatients, inpatients;

■ There is sufficient available land to enable the building to be extended in response to service change. Similarly the link to the exiting hospital provides opportunities in that facility;

■ Access to the facility is twofold, the first being from the existing hospital roadway system with the second from the highway to the east of the site via the current emergency point;

■ This location provides no known restrictions that will adversely impact on the buildability of the project;

■ The emergency access can provide an entry point for construction traffic away from the main hospital activity; and

■ Construction and commissioning timescales are 18 months (15 for construction and 3 for commissioning).

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1.1.5.6 Option G – Front of Site (AH) This option locates the new facility on the currently vacant land adjacent to the site entrance as illustrated below:

Front of Site (AH)

■ The proposed site is separate from the main hospital. Once the new facility has been built there will be some surplus land available to respond to a degree of service growth;

■ Access to the facility will be from the existing hospital roadway system;

■ As the new building is separate from the main hospital, any patient transfers will need to be by ambulance;

■ Access to the site for the builder will be from the main hospital roadway and therefore construction traffic may cause some disruption to the activities of the main hospital;

■ Construction and commissioning timescales are estimated to be 18 months (15 for construction and 3 for commissioning).

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1.6 Non Financial Evaluation A non financial evaluation of the shortlisted options was undertaken using a systematic and sequential process that covered:

■ Stage 1 : Selection of the criteria to be used to appraise the options;

■ Stage 2 : Weighting of criteria to reflect their relative importance;

■ Stage 3 : Consideration of the options and scoring against the agreed criteria;

■ Stage 4 : Analysis of the results and sensitivity testing to establish the robustness of the conclusions. The evaluation criteria were agreed by the Strategic Partnering Board, as outlined in Sections 1.6.1 and in detail in Section 6.1. An Evaluation Panel was established to undertake stages 2 and 3 as outlined above. The Strategic Partnering Board agreed the membership of the Evaluation Panel, ensuring there was a balanced representation across not only stakeholder groups (i.e. service users, providers and commissioners) but also from across the county. Details of the Evaluation Panel’s membership can be found at Appendix B.

1.6.1 Selecting the Evaluation Criteria The Strategic Partnering Board agreed that the evaluation criteria to be used would be based on those recommended by the Department of Health and commonly used in option appraisals, but adapted for local use by patients and clinicians as part of the evaluation of tenders during WAHT’s procurement exercise for a Strategic Partner. Thus, the evaluation criteria used at a high level were as follows:

■ Improved clinical quality of services in line with meeting national, regional and local policy imperatives;

■ Better access to services;

■ Development of existing services and/or provision of new services;

■ Improved strategic fit of services;

■ Meeting training, teaching and resource needs;

■ Making more effective use of resource; and

■ Ease of delivery.

The detailed criteria are set out in Section 6 of this report.

1.6.2 Weighting of the Options The Non Financial Evaluation Panel were invited to a workshop held on Friday 6th May 2011, to both weight the evaluation criteria, and to consider and score the options from a non‐ financial perspective.

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Members of the Panel were initially asked to rank the evaluation criteria in order of importance, and to then assign scores to each criterion to determine the relative difference between them. On this basis, the following weightings were agreed:

Criteria Weighting

Weighting Criteria Rank Score Weight Improved clinical quality of services in line with meeting national, regional and local =1 100 26.3% policy imperatives Better access to services =1 100 26.3% Development of existing services and/or 4 50 13.2% provision of new services Improved strategic fit of services 5 40 10.5% Meeting training, teaching and resource 6 20 5.3% needs Making more effective use of resource 3 60 15.8% Ease of delivery 7 10 2.6% Total 380 100.0%

1.6.3 Scoring the Options Having weighted the criteria, members of the Evaluation Panel were asked to consider the options as presented to them, and to score them accordingly. To help do this, a number of documents were made available to the Panel both in advance of the workshop, with additional information made available on the yda in relation to travel analyses showing the estimated impact on patient journey times if they were to travel to WRH or AH for their treatment, and information on accessing both sites by bus, road and train. This additional information can be found at Appendix C. Having considered the information made available to them, members of the Panel were asked to individually score each of the options against each of the 7 agreed criteria using a 10‐point scoring system (10 being the highest possible score and, 1 being the lowest). In addition to this, they were also asked to score a “Do Nothing” option, which although not being formally considered as a feasible option provided a baseline from which to measure the difference between the Trust not doing anything and each of the options being considered.

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1.6.4 Results of the Non Financial Evaluation Having combined the individual Panel member’s scores, the total weighted scores and results of the non‐financial evaluation exercise were as follows:

Non Financial Evaluation ‐ Weighed Scores and Results

Weighted Scores Do Option A Option C Option D Option E Option F Option G Criteria Nothing A&E Car Workshop Spetchley Back of Adj to Front of Park (WRH) (WRH) Site (AH) PGMC Site (AH) (WRH) (AH)

Improved clinical quality 1.23 2.47 1.48 1.24 2.19 1.93 1.13

Better access to services 0.54 2.35 1.86 1.61 1.77 1.74 1.24

Development of 0.29 1.04 0.74 0.74 0.95 0.87 0.67 existing/new services Improved strategic fit of 0.25 0.88 0.63 0.58 0.74 0.64 0.50 services Meeting teaching, 0.16 0.39 0.31 0.31 0.33 0.32 0.27 training & resource d Making more effective 0.68 1.29 0.85 0.72 1.20 1.04 0.61 use of resource

Ease of delivery 0.15 0.18 0.13 0.18 0.20 0.25 0.15

Total Score 3.31 8.60 5.99 5.38 7.38 6.79 4.57

Rank 7 1 4 5 2 3 6

% Difference 61.56% 0.00% 30.35% 37.43% 14.19% 21.14% 46.93%

The results show a clear preference for Option A over the second preferred option, Option E by a margin of 14%. Option F is the third preferred choice by a further margin of 7%, with options C, D, G and Do Nothing scoring significantly less. Analysis of the scores by all stakeholder groups represented on the Evaluation Panel identified a clear preference for Option A over the other options. The overall order of rank for provider representatives matched that of the overall rankings. User representatives however showed a reversed preference for third and fourth choices (preferring Option C over Option F), and commissioners a reversal in preference for second and third choices (preferring Option F over Option E), as illustrated below:

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Non Financial Evaluation Results – By Stakeholder Group

Users Providers Commissioners Total Option Score Rank Score Rank Score Rank Score Rank Do Nothing 2.54 7 3.96 7 3.85 7 3.31 7 Option A 8.75 1 8.58 1 8.34 1 8.60 1 Option C 6.72 3 5.55 4 5.20 4 5.99 4 Option D 5.74 5 5.15 5 5.02 5 5.38 5 Option E 7.18 2 7.73 2 7.26 3 7.38 2 Option F 5.89 4 7.28 3 7.35 2 6.79 3 Option G 4.52 6 4.81 6 4.30 6 4.57 6

1.6.5 Sensitivity Analyses A series of sensitivity analyses were undertaken to assess what, if any, impact there would be in the event that:

■ All criteria were given an equal weighting;

■ The criterion “ease of delivery” was given a higher weight; and

■ The criterion “effective use of resources” was given a higher weight.

All of the alternative weightings do not change the ranking of the options, nor the broad differentials between the options, showing that the results are robust to changes in weighting. The detailed results from the non financial evaluation can be found at Appendix D.

1.7 Financial Appraisal

1.7.1 Capital Costs An assessment has been made of the likely order of capital cost for each option, based on the information currently available. The resultant capital costs (at MIPS approval level 480, excluding land) for each of the options are summarised below:

Capital Costs

Outturn Capital Option Costs (MIPS 480) Option A A&E Car Park (WRH) £23,595,994 Option C Workshops (WRH) £24,541,751 Option D Spetchley Land (WRH) £22,590,606 Option E Rear of Site (AH) £26,830,696 Option F Adjacent to PGMC (AH) £24,160,283 Option G Front of Site (AH) £22,871,757

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Full details relating to the capital costs can be found at Appendix E. In addition to the above capital costs, land acquisition will be required for Option A (0.51 hectares to provide the displaced car parking) and Option D (0.69 hectares for the proposed development). In both cases the land would be acquired from the Berkeley & Spetchley Estate, and an indicative value of £1m per hectare has been assumed for the purposes of the Feasibility Study.

1.7.2 Lifecycle Costs The costs of maintaining the assets during the anticipated 60‐year operational life of the facility have been assessed in conjunction with professional advisers for inclusion within the economic analysis, as follows:

Building and Engineering Asset Component Lives

Component Building Engineering Replacement Cycle % % (Years) 60 Years 75% 38% 30 Years 1% 20% 25 Years 1% 15% 20 Years 15% 13% 15 Years 2% 7% 10 Years 5% 7% 5 Years 1% 0% Total 100% 100%

For all equipment, a 10‐year replacement cycle has been incorporated into the economic analysis for all options.

1.7.3 Revenue Costs Estimates of the costs of each option have been developed using the following methodology:

■ The costs of delivering the clinical services are based on the assessments made by UHCW in its Strategic Partner bid submission, and are viewed to be the same for each option;

■ FM costs are based on benchmark figures per m² of floor area, from analysis of other recent developments;

■ Capital charges on the basis of a 38‐year average asset life for Works elements (and 100% of spend adding to value) and a 10‐year life for equipment, with a 3.5% rate of return on capital.

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As the flows of patients are likely to be different dependent upon the site chosen, it has also been necessary to consider the impact this would have on the overall costs (and to ensure that the same volume of activity is included within the economic analysis in line with HM Treasury guidance). In order to assess this, the following approach has been followed:

■ The population projections for 2015 for each of the 6 districts within Worcestershire have been weighted to reflect the incidence of cancer in the different age groups;

■ The overall volume of 30,000 fractions to be delivered has then been apportioned to the weighted population of each district;

■ Travel times by car from each district to both the existing treatment centres and the two hospital sites have been calculated:

o Where travel times by car to the new centres is below 30 minutes it is assumed that all of the forecast workload will be undertaken in the new centre; o Where travel time by car to the new centres is between 30 and 45 minutes it is assumed that only 75% of the forecast workload will be undertaken in the new centre; o Where travel time by car to the new centres is above 45 minutes it is assumed that only 50% of the forecast workload will be undertaken in the new centre.

■ The resulting continuing "out of county" activity has been costed at a rate of £165 per fraction (based on national average NHS reference costs).

Details of the calculations of patient flows and travel times are included in Appendix F. The overall results of the revenue cost assessment are set out in Appendix G and are summarised below:

Revenue Cost Analysis

OPTION OPTION OPTION OPTION OPTION OPTION A C D E F G £000’s £000’s £000’s £000’s £000’s £000’s Clinical Costs 2,082 2,082 2,082 2,082 2,082 2,082 Support Costs 443 443 443 443 443 443 FM and Overheads 519 519 519 519 519 519 Other Costs (Out of County) 471 471 471 840 840 840 Capital Charges 1,967 1,998 1,916 2,144 1,982 1,903 Net Forecast Revenue Costs 5,481 5,512 5,430 6,028 5,866 5,787 Difference from Option 51 82 0 598 436 357 Ranked 1st Revenue Ranking 2 3 1 6 5 4

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1.7.4 Economic Appraisal

1.7.4.1 Methodology The shortlisted options have been fully evaluated in line with the requirements of Department of Health Business Case Guidance and the HM Treasury Green Book to assess the overall costs of each option over the life of the project and to identify which option therefore represents the best overall value for .money The economic analysis thus:

■ Covers an appraisal period of 63 years (including 2011/12 as Year 0), ensuring that a full 60 year period of operations from a start of operations in 2014/15 is reflected;

■ Uses a discount rate of 3.5% for the years 0 to 30;

■ Uses a discount rate of 3.0% for the remaining period;

■ Excludes VAT from all cash flows;

■ Reflects capital cash flows at a “current” price base, including Optimism Bias but excluding contingencies;

■ Includes lifecycle costs based on the profile and methodology outlined in section 7.2 above;

■ Includes revenue costs as outlined in section 7.3 above;

■ For those options which utilise land within the existing sites (i.e. all except Option D), an opportunity cost is included in respect of the use of the existing site;

■ Does not include a quantitative analysis of the potential impact of risk.

All of these cost inputs have been modelled to establish, for each option:

■ The Net Present Cost (NPC) of the discounted annual cash flows over the whole appraisal period;

■ The Equivalent Annual Cost (EAC), being an annualised equivalent of the NPC.

1.7.4.2 Results The summary of the economic analysis is summarised in the table below, which shows the Net Present Cost and Equivalent Annual Costs for each option.

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Economic Analysis Results

OPTION OPTION OPTION OPTION OPTION OPTION A C D E F G £000’s £000’s £000’s £000’s £000’s £000’s NPC 117,346 117,757 115,931 128,876 126,368 125,024 EAC 4,402 4,418 4,349 4,835 4,741 4,690 Economic Ranking 2 3 1 6 5 4 Marginal Impact Over Option Ranked 1st 53 69 0 486 392 341 Difference (%) 1.2% 1.6% 0.0% 11.2% 9.0% 7.8%

From this it can be seen that there is little difference in economic terms between Options A, C and D, with the other options being between 8% and 11% more costly. Full details of the economic assessment are set out in Appendix H.

1.7.5 Sensitivity Analysis The results of the economic appraisal have been subjected to a sensitivity analysis to assess the extent of change in cost estimates required to change the overall results of the appraisal, both in terms of capital and revenue costs. This has shown that the marginal preference for Option D over Options A and C may change with relatively small changes in the capital and revenue costs, as set out below:

Sensitivity Analysis – Capital Costs

OPTION OPTION OPTION OPTION OPTION OPTION A C D E F G £000’s £000’s £000’s £000’s £000’s £000’s Baseline Capital Costs 19,220 19,406 18,629 21,306 19,192 18,166 Flexed Capital Costs 17,722 17,463 20,124 7,632 8,162 8,554 Change required (1,498) (1,943) 1,495 (13,674) (11,030) (9,612) Change % ‐7.8% ‐10.0% 8.0% ‐64.2% ‐57.5% ‐52.9%

Sensitivity Analysis – Revenue Costs

OPTION OPTION OPTION OPTION OPTION OPTION A C D E F G £000’s £000’s £000’s £000’s £000’s £000’s Forecast Revenue Costs 3,515 3,515 3,515 3,884 3,884 3,884 Flexed Revenue Costs 3,455 3,438 3,574 3,339 3,445 3,501 Change required (60) (77) 60 (545) (439) (383) Change % ‐1.7% ‐2.2% 1.7% ‐14.0% ‐11.3% ‐9.9%

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1.8 Overall Appraisal Results

1.8.1 Results The economic and non‐financial appraisal results have been combined on an equal weighting basis to identify the preferred option, by taking the non‐financial appraisal scores (benefit points) and dividing them by the overall economic cost (EAC). The overall results are summarised in the table below:

Overall Appraisal Results

OPTION A OPTION C OPTION D OPTION E OPTION F OPTION G A&E Car Workshop Spetchley Rear of Site Adj to Front of Site Park (WRH) (WRH) (WRH) (AH) PGMC (AH) (AH) Weighted Non‐Financial Scores 860 599 538 738 679 457 Ranking 1 4 5 2 3 6 EAC Impact of Option 4,402 4,418 4,349 4,835 4,741 4,690 Economic Ranking 2 3 1 6 5 4 Benefit Points per EAC £m 195.4 135.7 123.8 152.7 143.1 97.3 Combined Ranking 1 4 5 2 3 6 % Difference 0.0% ‐30.6% ‐36.7% ‐21.9% ‐26.8% ‐50.2%

The overall results of the option appraisal show that Option A is clearly preferred on a combined basis, with a Benefit Point per £m EAC some 21.9% higher than the next best option (Option E).

1.8.1.2 Sensitivity Analysis A further sensitivity test has been run to assess by how much the non‐financial score would have to change to switch the overall (combined) preference between the two highest scoring options, as follows:

Sensitivity Analysis – Combined Results

OPTION A OPTION E £000’s £000’s Base Weighted Non‐Financial Scores 860.38 738.30 Weighted Non‐Financial Scores 671.81 945.41 needed to switch rankings Equivalent change in % ‐22% 28% EAC Impact (£000) 4,402.20 4,834.77 Benefit Points per EAC (£000) 152.61 195.54

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This shows that a significant change would be required in the weighted scores of the 2 highest ranked options for there to be a change in the preference for Option A. Such changes are viewed as unrealistic, and therefore the overall preference for Option A can be considered to be robust.

1.9 Conclusions The following conclusions can be drawn from the work undertaken to date:

■ A robust and transparent process has been followed to identify the optimal site upon which to locate a Radiotherapy facility, based on the information available to hand and the assumptions documented in this report, within the timescales of this study;

■ From a non‐financial perspective, Option A is the clearly preferred option, and is robust to changes in the weightings applied to the evaluation criteria;

■ From a financial and economic perspective, the overall economic analysis shows Option D to be the preferred option again over Options A and B, but with marginal differences between these 3 options which are sensitive to relatively small changes in either the capital and revenue costs;

■ Combining the non‐financial and financial and economic results, using an equal weighting, leads to Option A being the overall preferred option over Option E by a margin of 21.9%, with the overall rank order of options mirroring that resulting from the non‐financial evaluation; The Feasibility Study clearly shows that the optimal site for locating a Radiotherapy facility is on the existing A & E car park on the WRH site. The Project Team for the Worcestershire Oncology Project therefore recommends that:

■ Approval be given to preparing a detailed Outline Business Case and seeking planning permission for the development of the new Worcestershire Radiotherapy facility on the existing car park on the WRH site

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2. INTRODUCTION & BACKGROUND

2.1 Introduction In February 2011, the Trust appointed UHCW to be its Strategic Partner for the development of non‐surgical Oncology services for the population of Worcestershire. As part of the formal programme of work that has been established by the Strategic Partnering Board, a Feasibility Study was commissioned to look at the feasibility of developing a Radiotherapy facility on either the WRH site in Worcester or the AH site in Redditch. This report documents the work and results of that study, summarising:

■ The background to the development of Oncology services for Worcestershire;

■ The work undertaken to identify and shortlist potential options for a Radiotherapy facility on either the WRH or AH sites;

■ Details of the long‐ and shortlist of the options;

■ The process undertaken to evaluate the shortlisted options from both a non‐ financial and financial and economic perspective, and the respective results;

■ The overall results of the evaluation, combining both the non‐financial and financial and economic results; and

■ The recommendations put forward by the Radiotherapy Workstream that has overseen this work.

2.2 Background The need for developing non‐surgical Oncology services for Worcestershire arises from the inherent tension between the Trust’s current organisation of cancer services and the increasingly county‐wide nature of site‐specific cancer services and other general services (for example, emergency admissions). This tension gives rise to a range of operational problems which can lead to delays, inadequate communication and potential errors. As a result of the current configuration, patients have to travel further for treatment, making continuity of care more difficult and the quality and resulting outcomes of care potentially poorer. They also place significant pressure on staff caring for patients. To help address these issues, WAHT undertook a formal OJEU procurement to appoint a strategic partner with whom the Trust would develop local non‐surgical Oncology services, and as a result of this exercise, UHCW was selected as the Strategic Partner in February 2011. Since then, a formal programme of work has been established with the fundamental aim to improve the safety, quality and accessibility of cancer services for Worcestershire residents, with potentially positive impacts on other health economies, thus providing a ‘once in a lifetime’ opportunity to provide better cancer services for Worcestershire.

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2.3 Programme of Work to Develop Oncology Services As stated above, a formal programme of work has been established to secure the following benefits:

■ Greater local access to Oncology services, including Chemotherapy and, in due course, Radiotherapy;

■ Reduced risks to patients;

■ Improved patient pathways, including easier communication about patients, better access to information needed to treat patients appropriately and better management of patients with complications;

■ Easier and more robust quality assurance of cancer services;

■ Speedier, more consistent and more robust implementation of national guidance; and

■ Time spent in multiple network meetings to be reduced.

A project structure has been developed to oversee the work to help deliver these, including an overarching Project Team and a number of underpinning workstreams to deliver specific areas of work in relation to:

■ Acute Oncology and Chemotherapy;

■ MDTs and Specialised Surgery/Treatments;

■ Radiotherapy;

■ Service Continuity;

■ Finance; and

■ Engagement & Communications.

This report forms part of work within the remit of the Radiotherapy Workstream, which overall has been tasked with:

■ Identifying a preferred site for the Radiotherapy facility;

■ Developing a clinical, service and activity brief underpinning the requirements for such a facility;

■ Preparing, and securing all necessary approvals for, the Outline Business Case;

■ Identifying the optimum funding solution;

■ Procuring Business Partner(s), as necessary;

■ Preparing, and securing all necessary approvals for, the Full Business Case;

■ Securing planning consent; and

■ Constructing and commissioning the new facility.

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2.4 Programme of Work for the Radiotherapy Feasibility Review The Radiotherapy Workstream was specifically tasked to undertake the following work in relation to the feasibility review:

■ Develop a clinical, service and activity brief for the new facility;

■ Identify all of the available site options;

■ Develop the physical solutions for each option, to the level of detail needed for the preparation of capital cost estimates and timescales;

■ Undertake a non‐financial appraisal of the options;

■ Undertake a financial appraisal of the options, including an affordability assessment; and

■ Undertake an economic and value for money appraisal of the options.

2.4.1 Design & Technical Team To help assist this programme of work, external support was commissioned as follows:

■ Strategic Healthcare Planning LLP ‐ healthcare planning and design;

■ Holbrow Brookes LLP ‐ capital costs; and

■ Provex Consultancy ‐ finance and options appraisal support.

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3. THE REQUIREMENTS FOR A RADIOTHERAPY FACILITY

3.1 Site selection In 2009, prior to this study, the Trust undertook an option appraisal exercise to determine how best to move forward with the provision and location of Oncology services in the future. This exercise in part looked at the options to locate Radiotherapy services on a combination of either one or two sites. (The option to deliver Radiotherapy services from three sites was discounted on the grounds that this would give rise to issues around staffing, breakdowns, cover and governance, and would deliver the lowest proportion of fractions required for the county.) The option appraisal considered three sites for the possible location of Radiotherapy services, namely the WRH in Worcester; AH in Redditch; and an unspecified ‘central Worcestershire’ location (such as Bromsgrove or Droitwich). Following a formal evaluation on the range of options identified, the final report, Oncology Care for Worcestershire – Options Appraisal (April 2009), recommended that the Trust pursues a single‐provider for a single‐site Radiotherapy facility and inpatient Oncology services for Worcestershire, located at either WRH or the AH. It was deemed that either of these options would enable the greatest amount of radiotherapy to be delivered within the county, to reduce travel times (although not as much as a two site service), give the best possible outcomes and experience for patients, make the best use of staffing and equipment and provide a robust and sustainable basis for developing Worcestershire’s cancer services for the future. Given that NHS Worcestershire and the Trust had previously undertaken this robust and transparent evaluation and made a clear decision about the potential sites for Radiotherapy services, it was agreed that this feasibility review would not revisit this issue, and the options underpinning this review would be developed on the basis that Radiotherapy services would be located on either the WRH or AH sites as previously agreed. 3.2 Service Brief The Radiotherapy workstream developed and agreed the requirements for a Radiotherapy facility to underpin the options to be developed. The requirements are summarised in the Clinical Services & Activity brief attached at Appendix A. Information underpinning the brief was sourced from the following documents:

■ Invitation to Tender Document for A Strategic Partner for the Non‐Surgical Oncology Services for Worcestershire (WAHT, 2010), including the following documents contained therein:

o Draft NHS Worcestershire Cancer Strategy, 2009‐13 (NHS Worcestershire, December 2009); o Service Specification (WAHT, November 2010); and o Radiotherapy Needs Assessment (NHS Worcestershire’s Public Health Information Directorate, July 2010); and

■ UHCW’s bid document in response to the above tender (UHCW, January 2011).

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3.3 Linear Accelerators To help quantify the number of linear accelerators that will be required, the Clinical Services & Activity Brief used the disease incidence data in the Draft NHS Worcestershire Cancer Strategy 2009‐2013 as a starting point, and assumed that 95% of the fractions for the adult Worcestershire population will be delivered on the identified site (as assumed in the Trust’s service specification used for the OJEU procurement and referenced above). The modelling assumptions then assumed a mix of the model issued by the National Radiotherapy Advisory Group (NRAG) for Trusts to project future required levels of fractions, and a cancer site specific model developed by UHCW, to identify (a) the number of fractions that will need to be delivered; and (b) the resultant number of linear accelerators that will be required. The results of this analysis are outlined in the table below, indicating that WAHT will need 3 linear accelerators by 2015/16, moving to 4 by 2016/17:

Table 1. Projected Fractions / Linear Accelerator Requirements

2012/13 2013/14 2014/15 2015/16 2016/17 Linear accelerator Capacity Hours/linear accelerator/day 9.2 9.2 9.2 9.2 9.2 Days/year 239 239 239 239 239 Fractions/hour 4.5 4.5 4.5 4.5 4.5 Surplus 13% 13% 13% 13% 13%

Fractions/linear accelerator without the spare capacity 9,895 9,895 9,895 9,895 9,895 recommended by NRAG NRAG Model for Fractions Required Total fractions 27,653 29,345 31,150 32,729 34,308 95% delivered in Worcestershire 26,270 27,878 29,592 31,093 32,593 Reduce total by 3.5% for DXR 25,351 26,902 28,557 30,004 31,452 Linear accelerators required without the spare capacity 2.6 2.7 2.9 3.0 3.2 recommended by NRAG Linear accelerators required with 13% spare capacity 2.9 3.1 3.3 3.4 3.6 recommended by NRAG

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2012/13 2013/14 2014/15 2015/16 2016/17 Proposed Model for Fractions Required based on both the UHCW and NRAG models Hours/linear accelerator/day 8 8 8.5 9 9 Days/year 239 239 239 239 239 Fractions/hour 4.5 4.5 4.25 4.25 4.25 Fractions/linear accelerator 8,604 8,604 8,634 9,142 9,142 without spare capacity Total fractions 18,054 24,175 25,182 26,790 28,398 95% delivered in Worcestershire 17,151 22,966 23,923 25,451 26,978 Reduce total by 3.5% for DXR 16,551 22,162 23,086 24,560 26,034 Linear accelerators required without spare capacity 1.9 2.6 2.7 2.7 2.8 recommended by NRAG Linear accelerators required with 13% spare capacity 2.2 2.9 3.0 3.0 3.2 recommended by NRAG

3.4 Overall Facility Requirements In addition to the modelling work outlined above, the following requirements have been determined for a Radiotherapy service to be delivered from a single site for the population of Worcestershire:

■ Five linear accelerator bunkers;

■ Three dual energy linear accelerators equipped for arc therapy and cone‐beam CTs for IGRT;

■ All linear accelerators to be capable of delivering both photons and electrons, and equipped with portal image devices;

■ One CT together with virtual simulation software;

■ Comprehensive support facilities, including a mould room, dedicated treatment planning facilities and simulation suite; and

■ ‘Undeveloped space’ to facilitate the provision of an appropriately positioned additional simulation suite which will be required when 4 linear accelerators are operational.

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3.5 Schedule of Accommodation The above requirements have been translated into a schedule of accommodation totalling a gross internal area of 3,215m2. The schedule is appended to the Clinical Services & Activity Brief at Appendix A. Each of the options includes an allowance for 37 car parking spaces for the new facility. It should be noted that whilst the Schedule of Accommodation includes space for 2 CT scanners, the capital costs have only accounted for 1 CT scanner to be provided. The Schedule also outlines expansion space requirements for a Brachytherapy Suite as a potential future development for information purposes only, but neither the floor area nor costs for this are accounted for as part of this study.

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4. IDENTIFYING THE LONGLIST OF OPTIONS Having agreed the general requirements and size of the required facility, representatives from the Design & Technical Team, commissioned to support the feasibility review, reviewed both the WRH and AH sites, and identified a long list of 7 potentially feasible options for a new build. Four were identified on the WRH site, and a further 3 on the AH site as follows:

■ Option A – On the A&E car park at WRH;

■ Option B – On the Aconbury East building at WRH;

■ Option C – On the workshops at WRH;

■ Option D – On the Spetchley Land adjacent to WRH;

■ Option E – Rear of the AH site;

■ Option F – On the bank adjacent to the PGMC at AH; and

■ Option G – Front of the AH site.

Whilst other options would be possible, the implications in terms of disruption, timescale and deliverability were such that they were not viewed as viable. Upon further consideration, the Radiotherapy Workstream discounted Option B (on the Aconbury East building at WRH) on the grounds ttha the site constraints would result in a design that would be deep and long, and thus not optimal in terms of shape and available daylight. Additionally, the location meant that this would be the most disruptive solution from the long list in terms of impact on existing operations. On this basis, the remaining 6 options were further developed as described in Section 5.

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5. SHORTLISTED OPTIONS

5.1 Building Design The Design Team developed a design for a Radiotherapy facility that can deliver the agreed requirements, to give an indication of the overall size and shape of the facility required. The developed design provides all of the clinical accommodation that necessitates a patient interface at the ground floor, with staff and support facilities located on a first floor. However, due to the site constraints around Option C (to be located on the site currently occupied by the workshops at WRH), an alternative design was developed for this option only, which placed some of the clinical accommodation on the first floor (i.e. the Mould Room, Radiotherapy Physics and workshops) alongside the staff support facilities. The two designs are illustrated below:

Figure 1. Radiotherapy Facility Schematic – Options A, D, E, F & G

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Figure 2. Radiotherapy Facility Schematic – Option C

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5.2 Location of Options on WRH and AH Sites The physical location of the different options on each of the identified sites is illustrated below:

Figure 3. Site Options – Worcestershire Royal Hospital Site

Figure 4. Site Options – Alexandra Hospital

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5.3 The Options

5.3.1 Option A – A&E Car Park (WRH) As stated previously, this option proposes to locate the new Radiotherapy Centre on the existing A&E Car Park at the Worcester Royal Hospital as illustrated below:

Figure 5. Option A – A&E Car Park (WRH)

The ground floor of the new building will be linked to level 2 of the existing hospital, thus providing a clinical relationship between the new facility and the existing Oncology Outpatient Unit and the Specialist Radiology Department. There is an existing adjacent ward that the Trust may wish to consider re‐ locating in the future, to allow the development of an Integrated Cancer facility with inpatient beds. The building occupies the majority of the available site therefore the ability to extend outwards in the future is limited, although there may be potential to extend upwards. The proposed vehicular entrance and patient dropf ‐of is achieved through the retention of the existing car‐park entrance with a new exit point on to the adjacent mini‐island. There will be the provision of a disabled car‐parking zone in this area with the majority of car parking provided elsewhere. A separate service entrance will be provided to the rear of the facility. In order to make the site available for construction, it will be necessary to re‐provide the existing car parking that is displaced by the development. It is proposed to achieve this by the acquisition of adjacent land currently owned by the Berkeley and Spetchley Estate. Access for construction traffic will need to be via the hospital roadway system. It is proposed that the constructional techniques incorporated in the building will be such that off‐site fabrication is maximised to minimise the time in which disruption could occur.

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It is estimated that the timescales for construction and commissioning of the building and equipment are 22 months. This is made up of 4 months for enabling works to build the car park required to replace the displaced A&E car park, a 15 month construction period as with all options, and a 3 month period for commissioning of the facility, again as with all options. It has also been assumed that commissioning of the equipment under each of the options can commence prior to the end of the construction period.

5.3.2 Option C – The Workshops (WRH) The option illustrated below proposes to locate the new facility on the site currently occupied by the workshops and crèche:

Figure 6. Option C – The Workshops (WRH)

As stated previously, due to the restricted nature of the location, the facility accommodates the majority of the clinical accommodation on one floor level with the balance being provided at an upper level together with staff and support facilities. It is not possible to realistically link this new building with the existing hospital, therefore any transfers or inpatient activity will need to be undertaken by ambulance. The facility occupies all of the site, therefore the ability to extend in response to future needs is limited without the removal of other existing buildings for example, the mortuary. Access for ambulance services will be via the hospital road adjacent to A&E with visitors approaching from the opposite end of the site. This option enables a separate service entrance to be provided to the rear of the building. Discrete car parking areas can be provided for visitors and staff with a disabled parking zone adjacent to the main entrance. This option requires enabling works to be carried out to create the space required for the new building i.e. the re‐provision of a crèche and the Catalyst Lend Lease offices and

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workshops. It is proposed that these be accommodated in the ground floor of Aconbury East when space has been created following the redistribution of functions to currently vacant space within the building. The proposed site can be accessed for construction traffic from the Newtown Road and therefore not cause disruption to the main hospital. The total construction and commissioning period for this facility is 25 months, as it requires 7 months for the enabling works, and as with all the other options, 15 months for construction and 3 months for commissioning of the facility.

5.3.3 Option D – Spetchley Land (WRH) This option proposes to build the new facility on adjacent land currently in the ownership of the Berkeley and Spetchley Estate, as illustrated below:

Figure 7. Option D – Spetchley Land (WRH)

The proposed site is separate from the main hospital. Since this option is based on new land to be acquired, the Trust has the opportunity of purchasing sufficient land to enable the building to be extended to respond to future service growth or change. Access to the site is expected to be from the main highway and not from the main hospital site. It is anticipated that this will be provided by the developer of the overall Spetchley Estate land as part of the land acquisition. As the new building is separate from the main hospital any patient transfers will need to be by ambulance. Access to the existing hospital site will be provided through the existing staff car park. Access to the site for the builder will be from the main highway and therefore construction traffic will not disrupt the activities of the main hospital.

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The total timescales for construction and commissioning are estimated to be 18 months (15 for construction, 3 for commissioning) as no enabling works are required.

5.3.4 Option E – Rear of Site (AH) This option proposes to build the new Radiotherapy Centre on land recently acquired at the rear of the site as illustrated below:

Figure 8. Option E – Rear of Site (AH)

Due to the ground levels and the slope of the site, the first floor of the new building will be at the same level as the ground floor of the existing hospital. A link corridor will therefore provide the necessary clinical access to associate functions for example outpatients, radiology and inpatients. There is sufficient available land to enable the building to be extended in response to service change. Similarly the link to the exiting hospital provides opportunities in that facility. Access to the facility for vehicles will be via the existing hospital roadway that is scheduled to be extended to service the proposed site. Access will also be provided via the existing hospital main entrance. Access for construction traffic will need to be via the hospital roadway system. It is proposed however, that the constructional techniques incorporated in the building be such that off‐site fabrication is maximised to minimise the time in which disruption could occur. Access being provided via the main entrance will require the existing Rehabilitation services to be displaced.

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Timescales for the enabling works, construction and commissioning are 18 months (15 for enabling and construction work which can be undertaken in parallel, and 3 months for commissioning).

5.3.5 Option F – Adjacent to PGMC (AH) This option locates the new facility on the top of the bank adjacent to the PGMC as illustrated below:

Figure 9. Option F – Adjacent to PGMC (AH)

Due to the ground levels and the slope of the site, the ground floor of the new building will be at the same level as the first floor of the existing hospital. A link corridor will therefore provide the necessary clinical access to associated functions, for example Radiology, outpatients, inpatients. There is sufficient available land to enable the building to be extended in response to service change. Similarly, the link to the exiting hospital provides opportunities in that facility. Access to the facility is twofold, the first being from the existing hospital roadway system with the second from the highway to thet eas of the site via the current emergency point. This location provides no known restrictions that will adversely impact on the buildability of the project. The emergency access can provide an entry point for construction traffic away from the main hospital activity. Construction and commissioning timescales are 18 months (15 rfo construction and 3 for commissioning).

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5.3.6 Option G – Front of Site (AH) This option locates the new facility on the currently vacant land adjacent to the site entrance as illustrated below:

Figure 10. Front of Site (AH)

The proposed site is separate from the main hospital. Once the new facility has been built, there will be some surplus land available to respond to a degree of service growth. Access to the facility will be from the existing hospital roadway system. As the new building is separate from the main hospital, any patient transfers will need to be by ambulance. Access to the site for the builder will be from the main hospital roadway and therefore construction traffic may cause some disruption to the activities of the main hospital. Construction and commissioning timescales are estimated to be 18 months (15r fo construction and 3 for commissioning).

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6. NON FINANCIAL EVALUATION A non financial evaluation of the shortlisted options was undertaken using a systematic and sequential process that covered:

■ Stage 1 : Selection of the criteria to be used to appraise the options;

■ Stage 2 : Weighting of criteria to reflect their relative importance;

■ Stage 3 : Consideration of the options and scoring against the agreed criteria;

■ Stage 4 : Analysis of the results and sensitivity testing to establish the robustness of the conclusions. The evaluation criteria were agreed by the Strategic Partnering Board, as discussed in Section 6.1. An Evaluation Panel was established to undertake stages 2 and 3 as outlined above. The Strategic Partnering Board agreed the membership of the Evaluation Panel, ensuring there was a balanced representation across not only stakeholder groups (i.e. service users, providers and commissioners) but also from across the county. Details of the Evaluation Panel’s membership can be found at Appendix B.

6.1 Selecting the Evaluation Criteria The Strategic Partnering Board agreed that the evaluation criteria to be used would be based on those recommended by the Department of Health and commonly used in option appraisals, but adapted for local use by patients and clinicians as part of the evaluation of tenders during WAHT’s procurement exercise for a Strategic Partner. Thus, the evaluation criteria used were as follows:

Table 2. Non Financial Evaluation Criteria

1. Improved clinical quality of services in line with meeting national, regional and local policy imperatives:

■ Providing the best opportunity to enhance the quality of clinical services and teaching;

■ Providing better health outcomes for patients;

■ Facilitating modernisation, improvement and innovation in clinical practice and teaching;

■ Enabling new methods of providing clinical care and undertaking teaching;

■ Facilitating better configuration of services extending to the local health economy;

■ Addressing existing clinical problems;

■ Promoting new models for delivering services;

■ Promoting other national teaching and health priorities;

■ Flexibility to cope with future changes in service models / patterns;

■ Enabling better integration of services including with social and voluntary care; and

■ Delivering NHS Plan requirements, including waiting times.

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2. Better access to services:

■ Increasing the provision of care close to people’s homes;

■ Travelling time by public and private transport for both patients and staff;

■ Availability of car parking / accessibility of public transport;

■ Equality of access (different catchments, ethnic and socioeconomic groups);

■ Greater responsiveness and choice in the delivery of patients’ health needs; and

■ Minimising the environmental impact of the solution. 3. Development of existing services and/or provision of new services:

■ Developing or providing services required by commissioners of clinical services;

■ Contributing to an increase in the quantity of clinical services available; and

■ Ensuring the widest availability of services locally. 4. Improved strategic fit of services:

■ Meeting strategic needs of the locality and region for clinical services;

■ Contributing to the social and economic regeneration of the local area;

■ Improving the quality of service relationships and departmental links;

■ Realising benefits of inter‐dependence with other services;

■ Promoting opportunities for collaboration and the development of partnerships with other local facilities and businesses in the delivery of services; and

■ Providing flexibility to cope with changes in demand and changes in the delivery of services. 5. Meeting training, teaching and resource needs:

■ Making it easier to recruit staff;

■ Making it easier to retain staff;

■ Enabling the development of a clear “skills escalator” to engage all staff;

■ Meeting or protecting accreditation standards;

■ Improving productivity;

■ Providing social and cultural facilities and environments for staff. 6. Making more effective use of resource:

■ Making better use of cash, human and estate resources;

■ Meeting service needs within available resources;

■ Providing opportunities for generating income, including from research funding and private practice;

■ Encouraging the development of partnerships that facilitate the development of local businesses;

■ Providing opportunities for transferring risk on a cost‐effective basis; and

■ Providing better value for money overall for the public sector. 7. Ease of delivery:

■ Practicality of delivery of physical proposals;

■ Practicality of delivery of service proposals;

■ Timescale for implementation;

■ Impact on other local Projects;

■ Acceptability to staff;

■ Planning implications.

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6.2 Weighting of the Options The Non Financial Evaluation Panel were invited to a workshop held on Friday 6th May, to both weight the evaluation criteria, and to consider and score the options from a non‐ financial perspective. Members of the Panel were initially asked to rank the evaluation criteria in order of importance, and to then assign scores to each criterion to determine the relative difference between them. On this basis, the following weightings were agreed:

Table 3. Criteria Weighting

6.3 Scoring the Options Having weighted the criteria, members of the Evaluation Panel were asked to consider the options as presented to them, and to score them accordingly. To help do this, a number of documents were made available to the Panel both in advance of the workshop and on the day. These included:

■ A briefing paper issued in advance of the workshop that included details of the evaluation criteria to be used;

■ A copy of the presentation slides that were developed for the workshop and sent out in advance, detailing the process to be followed that day and more detailed information about the options, based on the information outlined in Section 5.3 of this report;

■ Additional information was tabled on the day, to provide more detail relating to the options, including travel analyses showing the estimated impact on patient journey times if they were to travel to WRH or AH for their treatment, and information on accessing both sites by bus, road and train. This additional information can be found at Appendix C.

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Having considered the information listed above, members of the Panel were asked to individually score each of the options against each of the 7 agreed criteria using a 10‐point scoring system (10 being the highest possible score and, 1 being the lowest). In addition to this, they were also asked to score a “Do Nothing” option, which although not being formally considered as a feasible option provided a baseline from which to measure the difference between the Trust not doing anything and each of the options being considered. 6.4 Results of the Non Financial Evaluation Having combined the individual Panel member’s scores, the total weighted scores and results of the non‐financial evaluation exercise were as follows:

Table 4. Non Financial Evaluation ‐ Weighed Scores and Results

Weighted Scores Do Option A Option C Option D Option E Option F Option G Criteria Nothing A&E Car Workshop Spetchley Back of Adj to Front of Park (WRH) (WRH) Site (AH) PGMC Site (AH) (WRH) (AH)

Improved clinical quality 1.23 2.47 1.48 1.24 2.19 1.93 1.13

Better access to services 0.54 2.35 1.86 1.61 1.77 1.74 1.24

Ease of delivery 0.15 0.18 0.13 0.18 0.20 0.25 0.15

Total Score 3.31 8.60 5.99 5.38 7.38 6.79 4.57

Rank 7 1 4 5 2 3 6

% Difference 61.56% 0.00% 30.35% 37.43% 14.19% 21.14% 46.93%

The results showed a clear preference for Option A (A&E Car Park at WRH) over the second preferred option, Option E (Back of Site at AH) by a margin of 14%. Option F (Adjacent to PGMC at AH) is the third preferred choice by a further margin of 7%, with options C (Workshops at WRH), D (Spetchley Land at WRH), G (Front of Site at AH) and Do Nothing scoring significantly less.

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Analysis of the scores by all stakeholder groups represented on the Evaluation Panel identified a clear preference for Option A over the other options. The overall order of rank for provider representatives matched that of the overall rankings. User representatives however showed a reversed preference for third and fourth choices (preferring Option C over Option F), and commissioners a reversal in preference for second and third choices (preferring Option F over Option E), as illustrated below:

Table 5. Non Financial Evaluation Results – By Stakeholder Group

6.4.1 Sensitivity Analyses A series of sensitivity analyses were undertaken to assess what, if any, impact there would be in the event that:

■ All criteria were given an equal weighting;

■ The criterion “ease of delivery” was given a higher weight; and

■ The criterion “effective use of resources” was given a higher weight.

None of these alternative weightings would change the ranking of the options, nor the broad differentials between the options, showing that the results are robust to changes in weighting. The detailed results from the non financial evaluation can be found at Appendix D.

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7. FINANCIAL APPRAISAL

7.1 Capital Costs An assessment has been made of the likely order of capital cost for each option, based on the information currently available. The resultant capital costs (at MIPS approval level 480, excluding land) for each of the options are summarised below:

Table 6. Capital Costs

The capital cost estimates have been calculated using standard NHS Estates costing guidelines, and make allowances as follows:

■ Option A makes allowances for for the costs of re‐providing the current A&E car park;

■ Option C makes cost allowances for displacing the existing workshops and crèche into the ground floor of Aconbury East, and relocating office accommodation from the ground floor of Aconbury East into an upper floor;

■ The land required in Option D (the only option falling outside the Trust’s physical boundaries) would be purchased as a fully serviced site; and

■ Option F makes an allowance for temporary office space for relocating Rehabilitation into former offices and to refurbish existing rehabilitation space for offices. In addition to the above capital costs, land acquisition will be required for Option A (0.51 hectares to provide the displaced car parking) and Option D (0.69 hectares rfo the proposed development). In both cases the land would be acquired from the Berkeley & Spetchley Estate, and an indicative value of £1m per hectare has been assumed for the purposes of the Feasibility Study. Full details relating to the capital costs (excluding land purchase costs) can be found at Appendix E. The costs of purchasing the land in line with the above assumptions are however included in the financial and economic model.

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7.2 Lifecycle Costs The costs of maintaining the assets during the anticipated 60‐year operational life of the facility have been assessed in conjunction with professional advisers for inclusion within the economic analysis, based on standard asset lives as follows:

■ All figures are at 2011/12 cost levels, exclusive of VAT and no assessment has been made of the impact of future inflation on cost levels;

■ The lifecycle cost driver for each option is based on the value of the initial new works, fees and contingencies, excluding VAT;

■ The assessment is based on standard building component lives expressed as a proportion of initial building and engineering costs, based on the profile shown in Table 7 below;

■ For each option cyclical “refurbishment” is assumed to be some 8.5% more expensive than the initial capital costs, as a result of the need to decant and the higher on‐costs attributable to refurbishment work;

■ In addition, an allowance has been included for annual spends on irregular maintenance based on an average cost of £5 per m²;

■ 60% of new build costs relate to building fabric, with the remaining 40% relating to engineering plant.

Table 7: Building and Engineering Asset Component Lives

Component Building Engineering Replacement Cycle % % (Years) 60 Years 75% 38% 30 Years 1% 20% 25 Years 1% 15% 20 Years 15% 13% 15 Years 2% 7% 10 Years 5% 7% 5 Years 1% 0% Total 100% 100%

For all equipment, a 10‐year replacement cycle has been incorporated into the economic analysis for all options.

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7.3 Revenue Costs Estimates of the costs of each option have been developed using the following methodology:

■ The costs of delivering the clinical services are based on the assessments made by UHCW in its Startegic Partner bid submission, and are viewed to be the same for each option;

■ FM costs are based on benchmark figures per m² of floor area, from analysis of other recent developments;

■ Capital charges calculated on the basis of a 38‐year average asset life for Works elements (and 100% of spend adding to value) and a 10‐year life for equipment, with a 3.5% rate of return on capital. As the flows of patients are likely to be different dependent upon the site chosen, it has also been necessary to consider the impact this would have on the overall costs (and to ensure that the same volume of activity is included within the economic analysis in line with HM Treasury guidance). In order to assess this, the following approach has been followed:

■ The population projections for 2015 for each of the 6 districts within Worcestershire have been weighted to reflect the incidence of cancer in the different age groups;

■ The overall volume of 30,000 fractions to be delivered has then been apportioned to the weighted population of each district;

■ Travel times by car from each district to both the existing treatment centres and the two hospital sites have been calculated:

o Where travel times by car to the new centres is below 30 minutes, it is assumed that all of the forecast workload will be undertaken in the new centre; o Where travel time by car to the new centres is between 30 and 45 minutes, it is assumed that only 75% of the forecast workload will be undertaken in the new centre; o Where travel time by car to the new centres is above 45 minutes, it is assumed that only 50% of the forecast workload will be undertaken in the new centre.

■ The resulting continuing "out of county" activity has been costed at a rate of £165 per fraction (based on national average NHS reference costs).

Details of the calculations of patient flows and travel times are included in Appendix F. It is acknowledged that this approach will require further more detailed analysis at the OBC stage of the project. Having said this, it does ensure that a "like for like" comparison is made between the options, and it is considered sufficiently robust for the Feasibility Study.

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The overall results of the revenue cost assessment are set out in Appendix G and are summarised below:

Table 8. Revenue Cost Analysis

OPTION A OPTION C OPTION D OPTION E OPTION F OPTION G £000’s £000’s £000’s £000’s £000’s £000’s Clinical Costs 2,082 2,082 2,082 2,082 2,082 2,082 Support Costs 443 443 443 443 443 443 FM and Overheads 519 519 519 519 519 519 Other Costs (Out of County) 471 471 471 840 840 840 Capital Charges 1,967 1,998 1,916 2,144 1,982 1,903 Net Forecast Revenue Costs 5,481 5,512 5,430 6,028 5,866 5,787 Difference from Option 51 82 0 598 436 357 Ranked 1st Revenue Ranking 2 3 1 6 5 4

7.4 Economic Appraisal

7.4.1 Methodology The shortlisted options have been fully evaluated in line with the requirements of Department of Health Business Case Guidance and the HM Treasury Green Book to assess the overall costs of each option over the life of the project and to identify which option therefore represents the best overall value for .money The economic analysis thus:

■ Covers an appraisal period of 63 years (including 2011/12 as Year 0), ensuring that a full 60 year period of operations from a start of operations in 2014/15 is reflected;

■ Uses a discount rate of 3.5% for the years 0 to 30;

■ Uses a discount rate of 3.0% for the remaining period;

■ Excludes VAT from all cash flows;

■ Reflects capital cash flows at a “current” price base, including Optimism Bias but excluding contingencies;

■ Includes lifecycle costs based on the profile and methodology outlined in section 7.2 above;

■ Includes revenue costs as outlined in section 7.3 above;

■ For those options which utilise land already owned by the Trust (i.e. all except Option D), an opportunity cost is included in respect of the use of the existing site;

■ Does not include a quantitative analysis of the potential impact of risk.

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All of these cost inputs have been modelled to establish, for each option:

■ The Net Present Cost (NPC) of the discounted annual cash flows over the whole appraisal period;

■ The Equivalent Annual Cost (EAC), being an annualised equivalent of the NPC.

7.4.2 Results The summary of the economic analysis is summarised in the table below, which shows the Net Present Cost and Equivalent Annual Costs for each option.

Table 9. Economic Analysis Results

OPTION A OPTION C OPTION D OPTION E OPTION F OPTION G £000’s £000’s £000’s £000’s £000’s £000’s NPC 117,346 117,757 115,931 128,876 126,368 125,024 EAC 4,402 4,418 4,349 4,835 4,741 4,690 Economic Ranking 2 3 1 6 5 4 Marginal Impact Over Option Ranked 1st 53 69 0 486 392 341 Difference (%) 1.2% 1.6% 0.0% 11.2% 9.0% 7.8%

7.4.3 Sensitivity Analysis The results of the economic appraisal have been subjected to a sensitivity analysis to assess the extent of change in cost estimates required to change the overall results of the appraisal, both in terms of capital and revenue costs. This has shown that the marginal preference for Option D over Options A and C may change with relatively small changes in the capital and revenue costs, as set out below:

Table 10. Sensitivity Analysis – Capital Costs

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Table 11. Sensitivity Analysis – Revenue Costs

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8. OVERALL APPRAISAL RESULTS

8.1 Results The economic and non‐financial appraisal results have been combined on an equal weighting basis to identify the preferred option, by taking the non‐financial appraisal scores (benefit points) and dividing them by the overall economic cost (EAC). The overall results are summarised in the table below:

Table 12. Overall Appraisal Results

OPTION A OPTION C OPTION D OPTION E OPTION F OPTION G Weighted Non‐Financial Scores 860 599 538 738 679 457 Ranking 1 4 5 2 3 6 EAC Impact of Option 4,402 4,418 4,349 4,835 4,741 4,690 Economic Ranking 2 3 1 6 5 4 Benefit Points per EAC £m 195.4 135.7 123.8 152.7 143.1 97.3 Combined Ranking 1 4 5 2 3 6 % Difference 0.0% ‐30.6% ‐36.7% ‐21.9% ‐26.8% ‐50.2%

The overall results of the option appraisal show that Option A is clearly preferred on a combined basis, with a Benefit Point per £m EAC some 21.9% higher than the next best option (Option E).

8.1.1 Sensitivity Analysis A further sensitivity test has been run to assess by how much the non‐financial score would have to change to switch the overall (combined) preference between the two highest scoring options, as follows:

Table 13. Sensitivity Analysis – Combined Results

OPTION A OPTION E £000’s £000’s Base Weighted Non‐Financial Scores 860.38 738.30 Weighted Non‐Financial Scores needed to switch rankings 671.81 945.41 Equivalent change in % ‐22% 28% EAC Impact (£000) 4,402.20 4,834.77 Benefit Points per EAC (£000) 152.61 195.54

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9. CONCLUSIONS The following conclusions can be drawn from the work undertaken to date:

■ From a non‐financial perspective, Option A is the clearly preferred option, and is robust to changes in the weightings applied to the evaluation criteria;

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APPENDIX A CLINICAL SERVICES & ACTIVITY BRIEF

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Worcester Oncology Project Radiotherapy

Clinical Activity & Service Brief

Version 1.2 (Final) Date 20th April 2011

55 Worcester Oncology Project Service & Activity Brief

Table of Contents

1. Introduction & Background ...... 1 1.1 Introduction ...... 1 1.2 Worcestershire Population ...... 1 1.3 Cancer Incidence ...... 1 1.4 Radiotherapy Fractions ...... 2 2. Projected Activity Levels ...... 4 3. Services & Facility Requirements ...... 5 4. Schedule of Accommodation ...... 6 Appendix A – Schedule of Accommodation ...... 7

Table of Tables

Table 1 Actual Number of Fractions for Worcestershire Patients (April 2008‐March 2009) ..... 3 Table 2 Projected Fractions / Linear Accelerator Requirements ...... 4

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1. Introduction & Background

1.1 Introduction This document provides a statement of the services and clinical activity to be delivered at the proposed new Radiotherapy facility for the Worcester Acute Hospitals NHS Trust (WAHT). The new facility is being proposed as part of the Trust’s plans to develop non‐surgical Oncology Services with its newly appointed Strategic Partner, University Hospitals Coventry and Warwickshire NHS Trust (UHCW). This brief has been developed using information sourced from the following documents: • Invitation to Tender Document for A Strategic Partner for the Non‐Surgical Oncology Services for Worcestershire (WAHT, 2010), including the following documents contained therein: • Radiotherapy Needs Assessment (NHS Worcestershire’s Public Health Information Directorate, July 2010); • Draft NHS Worcestershire Cancer Strategy, 2009‐13 (December 2009); and • Bid document in response to the above tender document (UHCW, January 2011).

Currently, all Worcestershire patients requiring radiotherapy travel out of county for treatment to: UHCW; Royal Wolverhampton Hospitals NHS Trust: and to Gloucestershire Hospitals NHS Foundation Trust. The proposed new facility is expected to have the appropriate linear accelerator capacity to meet the needs of the Worcestershire population at either the Worcester Royal Hospital and/or the Alexandra Hospital site.

1.2 Worcestershire Population The PCT’s registered population in 2009 was 574,600, approximately 18,000 more than the estimated resident population. The most recent population projections suggest that the resident population will increase from 557,000 in 2009 to 571,000 in 2016 (an increase of +2.6%), and by a further +7% to 596,000 by 2026. The number of people aged 60 and above (ie the biggest users of Radiotherapy) is expected to increase by 37% between 2009 and 2026, an increase of 200,000 people in that age group. The proportion of the population aged at least 60 will remain above the national average for England.

1.3 Cancer Incidence Although overall levels of cancer incidence is below the England level, the age‐standardised rate of cancer incidence in Worcestershire is rising faster than the rate in England. Although incidence rates are highest in the most deprived areas of Worcestershire, highest actual numbers of new cases reflect population size and the age profile of the overall district. The increasing standardised incidence rates, alongside the above average proportions of older people, will have an impact on the level of Radiotherapy provision required for Worcestershire.

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NHS Worcestershire’s Radiotherapy Needs Assessment, outlines the following key points in relation to cancer in Worcestershire: • There is currently no statistically significant difference in the incidence of all cancers for Worcestershire when compared to the national average. This may change however, if projected population increases occur; • The rate of increase in the incidence in Worcestershire is now higher, having previously been lower for 13 out of 14 years between 1993 and 2006; • The rate of increase in the incidence for breast, prostate and skin cancers (excluding malignant melanoma) is significantly higher in Worcestershire than it is nationally; • Standardised mortality is significantly lower in Worcestershire than it is nationally, and has been falling for 15 years (though with a lower rate of decline than the national rate); • There is a significantly higher incidence of breast cancer (which may reflect early diagnosis and the breast screening programme), but mortality is similar to the national average; • Lung, stomach and skin cancers (excluding malignant melanoma) have a significantly lower mortality in Worcestershire than nationally, and the 5 year survival rates for lung, colorectal, cervical, prostate and breast cancer are all significantly higher than the national rates.

1.4 Radiotherapy Fractions The number of Radiotherapy fractions delivered to Worcestershire patients was approximately 18,300 in the year upto April 2009, equating to around 32,000 fractions per million population. This figure is lower than for the main three cancer networks that serve Worcestershire (Three Counties, Arden and Greater Midlands), but similar to the 2007/08 England average. The National Radiotherapy Group (NRAG) has developed a model to provide PCTs with the number of fractions each PCT should deliver to satisfy their recommendations for increased Radiotherapy (Radiotherapy: developing a world class service for England, February 2007). It is understood however that the model is being revised to provide further flexibility, but is not expected to be published until Autumn 2011 at the earliest.

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1.4.1 Radiotherapy Fractions Delivered (April 2008‐March 2009) The number of fractions delivered to Radiotherapy patients by other acute Trusts between April 2008 – March 2009 is outlined below, where data was provided: Table 1 Actual Number of Fractions for Worcestershire Patients (April 2008‐March 2009)

University Hospitals Royal Gloucestershire Coventry and Wolverhampton University Hospitals NHS Warwickshire Hospitals NHS Hospital, Foundation Trust NHS Trust Trust Birmingham Total Breast 2,948 1,937 1,074 5,959 Prostate 2,443 540 625 3,608 Head & Neck 1,113 25 55 1,193 Colorectal 533 212 225 970 Gynaecological 493 247 195 935 Lung 451 240 162 853 Upper Gastrointestinal 310 55 37 402 No data Bladder 194 95 43 332 submitted CNS 75 160 34 269 Lymphoma 67 140 58 265 Anal 48 54 0 102 Sarcomas 33 ‐0 33 Testicular 30 ‐0 30 Other 1,057 97 170 1,324 Total 9,795 3,802 2,678 16,275 The total shown above equates to approximately 29,000 fractions per million population; if it is assumed that UHB delivered 2,000 fractions (based on WAHT’s Oncology Care for Worcestershire, Option Appraisal, September 2009 figures), then this figure rises to 32,000, which is below average for the three Cancer Networks that serve Worcestershire, but in line with the England average for 2007/08.

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2. Projected Activity Levels

The projected levels of required fractions uses the disease incidence data outlined in the Draft NHS Worcestershire Cancer Strategy 2009‐2013 as a starting point, and uses figures for 95% of fractions for the adult Worcestershire population being delivered in Worcestershire. The provision of Head and Neck services are predicated on the assumption that specialist Oncology support will be provided in county, to support IOG compliance. The external beam element of the treatment of gynaecological tumours could be carried out in Worcestershire but that the brachytherapy component would need to be carried out in Coventry. As a result of the well publicised concerns over the NRAG projections for the number of radiotherapy fractions required, we have used a mix of both the NRAG model and the cancer site specific model developed by UHCW to calculate the numbers of radiotherapy fractions required, and therefore the number of linear accelerations required. The results of this analysis are outlined in table 2. For comparison both the number of fractions predicted by NRAG and the number of fractions predicted by the combined use of the UHCW and NRAG models are shown. Table 2. Projected Fractions / Linear Accelerator Requirements

2012/13 2013/14 2014/15 2015/16 2016/17 Linac Capacity Hours/linac/day 9.2 9.2 9.2 9.2 9.2 Days/year 239 239 239 239 239 Fractions/hour 4.5 4.5 4.5 4.5 4.5 Surplus 13% 13% 13% 13% 13%

Fractions/linac without the spare 9,895 9,895 9,895 9,895 9,895 capacity recommended by NRAG

NRAG Model for Fractions Required Total fractions 27,653 29,345 31,150 32,729 34,308 95% delivered in Worcestershire 26,270 27,878 29,592 31,093 32,593 Reduce total by 3.5% for DXR 25,351 26,902 28,557 30,004 31,452 Linacs required without the spare 2.6 2.7 2.9 3.0 3.2 capacity recommended by NRAG Linacs required with 13% spare 2.9 3.1 3.3 3.4 3.6 capacity recommended by NRAG

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2012/13 2013/14 2014/15 2015/16 2016/17 Proposed Model for Fractions Required based on both the UHCW and NRAG models Hours/linac/day 8 8 8.5 9 9 Days/year 239 239 239 239 239 Fractions/hour 4.5 4.5 4.25 4.25 4.25 Fractions/linac without spare capacity 8,604 8,604 8,634 9,142 9,142 Total fractions 18,054 24,175 25,182 26,790 28,398 95% delivered in Worcestershire 17,151 22,966 23,923 25,451 26,978 Reduce total by 3.5% for DXR 16,551 22,162 23,086 24,560 26,034 Linacs required without spare capacity 1.9 2.6 2.7 2.7 2.8 recommended by NRAG Linacs required with 13% spare 2.2 2.9 3.0 3.0 3.2 capacity recommended by NRAG

3. Services & Facility Requirements

The facility will deliver Radiotherapy treatment services to adult WAHT patients (ie those patients whose cancer pathway starts in WAHT and where WAHT has the main responsibility for coordinating care). Based on the analyses in table 2, the fully commissioned facility should include: • Five linac bunkers; • Three dual energy linacs equipped for arc therapy and have cone‐beam CTs for IGRT; • All linacs to be capable of delivering both photons and electrons, and equipped with portal image devices; • One CT together with virtual simulation software; • A DXR treatment machine in a linac bunker for the treatment of surface tumours (maximum energy 300kV) which will optimise use of the linac facilities; • Housing the DXR in a linac bunker simplifies the provision of an additional Linac when this is required; • Comprehensive support facilities, including a mould room, dedicated treatment planning facilities and simulation suite; • ‘Undeveloped space’ to facilitate the provision of an appropriately positioned additional simulation suite which will be required when 4 linacs are operational.

The provision of an DXR for surface treatments is in response to the projected high incidence of skin cancers. The level of radiation protection and design of the room is much simpler than that required for a linac.

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61 Worcester Oncology Project Service & Activity Brief

The provision of 5 bunkers at the outset will allow economies of scale during the design and build phase of the project and ensure that the all the linear accelerators are positioned for an optimal patient pathway. When a 5th bunker is required, a new facility to house the DXR can be constructed with minimal disruption to the Department. It is proposed that the site of this DXR facility be indentified in the initial design for the facility. In planning this facility, the following need to be taken into consideration: • Patients will have easy access to phlebotomy, pharmacy and other support within the main acute hospital; • Lasers will be fitted to the acute hospital’s CT to provide planning in the event of a fault on the proposed facilities CT; and • Having the Chemotherapy facility co‐located with the Radiotherapy facility would lead to better coordination of treatment regimes involving both Chemotherapy and Radiotherapy and the best utilisation of staff resources.

4. Schedule of Accommodation

A schedule of accommodation has been produced in line with the planning assumptions made in this document, and can be found at Appendix A.

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Appendix A – Schedule of Accommodation

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63 WAHT & UCHW ONCOLOGY PROJECT SCHEDULE OF ACCOMMODATION - Radiotherapy Centre Version 5: 22nd March 2011

Activity Space Size No NIA

PUBLIC SPACES Main Entrance Reception: 2 staff 5.50 2 11.00 Reception office 2 person 12.00 1 12.00

Waiting area: 30 person 1.70 30 51.00 Interview room: 4 places 8.00 1 8.00 Nappy changing room 5.00 1 5.00 Infant feedng room 6.00 1 6.00 WC: semi-ambulant 2.50 2 5.00 WC: independent wheelchair/semi-ambul 5.50 1 5.50 Wheelchair hold 3.00 1 3.00 Information point 15.00 1 15.00 Coffee bar 8.00 1 8.00

CLINICAL SPACES On-treatment clinic Waiting area: 12 person 1.7 12 20.40 Treatment room/ clinical procedures 16.0 1 16.00 Consultiing/examination room 16.0 7 112.00 clean utility 16.0 1 16.00 diirty utility 8.0 1 8.00 staff base:2 person 5.5 2 11.00 Interview room: 6 places (including 1 wheelchair space) 12.0 1 12.00 storage allowance 11.00 linen 3.0 general 8.0 Radiotherapy treatment

Radiotherapy treatment room (bunker) and maze 140.0 5 700.00 Control area serving radiotherapy treatment room 20.0 5 100.00 radiographer prep room 10.0 5 50.00 patient changing cubicle: ambulant 2.0 5 10.00 patient changing cubicle:wheelchair 4.5 5 22.50 WC: independent wheelchair 4.5 3 13.50

Waiting area: 12 person 1.7 12 20.40

Waiting area: 6 person 1.70 6 10.20 Bed/trolley wait 3.00 4 12.00 Radiology

Waiting area: 6 person 1.7 12 20.40 patient changing cubicle: ambulant 2.0 2 4.00 patient changing cubicle:wheelchair 4.5 2 9.00 WC: independent wheelchair 4.5 2 9.00 CT simulator room 33.0 2 66.00 generator room 2 0.00

Control area serving CT simulator 25.0 2 50.00 CT office 8.0 1 8.00 Mould room Fitting room 25.00 1 25.00 Patient change 4.50 1 4.50 wc/wash/shower 4.50 1 4.50 clean workshop 20.00 1 20.00 dirty workshop 15.00 1 15.00 store 8.00 1 8.00

64 STAFF SPACES Radiotherapy physics

Treatment planning 6.60 12 79.20 Dosimetry lab 12.00 1 12.00 Physics workshop 50.00 1 50.00 Physics store 25.00 1 25.00 Offices 1 person office: senior physicist 8.00 1 8.00 1 person office: senior radiographer 8.00 1 8.00 Office: open-plan: physicists 5.00 7 35.00 Office: open-plan: radiographers 5.00 7 35.00 Office: open-plan: engineering technician 5.00 5 25.00 Office: open-plan: pre-treatment 6.60 6 39.60 Offices as Clive Irwin's e-mail 20th March various officces 100.00 1 100.00 Sue Smith quiet room 12.00 1 12.00 clinical trials 50.00 1 50.00 Workshops Workshop: linac maintenance 30.00 1 30.00 Staff facilities

cleaner's room 8.0 2 16.00 pantry 8.0 1 8.00 pneumatic tube station 1.0 1 1.00 parking bay: resuscitation trolley 2.0 1 2.00 disposal hold: 3000 litres 12.0 1 12.00 seminar room 1.8 20 36.00 seminar room store 6.0 1 6.00 staff rest room with beverage bay 1.9 15 28.50 staff wc 2.5 4 10.00

IT server room 1 0.00 staff changing room with cubicle & hand wash/wc/shower (12 place) 16.80 1 16.80 staff changing room with cubicle & hand wash/wc/shower (12 place) 16.80 1 16.80 storage allowance 35.00 general 12.0 linen 3.0 equipment 12.0 stationery 8.0

TOTAL 2235.20 5% planning 111.76 Sub-total 2346.96 3% engineering 70.41 sub-total 2417.37 33% circulation 797.73 GIA 3215.10

FUTURE DEVELOPMENT REQUIREMENTS

Brachytherapy Suite (as e-mail from Adel Makar dated 20th March) Waiting area: 6 person 1.70 6 10.20 clean utility 12.00 1 12.00 dirty utility 8.00 1 8.00 HDR treatment room & maze 68.00 1 68.00 control room 12.00 1 12.00 recovery room: 2 place 28.00 1 28.00 store: sealed source 12.00 1 12.00

TOTAL 150.20

65 Worcestershire Oncology Project

Radiotherapy Feasibility Review

APPENDIX B NON FINANCIAL EVALUATION PANEL MEMBERSHIP

Name Organisation

Service User Representatives Jim Caudwell South Worcestershire User Group Patricia Hackett Redditch and Bromsgrove User Group Marjorie Wallace Wyre Forest User Group Paul Crawford WAHT Patient Representative Umesh Udeshi, Diagnostics MDT member Graham James, Head and Neck MDT member Santi Vathenen, Physician MDT member Martin Wadley, Upper GI MDT member GP & Commissioner Representatives David Farmer* South Worcestershire GP Commissioning Consortium David Law Redditch & Bromsgrove GP Commissioning Consortium Fiona Simpson Wyre Forest GP Commissioning Consortium Anthony Kelly* NHSW Clinical Senate Simon Gartland, Cancer Commissioner NHS Worcestershire Danielle Taylor, Network Director Arden Cancer Network Provider Representatives Adel Makar, Lead Cancer Clinician WAHT Anne Sullivan, Cancer Services WAHT Manager/Macmillan Lead Cancer Nurse Lynne Mazzocchi, General Manager, WAHT Haematology, Oncology and Palliative Care Lydia Fresco, Clinical Director for Oncology UHCW Gareth Baugh, Clinical Physics UHCW Gill Elkins, Radiotherapy Manager UHCW

* Invited to be a member of the Evaluation Panel but unable to attend the Non Financial Appraisal Workshop or find representatives to attend on their behalf; therefore not involved in weighting the criteria or scoring the options

110511 Radiotherapy Feasibility Report_v1.1 66 Worcestershire Oncology Project

Radiotherapy Feasibility Review

APPENDIX C INFORMATION PROVIDED TO EVALUATION PANEL

110511 Radiotherapy Feasibility Report_v1.1 67 Worcestershire Oncology Project Radiotherapy Feasibility Study The Options

WORCESTERSHIRE ROYAL HOSPITAL SITE Criteria Option A – WRH A&E Option C – WRH Workshops Option D – WRH Spetchley A site map and floorplan for the Worcestershire Royal Hospital Site can be found at Attachment A Improved clinical quality of service in line with meeting national, regional and local policy imperatives Better access to services • Public transport exists on the site and will be readily accessible • Details of buses and train routes to the WRH site can be found at Attachment B (with timetables at Attachments B1‐B6) • Information on travel times can be found at Attachment C

Development of existing services and/or provision of new services

Improved strategic fit of services • WRH is the base for the inpatient haematology service, and there are plans for the inpatient solid tumour chemotherapy beds to be co‐located with the Haematology ward • WRH is likely to become the base for the Worcestershire Breast Service, including the base for the Herefordshire and Worcestershire Breast Screening Service • The gastric bleed rota will be based at WRH • There are plans agreed in principle with cancer networks, to site MOHS surgery at WRH • WRH is close to St Richard’s Hospice which provides the largest number of in county Palliative Care beds for Worcestershire • Head & Neck surgery is based at WRH Improved strategic fit of services • The location of this option will not • The location of this option will not • Since this option is located on an (contd) permit an extension as easily as other permit an extension as easily as other undeveloped site, there is the options options opportunity to extend in the future Since the facility is to be attached to • As this is a facility that is not • As this is a remote facility it does not the main hospital, links with several physically linked to the existing readily lend itself to service cancer‐related services (excepting hospital it does not readily lend itself integration Urology) will be easier. In particular: to service integration

110506 WAHT Radiotherapy Feasibility_Options Narrative v2.0 681 Worcestershire Oncology Project Radiotherapy Feasibility Study The Options

Criteria Option A – WRH A&E Option C – WRH Workshops Option D – WRH Spetchley • The proposal is for the clinical services in the Radiotherapy Centre to be on the same floor level and linked to associated functions in the main building i.e. Chemotherapy Day Unit. • It is also adjacent to Radiology which will provide additional access to imaging services Meeting training, teaching and resource need

Making more effective use of resource

Ease of delivery • Since this option sits on the existing • The car parking adjacent to this site is • Since this option is located on an A&E car park, the 150 displaced currently designated as staff spaces. undeveloped site, there is the spaces will be reprovided on the Some reprovision and reallocation opportunity to provide sufficient car Spetchley land, in addition to the will be required parking to service the increased additional parking specified for this • Accommodation will be displaced ‐ activity development Lend Lease offices, workshop and • As a ‘green field’ site, there is no • Access for construction traffic could crèche to be relocated to Aconbury encumbrance to construction cause disruption East especially if access to the site for • Land acquisition is required for • No planning implications envisaged construction traffic can be obtained from the main highway replacement car parking before work • Indicative timescales for construction can commence and commissioning is 25 months, as • Land acquisition required • No planning implications envisaged illustrated at Attachment D • Potential planning issues regarding • Indicative timescales for construction change of approved use and the and commissioning is 22 months, as bridle path illustrated at Attachment D • Indicative timescales for construction and commissioning is 18 months, as illustrated at Attachment D

110506 WAHT Radiotherapy Feasibility_Options Narrative v2.0 692 Worcestershire Oncology Project Radiotherapy Feasibility Study The Options

ALEXANDRA HOSPITAL SITE Criteria Option E – ALX Rear Option F – ALX Bank Adj to PGMC Option G – ALX Front A site map for the Alexandra Hospital Site can be found at Attachment E Improved clinical quality

Better access to services • Public transport exists on the site but does not currently access this zone • Details of buses and train routes to the site can be found at Attachment F (with timetables at AttachmentsF1‐F7) • Further information on travel times can be found at Attachment C

Development of existing services and/or provision of new services

Improved strategic fit of services • Inpatient Urology beds are based at the Alexandra Hospital • Since this option is located on an • Since this option is located on an • As this is a remote facility, it does not undeveloped site, there is the undeveloped site, there is the readily lend itself to service opportunity to extend in the future opportunity to extend in the future integration • Since the facility would be attached • Since the facility would be attached to the main hospital, links with some to the main hospital, links with some cancer‐related services will be easier. cancer‐related services will be easier, In particular, the proposal is for the in particular, the proposal is for the clinical services in the Radiotherapy clinical services in the oncology centre to be on the same floor level centre to be linked to the existing and linked to associated functions in hospital’s first floor level for ease of the main building i.e. outpatients. It is access to associated functions also adjacent to Radiology, which will provide additional access to imaging services

110506 WAHT Radiotherapy Feasibility_Options Narrative v2.0 703 Worcestershire Oncology Project Radiotherapy Feasibility Study The Options

Criteria Option E – ALX Rear Option F – ALX Bank Adj to PGMC Option G – ALX Front A site map for the Alexandra Hospital Site can be found at Attachment E Meeting training, teaching and resource need

Making more effective use of resource

Ease of delivery • Since this option is located on an • Since this option is located on an • Since this option is located on an undeveloped site, there is the undeveloped site, there is the undeveloped site, there is the opportunity to provide the required opportunity to provide the required opportunity to provide the required car parking spaces for the new Centre car parking spaces for the new Centre car parking spaces for the new Centre • If the Radiotherapy Centre is to be • This location provides no restrictions • Since this option is located on an accessed though the main hospital that have been identified that will undeveloped site there is the entrance, this will displace impact on the buildability of the opportunity to extend in the future Rehabilitation services project. The emergency entrance can • This location provides no restrictions • No planning issues are envisaged provide access for construction traffic that have been identified that will • Indicative timescales for construction away from hospital activity impact on the build ability of the and commissioning is 18 months, as • No planning issues are envisaged project illustrated at Attachment D • Indicative timescales for construction • No planning issues are envisaged and commissioning is 18 months, as • Indicative timescales for construction illustrated at Attachment D and commissioning is 18 months, as illustrated at Attachment D

110506 WAHT Radiotherapy Feasibility_Options Narrative v2.0 714 ATTACHMENT A

A449

6 Worcester Wardon Worcestershire Royal Hospital

M5 Charles Hastings Way From M5 J7 Newtown Road Ne wtown Rd (B4636) Leave the M5 and join the A44 Worcester towards Worcester. Continue H WR5 1DD straight over the first roundabout 01905 763333 A422 and at the second turn right joining the A4440 (Swinesherd A44 A4440 M5 Way). At the second roundabout on the A4440 turn left onto the A38 B4636. The hospital is located By Train left off the next roundabout Shrub Hills Station recieves a (Charles Hastings Way). 7 regular service from London (Euston and Paddington) as well From M5 J6 as Birmingham (New Street and Leave the M5 and join the Snow Hill). For futher information A4440. At the first roundabout on train times and fares call the take the first exit staying with the National Rail Enquiry Line on Ronkswood A4440. Continue along the 08457 48 49 50. Car Park A4440 until the third roundabout and then turn right onto the By Bus B4636. The hospital is located For information on all bus left off the next roundabout Newt services in Worcestershire call ow (Charles Hastings Way). n Ro the Traveline on 0871 200 22 33. ad Resident’s Parking Entrance to Aconbury East P

Aconbury P East Essential Users Only Mortuary Ambulance P Entrance Charles Hastings Sta Parking P P Essential Users Only Way Parking for CHEC only A&E Entrance Charles Hastings Main Vehicular Education Centre Aconbury Entrance (CHEC) West

Children’s Main Entrance Entrance Entrance to P Key P Visitor/Patient Parking 2 P Visitor/Patient Visitor/Patient Parking Parking 1 P Staff Parking Shows flow of one way system

Please note the speed limit on the P 10 hospital grounds is 10mph.

Produced by [email protected] Last updated 17/02/2011 ATTACHMENT A

73 ATTACHMENT A

74 ATTACHMENT B

Bus Routes to Worcestershire Royal Hospital:

• 24 o Worcester City Centre ‐ Worcestershire Royal Hospital via Wyld's Lane, Prestwich Avenue and Kilbury Drive (Bus timetable at Attachment B1)

• 31 / 31B o Worcestershire Royal Hospital ‐ Ronkswood ‐ Shrub Hill ‐ Worcester City Centre ‐ Henwick Park for University of Worcester (Bus timetable at Attachment B2)

• 31A / 31C o Worcester ‐ Bilford Road ‐ Warndon ‐ Worcestershire Royal Hospital ‐ Shrub Hill ‐ Worcester City Centre ‐ Henwick Park (Bus timetable at Attachment B2)

• 32A o Worcester ‐ St Peters ‐ County Hall ‐ Worcestershire Royal Hospital (Bus timetable at Attachment B3)

• 44 / 44A / 44B o Ledbury (44B) ‐ The Malverns ‐ Powick ‐ Worcester ‐ County Hall ‐ Worcestershire Royal Hospital (Bus timetable at Attachment B4)

• 300 o Worcestershire Royal Hospital ‐ Worcester ‐ Hallow ‐ Obersley ‐ Hartlebury ‐ Stourport ‐ Burlish ‐ Bewdley – Kidderminster (Bus timetable at Attachment B5)

• W2 / W3 o Sixways Park & Ride Site ‐ Worcestershire Royal Hospital ‐ Sixways Park & Ride Site (Bus timetable at Attachment B6)

Travelling by Train

Worcester Shrub Hill Railway Station is located 1.5 miles from Worcestershire Royal Hospital. There are regular buses running to the hospital from both Shrub Hill and Foregate Street station. Foregate Street is located in the city centre

75 Attachment B1 City Centre - Winchester Avenue "Village in the City" 21 Operator: Veolia England (Astons Coaches) No Sunday service Monday to Saturday from 27th February 2011

Worcester, Bus Station -- 12-23 Hanbury Park Road 09-30 12-30 Winchester Avenue 09-35 12-35 Worcester, Bus Station 09-40 12-40 City Centre - Broadway Grove "Village in the City" 22 Operator: Veolia England (Astons Coaches) No Sunday service Monday to Saturday from 27th February 2011

Worcester, Bus Station 09-42 12-42 Broadway Grove 09-50 12-50 Solitaire Avenue 09-55 12-55 Worcester, Bus Station 10-05 13-05 City Centre - Blanquettes Estate "Village in the City" 23 Operator: Veolia England (Astons Coaches) No Sunday service Monday to Saturday from 27th February 2011

Worcester, Bus Station 10-07 13-07 Blanquettes Avenue 10-20 13-20 Longfellow Road 10-23 13-23 Wordsworth Avenue 10-25 13-25 Worcester, Bus Station 10-35 13-35 City Centre - Worcestershire Royal Hospital "Village in the City" 24 via Wyld's Lane, Prestwich Avenue and Kilbury Drive Operator: Veolia England (Astons Coaches) No Sunday service Monday to Saturday from 27th February 2011

Worcester, Bus Station 10-37 Worcester, Bus Station 13-37 Wyld's Lane 10-47 Wyld's Lane 13-47 Nunnery Lane 10-57 Kilbury Drive 13-52 Prestwich Avenue 10-58 Baynham Drive 13-53 Liverpool Road 10-59 Worcestershire Royal Hosp., Main Entrance14-00 Worcestershire Royal Hosp., Main Entrance11-05 Liverpool Road 14-05 Baynham Drive 11-15 Prestwich Avenue 14-06 Kilbury Drive 11-16 Nunnery Lane 14-07 Wyld's Lane 11-25 Wyld's Lane 14-15 Worcester, Bus Station 11-30 Worcester, Bus Station 14-25

76 Attachment B2 Worcestershire Royal Hospital - Ronkswood - City Centre - Henwick Park 31 Worcestershire Royal Hospital - City Centre - Henwick Park 31B City Centre - Warndon - Worcestershire Royal Hospital - Ronkswood - City Centre - Henwick Park 31C Operator: First, Diamond (DIA ) Monday to Friday from 6th September 2010

Service: 31 31C 31 31C 31 31 31C 31 31C 31 31B 31C 31 31B 31C 31B Worcester, Bus Station -- 06-15 -- 06-44 -- -- 07-02 -- 07-24 -- -- 07-52 -- -- 08-22 -- Foregate Street, Rail Station -- 06-17 -- 06-46 -- -- 07-04 -- 07-26 -- -- 07-54 -- -- 08-24 -- Bilford Road, Retail Park -- 06-27 -- 06-56 -- -- 07-15 -- 07-37 -- -- 08-05 -- -- 08-36 -- Warndon, opp, Glovers Needle -- 06-31 -- 07-00 -- -- 07-19 -- 07-41 -- -- 08-09 -- -- 08-40 -- Shire Business Park, Three Pears -- 06-36 -- 07-05 -- -- 07-24 -- 07-47 -- -- 08-15 -- -- 08-46 -- Lyppard Centre, Tesco Store -- 06-40 -- 07-09 -- -- 07-29 -- 07-53 -- -- 08-22 -- -- 08-52 -- Worcestershire Royal Hospital (Main Entrance) -- 06-45 -- 07-15 -- -- 07-36 07-50 08-00 08-10 08-24 08-30 08-40 08-54 09-00 09-10 Ronkswood,C'bury Rd/L'pool Rd -- 06-50 -- 07-20 -- -- 07-41 07-56 08-06 08-16 | 08-36 08-46 | 09-06 09-16 Worcester, Shrub Hill Station -- 06-55 -- 07-25 -- -- 07-47 08-02 08-12 08-22 08-32 08-42 08-52 09-02 09-12 09-22 Worcester, Bus Station arrive -- 06-59 -- 07-31 -- -- 07-56 08-11 08-21 08-31 08-41 08-51 09-01 09-10 09-20 09-30 Worcester, Bus Station depart 06-37 07-07 07-20 07-35 07-45 07-55 08-05 08-15 08-25 08-35 08-45 08-55 09-05 09-15 09-25 09-35 University Gates 06-43 07-13 07-27 07-42 07-52 08-02 08-12 08-22 08-32 08-42 08-52 09-02 09-12 09-22 09-32 09-42 Henwick Park, Monarch Drive 06-49 07-19 07-34 07-49 07-59 08-09 08-19 08-29 08-39 08-49 08-59 09-09 09-19 09-29 09-39 09-49 Service: 31B 31C 31 31B 31C 31 31B 31C 31 31B 31C 31 31B 31C Worcester, Bus Station -- 54 -- -- 24 -- -- 13-54 -- -- 14-22 -- -- 14-50 Foregate Street, Rail Station -- 56 -- -- 26 -- -- 13-56 -- -- 14-24 -- -- 14-52 Bilford Road, Retail Park -- then 07 -- -- 37 -- -- 14-07 -- -- 14-35 -- -- 15-04 Warndon, opp, Glovers Needle -- at 11 -- -- 41 -- -- 14-11 -- -- 14-39 -- -- 15-08 Shire Business Park, Three Pears -- these 17 -- -- 47 -- -- 14-17 -- -- 14-45 -- -- 15-14 Lyppard Centre, Tesco Store -- mins. 23 -- -- 53 -- -- 14-23 -- -- 14-51 -- -- 15-20 Worcestershire Royal Hospital (Main Entrance) 09-24 past 30 40 54 00 10 24 until 14-30 14-38 14-52 14-58 15-08 15-22 15-28 Ronkswood,C'bury Rd/L'pool Rd | each 36 46 | 06 16 | 14-36 14-44 | 15-04 15-14 | 15-34 Worcester, Shrub Hill Station 09-32 hour 42 52 02 12 22 32 14-42 14-50 15-00 15-10 15-20 15-30 15-40 Worcester, Bus Station arrive 09-40 50 00 10 20 30 40 14-50 14-58 15-08 15-17 15-27 15-37 15-47 Worcester, Bus Station depart 09-45 55 05 15 25 35 45 14-55 15-01 15-11 15-21 15-31 15-41 15-51 University Gates 09-52 02 12 22 32 42 52 15-02 15-09 15-19 15-29 15-39 15-49 15-59 Henwick Park, Monarch Drive 09-59 09 19 29 39 49 59 15-09 15-19 15-29 15-39 15-49 15-59 16-09 Service: 31 31B 31C 31 31B 31C 31 31B 31C 31 31B 31C 31 31B 31C 31B Worcester, Bus Station -- -- 15-20 -- -- 15-48 -- -- 16-18 -- -- 16-48 -- -- 17-20 -- Foregate Street, Rail Station -- -- 15-22 -- -- 15-50 -- -- 16-20 -- -- 16-50 -- -- 17-22 -- Bilford Road, Retail Park -- -- 15-34 -- -- 16-04 -- -- 16-34 -- -- 17-04 -- -- 17-36 -- Warndon, opp, Glovers Needle -- -- 15-38 -- -- 16-08 -- -- 16-38 -- -- 17-08 -- -- 17-40 -- Shire Business Park, Three Pears -- -- 15-44 -- -- 16-14 -- -- 16-44 -- -- 17-14 -- -- 17-46 -- Lyppard Centre, Tesco Store -- -- 15-50 -- -- 16-20 -- -- 16-50 -- -- 17-20 -- -- 17-52 -- Worcestershire Royal Hospital (Main Entrance) 15-38 15-52 15-58 16-08 16-22 16-28 16-38 16-52 16-58 17-08 17-22 17-28 17-40 17-54 18-00 18-20 Ronkswood,C'bury Rd/L'pool Rd 15-44 | 16-04 16-14 | 16-34 16-44 | 17-04 17-14 | 17-34 17-46 | 18-06 | Worcester, Shrub Hill Station 15-50 16-00 16-10 16-20 16-30 16-40 16-50 17-00 17-10 17-20 17-30 17-40 17-52 18-02 18-12 18-28 Worcester, Bus Station arrive 15-57 16-07 16-17 16-27 16-37 16-47 16-57 17-07 17-17 17-27 17-37 17-47 17-59 18-09 18-19 18-35 Worcester, Bus Station depart 16-01 16-11 16-21 16-31 16-41 16-51 17-01 17-11 17-21 17-31 17-41 17-53 18-05 18-15 18-25 18-38 University Gates 16-09 16-19 16-29 16-39 16-49 16-59 17-09 17-19 17-29 17-39 17-49 18-01 18-12 18-22 18-32 18-44 Henwick Park, Monarch Drive 16-19 16-29 16-39 16-49 16-59 17-09 17-19 17-29 17-39 17-49 17-59 18-09 18-19 18-29 18-39 18-49 Service: 31C 31C 31C 31 31C 31 31C 31 31C 31 31C Worcester, Bus Station 17-53 18-25 19-00 -- 20-00 -- 21-00 -- 22-00 -- 23-00 Foregate Street, Rail Station 17-55 18-27 19-02 -- 20-02 -- 21-02 -- 22-02 -- 23-02 Bilford Road, Retail Park 18-08 18-38 19-12 -- 20-12 -- 21-12 -- 22-12 -- 23-12 Warndon, opp, Glovers Needle 18-12 18-42 19-16 -- 20-16 -- 21-16 -- 22-16 -- 23-16 Shire Business Park, Three Pears 18-18 18-48 19-21 -- 20-21 -- 21-21 -- 22-21 -- 23-21 Lyppard Centre, Tesco Store 18-24 18-54 19-25 -- 20-25 -- 21-25 -- 22-25 -- 23-25 Worcestershire Royal Hospital (Main Entrance) 18-31 19-00 19-30 20-00 20-30 21-00 21-30 22-00 22-30 23-00 23-30 Ronkswood,C'bury Rd/L'pool Rd 18-37 19-05 19-35 20-05 20-35 21-05 21-35 22-05 22-35 23-05 23-35 Worcester, Shrub Hill Station 18-42 19-10 19-40 20-10 20-40 21-10 21-40 22-10 22-40 23-10 23-40 Worcester, Bus Station arrive 18-46 19-14 19-44 20-14 20-44 21-14 21-44 22-14 22-44 23-14 23-44 Worcester, Bus Station depart -- 19-18 19-48 20-18 20-48 21-18 21-48 22-18 22-48 23-18 -- University Gates -- 19-24 19-54 20-24 20-54 21-24 21-54 22-24 22-54 23-24 -- Henwick Park, Monarch Drive -- 19-29 19-59 20-29 20-59 21-29 21-59 22-29 22-59 23-29 --

77 Attachment B2 Saturday from 6th September 2010

Service: 31 31C 31 31 31C 31 31C 31B 31 31 31C 31 31 31B 31C 31 Worcester, Bus Station -- 06-15 06-45 -- 07-15 -- 07-45 ------08-20 ------08-54 -- Foregate Street, Rail Station -- 06-17 06-47 -- 07-17 -- 07-47 ------08-22 ------08-56 -- Bilford Road, Retail Park -- 06-27 06-57 -- 07-27 -- 07-57 ------08-32 ------09-07 -- Warndon, opp, Glovers Needle -- 06-31 07-01 -- 07-31 -- 08-01 ------08-36 ------09-11 -- Shire Business Park, Three Pears -- 06-36 07-06 -- 07-36 -- 08-06 ------08-41 ------09-17 -- Lyppard Centre, Tesco Store -- 06-40 07-10 -- 07-40 -- 08-10 08-22 -- -- 08-46 ------09-23 -- Worcestershire Royal Hospital (Main Entrance) -- 06-45 07-15 07-30 07-45 08-00 08-15 08-28 -- 08-42 08-52 09-02 09-12 09-24 09-30 09-40 Ronkswood,C'bury Rd/L'pool Rd -- 06-50 07-20 07-35 07-50 08-05 08-20 08-33 -- 08-48 08-58 09-08 09-18 | 09-36 09-46 Worcester, Shrub Hill Station -- 06-55 07-25 07-41 07-56 08-11 08-26 08-39 -- 08-54 09-04 09-14 09-24 09-32 09-42 09-52 Worcester, Bus Station arrive -- 06-59 07-29 07-46 08-02 08-17 08-32 08-45 -- 09-00 09-11 09-21 09-31 09-40 09-50 10-00 Worcester, Bus Station depart 06-37 07-07 07-37 07-52 08-07 08-22 08-37 08-47 08-57 09-05 09-15 09-25 09-35 09-45 09-55 10-05 University Gates 06-43 07-13 07-43 07-58 08-13 08-28 08-43 08-53 09-03 09-12 09-22 09-32 09-42 09-52 10-02 10-12 Henwick Park, Monarch Drive 06-49 07-19 07-49 08-04 08-19 08-34 08-49 08-59 09-09 09-19 09-29 09-39 09-49 09-59 10-09 10-19 Service: 31B 31C 31 31B 31C 31 31B 31 31B 31C 31 31B 31C 31 Worcester, Bus Station -- 24 -- -- 54 ------15-24 -- -- 15-54 -- Foregate Street, Rail Station -- 26 -- -- 56 ------15-26 -- -- 15-56 -- Bilford Road, Retail Park -- then 37 -- -- 07 ------15-37 -- -- 16-07 -- Warndon, opp, Glovers Needle -- at 41 -- -- 11 ------15-41 -- -- 16-11 -- Shire Business Park, Three Pears -- these 47 -- -- 17 ------15-47 -- -- 16-17 -- Lyppard Centre, Tesco Store -- mins. 53 -- -- 23 ------15-53 -- -- 16-23 -- Worcestershire Royal Hospital (Main Entrance) 09-54 past 00 10 24 30 40 54 until 15-40 15-54 16-00 16-10 16-24 16-30 16-40 Ronkswood,C'bury Rd/L'pool Rd | each 06 16 | 36 46 | 15-46 | 16-06 16-16 | 16-36 16-46 Worcester, Shrub Hill Station 10-02 hour 12 22 32 42 52 02 15-52 16-02 16-12 16-22 16-32 16-42 16-52 Worcester, Bus Station arrive 10-10 20 30 40 50 00 10 16-00 16-10 16-20 16-30 16-40 16-50 17-00 Worcester, Bus Station depart 10-15 25 35 45 55 05 15 16-05 16-15 16-25 16-35 16-50 -- 17-05 University Gates 10-22 32 42 52 02 12 22 16-12 16-22 16-32 16-42 16-57 -- 17-12 Henwick Park, Monarch Drive 10-29 39 49 59 09 19 29 16-19 16-29 16-39 16-49 17-04 -- 17-19 Service: 31B 31C 31 31B 31C 31 31C 31 31C 31C 31C 31 31C 31 31C 31 Worcester, Bus Station -- 16-24 -- -- 16-54 -- 17-24 -- 17-58 18-28 19-00 -- 20-00 -- 21-00 -- Foregate Street, Rail Station -- 16-26 -- -- 16-56 -- 17-26 -- 18-00 18-30 19-02 -- 20-02 -- 21-02 -- Bilford Road, Retail Park -- 16-37 -- -- 17-07 -- 17-37 -- 18-11 18-41 19-12 -- 20-12 -- 21-12 -- Warndon, opp, Glovers Needle -- 16-41 -- -- 17-11 -- 17-41 -- 18-15 18-45 19-16 -- 20-16 -- 21-16 -- Shire Business Park, Three Pears -- 16-47 -- -- 17-17 -- 17-47 -- 18-20 18-50 19-21 -- 20-21 -- 21-21 -- Lyppard Centre, Tesco Store -- 16-53 -- -- 17-23 -- 17-53 -- 18-26 18-55 19-25 -- 20-25 -- 21-25 -- Worcestershire Royal Hospital (Main Entrance) 16-54 17-00 17-10 17-24 17-30 17-45 18-00 18-15 18-32 19-00 19-30 20-00 20-30 21-00 21-30 22-00 Ronkswood,C'bury Rd/L'pool Rd | 17-06 17-16 | 17-36 17-50 18-05 18-20 18-37 19-05 19-35 20-05 20-35 21-05 21-35 22-05 Worcester, Shrub Hill Station 17-02 17-12 17-22 17-32 17-42 17-56 18-10 18-25 18-42 19-10 19-40 20-10 20-40 21-10 21-40 22-10 Worcester, Bus Station arrive 17-10 17-20 17-30 17-40 17-50 18-03 18-16 18-31 18-46 19-14 19-44 20-14 20-44 21-14 21-44 22-14 Worcester, Bus Station depart 17-20 -- 17-35 17-50 -- 18-05 18-20 18-38 -- 19-18 19-48 20-18 20-48 21-18 21-48 22-18 University Gates 17-27 -- 17-42 17-57 -- 18-12 18-27 18-44 -- 19-24 19-54 20-24 20-54 21-24 21-54 22-24 Henwick Park, Monarch Drive 17-34 -- 17-49 18-04 -- 18-19 18-34 18-49 -- 19-29 19-59 20-29 20-59 21-29 21-59 22-29 Service: 31C 31 31C Worcester, Bus Station 22-00 -- 23-00 Foregate Street, Rail Station 22-02 -- 23-02 Bilford Road, Retail Park 22-12 -- 23-12 Warndon, opp, Glovers Needle 22-16 -- 23-16 Shire Business Park, Three Pears 22-21 -- 23-21 Lyppard Centre, Tesco Store 22-25 -- 23-25 Worcestershire Royal Hospital (Main Entrance) 22-30 23-00 23-30 Ronkswood,C'bury Rd/L'pool Rd 22-35 23-05 23-35 Worcester, Shrub Hill Station 22-40 23-10 23-40 Worcester, Bus Station arrive 22-44 23-14 23-44 Worcester, Bus Station depart 22-48 23-18 -- University Gates 22-54 23-24 -- Henwick Park, Monarch Drive 22-59 23-29 --

78 Attachment B2 Sunday (& Bank Holiday Mondays) from 5th September 2010 Service: 31C 31C 31 31C 31 31 31C 31 31 31 31C 31C 31 31 Worcester, Bus Station 06-20 07-20 -- 08-20 -- -- 09-24 ------24 16-24 -- -- Foregate Street, Rail Station 06-22 07-22 -- 08-22 -- -- 09-26 ------26 16-26 -- -- Bilford Road, Retail Park 06-32 07-32 -- 08-32 -- -- 09-36 then ------36 16-36 -- -- Warndon, opp, Glovers Needle 06-36 07-36 -- 08-36 -- -- 09-40 at ------40 16-40 -- -- Shire Business Park, Three Pears 06-41 07-41 -- 08-41 -- -- 09-45 these ------45 16-45 -- -- Lyppard Centre, Tesco Store 06-45 07-45 -- 08-45 -- -- 09-50 mins. ------50 16-50 -- -- Worcestershire Royal Hospital (Main Entrance) 06-50 07-50 -- 08-50 09-25 -- 09-55 past -- 25 -- 55 until 16-55 -- 17-25 Ronkswood,C'bury Rd/L'pool Rd 06-55 07-55 -- 08-55 09-30 -- 10-00 each -- 30 -- 00 17-00 -- 17-30 Worcester, Shrub Hill Station 06-59 07-59 -- 08-59 09-35 -- 10-05 hour -- 35 -- 05 17-05 -- 17-35 Worcester, Bus Station arrive 07-03 08-03 -- 09-03 09-40 -- 10-10 -- 40 -- 10 17-10 -- 17-40 Worcester, Bus Station depart -- -- 09-00 -- -- 10-00 -- 30 -- 00 -- -- 17-30 -- University Gates -- -- 09-06 -- -- 10-06 -- 36 -- 06 -- -- 17-36 -- Henwick Park, Monarch Drive -- -- 09-12 -- -- 10-12 -- 42 -- 12 -- -- 17-42 -- DIA DIA DIA Service: 31C 31C 31 31 31 Worcester, Bus Station 17-30 18-30 ------Foregate Street, Rail Station 17-32 18-32 ------Bilford Road, Retail Park 17-42 18-42 ------Warndon, opp, Glovers Needle 17-46 18-46 ------Shire Business Park, Three Pears 17-51 18-51 ------Lyppard Centre, Tesco Store 17-55 18-55 ------Worcestershire Royal Hospital (Main Entrance) 18-00 19-00 -- 20-00 21-00 Ronkswood,C'bury Rd/L'pool Rd 18-05 19-05 -- 20-05 21-05 Worcester, Shrub Hill Station 18-10 19-10 -- 20-09 21-09 Worcester, Bus Station arrive 18-14 19-14 -- 20-15 21-15 Worcester, Bus Station depart 18-18 -- 19-17 20-17 21-17 University Gates 18-24 -- 19-23 20-23 21-23 Henwick Park, Monarch Drive 18-29 -- 19-29 20-29 21-29 Operator Phone Number: Diamond - 0121 557 7337 First - 0800 587 7381

79 Attachment B2 Henwick Park - City Centre - Ronkswood - Worcestershire Royal Hospital 31 Henwick Park - City Centre - Ronkswood - Worcestershire Royal Hospital - Warndon - City Centre 31A Henwick Park - City Centre - Worcestershire Royal Hospital 31B Operator: First, Diamond (DIA ) Monday to Friday from 6th September 2010

Service: 31A 31A 31A 31A 31 31A 31B 31 31A 31B 31 31A 31B 31 31A 31B Henwick Park, Monarch Drive ------06-50 -- 07-20 07-35 -- 07-50 08-00 08-10 08-20 08-30 08-40 08-50 09-00 University Campus ------06-55 -- 07-26 07-41 -- 07-56 08-06 08-16 08-26 08-36 08-46 08-56 09-06 Worcester, Bus Station arrive ------07-03 -- 07-36 07-51 -- 08-06 08-20 08-30 08-40 08-46 08-56 09-08 09-16 Worcester, Bus Station depart 05-58 06-28 06-48 07-08 07-26 07-41 07-55 08-03 08-11 08-21 08-31 08-41 08-51 09-01 09-11 09-21 Worcester, Shrub Hill Station 06-01 06-31 06-53 07-13 07-31 07-46 08-00 08-08 08-16 08-26 08-36 08-46 08-56 09-06 09-16 09-26 Ronkswood,C'bury Rd/L'pool Rd 06-07 06-37 06-59 07-19 07-37 07-52 | 08-14 08-22 | 08-42 08-52 | 09-12 09-22 | Worcestershire Royal Hospital (Main Entrance) 06-12 06-42 07-05 07-25 07-43 07-59 08-08 08-21 08-29 08-35 08-49 08-59 09-05 09-19 09-29 09-35 Lyppard Centre, Tesco Store 06-17 06-47 07-10 07-30 -- 08-04 -- -- 08-34 -- -- 09-04 -- -- 09-34 -- Shire Business Park, Three Pears 06-22 06-52 07-16 07-37 -- 08-11 -- -- 08-41 -- -- 09-10 -- -- 09-40 -- Warndon, Glovers Needle 06-28 06-58 07-23 07-45 -- 08-19 -- -- 08-49 -- -- 09-17 -- -- 09-47 -- Bilford Road, Retail Park 06-31 07-01 07-26 07-48 -- 08-22 -- -- 08-52 -- -- 09-20 -- -- 09-50 -- Worcester, Bus Station 06-42 07-12 07-40 08-05 -- 08-40 -- -- 09-10 -- -- 09-36 -- -- 10-04 -- Service: 31 31A 31B 31 31A 31B 31 31A 31B 31 31A 31B 31 31A Henwick Park, Monarch Drive 09-10 20 30 40 50 00 10 14-50 15-00 15-10 15-20 15-30 15-40 15-50 University Campus 09-16 26 36 46 56 06 16 14-56 15-06 15-16 15-26 15-36 15-46 15-56 Worcester, Bus Station arrive 09-26 then 36 46 56 06 16 26 15-06 15-17 15-27 15-36 15-47 15-57 16-07 Worcester, Bus Station depart 09-31 at 41 51 01 11 21 31 15-11 15-21 15-30 15-40 15-50 16-00 16-10 Worcester, Shrub Hill Station 09-36 these 46 56 06 16 26 36 15-16 15-26 15-36 15-46 15-56 16-06 16-16 Ronkswood,C'bury Rd/L'pool Rd 09-42 mins. 52 | 12 22 | 42 until 15-22 | 15-42 15-52 | 16-12 16-22 Worcestershire Royal Hospital (Main Entrance) 09-49 past 59 05 19 29 35 49 15-29 15-35 15-49 15-59 16-05 16-19 16-29 Lyppard Centre, Tesco Store -- each 04 -- -- 34 -- -- 15-34 -- -- 16-05 -- -- 16-35 Shire Business Park, Three Pears -- hour 10 -- -- 40 -- -- 15-40 -- -- 16-12 -- -- 16-43 Warndon, Glovers Needle -- 17 -- -- 47 -- -- 15-47 -- -- 16-19 -- -- 16-50 Bilford Road, Retail Park -- 20 -- -- 50 -- -- 15-50 -- -- 16-22 -- -- 16-53 Worcester, Bus Station -- 34 -- -- 04 -- -- 16-04 -- -- 16-38 -- -- 17-12 Service: 31B 31 31A 31B 31 31A 31B 31 31A 31B 31 31A 31 31A 31 31A Henwick Park, Monarch Drive 16-00 16-10 16-20 16-30 16-40 16-50 17-00 17-10 17-20 17-30 17-40 17-50 18-05 18-20 18-35 18-50 University Campus 16-06 16-16 16-26 16-36 16-46 16-56 17-06 17-16 17-26 17-36 17-46 17-56 18-11 18-26 18-41 18-56 Worcester, Bus Station arrive 16-17 16-27 16-37 16-47 16-57 17-07 17-17 17-27 17-37 17-47 17-57 18-07 18-21 18-36 18-51 19-06 Worcester, Bus Station depart 16-20 16-30 16-40 16-50 17-00 17-10 17-21 17-30 17-40 17-50 18-00 18-12 -- 18-41 -- 19-14 Worcester, Shrub Hill Station 16-26 16-36 16-46 16-56 17-06 17-16 17-26 17-36 17-46 17-56 18-05 18-17 -- 18-46 -- 19-17 Ronkswood,C'bury Rd/L'pool Rd | 16-42 16-52 | 17-12 17-22 | 17-42 17-52 | 18-11 18-23 -- 18-52 -- 19-23 Worcestershire Royal Hospital (Main Entrance) 16-35 16-49 16-59 17-05 17-19 17-29 17-35 17-49 17-59 18-05 18-17 18-29 -- 18-58 -- 19-28 Lyppard Centre, Tesco Store -- -- 17-05 -- -- 17-35 -- -- 18-05 -- -- 18-34 -- 19-03 -- 19-33 Shire Business Park, Three Pears -- -- 17-13 -- -- 17-43 -- -- 18-13 -- -- 18-40 -- 19-08 -- 19-38 Warndon, Glovers Needle -- -- 17-20 -- -- 17-50 -- -- 18-20 -- -- 18-46 -- 19-14 -- 19-44 Bilford Road, Retail Park -- -- 17-23 -- -- 17-53 -- -- 18-23 -- -- 18-49 -- 19-17 -- 19-47 Worcester, Bus Station -- -- 17-42 -- -- 18-12 -- -- 18-40 -- -- 19-03 -- 19-28 -- 19-58 Service: 31 31A 31 31A 31 31A 31 31A Henwick Park, Monarch Drive 19-30 20-00 20-30 21-00 21-30 22-00 22-30 23-00 University Campus 19-35 20-05 20-35 21-05 21-35 22-05 22-35 23-05 Worcester, Bus Station arrive 19-42 20-12 20-42 21-12 21-42 22-12 22-42 23-12 Worcester, Bus Station depart 19-44 20-14 20-44 21-14 21-44 22-14 22-44 23-14 Worcester, Shrub Hill Station 19-47 20-17 20-47 21-17 21-47 22-17 22-47 23-17 Ronkswood,C'bury Rd/L'pool Rd 19-53 20-23 20-53 21-23 21-53 22-23 22-53 23-23 Worcestershire Royal Hospital (Main Entrance) 19-58 20-28 20-58 21-28 21-58 22-28 22-58 23-28 Lyppard Centre, Tesco Store -- 20-33 -- 21-33 -- 22-33 -- 23-33 Shire Business Park, Three Pears -- 20-38 -- 21-38 -- 22-38 -- 23-38 Warndon, Glovers Needle -- 20-44 -- 21-44 -- 22-44 -- 23-44 Bilford Road, Retail Park -- 20-47 -- 21-47 -- 22-47 -- 23-47 Worcester, Bus Station -- 20-58 -- 21-58 -- 22-58 -- 23-58

80 Attachment B2 Saturday from 6th September 2010

Service: 31A 31A 31A 31 31A 31 31A 31A 31 31A 31 31A 31B 31 31A 31B Henwick Park, Monarch Drive ------06-50 -- 07-20 -- 07-50 08-05 08-20 08-35 08-50 09-00 09-10 09-20 09-30 University Campus ------06-55 -- 07-25 -- 07-55 08-10 08-25 08-40 08-55 09-06 09-16 09-26 09-36 Worcester, Bus Station arrive ------07-03 -- 07-33 -- 08-03 08-18 08-33 08-48 09-03 09-16 09-26 09-36 09-46 Worcester, Bus Station depart 05-58 06-28 06-58 07-08 07-28 07-38 07-53 08-08 08-23 08-38 08-53 09-08 09-21 09-31 09-41 09-51 Worcester, Shrub Hill Station 06-01 06-31 07-01 07-13 07-33 07-43 07-58 08-13 08-28 08-43 08-58 09-13 09-26 09-36 09-46 09-56 Ronkswood,C'bury Rd/L'pool Rd 06-07 06-37 07-07 07-19 07-39 07-49 08-04 08-19 08-34 08-49 09-04 09-19 | 09-42 09-52 | Worcestershire Royal Hospital (Main Entrance) 06-12 06-42 07-12 07-25 07-45 07-55 08-10 08-25 08-40 08-55 09-10 09-25 09-35 09-49 09-59 10-05 Lyppard Centre, Tesco Store 06-17 06-47 07-17 -- 07-50 -- 08-15 08-30 -- 09-00 -- 09-30 -- -- 10-04 -- Shire Business Park, Three Pears 06-22 06-52 07-22 -- 07-55 -- -- 08-35 -- 09-06 -- 09-36 -- -- 10-10 -- Warndon, Glovers Needle 06-28 06-58 07-28 -- 08-01 -- -- 08-41 -- 09-13 -- 09-43 -- -- 10-17 -- Bilford Road, Retail Park 06-31 07-01 07-31 -- 08-04 -- -- 08-44 -- 09-16 -- 09-46 -- -- 10-20 -- Worcester, Bus Station 06-42 07-12 07-42 -- 08-17 -- -- 08-57 -- 09-30 -- 10-00 -- -- 10-34 -- Service: 31 31A 31B 31 31A 31B 31 31B 31 31A 31 31A 31 31A Henwick Park, Monarch Drive 09-40 50 00 10 20 30 40 16-30 16-40 16-50 17-05 17-20 17-35 17-50 University Campus 09-46 56 06 16 26 36 46 16-36 16-46 16-56 17-11 17-26 17-41 17-56 Worcester, Bus Station arrive 09-56 then 06 16 26 36 46 56 16-47 16-57 17-06 17-21 17-36 17-51 18-06 Worcester, Bus Station depart 10-01 at 11 21 31 41 51 01 16-50 17-00 17-11 17-26 17-41 17-56 18-11 Worcester, Shrub Hill Station 10-06 these 16 26 36 46 56 06 16-56 17-06 17-16 17-31 17-46 18-01 18-16 Ronkswood,C'bury Rd/L'pool Rd 10-12 mins. 22 | 42 52 | 12 until | 17-12 17-22 17-37 17-52 18-07 18-22 Worcestershire Royal Hospital (Main Entrance) 10-19 past 29 35 49 59 05 19 17-05 17-19 17-29 17-44 17-59 18-13 18-28 Lyppard Centre, Tesco Store -- each 34 -- -- 04 ------17-34 -- 18-04 -- 18-33 Shire Business Park, Three Pears -- hour 40 -- -- 10 ------17-40 -- 18-10 -- 18-39 Warndon, Glovers Needle -- 47 -- -- 17 ------17-47 -- 18-17 -- 18-45 Bilford Road, Retail Park -- 50 -- -- 20 ------17-50 -- 18-20 -- 18-48 Worcester, Bus Station -- 04 -- -- 34 ------18-04 -- 18-33 -- 19-00 Service: 31 31A 31 31A 31 31A 31 31A 31 31 31 31A Henwick Park, Monarch Drive 18-05 18-20 18-35 18-50 19-30 20-00 20-30 21-00 21-30 22-00 22-30 23-00 University Campus 18-11 18-26 18-41 18-56 19-35 20-05 20-35 21-05 21-35 22-05 22-35 23-05 Worcester, Bus Station arrive 18-21 18-36 18-51 19-06 19-42 20-12 20-42 21-12 21-42 22-12 22-42 23-12 Worcester, Bus Station depart -- 18-41 -- 19-14 19-44 20-14 20-44 21-14 21-44 22-14 22-44 23-14 Worcester, Shrub Hill Station -- 18-46 -- 19-17 19-47 20-17 20-47 21-17 21-47 22-17 22-47 23-17 Ronkswood,C'bury Rd/L'pool Rd -- 18-52 -- 19-23 19-53 20-23 20-53 21-23 21-53 22-23 22-53 23-23 Worcestershire Royal Hospital (Main Entrance) -- 18-58 -- 19-28 19-58 20-28 20-58 21-28 21-58 22-28 22-58 23-28 Lyppard Centre, Tesco Store -- 19-03 -- 19-33 -- 20-33 -- 21-33 -- 22-33 -- 23-33 Shire Business Park, Three Pears -- 19-08 -- 19-38 -- 20-38 -- 21-38 -- 22-38 -- 23-38 Warndon, Glovers Needle -- 19-14 -- 19-44 -- 20-44 -- 21-44 -- 22-44 -- 23-44 Bilford Road, Retail Park -- 19-17 -- 19-47 -- 20-47 -- 21-47 -- 22-47 -- 23-47 Worcester, Bus Station -- 19-28 -- 19-58 -- 20-58 -- 21-58 -- 22-58 -- 23-58

81 Attachment B2 Sunday (& Bank Holiday Mondays) from 5th September 2010

Service: 31A 31A 31A 31 31 31A 31 31 31A 31 31 31 31A 31 Henwick Park, Monarch Drive ------09-13 -- -- 10-13 -- 43 -- 13 -- 16-43 University Campus ------09-17 -- -- 10-17 -- 47 -- 17 -- 16-47 Worcester, Bus Station arrive ------09-25 -- -- 10-25 then -- 55 -- 25 -- 16-55 Worcester, Bus Station depart 06-30 07-30 08-30 09-05 -- 09-35 10-05 -- at 35 -- 05 -- 16-35 -- Worcester, Shrub Hill Station 06-33 07-33 08-33 09-09 -- 09-39 10-09 -- these 39 -- 09 -- until 16-39 -- Ronkswood,C'bury Rd/L'pool Rd 06-39 07-39 08-39 09-15 -- 09-45 10-15 -- mins. 45 -- 15 -- 16-45 -- Worcestershire Royal Hospital (Main Entrance) 06-44 07-44 08-44 09-20 -- 09-50 10-20 -- past 50 -- 20 -- 16-50 -- Lyppard Centre, Tesco Store 06-49 07-49 08-49 -- -- 09-55 -- -- each 55 ------16-55 -- Shire Business Park, Three Pears 06-54 07-54 08-54 -- -- 10-00 -- -- hour 00 ------17-00 -- Warndon, Glovers Needle 07-00 08-00 09-00 -- -- 10-06 -- -- 06 ------17-06 -- Bilford Road, Retail Park 07-03 08-03 09-03 -- -- 10-09 -- -- 09 ------17-09 -- Worcester, Bus Station 07-14 08-14 09-14 -- -- 10-20 -- -- 20 ------17-20 -- DIA DIA DIA Service: 31 31 31A 31 31A 31 31 31 Henwick Park, Monarch Drive -- 17-13 -- 17-43 18-30 19-29 20-29 21-29 University Campus -- 17-17 -- 17-47 18-34 19-33 20-33 21-33 Worcester, Bus Station arrive -- 17-25 -- 17-55 18-42 19-41 20-41 21-41 Worcester, Bus Station depart 17-05 -- 17-44 -- 18-44 19-43 20-43 21-43 Worcester, Shrub Hill Station 17-09 -- 17-47 -- 18-47 19-46 20-46 21-46 Ronkswood,C'bury Rd/L'pool Rd 17-15 -- 17-53 -- 18-53 19-52 20-52 21-52 Worcestershire Royal Hospital (Main Entrance) 17-20 -- 17-58 -- 18-58 19-57 20-57 21-57 Lyppard Centre, Tesco Store -- -- 18-03 -- 19-03 ------Shire Business Park, Three Pears -- -- 18-08 -- 19-08 ------Warndon, Glovers Needle -- -- 18-14 -- 19-14 ------Bilford Road, Retail Park -- -- 18-17 -- 19-17 ------Worcester, Bus Station -- -- 18-28 -- 19-28 ------Operator Phone Number: Diamond - 0121 557 7337 First - 0800 587 7381

82 Attachment B3 City Centre - St Peter's - County Hall - Worcestershire Royal H 32A Operator: First Monday to Friday from 1st September 2009

Worcester, Bus Station 07-16 07-46 08-16 08-46 St. Peter's, Greenhill Island 07-30 08-00 08-30 09-00 County Hall, Shelter 07-45 08-15 08-45 09-15 Worcestershire Royal Hospital REQ REQ REQ REQ

Notes: REQ - On request to driver only

Operator Phone Number: First - 0800 587 7381 Worcestershire Royal Hospital −County Hall - St Peters - City C32A Operator: First Monday to Friday from 31st August 2008

Worcestershire Royal Hospital 16-15 16-45 17-15 County Hall, Shelter 16-22 16-52 17-22 St. Peter's, Greenhill Island 16-37 17-07 17-37 Worcester, Bus Station 16-54 17-24 17-54

Operator Phone Number: Firsti - 0800 5878 738138

83 Attachment B4 Great Malvern - Worcester - Worcs. Royal Hospital via Pound Bank and Malvern Link 44 Great Malvern - Worcester - Worcs. Royal Hospital via Belmont and Malvern Link 44A Operator: First, Diamond (DIA) Monday to Friday from 2nd January 2011

Service : 44 44 44 44 44 44 44A 44A 44 44 44 44 44 44 44 44 44 Notes : CHOL COL COL CHOL COL CHOL COL COL ♥ HOL Malvern, Community Hospital ------Belmont, opp. Dyson Perrins School ------08-05 08-10 08-35 08-50 09-10 Link Top (Malvern), Shelter 06-14 06-54 07-14 07-21 07-21 ------07-44 -- 07-44 08-02 08-12 08-17 08-42 08-57 09-17 Gt Malvern, Foley Arms, Stop G 06-15 06-55 07-15 07-22 07-22 ------07-45 -- 07-45 08-03 08-13 08-18 08-43 08-58 09-18 Gt Malvern, Church Street, Stop A (Downhill) 06-17 06-57 07-17 07-24 07-24 ------07-47 -- 07-47 08-05 08-15 08-20 08-45 09-00 09-20 Gt Malvern, Graham Road, Stop B | | | | | -- 07-32 07-33 | -- | | | | | | | Link Top (Malvern), Newtown Road | | | | | -- 07-35 07-35 | -- | | | | | | | Belmont, Dyson Perrins School | | | | | -- 07-40 07-40 | -- | | | | | | | Malvern Link Station, Howsell Road | | | | | -- 07-44 07-44 | -- | | | | | | | Avenue Road (for Gt Malvern Station ) 06-19 06-59 07-19 07-26 07-26 -- | | 07-49 -- 07-49 08-07 08-17 08-22 08-47 09-02 09-22 Barnards Green, Shops 06-21 07-01 07-21 07-29 07-29 -- | | 07-52 -- 07-52 08-10 08-20♥ 08-25 08-50 09-05 09-24 Pound Bank, Moat Way (Northbound) 06-23 07-03 07-23 07-31 07-31 -- | | 07-54 -- 07-55 08-13 08-28♥ 08-28 08-53 09-08 09-27 Prospect View, Health Centre 06-25 07-05 07-25 07-33 07-33 -- | | 07-56 -- 07-59 08-17 08-32 08-32 08-56 09-11 09-30 Malvern Link, opp. Co-op 06-28 07-08 07-29 07-37 07-37 -- 07-46 07-46 08-00 -- 08-03 08-21 08-36 08-36 09-00 09-15 09-34 Malvern Link, Morrisons | | 07-33 07-43 07-43 -- 07-52 07-52 08-06 -- 08-10 08-28 08-43 08-43 09-07 09-22 09-41 Powick, Hospital Lane 06-35 07-15 07-39 07-50 07-51 -- 07-59 08-00 08-13 -- 08-18 08-35 08-50 08-50 09-14 09-29 09-48 Lower Wick, Island (Malvern Road) 06-39 07-19 07-44 07-55 07-57 -- 08-04 08-06 08-18 -- 08-23 08-40 08-55 08-55 09-19 09-34 09-53 Worcester, Bus Station Arrive 06-45 07-25 07-54 08-05 08-10 -- 08-14 08-20 08-28 -- 08-36 08-50 09-05 09-05 09-29 09-44 10-03 Worcester, Bus Station Depart -- 07-30 07-56 08-12 08-15 08-20 08-22 08-28 08-35 08-35 08-41 08-55 09-15 09-15 09-35 09-51 10-11 Red Hill, Red Hill Top -- 07-38 08-05 08-23 08-27 08-32 08-33 08-40 08-46 08-47 08-53 09-06 09-26 09-26 09-46 10-01 10-21 County Hall, Wildwood Drive -- 07-40 08-07 08-26 08-31 08-36 08-36 08-44 08-49 08-51 08-57 09-09 09-29 09-29 09-49 10-04 10-24 Worcestershire Royal Hosp, Entrance -- 07-46 08-13 08-32 08-41 -- 08-42 08-54 08-55 -- 09-05 09-17 09-37 09-37 09-55 10-10 10-30

Service : 44 44 44 44 44 44 44 44 44 44 44 44A 44A 44 44A Notes : HOL ▲ SCH HOL Malvern, Community Hospital -- 09-32 52 07 22 37 13-47 14-02 14-17 14-37 14-50 14-50 -- 15-05 -- Belmont, opp. Dyson Perrins School 09-30 09-45 00 15 30 45 14-00 14-14 14-29 14-44 14-57 14-57 -- 15-12 -- Link Top (Malvern), Shelter 09-36 09-51 06 21 36 51 14-06 14-20 14-35 14-50 15-03 15-03 -- 15-18 -- Gt Malvern, Foley Arms, Stop G 09-37 09-52 07 22 37 52 14-07 14-21 14-36 14-51 15-04 15-04 -- 15-19 -- Gt Malvern, Church Street, Stop A (Downhill) 09-39 09-54 then 09 24 39 54 14-09 14-23 14-38 14-53 15-06 15-06 -- 15-21 -- Gt Malvern, Graham Road, Stop B | | | | | | | | | | | | -- | 15-26 Link Top (Malvern), Newtown Road | | at | | | | | | | | | | -- | 15-29 Belmont, Dyson Perrins School | | | | | | | | | | | | 15-22 | 15-34 Malvern Link Station, Howsell Road | | these | | | | | | | | | | 15-27 | 15-37 Avenue Road (for Gt Malvern Station ) 09-41 09-56 11 26 41 56 14-11 14-25 14-40 14-55 15-08 15-08 | 15-23 | Barnards Green, Shops 09-43 09-58 mins 13 28 43 58 until 14-13 14-27 14-42 14-57 15-10 15-10▲ | 15-25 | Pound Bank, Moat Way (Northbound) 09-46 10-01 16 31 46 01 14-16 14-30 14-45 15-00 15-13 15-23▲ | 15-28 | Prospect View, Health Centre 09-49 10-04 past 19 34 49 04 14-19 14-33 14-48 15-03 15-16 15-26 | 15-31 | Malvern Link, opp. Co-op 09-53 10-08 23 38 53 08 14-23 14-37 14-52 15-07 15-20 15-30 15-30 15-35 15-39 Malvern Link, Morrisons 09-59 10-14 each 29 44 59 14 14-29 14-43 14-58 15-13 15-26 15-36 15-36 15-41 15-46 Powick, Hospital Lane 10-06 10-21 36 51 06 21 14-36 14-50 15-05 15-20 15-33 15-43 15-43 15-48 15-53 Lower Wick, Island (Malvern Road) 10-11 10-26 hour 41 56 11 26 14-41 14-55 15-10 15-25 15-38 15-48 15-48 15-53 15-58 Worcester, Bus Station Arrive 10-21 10-36 51 06 21 36 14-51 15-05 15-20 15-35 15-48 15-58 15-58 16-03 16-08 Worcester, Bus Station Depart 10-26 10-41 56 11 26 41 14-56 15-10 15-25 15-40 15-53 -- 16-07 16-08 -- Red Hill, Red Hill Top 10-36 10-51 06 21 36 51 15-06 15-20 15-35 15-50 16-03 -- 16-19 16-20 -- County Hall, Wildwood Drive 10-39 10-54 09 24 39 54 15-09 15-23 15-38 15-53 16-06 -- 16-22 16-23 -- Worcestershire Royal Hosp, Entrance 10-45 11-00 15 30 45 00 15-15 15-29 15-44 15-59 16-12 -- 16-28 16-29 --

Service : 44 44 44 44 44A 44 44 44A 44 44A 44 44 44 44 44 44 44 Notes : DIA DIA DIA DIA Malvern, Community Hospital ------Belmont, opp. Dyson Perrins School 15-26 ------16-49 ------Link Top (Malvern), Shelter 15-33 15-53 16-08 16-28 -- 16-55 17-20 -- 17-55 -- 18-35 18-55 19-22 20-05 21-20 22-35 23-48 Gt Malvern, Foley Arms, Stop G 15-34 15-54 16-09 16-29 -- 16-56 17-21 -- 17-56 -- 18-36 18-56 19-23 20-07 21-22 22-37 23-50 Gt Malvern, Church Street, Stop A (Downhill) 15-36 15-56 16-11 16-31 -- 16-58 17-23 -- 17-58 -- 18-38 18-58 19-25 20-08 21-23 22-38 23-51 Gt Malvern, Graham Road, Stop B | | | | 16-46 | | 17-38 | 18-13 | | | | | | | Link Top (Malvern), Newtown Road | | | | 16-49 | | 17-41 | 18-15 | | | | | | | Belmont, Dyson Perrins School | | | | 16-54 | | 17-46 | 18-20 | | | | | | | Malvern Link Station, Howsell Road | | | | 16-57 | | 17-50 | 18-24 | | | | | | | Avenue Road (for Gt Malvern Station ) 15-38 15-58 16-13 16-33 | 17-00 17-25 | 18-00 | 18-40 19-00 19-27 20-09 21-24 22-39 23-52 Barnards Green, Shops 15-41 16-01 16-15 16-35 | 17-02 17-27 | 18-02 | 18-42 19-02 19-29 20-12 21-27 22-42 23-55 Pound Bank, Moat Way (Northbound) 15-44 16-04 16-19 16-39 | 17-06 17-31 | 18-06 | 18-44 19-04 19-31 20-15 21-30 22-45 23-58 Prospect View, Health Centre 15-47 16-07 16-22 16-42 | 17-09 17-34 | 18-09 | 18-47 19-07 19-34 20-17 21-32 22-47 23-59 Malvern Link, opp. Co-op 15-51 16-11 16-26 16-46 16-59 17-13 17-38 17-53 18-13 18-27 18-51 19-11 19-37 20-20 21-35 22-50 00-03 Malvern Link, Morrisons 15-58 16-18 16-33 16-53 17-06 17-20 17-44 17-59 18-19 18-33 18-55 19-15 19-40 20-23 21-38 | | Powick, Hospital Lane 16-05 16-25 16-40 17-00 17-13 17-27 17-51 18-06 18-25 18-40 19-01 19-21 19-46 20-29 21-44 22-57 00-10 Lower Wick, Island (Malvern Road) 16-10 16-30 16-45 17-05 17-18 17-32 17-56 18-11 18-29 18-44 19-06 19-26 19-50 20-34 21-49 23-01 00-14 Worcester, Bus Station Arrive 16-21 16-41 16-57 17-17 17-28 17-44 18-06 18-21 18-38 18-53 19-15 19-35 19-59 20-41 21-56 23-08 00-21 Worcester, Bus Station Depart 16-26 16-46 17-03 17-23 -- -- 18-10 ------Red Hill, Red Hill Top 16-38 16-58 17-15 17-35 -- -- 18-20 ------County Hall, Wildwood Drive 16-41 17-01 17-18 17-38 -- -- 18-22 ------Worcestershire Royal Hosp, Entrance 16-47 17-07 17-24 17-44 ------Notes: COL - Runs on College Days only, CHOL - Does not run on College Days, SCH - Runs on Schooldays only, HOL - Runs in School Holidays only, 84 ♥ - Runs on schooldays only and operates via Chase High School (08-24) ▲ - Runs on schooldays only and operates via Chase High School (15-14) Attachment B4 Great Malvern - Worcester - Worcs. Royal Hospital via Pound Bank and Malvern Link 44 Operator: First, Diamond (DIA) Saturday from 2nd January 2011

Service : 44 44 44 44 44 44 44 44 44 44 44 44 44 44 44 Malvern, Community Hospital ------09-07 09-22 37 52 07 22 16-07 16-22 16-37 Belmont, opp. Dyson Perrins School ------09-15 09-30 45 00 15 30 16-15 16-30 16-45 Link Top (Malvern), Shelter 07-06 08-01 08-29 08-49 -- 09-07 09-21 09-36 51 06 21 36 16-21 16-36 16-51 Gt Malvern, Foley Arms, Stop G 07-07 08-02 08-30 08-50 -- 09-08 09-22 09-37 52 07 22 37 16-22 16-37 16-52 Gt Malvern, Church Street, Stop A (Downhill) 07-09 08-04 08-32 08-52 -- 09-10 09-24 09-39 then 54 09 24 39 16-24 16-39 16-54 Gt Malvern, Graham Road, Stop B | | | | -- | | | | | | | | | | Link Top (Malvern), Newtown Road | | | | -- | | | at | | | | | | | Belmont, Dyson Perrins School | | | | -- | | | | | | | | | | Malvern Link Station, Howsell Road | | | | -- | | | these | | | | | | | Avenue Road (for Gt Malvern Station ) 07-11 08-06 08-34 08-54 -- 09-12 09-26 09-41 56 11 26 41 16-26 16-41 16-56 Barnards Green, Shops 07-13 08-08 08-37 08-56 -- 09-14 09-28 09-43 mins. 58 13 28 43 until 16-28 16-43 16-58 Pound Bank, Moat Way (Northbound) 07-15 08-10 08-39 08-59 -- 09-17 09-31 09-46 01 16 31 46 16-31 16-46 17-01 Prospect View, Health Centre 07-17 08-12 08-42 09-02 -- 09-20 09-34 09-49 past 04 19 34 49 16-34 16-49 17-04 Malvern Link, opp. Co-op 07-20 08-15 08-45 09-05 -- 09-24 09-38 09-53 08 23 38 53 16-38 16-53 17-08 Malvern Link, Morrisons 07-25 08-20 08-50 09-10 -- 09-30 09-44 09-59 each 14 29 44 59 16-44 16-59 17-14 Powick, Hospital Lane 07-32 08-27 08-57 09-17 -- 09-37 09-51 10-06 21 36 51 06 16-51 17-06 17-21 Lower Wick, Island (Malvern Road) 07-37 08-32 09-02 09-22 -- 09-42 09-56 10-11 hour 26 41 56 11 16-56 17-11 17-26 Worcester, Bus Station Arrive 07-45 08-40 09-10 09-30 -- 09-52 10-06 10-21 36 51 06 21 17-06 17-21 17-36 Worcester, Bus Station Depart 07-47 08-47 09-17 -- 09-47 -- 10-11 -- 41 -- 11 -- 17-11 -- -- Red Hill, Red Hill Top 07-55 08-57 09-27 -- 09-57 -- 10-21 -- 51 -- 21 -- 17-21 -- -- County Hall, Wildwood Drive 07-58 09-00 09-30 -- 10-00 -- 10-24 -- 54 -- 24 -- 17-24 -- -- Worcestershire Royal Hosp, Entrance 08-04 09-06 09-36 -- 10-06 -- 10-30 -- 00 -- 30 -- 17-30 -- --

Service : 44 44 44 44 44 44 44 44 44 44 44 Notes : DIA DIA DIA DIA Malvern, Community Hospital ------Belmont, opp. Dyson Perrins School ------Link Top (Malvern), Shelter 17-08 17-23 17-38 17-53 18-17 18-42 19-22 20-05 21-20 22-35 23-48 Gt Malvern, Foley Arms, Stop G 17-09 17-24 17-39 17-54 18-18 18-43 19-23 20-07 21-22 22-37 23-50 Gt Malvern, Church Street, Stop A (Downhill) 17-11 17-26 17-41 17-56 18-20 18-45 19-25 20-08 21-23 22-38 23-51 Gt Malvern, Graham Road, Stop B ||||||||||| Link Top (Malvern), Newtown Road ||||||||||| Belmont, Dyson Perrins School ||||||||||| Malvern Link Station, Howsell Road ||||||||||| Avenue Road (for Gt Malvern Station ) 17-13 17-28 17-43 17-58 18-22 18-47 19-27 20-09 21-24 22-39 23-52 Barnards Green, Shops 17-16 17-31 17-46 18-01 18-24 18-49 19-29 20-12 21-27 22-42 23-55 Pound Bank, Moat Way (Northbound) 17-18 17-33 17-48 18-03 18-26 18-51 19-31 20-15 21-30 22-45 23-58 Prospect View, Health Centre 17-21 17-36 17-51 18-06 18-29 18-54 19-34 20-17 21-32 22-47 23-59 Malvern Link, opp. Co-op 17-25 17-40 17-55 18-10 18-32 18-57 19-37 20-20 21-35 22-50 00-03 Malvern Link, Morrisons 17-31 17-46 18-00 18-15 18-35 19-00 19-40 20-23 21-38 | | Powick, Hospital Lane 17-38 17-53 18-06 18-21 18-41 19-06 19-46 20-29 21-44 22-57 00-10 Lower Wick, Island (Malvern Road) 17-43 17-58 18-10 18-25 18-45 19-10 19-49 20-34 21-49 23-01 00-14 Worcester, Bus Station Arrive 17-52 18-07 18-19 18-34 18-54 19-19 19-59 20-41 21-56 23-08 00-21 Worcester, Bus Station Depart 18-00 ------Red Hill, Red Hill Top 18-10 ------County Hall, Wildwood Drive 18-13 ------Worcestershire Royal Hosp, Entrance 18-19 ------Great Malvern - Worcester via Pound Bank and Malvern Link 44

Operator: First Sunday (& Bank Holiday Mondays) from 2nd January 2011

Service : 44 44 44 44 44 Link Top (Malvern), Shelter 09-15 10-25 16-25 17-42 18-45 Gt Malvern, Foley Arms, Stop G 09-16 10-26 16-26 17-43 18-46 Gt Malvern, Church Street, Stop A 09-18 10-28 then 16-28 17-45 18-48 Avenue Road (for Gt Malvern Station ) 09-20 10-30 16-30 17-47 18-50 Barnards Green, Shops 09-22 10-32 every 16-32 17-49 18-52 Pound Bank (Malvern), Moat Way 09-25 10-35 16-35 17-52 18-55 Prospect View, Health Centre 09-27 10-37 hour 16-37 17-54 18-57 Malvern Link, opp. Pioneer Store 09-30 10-40 16-40 17-57 19-00 Malvern Link, Morrisons 09-34 10-44 until 16-44 | | Powick, Hospital Lane 09-39 10-49 16-49 18-04 19-07 Lower Wick, Island 09-43 10-53 16-53 18-08 19-11 Worcester, Bus Station 09-50 11-00 17-00 18-15 19-18

Operator Phone Number:

Diamond - 0121 557 7337 First - 0800 587 7381

85 Attachment B4 Worcs. Royal Hospital - Worcester - Malvern Link - Great Malvern via Malvern Link and Pound Bank 44 Worcs. Royal Hospital - Worcester - Malvern Link - Great Malvern via Malvern Link and Belmont 44A Operator: First, Diamond (DIA) Monday to Friday from 2nd January 2011

Service : 44 44 44 44 44 44 44A 44A 44 44 44 44A 44A 44 44 44 44 Notes : SCH HOL SCH HOL ♥ SCH HOL Worcestershire Royal Hosp, Entrance ------07-30 07-30 -- -- 07-52 08-17 -- 08-52 County Hall, Wildwood Drive ------07-35 07-35 -- -- 07-57 08-22 08-42 08-57 Red Hill, Traffic Island ------07-38 07-38 -- -- 08-00 08-25 08-45 09-00 Worcester, Bus Station Arrive ------07-47 07-47 -- -- 08-15 08-40 09-00 09-15 Worcester, Bus Station Depart 05-40 06-20 06-40 06-55 07-05 07-20 07-32 07-40 07-38 07-50 07-50 07-58 08-04 08-25 08-48 09-08 09-23 Lower Wick, Island 05-46 06-26 06-46 07-01 07-11 07-26 07-39 07-47 07-45 07-58 07-58 08-06 08-12 08-33 08-56 09-16 09-31 Powick, Hospital Lane 05-49 06-29 06-49 07-05 07-15 07-30 07-43 07-51 07-49 08-02 08-02 08-10 08-16 08-38 09-01 09-21 09-36 Malvern Link, Morrisons | | | 07-11 07-21 07-38 07-51 07-59 07-57 08-08 08-10 08-19 08-23 08-45 09-08 09-28 09-43 Malvern Link, Co-op 05-54 06-34 06-54 07-14 07-24 07-41 07-54 08-02 08-00 08-11 08-14 08-23 08-26 08-50 09-13 09-33 09-48 Prospect View, Health Centre 05-57 06-37 06-57 07-17 07-27 07-44 | | 08-04 08-15 08-18 | | 08-54 09-17 09-37 09-52 Pound Bank, Moat Way (Southbound) 05-59 06-39 06-59 07-19 07-29 07-46 | | 08-07 08-18 08-22♥ | | 08-57 09-20 09-40 09-55 Barnards Green, Clock Shelter 06-02 06-42 07-02 07-23 07-33 07-50 | | 08-11 08-23 08-37♥ | | 09-02 09-25 09-45 10-00 Avenue Road, (for Great Malvern Station ) 06-04 06-44 07-04 07-25 07-35 07-52 | | 08-14 08-25 08-40 | | 09-04 09-27 09-47 10-02 Gt Malvern, Graham Road, Stop B 06-08 06-48 07-08 07-29 07-39 07-56 | | 08-19 08-29 08-44 | | 09-07 09-30 09-50 10-05 Link Top (Malvern), Shelter 06-10 06-50 07-10 ■ 07-42 07-59 | | | | | | | | | | | Malvern, Community Hospital | | | ■ | | | | 08-22 08-32 08-47 | | 09-10 09-32 09-52 10-07 Malvern Link Station, Howsell Road | | | (07-44) | | 07-56 08-04 08-23 08-33 08-48 08-26 08-28 09-11 09-33 09-53 10-08 Belmont, opp. Dyson Perrins School | | | 07-40 | | 08-02 08-08 08-30 08-38 08-55 08-33 08-33 09-15 09-37 09-57 10-12 Great Malvern, Foley Arms, Stop G 06-15 06-55 07-15 -- 07-45 08-03 08-13 08-18 08-43 -- -- 08-43 08-43 -- -- 10-07 10-22 Gt Malvern, Church Street, Stop A (downhill) 06-17 06-57 07-17 -- 07-47 08-05 08-15 08-20 08-45 -- -- 08-45 08-45 -- -- 10-09 10-24

Service : 44 44 44 44 44 44 44 44 44 44 44 44A 44 44 44 Notes : ▲ HOL Worcestershire Royal Hosp, Entrance 09-10 25 40 55 10 13-10 13-25 13-38 13-53 14-08 14-10 14-23 14-38 14-55 15-13 County Hall, Wildwood Drive 09-15 30 45 00 15 13-15 13-30 13-43 13-58 14-13 14-15 14-28 14-43 15-00 15-18 Red Hill, Traffic Island 09-19 34 49 04 19 13-19 13-34 13-47 14-02 14-17 14-19 14-32 14-47 15-04 15-22 Worcester, Bus Station Arrive 09-32 then 47 02 17 32 13-32 13-47 14-00 14-15 14-30 14-32 14-45 15-00 15-17 15-35 Worcester, Bus Station Depart 09-38 53 08 23 38 13-38 13-53 14-06 14-21 14-34 14-38 14-50 15-05 15-22 15-40 Lower Wick, Island 09-46 at 01 16 31 46 13-46 14-01 14-14 14-29 14-42 14-46 14-58 15-13 15-30 15-48 Powick, Hospital Lane 09-51 06 21 36 51 13-51 14-06 14-19 14-34 14-47 14-51 15-03 15-18 15-35 15-53 Malvern Link, Morrisons 09-58 these 13 28 43 58 13-58 14-13 14-26 14-41 14-54 14-58 15-10 15-25 15-42 16-00 Malvern Link, Co-op 10-03 18 33 48 03 14-03 14-18 14-31 14-46 14-59 15-03 15-15 15-30 15-47 16-05 Prospect View, Health Centre 10-07 mins. 22 37 52 07 until 14-07 14-22 14-35 14-50 15-03 15-07 | 15-34 15-51 16-09 Pound Bank, Moat Way (Southbound) 10-10 25 40 55 10 14-10 14-25 14-38 14-53 15-06▲ 15-10 | 15-37 15-54 16-12 Barnards Green, Clock Shelter 10-15 past 30 45 00 15 14-15 14-30 14-43 14-58 15-18▲ 15-15 | 15-42 15-59 16-17 Avenue Road, (for Great Malvern Station ) 10-17 32 47 02 17 14-17 14-32 14-45 15-00 15-20 15-17 | 15-44 16-01 16-19 Gt Malvern, Graham Road, Stop B 10-20 each 35 50 05 20 14-20 14-35 14-48 15-03 15-23 15-20 | 15-47 16-04 16-22 Link Top (Malvern), Shelter | | | | | | | | | ■ ■ | 15-49 16-06 16-24 Malvern, Community Hospital 10-22 hour 37 52 07 22 14-22 14-37 14-50 15-05 ■ ■ | | | | Malvern Link Station, Howsell Road 10-23 38 53 08 23 14-23 14-38 14-51 15-06 (15-37) (15-37) 15-17 | | | Belmont, opp. Dyson Perrins School 10-27 42 57 12 27 14-27 14-42 14-55 15-10 15-34 15-34 15-21 | | | Great Malvern, Foley Arms, Stop G 10-37 52 07 22 37 14-37 14-51 15-04 ------15-34 15-54 16-09 16-29 Gt Malvern, Church Street, Stop A (downhill) 10-39 54 09 24 39 14-39 14-53 15-06 ------15-36 15-56 16-11 16-31

Service : 44 44A 44 44 44 44 44 44 44 44 44 44 44 44 Notes : COL DIA DIA DIA DIA Worcestershire Royal Hosp, Entrance 15-33 15-48 16-05 -- 16-25 16-40 17-00 17-20 17-45 18-20 ------County Hall, Wildwood Drive 15-38 15-53 16-10 16-20 16-30 16-45 17-05 17-25 17-50 18-25 ------Red Hill, Traffic Island 15-42 15-57 16-14 16-24 16-34 16-49 17-09 17-29 17-53 18-28 ------Worcester, Bus Station Arrive 15-55 16-10 16-28 16-38 16-48 17-03 17-23 17-43 18-05 18-40 ------Worcester, Bus Station Depart 16-00 16-15 16-33 -- 16-53 17-08 17-28 17-48 18-10 18-45 19-30 20-45 22-00 23-15 Lower Wick, Island 16-08 16-23 16-41 -- 17-01 17-16 17-36 17-56 18-17 18-51 19-36 20-51 22-06 23-21 Powick, Hospital Lane 16-13 16-28 16-46 -- 17-06 17-21 17-41 18-01 18-21 18-54 19-40 20-55 22-10 23-25 Malvern Link, Morrisons 16-20 16-35 16-53 -- 17-13 17-28 17-48 18-08 18-29 19-00 19-46 21-01 22-16 | Malvern Link, Co-op 16-25 16-40 16-58 -- 17-18 17-33 17-53 18-13 18-33 19-03 19-49 21-04 22-19 23-32 Prospect View, Health Centre 16-29 | 17-02 -- 17-22 17-37 17-57 18-17 18-37 19-06 19-51 21-06 22-21 23-33 Pound Bank, Moat Way (Southbound) 16-32 | 17-05 -- 17-25 17-40 18-00 18-20 18-40 19-09 19-54 21-09 22-24 23-37 Barnards Green, Clock Shelter 16-37 | 17-10 -- 17-30 17-45 18-05 18-25 18-45 19-13 19-58 21-13 22-28 23-41 Avenue Road, (for Great Malvern Station ) 16-39 | 17-12 -- 17-32 17-47 18-07 18-27 18-47 19-15 19-59 21-14 22-29 23-45 Gt Malvern, Graham Road, Stop B 16-42 | 17-15 -- 17-35 17-50 18-10 18-30 18-50 19-18 20-03 21-18 22-33 23-46 Link Top (Malvern), Shelter ■ | 17-17 -- ■ 17-52 ■ 18-32 18-52 19-20 20-05 21-20 22-35 23-48 Malvern, Community Hospital ■ | | -- ■ | ■ | | | | | | | Malvern Link Station, Howsell Road (16-57) 16-42 | -- (17-50) | (18-24) | | | | | | | Belmont, opp. Dyson Perrins School 16-54 16-46 | -- 17-46 | 18-20 | | | | | | | Great Malvern, Foley Arms, Stop G -- 16-56 17-21 -- -- 17-56 -- 18-36 18-56 19-23 20-07 21-22 22-37 23-50 Gt Malvern, Church Street, Stop A (downhill) -- 16-58 17-23 -- -- 17-58 -- 18-38 18-58 19-25 20-08 21-23 22-38 23-51

Notes: COL - Runs on College Days only, CHOL - Does not run on College Days, SCH - Runs on Schooldays only, HOL - Runs in School Holidays only, ♥ - Runs on schooldays only and operates via Chase High School (08-32), ▲ - Runs on schooldays only and operates via Chase High School (15-14) ■ - Continues as Service 44A via Belmont to Malvern Link and Worcester Additional College Day Journeys leaving Sixth Form College to Worcester Bus Station 12-40 (Wednesdays only) & 16-10 (Monday to Friday)

86 Attachment B4 Worcs. Royal Hospital - Worcester - Malvern Link - Great Malvern via Malvern Link and Pound Bank 44 Operator: First, Diamond (DIA) Saturday from 2nd January 2011

Service : 44 44 44 44 44 44 44 44 44 44 44 44 44 44 44 Notes : Worcestershire Royal Hosp, Entrance ------08-07 -- -- 08-40 -- 10 -- 40 15-40 -- 16-10 County Hall, Wildwood Drive ------08-12 -- -- 08-45 -- 15 -- 45 15-45 -- 16-15 Red Hill, Traffic Island ------08-15 -- -- 08-49 -- 19 -- 49 15-49 -- 16-19 Worcester, Bus Station Arrive ------08-25 -- -- 09-02 then -- 32 -- 02 16-02 -- 16-32 Worcester, Bus Station Depart 06-35 07-25 07-50 08-10 08-28 08-40 08-53 09-08 23 38 53 08 16-08 16-23 16-38 Lower Wick, Island 06-41 07-31 07-57 08-17 08-35 08-47 09-01 09-16 at 31 46 01 16 16-16 16-31 16-46 Powick, Hospital Lane 06-44 07-34 08-00 08-20 08-38 08-51 09-06 09-21 36 51 06 21 16-21 16-36 16-51 Malvern Link, Morrisons | 07-40 08-06 08-26 08-44 08-58 09-13 09-28 these 43 58 13 28 16-28 16-43 16-58 Malvern Link, Co-op 06-49 07-43 08-09 08-29 08-48 09-03 09-18 09-33 48 03 18 33 16-33 16-48 17-03 Prospect View, Health Centre 06-52 07-46 08-13 08-33 08-52 09-07 09-22 09-37 mins. 52 07 22 37 until 16-37 16-52 17-07 Pound Bank, Moat Way (Southbound) 06-54 07-49 08-16 08-36 08-55 09-10 09-25 09-40 55 10 25 40 16-40 16-55 17-10 Barnards Green, Clock Shelter 06-57 07-52 08-20 08-40 09-00 09-15 09-30 09-45 past 00 15 30 45 16-45 17-00 17-15 Avenue Road, (for Great Malvern Station ) 06-59 07-54 08-22 08-42 09-02 09-17 09-32 09-47 02 17 32 47 16-47 17-02 17-17 Gt Malvern, Graham Road, Stop B 07-03 07-58 08-26 08-46 09-05 09-20 09-35 09-50 each 05 20 35 50 16-50 17-05 17-20 Link Top (Malvern), Shelter 07-05 08-00 08-28 08-48 | | | | | | | | | 17-07 17-22 Malvern, Community Hospital | | | | 09-07 09-22 09-37 09-52 hour 07 22 37 52 16-52 | | Malvern Link Station, Howsell Road | | | | 09-08 09-23 09-38 09-53 08 23 38 53 16-53 | | Belmont, opp. Dyson Perrins School | | | | 09-12 09-27 09-42 09-57 12 27 42 57 16-57 | | Great Malvern, Foley Arms, Stop G 07-07 08-02 08-30 08-50 09-22 09-37 09-52 10-07 22 37 52 07 17-07 17-09 17-24 Gt Malvern, Church Street, Stop A (downhill) 07-09 08-04 08-32 08-52 09-24 09-39 09-54 10-09 24 39 54 09 17-09 17-11 17-26

Service : 44 44 44 44 44 44 44 44 44 Notes : DIA DIA DIA DIA Worcestershire Royal Hosp, Entrance -- 16-40 17-10 17-40 18-25 ------County Hall, Wildwood Drive -- 16-45 17-15 17-45 18-30 ------Red Hill, Traffic Island -- 16-49 17-18 17-48 18-33 ------Worcester, Bus Station Arrive -- 17-02 17-30 18-00 18-43 ------Worcester, Bus Station Depart 16-53 17-08 17-35 18-05 18-45 19-30 20-45 22-00 23-15 Lower Wick, Island 17-01 17-16 17-43 18-11 18-51 19-36 20-51 22-06 23-21 Powick, Hospital Lane 17-06 17-21 17-46 18-14 18-54 19-40 20-55 22-10 23-25 Malvern Link, Morrisons 17-13 17-28 17-53 18-20 19-00 19-46 21-01 22-16 | Malvern Link, Co-op 17-18 17-33 17-57 18-23 19-03 19-49 21-04 22-19 23-32 Prospect View, Health Centre 17-22 17-37 18-01 18-26 19-06 19-51 21-06 22-21 23-33 Pound Bank, Moat Way (Southbound) 17-25 17-40 18-04 18-29 19-09 19-54 21-09 22-24 23-37 Barnards Green, Clock Shelter 17-30 17-45 18-08 18-33 19-13 19-58 21-13 22-28 23-41 Avenue Road, (for Great Malvern Station ) 17-32 17-47 18-10 18-35 19-15 19-59 21-14 22-29 23-45 Gt Malvern, Graham Road, Stop B 17-35 17-50 18-13 18-38 19-18 20-03 21-18 22-33 23-46 Link Top (Malvern), Shelter 17-37 17-52 18-15 18-40 19-20 20-05 21-20 22-35 23-48 Malvern, Community Hospital | | | | | | | | | Malvern Link Station, Howsell Road | | | | | | | | | Belmont, opp. Dyson Perrins School | | | | | | | | | Great Malvern, Foley Arms, Stop G 17-39 17-54 18-18 18-43 19-23 20-07 21-22 22-37 23-50 Gt Malvern, Church Street, Stop A (downhill) 17-41 17-56 18-20 18-45 19-25 20-08 21-23 22-38 23-51 Worcester - Great Malvern via Malvern Link and Pound Bank 44 Operator: First Sunday (& Bank Holiday Mondays) from 2nd January 2011

Service : 44 44 44 44 44 44 Worcester, Bus Station Depart 08-40 09-47 10-47 15-47 17-05 18-10 Lower Wick, Island 08-47 09-54 10-54 15-54 17-12 18-17 Powick, Hospital Lane 08-50 09-57 10-57 15-57 17-15 18-20 Malvern Link, Morrisons | 10-03 11-03 then 16-03 17-21 | Malvern Link, Co-op 08-57 10-07 11-07 16-07 17-25 18-27 Prospect View, Health Centre 09-00 10-10 11-10 every 16-10 17-28 18-30 Pound Bank, Moat Way (Southbound) 09-03 10-13 11-13 16-13 17-31 18-33 Barnards Green, Clock Shelter 09-07 10-17 11-17 hour 16-17 17-35 18-37 Avenue Road, (for Great Malvern Station ) 09-09 10-19 11-19 16-19 17-37 18-39 Gt Malvern, Graham Road, Stop B 09-11 10-21 11-21 until 16-21 17-39 18-41 Link Top (Malvern), Shelter 09-13 10-23 11-23 16-23 17-41 18-43 Great Malvern, Foley Arms, Stop G 09-16 10-26 11-26 16-26 17-43 18-46 Gt Malvern, Church Street, Stop A (downhill) 09-18 10-28 11-28 16-28 17-45 18-48

Operator Phone Number: Diamond - 0121 557 7337 First - 0800 587 7381

87 Worcestershire Royal Hospital ↔↔↔ Worcester ↔ Stourport ↔↔↔ Bewdley ↔↔↔ Kidderminster 300300300 Operator: First

Sundays and Bank Holiday Mondays from 2nd September 2007

Worcestershire Royal Hospital, Main Entrance -- 10-15 12-15 14-15 16-15 18-15 Kidderminster, Bus Station 09-00 11-00 13-00 15-00 17-00 19-00 Worcester, opp.Shrub Hill Station X -- 10-20 12-20 14-20 16-20 18-20 Kidderminster, Swan Centre 09-02 11-02 13-02 15-02 17-02 19-02 Worcester, Bus Station 08-25 10-25 12-25 14-25 16-25 18-25 Kidderminster, General Hospital, Grounds 09-04 11-04 13-04 15-04 17-04 19-04 Henwick, Post Office 08-32 10-32 12-32 14-32 16-32 18-32 Bewdley, Load Street 09-13 11-13 13-13 15-13 17-13 19-13 Hallow, Royal Oak 08-35 10-35 12-35 14-35 16-35 18-35 Bewdley, Stourport Road (for S.V.R. Station _) 09-15 11-15 13-15 15-15 17-15 19-15 Holt Heath, Lambourne Orchard 08-42 10-42 12-42 14-42 16-42 18-42 Burlish, Crossroads 09-18 11-18 13-18 15-18 17-18 19-18 Holt Fleet, Shop 08-44 10-44 12-44 14-44 16-44 18-44 Stourport, York Street 09-23 11-23 13-23 15-23 17-23 19-23 Ombersley, Woodhall Lane, Shelter 08-48 10-48 12-48 14-48 16-48 18-48 Hartlebury, Church (for Castle) 09-30 11-30 13-30 15-30 17-30 19-30 Crossway Green, Mitre Oak 08-52 10-52 12-52 14-52 16-52 18-52 Waresley, St. Gilberts 09-32 11-32 13-32 15-32 17-32 19-32 Waresley, Garage, Old Worcester Road 08-54 10-54 12-54 14-54 16-54 18-54 Crossway Green, opp. Mitre Oak 09-34 11-34 13-34 15-34 17-34 19-34 Hartlebury, Church (for Castle) 08-56 10-56 12-56 14-56 16-56 18-56 Ombersley, School Bank 09-38 11-38 13-38 15-38 17-38 19-38 Stourport, High Street 09-03 11-03 13-03 15-03 17-03 19-03 Holt Fleet, Shop 09-42 11-42 13-42 15-42 17-42 19-42 Burlish, Crossroads 09-08 11-08 13-08 15-08 17-08 19-08 Holt Heath, Woodbury Park 09-44 11-44 13-44 15-44 17-44 19-44 Bewdley, Stourport Road (for S.V.R. Station _) 09-11 11-11 13-11 15-11 17-11 19-11 Hallow, Royal Oak 09-51 11-51 13-51 15-51 17-51 19-51 Bewdley, Load Street 09-13 11-13 13-13 15-13 17-13 19-13 Henwick, Post Office 09-54 11-54 13-54 15-54 17-54 19-54 Kidderminster, General Hospital, Grounds 09-22 11-22 13-22 15-22 17-22 19-22 Worcester, Bus Station 10-01 12-01 14-01 16-01 18-01 20-01 Kidderminster, opp. Swan Centre 09-24 11-24 13-24 15-24 17-24 19-24 Worcester, Shrub Hill Station X 10-04 12-04 14-04 16-04 18-04 -- Kidderminster, Bus Station 09-26 11-26 13-26 15-26 17-26 19-26 Worcestershire Royal Hospital, Main Entrance 10-09 12-09 14-09 16-09 18-09 -- Kidderminster, Rail Stations Forecourt X _ ------19-29

For weekday services along the line of route see services 2, 2A, 3, 11, 31, 294, 295, 303, 758, 914, X3

Operator Phone Number: First - 0800 587 7381

Attachment B5

88 Attachment B6 Sixways P&R Site - Warndon Villages - Worcs. Royal Hospital W2 Sixways P&R Site - Worcs. Royal Hospital W3 Operator: Worcestershire County Council No Saturday or Sunday service on this route LIMITED STOP SERVICE (W2 STOPS) : Sixways (Park & Ride Site), Plantation Drive (Barass Avenue), Millwood Drive (Debdale Avenue), Millwood Drive (Lyppard Centre), Woodgreen Drive (Hoskyns Avenue), Worcestershire Royal Hospital (A & E Unit), Worcestershire Royal Hospital (Children's Unit), Worcestershire Royal Hospital (Main Entrance) LIMITED STOP SERVICE (W3 STOPS) : Sixways (Park & Ride Site), Worcestershire Royal Hospital (A & E Unit), Worcestershire Royal Hospital (Aconbury Unit) Monday to Friday from 6th September 2010

Service : W2 W2 W2 W2 W3 W2 W3 W2 W3 W2 W3 W2 W3 Sixways, Park & Ride Site depart 06-44 07-00 07-10 07-20 07-30 07-40 07-50 08-00 08-10 08-20 08-30 08-40 08-50 WWWW | W | W | W | W | Worcestershire Royal Hospital, A&E Unit 06-53 07-09 07-19 07-30 07-39 07-51 08-00 08-11 08-20 08-31 08-40 08-51 09-00 Worcestershire Royal Hospital, Main Entrance 06-55 07-11 07-21 07-32 | 07-55 | 08-15 | 08-35 | 08-55 | ||||||||||||| Sixways, Park & Ride Site arrive 07-03 07-19 07-31 07-42 07-50 08-07 08-13 08-28 08-35 08-48 08-54 09-07 09-13

Service : W2 W3 W2 W2 W2 W2 W2 W2 W2 W2 W2 W2 W2 Sixways, Park & Ride Site depart 09-00 09-10 09-20 09-40 10-00 10-20 10-40 11-00 11-20 11-40 12-00 12-20 12-40 W | WWWWWWWWWWW Worcestershire Royal Hospital, A&E Unit 09-11 09-20 09-31 09-51 10-11 10-31 10-51 11-11 11-31 11-51 12-11 12-31 12-51 Worcestershire Royal Hospital, Main Entrance 09-14 | 09-34 09-54 10-14 10-34 10-54 11-14 11-34 11-54 12-14 12-34 12-54 W | WWWWWWWWWWW Sixways, Park & Ride Site arrive 09-25 09-32 09-45 10-05 10-25 10-45 11-05 11-25 11-45 12-05 12-25 12-45 13-05

Service : W2 W2 W2 W2 W2 W2 W2 W2 W2 W2 W2 W3 W2 Sixways, Park & Ride Site depart 13-00 13-20 13-40 14-00 14-20 14-40 15-00 15-20 15-40 16-00 16-10 16-20 16-30 WWWWWW WWW | | | | Worcestershire Royal Hospital, A&E Unit 13-11 13-31 13-51 14-11 14-31 14-51 15-11 15-31 15-51 16-10 16-20 16-30 16-40 Worcestershire Royal Hospital, Main Entrance 13-14 13-34 13-54 14-14 14-34 14-54 15-14 15-34 15-54 16-13 16-23 | 16-43 WWWWWWWWWWW | W Sixways, Park & Ride Site arrive 13-25 13-45 14-05 14-25 14-45 15-05 15-25 15-45 16-05 16-28 16-38 16-44 16-58

Service : W3 W3 W3 W2 W3 W2 W3 W2 W3 W2 W2 Notes : ▲ ▲ ▲ Sixways, Park & Ride Site depart 16-40 16-50 17-00 17-10 17-20 17-30 17-40 17-50 18-00 18-10 18-30 Worcestershire Royal Hospital, A&E Unit 16-50 17-00 17-10 17-20 17-30 17-40 1749 17-59 18-09 18-19 18-39 Worcestershire Royal Hospital, Main Entrance | 17-03 | 17-23 | 17-43 | 18-02 | 18-22 18-42 | W | W | W | W | WW Sixways, Park & Ride Site arrive 17-04 17-18 17-24 17-38 17-44 17-58 18-02♥ 18-17♥ 18-21 18-37 18-57

Notes : W - Operates via Warndon Villages, ▲ - Does not operate on Worcester Warriors "home" match days ♥ - Serves Three Pears, NOT Sixways on Worcester Warriors "home" match days

89 ATTACHMENT C Travel Times

1. Travel Times Information from PCT Radiotherapy Needs Analysis NHS Worcestershire’s Radiotherapy Needs Assessment (July 2010) states that: “During 2003‐2007, an average of 1,000 patients each year were referred for, or received, radiotherapy ... The average travel time to where patients received radiotherapy was 44 minutes, with an average distance travelled of 30 miles. If they had all been treated at the Alexandra Hospital the average travel time would be reduced by 18 minutes and the distance by 14 miles. Treatment at Worcester Royal would reduce average travel time by 24 minutes (more than half), and distance by 16 miles.” The above figures represents a reduction of 41% in travel time and 47% reduction in distance travelled, if all patients treated during 2003‐07 had travelled to Alexandra Hospital; and a reduction of 55% in travel time and 53% in distance travelled if all patients had travelled to the Worcestershire Royal Hospital.

2. Travel Time Analysis – From Current Treatment Centre to ALX or WRH Some further analysis has been undertaken, based on a single journey for each patient and on the assumption that all Redditch & Bromsgrove patients travel from the centre of those locations to Coventry; that all Wyre Forest patients travel from the centre of Kidderminster to Wolverhampton; and that all Malvern, Worcester and Wychavon patients travel from the centre of those locations to Cheltenham. The exception is where Redditch to Alex and Worcester to WRH journeys are reckoned as zero: ALEXANDRA HOSPITAL WORCESTERSHIRE ROYAL HOSPITAL CURRENT (REDDITCH) (WORCESTER) No of % Population by Miles to Current Time by Time by Radiotherapy Area Time by Time by Treatment Miles Public Miles Public Patients Car Car Centre Transport Transport (2003‐07) Wyre Forest 870 17.3% 17% 19 18 34 59 17 31 45 (Kidderminster) Bromsgrove 998 19.9% 33 9 17 45 12 22 68 34% Redditch 715 14.2% 32 0 0 0 19 35 87 Malvern Hills (Great 689 13.7% 34 27 54 85 11 26 35 Malvern) Worcester 669 13.3% 49% 27 19 40 72 0 0 0 Wychavon 1,085 21.6% 17 16 27 64 14 25 50 (Evesham) TOTAL 5,026 100% 100% 162 89 172 325 73 139 285

110506 WAHT Radiotherapy Feasibility_Travel Analysis 90 ATTACHMENT D Worcestershire Oncology Project Radiotherapy Feasibility Study Options Appraisal – Construction & Commissioning Timescales

Months 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

A Enabling Works Construction Commissioning Option

C Enabling Works Construction Commissioning Option

Construction Commissioning Option

Construction & Enabling Works Commissioning Option

Construction Commissioning Option

G Construction Commissioning Option

NB: All options assume that activities relating to detailed design development, procurement and land acquisition will be undertaken during the Full Business Case stage Enabling Works: Option A – Build car park Option C ‐ Move existing accommodation on ground floor of Aconbury East elsewhere in building, and remodel Aconbury East for creche and workshops Option E – Provide temporary office accommodation; convert offices to Rehab space, and convert vacated Rehab space to Oncology entrance and offices

110419 WAHT Radiotherapy Feasibility_Options Timelines V1.2 91 ATTACHMENT E

92 ATTACHMENT F

Bus Routes to Alexandra Hospital:

• 55 / 55A / 56 / 56A o Redditch ‐ Batchley ‐ Webheath ‐ Oakenshaw ‐ Alexandra Hospital ‐ Crabbs Cross ‐ Walkwood ‐ Redditch (55A/56A) (Bus timetable at Attachment E1)

o Redditch ‐ Oakenshaw ‐ Alexandra Hospital ‐ Crabbs Cross ‐ Walkwood ‐ Redditch (55/56) (Bus timetable at Attachment E1)

• 55 / 56 o Redditch ‐ Oakenshaw ‐ Alexandra Hospital ‐ Crabbs Cross ‐ Walkwood – Redditch (Bus timetable at Attachment E2)

• 57 / 57A / 58 / 58A o Redditch ‐ Woodrow ‐ Alexandra Hospital ‐ Matchborough ‐ Winyates ‐ Church Hill – Redditch (Bus timetable at Attachment E3)

• 66 / 67 o Redditch ‐ Greenlands (67) ‐ Lodge Park (66) ‐ Alexandra Hospital – Studley (Bus timetable at Attachment E4)

• 177 / 178 / 179 o Redditch ‐ Alexandra Hospital ‐ Matchborough ‐ Inkford ‐ Wythall ‐ Hollywood ‐ Maypole – Birmingham (Bus timetable at Attachment E5)

• 247 o Evesham ‐ Badsey ‐ South Littleton ‐ Bidford‐on‐Avon ‐ Alcester ‐ Studley ‐ Alexandra Hospital ‐ Crabbs Cross – Redditch (Bus timetable at Attachment E6)

• 350 o Worcester ‐ County Hall ‐ Broughton Hackett ‐ Inkberrow ‐ Feckenham ‐ Astwood Bank ‐ Alexandra Hospital ‐ Matchborough – Redditch (Bus timetable at Attachment E7)

Travelling by Train

Redditch Railway Station is located 3 miles from the Alexandra Hospital. There are regular buses running to the hospital.

93 Attachment F1 Redditch - Oakenshaw - Alex. Hospital - Crabbs Cross - Walkwood - Redditch 55 / 55A Operator: Diamond First also operate a service on this route (For journeys in the opposite direction see service 56 / 56A) Monday to Friday from 28th November 2010

Service: 55 55 55 55 55 55 55 55 55 55 55 55 55 Redditch, Bus Station 06-46 07-08 07-28 07-48 08-10 08-30 08-50 09-10 16-50 17-13 17-43 18-23 19-23 Oakenshaw, Castleditch Lane 06-53 07-15 07-35 07-55 08-17 08-37 08-57 09-17 then 16-57 17-20 17-50 18-30 19-30 Oakenshaw, Tesco | | | | | | 08-5909-19 every 16-59 17-22 17-52 18-31 19-31 Alexandra Hospital, Grounds 06-57 07-19 07-39 08-00 08-22 08-42 09-04 09-24 20 17-04 17-27 17-57 18-36 19-36 Crabbs Cross 07-02 07-24 07-44 08-05 08-27 08-47 09-09 09-29 minutes 17-09 17-32 18-02 18-40 19-40 Walkwood, Boulton's Lane 07-05 07-27 07-47 08-08 08-30 08-50 09-12 09-32 until 17-12 17-35 18-05 18-43 19-43 Plymouth Road 07-09 07-31 07-52 08-13 08-35 08-55 09-17 09-37 17-17 17-40 18-10 18-47 19-47 Redditch, Bus Station 07-13 07-35 07-55 08-19 08-41 09-01 09-23 09-43 17-23 17-46 18-16 18-51 19-51

Service: 55A 55A Redditch, Bus Station 20-20 22-15 Batchley, Poplar Road 20-24 22-19 Webheath, Middlepiece Drive 20-29 22-24 Headless Cross 20-32 22-27 Oakenshaw, Castleditch Lane 20-36 22-31 Oakenshaw, Tesco 20-38 22-33 Alexandra Hospital, Grounds 20-42 22-37 Crabbs Cross 20-45 22-40 Walkwood, Boulton's Lane 20-54 22-49 Redditch, Bus Station 21-04 22-59 Saturday from 28th November 2010

Service: 55 55 55 55 55 55 55 55 55 55 55 55A 55A Redditch, Bus Station 07-13 08-10 08-43 09-10 09-30 09-50 16-50 17-20 17-50 18-23 19-23 20-20 22-15 Batchley, Poplar Road | | | | | | | | | | | 20-2422-19 Webheath, Middlepiece Drive | | | | | | then | | | | | 20-2922-24 Headless Cross | | | | | | every | | | | | 20-3222-27 Oakenshaw, Castleditch Lane 07-20 08-17 08-50 09-17 09-37 09-57 20 16-57 17-27 17-57 18-30 19-30 20-36 22-31 Oakenshaw, Tesco | | 08-52 09-19 09-39 09-59 minutes 16-59 17-29 17-59 18-31 19-31 20-38 22-33 Alexandra Hospital, Grounds 07-24 08-22 08-57 09-24 09-44 10-04 until 17-04 17-34 18-04 18-36 19-36 20-42 22-37 Crabbs Cross 07-29 08-27 09-02 09-29 09-49 10-09 17-09 17-39 18-09 18-40 19-40 20-50 22-45 Walkwood, Boulton's Lane 07-32 08-30 09-05 09-32 09-52 10-12 17-12 17-42 18-12 18-43 19-43 20-54 22-49 Plymouth Road 07-36 08-35 09-10 09-37 09-57 10-17 17-17 17-47 18-17 18-47 19-47 | | Redditch, Bus Station 07-40 08-41 09-16 09-43 10-03 10-23 17-23 17-53 18-23 18-51 19-51 21-04 22-59 Sunday from 12th April 2009

Service: 55A 55A 55A 55A 55A 55A 55A 55A 55A Redditch, Bus Station 10-00 11-00 12-00 13-00 14-00 15-00 16-00 17-00 18-20 Batchley, Poplar Road 10-04 11-04 12-04 13-04 14-04 15-04 16-04 17-04 18-24 Webheath, Middlepiece Drive 10-09 11-09 12-09 13-09 14-09 15-09 16-09 17-09 18-29 Headless Cross 10-12 11-12 12-12 13-12 14-12 15-12 16-12 17-12 18-32 Oakenshaw, Castleditch Lane 10-16 11-16 12-16 13-16 14-16 15-16 16-16 17-16 18-36 Oakenshaw, Tesco 10-18 11-18 12-18 13-18 14-18 15-18 16-18 17-18 | Alexandra Hospital, Grounds 10-23 11-23 12-23 13-23 14-23 15-23 16-23 17-23 18-42 Crabbs Cross 10-30 11-30 12-30 13-30 14-30 15-30 16-30 17-30 18-49 Walkwood, Boulton's Lane 10-32 11-32 12-32 13-32 14-32 15-32 16-32 17-32 18-51 Redditch, Bus Station 10-46 11-46 12-46 13-46 14-46 15-46 16-46 17-46 19-05

For other daytime bus services between Redditch Bus Station and the Alexandra Hospital, see services 66, 67, 178 and 247 Operator Phone Number: Diamond - 0121 557 7337

94 Attachment F1 Redditch - Walkwood - Crabbs Cross - Alex. Hospital - Oakenshaw - Redditch 56 / 56A Operator: Diamond First also operate a service on this route (For journeys in the opposite direction see service 55 / 55A) Monday to Friday from 28th November 2010

Service: 56 56 56 56 56 56 56 56 56 56 56 56 56 Redditch, Bus Station 07-00 07-35 08-02 08-22 08-42 09-00 09-20 09-40 16-20 16-40 17-00 17-28 18-08 Plymouth Road 07-04 07-39 08-06 08-26 08-46 09-04 09-24 09-44 then 16-24 16-44 17-04 17-32 18-12 Walkwood, Boulton's Lane 07-08 07-43 08-13 08-33 08-53 09-11 09-31 09-51 every 16-31 16-51 17-11 17-39 18-19 Crabbs Cross 07-11 07-46 08-16 08-36 08-56 09-14 09-34 09-54 20 16-34 16-54 17-14 17-42 18-22 Alexandra Hospital, Grounds 07-16 07-51 08-21 08-41 09-01 09-19 09-39 09-59 minutes 16-39 16-59 17-19 17-47 18-26 Oakenshaw, Tesco | | | | 09-06 09-24 09-44 10-04 until 16-44 17-04 17-24 17-52 18-31 Oakenshaw, Castleditch Lane 07-21 07-56 08-26 08-46 09-08 09-26 09-46 10-06 16-46 17-06 17-26 17-54 18-33 Redditch, Bus Station 07-28 08-03 08-33 08-53 09-15 09-33 09-53 10-13 16-53 17-13 17-33 18-01 18-40

Service: 56 56 56A 56A Redditch, Bus Station 18-52 19-52 21-20 23-00 Plymouth Road 18-56 19-56 | | Walkwood, Boulton's Lane 19-00 20-00 21-30 23-10 Crabbs Cross 19-03 20-03 21-34 23-14 Alexandra Hospital, Grounds 19-07 20-07 21-42 23-22 Oakenshaw, Tesco 19-12 20-12 21-46 23-26 Oakenshaw, Castleditch Lane 19-13 20-13 21-48 23-28 Headless Cross | | 21-52 23-32 Webheath, Middlepiece Drive | | 21-55 23-35 Batchley, Poplar Road | | 22-00 23-40 Redditch, Bus Station 19-20 20-20 22-04 23-44 Saturday from 28th November 2010

Service: 56 56 56 56 56 56 56 56 56 56 56 56A 56A Redditch, Bus Station 07-45 08-30 09-00 09-20 16-20 16-40 17-05 17-35 18-08 18-52 19-52 21-20 23-00 Plymouth Road 07-49 08-34 09-04 09-24 16-24 16-44 17-09 17-40 18-12 18-56 19-56 | | Walkwood, Boulton's Lane 07-56 08-41 09-11 09-31 16-31 16-51 17-16 17-46 18-19 19-00 20-00 21-30 23-10 Crabbs Cross 07-59 08-44 09-14 09-34 then 16-34 16-54 17-19 17-49 18-22 19-03 20-03 21-34 23-14 Alexandra Hospital, Grounds 08-03 08-49 09-19 09-39 every 16-39 16-59 17-24 17-54 18-26 19-07 20-07 21-42 23-22 Oakenshaw, Tesco | 08-54 09-24 09-44 20 16-44 17-04 17-29 17-59 18-31 19-12 20-12 21-46 23-26 Oakenshaw, Castleditch Lane 08-08 08-56 09-26 09-46 minutes 16-46 17-06 17-31 18-01 18-33 19-13 20-13 21-48 23-28 Headless Cross | | | | until | | | | | | | 21-5223-32 Webheath, Middlepiece Drive | | | | | | | | | | | 21-5523-35 Batchley, Poplar Road | | | | | | | | | | | 22-0023-40 Redditch, Bus Station 08-15 09-03 09-33 09-53 16-53 17-13 17-38 18-08 18-40 19-20 20-20 22-04 23-44 Sunday from 12th April 2009

Service: 56A 56A 56A 56A 56A 56A 56A 56A 56A Redditch, Bus Station 09-30 10-30 11-30 12-30 13-30 14-30 15-30 16-30 17-30 Walkwood, Boulton's Lane 09-44 10-44 11-44 12-44 13-44 14-44 15-44 16-44 17-44 Crabbs Cross 09-46 10-46 11-46 12-46 13-46 14-46 15-46 16-46 17-46 Alexandra Hospital, Grounds 09-53 10-53 11-53 12-53 13-53 14-53 15-53 16-53 17-53 Oakenshaw, Tesco 09-58 10-58 11-58 12-58 13-58 14-58 15-58 16-58 | Oakenshaw, Castleditch Lane 10-00 11-00 12-00 13-00 14-00 15-00 16-00 17-00 17-59 Headless Cross 10-04 11-04 12-04 13-04 14-04 15-04 16-04 17-04 18-03 Webheath, Middlepiece Drive 10-07 11-07 12-07 13-07 14-07 15-07 16-07 17-07 18-06 Batchley, Poplar Road 10-12 11-12 12-12 13-12 14-12 15-12 16-12 17-12 18-11 Redditch, Bus Station 10-16 11-16 12-16 13-16 14-16 15-16 16-16 17-16 18-15

For other daytime bus services between Redditch Bus Station and the Alexandra Hospital, see services 66, 67, 178 and 247

Operator Phone Number: Diamond - 0121 557 7337

95 Attachment F2 Redditch - Oakenshaw - Alexandra Hospital - Crabbs Cross - Walkwood - Redditch 55 / 55A Operators: 55 - First, 55A - Diamond (For journeys in the opposite direction see service 56 / 56A) Monday to Friday from 4th January 2011

Service: 55 55 55 55 55 55 55 55 55 55 55 55 55 55 55 55 Notes: HOL SCH Redditch, Bus Station 06-25 06-45 07-05 07-25 07-40 07-53 08-08 08-23 08-38 08-53 09-08 14-53 15-08 15-08 15-23 15-38 Oakenshaw, Castleditch Lane 06-32 06-52 07-12 07-32 07-47 08-00 08-15 08-30 08-45 09-00 09-15 then 15-00 15-15 15-15 15-30 15-45 Oakenshaw, Tesco | | | | | | | | | 09-02 09-17 every 15-02 15-17 15-17 15-32 15-47 Alexandra Hospital, Grounds 06-36 06-56 07-16 07-37 07-52 08-05 08-20 08-35 08-50 09-07 09-22 15 15-07 15-22 15-22 15-37 15-52 Crabbs Cross 06-41 07-01 07-21 07-42 07-57 08-10 08-25 08-40 08-55 09-12 09-27 minutes 15-12 15-27 -- 15-42 15-57 Walkwood, Boulton's Lane 06-44 07-04 07-24 07-45 08-00 08-13 08-28 08-43 08-58 09-15 09-30 until 15-15 15-30 -- 15-45 16-00 Plymouth Road 06-48 07-08 07-28 07-50 08-05 08-18 08-33 08-48 09-03 09-20 09-35 15-20 15-35 -- 15-50 16-05 Redditch, Bus Station 06-52 07-12 07-32 07-54 08-10 08-26 08-41 08-56 09-11 09-26 09-41 15-26 15-41 -- 15-56 16-11

Service: 55 55 55 55 55 55 55 55 55A 55A

Redditch, Bus Station 15-53 16-08 16-38 16-53 17-08 17-40 18-20 19-20 20-20 22-15 Batchley, Poplar Road | | | | | | | | 20-24 22-19 Webheath, Middlepiece Drive | | | | | | | | 20-29 22-24 Headless Cross | | | | | | | | 20-32 22-27 Notes: SCH - Schooldays only Oakenshaw, Castleditch Lane 16-00 16-15 16-45 17-00 17-15 17-47 18-26 19-26 20-36 22-31 HOL - School Holidays only Oakenshaw, Tesco 16-02 16-17 16-47 17-02 17-17 17-49 18-28 19-28 20-38 22-33 Alexandra Hospital, Grounds 16-07 16-22 16-52 17-07 17-22 17-54 18-33 19-33 20-42 22-37 Crabbs Cross 16-12 16-27 16-57 17-12 17-27 17-59 18-37 19-37 20-50 22-45 Walkwood, Boulton's Lane 16-15 16-30 17-00 17-15 17-30 18-02 18-40 19-40 20-54 22-49 Plymouth Road 16-20 16-35 17-05 17-20 17-35 18-07 18-44 19-44 | | Redditch, Bus Station 16-26 16-41 17-11 17-26 17-41 18-13 18-48 19-48 21-04 22-59 Saturday from 4th January 2011

Service: 55 55 55 55 55 55 55 55 55 55 55 55 55 55 55A 55A Redditch, Bus Station 06-30 07-10 08-05 08-38 09-08 09-23 15-53 16-08 16-28 16-48 17-18 17-48 18-20 19-20 20-20 22-15 Batchley, Poplar Road | | | | | | | | | | | | | | 20-24 22-19 Webheath, Middlepiece Drive | | | | | | then | | | | | | | | 20-29 22-24 Headless Cross | | | | | | every | | | | | | | | 20-32 22-27 Oakenshaw, Castleditch Lane 06-37 07-17 08-12 08-45 09-15 09-30 15 16-00 16-15 16-35 16-55 17-25 17-55 18-26 19-26 20-36 22-31 Oakenshaw, Tesco | | | 08-47 09-17 09-32 minutes 16-02 16-17 16-37 16-57 17-27 17-57 18-28 19-28 20-38 22-33 Alexandra Hospital, Grounds 06-41 07-21 08-17 08-52 09-22 09-37 until 16-07 16-22 16-42 17-02 17-32 18-02 18-33 19-33 20-42 22-37 Crabbs Cross 06-46 07-26 08-22 08-57 09-27 09-42 16-12 16-27 16-47 17-07 17-37 18-07 18-37 19-37 20-50 22-45 Walkwood, Boulton's Lane 06-49 07-29 08-25 09-00 09-30 09-45 16-15 16-30 16-50 17-10 17-40 18-10 18-40 19-40 20-54 22-49 Plymouth Road 06-53 07-33 08-30 09-05 09-35 09-50 16-20 16-35 16-55 17-15 17-45 18-15 18-44 19-44 | | Redditch, Bus Station 06-57 07-37 08-36 09-11 09-41 09-56 16-26 16-41 17-01 17-21 17-51 18-21 18-48 19-48 21-04 22-59 Sunday from 12th April 2009

For other daytime bus services between Redditch Bus Station and the Alexandra Hospital, see services 66, 67, 178 and 247 Operator Phone Number: Diamond - 0121 557 7337 First - 0800 587 7381

96 Attachment F2 Redditch - Walkwood - Crabbs Cross - Alexandra Hospital - Oakenshaw - Redditch 56 / 56A Operators: 56 - First, 56A - Diamond (For journeys in the opposite direction see service 55 / 55A) Monday to Friday from 4th January 2011

Service: 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56 Redditch, Bus Station 06-55 07-30 08-00 08-15 08-30 08-45 09-00 09-15 09-30 16-30 16-45 17-05 17-25 18-00 18-50 19-50 Plymouth Road 06-59 07-34 08-04 08-19 08-34 08-49 09-04 09-19 09-34 then 16-34 16-49 17-09 17-29 18-04 18-54 19-54 Walkwood, Boulton's Lane 07-03 07-38 08-11 08-26 08-41 08-56 09-11 09-26 09-41 every 16-41 16-56 17-16 17-36 18-11 18-58 19-58 Crabbs Cross 07-06 07-41 08-14 08-29 08-44 08-59 09-14 09-29 09-44 15 16-44 16-59 17-19 17-39 18-14 19-01 20-01 Alexandra Hospital, Grounds 07-11 07-46 08-19 08-34 08-49 09-04 09-19 09-34 09-49 minutes 16-49 17-04 17-24 17-44 18-19 19-05 20-05 Oakenshaw, Tesco | | | | | 09-09 09-24 09-39 09-54 until 16-54 17-09 17-29 17-49 18-24 19-10 20-10 Oakenshaw, Castleditch Lane 07-16 07-51 08-24 08-39 08-54 09-11 09-26 09-41 09-56 16-56 17-11 17-31 17-51 18-26 19-11 20-11 Redditch, Bus Station 07-23 07-58 08-33 08-48 09-03 09-18 09-33 09-48 10-03 17-03 17-18 17-38 17-58 18-33 19-18 20-18

Service: 56A 56A Redditch, Bus Station 21-20 23-00 Plymouth Road | | Walkwood, Boulton's Lane 21-30 23-10 Crabbs Cross 21-34 23-14 Alexandra Hospital, Grounds 21-42 23-22 Oakenshaw, Tesco 21-46 23-26 Oakenshaw, Castleditch Lane 21-48 23-28 Headless Cross 21-52 23-32 Webheath, Middlepiece Drive 21-55 23-35 Batchley, Poplar Road 22-00 23-40 Redditch, Bus Station 22-04 23-44 Saturday from 4th January 2011

Service: 56 56 56 56 56 56 56 56 56 56 56 56 56 56 56A 56A Redditch, Bus Station 07-40 08-25 08-55 09-15 09-30 15-45 16-00 16-18 16-38 17-03 17-33 18-05 18-50 19-50 21-20 23-00 Plymouth Road 07-44 08-29 08-59 09-19 09-34 15-49 16-04 16-22 16-42 17-08 17-38 18-09 18-54 19-54 | | Walkwood, Boulton's Lane 07-51 08-36 09-06 09-26 09-41 15-56 16-11 16-29 16-49 17-14 17-44 18-15 18-58 19-58 21-30 23-10 Crabbs Cross 07-54 08-39 09-09 09-29 09-44 then 15-59 16-14 16-32 16-52 17-17 17-47 18-19 19-01 20-01 21-34 23-14 Alexandra Hospital, Grounds 07-58 08-44 09-14 09-34 09-49 every 16-04 16-19 16-37 16-57 17-22 17-52 18-22 19-05 20-05 21-42 23-22 Oakenshaw, Tesco | 08-49 09-19 09-39 09-54 15 16-09 16-24 16-42 17-02 17-27 17-57 18-27 19-10 20-10 21-46 23-26 Oakenshaw, Castleditch Lane 08-03 08-51 09-21 09-41 09-56 minutes 16-11 16-26 16-44 17-04 17-29 17-59 18-29 19-11 20-11 21-48 23-28 Headless Cross | | | | | until | | | | | | | | | 21-52 23-32 Webheath, Middlepiece Drive | | | | | | | | | | | | | | 21-55 23-35 Batchley, Poplar Road | | | | | | | | | | | | | | 22-00 23-40 Redditch, Bus Station 08-10 08-58 09-28 09-48 10-03 16-18 16-33 16-51 17-11 17-36 18-06 18-35 19-18 20-18 22-04 23-44 Sunday from 12th April 2009

For other daytime bus services between Redditch Bus Station and the Alexandra Hospital, see services 66, 67, 178 and 247

Operator Phone Number: Diamond - 0121 557 7337 First - 0800 587 7381

97 Attachment F3 Redditch - Woodrow - Matchborough - Winyates Circular 57 Redditch - Woodrow - Alexandra Hospital - Matchborough - Winyates Circular 57A Operator: Diamond (Other daytime services are also operated frequently on this route by First - see separate timetable). Monday to Friday from 21st February 2011

Service : 57 57 57A 57 57A 57A 57A 57A 57A 57A 57A 57A 57A Redditch, Bus Station, Stand K 05-26 05-51 06-06 06-21 06-36 06-48 17-43 17-58 18-13 18-28 18-50 19-20 19-50 Woodrow, Centre 05-33 05-58 06-13 06-28 06-43 06-55 then 17-51 18-06 18-20 18-35 18-57 19-27 19-57 Alexandra Hospital, Grounds | | 06-16 | 06-46 06-58 at 17-54 18-09 18-23 18-38 19-00 19-30 20-00 Studley Road(Redditch),Island 05-35 06-00 06-17 06-30 06-47 06-59 frequent 17-56 18-11 18-24 18-39 19-01 19-31 20-01 Matchborough, Centre 05-39 06-04 06-21 06-34 06-51 07-03 intervals 18-01 18-16 18-28 18-43 19-05 19-35 20-05 Winyates, Centre 05-41 06-06 06-23 06-36 06-53 07-05 until 18-03 18-18 18-30 18-45 19-07 19-37 20-07 Church Hill (Redditch), Centre 05-44 06-09 06-26 06-39 06-56 07-08 18-06 18-21 18-33 18-48 19-10 19-40 20-10 Redditch, Bus Station 05-53 06-18 06-35 06-48 07-05 07-17 18-16 18-31 18-42 18-57 19-19 19-49 20-19

Service : 57A 57A 57A 57A 57A 57A 57A Redditch, Bus Station, Stand K 20-15 20-45 21-15 21-45 22-15 22-45 23-15 Woodrow, Centre 20-22 20-52 21-22 21-52 22-22 22-52 23-22 Alexandra Hospital, Grounds 20-25 20-55 21-25 21-55 22-25 22-55 23-25 Studley Road(Redditch),Island 20-26 20-56 21-26 21-56 22-26 22-56 23-26 Matchborough, Centre 20-30 21-00 21-30 22-00 22-30 23-00 23-30 Winyates, Centre 20-32 21-02 21-32 22-02 22-32 23-02 23-32 Church Hill (Redditch), Centre 20-35 21-05 21-35 22-05 22-35 23-05 23-35 Redditch, Bus Station 20-44 21-14 21-44 22-14 22-44 23-14 23-44 Saturday from 21st February 2011

Service : 57A 57A 57A 57A 57A 57A 57A 57A 57 57 57A 57A 57A Redditch, Bus Station, Stand K 06-20 06-50 07-10 07-30 07-50 08-10 08-25 08-40 08-55 09-10 09-25 09-35 17-15 Woodrow, Centre 06-27 06-57 07-17 07-37 07-58 08-18 08-33 08-48 09-03 09-18 09-33 09-43 then 17-23 Alexandra Hospital, Grounds 06-30 07-00 07-20 07-40 08-01 08-21 08-36 08-51 | | 09-36 09-46 at 17-26 Studley Road(Redditch),Island 06-31 07-01 07-21 07-41 08-03 08-23 08-38 08-53 09-05 09-20 09-38 09-48 frequent 17-28 Matchborough, Centre 06-35 07-05 07-25 07-45 08-08 08-28 08-43 08-58 09-10 09-25 09-43 09-53 intervals 17-33 Winyates, Centre 06-37 07-07 07-27 07-47 08-10 08-30 08-45 09-00 09-12 09-27 09-45 09-55 until 17-35 Church Hill (Redditch), Centre 06-40 07-10 07-30 07-50 08-13 08-33 08-48 09-03 09-15 09-30 09-48 09-58 17-38 Redditch, Bus Station 06-49 07-19 07-39 07-59 08-23 08-43 08-58 09-13 09-25 09-40 09-58 10-08 17-48

Service : 57 57 57A 57 57A 57A 57A 57A 57A 57A 57A 57A 57A 57A Redditch, Bus Station, Stand K 17-30 17-45 18-05 18-25 18-50 19-20 19-50 20-15 20-45 21-15 21-45 22-15 22-45 23-15 Woodrow, Centre 17-38 17-53 18-13 18-33 18-57 19-27 19-57 20-22 20-52 21-22 21-52 22-22 22-52 23-22 Alexandra Hospital, Grounds | | 18-16 | 19-00 19-30 20-00 20-25 20-55 21-25 21-55 22-25 22-55 23-25 Studley Road(Redditch),Island 17-40 17-55 18-18 18-35 19-01 19-31 20-01 20-26 20-56 21-26 21-56 22-26 22-56 23-26 Matchborough, Centre 17-45 18-00 18-23 18-40 19-05 19-35 20-05 20-30 21-00 21-30 22-00 22-30 23-00 23-30 Winyates, Centre 17-47 18-02 18-25 18-42 19-07 19-37 20-07 20-32 21-02 21-32 22-02 22-32 23-02 23-32 Church Hill (Redditch), Centre 17-50 18-05 18-28 18-45 19-10 19-40 20-10 20-35 21-05 21-35 22-05 22-35 23-05 23-35 Redditch, Bus Station 18-00 18-15 18-38 18-55 19-19 19-49 20-19 20-44 21-14 21-44 22-14 22-44 23-14 23-44 Sunday from 21st February 2011

Service : 57 57 57A 57 57 57A 57 57 57A 57 57 57 57 Redditch, Bus Station, Stand K 08-20 09-00 09-20 09-40 00 20 40 16-00 16-20 16-40 17-10 17-40 18-25 Woodrow, Centre 08-28 09-08 09-28 09-48 then 08 28 48 16-08 16-28 16-48 17-18 17-48 18-33 Alexandra Hospital, Grounds | | 09-30 | at | 30 | | 16-30 | | | | Studley Road(Redditch),Island 08-30 09-10 09-32 09-50 these 10 32 50 16-10 16-32 16-50 17-20 17-50 18-35 Matchborough, Centre 08-35 09-15 09-37 09-55 mins. 15 37 55 until 16-15 16-37 16-55 17-25 17-55 18-40 Winyates, Centre 08-37 09-17 09-39 09-57 past 17 39 57 16-17 16-39 16-57 17-27 17-57 18-42 Church Hill (Redditch), Centre 08-41 09-21 09-43 10-01 each 21 43 01 16-21 16-43 17-01 17-31 18-01 18-46 Redditch, Bus Station 08-48 09-28 09-50 10-08 hour 28 50 08 16-28 16-50 17-08 17-38 18-08 18-53 98 Attachment F3 Redditch - Winyates - Matchborough - Woodrow Circular 58 Redditch - Winyates - Matchborough - Alexandra Hospital - Woodrow Circular 58A Operator: Diamond (Other daytime services are also operated frequently on this route by First - see separate timetable). Monday to Friday from 21st February 2011

Service : 58 58A 58 58A 58 58A 58 58 58 58A 58A 58A 58A Redditch, Bus Station, Stand B 05-31 06-01 06-31 06-46 07-01 07-10 07-18 07-28 07-38 07-48 08-00 08-10 17-20 Church Hill (Redditch) 05-40 06-08 06-40 06-53 07-09 07-18 07-26 07-36 07-46 07-56 08-08 08-18 then 17-28 Winyates, Centre 05-43 06-13 06-43 06-58 07-14 07-23 07-31 07-41 07-51 08-01 08-13 08-23 at 17-33 Matchborough, Centre 05-45 06-15 06-45 07-00 07-16 07-25 07-33 07-43 07-53 08-03 08-15 08-25 frequent 17-35 Studley Road(Redditch),Island 05-49 06-19 06-49 07-04 07-21 07-30 07-38 07-48 07-58 08-08 08-20 08-30 intervals 17-40 Alexandra Hospital, Grounds | 06-20 | 07-05 | 07-33 | | | 08-1108-2308-33 until 17-43 Woodrow, Centre 05-51 06-22 06-51 07-07 07-23 07-35 07-40 07-50 08-00 08-13 08-25 08-35 17-45 Redditch, Bus Station 05-58 06-29 06-58 07-14 07-31 07-43 07-48 07-58 08-08 08-21 08-33 08-43 17-53

Service : 58 58A 58 58 58A 58 58A 58A 58A 58A 58A 58A 58A 58A 58A Redditch, Bus Station, Stand B 17-28 17-38 17-53 18-08 18-23 18-43 19-05 19-35 20-05 20-30 21-00 21-30 22-00 22-30 23-00 Church Hill (Redditch) 17-36 17-46 18-01 18-16 18-32 18-50 19-14 19-44 20-14 20-39 21-09 21-39 22-09 22-39 23-09 Winyates, Centre 17-41 17-51 18-06 18-21 18-35 18-55 19-17 19-47 20-17 20-42 21-12 21-42 22-12 22-42 23-12 Matchborough, Centre 17-43 17-53 18-08 18-23 18-37 18-57 19-19 19-49 20-19 20-44 21-14 21-44 22-14 22-44 23-14♦ Studley Road(Redditch),Island 17-48 17-58 18-13 18-28 18-41 19-00 19-23 19-53 20-23 20-48 21-18 21-48 22-18 22-48 23-27 Alexandra Hospital, Grounds | 18-01 | | 18-42 | 19-24 19-54 20-24 20-49 21-19 21-49 22-19 22-49 23-28 Woodrow, Centre 17-50 18-03 18-15 18-30 18-45 19-02 19-27 19-57 20-27 20-52 21-22 21-52 22-22 22-52 23-31 Redditch, Bus Station 17-58 18-11 18-23 18-38 18-52 19-10 19-34 20-04 20-34 20-59 21-29 21-59 22-29 22-59 23-38 Saturday from 21st February 2011

Service : 58A 58A 58A 58A 58 58 58A 58 58A 58 58A 58A 58A Redditch, Bus Station, Stand B 06-05 06-35 07-05 07-35 08-00 08-30 08-45 09-00 09-15 09-23 09-33 09-43 17-23 Church Hill (Redditch) 06-12 06-42 07-13 07-43 08-08 08-38 08-53 09-08 09-23 09-31 09-41 09-51 then 17-31 Winyates, Centre 06-17 06-47 07-17 07-47 08-12 08-42 08-57 09-13 09-27 09-36 09-45 09-55 at 17-35 Matchborough, Centre 06-19 06-49 07-19 07-49 08-14 08-44 08-59 09-15 09-29 09-38 09-47 09-57 frequent 17-37 Studley Road(Redditch),Island 06-23 06-53 07-24 07-54 08-19 08-49 09-04 09-20 09-34 09-43 09-52 10-02 intervals 17-42 Alexandra Hospital, Grounds 06-24 06-54 07-26 07-56 08-21 08-51 09-06 | 09-36 | 09-54 10-04 until 17-44 Woodrow, Centre 06-26 06-56 07-28 07-58 08-23 08-53 09-08 09-22 09-38 09-45 09-56 10-06 17-46 Redditch, Bus Station 06-33 07-03 07-35 08-05 08-31 09-01 09-16 09-30 09-46 09-53 10-04 10-14 17-54

Service : 58 58A 58A 58A 58A 58A 58A 58A 58A 58A 58A 58A 58A Redditch, Bus Station, Stand B 17-35 17-55 18-15 18-40 19-05 19-35 20-05 20-30 21-00 21-30 22-00 22-30 23-00 Church Hill (Redditch) 17-43 18-03 18-24 18-49 19-14 19-44 20-14 20-39 21-09 21-39 22-09 22-39 23-09 Winyates, Centre 17-48 18-07 18-27 18-52 19-17 19-47 20-17 20-42 21-12 21-42 22-12 22-42 23-12 Matchborough, Centre 17-50 18-09 18-29 18-54 19-19 19-49 20-19 20-44 21-14 21-44 22-14 22-44 23-14♦ Studley Road(Redditch),Island 17-55 18-14 18-33 18-58 19-23 19-53 20-23 20-48 21-18 21-48 22-18 22-48 23-27 Alexandra Hospital, Grounds | 18-16 18-34 18-59 19-24 19-54 20-24 20-49 21-19 21-49 22-19 22-49 23-28 Woodrow, Centre 17-57 18-18 18-37 19-02 19-27 19-57 20-27 20-52 21-22 21-52 22-22 22-52 23-31 Redditch, Bus Station 18-05 18-26 18-44 19-09 19-34 20-04 20-34 20-59 21-29 21-59 22-29 22-59 23-38 Notes : ♦ - Also serves Studley, Crooks Lane at 2321 Sunday from 21st February 2011

Service : 58 58A 58 58 58A 58 58 58A 58 58 58 58 Redditch, Bus Station, Stand B 08-45 09-30 09-50 10-10 30 50 10 16-30 16-55 17-25 17-45 18-55 Church Hill (Redditch) 08-52 09-37 09-57 10-17 then 37 57 17 16-37 17-02 17-32 17-52 19-02 Winyates, Centre 08-56 09-41 10-01 10-21 at 41 01 21 16-41 17-06 17-36 17-56 19-06 Matchborough, Centre 08-58 09-43 10-03 10-23 these 43 03 23 16-43 17-08 17-38 17-58 19-08 Studley Road(Redditch),Island 09-03 09-48 10-08 10-28 mins. 48 08 28 until 16-48 17-13 17-43 18-03 19-13 Alexandra Hospital, Grounds | 09-50 | | past 50 | | 16-50 | | | | Woodrow, Centre 09-05 09-52 10-10 10-30 each 52 10 30 16-52 17-15 17-45 18-05 19-15 Redditch, Bus Station 09-13 10-00 10-15 10-38 hour 00 18 38 17-00 17-23 17-53 18-1399 19-23 Attachment F4 Redditch - Smallwood - Greenlands - Alexandra Hospital - Studley 66 Redditch - Lakeside - Greenlands - Alexandra Hospital - Studley 67 Operator: First includng extracts from Services 247 (operated by First) and 58A (operated by Diamond) For other services Redditch - Crabbs Cross - Studley & vice versa see service 26 operated by Stagecoach in Warwickshire Monday to Friday from 25th October 2009

Service: 67 247 67 67 66 247 67 66 247 67 66 247 67 66 247 67 66 Notes: Redditch, Bus Station 06-55 07-25 07-52 08-57 09-27 09-40 09-57 10-27 10-40 10-57 11-27 11-40 11-57 12-27 12-40 12-57 13-27 Lakeside, Arthur Street 07-00 | 07-57 09-02 | | 10-02 | | 11-02 | | 12-02 | | 13-02 | Smallwood, Tunnel Drive | | | | 09-32 | | 10-32 | | 11-32 | | 12-32 | | 13-32 Greenlands, Auxerre Avenue 07-06 | 08-05 09-10 09-40 | 10-10 10-40 | 11-10 11-40 | 12-10 12-40 | 13-10 13-40 Wishaw, Wharrington Close 07-07 | 08-06 09-11 09-41 | 10-11 10-41 | 11-11 11-41 12-11 12-41 | 13-11 13-41 Crabbs Cross, Fleece Inn | 07-31 | | | 09-48 | | 10-48 | | 11-48 | | 12-48 | | Alexandra Hospital (Redditch), Grounds 07-09 07-35 08-07 09-12 09-42 09-53 10-12 10-42 10-53 11-12 11-42 11-53 12-12 12-42 12-53 13-12 13-42 Studley Road (Redditch), Island 07-11 07-37 08-09 09-14 09-44 09-55 10-14 10-44 10-55 11-14 11-44 11-55 12-14 12-44 12-55 13-14 13-44 Littlewood Green 07-14 | 08-14 09-19 09-49 | 10-19 10-49 | 11-19 11-49 | 12-19 12-49 | 13-19 13-49 Studley, Alcester Road, Tesco 07-18 07-41 08-18 09-25 09-55 09-59 10-25 10-55 10-59 11-25 11-55 11-59 12-25 12-55 12-59 13-25 13-55

Service: 247 67 66 247 67 247 247 67 247 67 247 67 247 58A Notes: Sch HOL Redditch, Bus Station 13-40 13-57 14-27 14-40 14-52 15-12 15-40 16-10 16-40 17-10 17-40 18-10 19-15 23-00 Lakeside, Arthur Street | 14-02 | | 14-57 | | 16-15 | 17-15 | 18-15 | | Smallwood, Tunnel Drive | | 14-32 | | | | | | | | | | | Greenlands, Auxerre Avenue | 14-10 14-40 | 15-05 | | 16-21 | 17-21 | 18-21 | | Wishaw, Wharrington Close | 14-11 14-41 | 15-06 | | 16-23 | 17-23 | 18-23 | | Crabbs Cross, Fleece Inn 13-48 | | 14-48 | 15-20 15-48 | 16-48 | 17-48 | 19-22 | Alexandra Hospital (Redditch), Grounds 13-53 14-12 14-42 14-53 15-07 15-25 15-53 16-25 16-53 17-25 17-53 18-25 19-27 | Studley Road (Redditch), Island 13-55 14-14 14-44 14-55 15-09 15-27 15-55 16-27 16-55 17-27 17-55 18-27 19-29 | Littlewood Green | 14-19 14-49 | 15-14 | | 16-32 | 17-32 | 18-32 | | Studley, Alcester Road, Tesco 13-59 14-25 14-55 14-59 15-20 15-31 15-59 16-38 16-59 17-38 17-59 18-38 19-32 23-21

Notes : Sch - Schooldays only, HOL - School Holidays opnly

Saturday from 25th October 2009

Service: 247 66 247 67 66 247 67 66 247 67 66 247 67 66 247 67 66 Redditch, Bus Station 07-35 08-27 08-40 08-57 09-27 09-40 09-57 10-27 10-40 10-57 11-27 11-40 11-57 12-27 12-40 12-57 13-27 Lakeside, Arthur Street | | | 09-02 | | 10-02 | | 11-02 | | 12-02 | | 13-02 | Smallwood, Tunnel Drive | 08-32 | | 09-32 | | 10-32 | | 11-32 | | 12-32 | | 13-32 Greenlands, Auxerre Avenue | 08-40 | 09-10 09-40 | 10-10 10-40 | 11-10 11-40 | 12-10 12-40 | 13-10 13-40 Wishaw, Wharrington Close | 08-41 | 09-11 09-41 | 10-11 10-41 | 11-11 11-41 | 12-11 12-41 | 13-11 13-41 Crabbs Cross, Fleece Inn 07-42 | 08-48 | | 09-48 | | 10-48 | | 11-48 | | 12-48 | | Alexandra Hospital (Redditch), Grounds 07-47 08-42 08-53 09-12 09-42 09-53 10-12 10-42 10-53 11-12 11-42 11-53 12-12 12-42 12-53 13-12 13-42 Studley Road (Redditch), Island 07-49 08-44 08-55 09-14 09-44 09-55 10-14 10-44 10-55 11-14 11-44 11-55 12-14 12-44 12-55 13-14 13-44 Littlewood Green | 08-49 | 09-19 09-49 | 10-19 10-49 | 11-19 11-49 | 12-19 12-49 | 13-19 13-49 Studley, Alcester Road, Tesco 07-59 08-55 08-59 09-25 09-55 09-59 10-25 10-55 10-59 11-25 11-55 11-59 12-25 12-55 12-59 13-25 13-55

Service: 247 67 66 247 67 66 247 67 66 247 67 66 247 247 58A Redditch, Bus Station 13-40 13-57 14-27 14-40 14-57 15-27 15-40 15-57 16-27 16-40 16-57 17-32 18-00 19-15 23-00 Lakeside, Arthur Street | 14-02 | | 15-02 | | 16-02 | | 17-02 | | | | Smallwood, Tunnel Drive | | 14-32 | | 15-32 | | 16-32 | | 17-37 | | | Greenlands, Auxerre Avenue | 14-10 14-40 | 15-10 15-40 | 16-10 16-40 | 17-10 17-45 | | | Wishaw, Wharrington Close | 14-11 14-41 | 15-11 15-41 | 16-11 16-41 | 17-11 17-46 | | | Crabbs Cross, Fleece Inn 13-48 | | 14-48 | | 15-48 | | 16-48 | | 18-08 19-22 | Alexandra Hospital (Redditch), Grounds 13-53 14-12 14-42 14-53 15-12 15-42 15-53 16-12 16-42 16-53 17-12 17-47 18-13 19-27 | Studley Road (Redditch), Island 13-55 14-14 14-44 14-55 15-14 15-44 15-55 16-14 16-44 16-55 17-14 17-49 18-15 19-29 | Littlewood Green | 14-19 14-49 | 15-19 15-49 | 16-19 16-49 | 17-19 17-54 | | | Studley, Alcester Road, Tesco 13-59 14-25 14-55 14-59 15-25 15-55 15-59 16-25 16-55 16-59 17-25 18-00 18-19 19-32 23-21

Sundays (& Bank Holiday Mondays) from 31st August 2008

Extract from Sunday service 247 operated by Diamond (Most journeys start from or continue to Alcester / Evesham.)

100 StudleyAttachment -F4 Alexandra Hospital - Greenlands - Smallwood - Redditch 66 Studley - Alexandra Hospital - Greenlands - Lakeside - Redditch 67 Operator: First includng extracts from Services 247 (operated by First) and 58A (operated by Diamond) For other services Redditch - Crabbs Cross - Studley & vice versa see service 26 operated by Stagecoach in Warwickshire Monday to Friday from 25th October 2009

Service : 247 67 247 67 67 247 66 67 247 66 67 247 66 67 247 66 67 Notes: Littlewood Green -- 07-14 -- 08-14 -- -- 09-19 09-49 -- 10-19 10-49 -- 11-19 11-49 -- 12-19 12-49 Studley, Alcester Road, opp. Tesco 06-58 07-18 07-38 08-18 -- 09-01 09-25 09-55 10-11 10-25 10-55 11-01 11-25 11-55 12-01 12-25 12-55 Studley Road (Redditch), Island 07-00 07-21 07-40 08-21 -- 09-05 09-28 09-58 10-15 10-28 10-58 11-05 11-28 11-58 12-05 12-28 12-58 Alexandra Hospital (Redditch), Grounds 07-03 07-24 07-43 08-24 09-05 09-08 09-30 10-00 10-18 10-30 11-00 11-08 11-30 12-00 12-08 12-30 13-00 Crabbs Cross, Fleece Inn 07-08 | 07-48 | | 09-13 | | 10-23 | | 11-13 | | 12-13 | | Wishaw, Wharrington Close | 07-27 | 08-27 09-06 | 09-31 10-01 | 10-31 11-01 | 11-31 12-01 | 12-31 13-01 Greenlands, Auxerre Avenue | 07-28 | 08-29 09-07 | 09-32 10-02 | 10-32 11-02 | 11-32 12-02 | 12-32 13-02 Smallwood, Tunnel Drive | | | | | | 09-40 | | 10-40 | | 11-40 | | 12-40 | Lakeside, Arthur Street | 07-36 | 08-36 09-15 | | 10-10 | | 11-10 | | 12-10 | | 13-10 Redditch, Bus Station 07-16 07-41 07-56 08-43 09-20 09-24 09-45 10-15 10-31 10-45 11-15 11-21 11-45 12-15 12-21 12-45 13-15 Service : 247 66 67 247 66 67 247 67 247 67 247 247 67 247 58A Notes: HOL Sch Littlewood Green -- 13-19 13-49 -- 14-19 15-14 -- 16-32 -- 17-32 -- -- 18-32 -- -- Studley, Alcester Road, opp. Tesco 13-01 13-25 13-55 14-01 14-25 15-20 16-01 16-38 17-01 17-38 18-01 18-16 18-38 18-52 23-21 Studley Road (Redditch), Island 13-05 13-28 13-58 14-05 14-28 15-23 16-05 16-41 17-05 17-41 18-05 18-19 18-41 18-55 23-27 Alexandra Hospital (Redditch), Grounds 13-08 13-30 14-00 14-08 14-30 15-25 16-08 16-43 17-08 17-43 18-08 18-22 18-43 18-57 23-28 Crabbs Cross, Fleece Inn 13-13 | | 14-13 | | 16-13 | 17-13 | 18-13 18-27 | 19-02 | Wishaw, Wharrington Close | 13-31 14-01 | 14-31 15-26 | 16-44 | 17-44 | | 18-44 | | Greenlands, Auxerre Avenue | 13-32 14-02 | 14-32 15-27 | 16-45 | 17-45 | | 18-45 | | Smallwood, Tunnel Drive | 13-40 | | 14-40 | | | | | | | | | | Lakeside, Arthur Street | | 14-10 | | 15-35 | 16-53 | 17-53 | | 18-53 | | Redditch, Bus Station 13-21 13-45 14-15 14-21 14-45 15-40 16-21 16-58 17-21 17-58 18-21 18-35 18-58 19-10 23-38

Notes : Sch - Schooldays only, HOL - School Holidays opnly

Saturday from 25th October 2009

Service: 247 66 67 247 66 67 247 66 67 247 66 67 247 66 67 247 66 Littlewood Green -- 08-24 08-49 -- 09-19 09-49 -- 10-19 10-49 -- 11-19 11-49 -- 12-19 12-49 -- 13-19 Studley, Alcester Road, opp. Tesco 07-53 08-30 08-55 09-01 09-25 09-55 10-01 10-25 10-55 11-01 11-25 11-55 12-01 12-25 12-55 13-01 13-25 Studley Road (Redditch), Island 07-55 08-33 08-58 09-05 09-28 09-58 10-05 10-28 10-58 11-05 11-28 11-58 12-05 12-28 12-58 13-05 13-28 Alexandra Hospital (Redditch), Grounds 07-58 08-35 09-00 09-08 09-30 10-00 10-08 10-30 11-00 11-08 11-30 12-00 12-08 12-30 13-00 13-08 13-30 Crabbs Cross, Fleece Inn 08-03 | | 09-13 | | 10-13 | | 11-13 | | 12-13 | | 13-13 | Wishaw, Wharrington Close | 08-36 09-01 | 09-31 10-01 | 10-31 11-01 | 11-31 12-01 | 12-31 13-01 | 13-31 Greenlands, Auxerre Avenue | 08-37 09-02 | 09-32 10-02 | 10-32 11-02 | 11-32 12-02 | 12-32 13-02 | 13-32 Smallwood, Tunnel Drive | 08-45 | | 09-40 | | 10-40 | | 11-40 | | 12-40 | | 13-40 Lakeside, Arthur Street | | 09-10 | | 10-10 | | 11-10 | | 12-10 | | 13-10 | | Redditch, Bus Station 08-11 08-50 09-15 09-21 09-45 10-15 10-21 10-45 11-15 11-21 11-45 12-15 12-21 12-45 13-15 13-21 13-45

Service: 67 247 66 67 247 66 67 247 66 67 247 66 67 247 247 58A Littlewood Green 13-49 -- 14-19 14-49 -- 15-19 15-49 -- 16-19 16-49 -- 17-19 17-54 ------Studley, Alcester Road, opp. Tesco 13-55 14-01 14-25 14-55 15-01 15-26 15-55 16-01 16-25 16-55 17-01 17-25 18-00 18-01 18-52 23-21 Studley Road (Redditch), Island 13-58 14-05 14-28 14-58 15-05 15-28 15-58 16-05 16-28 16-58 17-05 17-28 18-03 18-05 18-55 23-27 Alexandra Hospital (Redditch), Grounds 14-00 14-08 14-30 15-00 15-08 15-30 16-00 16-08 16-30 17-00 17-08 17-30 18-05 18-08 18-57 23-28 Crabbs Cross, Fleece Inn | 14-13 | | 15-13 | | 16-13 | | 17-13 | | 18-13 19-02 | Wishaw, Wharrington Close 14-01 | 14-31 15-01 | 15-31 16-01 | 16-31 17-01 | 17-31 18-06 | | | Greenlands, Auxerre Avenue 14-02 | 14-32 15-02 | 15-32 16-02 | 16-32 17-02 | 17-32 18-07 | | | Smallwood, Tunnel Drive | | 14-40 | | 15-40 | | 16-40 | | 17-40 | | | | Lakeside, Arthur Street 14-10 | | 15-10 | | 16-10 | | 17-10 | | 18-15 | | | Redditch, Bus Station 14-15 14-21 14-45 15-15 15-21 15-45 16-15 16-21 16-45 17-15 17-21 17-45 18-20 18-21 19-10 23-38

Sundays (& Bank Holiday Mondays) from 31st August 2008

Extract from Sunday service 247 operated by Diamond (Most journeys start from or continue to Alcester / Evesham.) Studley, Alcester Road, opp. Dillons 09-59 11-59 13-59 15-59 17-59 19-59 Studley Road(Redditch),Island 10-01 12-01 14-01 16-01 18-01 20-01 Alexandra Hospital, Redditch, Grounds 10-03 12-03 14-03 16-03 18-03 20-03 Crabbs Cross, Fleece Inn 10-08 12-08 14-08 16-08 18-08 20-08 Redditch, Bus Station 10-16 12-16 14-16 16-16 18-16 20-16

Operator Phone Numbers: Diamond - 0121 557 7337 First - 0800 587 7381 101 Attachment F5 Redditch - Wythall - Birmingham 177 / 178 Operator: Diamond Includes extracts from Service 175, No Sunday service on these routes Monday to Saturday from 12th April 2009

Service : 178 175 178 178 178 177 175 178 177 178 175 178 177 178 175 Notes: NS NS NS S Redditch Bus Station, stand E 05-52 -- 07-08 07-16 08-16 -- -- 09-16 -- 10-16 -- 11-16 -- 12-16 -- Bromsgrove Road/Woodland Road 05-57 -- 07-13 07-21 08-21 -- -- 09-21 -- 10-21 -- 11-21 -- 12-21 -- Crabbs Cross, Fleece Inn 06-05 -- 07-21 07-29 08-29 -- -- 09-29 -- 10-29 -- 11-29 -- 12-29 -- Alexandra Hospital (Redditch), Grounds 06-10 -- 07-26 07-34 08-34 -- -- 09-34 -- 10-34 -- 11-34 -- 12-34 -- Studley Road (Redditch), Island 06-11 -- 07-27 07-35 08-35 -- -- 09-35 -- 10-35 -- 11-35 -- 12-35 -- Woodrow, Centre 06-13 -- 07-29 07-37 08-37 -- -- 09-37 -- 10-37 -- 11-37 -- 12-37 -- Matchborough, Centre 06-19 -- 07-35 07-43 08-43 -- -- 09-43 -- 10-43 -- 11-43 -- 12-43 -- Winyates, Centre 06-20 -- 07-36 07-44 08-44 -- -- 09-44 -- 10-44 -- 11-44 -- 12-44 -- Church Hill, Pharmacy 06-24 -- 07-40 07-48 08-48 -- -- 09-48 -- 10-48 -- 11-48 -- 12-48 -- Bransons Cross,Interchange 06-31 -- 07-47 07-55 08-55 -- -- 09-55 -- 10-55 -- 11-55 -- 12-55 -- Portway, Village, Old Rd 06-33 -- 07-49 07-57 08-57 -- -- 09-57 -- 10-57 -- 11-57 -- 12-57 -- Inkford, Total Garage 06-34 -- 07-51 07-59 08-59 08-56 -- 09-59 10-23 10-59 -- 11-59 12-23 12-59 -- Inkford Brook 06-34 07-48 07-53 08-00 09-00 08-57 09-28 10-00 10-24 11-00 11-28 12-00 12-24 13-00 13-28 Wythall, Church (Chapel Lane) | 07-51 | | | 09-00 09-31 | 10-27 | 11-31 | 12-27 | 13-31 Wythall, Island (Alcester Road) 06-35 | 07-56 08-03 09-03 | | 10-03 | 11-03 | 12-03 | 13-03 | Wythall, Island (Station Road) | 07-53 | | | 09-02 09-33 | 10-29 | 11-33 | 12-29 | 13-33 Grimes Hill (Wythall Railway Stn) | 07-56 | | | 09-05 09-36 | 10-32 | 11-36 | 12-32 | 13-36 Drakes Cross, White Swan 06-36 | 07-57 08-05 09-05 | | 10-05 | 11-05 | 12-05 | 13-05 | Trueman's Heath, Crossroads | 07-58 | | | 09-07 09-38 | 10-34 | 11-38 | 12-34 | 13-38 Drakes Cross, Woodrush School | 07-59 | | | 09-08 09-39 | 10-35 | 11-39 | 12-35 | 13-39 Hollywood, Pack Horse Inn 06-38 08-01 07-59 08-07 09-07 09-10 09-41 10-07 10-37 11-07 11-41 12-07 12-37 13-07 13-41 Maypole, Sainsbury's | | | | | 09-13 | | 10-40 | | | 12-40 | | Maypole, Island, Maypole Lane | 08-07 | | | | 09-47 | | | 11-47 | | | 13-47 Maypole, Island, opp.Co-op 06-41 -- 08-03 08-10 09-10 09-14 -- 10-10 10-41 11-10 -- 12-10 12-41 13-10 -- King's Heath, Church 06-48 -- 08-16 08-21 09-21 09-25 -- 10-21 10-52 11-21 -- 12-21 12-52 13-21 -- Moseley, Village 06-53 -- 08-23 08-26 09-26 -- -- 10-26 10-56 11-26 -- 12-26 12-56 13-26 -- Birmingham, Smallbrook Queensway 07-07 -- 08-40 08-40 09-40 -- -- 10-40 11-12 11-40 -- 12-40 13-12 13-40 --

Service : 178 177 175 178 178 175 178 177 175 178 178 Notes: SCH SCH SH SH NS Redditch Bus Station, stand E 13-16 -- -- 14-22 14-26 -- 15-16 -- -- 16-16 17-21 Bromsgrove Road/Woodland Road 13-21 -- -- 14-27 14-31 -- 15-21 -- -- 16-21 17-26 Crabbs Cross, Fleece Inn 13-29 -- -- 14-35 14-39 -- 15-29 -- -- 16-29 17-34 Alexandra Hospital (Redditch), Grounds 13-34 -- -- 14-40 14-44 -- 15-34 -- -- 16-34 17-39 Studley Road (Redditch), Island 13-35 -- -- 14-41 14-45 -- 15-35 -- -- 16-35 17-40 Woodrow, Centre 13-37 -- -- 14-43 14-47 -- 15-37 -- -- 16-37 17-42 Matchborough, Centre 13-43 -- -- 14-49 14-53 -- 15-43 -- -- 16-43 17-48 Winyates, Centre 13-44 -- -- 14-50 14-54 -- 15-44 -- -- 16-44 17-49 Church Hill, Pharmacy 13-48 -- -- 14-54 14-58 -- 15-48 -- -- 16-48 17-53 Bransons Cross,Interchange 13-55 -- -- 15-01 15-05 -- 15-55 -- -- 16-55 18-00 Portway, Village, Old Rd 13-57 -- -- 15-03 15-07 -- 15-57 -- -- 16-57 18-02 Inkford, Total Garage 13-59 14-23 -- 15-05 15-09 -- 15-59 16-23 -- 16-59 18-04 Inkford Brook 14-00 14-24 15-00 15-06 15-10 15-05 16-00 16-24 16-40 17-00 18-05 Wythall, Church (Chapel Lane) | 14-27 15-03 | | 15-08 | 16-27 16-43 | | Wythall, Island (Alcester Road) 14-03 | | 15-09 15-13 | 16-03 | | 17-03 18-08 Wythall, Island (Station Road) | 14-29 15-05 | | 15-10 | 16-29 16-45 | | Grimes Hill (Wythall Railway Stn) | 14-32 15-08 | | 15-13 | 16-32 16-48 | | Drakes Cross, White Swan 14-05 | | 15-11■ 15-15 | 16-05 | | 17-05 18-10 Trueman's Heath, Crossroads | 14-34 15-10 | | 15-15 | 16-34 16-50 | | Drakes Cross, Woodrush School | 14-35 15-16 15-15 | 15-16 | 16-35 16-51 | | Hollywood, Pack Horse Inn 14-07 14-37 15-18 15-17 15-17 15-18 16-07 16-37 16-53 17-07 18-12 Maypole, Sainsbury's | 14-40 | | | | | 16-40 | | | Maypole, Island, Maypole Lane | | 15-24 | | 15-24 | | 17-09 | | Maypole, Island, opp.Co-op 14-10 14-41 -- 15-20 15-20 -- 16-10 16-41 -- 17-10 18-15 King's Heath, Church 14-21 14-52 -- 15-31 15-31 -- 16-21 16-52 -- 17-21 18-26 Moseley, Village 14-26 14-56 -- 15-36 15-36 -- 16-26 16-56 -- 17-26 18-31 Birmingham, Smallbrook Queensway 14-40 15-12 -- 15-50 15-50 -- 16-40 17-12 -- 17-40 18-45

Notes: S - Runs Saturdays only, ■ - from White Swan via Alcester Road, May Lane & Shawhurst Lane SCH - Runs Schooldays only (when Woodrush School is open), SH - Runs every Saturday, and Mondays to Fridays during School Holidays (when Woodrush School is closed.) NS - Runs Mondays to Fridays only Journeys on services 177, 178 and 179 are financially supported by Worcestershire County Council.

102 BirminghamAttachment F5 - Wythall - Redditch 177 / 178 / 179 Operator: Diamond Includes extracts from Service 175, No Sunday service on these routes Monday to Saturday from 12th April 2009

Service : 179 175 178 177 178 175 178 177 178 175 178 177 178 175 178 Notes : NS NS Birmingham, Smallbrook Queensway 07-45 -- 08-45 -- 09-45 -- 10-45 11-17 11-45 -- 12-45 13-17 13-45 -- 14-45 Moseley, Alcester Road 07-56 -- 08-57 -- 09-57 -- 10-57 11-28 11-57 -- 12-57 13-28 13-57 -- 14-57 King's Heath, Church 08-00 -- 09-04 09-32 10-04 -- 11-04 11-32 12-04 -- 13-04 13-32 14-04 -- 15-04 Maypole, Island, Co-op 08-10 -- 09-13 09-42 10-13 -- 11-13 11-42 12-13 -- 13-13 13-42 14-13 -- 15-13 Maypole, Island, Maypole Lane | 09-14 | | | 10-46 | | | 12-46 | | | 14-46 | Maypole, Sainsbury's | | | 09-43 | | | 11-43 | | | 13-43 | | | Hollywood, Pack Horse Inn 08-14■ 09-17 09-17 09-46 10-17 10-49 11-17 11-46 12-17 12-49 13-17 13-46 14-17 14-49 15-17 Drakes Cross, Woodrush School 08-15 09-19 | 09-48 | 10-51 | 11-48 | 12-51 | 13-48 | 14-51 | Drakes Cross, White Swan 08-19 | 09-19 | 10-19 | 11-19 | 12-19 | 13-19 | 14-19 | 15-19 Trueman's Heath, Crossroads | 09-21 | 09-50 | 10-53 | 11-50 | 12-53 | 13-50 | 14-53 | Grimes Hill (Wythall Railway Stn) | 09-24 | 09-53 | 10-56 | 11-53 | 12-56 | 13-53 | 14-56 | Wythall, Island (Station Road) | 09-26 | 09-55 | 10-58 | 11-55 | 12-58 | 13-55 | 14-58 | Wythall, Island (Alcester Road) 08-20 | 09-20 | 10-20 | 11-20 | 12-20 | 13-20 | 14-20 | 15-20 Inkford Brook, Horse & Jockey 08-24 09-28 09-24 09-57 10-24 REQ 11-24 11-57 12-24 REQ 13-24 13-57 14-24 15-00 15-24 Inkford, Total Garage | | | 09-59 | | | 11-59 | | | 13-59 | | | Wythall, Church, (Chapel Lane) | 09-31 | 10-02 | REQ | 12-02 | REQ | 14-02 | 15-03 | Portway, Village, Slip Road 08-27 -- 09-27 -- 10-27 -- 11-27 -- 12-27 -- 13-27 -- 14-27 -- 15-27 Bransons Cross, Interchange 08-31 -- 09-31 -- 10-31 -- 11-31 -- 12-31 -- 13-31 -- 14-31 -- 15-31 Church Hill(Redditch), Tanhouse Lane 08-36 -- 09-36 -- 10-36 -- 11-36 -- 12-36 -- 13-36 -- 14-36 -- 15-36 Winyates, Centre | -- 09-40 -- 10-40 -- 11-40 -- 12-40 -- 13-40 -- 14-40 -- 15-40 Matchborough, Centre | -- 09-42 -- 10-42 -- 11-42 -- 12-42 -- 13-42 -- 14-42 -- 15-42 Woodrow, Centre | -- 09-47 -- 10-47 -- 11-47 -- 12-47 -- 13-47 -- 14-47 -- 15-47 Studley Road (Redditch), Island | -- 09-48 -- 10-48 -- 11-48 -- 12-48 -- 13-48 -- 14-48 -- 15-48 Alexandra Hospital (Redditch), Grounds | -- 09-50 -- 10-50 -- 11-50 -- 12-50 -- 13-50 -- 14-50 -- 15-50 Crabbs Cross, Fleece Inn | -- 09-54 -- 10-54 -- 11-54 -- 12-54 -- 13-54 -- 14-54 -- 15-54 Bromsgrove Road/Woodland Road | -- 10-02 -- 11-02 -- 12-02 -- 13-02 -- 14-02 -- 15-02 -- 16-02 Redditch, Bus Station 08-47 -- 10-07 -- 11-07 -- 12-07 -- 13-07 -- 14-07 -- 15-07 -- 16-07

Service : 177 178 175 178 175 178 178 Notes : NS Birmingham, Smallbrook Queensway 15-17 15-55 -- 16-45 -- 17-45 18-50 Moseley, Alcester Road 15-28 16-07 -- 16-57 -- 17-57 19-00 King's Heath, Church 15-32 16-14 -- 17-04 -- 18-04 19-05 Maypole, Island, Co-op 15-42 16-23 -- 17-13 -- 18-13 19-11 Maypole, Island, Maypole Lane | | 16-26 | 18-04 | | Maypole, Sainsbury's 15-43 | | | | | | Hollywood, Pack Horse Inn 15-46 16-27 16-29 17-17 18-07 18-17 19-14 Drakes Cross, Woodrush School 15-48 | 16-31 | 18-09 | | Drakes Cross, White Swan | 16-29 | 17-19 | 18-19 19-16 Trueman's Heath, Crossroads 15-50 | 16-33 | 18-11 | | Grimes Hill (Wythall Railway Stn) 15-53 | 16-36 | 18-14 | | Wythall, Island (Station Road) 15-55 | 16-38 | 18-16 | | Wythall, Island (Alcester Road) | 16-30 | 17-20 | 18-20 19-17 Inkford Brook, Horse & Jockey 15-57 16-34 16-40 17-24 REQ 18-24 19-21 Inkford, Total Garage 15-59 | | | | | | Wythall, Church (Chapel Lane) 16-02 | 16-43 | REQ | | Portway, Village, Slip Road -- 16-37 -- 17-27 -- 18-27 19-23 Bransons Cross, Interchange -- 16-41 -- 17-31 -- 18-31 19-28 Church Hill(Redditch), Tanhouse Lane -- 16-46 -- 17-36 -- 18-36 19-33 Winyates, Centre -- 16-50 -- 17-40 -- 18-40 19-36 Matchborough, Centre -- 16-52 -- 17-42 -- 18-42 19-38 Woodrow, Centre -- 16-57 -- 17-47 -- 18-47 19-43 Studley Road (Redditch), Island -- 16-58 -- 17-48 -- 18-48 19-44 Alexandra Hospital (Redditch), Grounds -- 17-00 -- 17-50 -- 18-50 19-46 Crabbs Cross, Fleece Inn -- 17-04 -- 17-54 -- 18-54 19-50 Bromsgrove Road/Woodland Road -- 17-12 -- 18-02 -- 19-02 19-58 Redditch, Bus Station -- 17-17 -- 18-07 -- 19-07 20-03

Notes: NS - Runs Mondays to Fridays only, ■ - Via May Lane & Shawhurst Lane (past Woodrush School), REQ - Served on request to driver only Journeys on services 177, 178 and 179 are financially supported by Worcestershire County Council.

Operator Phone Number: Diamond - 0121 557 7337

103 Attachment F6 Evesham - Alcester - Redditch 247

Operator: First For other services Alcester - Studley -Crabbs Cross - Redditch & vice versa see service 26 operated by Stagecoach in Warwickshire Monday to Fridays from 12th July 2010

Notes : B HOL G HOL HOL A Evesham, Bus Station, Stand A 06-12 06-52 07-45 08-05 09-15 10-05 11-05 12-05 13-05 15-05 16-00G 16-05 17-05 17-20 18-00 Evesham, Waterside, opp. Hospital 06-14 06-54 07-47 08-08 09-18 10-08 11-08 12-08 13-08 15-08 G 16-08 17-08 17-23 18-03 Evesham, Davies Road 06-16 06-56 07-49 08-10 09-20 10-10 11-10 12-10 13-10 15-10 G 16-10 17-10 17-25 18-05 Evesham, The Link, Morrisons 06-18 06-58 07-52 08-13 09-23 10-13 11-13 12-13 13-13 15-13 16-13 16-13 17-13 17-28 18-08 Badsey, Pike 06-23 07-03 07-57B 08-18 09-28 10-18 11-18 12-18 13-18 then 15-18 16-18 16-18 17-18 17-33 18-13 South Littleton, opp. King Edward 06-28 07-08 08-12 08-24 09-34 10-24 11-24 12-24 13-24 15-24 16-24 16-24 17-24 17-39 18-19 Cleeve Prior, King's Arms 06-34 07-14 08-19 08-31 09-41 10-31 11-31 12-31 13-31 15-31 16-31 16-31 17-31 17-46 18-26 Bidford-on-Avon, Memorial 06-39 07-19 08-25 08-37 09-47 10-37 11-37 12-37 13-37 15-37 16-37 16-37 17-37 17-52 18-32 Wixford, Fish Inn 06-44 07-24 08-31 08-43 09-53 10-43 11-43 12-43 13-43 15-43 16-43 16-43 17-43 17-58 18-36 Alcester, Priory Road, Police Station 06-49 07-29 08-49B 08-49 09-59 10-49 11-49 12-49 13-49 15-49 16-49 16-49 17-49 18-04 18-42 Studley, Alcester Road, opp.Tesco 06-58 07-38 09-01 09-01 10-11 11-01 12-01 13-01 14-01 16-01 17-01 17-01 18-01 18-16 18-52 Studley Road(Redditch), Island 07-00 07-40 09-05 09-05 10-15 11-05 12-05 13-05 14-05 16-05 17-05 17-05 18-05 18-19 18-55 Alexandra Hospital (Redditch), Grounds 07-03 07-43 09-08 09-08 10-18 11-08 12-08 13-08 14-08 16-08 17-08 17-08 18-08 18-22 18-57 Crabbs Cross, Fleece Inn 07-08 07-48 09-13 09-13 10-23 11-13 12-13 13-13 14-13 16-13 17-13 17-13 18-13 18-27 19-02 Redditch, Bus Station 07-16 07-56 09-21 09-21 10-31 11-21 12-21 13-21 14-21 16-21 17-21 17-21 18-21 18-35 19-10

Notes: HOL - Runs Mondays to Fridays during School Holidays A - Runs schooldays (Mon - Fri) only, and starts at Pershore College, departs 1700 B - Runs schooldays (Mon - Fri) only and serves Badsey First School (Chapel Street) (08-00) & St. Benedicts RC School (Alcester) (08-46). G - Runs schooldays (Mon - Fri) only and runs via Evesham High School (16-10).

Saturdays from 12th July 2010

Evesham, Bus Station, Stand A -- 08-05 09-05 10-05 11-05 12-05 13-05 14-05 15-05 16-05 17-05 18-00 Evesham, Waterside, opp. Hospital -- 08-08 09-08 10-08 11-08 12-08 13-08 14-08 15-08 16-08 17-08 18-03 Evesham, Davies Road -- 08-10 09-10 10-10 11-10 12-10 13-10 14-10 15-10 16-10 17-10 18-05 Evesham, The Link, Morrisons -- 08-13 09-13 10-13 11-13 12-13 13-13 14-13 15-13 16-13 17-13 18-08 Badsey, Pike -- 08-18 09-18 10-18 11-18 12-18 13-18 14-18 15-18 16-18 17-18 18-13 South Littleton, opp. King Edward -- 08-24 09-24 10-24 11-24 12-24 13-24 14-24 15-24 16-24 17-24 18-19 Cleeve Prior, King's Arms -- 08-31 09-31 10-31 11-31 12-31 13-31 14-31 15-31 16-31 17-31 18-26 Bidford-on-Avon, Memorial -- 08-37 09-37 10-37 11-37 12-37 13-37 14-37 15-37 16-37 17-37 18-32 Wixford, Fish Inn -- 08-43 09-43 10-43 11-43 12-43 13-43 14-43 15-43 16-43 17-43 18-36 Alcester, Priory Road, Police Station 07-44 08-49 09-49 10-49 11-49 12-49 13-49 14-49 15-49 16-49 17-49 18-42 Studley, Alcester Road, opp.Tesco 07-53 09-01 10-01 11-01 12-01 13-01 14-01 15-01 16-01 17-01 18-01 18-52 Studley Road(Redditch), Island 07-55 09-05 10-05 11-05 12-05 13-05 14-05 15-05 16-05 17-05 18-05 18-55 Alexandra Hospital (Redditch), Grounds 07-58 09-08 10-08 11-08 12-08 13-08 14-08 15-08 16-08 17-08 18-08 18-57 Crabbs Cross, Fleece Inn 08-03 09-13 10-13 11-13 12-13 13-13 14-13 15-13 16-13 17-13 18-13 19-02 Redditch, Bus Station 08-11 09-21 10-21 11-21 12-21 13-21 14-21 15-21 16-21 17-21 18-21 19-10 Operator: Diamond Sunday (& Bank Holiday Mondays only) from 12th July 2010

Evesham, Bus Station, Stand A -- 11-15 13-15 15-15 17-15 19-15 Evesham, Waterside, opp. Hospital -- 11-17 13-17 15-17 17-17 19-17 Evesham, Davies Road -- 11-19 13-19 15-19 17-19 19-19 Evesham, The Link, Morrisons -- 11-21 13-21 15-21 17-21 19-21 Badsey, Pike -- 11-26 13-26 15-26 17-26 19-26 South Littleton,King Edward -- 11-30 13-30 15-30 17-30 19-30 Cleeve Prior, King's Arms -- 11-35 13-35 15-35 17-35 19-35 Bidford-on-Avon, Memorial -- 11-40 13-40 15-40 17-40 19-40 Wixford,Fish Inn -- 11-45 13-45 15-45 17-45 19-45 Alcester, Priory Road,Police Station -- 11-50 13-50 15-50 17-50 19-50 Studley, Alcester Road, opp. Dillons 09-59 11-59 13-59 15-59 17-59 19-59 Studley Road(Redditch),Island 10-01 12-01 14-01 16-01 18-01 20-01 Alexandra Hospital, Redditch, Grounds 10-03 12-03 14-03 16-03 18-03 20-03 Crabbs Cross, Fleece Inn 10-08 12-08 14-08 16-08 18-08 20-08 Redditch, Bus Station 10-16 12-16 14-16 16-16 18-16 20-16

104 Attachment F6 Redditch - Alcester - Evesham 247

Operator: First For other services Redditch - Crabbs Cross - Studley - Alcester & vice versa see service 26 operated by Stagecoach in Warwickshire Monday to Fridays from 27th April 2009

Notes : A HOL C SCH HOL D HOL Redditch, Bus Station 07-25 07-25 -- 09-40 10-40 11-40 12-40 13-40 -- 14-40 14-40 15-12 15-40 16-40 17-40 19-15 Crabbs Cross, Fleece Inn 07-31 07-31 -- 09-48 10-48 11-48 12-48 13-48 -- 14-48 14-48 15-20 15-48 16-48 17-48 19-22 Alexandra Hospital (Redditch), Grounds 07-35 07-35 -- 09-53 10-53 11-53 12-53 13-53 -- 14-53 14-53 15-25 15-53 16-53 17-53 19-27 Studley Road(Redditch),Island 07-37 07-37 -- 09-55 10-55 11-55 12-55 13-55 -- 14-55 14-55 15-27 15-55 16-55 17-55 19-29 Studley, Alcester Road, Tesco 07-41 07-41 -- 09-59 10-59 11-59 12-59 13-59 -- 14-59 14-59 15-31 15-59 16-59 17-59 19-32 Alcester, Priory Road, opp. Police Station 07-51 07-51 09-11 10-11 11-11 12-11 13-11 14-11 -- 15-11 15-11 15-43D 16-11 17-11 18-11 19-39 Wixford, Fish Inn 07-57 07-57 09-17 10-17 11-17 12-17 -- 14-17 -- -- 15-17 15-59 16-17 17-17 18-17 19-44 Bidford-on-Avon, Church 08-03 08-03 09-23 10-23 11-23 12-23 -- 14-23 -- -- 15-23 16-05 16-23 17-23 18-23 19-48 Cleeve Prior, King's Arms 08-09 08-09 09-29 10-29 11-29 12-29 -- 14-29 -- -- 15-29 16-11 16-29 17-29 18-29 19-53 South Littleton, King Edward 08-15 08-15 09-35 10-35 11-35 12-35 -- 14-35 C -- 15-35 16-17 16-35 17-35 18-35 19-58 Badsey, Pike 08-19 08-19 09-39 10-39 11-39 12-39 -- 14-39 15-32 -- 15-39 16-21 16-39 17-39 18-39 20-01 Evesham, The Link, opp. Morrisons 08-24 08-24 09-44 10-44 11-44 12-44 -- 14-44 15-37 -- 15-44 16-26 16-44 17-44 18-44 20-05 Evesham, Davies Road 08-25 08-25 09-45 10-45 11-45 12-45 -- 14-45 15-38 -- 15-45 16-27 16-45 17-45 18-45 20-06 Evesham, Waterside, Hospital | 08-30 09-50 10-50 11-50 12-50 -- 14-50 15-43 -- 15-50 16-32 16-50 17-50 18-50 20-09 Evesham, Bus Station 08-34A 08-37 09-55 10-55 11-55 12-55 -- 14-55 15-48 -- 15-55 16-37 16-55 17-55 18-55 20-13

Notes: HOL - Runs Mondays to Fridays during School Holidays, SCH - Schooldays only A - Runs schooldays (Mon - Fri) only, and continues to Pershore College, arrive 0852 C - Runs schooldays (Mon - Fri) only, starts at Blackminster School dep. 15-25 and serves Badsey First School (Chapel Street) at 15-30. D - Runs schooldays (Mon - Fri) only and serves St. Benedicts RC School (Alcester) at 15-45, & Alcester Grammar School at 15-50,

Saturdays from 27th April 2009

Redditch, Bus Station 07-35 08-40 09-40 10-40 11-40 12-40 13-40 14-40 15-40 16-40 18-00 19-15 Crabbs Cross, Fleece Inn 07-42 08-48 09-48 10-48 11-48 12-48 13-48 14-48 15-48 16-48 18-08 19-22 Alexandra Hospital (Redditch), Grounds 07-47 08-53 09-53 10-53 11-53 12-53 13-53 14-53 15-53 16-53 18-13 19-27 Studley Road(Redditch),Island 07-49 08-55 09-55 10-55 11-55 12-55 13-55 14-55 15-55 16-55 18-15 19-29 Studley, Alcester Road, Tesco 07-52 08-59 09-59 10-59 11-59 12-59 13-59 14-59 15-59 16-59 18-19 19-32 Alcester, Priory Road, opp. Police Station 07-59 09-11 10-11 11-11 12-11 13-11 14-11 15-11 16-11 17-11 18-31 19-39 Wixford, Fish Inn 08-05 09-17 10-17 11-17 12-17 13-17 14-17 15-17 16-17 17-17 18-36 19-44 Bidford-on-Avon, Church 08-11 09-23 10-23 11-23 12-23 13-23 14-23 15-23 16-23 17-23 18-40 19-48 Cleeve Prior, King's Arms 08-17 09-29 10-29 11-29 12-29 13-29 14-29 15-29 16-29 17-29 18-45 19-53 South Littleton, King Edward 08-23 09-35 10-35 11-35 12-35 13-35 14-35 15-35 16-35 17-35 18-50 19-58 Badsey, Pike 08-27 09-39 10-39 11-39 12-39 13-39 14-39 15-39 16-39 17-39 18-53 20-01 Evesham, The Link, opp. Morrisons 08-32 09-44 10-44 11-44 12-44 13-44 14-44 15-44 16-44 17-44 18-57 20-05 Evesham, Davies Road 08-33 09-45 10-45 11-45 12-45 13-45 14-45 15-45 16-45 17-45 18-58 20-06 Evesham, Waterside, Hospital 08-38 09-50 10-50 11-50 12-50 13-50 14-50 15-50 16-50 17-50 19-01 20-09 Evesham, Bus Station 08-43 09-55 10-55 11-55 12-55 13-55 14-55 15-55 16-55 17-55 19-05 20-13 Operator: Diamond Sunday (& Bank Holiday Mondays only) from 31st August 2008

Redditch, Bus Station 09-45 11-45 13-45 15-45 17-45 Crabbs Cross, Fleece Inn 09-52 11-52 13-52 15-52 17-52 Alexandra Hospital, Redditch, Grounds 09-57 11-57 13-57 15-57 17-57 Studley Road(Redditch),Island 09-59 11-59 13-59 15-59 17-59 Studley, Alcester Road,Video Shop 10-02 12-02 14-02 16-02 18-02 Alcester, Priory Road,opp. Police Station 10-09 12-09 14-09 16-09 18-09 Wixford,Fish Inn 10-14 12-14 14-14 16-14 18-14 Bidford-on-Avon, Church 10-18 12-18 14-18 16-18 18-18 Cleeve Prior, King's Arms 10-23 12-23 14-23 16-23 18-23 South Littleton,King Edward 10-28 12-28 14-28 16-28 18-28 Badsey, Pike 10-31 12-31 14-31 16-31 18-31 Evesham, The Link, opp. Morrisons 10-35 12-35 14-35 16-35 18-35 Evesham, Davies Road 10-36 12-36 14-36 16-36 18-36 Evesham, Waterside, Hospital 10-39 12-39 14-39 16-39 18-39 Evesham, Bus Station 10-43 12-43 14-43 16-43 18-43

Operator Phone Numbers:

Diamond - 0121 557 7337 First - 0800 587 7381

105 Attachment F7 Worcester - Inkberrow - Astwood Bank - Alexandra Hospital - Redditch 350 Operators: Diamond (DIA), Dudleys Coaches (DUD) from 1st April 2011 Monday to Friday Saturday

Operator: DUD DIA DIA DUD DIA DUD DUD DIA DIA DIA DIA DIA DIA Notes : J CP e e e SCH SCH e e e e e e Alice Ottley Sch, Worcester, The Tything ------16-07 17-05 A ------Worcester, Bus Station -- 09-15 12-15 14-00 15-15 16-10 | 17-45 08-30 10-45 13-25 15-40 17-45 Worcester, Cathedral, Giffard Hotel -- 09-17 12-17 14-02 15-17 16-14 17-10 17-47 08-32 10-47 13-27 15-42 17-47 Worcester, Shrub Hill (outside Rail Station ) -- 09-23 12-23 | 15-23 | | | 08-38 10-53 13-33 15-48 | Worcestershire Royal Hospital (Main Entrance) -- 09-32 12-32 | 15-32 | | | 08-47 11-02 13-42 15-57 | Red Hill (Worcester), London Road Top -- | | 14-09 | 16-16 17-21 17-51 | | | | 17-51 County Hall, Grounds -- | | | | | | 17-52 | | | | | Spetchley Park, Gardens -- 09-34 12-34 14-13 15-34 16-20 17-30 17-54 08-49 11-04 13-44 15-59 17-54 Broughton Hackett, opp. March Hare -- 09-36 12-36 14-15 15-36 16-25 17-32 17-56 08-51 11-06 13-46 16-01 17-56 Upton Snodsbury, opp. Shelter -- 09-38 12-38 14-17 15-38 16-28 17-34 17-58 08-53 11-08 13-48 16-03 17-58 Flyford Flavell, Flyford Arms -- 09-42 12-42 14-21 15-42 16-32 17-38 18-03 08-57 11-12 13-52 16-07 18-03 Flyford Flavell, First School -- | | | | 16-33 | | | | | | | Dormston, Red Hart -- 09-44 12-44 14-23 15-44 16-34 17-40 18-05 08-59 11-14 13-54 16-09 18-05 Inkberrow, Bull's Head 07-25 09-48 12-48 14-27 15-48 16-44C 17-45 18-10 09-03 11-18 13-58 16-13 18-10 Cookhill, Village Hall 07-32 09-55 12-55 14-34 15-55 | 17-52R 18-15 09-10 11-25 14-05 16-20 18-15 Cladswell Lane | 09-57 | | | | | | | 11-27 | | | Feckenham, Garage, Droitwich Road | | | | | 16-50 | | | | | | | New End, Nevill Arms 07-34 10-01 12-57 14-36 15-57 17-00 17-54R 18-17 09-12 11-31 14-07 16-22 18-17 Astwood Bank, The Bell Inn 07-37 10-04 13-00 14-38 16-00 17-06R -- 18-20 09-15 11-33 14-10 16-25 18-20 Alexandra Hospital, Grounds | 10-10 13-06 14-43R 16-06 17-12R -- 18-26R 09-23 11-39 14-18 16-33 18-26R Woodrow, Centre | | 13-09 14-45 16-09 17-14R -- 18-29R 09-26 11-42 14-21 16-36 18-29R Matchborough West, Ilmington Close | 10-16 | | | | -- | | | | | | Matchborough, Centre | | | 14-50 16-14 | -- 18-34R 09-31 11-47 14-26 16-41 18-34R Winyates, Centre | | | 14-52 16-16 | -- 18-36R 09-33 11-49 14-28 16-43 18-36R Church Hill (Redditch), Pharmacy | | | 14-55 16-19 | -- 18-39R 09-36 11-52 14-31 16-46 18-39R Redditch, Bus Station 07-48 10-28 13-15 15-03 16-27 17-20R -- 18-45 09-44 12-00 14-37 16-54 18-45 Headless Cross, Traffic Lights (07-45) -- -- 15-06R 16-35 17-23R -- 18-50R 09-50 12-05 14-45 17-00 18-50R Crabbs Cross, Star & Garter (07-41) -- -- 15-10R 16-39 17-26R -- 18-54R 09-52 12-09 14-49 17-04 18-54R

Notes: R - On Request to driver, J - runs on Bromsgrove area School / College days only, SCH - Runs on School / College days only, e - journey scheduled to be operated by easy access low floor bus, (Times in brackets) - stop served out of usual order, A - On College/School days starts from opposite Barbourne Technical College at 17-35, via Alice Ottley School, CP - Will accept concessionary pass holders C - Arrival time, connection by service 850, change from service 350 to service 850 at Broughton Hackett.

106 Attachment F7 Alexandra Hospital - Redditch - Astwood Bank - Inkberrow - Worcester 350 Operators: Diamond (DIA), Dudleys Coaches (DUD) from 1st April 2011 Monday to Friday Saturday

Operator: DUD DIA DUD DIA DIA DIA DIA DIA DIA DIA DIA Notes : SCH e CPR e e e e e e e e Alexandra Hospital, Grounds -- 07-17 09-17 (11-18) (13-43) 16-06 07-17 09-23 11-39 14-18 16-33 Woodrow, Centre -- 07-20 09-20 (11-16) | 16-09 07-20 09-26 11-42 14-21 16-36 Matchborough West, Ilmington Close -- | | | (13-37) | | | | | | Matchborough, Centre -- 07-25 09-25 | | 16-14 07-25 09-31 11-47 14-26 16-41 Winyates, Centre -- 07-27 09-27 | | 16-16 07-27 09-33 11-49 14-28 16-43 Church Hill (Redditch), Pharmacy -- 07-30 09-30 | | 16-19 07-30 09-36 11-52 14-31 16-46 Redditch, Bus Station (arrive) -- 07-38 09-38 | | 16-27 07-38 09-44 12-00 14-37 16-54 Redditch, Bus Station (depart) -- 07-40 09-40 11-10 13-25 16-30 07-40 09-45 12-00 14-40 16-55 Woodrow, Centre -- | | 11-16 | | | | | | | Matchborough West, Ilmington Close -- | | | 13-37 | | | | | | Alexandra Hospital, Grounds -- | | 11-18 13-43 | | | | | | Headless Cross, Traffic Lights -- 07-45 09-45 | | 16-35 07-45 09-50 12-05 14-45 17-00 Crabbs Cross, Star & Garter -- 07-49 09-49 | | 16-39 07-49 09-52 12-09 14-49 17-04 Astwood Bank, opp. The Bell Inn -- 07-52 09-52 11-24 13-49 16-42 07-52 09-55 12-12 14-52 17-07 New End, Nevill Arms 07-30D 07-55 09-55 11-27 13-52 16-45 07-55 09-58 12-15 14-55 17-10 Feckenham, Garage, Droitwich Road 07-35D | | | | | | | | | | Cladswell Lane | | | 11-31 13-56 | | | | 14-59 | Cookhill, Village Hall | 07-57 09-57 11-33 13-58 16-47 07-57 10-00 12-17 15-01 17-12 Inkberrow, Shelter 07-45 08-03 10-03 11-40 14-05 16-53 08-03 10-06 12-23 15-07 17-17 Dormston, Red Hart 07-50 08-07 10-07 11-44 14-09 16-57 08-07 10-10 12-27 15-11 17-21 Flyford Flavell, Flyford Arms 07-52 08-09 10-09 11-46 14-11 16-59 08-09 10-12 12-29 15-13 17-23 Upton Snodsbury, Shelter 07-56 08-14 10-14 11-51 14-16 17-04 08-14 10-17 12-34 15-18 17-27 Broughton Hackett, March Hare 08-00 08-16 10-16 11-53 14-18 17-06 08-16 10-19 12-36 15-20 17-29 Spetchley Park, Gardens 08-05 08-18 10-18 11-55 14-20 17-08 08-18 10-21 12-38 15-22 17-31 County Hall, Grounds | 08-20 | | | | | | | | | Red Hill(Worcester), London Rd Top 08-10 08-22 | | | | 08-22 | | | | Worcester, Cathedral 08-20 | | | | | | | | | | Worcestershire Royal Hospital (Main Entrance) | | 10-21R 11-58R 14-23R 17-11R | 10-24R 12-41R 15-25R 17-34R Worcester, opp.Shrub Hill Station | | 10-25 12-02 14-27 17-15 | 10-28 12-45 15-29 17-38 Worcester, Bus Station | 08-37 10-32 12-09 14-34 17-22 08-29 10-35 12-52 15-36 17-43 Alice Ottley School, Worcester, The Tything 08-30 A ------

Notes: A - On School / College days only continues to Alice Ottley School (08-43), & Barbourne Technical College (08-45), as required. e - journey scheduled to be operated by easy access low-floor bus, (Times in brackets) - stop served out of usual order, R - On request to driver, SCH - Runs School / College days only, D - Connection by service 850, change from service 850 to service 350 at Upton Snodsbury. CPR - Will accept concessionary pass holders if travelling beyond Redditch, Bus Station

107 Worcestershire Oncology Project

Radiotherapy Feasibility Review

APPENDIX D NON FINANCIAL APPRAISAL RESULTS

110511 Radiotherapy Feasibility Report_v1.1 108 Weightings

Worcestershire Oncology Project Radiotherapy Facility

NON-FINANCIAL APPRAISAL WORKSHOP 6th May 2011

SUMMARY SENSITIVITY

WEIGHTING WEIGHTING CRITERION Rank Score Weight Alternative 1 Alternative 2 Alternative 3

Clinical Quality 1= 100 26.3% 50 14.3% 100 23.8% 100 25.0%

Access to services 1= 100 26.3% 50 14.3% 100 23.8% 100 25.0%

Developing existing/new Services 4 50 13.2% 50 14.3% 50 11.9% 50 12.5%

Strategic Fit 5 40 10.5% 50 14.3% 40 9.5% 40 10.0%

Training, Teaching, Research 6 20 5.3% 50 14.3% 20 4.8% 20 5.0%

Effective Use of Resources 3 60 15.8% 50 14.3% 60 14.3% 80 20.0%

Ease of Delivery 7 10 2.6% 50 14.3% 50 11.9% 10 2.5%

380 100.0% 350 100.0% 420 100.0% 400 100.0%

Weightings 110506 WOP Radiotherapy Non-Fin Appraisal Results 109 Overall Scores

Worcestershire Oncology Project Radiotherapy Facility SCORER : TOTAL

NON-FINANCIAL APPRAISAL WORKSHOP 6th May 2011

Number of scoring participants 18

RAW SCORES WEIGHTED SCORES

Weight Do Nothing OPTION A OPTION C OPTION D OPTION E OPTION F OPTION G Do Nothing OPTION A OPTION C OPTION D OPTION E OPTION F OPTION G

WRH - ALX - Bank WRH - ALX - Bank WRH - A&E WRH - ALX - Rear of ALX - Front WRH - A&E WRH - ALX - Rear of ALX - Front of Spetchley Adjacent to Spetchley Adjacent to Car Park Workshops Site of Site Car Park Workshops Site Site Land PGMC Land PGMC

Clinical Quality 26.3% 4.67 9.39 5.61 4.72 8.33 7.33 4.28 1.23 2.47 1.48 1.24 2.19 1.93 1.13

Access to services 26.3% 2.06 8.94 7.06 6.11 6.72 6.61 4.72 0.54 2.35 1.86 1.61 1.77 1.74 1.24

Developing existing/new Services 13.2% 2.22 7.89 5.61 5.61 7.22 6.61 5.06 0.29 1.04 0.74 0.74 0.95 0.87 0.67

Strategic Fit 10.5% 2.39 8.39 5.94 5.56 7.00 6.11 4.78 0.25 0.88 0.63 0.58 0.74 0.64 0.50

Training, Teaching, Research 5.3% 3.06 7.33 5.89 5.83 6.22 6.06 5.17 0.16 0.39 0.31 0.31 0.33 0.32 0.27

Effective Use of Resources 15.8% 4.33 8.17 5.39 4.56 7.61 6.56 3.83 0.68 1.29 0.85 0.72 1.20 1.04 0.61

Ease of Delivery 2.6% 5.67 6.94 5.11 6.94 7.78 9.44 5.78 0.15 0.18 0.13 0.18 0.20 0.25 0.15 TOTAL 100% 24.39 57.06 40.61 39.33 50.89 48.72 33.61 3.31 8.60 5.99 5.38 7.38 6.79 4.57

RANK 7 1 4 5 2 3 6

DIFFERENCE 61.56% 0.00% 30.35% 37.43% 14.19% 21.14% 46.93%

Scores - All 110506 WOP Radiotherapy Non-Fin Appraisal Results 110 Scores - Alternative Weight (1)

Worcestershire Oncology Project Radiotherapy Facility SCORER : TOTAL

NON-FINANCIAL APPRAISAL WORKSHOP 6th May 2011

Number of scoring participants 18

RAW SCORES WEIGHTED SCORES Alternative Do Nothing OPTION A OPTION C OPTION D OPTION 14a OPTION F OPTION G Do Nothing OPTION A OPTION C OPTION D OPTION 14a OPTION F OPTION G Weight 1

WRH - ALX - Bank WRH - ALX - Bank WRH - A&E WRH - ALX - Rear of ALX - Front WRH - A&E WRH - ALX - Rear of ALX - Front 0.00 Spetchley Adjacent to Spetchley Adjacent to Car Park Workshops Site of Site Car Park Workshops Site of Site Land PGMC Land PGMC

Clinical Quality 14.3% 4.67 9.39 5.61 4.72 8.33 7.33 4.28 0.67 1.34 0.80 0.67 1.19 1.05 0.61

Access to services 14.3% 2.06 8.94 7.06 6.11 6.72 6.61 4.72 0.29 1.28 1.01 0.87 0.96 0.94 0.67

Developing existing/new Services 14.3% 2.22 7.89 5.61 5.61 7.22 6.61 5.06 0.32 1.13 0.80 0.80 1.03 0.94 0.72

Strategic Fit 14.3% 2.39 8.39 5.94 5.56 7.00 6.11 4.78 0.34 1.20 0.85 0.79 1.00 0.87 0.68

Training, Teaching, Research 14.3% 3.06 7.33 5.89 5.83 6.22 6.06 5.17 0.44 1.05 0.84 0.83 0.89 0.87 0.74

Effective Use of Resources 14.3% 4.33 8.17 5.39 4.56 7.61 6.56 3.83 0.62 1.17 0.77 0.65 1.09 0.94 0.55

Ease of Delivery 14.3% 5.67 6.94 5.11 6.94 7.78 7.22 5.78 0.81 0.99 0.73 0.99 1.11 1.03 0.83

TOTAL 100% 24.39 57.06 40.61 39.33 50.89 46.50 33.61 3.48 8.15 5.80 5.62 7.27 6.64 4.80

RANK 7 1 4 5 2 3 6

DIFFERENCE 57.25% 0.00% 28.82% 31.06% 10.81% 18.50% 41.09%

Alternative 1 110506 WOP Radiotherapy Non-Fin Appraisal Results 111 Worcestershire Oncology Project Scores - Alternative Weight (2) Radiotherapy Facility SCORER : TOTAL

NON-FINANCIAL APPRAISAL WORKSHOP 6th May 2011

Number of scoring participants 18

RAW SCORES WEIGHTED SCORES Alternative Do Nothing OPTION A OPTION C OPTION D OPTION 14a OPTION F OPTION G Do Nothing OPTION A OPTION C OPTION D OPTION 14a OPTION F OPTION G Weight 2

Clinical Quality 23.8% 4.67 9.39 5.61 4.72 8.33 7.33 4.28 1.11 2.24 1.34 1.12 1.98 1.75 1.02

Access to services 23.8% 2.06 8.94 7.06 6.11 6.72 6.61 4.72 0.49 2.13 1.68 1.46 1.60 1.57 1.12

Developing existing/new Services 11.9% 2.22 7.89 5.61 5.61 7.22 6.61 5.06 0.26 0.94 0.67 0.67 0.86 0.79 0.60

Strategic Fit 9.5% 2.39 8.39 5.94 5.56 7.00 6.11 4.78 0.23 0.80 0.57 0.53 0.67 0.58 0.46

Training, Teaching, Research 4.8% 3.06 7.33 5.89 5.83 6.22 6.06 5.17 0.15 0.35 0.28 0.28 0.30 0.29 0.25

Effective Use of Resources 14.3% 4.33 8.17 5.39 4.56 7.61 6.56 3.83 0.62 1.17 0.77 0.65 1.09 0.94 0.55

Ease of Delivery 11.9% 5.67 6.94 5.11 6.94 7.78 7.22 5.78 0.67 0.83 0.61 0.83 0.93 0.86 0.69 TOTAL 100% 24.39 57.06 40.61 39.33 50.89 46.50 33.61 3.53 8.45 5.91 5.53 7.42 6.77 4.68

RANK 7 1 4 5 2 3 6

DIFFERENCE 58.18% 0.00% 30.04% 34.50% 12.14% 19.80% 44.57%

Alternative 2 110506 WOP Radiotherapy Non-Fin Appraisal Results 112 Scores - Alternative Weight (3)

Worcestershire Oncology Project Radiotherapy Facility SCORER : TOTAL

NON-FINANCIAL APPRAISAL WORKSHOP 6th May 2011

Number of scoring participants 18

RAW SCORES WEIGHTED SCORES Alternative Do Nothing OPTION A OPTION C OPTION D OPTION 14a OPTION F OPTION G Do Nothing OPTION A OPTION C OPTION D OPTION 14a OPTION F OPTION G Weight 3

WRH - ALX - Bank WRH - ALX - Bank WRH - A&E WRH - ALX - Rear of ALX - Front WRH - A&E WRH - ALX - Rear of ALX - Front Spetchley Adjacent to Spetchley Adjacent to Car Park Workshops Site of Site Car Park Workshops Site of Site Land PGMC Land PGMC

Clinical Quality 25.0% 4.67 9.39 5.61 4.72 8.33 7.33 4.28 1.17 2.35 1.40 1.18 2.08 1.83 1.07

Access to services 25.0% 2.06 8.94 7.06 6.11 6.72 6.61 4.72 0.51 2.24 1.76 1.53 1.68 1.65 1.18

Developing existing/new Services 12.5% 2.22 7.89 5.61 5.61 7.22 6.61 5.06 0.28 0.99 0.70 0.70 0.90 0.83 0.63

Strategic Fit 10.0% 2.39 8.39 5.94 5.56 7.00 6.11 4.78 0.24 0.84 0.59 0.56 0.70 0.61 0.48

Training, Teaching, Research 5.0% 3.06 7.33 5.89 5.83 6.22 6.06 5.17 0.15 0.37 0.29 0.29 0.31 0.30 0.26

Effective Use of Resources 20.0% 4.33 8.17 5.39 4.56 7.61 6.56 3.83 0.87 1.63 1.08 0.91 1.52 1.31 0.77

Ease of Delivery 2.5% 5.67 6.94 5.11 6.94 7.78 7.22 5.78 0.14 0.17 0.13 0.17 0.19 0.18 0.14 TOTAL 100% 24.39 57.06 40.61 39.33 50.89 46.50 33.61 3.36 8.58 5.96 5.34 7.39 6.72 4.53

RANK 7 1 4 5 2 3 6

DIFFERENCE 60.87% 0.00% 30.52% 37.76% 13.84% 21.72% 47.22%

Alternative 3 110506 WOP Radiotherapy Non-Fin Appraisal Results 113 Total Scores - User Representatives

Worcestershire Oncology Project Radiotherapy Facility SCORER : USERS

NON-FINANCIAL APPRAISAL WORKSHOP 6th May 2011

Number of scoring participants 8

RAW SCORES WEIGHTED SCORES

Weight Do Nothing OPTION A OPTION C OPTION D OPTION E OPTION F OPTION G Do Nothing OPTION A OPTION C OPTION D OPTION E OPTION F OPTION G

Clinical Quality 26.3% 3.13 9.50 6.50 5.13 8.38 6.63 4.13 0.82 2.50 1.71 1.35 2.20 1.74 1.09

Access to services 26.3% 2.00 9.13 7.88 7.00 6.00 5.88 5.00 0.53 2.40 2.07 1.84 1.58 1.55 1.32

Developing existing/new Services 13.2% 1.63 8.00 6.50 5.25 7.00 5.88 4.75 0.21 1.05 0.86 0.69 0.92 0.77 0.63

Strategic Fit 10.5% 2.38 8.63 6.75 6.13 6.75 5.25 4.75 0.25 0.91 0.71 0.64 0.71 0.55 0.50

Training, Teaching, Research 5.3% 2.63 8.13 6.38 5.88 6.88 5.38 5.00 0.14 0.43 0.34 0.31 0.36 0.28 0.26

Effective Use of Resources 15.8% 3.00 8.00 5.63 4.50 7.63 5.63 3.75 0.47 1.26 0.89 0.71 1.20 0.89 0.59

Ease of Delivery 2.6% 4.50 7.63 5.63 7.25 7.75 4.00 5.13 0.12 0.20 0.15 0.19 0.20 0.11 0.13 TOTAL 100% 19.25 59.00 45.25 41.13 50.38 38.63 32.50 2.54 8.75 6.72 5.74 7.18 5.89 4.52

RANK 7 1 3 5 2 4 6

DIFFERENCE 70.95% 0.00% 23.22% 34.46% 17.93% 32.69% 48.40%

Scores - Users 110506 WOP Radiotherapy Non-Fin Appraisal Results 114 Total Scores - Commissioner Representatives

Worcestershire Oncology Project Radiotherapy Facility SCORER : COMMISSIONERS

NON-FINANCIAL APPRAISAL WORKSHOP 6th May 2011

Number of scoring participants 4

RAW SCORES WEIGHTED SCORES

Weight Do Nothing OPTION A OPTION C OPTION D OPTION E OPTION F OPTION G Do Nothing OPTION A OPTION C OPTION D OPTION E OPTION F OPTION G

WRH - ALX - Bank WRH - ALX - Bank WRH - A&E WRH - ALX - Rear of ALX - Front WRH - A&E WRH - ALX - Rear of ALX - Front of Spetchley adjacent to Spetchley adjacent to Car Park Workshops Site of site Car Park Workshops Site site Land PGMC Land PGMC

Clinical Quality 26.3% 5.75 9.50 5.50 5.00 7.75 8.25 5.25 1.51 2.50 1.45 1.32 2.04 2.17 1.38

Access to services 26.3% 2.50 8.50 6.25 5.50 7.00 7.00 4.00 0.66 2.24 1.64 1.45 1.84 1.84 1.05

Developing existing/new Services 13.2% 3.25 7.75 5.25 5.75 7.50 7.25 5.50 0.43 1.02 0.69 0.76 0.99 0.95 0.72

Strategic Fit 10.5% 2.00 8.25 4.75 5.25 6.75 7.00 4.50 0.21 0.87 0.50 0.55 0.71 0.74 0.47

Training, Teaching, Research 5.3% 2.50 6.00 4.00 4.75 4.75 6.25 3.75 0.13 0.32 0.21 0.25 0.25 0.33 0.20

Effective Use of Resources 15.8% 5.00 8.00 3.75 3.25 7.75 7.00 2.00 0.79 1.26 0.59 0.51 1.22 1.11 0.32

Ease of Delivery 2.6% 4.50 5.00 4.50 7.00 8.00 8.00 5.75 0.12 0.13 0.12 0.18 0.21 0.21 0.15 TOTAL 100% 25.50 53.00 34.00 36.50 49.50 50.75 30.75 3.85 8.34 5.20 5.02 7.26 7.35 4.30

RANK 7 1 4 5 3 2 6

DIFFERENCE 53.83% 0.00% 37.57% 39.78% 12.87% 11.84% 48.46%

Scores - Commissioners 110506 WOP Radiotherapy Non-Fin Appraisal Results 115 Total Scores - Provider Representatives

Worcestershire Oncology Project Radiotherapy Facility SCORER : PROVIDERS

NON-FINANCIAL APPRAISAL WORKSHOP 6th May 2011

Number of scoring participants 6

RAW SCORES WEIGHTED SCORES

Weight Do Nothing OPTION A OPTION C OPTION D OPTION E OPTION F OPTION G Do Nothing OPTION A OPTION C OPTION D OPTION E OPTION F OPTION G

Clinical Quality 26.3% 6.00 9.17 4.50 4.00 8.67 7.67 3.83 1.58 2.41 1.18 1.05 2.28 2.02 1.01

Access to services 26.3% 1.83 9.00 6.50 5.33 7.50 7.33 4.83 0.48 2.37 1.71 1.40 1.97 1.93 1.27

Developing existing/new Services 13.2% 2.33 7.83 4.67 6.00 7.33 7.17 5.17 0.31 1.03 0.61 0.79 0.96 0.94 0.68

Strategic Fit 10.5% 2.67 8.17 5.67 5.00 7.50 6.67 5.00 0.28 0.86 0.60 0.53 0.79 0.70 0.53

Training, Teaching, Research 5.3% 4.00 7.17 6.50 6.50 6.33 6.83 6.33 0.21 0.38 0.34 0.34 0.33 0.36 0.33

Effective Use of Resources 15.8% 5.67 8.50 6.17 5.50 7.50 7.50 5.17 0.89 1.34 0.97 0.87 1.18 1.18 0.82

Ease of Delivery 2.6% 8.00 7.33 4.83 6.50 7.67 5.33 6.67 0.21 0.19 0.13 0.17 0.20 0.14 0.18 TOTAL 100% 30.50 57.17 38.83 38.83 52.50 48.50 37.00 3.96 8.58 5.55 5.15 7.73 7.28 4.81

RANK 7 1 4 5 2 3 6

DIFFERENCE 53.81% 0.00% 35.36% 39.96% 9.96% 15.23% 43.94%

Scores - Providers 110506 WOP Radiotherapy Non-Fin Appraisal Results 116 Worcestershire Oncology Project

Radiotherapy Feasibility Review

APPENDIX E CAPITAL COSTS

110511 Radiotherapy Feasibility Report_v1.1 117 OPTION STUDY COST REPORT

HOLBROW BROOKES CONSTRUCTION CONSULTANTS

WORCESTERSHIRE RADIOTHERAPY CENTRE

for Holbrow Brookes Pinewood Bell Heath Way Woodgate Business Park WORCESTERSHIRE ACUTE Birmingham HOSPITALS NHS TRUST B32 3BZ

Phone: 0121 423 4000 Fax: 0121 423 4230 Email: TH [email protected] 2831 6 APRIL 2011

Holbrow Brookes is registered in Rev B England and Wales as a Limited Liability Partnership Registration No. 0C308960

118 OPTION STUDY COST REPORT for WORCESTERSHIRE RADIOTHERAPY CENTRE for WORCESTERSHIRE ACUTE HOSPITALS NHS TRUST

CONTENTS

1.00 INTRODUCTION

2.00 CAPITAL COSTS

3.00 SUMMARY

APPENDIX

A Schedules of Accommodation

B Notes on Cost Plan

C Cost Plan

D On-cost calculations

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1.00 INTRODUCTION

1.01 University Hospitals Coventry and Warwickshire NHS Trust have been selected as strategic partner for the new Worcestershire Radiotherapy Centre.

1.02 Worcestershire Acute Hospitals NHS Trust have identified a number of locations for the proposed centre at their Worcestershire Royal Hospital in Worcester and Alexandra Hospital in Redditch. A long list of option was drawn up at these two sites.

1.03 A visit of the proposed locations was made by the project team on 22nd March 2011 in conjunction with University Hospitals Coventry and Warwickshire NHS Trust and Worcestershire Acute Hospitals NHS Trust. Six options were selected for the short list – these are as follows;

Option A – Worcestershire Royal hospital on the site of the existing Accident and Emergency Unit car park.

Option C – Worcestershire Royal Hospital on the site of the existing Workshops and Crèche.

Option D – Worcestershire Royal Hospital on Spetchley land.

Option E – Alexandra Hospital at the rear of the site.

Option F – Alexandra Hospital on the bank adjacent to PGMC.

Option G – Alexandra Hospital at front of site.

1.04 Strategic Healthcare Planning have developed a Schedule of accommodation (version 5 dated 22nd march 2011) that applies to all options. This indicates a floor area (excluding communications and plant) of 3215m².

1.05 A meeting was held on 1st April 2011 with Provex, Strategic healthcare Planning and Holbrow Brookes in attendance to assess the on-cost requirements for each option. SHP have subsequently produced an option study paper that indicates location and requirements to each option. A draft programme has also been produced indicating the anticipated construction period for the six short list options.

1.06 A cost plan has been developed for each option. The costs have been compiled in accordance with the NHS Capital Investment Manual and have used the Departmental Cost Allowance Guidance (DCAGs) as required by the local Strategic Health Authority of the NHS. The on-costs for each option has been assessed based on proposed high level location information and assumptions which are given elsewhere in this document.

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120 OPTION STUDY COST REPORT for WORCESTERSHIRE RADIOTHERAPY FACILITY for WORCESTERSHIRE ACUTE HOSPITALS NHS TRUST

2.00 CAPITAL COSTS

2.01 With the exception of option D (which is built on adjacent land) all options are within the boundaries of Worcestershire Royal or Alexandra hospitals. For option D is has been assumed for costing purposes that the site would be bought as fully serviced (i.e. with adequate road connections and services to each on the proposed site) and that the cost of these works will be reflected in the land cost; therefore no costs for “servicing” the site have been included in these capital costs.

2.02 No information has been made available regarding the ground conditions of the proposed sites on the existing hospitals. In all cases it has been assumed there are no service or drainage diversions, major obstructions in the ground, unsuitable bearing pressures, significant ground contamination or ground water.

2.02 With the exception of option A, C and F no costs have been allowed for relocating existing accommodation. Option A includes for the displacement of the current accident and emergency car park. For Option C allowance has been made in the costs for relocating the displaced accommodation in the Workshop and Crèche (which are indicated to be demolished) into the ground floor of Aconbury east, and relocating office accommodation from ground floor Aconbury east into an upper floor. For Option F an allowance has been made for temporary office space (hire of modular cabins), relocating Rehabilitation into former offices and refurbishing existing rehabilitation space for offices.

2.03 Notes on the assumptions for each option used are included in Appendix B to this report and should be read in conjunction with the cost plans.

2.04 The proposed facilities Schedule of Accommodation is included within Appendix A to this report..

2.05 It has been assumed that existing drainage and services are of sufficient capacity and are present in the locality of the development, and the proposed development does not require any new infrastructure.

2.06 Allowance has been made for car parking and service yard as indicated on SHP’s option study document issued on 4th April 2011.

2.07 It has been assumed that construction works for the new facility can be undertaken without the need for phasing of works except where enabling works are required (option C and F).

2.08 A copy of the cost forms are included in Appendix C to this report together with the assessment of on-costs in Appendix D.

2.10 A summary of these costs is given on the following page. These cost datum for these are at the current NHS reporting level of MIPS 480. The location factor is included as -5% as indicated for the West Midlands in the NHS Quarterly Briefing Volume 19 Number 2.

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121 OPTION STUDY COST REPORT for WORCESTERSHIRE RADIOTHERAPY FACILITY for WORCESTERSHIRE ACUTE HOSPITALS NHS TRUST

3.00 SUMMARY OF CAPITAL COSTS

Option A Option C Option D Option E Option F Option G

Worcestershire Worcestershire Worcestershire Alexandra Alexandra Alexandra Hospital location Royal Hospital Royal Hospital Royal Hospital Hospital Hospital Hospital

Bank by Site location A&E car park Workshop Spetchley Rear of site Front of site PGMC

Works Cost 10,216,708 10,795,364 9,601,566 11,631,968 10,561,965 9,773,586

Design Team fees 1,532,506 1,619,305 1,440,235 1,744,795 1,584,295 1,466,038

F&E 4,790,144 4,790,144 4,790,144 4,790,144 4,790,144 4,790,144

Non Works Cost 102,167 107,954 96,016 756,320 105,620 97,736

Optimism Bias & Planning Contingency 3,328,305 3,462,553 3,185,592 3,784,645 3,408,405 3,225,501

Total excluding VAT 19,969,830 20,775,320 19,113,552 22,707,872 20,450,428 19,353,005

VAT 3,626,164 3,766,431 3,477,054 4,122,824 3,709,855 3,518,752

Out-turn costs including VAT 23,595,994 24,541,751 22,590,606 26,830,696 24,160,283 22,871,757

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122 Worcestershire Oncology Project

Radiotherapy Feasibility Review

APPENDIX F PATIENT FLOW AND TRAVEL TIME ANALYSIS

110511 Radiotherapy Feasibility Report_v1.1 123 Worcestershire Oncology Project POPULATION PROJECTIONS

Total Worcester Bromsgrove Redditch Malvern Hills Wychavon Wyre Forest Total City 2015 2015 2015 2015 2015 2015 2015 0-4 4.9 5.3 3.3 6 5.7 5.1 30.3 5-9 5.6 5.2 4.1 5.5 6.6 5.4 32.4 10-14 5.5 4.4 4.4 4.9 6.5 5 30.7 15-19 5.3 4.3 4.6 5.4 6.4 5.1 31.1 20-24 3.7 4.1 2.2 6.9 4.7 4.8 26.4 25-29 4.7 5.4 3 7.7 5.7 5.6 32.1 30-34 5.3 5.4 3.1 7.1 5.6 5.3 31.8 35-39 5.5 5 3.7 6.2 6 5.2 31.6 40-44 6.6 5.4 4.8 6.3 7.7 6.3 37.1 45-49 7.8 5.7 5.8 7 9.6 7.5 43.4 50-54 7.5 5.5 5.8 6.6 9.6 7.2 42.2 55-59 6.5 5.1 5.5 5.5 8.5 6.4 37.5 60-64 5.8 5.1 5.3 4.7 8.1 6.7 35.7 65-69 6.2 4.9 6.1 4.9 9.1 7.9 39.1 70-74 5 3.4 4.8 3.8 6.9 6.3 30.2 75-79 4 2.4 3.9 3 5.4 4.5 23.2 80-84 3.1 1.7 2.9 2.2 3.8 2.9 16.6 85-89 2 1 1.9 1.3 2.5 1.8 10.5 90-plus 1.3 0.6 1.3 0.9 1.4 1.2 6.7 Total 96.3 79.9 76.5 95.9 119.8 100.2 568.6

110505 Patient Flows.xlsx Population 124 Male Worcester Bromsgrove Redditch Malvern Hills Wychavon Wyre Forest Total City 2015 2015 2015 2015 2015 2015 2015 0-4 2.5 2.7 1.7 3.1 2.9 2.6 15.5 5-9 2.9 2.7 2.1 2.9 3.4 2.8 16.8 10-14 2.9 2.3 2.3 2.5 3.4 2.6 15.9 15-19 2.8 2.2 2.4 2.8 3.3 2.7 16.2 20-24 1.9 2.1 1.1 3.6 2.4 2.5 13.8 25-29 2.3 2.6 1.5 3.8 2.8 2.7 15.7 30-34 2.6 2.6 1.5 3.5 2.7 2.6 15.6 35-39 2.7 2.4 1.8 3.0 2.9 2.5 15.5 40-44 3.2 2.6 2.4 3.1 3.8 3.1 18.2 45-49 3.8 2.8 2.9 3.4 4.7 3.7 21.4 50-54 3.7 2.7 2.9 3.2 4.7 3.5 20.8 55-59 3.3 2.6 2.8 2.8 4.3 3.2 18.8 60-64 2.9 2.6 2.7 2.4 4.1 3.4 17.9 65-69 3.0 2.4 3.0 2.4 4.4 3.9 19.1 70-74 2.4 1.7 2.3 1.9 3.4 3.1 14.7 75-79 1.6 0.9 1.5 1.2 2.1 1.7 9.0 80-84 1.2 0.7 1.1 0.9 1.5 1.1 6.5 85-89 0.8 0.4 0.7 0.5 1.0 0.7 4.1 90-plus 0.5 0.2 0.5 0.3 0.5 0.5 2.6 Total 47.0 39.3 37.1 47.2 58.4 48.9 277.9

110505 Patient Flows.xlsx Population 125 Female Worcester Bromsgrove Redditch Malvern Hills Wychavon Wyre Forest Total City 2015 2015 2015 2015 2015 2015 2015 0-4 2.4 2.6 1.6 2.9 2.8 2.5 14.8 5-9 2.7 2.5 2.0 2.6 3.2 2.6 15.6 10-14 2.6 2.1 2.1 2.4 3.1 2.4 14.8 15-19 2.5 2.1 2.2 2.6 3.1 2.4 14.9 20-24 1.8 2.0 1.1 3.3 2.3 2.3 12.6 25-29 2.4 2.8 1.5 3.9 2.9 2.9 16.4 30-34 2.7 2.8 1.6 3.6 2.9 2.7 16.2 35-39 2.8 2.6 1.9 3.2 3.1 2.7 16.1 40-44 3.4 2.8 2.4 3.2 3.9 3.2 18.9 45-49 4.0 2.9 2.9 3.6 4.9 3.8 22.0 50-54 3.8 2.8 2.9 3.4 4.9 3.7 21.4 55-59 3.2 2.5 2.7 2.7 4.2 3.2 18.7 60-64 2.9 2.5 2.6 2.3 4.0 3.3 17.8 65-69 3.2 2.5 3.1 2.5 4.7 4.0 20.0 70-74 2.6 1.7 2.5 1.9 3.5 3.2 15.5 75-79 2.4 1.5 2.4 1.8 3.3 2.8 14.2 80-84 1.9 1.0 1.8 1.3 2.3 1.8 10.1 85-89 1.2 0.6 1.2 0.8 1.5 1.1 6.4 90-plus 0.8 0.4 0.8 0.6 0.9 0.7 4.1 Total 49.3 40.6 39.4 48.7 61.4 51.3 290.7

110505 Patient Flows.xlsx Population 126 Worcestershire Oncology Project CANCER INCIDENCE RATES

Male Female Male Female Age Range Cases Cases Rates Rates 0 to 04 376 262 19.8 14.5 05 to 09 181 166 10.4 10 10 to 14 241 201 12.9 11.3 15 to 19 415 278 20.3 14.3 20 to 24 654 609 30.2 29.5 25 to 29 971 1,289 46.9 64.1 30 to 34 1,088 1,876 56.7 98.2 35 to 39 1,721 3,362 78.3 150 40 to 44 2,667 5,690 114.3 239.6 45 to 49 4,049 8,188 189 370.6 50 to 54 6,578 10,603 349.2 550.2 55 to 59 11,822 13,191 661.2 714.4 60 to 64 19,667 18,221 1104.8 979 65 to 69 22,814 17,592 1721.9 1,227.90 70 to 74 25,248 17,832 2246.9 1,397.80 75 to 79 24,564 19,024 2813.6 1,709.80 80 to 84 18,391 17,162 3174.2 1,960.00 85+ 13,879 18,655 3291.9 2,041.60 All Ages 155,326 154,201 515.1 493.5

110505 Patient Flows.xlsx Incidence_Rates 127 Worcestershire Oncology Project CANCER INCIDENCE RATES (PER 100,000 POP'N)

Total Worcester Bromsgrove Redditch Malvern Hills Wychavon Wyre Forest Total City 2015 2015 2015 2015 2015 2015 2015 0-4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 5-9 0.0 0.0 0.0 0.0 0.0 0.0 0.0 10-14 0.0 0.0 0.0 0.0 0.0 0.0 0.0 15-19 0.0 0.0 0.0 0.0 0.0 0.0 0.0 20-24 0.0 0.0 0.0 0.0 0.0 0.0 0.0 25-29 0.0 0.0 0.0 0.0 0.0 0.0 0.0 30-34 0.0 0.0 0.0 0.0 0.0 0.0 0.0 35-39 0.0 0.0 0.0 0.0 0.0 0.0 0.0 40-44 0.0 0.0 0.0 0.0 0.0 0.0 0.1 45-49 0.0 0.0 0.0 0.0 0.0 0.0 0.1 50-54 0.0 0.0 0.0 0.0 0.0 0.0 0.2 55-59 0.0 0.0 0.0 0.0 0.0 0.1 0.2 60-64 0.0 0.1 0.1 0.1 0.1 0.1 0.3 65-69 0.1 0.1 0.1 0.1 0.1 0.1 0.5 70-74 0.1 0.1 0.1 0.1 0.1 0.1 0.5 75-79 0.1 0.1 0.1 0.1 0.1 0.1 0.5 80-84 0.1 0.1 0.1 0.1 0.1 0.1 0.4 85-89 0.0 0.0 0.0 0.0 0.0 0.1 0.3 90-plus 0.0 0.0 0.0 0.0 0.0 0.0 0.1 Total 0.4 0.5 0.5 0.5 0.6 0.7 3.2

110505 Patient Flows.xlsx Incidence_by_age 128 Male Worcester Bromsgrove Redditch Malvern Hills Wychavon Wyre Forest Total City 2015 2015 2015 2015 2015 2015 2015 0-4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 5-9 0.0 0.0 0.0 0.0 0.0 0.0 0.0 10-14 0.0 0.0 0.0 0.0 0.0 0.0 0.0 15-19 0.0 0.0 0.0 0.0 0.0 0.0 0.0 20-24 0.0 0.0 0.0 0.0 0.0 0.0 0.0 25-29 0.0 0.0 0.0 0.0 0.0 0.0 0.0 30-34 0.0 0.0 0.0 0.0 0.0 0.0 0.0 35-39 0.0 0.0 0.0 0.0 0.0 0.0 0.0 40-44 0.0 0.0 0.0 0.0 0.0 0.0 0.0 45-49 0.0 0.0 0.0 0.0 0.0 0.0 0.0 50-54 0.0 0.0 0.0 0.0 0.0 0.0 0.1 55-59 0.0 0.0 0.0 0.0 0.0 0.0 0.1 60-64 0.0 0.0 0.0 0.0 0.0 0.0 0.2 65-69 0.1 0.0 0.1 0.0 0.1 0.1 0.3 70-74 0.1 0.0 0.1 0.0 0.1 0.1 0.3 75-79 0.0 0.0 0.0 0.0 0.1 0.0 0.3 80-84 0.0 0.0 0.0 0.0 0.0 0.0 0.2 85-89 0.0 0.0 0.0 0.0 0.0 0.0 0.1 90-plus 0.0 0.0 0.0 0.0 0.0 0.0 0.0 Total 0.3 0.2 0.3 0.2 0.4 0.3 1.8

110505 Patient Flows.xlsx Incidence_by_age 129 Female Worcester Bromsgrove Redditch Malvern Hills Wychavon Wyre Forest Total City 2015 2015 2015 2015 2015 2015 2015 0-4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 5-9 0.0 0.0 0.0 0.0 0.0 0.0 0.0 10-14 0.0 0.0 0.0 0.0 0.0 0.0 0.0 15-19 0.0 0.0 0.0 0.0 0.0 0.0 0.0 20-24 0.0 0.0 0.0 0.0 0.0 0.0 0.0 25-29 0.0 0.0 0.0 0.0 0.0 0.0 0.0 30-34 0.0 0.0 0.0 0.0 0.0 0.0 0.0 35-39 0.0 0.0 0.0 0.0 0.0 0.0 0.0 40-44 0.0 0.0 0.0 0.0 0.0 0.0 0.0 45-49 0.0 0.0 0.0 0.0 0.0 0.0 0.1 50-54 0.0 0.0 0.0 0.0 0.0 0.0 0.1 55-59 0.0 0.0 0.0 0.0 0.0 0.0 0.1 60-64 0.0 0.0 0.0 0.0 0.0 0.0 0.1 65-69 0.0 0.0 0.0 0.0 0.0 0.1 0.2 70-74 0.0 0.0 0.0 0.0 0.0 0.0 0.2 75-79 0.0 0.0 0.0 0.0 0.0 0.1 0.2 80-84 0.0 0.0 0.0 0.0 0.0 0.0 0.2 85-89 0.0 0.0 0.0 0.0 0.0 0.0 0.1 90-plus 0.0 0.0 0.0 0.0 0.0 0.0 0.1 Total 0.1 0.3 0.2 0.3 0.2 0.4 1.5

110505 Patient Flows.xlsx Incidence_by_age 130 Worcestershire Oncology Project RADIOTHERAPY ACTIVITY BY LOCALITY

Total Worcester Bromsgrove Redditch Malvern Hills Wychavon Wyre Forest Total City 2015 2015 2015 2015 2015 2015 2015 20-24 6.7 10.8 8.6 13.0 15.9 13.2 68.2 25-29 13.1 25.8 22.8 25.5 35.5 29.3 152.0 30-34 18.3 38.6 33.1 32.7 47.5 39.7 210.0 35-39 26.7 56.9 48.7 48.4 65.4 61.1 307.2 40-44 45.7 103.0 86.2 87.2 111.5 120.1 553.8 45-49 84.8 185.6 149.7 161.8 205.3 232.6 1,019.8 50-54 145.6 282.4 235.3 255.8 324.4 364.0 1,607.5 55-59 232.9 372.1 338.0 351.2 443.4 478.3 2,216.0 60-64 343.2 525.2 503.7 482.0 629.3 711.8 3,195.3 65-69 542.3 744.3 762.1 738.4 996.3 1,147.7 4,931.0 70-74 575.7 678.5 714.8 705.9 955.2 1,100.1 4,730.1 75-79 503.2 631.9 628.9 683.1 839.4 981.0 4,267.6 80-84 466.3 539.7 521.3 574.7 680.0 755.0 3,537.0 85-89 353.5 350.6 341.6 374.6 447.6 503.6 2,371.5 90-plus 131.3 157.8 85.0 161.4 120.9 176.5 833.0 Total 3,489.4 4,703.1 4,479.8 4,695.9 5,917.9 6,714.0 30,000.0

110505 Patient Flows.xlsx Fractions_by Age_District_Sex 131 Male Worcester Bromsgrove Redditch Malvern Hills Wychavon Wyre Forest Total City 2015 2015 2015 2015 2015 2015 2015 20-24 5.4 6.0 3.2 10.1 6.9 7.0 38.6 25-29 10.0 11.5 6.4 16.4 12.2 11.9 68.4 30-34 13.7 13.9 8.0 18.3 14.4 13.7 82.0 35-39 19.6 17.8 13.2 22.1 21.4 18.5 112.6 40-44 34.3 28.1 25.0 32.8 40.0 32.8 192.9 45-49 67.4 49.2 50.1 60.4 82.9 64.8 374.8 50-54 119.7 87.8 92.5 105.3 153.2 114.9 673.3 55-59 199.8 156.7 169.0 169.0 261.2 196.7 1,152.5 60-64 297.8 261.9 272.2 241.3 415.9 344.1 1,833.2 65-69 483.9 382.5 476.1 382.5 710.3 616.6 3,052.0 70-74 509.3 346.3 488.9 387.0 702.8 641.7 3,076.0 75-79 406.1 243.7 395.9 304.6 548.2 456.9 2,355.3 80-84 355.1 194.7 332.1 252.0 435.2 332.1 1,901.3 85-89 237.6 118.8 225.7 154.4 297.0 213.8 1,247.2 90-plus 15.4 7.1 15.4 10.7 16.6 14.3 79.6 Total 2,775.0 1,926.0 2,573.8 2,166.9 3,718.2 3,079.7 16,239.6

110505 Patient Flows.xlsx Fractions_by Age_District_Sex 132 Female Worcester Bromsgrove Redditch Malvern Hills Wychavon Wyre Forest Total City 2015 2015 2015 2015 2015 2015 2015 20-24 1.3 4.9 5.4 2.9 9.1 6.2 29.6 25-29 3.0 14.3 16.4 9.1 23.4 17.3 83.5 30-34 4.7 24.7 25.1 14.4 33.0 26.1 128.0 35-39 7.1 39.1 35.5 26.3 44.0 42.6 194.6 40-44 11.3 74.9 61.3 54.5 71.5 87.4 360.8 45-49 17.5 136.3 99.6 101.4 122.4 167.8 645.0 50-54 26.0 194.6 142.7 150.5 171.3 249.1 934.2 55-59 33.1 215.4 169.0 182.2 182.2 281.6 1,063.5 60-64 45.4 263.3 231.6 240.6 213.4 367.8 1,362.1 65-69 58.4 361.8 285.9 356.0 285.9 531.0 1,879.0 70-74 66.4 332.2 225.9 318.9 252.4 458.4 1,654.1 75-79 97.1 388.3 233.0 378.6 291.2 524.2 1,912.3 80-84 111.3 345.0 189.2 322.7 244.8 422.8 1,635.8 85-89 115.9 231.8 115.9 220.2 150.7 289.8 1,124.3 90-plus 115.9 150.7 69.5 150.7 104.3 162.3 753.4 Total 714.4 2,777.1 1,906.0 2,528.9 2,199.7 3,634.3 13,760.4

110505 Patient Flows.xlsx Fractions_by Age_District_Sex 133 Worcestershire Oncology Project AVERAGE TRAVEL DISTANCES & TIMES

1. From Evaluation Papers

Current Centre Alexandra Hospital Worcester Royal Hospital No of % Population by Area Radiotherapy Time by Public Miles to Alex Time by Public Time by Public Patients Location Miles to Centre Time by Car Transport Hospital Time by Car Transport Miles to WRH Time by Car Transport (2003‐07) Wyre Forest (Kidderminster) 870 17.30% 17% Wolverhampton 19 18 34 59 17 31 45

Bromsgrove 998 19.90% Coventry 33 9 1745 122268

Redditch 715 14.20% 34% Coventry 32 0 0 0 19 35 87 Malvern Hills (Great Malvern) 689 13.70% Cheltenham 34 27 54 85 11 26 35

Worcester 669 13.30% Cheltenham 27 19 40 72 0 0 0 Wychavon (Evesham) 1,085 21.60% 49% Cheltenham 17 16 27 64 14 25 50

TOTAL 5,026 100% 100% 26.3 14.6 27.8 54.2 12.6 23.7 49.3

3. From MapPoint (slower travel times) Current Centre Alexandra Hospital Worcester Royal Hospital No of % Population by Area Radiotherapy Time by Public Miles to Alex Time by Public Time by Public Patients Location Miles to Centre Time by Car Transport Hospital Time by Car Transport Miles to WRH Time by Car Transport (2003‐07) Wyre Forest (Kidderminster) 870 17.30% 17% Wolverhampton 18 35 19 29 18 25

Bromsgrove 998 19.90% Coventry 38 42 8 10 13 17

Redditch 715 14.20% 34% Coventry 36 40 3 7 21 26 Malvern Hills (Great Malvern) 689 13.70% Cheltenham 28 38 31 42 11 19

Worcester 669 13.30% Cheltenham 27 33 23 31 4 7 Wychavon (Evesham) 1,085 21.60% 49% Cheltenham 20 29 14 22 14 18

TOTAL 5,026 100% 100% 27.5 36.0 15.6 22.6 13.7 18.8

110505 Patient Flows.xlsx Travel Times 134 Worcestershire Oncology Project ESTIMATED OUTFLOWS

Centre Worcester Centre Redditch

Total Total

Bromsgrove Redditch Malvern Hills Worcester City Wychavon Wyre Forest Total Bromsgrove Redditch Malvern Hills Worcester City Wychavon Wyre Forest Total 100% 75% 100% 100% 100% 75% 100% 100% 50% 75% 100% 75% Total Total 3,489 3,527 4,480 4,696 5,918 5,035 27,146 3,489 4,703 2,240 3,522 5,918 5,035 24,908 Fractions Fractions

% OUTFLOW TO OTHER CENTRES 10% 17%

Total Total

Bromsgrove Redditch Malvern Hills Worcester City Wychavon Wyre Forest Total Bromsgrove Redditch Malvern Hills Worcester City Wychavon Wyre Forest Total 2015 2015 2015 2015 2015 2015 2015 2015 2015 2015 2015 2015 2015 2015 20-24 6.7 10.8 8.6 13.0 15.9 13.2 68.2 20-24 6.7 10.8 8.6 13.0 15.9 13.2 68.2 25-29 13.1 25.8 22.8 25.5 35.5 29.3 152.0 25-29 13.1 25.8 22.8 25.5 35.5 29.3 152.0 30-34 18.3 38.6 33.1 32.7 47.5 39.7 210.0 30-34 18.3 38.6 33.1 32.7 47.5 39.7 210.0 35-39 26.7 56.9 48.7 48.4 65.4 61.1 307.2 35-39 26.7 56.9 48.7 48.4 65.4 61.1 307.2 40-44 45.7 103.0 86.2 87.2 111.5 120.1 553.8 40-44 45.7 103.0 86.2 87.2 111.5 120.1 553.8 45-49 84.8 185.6 149.7 161.8 205.3 232.6 1,019.8 45-49 84.8 185.6 149.7 161.8 205.3 232.6 1,019.8 50-54 145.6 282.4 235.3 255.8 324.4 364.0 1,607.5 50-54 145.6 282.4 235.3 255.8 324.4 364.0 1,607.5 55-59 232.9 372.1 338.0 351.2 443.4 478.3 2,216.0 55-59 232.9 372.1 338.0 351.2 443.4 478.3 2,216.0 60-64 343.2 525.2 503.7 482.0 629.3 711.8 3,195.3 60-64 343.2 525.2 503.7 482.0 629.3 711.8 3,195.3 65-69 542.3 744.3 762.1 738.4 996.3 1,147.7 4,931.0 65-69 542.3 744.3 762.1 738.4 996.3 1,147.7 4,931.0 70-74 575.7 678.5 714.8 705.9 955.2 1,100.1 4,730.1 70-74 575.7 678.5 714.8 705.9 955.2 1,100.1 4,730.1 75-79 503.2 631.9 628.9 683.1 839.4 981.0 4,267.6 75-79 503.2 631.9 628.9 683.1 839.4 981.0 4,267.6 80-84 466.3 539.7 521.3 574.7 680.0 755.0 3,537.0 80-84 466.3 539.7 521.3 574.7 680.0 755.0 3,537.0 85-89 353.5 350.6 341.6 374.6 447.6 503.6 2,371.5 85-89 353.5 350.6 341.6 374.6 447.6 503.6 2,371.5 90-plus 131.3 157.8 85.0 161.4 120.9 176.5 833.0 90-plus 131.3 157.8 85.0 161.4 120.9 176.5 833.0 Total 3,489.4 4,703.1 4,479.8 4,695.9 5,917.9 6,714.0 30,000.0 Total 3,489.4 4,703.1 4,479.8 4,695.9 5,917.9 6,714.0 30,000.0

110505 Patient Flows.xlsx Proportions 135 Worcestershire Oncology Project

Radiotherapy Feasibility Review

APPENDIX G REVENUE COSTS

110511 Radiotherapy Feasibility Report_v1.1 136 OPTION APPRAISAL REVENUE COSTS Worcestershire Acute Hospitals NHS Trust Radiotherapy Feasibility Version 1.2 9th May 2011

Do Nothing Option A Option C Option D Option E Option F Option G FORECAST 2014/15 2014/15 2014/15 2014/15 2014/15 2014/15 2014/15 Clinical WTE £000 WTE £000 WTE £000 WTE £000 WTE £000 WTE £000 WTE £000 Radiotherapy Staff Pay 30.00 1,055 30.00 1,055 30.00 1,055 30.00 1,055 30.00 1,055 30.00 1,055 Non-Pay

Total Radiotherapy Staff 0.00 0 30.00 1,055 30.00 1,055 30.00 1,055 30.00 1,055 30.00 1,055 30.00 1,055 Clinical Physics Staff Pay 22.00 1,027 22.00 1,027 22.00 1,027 22.00 1,027 22.00 1,027 22.00 1,027 Non-Pay

Total Clinical Physics Staff 0.00 0 22.00 1,027 22.00 1,027 22.00 1,027 22.00 1,027 22.00 1,027 22.00 1,027

Total Clinical 0.00 0 52.00 2,082 52.00 2,082 52.00 2,082 52.00 2,082 52.00 2,082 52.00 2,082 Support £000 £000 £000 £000 £000 £000 £000 Radiotherapy Non-Pay All 436 436 436 436 436 436

Total Radiotherapy Non-Pay 0 436 436 436 436 436 436 Medical Training All 7 7 7 7 7 7

Total Medical Training 0 0.00 7 7 7 7 7 7

Total Support 0 443 443 443 443 443 443 FM & Overheads £000 £000 £000 £000 £000 £000 £000 FM Estates Maintenance 0 94 94 94 94 94 94 Cleaning 0 128 128 128 128 128 128 Portering 0 109 109 109 109 109 109 Energy and Utilities 0 75 75 75 75 75 75 Catering (OBD) (Or Beds below) 0 0 0 0 0 0 0 Laundry (OBD) (or Beds below) 0 0 0 0 0 0 0 Rates 0 113 113 113 113 113 113 Insurance 0 0 0 0 0 0 0

Total FM 0 519 519 519 519 519 519 OVERHEADS All

Total OVERHEADS 0 0 0 0 0 0 0

Total FM & Overheads 0 519 519 519 519 519 519 Other £000 £000 £000 £000 £000 £000 £000 Cost of Activity "Out of County" 471 471 471 840 840 840

Total Other 0 471 471 471 840 840 840 Total Revenue excluding capital char 0.00 0 52.00 3,515 52.00 3,515 52.00 3,515 52.00 3,884 52.00 3,884 52.00 3,884 Capital Charges 0 1,967 1,998 1,916 2,144 1,982 1,903 Total Forecast: 0.00 0 52.00 5,481 52.00 5,512 52.00 5,430 52.00 6,028 52.00 5,866 52.00 5,787

110506 Radiotherapy Feasibility Model Revenue Summary 137 Revenue Per UHCW Bid - Attachment

wte Cost £ Pay

Clincial Physics Staff Clinical Technologist Band 6 8.0 295,299 Clinical Technologist Band 7 4.0 138,344 Clinical Technologist Band 8A 2.0 113,702 Clinical Scientist Band 7 4.0 195,503 Clinical Scientist Band 8A 1.0 50,461 Clinical Scientist Band 8B 2.0 137,424 Clinical Scientist Band 8D 1.0 95,808 Sub-Total 22.0 1,026,540

Radiotherapy Staff Admin & Clerical Band 2 3.0 53,714 Admin & Clerical Band 4 2.0 44,000 Radiographer Band 5 8.0 217,876 Radiographer Band 6 8.0 280,186 Radiographer Band 7 7.0 338,572 Radiographer Band 8A 1.0 56,851 Radiographer Band 8B 1.0 64,213 Sub-Total 30.0 1,055,411

Total Staff Costs 52.0 2,081,951

Radiotherapy Non Pay Lin Acc Parts Only 120,000 SXR (2nd line and parts contract) 30,000 CT Scanner 50,000 Treatment planning software 30,000 Virtual Simulator software 40,000 ARC/IMRT planning software including atlas 20,000 Workstation lifecycle programme 10,000 Calibration equipment 20,000 Maintenance Contracts 0 Mosaiq Software 90,600 Training 0 Other 25,000 Total Non Pay 0.0 435,600

Overheads Other (Medical training) 7,000

Total Overheads 0.0 7,000

Total Cost 52.0 2,524,551 110506 Radiotherapy Feasibility Model Bid attachment 138 Worcestershire Oncology Project

Radiotherapy Feasibility Review

APPENDIX H ECONOMIC ANALYSIS

110511 Radiotherapy Feasibility Report_v1.1 139 Worcestershire Acute Hospitals NHS Trust

Radiotherapy Feasibility

MODEL VERSION: Version 1.2 MODEL DATE: 9th May 2011

110506 Radiotherapy Feasibility Model Title

140 OPTION APPRAISAL OUTPUTS SUMMARY Worcestershire Acute Hospitals NHS Trust Radiotherapy Feasibility Version 1.2 9th May 2011

1.0 CAPITAL COSTS AT APPROVALS LEVEL MIPS Do Nothing Option A Option C Option D Option E Option F Option G

WRH - A&E WRH - WRH - AH - Rear of AH - Adjacent AH - Front of BASED ON DoH Quarterly Briefing: VOLUME 19 No.2 Car Park Workshop Spetchley Site PGMC Site

£000 £000 £000 £000 £000 £000 £000 Departmental Costs 0 6,398 7,056 6,398 7,714 6,398 6,398 On-Costs 0 4,356 4,308 3,709 4,530 4,719 3,890 Location Adjustment 0 (538) (568) (505) (612) (556) (514) Works Cost Total 0 10,217 10,795 9,602 11,632 10,562 9,774 Fees 0 1,533 1,619 1,440 1,745 1,584 1,466 Non-Works 0 102 108 96 756 106 98 Land Acquisition 0 510 0 690 0 0 0 Equipment 0 4,790 4,790 4,790 4,790 4,790 4,790 Planning Contingencies 0 998 1,039 956 1,135 1,023 968 Optimism Bias 0 2,330 2,424 2,230 2,649 2,386 2,258 TOTAL CAPITAL COSTS AT APPROVAL MIPS 480 0 20,480 20,775 19,804 22,708 20,450 19,353 VAT 0 3,728 3,766 3,615 4,123 3,710 3,519 TOTAL OB1 CAPITAL COSTS AT APPROVAL LEVEL MIPS 0 24,208 24,542 23,419 26,831 24,160 22,872 MIPS AT APPROVALS LEVEL 480 480 480 480 480 480 480

TOTAL NEW CAPITAL COSTS AT OUTTURN LEVEL MIPS 0 24,695 25,056 23,876 27,412 24,664 23,338 MIPS AT START ON SITE 494 494 494 494 494 494 494

TOTAL NEW CAPITAL COSTS AT CURRENT: 2011/12 0 24,055 24,293 23,317 26,679 24,030 22,750 MIPS AT CURRENT N/A 475 472 476 476 476 476

110506 Radiotherapy Feasibility Model Outputs Summary 141 OPTION APPRAISAL OUTPUTS SUMMARY Worcestershire Acute Hospitals NHS Trust Radiotherapy Feasibility Version 1.2 9th May 2011

2.0 RECURRENT REVENUE IMPACT Do Nothing Option A Option C Option D Option E Option F Option G

WRH - A&E WRH - WRH - AH - Rear of AH - Adjacent AH - Front of Car Park Workshop Spetchley Site PGMC Site

NET REVENUE CHANGE at 2011/12 prices £000 £000 £000 £000 £000 £000 £000 Baseline Year: 2011/12 Clinical 0 0 0 0 0 0 0 Support 0 0 0 0 0 0 0 FM & Overheads 0 0 0 0 0 0 0 Other 0 0 0 0 0 0 0 Capital Charges 0 0 0 0 0 0 0 Net Baseline Expenditure 0 0 0 0 0 0 0 Forecast Year 2014/15 2014/15 2014/15 2014/15 2014/15 2014/15 2014/15 Clinical 0 2,082 2,082 2,082 2,082 2,082 2,082 Support 0 443 443 443 443 443 443 FM & Overheads 0 519 519 519 519 519 519 Other 0 471 471 471 840 840 840 Capital Charges 0 1,967 1,998 1,916 2,144 1,982 1,903 Net Forecast Expenditure 0 5,481 5,512 5,430 6,028 5,866 5,787 Forecast: Change Clinical 0 2,082 2,082 2,082 2,082 2,082 2,082 Support 0 443 443 443 443 443 443 FM & Overheads 0 519 519 519 519 519 519 Other 0 471 471 471 840 840 840 Capital Charges 0 1,967 1,998 1,916 2,144 1,982 1,903 Net Addtional Revenue Cost 0 5,481 5,512 5,430 6,028 5,866 5,787 Affordability Ranking of Development Options 2 3 1 6 5 4 MARGINAL AFFORDABILITY IMPACT OVER OPTION RANKED 1 51 82 0 598 435 357 Net Addtional Revenue Cost excluding Capital Charges 0 3,515 3,515 3,515 3,884 3,884 3,884

110506 Radiotherapy Feasibility Model Outputs Summary 142 OPTION APPRAISAL OUTPUTS SUMMARY Worcestershire Acute Hospitals NHS Trust Radiotherapy Feasibility Version 1.2 9th May 2011

3.0 ECONOMIC IMPACT Do Nothing Option A Option C Option D Option E Option F Option G

WRH - A&E WRH - WRH - AH - Rear of AH - Adjacent AH - Front of Car Park Workshop Spetchley Site PGMC Site

APPRAISAL PERIOD (YEARS) 63 63 63 63 63 63 63 £000 £000 £000 £000 £000 £000 £000 3.1 Base Impact excluding Risk Net Present Cost (NPC) 0 117,346 117,757 115,931 128,876 126,368 125,024 Equivalent Annual Cost (EAC) 0 4,402 4,418 4,349 4,835 4,741 4,690 Economic Ranking of Options: Base Impact excluding Risk 2 3 1 6 5 4 3.2 Impact of Risk Net Present Cost (NPC) 0 0 0 0 0 0 0 Equivalent Annual Cost (EAC) 0 0 0 0 0 0 0 Economic Ranking of Options: Impact of Risk 3.3 Economic Impact including Risk Net Present Cost (NPC) 0 117,346 117,757 115,931 128,876 126,368 125,024 Equivalent Annual Cost (EAC) 0 4,402 4,418 4,349 4,835 4,741 4,690 Economic Ranking of Development Options 2 3 1 6 5 4 MARGINAL EAC IMPACT OVER OPTION RANKED 1 53 69 0 486 392 341 EAC SWITCH VALUES (53) (69) 53 (486) (392) (341) DIFFERENCE (% above Preferred Option) 1.2% 1.6% 0.0% 11.2% 9.0% 7.8%

110506 Radiotherapy Feasibility Model Outputs Summary 143 OPTION APPRAISAL OUTPUTS SUMMARY Worcestershire Acute Hospitals NHS Trust Radiotherapy Feasibility Version 1.2 9th May 2011

4.0 ECONOMIC SENSITIVITY - Change in Costs required to trigger Do Nothing Option A Option C Option D Option E Option F Option G switch values WRH - A&E WRH - WRH - AH - Rear of AH - Adjacent AH - Front of Car Park Workshop Spetchley Site PGMC Site

£000 £000 £000 £000 £000 £000 £000 4.1 Capital Costs Base Case Capital Costs (at Current, exc VAT & Contingencies) 19,220 19,406 18,629 21,306 19,192 18,166 Flexed Capital Costs 17,722 17,463 20,124 7,632 8,162 8,554 Change required (1,498) (1,943) 1,495 (13,674) (11,030) (9,612) Change % -7.8% -10.0% 8.0% -64.2% -57.5% -52.9% 4.2 Revenue Costs Base Case Revenue Costs (excluding capital charges) 3,515 3,515 3,515 3,884 3,884 3,884 Flexed Revenue Costs 3,455 3,438 3,574 3,339 3,445 3,501 Change required (60) (77) 60 (545) (439) (383) Change % -1.7% -2.2% 1.7% -14.0% -11.3% -9.9%

110506 Radiotherapy Feasibility Model Outputs Summary 144 OPTION APPRAISAL OUTPUTS SUMMARY Worcestershire Acute Hospitals NHS Trust Radiotherapy Feasibility Version 1.2 9th May 2011

5.0 COMBINED ECONOMIC AND NON-FINANCIAL APPRAISALS Do Nothing Option A Option C Option D Option E Option F Option G

WRH - A&E WRH - WRH - AH - Rear of AH - Adjacent AH - Front of Car Park Workshop Spetchley Site PGMC Site

5.1 Weighted Non-Financial Scores 860 599 538 738 679 457 NON-FINANCIAL RANKING OF DEVELOPMENT OPTIONS 1 4 5 2 3 6

5.2 EAC Impact of Option 0 4,402 4,418 4,349 4,835 4,741 4,690 ECONOMIC RANKING OF DEVELOPMENT OPTIONS 2 3 1 6 5 4

5.3 Benefit Points per EAC £m 195.4 135.7 123.8 152.7 143.1 97.3 COMBINED RANKING OF DEVELOPMENT OPTIONS 1 4 5 2 3 6 DIFFERENCE (% below Preferred Option on Combined Score Basis) 0.0% -30.6% -36.7% -21.9% -26.8% -50.2%

110506 Radiotherapy Feasibility Model Outputs Summary 145