2011/12 THE NHS ESTATE IN WALES Estate Condition and Performance Report THE NHS ESTATE IN WALES

Estate Condition and Performance Report 2011/12

CONTENTS

1 INTRODUCTION 5-6

1.1 Background of the report 1.2 Purpose, format and scope of the report 1.3 Changes to the content of the report 1.4 Report validation 1.5 2011/12 Facilities Performance Report

2 EXECUTIVE SUMMARY 7-13

3 ESTATE PROFILE 14-18

3.1 Key statistics of the NHS estate in Wales 3.2 The age of the estate 3.3 The essential and non-essential estate 3.4 Expenditure on the NHS estate

44 EEstateSTATE PerformancePERFORMANCE 7 - 20 19-29

4.1 General information 4.2 Physical condition 4.3 Statutory and safety compliance 4.4 Functional suitability 4.5 Space utilisation 4.6 Energy performance

55 EEnvironmentalNVIRONMENTAL Issues 20 - 23ISSUES 30-34

5.1 Waste 5.2 Transport 5.3 Water usage

66 ASummaryPPENDICES 24 - 25 35-108

Appendix I Health Board/Trust Risk Adjusted Backlog Costs Appendices II-X Summary of Health Board/Trust information Appendix XI Details of non-essential Health Board/Trust property Appendix XII Performance Indicators and Targets

1 INTRODUCTION 1.1 Background of the report

1.1.1 This is the 11th Estate Condition and Performance Report published by NHS Wales Shared Services Partnership – Facilities Services (NWSSP-FS) and its predecessor organisation, Welsh Health Estates. 1.1.2 The report is based on annual estate data returns submitted to the on-line Estates and Facilities Performance Management System (EFPMS) by seven Health Boards, Velindre NHS Trust and the Welsh Ambulance Services NHS Trust, and covers the period from April 2011 to March 2012. The system was introduced by the Welsh Government, formerly the Welsh Assembly Government (WAG), in April 2002 and is managed by NWSSP-FS.

1.2 Purpose, format and scope of the report

1.2.1 The report serves two main functions:

❖ It provides the Welsh Government with high-level data and information on the condition of the health estate in order to monitor year-on-year performance trends, inform the strategic planning process and assist in the prioritisation and allocation of resources. ❖ It provides Health Boards/Trusts with data and information to enable them to compare their own individual performance with that of other Health Boards/Trusts, as well as against national trends. For each organisation the report includes data and information relating each of its hospital sites and the remainder of the estate aggregated into one group. The report, therefore, should be a driver in the process of improving the performance and efficiency of the health estate. 1.2.2 As in previous years, the report focuses on the condition and performance of the health estate measured against the following national performance indicators (PI): ❖ Physical condition ❖ Statutory and safety compliance ❖ Functional suitability ❖ Space utilisation ❖ Energy performance

In addition, performance data on Fire safety compliance is included, measured separately from general Statutory and safety compliance data. More comprehensive data on fire safety standards and management is collated annually through the on-line Fire Audit Information System and the Fire and UwFS Incident Reporting System. Separate reports analysing this data are published by NWSSP-FS. 1.2.3 The report also recognises the importance of environmental issues and significant efforts have been made to evaluate the performance of the health estate in respect of energy, waste, transport and water. Reference is also made to the Welsh Government’s Sustainable Development Scheme One Wales: One Planet and its Climate Change strategy and Action Plan for Wales and any requirements and targets from these documents.

Estate Condition and Performance Report 2011/12 5 INTRODUCTION

1.2.4 The format of the report is broadly the same as previous years and, in line with the decision taken last year, backlog maintenance costs are reported only in terms of Risk Adjusted Backlog (RAB) costs. As mentioned in last year’s report, NWSSP-FS recognises that there is a need to provide Health Boards/Trusts with a more effective methodology to identify and prioritise critical failures that are likely to affect the safety of patients and other users or are likely to affect the viability of the services delivered by these organisations. Accordingly, an alternative methodology is currently being considered in conjunction with the Welsh Government for possible future roll-out across the NHS in Wales at some time in the future.

1.3 Changes to the content of the report

1.3.1 Whilst the format of the report has remained broadly the same as in previous years, some minor changes have been made to the content of the report with the inclusion of the following new waste fields:

Non-infectious Offensive Waste weight

Non-infectious Offensive Waste cost

1.4 Report validation

1.4.1 Whilst NWSSP-FS has not carried out a systematic validation of data submitted by the Health Boards/Trusts, every effort has been made to identify and address anomalies. Responsibility for the accuracy of the data submitted to the EFPMS, however, rests ultimately with the Health Boards/Trusts. All the data used in the preparation of this report is available electronically from the NWSSP-FS intranet website.

1.5 2011/12 Facilities Performance Report

1.5.1 This Estates Condition and Performance Report is complemented by the 2011/12 Facilities Performance Report which focuses on ‘hotel services’ included in the EFPMS. These cover: ❖ telecommunications ❖ car parking ❖ cleaning ❖ catering ❖ laundry & linen ❖ security ❖ portering ❖ postal services The report is published as a separate, stand-alone document. As with the Estate Condition and Performance Report, all the data used in the preparation of this report is available electronically from the NWSSP-FS intranet website.

6 Estate Condition and Performance Report 2011/12 2 EXECUTIVE SUMMARY

2.1 Context of the report

This report addresses the condition and performance of the NHS Estate in Wales from April 2011 to March 2012. It has been compiled by NHS Wales Shared Services Partnership – Facilities Services (NWSSP–FS) and is based on the Estates and Facilities Performance Management System (EFPMS) data submitted by the following NHS organisations:

❖ Abertawe Bro Morgannwg University Health Board ❖ Aneurin Bevan Health Board ❖ Betsi Cadwaladr University Health Board ❖ Cardiff and Vale University Health Board ❖ Cwm Taf Health Board ❖ Hywel Dda Health Board ❖ Powys Teaching Health Board ❖ Velindre NHS Trust ❖ Welsh Ambulance Services NHS Trust

As well as hospital sites, the report includes data on other NHS sites, aggregated on the basis set down in the EFPMS data definitions.

As in previous years, a number of the above mentioned organisations were not able to commit the data by the deadline of 30th June 2012. This, combined with an extensive high-level data 1 verification exercise by NWSSP-FS that revealed a substantial number of anomalies requiring rectification, added to the pressure to publish the report in a timely manner.

As stated in previous years, the effectiveness of the EFPMS is largely dependent upon the reliability and consistency of its data. The problems encountered again this year remain, therefore, an issue of concern.

The 2011/12 report generally follows the format of previous years

2.2 Estate profile The two new pie charts introduced last year comparing the ‘then and now’ age profiles of the all- Wales health estate have been updated in Section 3.2 and graphically demonstrate the level of estate development activity during the last 11 years. By focusing on the extremes of the age profile it can be seen that the proportion of the estate built since 1995 has increased from 8% to 27% while the proportion of the estate pre-dating 1948 has shrunk from 32% to 19%. This comparison also provides a useful reminder of the importance of implementing, on the one hand, a robust disposal programme of the surplus estate and, on the other hand, investing in the modernisation of the health estate. Full details of the age profile can be found in Section 3.2.

1 Responsibility for the accuracy of the data committed to the EFPMS rests with the Health Boards/Trusts. However, in the interest of publishing a robust report, NWSSP-FS undertakes informal verification checks.

Estate Condition and Performance Report 2011/12 7 EXECUTIVE SUMMARY

The disposal of surplus building stock and the modernisation of the health estate continue to be important priorities for both the Welsh Government, and the NHS. Key to the modernisation process is the development of estate strategies that support service plans, leading to the requirement for new buildings and, where appropriate, the refurbishment of old stock.

The identification of essential and non-essential buildings, based on whether or not they have a health use exceeding five years, is designed to encourage NHS organisations to dispose of stock with a short-term future as quickly as possible. Data submitted by the NHS indicates that 228,060m2 of building area has been identified as non-essential – an increase of 59,862m2 since the previous reporting year. The rationalisation process also involves the disposal of non-essential land. According to the data provided, 94 ha of land have only a short-term future – a decrease of 6 ha since the previous reporting year. This is mainly accounted for with plans to dispose of HM Stanley, Cardigan, Hill House, Gellinudd, Cefn Coed, St Tydfil’s, and Rookwood Hospitals.

Following the recent openings of Ysbyty Ystrad Fawr in Ystrad Mynach, Ysbyty Cwm Cynon Neighbourhood Hospital in Mountain Ash and Merthyr Health Park in Merthyr Tydfil, there are plans to dispose of Aberdare Hospital, Seymour Berry Health Centre, Hollies Health Centre and Hirwaun Health Centre.

Early disposal of the non-essential estate is vital if scarce resources are to be directed where they can be used more effectively. This, combined with the current and projected capital made available by the Welsh Government and the implementation of Designed for Life: Building for Wales - the construction procurement framework based on collaborative working - will continue to play a significant part in revitalising and modernising the estate.

2.3 Estate performance

2.3.1 General

The NHS is committed to meeting a number of targets based on the following national PIs: ❖ Physical condition ❖ Statutory and safety compliance ❖ Functional suitability ❖ Space utilisation ❖ Energy performance The targets relate to the essential estate and have been introduced as a colour banding as a way of visually expressing the extent of the challenge faced by Health Boards/Trusts in achieving the required performance.

Red: Significant effort required to meet the targets

Amber: Some effort required to meet the targets

Green: Met the targets

8 Estate Condition and Performance Report 2011/12 EXECUTIVE SUMMARY

2.3.2 Physical condition and Statutory and safety compliance

Over the reporting year, RAB maintenance costs decreased by almost £30 million, to just over £185 million. This decrease can be generally attributed to large reductions reported by most Health Boards/Trusts. Details of the individual reductions can be found in Appendices II-X.

The overall reduction hides the fact that, on a site-by-site basis, excluding WAST and the aggregated group of properties, there have been swings in both directions, with 34 sites showing reductions totalling just over £34 million and 58 sites showing increases totalling nearly £4 million.

Some of the swings on an individual site basis are likely to reflect difficulties Health Boards/Trusts continue to experience in providing consistent and accurate data in line with the EFPMS definitions.

The report also points to opportunities for significant reductions in the backlog maintenance liability through the disposal of the residual estate and sites that are either closed or scheduled to close. These include Aberdare General, Maesgwyn and Fairwood.

The cost of complying with statutory and safety requirements, including fire safety, is estimated to be £135 million, of which £132 million relates to the essential estate.

According to the data provided by Health Boards/Trusts, the all-Wales average for the Physical condition performance indicator improved from just over 79.5% in 2010/11 to 82% in 2011/12, against the target of 90% of the estate to be in condition category B or better.

The average for the Statutory and safety compliance performance indicator increased marginally from almost 82.5% in 2010/11 to just over 82.7% in 2011/12, against the target for 90% of the estate to be in condition category B or better.

2.3.3 Functional suitability and space utilisation

Data submitted in respect of the Functional suitability performance indicator shows that the all-Wales average improved from 77.8% in 2010/11 to nearly 80% in 2011/12, against the target of 90% of the estate to be in condition category B or better.

As for the Space utilisation performance indicator, the all-Wales average increased from 90.3% in 2010/11 to 91.2% in 2011/12 against the target of 90% of the estate to be in condition category F.

2.3.4 Energy performance

Weather-corrected net energy consumption for 2011/12 was 14.1% below the 1999/2000 base year and total net energy fell by 36 million kWh or 3.6% in the 2011/12 period. With regard to CHP output, the total amount of electricity generated was 17.9% of the total electrical requirement.

Energy consumption associated with service demand is a long-term issue and is likely to increase rather than level out in future. The emphasis, therefore, must continue to be placed on efficiency, by improving the way energy is used. The energy efficiency PI for 2011/12 was 407 kWh/m2, indicating an excellent improvement over the previous year’s PI of 441 kWh/m2.

Estate Condition and Performance Report 2011/12 9 EXECUTIVE SUMMARY

However, the mild winter period and decommissioning issues of older properties need to be taken into account.

Carbon emissions from the reported consumption of energy fell by 0.77% during this period, with an improvement in the carbon intensity performance indicator falling from 2 2 119.78 kgCO2/m in 2010/11 to 115.54 kgCO2/m in 2011/12. A summary of the main findings of this year’s returns is given below: ❖ The trend in net energy consumption remains downward with a 3.6% fall during this period. ❖ Absolute carbon emissions from energy consumption fell by 0.77% over the previous year 2 with an improvement in the carbon intensity performance indicator from 119.78 kgCO2/m 2 to 115.54 kgCO2/m . ❖ The energy efficiency PI is 407 kWh/m2, which is a considerable improvement over last year’s figure of 441 kWh/m2. ❖ The amount of CHP-generated electricity was 17.9% of the total electricity consumption and, at 39,600,000 kWh, continues to provide a significant contribution to the electricity requirement.

2.4 Environmental

2.4.1 Waste

Data submitted shows a small increase in the overall amount of waste reported for a second year in succession, although there has been a corresponding but more significant 6% increase in disposal costs. For the first time, this year’s waste data includes non-infectious clinical waste (or offensive waste as it is commonly known) as a separate reporting category. 19% of clinical waste goes via this disposal route (11% by cost). Overall, clinical waste has seen a significant increase in volumes and costs. Much of this may be attributed to the new non-infectious disposal stream which may previously have been included as landfill in some returns. The data shows that just under 15% of the clinical waste goes for incineration, a slight improvement on last year, while the majority, 66%, goes for alternative non-incineration treatment. The figures indicate that landfill general waste has fallen by 8%. This is partly attributable to the point mentioned above and partly to continuing improvements in recycling performance. Positive signs from the recycling figures continue and recycling performance has improved slightly to 15% this year. Continued efforts to improve recycling will be required as future changes in legislation could potentially require much stricter standards of segregation at source of recycling waste. 2.4.2 Transport

Data submitted on transport for 2011/12 was, once again, incomplete. As a result of this ongoing situation, the type and nature of the data asked for within the EFPMS is to be reviewed

10 Estate Condition and Performance Report 2011/12 EXECUTIVE SUMMARY

in order to determine a way forward to ensure that, in future, more meaningful data can be monitored and measured.

2.4.3 Water usage

There was little change in water consumption in this period. The long term downward trend continues, with consumption for this period 10% lower than in 2000. There continues to be a great variation in consumption across Health Boards/Trusts, which suggests there is scope for improvement. As the cost of water continues to increase, the benefits of conservation measures and the introduction of additional metering on sites should be fully exploited.

2.5 Key issues arising from the report

2.5.1 Performance in 2011/12

Health Boards/Trusts’ performance in 2011/12, assessed on the basis of the five national estate key performance indicator targets, was mixed. Using the colour banding or ‘traffic light’ system referred to in Sections 2.3.1 and 4.1.3, most Health Boards/Trusts achieved performance figures within the amber range, indicating that some effort is required to meet the targets, although some Health Boards have improved. Within the green range, there are examples of excellent performance, indicating that some Health Boards/Trusts have met the targets, particularly in respect of the ‘Space utilisation’ PI. It is noted that the all-Wales average for ‘Fire safety’, which currently is not one of the national performance indicators, has moved from the amber band to the green band. The number of Health Boards/Trusts still achieving performance within the red band, indicating that significant effort is required to meet the targets, is small. Within the red band, the performance indicator suffering the poorest performance is ‘Functional suitability’, suggesting that significant parts of the estate are still not considered suitable for the delivery of modern services. Risk Adjusted Backlog costs decreased by almost £30 million since 2010/11 and now stand at approximately £185 million, the lowest figure since 2004/05 when backlog maintenance costs first started to be assessed on the basis of risk. Broadly, this significant reduction has been achieved as a result of the modernisation of significant parts of the health estate which has seen the closure and disposal of poor building stock carrying a heavy backlog maintenance burden and its replacement with new facilities. Whilst the reduction in backlog costs is welcome, both the performance against the national PIs and the substantial backlog maintenance costs point to the fact that significant improvements in performance and reductions in backlog maintenance costs will be achieved only through the implementation of a radical modernisation programme. On the energy front, improvements have been made in net energy consumption and in performance indicators, indicating that considerable improvements have been made in energy efficiency. However, it should be noted that this period did include a milder winter in some areas, which is a mitigating factor. Again this year a major contributing factor has been the substantial

Estate Condition and Performance Report 2011/12 11 EXECUTIVE SUMMARY

contribution in CHP-derived electricity, which now stands at 17.9% of the total electrical demand for the NHS in Wales.

2.5.2 Performance over the 11-year period since the publication of the first EFPMS report

When the five national estate PIs were introduced in 2002 there was an expectation that the 90% performance targets would be met by 2008. The table below, which excludes ‘Energy performance’ as this is measured differently, but includes ‘Fire safety’, currently not one of the national PIs, illustrates the progress made on an all-Wales basis during this 11-year period.

Performance indicator Percentage Percentage compliance in compliance in 2001/02 2011/12

Physical condition 69.17 81.94

Statutory and safety compliance 70.38 82.73

Fire safety 75.65 91.00

Functional suitability 77.71 85.00

Space utilisation 79.29 91.26

It is noted that the ‘Space utilisation’ and ‘Fire safety’ targets have been met and exceeded. The remainder still fall far short of the targets. As stated previously, only a radical modernisation programme will address the current shortfalls. Backlog maintenance costs, expressed in terms of Risk Adjusted Backlog, have fallen from almost £305 million in 2004/05, when they were first introduced, to almost £185 million in 2011/12, an indication that considerable effort has gone into addressing the most serious estates risks. Age profile has been consistently highlighted as a useful indicator of the likely condition of the estate. Over the 11-year period there has been a 13% reduction in pre-1948 buildings in the overall profile of the estate in Wales, along with a 19% improvement in post-1995 building stock. It is expected that the current modernisation programme will continue to impact on the all-Wales age profile. Over the 11-year period, the percentage of the non-essential building areas still in the ownership of the NHS has decreased from 17% to 12% while the percentage of the non-essential land area has decreased from 28% to 14%, indicating that considerable efforts have been made to ensure that resources tied up in maintaining these assets are directed to where they can be used more efficiently. The importance of driving forward a vigorous land and property disposal programme, focusing on those elements of the estate in particularly poor physical condition, that fail to comply with statutory requirements and present major challenges in delivering modern clinical services, has also been consistently stated. Accordingly, during the EFPMS 11-year reporting period significant

12 Estate Condition and Performance Report 2011/12 EXECUTIVE SUMMARY

progress has been made, resulting in the disposal of 242 hectares of land and 210,000m2 of building with a disposal value of over £102 million. With regard to energy usage, the trends in energy consumption continue to be encouraging with further improvements in the energy efficiency performance indicator and of absolute carbon emissions. Similarly with water usage, the trend has continued downward, although absolute consumption has remained virtually unchanged.

Estate Condition and Performance Report 2011/12 13 3 ESTATE PROFILE

3.1 Key statistics of the NHS estate in Wales

3.1.1 Serving a population of approximately 3 million, the NHS is the largest employer in Wales. Of the 72,423 whole time equivalent (WTE) staff reported to be employed by the NHS in Wales, 1,007 (1.39%) fulfil estates functions and 6,222 (8.59%) deliver hotel services.

Services are delivered from a diverse, complex and geographically widespread portfolio of properties, comprising:

❖ A total land area of almost 700 hectares; ❖ Over 100 hospitals of varying age, construction, size and function; ❖ Over 200 health centres and clinics; ❖ Approximately 80 mental health and learning disability units; ❖ Approximately 90 ambulance stations; ❖ Over 160 miscellaneous properties in the form of offices, housing, storage and distribution warehouses.

3.1.2 Although the property market remained difficult during the year, over £5m was generated from the sale of 17 surplus NHS properties. This included the sales under the NHS Affordable Housing protocol of Caerphilly and District Miners’ Hospital, Aberbargoed Hospital and Ty Sirhowy Hospital in Blackwood.

The development of Ysbyty Cwm Cynon in Mountain Ash has released for disposal the hospitals at Aberdare and Mountain Ash, and HM Stanley Hospital, St Asaph will become available for disposal during 2012/13.

3.2 The age of the estate

3.2.1 Age profile can be a useful indicator of the likely condition of the estate. Figure 1 compares the current profile with that in 2001/02 when the first EFPMS report was published and illustrates the level of estate activity during the last 11 years. Focusing on the two extremes of the age profile it can be seen that the proportion of the estate pre-dating 1948 has shrunk from 32% to 19% while the proportion of the estate built since 1995 has increased from 8% to 27%.

This comparison provides a useful reminder of the importance of implementing, on the one hand, a robust disposal programme of the surplus estate and, on the other hand, investing in the modernisation of the health estate. Further changes to the profile will arise over the next few years if older hospitals continue to be closed. 3.3 The essential and non-essential estate

3.3.1 The Welsh Government requires NHS property holding bodies to develop estate strategies that support service plans. This process can lead to the requirement for new buildings and the rationalisation of old stock. If a building or land has a health use of more than five years it is

14 Estate Condition and Performance Report 2011/12 ESTATE PROFILE

All-Wales Age Profile 2001/02

8%

17% 32%

15% 2%

5%

21%

Pre 1948 1948 to 1954 1955 to 1964 1965 to 1974 1975 to 1984 1985 to 1994 1995 to Present

All-Wales Age Profile 2011/12

19% 27%

1%

6%

14% 18%

15%

Pre 1948 1948 to 1954 1955 to 1964 1965 to 1974 1975 to 1984 1985 to 1994 1995 to Present

Figure 1: Comparison of all-Wales age profiles between 2001/02 and 2011/12

Estate Condition and Performance Report 2011/12 15 ESTATE PROFILE

categorised as essential, and five years or less as non-essential. It is important for the Service that non-essential buildings and land are disposed of as quickly as possible to ensure that resources tied up in maintaining these assets are directed to where they can be used more efficiently.

Figure 2 compares the percentage of essential and non-essential building areas across Wales in 2010/11 with 2011/12. It can be seen that in 2011/12 the proportion of non-essential building area increased by 3% compared with 2010/11. This is due to a change from essential to non- essential for parts of Singleton, St Woolos, Llanfrechfa and Whitchurch Hospitals.

12% 9%9% 12%

91% 88%

91% 88%

2010/11 Essential Non-Essential 2011/12

Figure 2: Percentage of essential and non-essential building areas across Wales in 2010-11 compared with 2011-12

Figure 3 compares the percentage of essential and non-essential land areas across Wales in 2010/11 with 2011/12. It can be seen that in 2011/12 the proportion of non-essential land increased by 1% compared with 2010/11.

13%13% 14%14%

87% 86% 87% 86% 2010/11 Essential Non-Essential 2011/12

Figure 3: Percentage of essential and non- essential land areas across Wales in 2010/11 compared with 2011/12

16 Estate Condition and Performance Report 2011/12 ESTATE PROFILE

Figure 4 shows the extent of essential and non-essential buildings in 2011/12 relating to each Health Board/Trust.

400,000

350,000

300,000

250,000 ) ) 2

200,000 GIA (m GIA (m² 150,000

100,000

50,000

0 ys le da an ST Taf BM adr dre v a w D A A Powys Service elindre V Cwm Taf Abertawe Hywel Dda lsh Ambulance Aneurin Bevan Betsi Cadwaladr Cardiff and Vale Cardiff Bro Morgannwg We

Essential Non-Essential

Figure 4: Essential and non-essential building areas by organisation

Figure 5 shows the extent of essential and non-essential land areas in 2011/12 relating to each Health Board/Trust.

160

140

120 )

100

80

60 Land Area (ha) Land Area (ha 40

20

0 AST ABM evan owys aladr Vale l Dda lindre m Taf m Powys B e P W w Service elindre V Cwm Taf Abertawe Hywel Dda lsh Ambulance Aneurin Bevan Betsi Cadwaladr Cardiff and Vale Cardiff Bro Morgannwg We

Essential Non-Essential

Figure 5: Essential and non-essential land areas by organisation

Estate Condition and Performance Report 2011/12 17 .. TheNHSestateisanextremely importantresource which,basedonavaluationdateof1April 3.4.1 ExpenditureontheNHSestate 3.4 PROFILE ESTATE 18 £ Millions 100.0 200.0 300.0 400.0 500.0 600.0 0.0 this period. expenditure above2016/17andassumesthatexistingmaintenancelevelsare achievableduring maintenance linebeyond2011/12isaprediction basedupontheeffects ofthecontinuedcapital the process ofrefurbishment orreplacement ofexistingsub-standard assets.Thebacklog increase incapitalexpenditure hashadasubstantialeffect inreducing backlogmaintenanceby would havebeenrequired tokeeppacewithinflationat April2000.Itcanbeseenthatthereal W Figure 6 it,andtodevelopnewfacilities. and modernise running costisestimatedatover£300millionand,inaddition,capitalrequired tomaintain 2012, theValuation Office hasvaluedatan‘existingusevalue’ofover£2billion.Itsannual Estate Condition andPerformance Report2011/12 ales sinceApril2000andprojected to2016/17.Thered lineshowsthecapitalinvestmentthat 2000-01

2001-02 shows capitalinvestment(darkblue)andestimatedbacklogmaintenance(green) in Annual net investment Annual net investment

2002-03

2003-04 Figure 6:CapitalinvestmentintheNHSWales

2004-05

2005-06

Inve 2006-07 stm ent required to keep pace with inflation inflation withkeep pace to ent required

2007-08 Financial Financial year

2008-09

2009-10

2010-11

2011-12

2012-13 T otal backlog maintenance otal maintenance backlog

2013-14

2014-15

2015-16

2016-17 4 ESTATE PERFORMANCE 4.1 General information

4.1.1 Welsh Health Circular WHC(2002)50 Introduction of an Estates Performance Management System, issued in April 2002, set out details of five national PIs based on guidance contained in Estatecode. The current targets agreed with the Welsh Government are shown in Figure 7. They relate to the essential estate, that is, the estate that is deemed to have a health use of five years or more.

National PI Target Definition of condition category Physical condition 90% of the estate to be Condition category ‘B’ applies to in condition category ‘B’ buildings that are sound, operationally or above. safe and exhibit only minor deterioration. Statutory and safety 90% of the estate to be Condition category ‘B’ applies to compliance in condition category ‘B’. buildings where action will be needed in the current plan period to comply with relevant guidance and statutory requirements. Functional suitability 90% of the estate to be Condition category ‘B’ applies to in condition category ‘B’ buildings that are satisfactory and or above. minor changes are needed. Space utilisation 90% of the estate to be Category ‘F’ applies to buildings that in category ‘F’. are fully used. Energy performance The estate to achieve Energy ‘B’ rating applies to buildings energy ‘B’ rating or with an energy consumption of 410 better. kWh/m2 or less.

Figure 7: Table showing national performance indicators and targets

4.1.2 The PIs and Health Boards/Trusts’ progress in meeting the targets are discussed in more detail later in this report.

4.1.3 The ‘traffic light’ compliance code adopted previously has been used again in this report as a way of visually expressing Health Boards/Trusts’ progress in meeting the targets set out in Figure 7. Each PI has again been split into three bands of compliance, colour coded as follows:

Percentage of the estate in condition category ‘B’/’F’: 90% or above (Energy performance: consumption 410 kWh/m2 or less)

Percentage of the estate in condition category ‘B’/’F’: Within 75-89% range (Energy performance: consumption within 411-479 kWh/m2 range)

Percentage of the estate in condition category ‘B’/’F’: Below 75% (Energy performance: consumption 480 kWh/m2 or above)

All Health Boards/Trusts have been banded according to the above criteria for each of the national PIs.

Estate Condition and Performance Report 2011/12 19 ESTATE PERFORMANCE

4.1.4 Health Boards/Trusts’ performance against each of the targets has been estimated from the data submitted and used to obtain an average figure for each Health Board/Trust as well as an all-Wales figure.

4.2 Physical condition

Backlog maintenance

4.2.1 Risk Adjusted Backlog (RAB) costs across Wales have reduced by £29.6 million, from just over £214.5 million in 2010/11 to just under £184.9 million in 2011/12. With the exception of Powys Teaching Health Board, Velindre NHS Trust and WAST, reductions in RAB costs were reported by all other Health Boards. 4.2.2 The RAB cost position for the seven-year period from 2005/06 is summarised in Figure 8 along with the component risk level costs. A breakdown of the individual Health Board/Trust costs is detailed in Appendices II-X. It can be seen that during this period RAB costs have decreased by approximately £58 million, from just under £243.3 million in 2005/06 to just under £184.9 million in 2011/12. It is also noted that costs within the high and significant risks bands have decreased over the period while costs within the moderate and low risk bands have increased.

Backlog Costs (£) 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 High Risks 89,012,153 79,664,860 74,679,970 82,216,438 67,220,657 65,223,999 58,975,682 Significant Risks Cost 146,141,690 152,657,209 131,722,434 159,099,421 141,837,253 134,939,981 111,987,663 Moderate Risks Cost 90,578,800 95,973,613 108,342,166 111,169,395 110,189,965 112,720,419 105,474,312 Low Risks Cost 155,713,518 151,989,807 153,516,646 152,732,822 141,025,178 132,201,858 119,049,126 Risk Adjusted Cost 243,290,399 252,354,414 226,544,578 258,500,088 231,932,906 214,545,946 184,896,886

Figure 8: Table showing all-Wales risk banded costs between 2005/06 and 2011/12

4.2.3 Figure 9 shows the four risk categories of each Health Board/Trust’s total backlog, (as a percentage of total backlog) and reported capital investment in backlog (as a percentage of total backlog). Capital investment in backlog is defined as The amount contained within the Total Capital Investment figure which was invested in the NHS Health Boards/Trusts’ estate specifically to reduce backlog maintenance costs, inclusive of physical condition, fire safety, and health & safety.

It can be seen that only 4 Health Boards/Trusts appear to have invested sufficient capital to address the high-risk backlog. The remainder are either awaiting funding associated with outstanding business cases or are striving to manage the risks.

20 Estate Condition and Performance Report 2011/12 ESTATE PERFORMANCE

100%

90%

80%

70%

60%

50%

40%

30%

20%

10%

0% Powys elindre V Cwm Taf Abertawe Hywel Dda Aneurin Bevan Betsi Cadwaladr Cardiff and Vale Cardiff Bro Morgannwg elsh Ambulance Service W

High Risk Significant Risk Moderate Risk Low Risk Investment to reduce backlog

Figure 9: Risk profile of backlog and investment to reduce backlog

4.2.4 Figure 10 shows RAB costs by Health Board/Trust submitted for the period 2011/12. Detailed analysis of the individual Health Board/Trust data is included in Appendices II-X.

45.00

40.00 0 35.00

30.00

25.00

20.00

15.00

RAB Costs (£ x 1,000,000) 10.00 RAB Costs (£ x 1,000,00

5.00

0.00 Powys elindre V Cwm Taf Abertawe Hywel Dda Aneurin Bevan Betsi Cadwaladr Cardiff and Vale Cardiff Bro Morgannwg elsh Ambulance Service W

Figure 10: Comparison of risk adjusted backlog costs by Health Board/Trust

Estate Condition and Performance Report 2011/12 21 ESTATE PERFORMANCE

Physical condition targets

4.2.5 Figure 11 shows the percentage of the estate in physical condition category ‘B’ or above.

It is noted that none of the Health Boards/Trusts have met the 90% target. The all-Wales performance, however, has improved but is falling still far short of the target required in order to move it into the green band.

Health Board/Trust Physical condition performance indicator 2011/12 2010/11 Abertawe Bro Morgannwg 81.46 78.00 Aneurin Bevan 80.89 75.93 Betsi Cadwaladr 83.41 82.76 Cardiff and Vale 86.52 82.31 Cwm Taf 82.52 83.05 Hywel Dda 86.16 85.25 Powys Teaching 67.70 67.70 Velindre 85.10 84.00 Welsh Ambulance Services 32.53 31.42

All Wales Average 81.94 79.52

Key

Percentage of the estate in condition ’B’: 90% or above (current target)

Percentage of the estate in condition ’B’: 75-89%

Percentage of the estate in condition ’B’: 74% or below

Figure 11: Physical condition of Health Organisations

4.3 Statutory and safety compliance

4.3.1 All Health Boards/Trusts must comply with current Health and Safety Standards and Codes of Practice. Some examples of the main health and safety requirements that Health Boards/Trusts have to comply with include:

❖ Electricity at Work Regulations ❖ Asbestos ❖ Control of legionella ❖ Pressure systems ❖ Firecode ❖ Equality Act 2010 replacing the Disability ❖ Control of Substances Hazardous Discrimination Act (DDA) to Health ❖ The Hazardous Waste Regulations ❖ Health and Safety at Work

This list is not exhaustive and there are many other statutory requirements that Health Boards/Trusts have to comply with in order to protect the safety of their staff, patients and visitors on their sites.

22 Estate Condition and Performance Report 2011/12 ESTATE PERFORMANCE

4.3.2 The cost of complying with statutory and safety requirements (excluding fire safety) is estimated to be almost £61 million.

4.3.3 The cost of complying with Firecode across Wales is estimated to be £16 million, which is an increase of £2 million on the 2010/11 figure. The estimated cost excludes specific remedial works associated with Ysbyty Glan Clwyd which total approximately £57 million. Remedial works have commenced on this site which are expected to last for approximately 7 years, dealing with asbestos, fire safety and a major ward refurbishment programme.

Statutory and safety compliance targets

4.3.4 Figure 12 shows the percentage of the estate under Statutory and safety compliance that is in Estatecode condition category ‘B’ or above. It is noted that Cardiff and Vale University Health Board have met the current target of 90%.

Health Board/Trust Statutory & safety compliance performance indicator 2011/12 2010/11 Abertawe Bro Morgannwg 72.61 72.19 Aneurin Bevan 87.80 85.92 Betsi Cadwaladr 81.72 84.95 Cardiff and Vale 90.18 87.94 Cwm Taf 81.84 82.35 Hywel Dda 85.82 85.55 Powys Teaching 81.43 81.43 Velindre 88.20 87.40 Welsh Ambulance Services 64.10 63.89

All Wales Average 82.73 82.54

Key

Percentage of the estate in condition ’B’: 90% or above (current target)

Percentage of the estate in condition ’B’: 75-89%

Percentage of the estate in condition ’B’: 74% or below

Figure 12: Statutory and safety compliance of Health Organisations

4.3.5 In addition to statutory and safety compliance, the EFPMS collects separate data relating to the level of fire safety compliance within each Health Board/Trust, together with an estimate of the costs required to achieve that compliance. These costs are summarised in 4.3.3.

Figure 13 overleaf, shows the percentage of essential building area considered to be in full fire safety compliance. It is noted that one Health Board falls significantly short of the 90% target, while five Health Boards meet or exceed the target. The all-Wales performance has moved from the amber to the green band.

Estate Condition and Performance Report 2011/12 23 ESTATE PERFORMANCE

Health Board/Trust Fire safety compliance performance indicator 2011/12 2010/11 Abertawe Bro Morgannwg 100.00 100.00 Aneurin Bevan 94.72 94.87 Betsi Cadwaladr 85.68 80.00 Cardiff and Vale 95.31 95.40 Cwm Taf 73.57 74.42 Hywel Dda 90.56 85.55 Powys Teaching 80.01 80.01 Velindre 83.50 82.40 Welsh Ambulance Services 90.35 90.31

All Wales Average 91.00 89.96 Key Key Percentage of the estate in condition ’B’: 90% or above (current target)

Percentage of the estate in condition ’B’: 75-89%

Percentage of the estate in condition ’B’: 74% or below

Figure 13: Fire safety compliance of Health Organisations

4.4 Functional suitability

4.4.1 Functional suitability is used to determine how effectively a building (or part of a building) supports the delivery of specific Health Board/Trust services. Key factors, which contribute to these assessments, are: ❖ Internal space relationships including critical dimensions are suitable for the function, observation of dependent patients by staff, separate sex/bed cubicle areas and toilet facilities and security; ❖ Support facilities such as the adequate provision of toilets and bathrooms, adequate storage space, adequate seating and waiting space and provision for disabled people; ❖ Location, including distance to key linked facilities, access to parking areas and access to public transport. 4.4.2 Figure 14 shows the percentage of the estate under Functional suitability that is in Estatecode condition category ‘B’ or above.

It can be seen that two Health Boards have met and exceeded the 90% target. The all-Wales performance remains within the amber band, with two Health Board/Trusts showing very little improvement.

24 Estate Condition and Performance Report 2011/12 ESTATE PERFORMANCE

Health Board/Trust Functional suitability performance indicator 2011/12 2010/11 Abertawe Bro Morgannwg 93.12 92.59 Aneurin Bevan 81.62 74.39 Betsi Cadwaladr 66.78 63.55 Cardiff and Vale 81.60 80.23 Cwm Taf 76.59 77.27 Hywel Dda 89.09 88.84 Powys Teaching 82.45 82.45 Velindre 90.10 89.40 Welsh Ambulance Services 35.47 35.47

All Wales Average 79.91 77.81 Key

Percentage of the estate in condition ’B’: 90% or above (current target)

Percentage of the estate in condition ’B’: 75-89%

Percentage of the estate in condition ’B’: 74% or below

Figure 14: Functional suitability of Health Organisations 4.5 Space utilisation

4.5.1 Space utilisation explores how well available space is being used. The objective is to hold no more space than is necessary to satisfy the reasonable demands of the present function and planned requirements.

Health Board/Trust Space utilisation performance indicator 2011/12 2010/11 Abertawe Bro Morgannwg 97.55 98.37 Aneurin Bevan 80.80 76.11 Betsi Cadwaladr 89.95 87.85 Cardiff and Vale 90.94 87.89 Cwm Taf 94.25 94.32 Hywel Dda 95.66 96.01 Powys Teaching 99.76 99.76 Velindre 90.60 89.90 Welsh Ambulance Services 94.53 94.08

All Wales Average 91.26 90.26 Key

Percentage of the estate in condition ’F’: 90% or above (current target)

Percentage of the estate in condition ’F’: 75-89%

Percentage of the estate in condition ’F’: 74% or below

Figure 15: Space utilisation of Health Organisations

Estate Condition and Performance Report 2011/12 25 ESTATE PERFORMANCE

4.5.2 Figure 15 shows the percentage of the estate under Space utilisation that is in Estatecode condition F. It is noted that eight Health Boards/Trusts have met the 90% target and the all-Wales performance remains in the green band. 4.6 Energy performance

Net energy

4.6.1 Net energy consumption for the whole of Wales fell from 730 million kWh in 2010/11 to 694 million kWh in 2011/12, a fall of 36 million kWh or 4.9%.

It should be noted, however, that this period included a milder than average winter which would have reduced the winter energy demand. Therefore, in order to accurately determine the trend in energy consumption, a factor to allow for weather correction has been used. Accordingly, based on weather-corrected figures, consumption for 2011/12 is estimated to be 692 million kWh compared with a weather corrected figure of 690 million kWh in 2010/11 and 806 million kWh for the base year of 1999/2000. The figure for 2011/12 is 14.1% below that of the base year.

Transposing these figures to the graph in Figure 16 shows that since 1999 there has been a general downward trend in weather-corrected consumption.

1,000,000 950,000 900,000 850,000 800,000 750,000

MWh 700,000 650,000 600,000 550,000 500,000

0 2 3 4 5 6 7 8 9 0 1 2 1999/00 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12

MWh Trendline

Figure 16: Graph showing net energy consumption and trend

4.6.2 The breakdown of energy returns show that 39.6 million kWh of CHP on-site generated electricity was reported for 2011/12, which was 17.9% of the total electrical consumption. This compares with a figure of 17.7% for the previous reporting year, indicating that the NHS in Wales is maintaining its level of CHP generated electricity.

Further analysis on an individual Health Board/Trust basis can be found in Appendices II-X.

26 Estate Condition and Performance Report 2011/12 ESTATE PERFORMANCE

4.6.3 It is noted that Health Boards/Trusts are reporting a greater floor area (2.9% increase over the previous year and now significantly greater than the base year) resulting from new developments. Similarly, they are reporting increased service demand for high electrical energy consuming clinical services such as diagnostic imaging. Both issues are impacting on energy consumption; however, it is difficult to quantify the impact with no direct statistical comparison.

4.6.4 The total cost of energy across the NHS in Wales for 2011/12 was £34.2 million compared with £32 million last year, an increase of 6.7%. Although no clear long term trend can be predicted, forecasts are anticipating further rises in the cost of energy in the near future. It should also be noted that if the fall in net energy of 4.9% had not occurred, the rise in overall energy costs would have been greater and although the drop in energy demand was not able to balance out the price rises in energy costs, there was a benefit in terms of cost avoidance.

4.6.5 Figure 17 below shows total energy costs for each LHB and the cost per square metre. The data indicated a disproportionately high cost of energy per square metre for Hywel Dda Health Board and Velindre NHS Trust. The high proportion of fuel oil used within Hywel Dda Health Board is the reason for their high cost per square metre. Velindre NHS Trust’s figure is due to its high electricity usage which accounts for 44% of its energy requirement. This figure is much higher than other organisations and is due to the electrical power-intensive diagnostic and treatment equipment installed at Velindre Hospital. Both these high cost indicators contrast strongly with Cardiff and Vale University Health Board’s figure which is the lowest in Wales. This low figure is mainly due to the Health Board’s investment in CHP, which provides 49% of its total electrical consumption, giving it a considerable saving in the amount of purchased electricity required from the utilities supplier.

Total Energy Gross Internal Cost per Health Board/Trust Cost Area square metre

(£) (m2) (£/m²) Abertawe Bro Morgannwg 6,565,105 296,440 22.15 Aneurin Bevan 5,120,761 305,560 16.76 Betsi Cadwaladr 7,654,782 356,840 21.45 Cardiff and Vale 5,730,751 356,927 16.06 Cwm Taf 3,368,451 164,080 20.53 Hywel Dda 4,499,141 164,399 27.37 Powys Teaching 875,109 43,049 20.33 Velindre 411,858 15,724 26.19 All Wales Total 34,225,958 1,703,019 20.10

Figure 17: Total energy costs and cost per square metre

Estate Condition and Performance Report 2011/12 27 ESTATE PERFORMANCE

Carbon emissions

4.6.6 Figure 18 shows the amount of carbon dioxide emissions for each Health Board/Trust calculated from their reported consumption of energy.

4.6.7 The table shows that overall net carbon emissions have decreased slightly. However, the majority of returns are showing increases. The carbon PI indicator shows an improvement at five of the Health Boards/Trusts. It is notable that among the lowest PIs are those of Aueurin Bevan Health Board and Cardiff and Vale University Health Board both of which are fully ISO14001 certified and, in the case of Cardiff and Vale, a high proportion of its energy used is derived from CHP which has considerably improved its performance in this area.

With the introduction of ISO 14001 certification at all major NHS sites in Wales expected to be in place by the end of 2012 and the introduction of annual carbon footprint reporting recently

introduced, it is expected that both absolute CO2 emissions and the carbon PI will improve in subsequent years.

Health Board/Trust Change 2011/12 Previous 2011/12 CO2 from Last GIA Year PI Year PI Comparison (Tonnes) % (m2) (kg/m²) (kg/m²) Abertawe Bro 40,157 -2.67% 296,440 135.47 140.77 Morgannwg Aneurin Bevan 31,173 3.84% 305,560 102.02 111.29 Betsi Cadwaladr 41,729 2.00% 356,840 116.94 117.86 Cardiff and Vale 34,975 -12.65% 356,927 97.99 112.47 Cwm Taf 18,924 6.79% 164,080 115.34 108.72 Hywel Dda 22,963 3.49% 164,399 139.68 135.81 Powys Teaching 4,572 17.13% 43,049 106.23 80.71 Velindre 2,265 0.76% 15,724 144.10 152.79 All Wales Total 196,758 -0.77% 1,703,019 115.54 119.78

Figure 18: Carbon dioxide emissions

Energy performance indicator

4.6.8 Figure 19 opposite, shows Health Boards/Trusts’ performance against the energy PI for existing buildings. With a figure of 407 kWh/m2 the all-Wales performance is significantly improved compared with last year’s figure of 441 kWh/m2. This is generally due to improvements in performance across the board. However, it should be noted that the mild winter period will have been a contributory factor and that some older premises are still counted in the gross internal floor area as they have not been fully decommissioned, before services are moved into new premises.

Comparing individual performances they have improved across the board indicating a high commitment to energy efficiency, with notable improvements at Velindre NHS Trust, Aneurin Bevan Health Board and Cardiff and Vale University Health Board.

28 Estate Condition and Performance Report 2011/12 ESTATE PERFORMANCE

Health Board/Trust Energy performance indicator (kWh/m2) 2011/12 2010/11 Abertawe Bro Morgannwg 436 473 Aneurin Bevan 356 414 Betsi Cadwaladr 418 437 Cardiff and Vale 381 422 Cwm Taf 426 439 Hywel Dda 465 493 Powys Teaching LHB 419 386 Velindre 398 482

All Wales Average 407 441

Key

Energy consumption: 410 kWh/m2 or below

Energy consumption: 411-479 kWh/m2

Energy consumption: 480 kWh/m2 or above

Figure 19: Energy performance of Health Organisations

Estate Condition and Performance Report 2011/12 29 5 ENVIRONMENTAL ISSUES 5.1 Waste

5.1.1 Data submitted shows a small increase in the overall amount of waste reported for a second year in succession, and there has been a more significant 6% increase in disposal costs. The total quantity of waste disposed of in 2011/12 was reported as 18,239 tonnes, compared with 17,965 tonnes in the previous year (these figures exclude recycled material). The cost of disposal of this waste was £5.46 million compared with £5.13 million in the previous year.

24,000

21,000 onnes Tonnes T 18,000

15,000

2006/07 2007/08 2008/09 2009/10 2010/11 2011/12

Tonnes Trendline

Figure 20: Overall waste trend 2007-2012

5.1.2 For the first time, this year’s waste data includes non-infectious clinical waste (EWC code 18 01 04 or offensive waste as it is commonly known) as a separate reporting category joining the existing clinical waste streams of high temperature infectious waste (incineration) and non-burn ‘alternative treatment’ infectious waste. The inclusion of this as a separate figure has a knock- on effect on other waste streams and this picture should become clearer in time.

As last year, figures submitted from Powys are viewed with caution, with data in many categories showing large changes from previous years, and significant deviations from the all-Wales averages. Following conversations with the Board it is hoped that changes have been implemented this year that mean that data captured is more comprehensive than in the past; this will continue to be monitored.

5.1.3 Figures 21 and 22 show the relative proportions each waste stream account for in the overall total waste. For the first time, these figures include offensive waste as a distinct element.

In terms of waste volumes 46% of waste goes to landfill, 15% is recycled with the remaining 39% being clinical waste. By contrast, in terms of costs landfill accounts for only 25% of costs, recycling only 5%, whereas 70% of costs are incurred for clinical waste disposal. This clearly demonstrates the more complex treatment and disposal requirements of clinical wastes.

30 Estate Condition and Performance Report 2011/12 ENVIRONMENTAL ISSUES

6% 5% 15% 18%

25% 26%

7% 8% 46% 44%

High temp disposal High temp disposal Non burn treatment waste Non burn treatment waste Offensive waste Offensive waste Landfill waste Landfill waste Recycling Recycling

Figure 21: Breakdown of waste tonnage Figure 22: Breakdown of waste costs in 2011/12 in 2011/12

Clinical waste

5.1.4 Clinical waste has seen an increase in volumes and costs, up to 8,451 tonnes from 7,344 tonnes last year and £3.95 million from £3.49 million last year. It is thought that much of this can be attributed to the new non-infectious disposal stream which may previously have been included as general landfill in some returns. 5.1.5 The data submitted shows that just under 15% of the clinical waste in Wales goes for incineration, a slight improvement in percentage terms on last year. While the majority, 66% goes for alternative non-incineration treatment and the remaining 19% to the non-infectious offensive stream. The cost split is 26% incineration, 63% non-burn treatment and 11% non- infectious offensive waste. 5.1.6 The all-Wales average disposal cost for clinical waste in 2011/12 was £467 per tonne, a slight fall on last year. This is a combined figure for all clinical wastes and as an illustration of the incentive to introduce the offensive waste stream, the respective costs per tonne for each stream are £691 for incineration waste, £444 for non-burn treatment waste and £274 per tonne for offensive waste. (Note: the incineration figure excludes WAST & Powys for reliability and consistency purposes). It is noteworthy that the Health Boards that have most comprehensively implemented the offensive waste stream: Aneurin Bevan, Cardiff and Vale & Hywel Dda, have shown the most significant decreases in their overall combined cost per tonne for clinical waste. By contrast Betsi Cadwaladr University Health Board has yet to introduce this waste segregation methodology. 5.1.7 The breakdown of how much clinical waste in total has been generated across the Health Boards/Trusts in Wales over the past five reporting years is illustrated in Figure 23. This illustrates

Estate Condition and Performance Report 2011/12 31 ENVIRONMENTAL ISSUES

2,500

2,000

1,500 onnes T

Tonnes 1,000

500

0 Powys elindre V Cwm Taf Abertawe Hywel Dda Aneurin Bevan Betsi Cadwaladr Cardiff and Vale Cardiff Bro Morgannwg

2007/08 2008/09 2009/10 2010/11 2011/12

Figure 23: Clinical waste volumes 2008-2012

that the Abertawe Bro Morgannwg and the Cardiff & Vale University Health Boards are the biggest producers of clinical waste, accounting for over 4,000 tonnes and £1.7 million between them in 2011/12. The increase at Cardiff & Vale is largely due to the offensive waste stream’s inclusion.

Landfill waste

5.1.8 The returns indicate that landfill general waste has fallen by 8% overall. This is partly attributable to continuing improvements in recycling performance, although the introduction of the new non-infectious offensive waste stream, (which is also a landfilled waste), may have impacted on reported totals.

In total, Health Boards/Trusts in Wales disposed of 9,678 tonnes of waste to landfill in 2011/12 compared with last year’s figure of 10,517 tonnes, an 8% decrease. The cost for disposal remained approximately static at £150 per tonne.

5.1.9 The breakdown of how much landfill waste in total has been generated across the Health Boards/Trusts in Wales over the past five reporting years is illustrated in Figure 24. The largest producers of landfill waste (i.e. general non-clinical) in 2011/12 was again Abertawe Bro Morgannwg University Health Board. The landfill at Cardiff & Vale University Health Board fell by 760 tonnes and £155,000 from last year which is thought largely to be due to the new reporting category discussed above.

Waste recovery/recycling of waste

5.1.10 Positive signs from the recycling figures continue: recycling performance has improved slightly to 15% this year. Continued efforts to improve recycling will be required as future changes in legislation could potentially require much stricter standards of segregation at source of recycling waste rather than the current model of mixed recycling bags that dominates.

Data submitted this year shows that all Health Boards/Trusts in Wales report waste recovery/recycling activity which continues to be an encouraging trend.

32 Estate Condition and Performance Report 2011/12 ENVIRONMENTAL ISSUES

3,000

2,500

2,000

1,500 onnes T Tonnes 1,000

500

0 Powys elindre V Cwm Taf Abertawe Hywel Dda Aneurin Bevan Betsi Cadwaladr Cardiff and Vale Cardiff Bro Morgannwg

2007/08 2008/09 2009/10 2010/11 2011/12

Figure 24: Landfilled waste volumes 2008-2012

5.1.11 The All-Wales average recycling figure for 2011/12 is now 15.5%, an improvement on the previous year’s rate of 13.4%. A comparison of recycling rates across the Health Boards/Trusts is shown in Figure 25. However, there remains much scope for further improvement.

The best performer in terms of recycling during 2011/12 was again Aneurin Bevan University Health Board which reported an overall recycling rate of 27%, a steady improvement year-on- year and compared to a rate of 6% at Cwm Taf Health Board.

5.1.12 Aneurin Bevan Health Board is certified to the environmental management standard ISO14001 and as part of their management system waste reduction and recycling programmes are among

30.00%

25.00%

20.00%

15.00%

10.00%

5.00%

0.00% Powys elindre Services V Cwm Taf Abertawe Hywel Dda lsh Ambulance Aneurin Bevan Betsi Cadwaladr Cardiff and Vale Cardiff Bro Morgannwg We All Wales Average All Wales

Figure 25: Waste recycling performance in 2011/12

Estate Condition and Performance Report 2011/12 33 ENVIRONMENTAL ISSUES

the key objectives and targets. It is Welsh Government policy that all Health Boards/Trusts should have achieved ISO 14001 certification by the end of 2012 at major hospitals in Wales. With this policy it is hoped that all bodies can show similar improvements in future.

5.2 Transport

5.2.1 The reporting of transport information remains poor with gaps in much of the required data from several Health Boards/Trusts and large fluctuations in year-on-year figures. As a result of this ongoing situation, the type and nature of the data asked for within the EFPMS is to be reviewed in order to determine a way forward to try to ensure that, in future, more meaningful data can be monitored and measured.

5.2.2 In terms of the number of organisations that have implemented Sustainable Transport Plans, it is noted that all reported having a board-approved plan in place at hospitals requiring them.

5.3 Water usage

5.3.1 The total water consumption in 2011/12 was just over 2.4 million cubic metres, an increase of 1.3% on the figure reported for 2010/11. Figure 26 shows the trend in water consumption has been generally downward, with consumption now 10% lower than in 2000.

5.3.2 The average cost of water, including sewage and other charges, was £2.36/m3. Costs varied between £2.08/m3 at Betsi Cadwaladr University Health Board and £2.70/m3 at Velindre NHS Trust.

Figure 26 shows annual consumption for 2001 to 2012 and the trend for that period.

2.8

2.7

3 2.6

2.5

2.4 millions m 2.3 Millions cubic metres 2.2

2.1 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2000/012001/022002/032003/042004/052005/062006/072007/082008/092009/102010/112011/12

Volume Trendline

Figure 26: Total water consumption and trend 2001-2012

34 Estate Condition and Performance Report 2011/12 APPENDIX I

Health Board/Trust Risk Adjusted Backlog Costs

Estate Condition and Performance Report 2011/12 35

APPENDIX I

Health Board / Trust High risk Significant Moderate Low risk Risk Risk Variation in backlog risk risk backlog adjusted adjusted risk cost backlog backlog cost backlog backlog adjusted cost cost cost cost backlog 2011/12 2010/11 cost (£) (£) (£) (£) (£) (£) (£)

Abertawe Bro Morgannwg 19,962,245 19,929,675 15,003,101 6,973,372 40,771,887 41,930,934 -1,159,047 Aneurin Bevan 2,484,000 7,995,789 7,732,953 19,815,744 12,592,093 15,963,220 -3,371,127 Betsi Cadwaladr 18,843,207 15,734,723 34,225,265 58,970,966 41,023,204 41,285,883 -262,679 Cardiff and Vale 0 27,210,163 11,741,014 5,709,127 27,935,625 43,923,905 -15,988,280 Cwm Taf 13,889,045 6,068,507 9,834,999 10,177,032 20,844,558 28,633,188 -7,788,630 Hywel Dda 1,164,375 24,846,350 16,962,086 13,369,563 27,523,281 29,881,820 -2,358,539 Powys Teaching LHB 990,640 4,020,439 3,557,543 288,329 5,196,134 4,939,738 256,396 Velindre 0 672,178 1,115,557 1,103,121 887,944 438,647 449,297

Totals excluding WAST 57,333,512 106,477,824 100,172,518 116,407,254 176,774,726 206,997,335 -30,222,609

Welsh Ambulance Services 1,642,170 5,509,839 5,301,794 2,641,872 8,122,160 7,548,611 573,549

Totals including WAST 58,975,682 111,987,663 105,474,312 119,049,126 184,896,886 214,545,946 -29,649,060

Health Board/Trust Risk Adjusted Backlog costs

250.00

200.00

150 . 00

RAB Costm² / 100.00

50.00

0.00 Powys elindre V Cwm Taf Hywel Dda Aneurin Bevan Betsi Cadwaladr Cardiff and Vale Cardiff elsh Ambulance Service W Abertawe Bro Morgannwg

RA B Costs / Occupied Floor Area (m²) All-Wales average (£105.08)

Comparison of Health Board/Trust RAB costs/occupied floor area

Estate Condition and Performance Report 2011/12 37

APPENDIX II

Summary of Health Board/Trust information

ABERTAWE BRO MORGANNWG UNIVERSITY HEALTH BOARD

Estate Condition and Performance Report 2011/12 39

APPENDIX II

Organisation: Abertawe Bro Morgannwg University Health Board

1.0 Estate profile

1.1 The Health Board’s estate covers a total land area of 139 hectares with buildings having a total gross internal floor area of just over 333,000m2.

1.2 The profile of Health Board premises includes the following: • General Acute Hospitals: 4 • Multi-service Hospitals: 1 • Short Term Non-acute Hospitals: 5 • Long Stay Hospitals: 5 • Specialist Hospitals: 6 • Community Hospitals: 2 • Other Patient Facilities: 53 • Other Support Facilities: 37

1.3 The percentage of building area and land area categorised as ‘essential’ is 78% and 90% respectively, compared with 86% and 89% last year. 1.4 Figure 1 compares the age profile of the Health Board’s estate in 2011/12 with 2001/02. It can be seen that the Health Board’s estate modernisation programme over the last 11 years has resulted in a reduction in ‘Pre 1948’ facilities from 24% to 14% and an increase in ‘post 1995’ facilities from 2% to 35%.

2% 14%

24% 1% 2% 35%

45% 13% 5%

5% 9%

15% 4% 26%

2001/02 2011/12

Pre 1948 1948 to 1954 1955 to 1964 1965 to 1974 1975 to 1984 1985 to 1994 1995 to Present

Figure 1: Age profile of the estate in 2001/02 and 2011/12

Estate Condition and Performance Report 2011/12 41 APPENDIX II

2.0 Condition of the estate 2.1 Backlog maintenance

2.1.1 Figure 2 identifies the 2011/12 Risk Adjusted Backlog (RAB) costs and compares them with the figures submitted for 2010/11. 2.1.2 Also shown are the backlog costs broken down by risk category that, in conjunction with the estimated remaining life of the building, are used to calculate the RAB costs. It can be seen that the RAB costs have decreased by just over £1.1m since the previous year.

High risk Significant Moderate risk Low risk Risk adjusted Risk adjusted Variation in Site Name backlog risk backlog backlog backlog backlog backlog risk cost cost cost cost cost cost adjusted backlog 2011-12 2010-11 (£) (£) (£) (£) (£) (£) (£) Cefn Coed Hospital 665,000 1,850,493 4,138,486 329,922 2,738,913 2,662,432 76,481 Cimla Hospital 0 0 0 37,878 1,184 970 214 Fairwood Hospital 0 0 0 0 0 13,500 -13,500 Garngoch Hospital 40,000 0 29,319 226,425 53,460 48,283 5,177 Gellinudd Hospital 0 0 0 11,611 503 352 151 Glanrhyd Hospital 305,660 290,000 342,890 584,447 626,571 255,096 371,475 Gorseinon Hospital 0 32,500 500 14,172 33,363 33,035 328 Hill House Hospital 78,345 0 85,886 58,067 85,921 83,161 2,760 Llwyneryr Hospital 0 0 600 25,910 353 500 -147 Maesgwyn Hospital 0 35,000 43,614 134,045 70,532 38,898 31,634 Maesteg Community 116,000 25,000 295,350 789,469 198,096 54,162 143,934 Morriston Hospital 1,054,394 11,594,883 6,236,214 1,032,042 12,830,983 14,472,589 -1,641,606 Neath Port Talbot Hospital 0 0 0 0 0 0 0 Princess of Wales Hospital 2,029,500 4,324,701 1,314,865 1,593,963 6,492,717 6,680,629 -187,912 Singleton Hospital 14,930,846 390,000 1,929,864 431,768 15,433,305 15,407,895 25,410 Tonna Hospital 24,000 88,000 5,450 137,955 119,170 114,008 5,162 ABM - Aggregated Sites 718,500 1,299,098 580,063 1,565,698 2,086,816 2,065,424 21,392 Health Board Totals 19,962,245 19,929,675 15,003,101 6,973,372 40,771,887 41,930,934 -1,159,047

Figure 2: Risk adjusted backlog (RAB) cost comparison and costs by risk category for 2011/12

2.2 Performance based on the national performance indicators

2.2.1 Figure 3 opposite, shows the Health Board’s 2011/12 performance for the essential estate based on the five national performance indicators and compares it with the 2010/11 figures. Figures relate to the percentage of the estate in condition category ‘B’ for Physical condition, Statutory and safety compliance (excluding Fire safety which is measured separately, also on the basis of the percentage of the estate in condition category ‘B’), and Space utilisation. Figures for Functional suitability relate to the percentage of the estate in condition category ‘F’. Energy performance is based on consumption measured in terms of kWh/m2.

42 Estate Condition and Performance Report 2011/12 APPENDIX II

National Performance Indicator 2011/122011/12 2010/112010/11

Physical condition 81% 78%

Statutory and safety compliance 73% 72%

Fire safety* 100% 100%

Functional suitability 93% 93%

Space utilisation 98% 98%

436 473 Energy performance kWh/m2 kWh/m2

* Compliance with statutory Fire Safety legislation is not included under the Statutory and safety compliance National Performance Indicator

Key

90% (current target) or above (Energy performance: 410 kWh/m2 or below)

75-89% (Energy performance: 411-479 kWh/m2)

74% or below (Energy performance: 480 kWh/m2 or above)

Figure 3: Health Board performance matrix for national performance indicators

2.2.2 The performance of Abertawe Bro Morgannwg University Health Board against that of other Health Boards/Trusts in Wales is graphically represented in Appendix XII.

3.0 Energy Performance

3.1 For 2011/12 hospitals in the Health Board recorded a net energy consumption of 129 million kWh, a decrease of 6.77% on last year’s figure of 138 million kWh. The main reason for the reduction is the decreased consumption reported generally and, in particular, at the Princess of Wales Hospital, one of the Health Board’s largest sites, which recorded a reduction of 12.41%. The only site to record an increase in energy consumption is Cefn Coed Hospital and this is because of new developments coming on line, with the rationalisation of the existing hospital yet to be completed.

3.2 Figure 4 overleaf, shows the overall energy efficiency PI, which is 436 kWh/m2, a considerable improvement compared with last year’s figure of 473 kWh/m2. However, there is still some way to go before the overall figure is below 410 kWh/m2.

Estate Condition and Performance Report 2011/12 43 APPENDIX II

Hospital Net Hospital Change on Site PI Energy Previous Year

Consumption kWh % kWh/m2 Cefn Coed Hospital 9,616,624 4.75% 455 Cimla Hospital 962,015 -6.83% 302 Fairwood Hospital 42,295 -85.04% 64 Garngoch Hospital 796,275 -3.47% 434 Gellinudd Hospital 381,667 -6.20% 421 Glanrhyd Hospital 6,049,592 -2.34% 298 Gorseinon Hospital 1,121,474 -3.31% 292 Hill House Hospital 1,796,431 -5.32% 493 Llwyneryr Hospital 394,940 -7.91% 373 Maesgwyn Hospital 75,632 -89.43% 50 Maesteg Community Hospital 1,440,296 -3.23% 459 Morriston Hospital 40,729,324 -2.29% 488 Neath Port Talbot Hospital** 9,962,579 -16.81% 338 Princess of Wales Hospital* 24,224,493 -12.41% 455 Singleton Hospital 29,654,826 -5.55% 466 Tonna Hospital 2,130,097 -12.91% 386 Health Board Totals 129,378,560 -6.77% 436

* Site with CHP installed ** PFI Hospital Key

Energy performance: 410 kWh/m2 or below

Energy performance: 411-479 kWh/m2

Energy performance: 480 kWh/m2 and above

Figure 4: Individual hospital net energy PIs

4.0 Summary

4.1 The performance of Abertawe Bro Morgannwg University Health Board against the five Welsh Government national estate performance targets continues to show a mixed picture. Targets for Functional suitability, Space utilisation have been exceeded. Of greatest concern is the performance under Statutory and safety compliance which remains in the red band. It is noted that Fire safety, currently not one of the national performance indicators, is fully compliant. 4.2 The Health Board’s RAB costs have decreased. It can be seen that the three major acute sites account for approximately 85% of the total RAB costs. The sale of Maesgwyn Hospital as part of the Health Board’s modernisation programme will have a small impact on the Health Board’s RAB costs in future years. 4.3 Energy performance figures suggest that good progress has been made by the Health Board although there is, once again, concern in relation to the three main acute hospitals.

44 Estate Condition and Performance Report 2011/12 APPENDIX III

Summary of Health Board/Trust information

ANEURIN BEVAN HEALTH BOARD

Estate Condition and Performance Report 2011/12 45

APPENDIX III

Organisation: Aneurin Bevan Health Board

1.0 Estate profile

1.1 The Health Board’s estate covers a total land area of 128 hectares with buildings having a total gross internal floor area of just over 330,000m2.

1.2 The profile of Health Board premises includes the following: • General Acute Hospitals: 3 • Multi-service Hospitals: 2 • Short Term Non-acute Hospitals: 2 • Long Stay Hospitals: 3 • Specialist Hospitals: 1 • Community Hospitals: 6 • Other Patient Facilities: 42 • Other Support Facilities: 11

1.3 The percentage of the building area and land area categorised as ‘essential’ is 85% and 92% respectively, compared with 88% and 91% last year.

5% 10% 19% 24% 29%

1%

18% 7% 12%

2%

16% 17% 20% 20%

2001/02 2011/12

Pre 1948 1948 to 1954 1955 to 1964 1965 to 1974 1975 to 1984 1985 to 1994 1995 to Present

Figure 1: Age profile of the estate in 2001/02 and 2011/12

1.4 Figure 1 compares the age profile of the Health Board’s estate in 2011/12 with 2001/02. It can be seen that the Health Board’s modernisation programme over the last 11 years has resulted in a reduction in ‘Pre 1948’ facilities from 29% to 19% and an increase in ‘Post 1995’ facilities from 5% to 24%. During this period the Health Board has delivered two new hospitals, Ysbyty Aneurin Bevan in Ebbw Vale and Ysbyty Ystrad Fawr in Ystrad Mynach. The business case for a Specialist Critical Care Centre (SCCC) is progressing.

Estate Condition and Performance Report 2011/12 47 APPENDIX III

2.0 Condition of the estate 2.1 Backlog maintenance

2.1.1 Figure 2 identifies the 2011/12 Risk Adjusted Backlog (RAB) costs and compares them with the figures submitted for 2010/11. 2.1.2 Also shown are the backlog costs broken down by risk category that, in conjunction with the estimated remaining life of the building, are used to calculate the RAB costs. It can be seen that these have decreased by in excess of £3m compared with 2010/11. It is noted that Nevill Hall and Royal Gwent Hospitals account for approximately 72% of the RAB costs.

High risk Significant Moderate risk Low risk Risk adjusted Risk adjusted Variation in Site Name backlog risk backlog backlog backlog backlog backlog risk cost cost cost cost cost cost adjusted 2011-12 2010-11 backlog (£) (£) (£) (£) (£) (£) (£) Blaenavon Health Care Unit 0 4,140 39,258 144,269 14,936 13,932 1,004 Caerphilly District Miners 0 0 0 0 0 1,125,905 -1,125,905 Chepstow Community 0 17,595 21,119 0 18,098 17,819 279 County Hospital 0 416,070 865,416 2,603,949 598,668 577,723 20,945 Llanfrechfa Grange Hospital 0 252,540 194,108 713,343 309,256 300,503 8,753 Maindiff Court Hospital 0 156,285 139,729 378,731 188,688 234,527 -45,839 Monnow Vale Health Care 0 0 0 0 0 0 0 Nevill Hall Hospital 621,000 2,471,580 2,605,065 4,140,000 3,654,669 3,815,569 -160,900 Redwood Memorial Hospital 0 39,330 25,185 22,088 41,694 61,605 -19,911 Royal Gwent Hospital 1,863,000 3,146,400 1,523,056 3,881,250 5,459,759 6,006,907 -547,148 Serennu Childrens Centre 0 0 0 0 0 0 0 St Cadoc's Hospital 0 169,740 331,499 1,701,602 354,567 331,009 23,558 St Woolos Hospital 0 1,122,975 1,380,564 4,807,168 1,638,619 1,566,800 71,819 Talygarn & Ty Siriol 0 40,779 80,241 3,743 43,890 43,094 796 Ty Sirhowy Unit 0 0 0 0 0 5,518 -5,518 Ysbyty Aneurin Bevan 0 0 0 0 0 0 0 Ysbyty Ystrad Fawr 0 0 0 0 0 0 0 Ysbytyr Tri Chwm 0 47,610 51,610 127,822 54,511 53,350 1,161 Ystrad Mynach Hospital 0 0 0 0 0 1,604,903 -1,604,903 AB - Aggregated Sites 0 110,745 476,103 1,291,779 214,738 204,056 10,682 Health Board Totals 2,484,000 7,995,789 7,732,953 19,815,744 12,592,093 15,963,220 -3,371,127

Figure 2: Risk adjusted backlog (RAB) cost comparison and costs by risk category for 2011/12

2.2 Performance based on the national performance indicators

2.2.1 Figure 3 opposite, shows the Health Board’s 2011/12 performance for the essential estate based on the five national performance indicators, and compares it with the 2010/11 figures. Figures relate to the percentage of the estate in condition category ‘B’ for Physical condition, Statutory and safety compliance (excluding Fire safety which is measured separately, also on the basis of the percentage of the estate in condition category ‘B’) and Space utilisation. Figures for Functional suitability relate to the percentage of the estate in condition category ‘F’. Energy performance is based on consumption measured in terms of kWh/m2.

48 Estate Condition and Performance Report 2011/12 APPENDIX III

National Performance Indicator 2011/12 2010/11

Physical condition 81% 76%

Statutory and safety compliance 88% 86%

Fire safety* 95% 95%

Functional suitability 82% 74%

Space utilisation 81% 76%

356 407 Energy performance kWh/m2 kWh/m2

* Compliance with statutory Fire Safety legislation is not included under the Statutory and safety compliance National Performance Indicator

Key

90% (current target) or above (Energy performance: 410 kWh/m2 or below)

75-89% (Energy performance: 411-479 kWh/m2)

74% or below (Energy performance: 480 kWh/m2 or above)

Figure 3: Health Board performance matrix for national performance indicators

2.2.2 The performance of Aneurin Bevan Health Board against that of other Health Boards/Trusts in Wales is graphically represented in Appendix XII.

3.0 Energy Performance

3.1 In 2011/12, hospitals in the Health Board recorded a net energy consumption of 108 million kWh compared with 109 million kWh last year, a decrease of 1.1%. As in the last three years, the energy consumption at the Royal Gwent Hospital and St Woolos Hospital sites has been aggregated to avoid the inaccuracies caused by the method of apportionment of energy used previously.

3.2 Figure 4 overleaf, shows the overall PI is 355 kWh/m2 compared with last year’s figure of 407 kWh/m2. This is a considerable improvement, albeit partly achieved as a result of reduced energy consumption at a number of hospitals that are due to be decommissioned whilst still being included in the overall gross internal floor area. This is a unique set of circumstance as in forthcoming years we will see consumption averaging out as the older hospital sites close and the new sites are fully commissioned. The individual hospital PIs suggest that savings can be made by focusing on poorer performing hospitals and, in particular, Nevill Hall and Royal Gwent Hospitals where, for example, the CHP is now no longer operational.

Estate Condition and Performance Report 2011/12 49 APPENDIX III

Hospital Net Hospital Change on Site PI Energy Previous

Consumption Year

(kWh) (%) (kWh/m2)

Blaenavon Health Care Unit 337,005 -22.95% 256 Caerphilly District Miners Hospital 3,213,667 -42.27% 247 Chepstow Community Hospital** 2,116,965 -14.04% 347 County Hospital 5,326,470 -1.87% 426 Llanfrechfa Grange Hospital 3,501,607 -25.78% 181 Maindiff Court Hospital 2,288,657 14.90% 448 Monnow Vale Health & Social Care Facility 923,231 -24.55% 357 Nevill Hall Hospital* 23,077,268 0.25% 432 Redwood Memorial Hospital 500,148 -14.91% 545 Royal Gwent /St Woolos Hospital* 44,646,599 -8.36% 446 Serennu Children’s Centre 959,616 237 St Cadoc's Hospital* 5,907,229 6.64% 236 St Woolos Hospital 0 0 0 Talygarn & Ty Siriol 1,227,791 -10.99% 330 Tredegar General Hospital 678,399 -47.78% 224 Ty Sirhowy Unit 103,899 -61.42% 81 Ysbyty Aneurin Bevan 4,170,401 209.77% 319 Ysbyty Ystrad Fawr 6,821,948 224 Ysbyty Tri Chwm 1,092,018 -4.18% 354 Ystrad Mynach Hospital 1,833,620 -48.64% 246 Health Board Totals 108,726,538 -1.03% 356 * Site with CHP installed ** PFI Hospital Key

Energy performance: 410 kWh/m2 or below

Energy performance: 411-479 kWh/m2

Energy performance: 480 kWh/m2 and above

Figure 4: Individual hospital net energy PIs

50 Estate Condition and Performance Report 2011/12 APPENDIX III

4.0 Summary

4.1 With the exception of the Energy performance indicator, the performance of Aneurin Bevan Health Board against the five Welsh Government national estate performance indicator targets leaves room for considerable improvement. However, the significant improvement in Functional suitability performance, which has moved from the red band to the amber band, is noted, as is the excellent performance under Fire safety which is currently not one of the five national performance indicators. 4.2 As was the case last year, the Health Board’s RAB costs have seen a significant reduction, again, largely as a result of the modernisation programme which has seen the closure of more poorly performing hospitals and the opening of Ysbyty Ystrad Fawr. Subject to business case approval, the new Specialist and Critical Care Centre (SCCC) is expected to further support the Board’s modernisation programme leading to reductions in backlog maintenance costs. 4.3 Energy performance figures suggest that considerable progress has been made by the Health Board; however, improved energy performance at the Royal Gwent and Nevill Hall Hospitals will further improve energy efficiency.

Estate Condition and Performance Report 2011/12 51

APPENDIX IV

Summary of Health Board/Trust information

BETSI CADWALADR UNIVERSITY HEALTH BOARD

Estate Condition and Performance Report 2011/12 53

APPENDIX IV

Organisation: Betsi Cadwaladr University Health Board

1.0 Estate profile

1.1 The Health Board’s estate covers a total land area of 147 hectares with buildings having a total gross internal floor area of just over 394,000m2.

1.2 The profile of Health Board premises includes the following: • General Acute Hospitals: 4 • Multi-service Hospitals: 1 • Short Term Non-acute Hospitals: 11 • Long Stay Hospitals: 3 • Specialist Hospitals: 1 • Community Hospitals: 15 • Other Patient Facilities: 88 • Other Support Facilities: 12

1.3 The percentage of building area and land area categorised as ‘essential’ is 96% and 95% respectively, compared with 87% and 93% last year. 1.4 Figure 1 compares the age profile of the Health Board’s estate in 2011/12 with 2001/02. It can be seen that the Health Board’s modernisation programme over the last 11 years has resulted in a reduction in ‘Pre 1948’ facilities from 30% to 22% and an increase in ‘Post 1995’ facilities from 8% to 19%.

8% 19% 22% 30% 18%

1% 2%

10% 1% 18%

11.00%

32% 28%

2001/02 2011/12

Pre 1948 1948 to 1954 1955 to 1964 1965 to 1974 1975 to 1984 1985 to 1994 1995 to Present

Figure 1: Age profile of the estate in 2001/02 and 2011/12

Estate Condition and Performance Report 2011/12 55 APPENDIX IV

2.0 Condition of the estate 2.1 Backlog maintenance

2.1.1 Figure 2 identifies the 2011/12 Risk Adjusted Backlog (RAB) costs comparing these with the figures submitted for 2010/11. 2.1.2 Also shown are the backlog costs broken down by risk category that, in conjunction with the estimated remaining life of the building, are used to calculate the RAB costs. It can be seen that the RAB costs have decreased by just over £260,000 when compared with the previous year.

High risk Significant Moderate risk Low risk Risk adjusted Risk adjusted Variation in Site Name backlog risk backlog backlog backlog backlog backlog risk cost cost cost cost cost cost adjusted 2011-12 2010-11 backlog (£) (£) (£) (£) (£) (£) (£) Abergele Hospital 75,000 420,000 2,500,000 804,466 710,000 581,630 128,370 Ablett Unit 0 90,000 185,000 246,995 109,750 12,500 97,250 Bodnant Psychiatric Unit 0 60,000 195,000 231,000 107,200 84,200 23,000 Bryn Beryl Hospital 4,647 35,160 173,267 99,884 51,682 50,177 1,505 Bryn Hesketh 0 0 35,000 99,450 4,480 4,480 0 Bryn-y-Neuadd Hospital 297,692 847,360 360,867 163,989 1,568,576 1,629,657 -61,081 Cefni Hospital 30,554 17,929 6,742 3,925 48,778 47,358 1,420 Chirk Community Hospital 0 0 6,000 0 250 250 0 Coed Celyn 0 0 0 0 0 0 0 Colwyn Bay Community 0 140,000 215,400 230,000 162,000 192,270 -30,270 Deeside Community Hospital 0 0 24,000 5,000 906 906 0 Denbigh Community 0 30,000 60,000 455,138 50,273 30,106 20,167 Dolgellau & Barmouth 10,841 161,552 161,446 60,831 180,994 175,674 5,320 Eryri Hospital 406,272 531,139 468,129 102,960 958,562 930,643 27,919 Ffestiniog Memorial Hospital 6,704 59,616 32,278 137,655 74,107 71,949 2,158 Flint Community Hospital 0 0 25,000 0 5,000 5,000 0 Glan Traeth Day Hospital 0 0 30,000 120,600 7,920 6,405 1,515 Glan Traeth Ward 0 25,000 15,100 148,000 34,500 10,155 24,345 Hafod MHRC 0 6,497 0 151,987 13,000 7,849 5,151 HM Stanley Hospital 110,565 1,180,650 450,000 1,353,785 1,892,476 1,892,476 0 Holywell Community 0 0 0 0 0 0 0 Llandudno General Hospital 104,028 723,098 583,023 96,125 855,506 765,540 89,966 Llangollen Community 0 220,000 668,500 454,500 361,270 180,950 180,320 Mold Community Hospital 0 0 5,000 25,000 1,200 1,200 0 Nant Y Glyn Day Hospital 0 30,000 40,000 160,000 41,150 9,160 31,990 Penley Hospital 0 0 0 0 0 0 0 Prestatyn Community 0 60,000 12,000 116,750 66,712 6,362 60,350 Royal Alexandra Hospital 180,000 575,000 2,700,000 1,034,529 1,066,210 1,066,210 0 Ruthin Community Hospital 0 103,000 125,000 198,000 119,250 38,400 80,850 Tywyn & District Hospital 10,464 73,020 230,015 68,088 95,908 93,115 2,793 Ysbyty Alltwen 0 0 0 0 0 0 0 Ysbyty Glan Clwyd 8,110,000 2,000,000 15,438,920 43,254,864 13,660,500 14,666,498 -1,005,998 Ysbyty Gwynedd 8,813,171 3,442,905 932,668 4,183,248 12,478,543 12,104,187 374,356 Ysbyty Maelor 365,000 3,682,000 3,105,000 2,961,500 4,178,663 4,502,738 -324,075 Ysbyty Penrhos Stanley 16,765 242,904 50,580 25,290 262,588 262,588 0 BC - Aggregated Sites 301,504 977,893 5,391,330 1,977,407 1,855,250 1,855,250 0 Health Board Totals 18,843,207 15,734,723 34,225,265 58,970,966 41,023,204 41,285,883 -262,679

Figure 2: Risk adjusted backlog (RAB) costs and costs by risk band

56 Estate Condition and Performance Report 2011/12 APPENDIX IV

2.2 Performance based on the national performance indicators 2.2.1 Figure 3 shows the Health Board’s 2011/12 performance for the essential estate based on the five national performance indicators and compares it with the 2010/11 figures. Figures relate to the percentage of the estate in condition category ‘B’ for Physical condition, Statutory and safety compliance (excluding Fire safety which is measured separately, also on the basis of the percentage of the estate in condition category ‘B’), and Space utilisation. Figures for Functional suitability relate to the percentage of the estate in condition category ‘F’. Energy performance is based on consumption measured in terms of kWh/m2.

National Performance Indicator 2011/12 2010/11

Physical condition 83% 83%

Statutory and safety compliance 82% 86%

Fire safety* 86% 80%

Functional suitability 67% 64%

Space utilisation 90% 88%

418 435 Energy performance kWh/m2 kWh/m2

* Compliance with statutory Fire safety legislation is not included under the Statutory and safety compliance National Performance Indicator.

Key

90% (current target) or above (Energy performance: 410 kWh/m2 or below)

75-89% (Energy performance: 411-479 kWh/m2)

74% or below (Energy performance: 480 kWh/m2 or above)

Figure 3: Health Board performance matrix for national performance indicators

2.2.2 The performance of Betsi Cadwaladr University Health Board against that of other Health Boards/ Trusts in Wales is graphically represented in Appendix XII.

3.0 Energy Performance

3.1 In 2011/12 hospitals in the Health Board recorded a net energy consumption of 149 million kWh compared with 151 million kWh last year, a decrease of 1.5%.

3.2 Figure 4 overleaf, shows the overall Health Board PI is 418 kWh/m2 compared with last year’s figure of 435 kWh/m2, indicating that good progress has been made with regard to energy efficiency. It can be seen that three hospitals lie within the red zone, suggesting that significant improvements should be made here and in particular at Ysbyty Glan Clwyd, the largest of the three. Similarly, it is noted that Ysbyty Gwynedd sits within the upper limit of the amber zone, only marginally better than the red zone threshold of 479 kWh/m2.

Estate Condition and Performance Report 2011/12 57 APPENDIX IV

Hospital Net Hospital Change on Site PI Energy Previous Consumption Year 2 (kWh) (%) (kWh/m ) Abergele Hospital 6,210,900 -0.60% 436 Ablett Unit 1,012,281 -0.57% 268 Bodnant Psychiatric Unit 361,904 -29.27% 294 Bryn Beryl Hospital 801,761 -11.95% 379 Bryn Hesketh EMI 409,765 -10.37% 332 Bryn-y-Neuadd Hospital 6,179,707 -22.22% 270 Cefni Hospital 1,169,551 -6.03% 443 Chirk Community Hospital 1,137,876 -0.35% 466 Coed Celyn Support Unit 128,833 -8.42% 440 Colwyn Bay Community Hospital 1,322,812 -17.28% 284 Deeside Community Hospital 2,063,343 -5.21% 444 Denbigh Community Hospital 1,137,175 -10.44% 350 Dolgellau & Barmouth District Hospital 1,436,571 5.53% 588 Eryri Hospital 1,793,156 0.54% 352 Ffestiniog Memorial Hospital 335,341 -2.10% 389 Flint Community Hospital 355,576 -20.27% 400 Glan Traeth Day Hospital (EMI) 153,876 -16.20% 294 Glan Traeth Ward 232,003 -9.01% 368 Hafod MHRC 182,251 -13.24% 214 HM Stanley Hospital 5,048,355 6.06% 473 Holywell Community Hospital 1,521,956 -7.07% 320 Llandudno General Hospital 5,231,101 -6.84% 428 Llangollen Community Hospital 465,900 10.22% 379 Mold Community Hospital 1,513,358 -3.10% 454 Nant y Glyn Resource Centre & Day Hospital 253,544 -13.11% 237 Penley Hospital 187,938 190.65% 475 Prestatyn Community Hospital 261,708 -12.63% 303 Royal Alexandra Hospital 1,530,470 -17.24% 160 Ruthin Community Hospital 851,136 57.29% 343 Tywyn & District War Memorial Hospital 1,012,433 -13.63% 484 Ysbyty Alltwen 2,207,610 -11.70% 309 Ysbyty Glan Clwyd* 34,435,696 -7.79% 500 Ysbyty Gwynedd* 30,462,840 -5.20% 478 Ysbyty Maelor 35,820,790 19.49% 402 Ysbyty Penrhos Stanley 2,096,782 -3.81% 460 Health Board Totals 149,326,299 -1.50% 418 * Site with CHP installed Key

Energy performance: 410 kWh/m2 or below

Energy performance: 411-479 kWh/m2

Energy performance: 480 kWh/m2 and above

Figure 4: Individual hospital net energy PIs

58 Estate Condition and Performance Report 2011/12 APPENDIX IV

4.0 Summary

4.1 The performance of Betsi Cadwaladr University Health Board against the five Welsh Government national estate performance indicator targets presents a mixed picture. It is noted that the Space utilisation target has been met whilst Functional suitability remains in the red band. Performance with the other indicators demonstrates that there is considerable scope for improvement. 4.2 The very small reduction in RAB costs is noted along with the fact that approximately 73% of RAB costs are associated with the Health Board’s three largest hospitals, Ysbyty Glan Clwyd, Ysbyty Gwynedd and Ysbyty Maelor. On a more positive note, the major refurbishment programme at Ysbyty Glan Clwyd, currently underway, is expected to significantly reduce backlog maintenance costs at this hospital upon completion. 4.3 Energy performance figures suggest that good progress has been made. However, there is scope for improvement, especially at Ysbyty Glan Clwyd and Ysbyty Gwynedd, two of the largest hospitals in the Health Board’s estate.

Estate Condition and Performance Report 2011/12 59

APPENDIX V

Summary of Health Board/Trust information

CARDIFF AND VALE UNIVERSITY HEALTH BOARD

Estate Condition and Performance Report 2011/12 61

APPENDIX V

Organisation: Cardiff and Vale University Health Board

1.0 Estate profile

1.1 The Health Board’s estate covers a total land area of 88 hectares with buildings having a total gross internal floor area of just over 369,000m2.

1.2 The profile of Health Board premises includes the following: • General Acute Hospitals: 1 • Multi-service Hospitals: 1 • Short Term Non-acute Hospitals: 0 • Long Stay Hospitals: 2 • Specialist Hospitals: 1 • Community Hospitals: 2 • Other Patient Facilities: 31 • Other Support Facilities: 20

1.3 The percentage of building area and land area categorised as ‘essential’ has reduced from 98% to 89% and 84% to 66% respectively. This is due to the Health Board’s re-categorisation of Whitchurch Hospital from essential to non-essential. 1.4 Figure 1 compares the age profile of the Health Board’s estate in 2011/12 with 2001/02. It can be seen that the Health Board’s modernisation programme over the last 11 years has resulted in a reduction in ‘Pre 1948’ facilities from 43% to 27% and an increase in ‘Post 1995’ facilities from 3% to 20%.

3% 6% 1% 20% 27%

43% 5%

2% 1% 2%

45%

2% 43%

2001/02 2011/12

Pre 1948 1948 to 1954 1955 to 1964 1965 to 1974 1975 to 1984 1985 to 1994 1995 to Present

Figure 1: Age profile of the estate in 2001/02 and 2011/12

Estate Condition and Performance Report 2011/12 63 APPENDIX V

2.0 Condition of the estate 2.1 Backlog maintenance

2.1.1 Figure 2 identifies the 2011/12 Risk Adjusted Backlog (RAB) costs and compares them with the figures submitted for 2010/11. 2.1.2 Also shown are the backlog costs broken down by risk category that, in conjunction with the estimated remaining life of the building, are used to calculate the RAB costs. It can be seen that, compared with the previous year, RAB costs have decreased by nearly £16m, largely as a result of the major refurbishment work being undertaken at the Cardiff Royal Infirmary (CRI). Notwithstanding this reduction, it is noted that 81% of the RAB costs are associated with the CRI. On completion of the CRI refurbishment work, the Health Board’s backlog maintenance burden is expected to reduce very significantly.

High risk Significant Moderate risk Low risk Risk adjusted Risk adjusted Variation in Site Name backlog risk backlog backlog backlog backlog backlog risk cost cost cost cost cost cost adjusted backlog 2011-12 2010-11 (£) (£) (£) (£) (£) (£) (£) Barry Hospital 0 96,720 28,222 27,450 98,758 98,758 0 Cardiff Royal Infirmary 0 22,037,869 0 0 22,037,869 37,562,096 -15,524,227 CRI - West Wing 0 899,109 785,508 180,581 952,781 1,095,237 -142,456 Fieldway Pharmacy 0 0 0 0 0 0 0 Iorweth Jones Centre 0 0 0 0 0 0 0 Llandough Hospital 0 471,316 530,863 109,572 496,681 496,680 1 Rookwood Hospital 0 1,279,455 188,862 110,227 1,294,153 1,294,689 -536 St David's Hospital 0 0 0 0 0 0 0 University Hospital of Wales 0 1,254,182 5,764,499 2,121,284 1,601,402 1,930,747 -329,345 Whitchurch Hospital 0 557,071 3,121,488 2,417,690 741,748 749,522 -7,774 C&V - Aggregated Sites 0 614,441 1,321,572 742,323 712,233 696,176 16,057 Health Board Totals 0 27,210,163 11,741,014 5,709,127 27,935,625 43,923,905 -15,988,280

Figure 2: Risk adjusted backlog (RAB) costs and costs by risk band

2.2 Performance based on the national performance indicators

2.2.1 Figure 3 opposite, shows the Health Board’s 2011/12 performance for the essential estate based on the five national performance indicators, and compares them with the 2010/11 figures. Figures relate to the percentage of the estate in condition category ‘B’ for Physical condition, Statutory and safety compliance (excluding Fire safety which is measured separately, also on the basis of the percentage of the estate in condition category ‘B’), and Space utilisation. Figures for Functional suitability relate to the percentage of the estate in condition category ‘F’. Energy performance is based on consumption measured in terms of kWh/m2.

64 Estate Condition and Performance Report 2011/12 APPENDIX V

National Performance Indicator 2011/12 2010/11

Physical condition 87% 82%

Statutory and safety compliance 90% 88%

Fire safety* 95% 95%

Functional suitability 82% 80%

Space utilisation 91% 90%

381 422 Energy performance kWh/m2 kWh/m2

* Compliance with statutory Fire Safety legislation is not included under the Statutory and safety compliance National Performance Indicator

Key

90% (current target) or above (Energy performance: 410 kWh/m2 or below)

75-89% (Energy performance: 411-479 kWh/m2)

74% or below (Energy performance: 480 kWh/m2 or above)

Figure 3: Health Board performance matrix for national performance indicators

2.2.2 The performance of Cardiff and Vale University Health Board against that of other Health Boards/ Trusts in Wales is graphically represented in Appendix XII.

3.0 Energy Performance

3.1 In 2011/12 hospitals in the Health Board recorded a net energy consumption of 134 million kWh, a reduction of 9.56% on last year’s figure of 150 million kWh.

3.2 Figure 4 overleaf, shows the overall PI of 381 kWh/m2 compared with last year’s figure of 422 kWh/m2. 3.3 This year’s figures show considerable progress has been made. However, it should be noted that the large fall in energy consumption at the CRI, due to the ongoing reconfiguration and construction work at this facility, together with the mild winter conditions have contributed to this reduction. On a particularly positive note, Cardiff and Vale University Health Board should be commended for being responsible for over 50% of the total installed CHP capacity in NHS Wales, and over 60% in terms of the electricity generated from CHP.

Estate Condition and Performance Report 2011/12 65 APPENDIX V

Net Hospital Hospital Change on Energy Site PI Previous Year Consumption (kWh) (%) (kWh/m2) Barry Hospital 1,091,424 -1.18% 156 Cardiff Royal Infirmary 3,099,984 -41.45% 124 CRI - West Wing 2,417,462 -14.63% 327 Iorwerth Jones Centre 939,917 -16.15% 384 Llandough Hospital* 28,140,146 -2.37% 475 Rookwood Hospital 6,677,317 -20.26% 532 St David’s Hospital ** 3,064,083 -14.09% 261 University Hospital of Wales* 80,644,939 -9.88% 411 Whitchurch Hospital 8,135,502 -15.21% 248 Health Board Totals 134,210,774 -9.56% 381

* Site with CHP installed ** PFI Hospital Key

Energy performance: 410 kWh/m2 or below

Energy performance: 411-479 kWh/m2

Energy performance: 480 kWh/m2 and above

Figure 4: Individual hospital net energy PIs

4.0 Summary

4.1 With three of the five National Performance Indicator targets having been met, the performance of Cardiff and Vale University Health Board demonstrates the benefits of moving towards a more modern estate. The excellent Fire safety performance, which is currently not included amongst the National Performance Indicators, is noted. Whilst there have been improvements in Physical condition and Functional suitability, there is scope for significant improvement in these areas. 4.2 The high backlog maintenance figure for the Health Board continues to be accounted for by the CRI, although, as reported last year, this hospital has now been given a long term future. The current modernisation programme at this site will, on completion, have a significant impact on the Health Board’s backlog maintenance costs. 4.3 Considerable progress has been made with regard to energy efficiency, which is reflected in the performance indicators. They also show that Llandough Hospital, which is the second largest consumer of energy at the Health Board, is at the top end of the amber zone almost in the red area, indicating that it is a prime location for energy efficiency measures to be targeted.

66 Estate Condition and Performance Report 2011/12 APPENDIX VI

Summary of Health Board/Trust information

CWM TAF HEALTH BOARD

Estate Condition and Performance Report 2011/12 67

APPENDIX VI

Organisation: Cwm Taf Health Board

1.0 Estate profile

1.1 The Health Board’s estate covers a total land area of 74 Hectares with buildings having a total gross internal floor area of 180,000m2.

1.2 The profile of Health Board premises includes the following: • General Acute Hospitals: 2 • Multi-service Hospitals: 1 • Short Term Non-acute Hospitals: 0 • Long Stay Hospitals: 4 • Specialist Hospitals: 2 • Community Hospitals: 0 • Other Patient Facilities: 21 • Other Support Facilities: 4

1.3 The percentage of building area and land area categorised as ‘essential’ is 84% and 67% respectively, compared with 85% and 67% last year. 1.4 Figure 1 compares the age profile of the Health Board’s estate in 2011/12 with 2001/02. It can be seen that the Health Board’s modernisation programme over the last 11 years has resulted in a reduction in ‘Pre 1948’ facilities from 26% to 16% and an increase in ‘Post 1995’ facilities from 30% to 48%. 1.5 The refurbishment programme to the wards at Prince Charles Hospital is near completion. The new Ysbyty Cwm Cynon has opened and the new Keir Hardie Health Park is due to open shortly. Mountain Ash hospital has been sold and plans are progressing for the disposal of Aberdare and St Tydfil’s hospitals. Seymour Berry Health Centre has also been sold and plans are progressing to dispose of the Hollies Health Centre.

16% 30% 26% 1%

48% 10%

11% 9% 16%

24% 9%

2001/02 2011/12

Pre 1948 1948 to 1954 1955 to 1964 1965 to 1974 1975 to 1984 1985 to 1994 1995 to Present

Figure 1: Age profile of the estate in 2001/02 and 2011/12

Estate Condition and Performance Report 2011/12 69 APPENDIX VI

2.0 Condition of the estate 2.1 Backlog maintenance

2.1.1 Figure 2 identifies the 2011/12 Risk Adjusted Backlog (RAB) costs and compares them with the figures submitted for 2010/11. 2.1.2 Also shown are the backlog costs broken down by risk category that, in conjunction with the estimated remaining life of the building, are used to calculate the RAB costs. It can be seen that, compared with the previous year, the RAB costs have decreased by almost £7.8m, largely as a result of the refurbishment works at Prince Charles Hospital.

High risk Significant Moderate risk Low risk Risk adjusted Risk adjusted Variation in Site Name backlog risk backlog backlog backlog backlog backlog risk adjusted cost cost cost cost cost cost backlog 2011-12 2010-11 (£) (£) (£) (£) (£) (£) (£) Aberdare General Hospital 3,332,109 989,752 1,979,507 1,484,632 4,450,162 4,445,581 4,581 Dewi Sant Hospital 38,110 55,953 18,540 0 94,702 94,682 20 Mountain Ash General 2,854,800 937,900 1,474,069 2,024,511 4,042,599 3,964,672 77,927 Pontypridd & District 46,350 105,090 10,590 0 151,881 151,864 17 Prince Charles Hospital 7,224,452 2,274,632 4,836,701 5,625,833 9,872,746 15,861,315 -5,988,569 Royal Glamorgan Hospital 0 504,120 397,298 149,356 528,968 543,524 -14,556 St Tydfil's Hospital 155,500 573,650 631,300 742,580 809,966 2,776,632 -1,966,666 Tonteg Hospital 20,394 129,780 239,930 0 164,288 163,200 1,088 Ysbyty Cwm Rhondda 0 0 0 0 0 0 0 Ysbyty George Thomas 10,300 250,680 46,350 29,703 263,797 283,903 -20,106 CT - Aggregated Site 207,030 246,950 200,714 120,417 465,449 347,815 117,634 Health Board Totals 13,889,045 6,068,507 9,834,999 10,177,032 20,844,558 28,633,188 -7,788,630

Figure 2: Risk adjusted backlog (RAB) costs and costs by risk band

2.2 Performance based on the national performance indicators

2.2.1 Figure 3 opposite, shows the Health Board’s 2011/12 performance for the essential estate based on the five national performance indicators and compares it with the 2010/11 figures. Figures relate to the percentage of the estate in condition category ‘B’ for Physical condition, Statutory and safety compliance (excluding Fire safety which is measured separately, also on the basis of the percentage of the estate in condition category ‘B’), and Space utilisation. Figures for Functional suitability relate to the percentage of the estate in condition category ‘F’. Energy performance is based on consumption measured in terms of kWh/m2.

70 Estate Condition and Performance Report 2011/12 APPENDIX VI

National Performance Indicator 2011/12 2010/11

Physical condition 83% 83%

Statutory and safety compliance 82% 82%

Fire safety* 74% 74%

Functional suitability 77% 77%

Space utilisation 94% 94%

426 439 Energy performance kWh/m2 kWh/m2

* Compliance with statutory Fire Safety legislation is not included under the Statutory and safety compliance National Performance Indicator

Key

90% (current target) or above (Energy performance: 410 kWh/m2 or below)

75-89% (Energy performance: 411-479 kWh/m2)

74% or below (Energy performance: 480 kWh/m2 or above)

Figure 3: Health Board performance matrix for national performance indicators

2.2.2 The performance of Cwm Taf Health Board against that of other Health Boards/Trusts in Wales is graphically represented in Appendix XII.

3.0 Energy Performance

3.1 In 2011/12 hospitals in the Health Board recorded a net energy consumption of 69 million kWh, a decrease of 2.36% on last year’s figure of 71 million kWh.

3.2 Figure 4 overleaf, shows the overall PI of 426 kWh/m2 compared with last year’s figure of 439 kWh/m2. 3.3 The above figures indicate an overall improvement in energy efficiency. However, it should be noted that the Royal Glamorgan Hospital, the largest energy consumer in the Health Board, is now in the red zone with a consumption increase on last year’s figures. The CHP installations at both Royal Glamorgan and Prince Charles Hospitals have not operated fully this year and maximising the use of these should be a priority.

Estate Condition and Performance Report 2011/12 71 APPENDIX VI

Hospital Net Hospital Energy Change on Site PI Consumption Previous Year (kWh) (%) (kWh/m2) Aberdare General Hospital 3,835,336 -7.65% 355 Dewi Sant Hospital 2,507,996 -6.96% 280 Mountain Ash General Hospital 898,136 -11.05% 234 Pontypridd & District Hospital 828,903 1.34% 335 Prince Charles Hospital* 24,170,796 -2.21% 462 Royal Glamorgan Hospital* 25,841,031 2.61% 506 St Tydfil's Hospital 4,507,607 -8.84% 342 Tonteg Hospital 684,151 0.79% 418 Ysbyty Cwm Rhondda 4,300,644 -13.40% 299 Ysbyty George Thomas 2,255,976 -3.95% 420 LHB Totals 69,830,576 -2.36% 426

* Site with CHP installed Key

Energy performance: 410 kWh/m2 or below

Energy performance: 411-479 kWh/m2

Energy performance: 480 kWh/m2 and above

Figure 4: Individual hospital net energy PIs

4.0 Summary

4.1 The performance of Cwm Taf Health Board against the five Welsh Government national estate performance indicator targets remains very similar to last year. Space utilisation target has again been met and remains in the green band. There are no changes in performance for Physical condition, Statutory and safety compliance, Functional suitability and Energy performance and therefore remain in the amber band. It is noted that Fire safety, currently not one of the national performance indicators, remains in the red band, indicating there is scope for significant improvement. 4.2 The Health Board’s significant reduction in RAB costs is noted. It is noticeable that Prince Charles Hospital accounts for 47% (£9.9m) of the Health Board’s RAB, and Aberdare General, Mountain Ash and St Tydfil’s Hospitals jointly account for 44% (£9.3m). On completion of the refurbishment works at Prince Charles Hospital and the disposal of the three above mentioned hospitals, the Health Board’s backlog maintenance burden will be significantly reduced. 4.3 Energy consumption has decreased overall. However, the Health Board needs to concentrate its efforts on improving efficiency at both the Royal Glamorgan and Prince Charles Hospitals. These are the Heath Board’s major energy consuming sites and their energy efficiency performance indicators show that efforts to improve performance need to be concentrated at these locations, for maximum impact.

72 Estate Condition and Performance Report 2011/12 APPENDIX VII

Summary of Health Board/Trust information

HYWEL DDA HEALTH BOARD

Estate Condition and Performance Report 2011/12 73

APPENDIX VII

Organisation: Hywel Dda Health Board

1.0 Estate profile

1.1 The Health Board’s estate covers a total land area of 56 Hectares with buildings having a total gross internal floor area of 183,000m 2.

1.2 The profile of Health Board premises includes the following: • General Acute Hospitals: 4 • Multi-service Hospitals: 0 • Short Term Non-acute Hospitals: 0 • Long Stay Hospitals: 0 • Specialist Hospitals: 2 • Community Hospitals: 6 • Other Patient Facilities: 31 • Other Support Facilities: 30

1.3 The percentage of building area and land area categorised as ‘essential’ is 97% and 96% respectively, remaining unchanged from last year. 1.4 Figure 1 compares the age profile of the Health Board’s estate in 2011/12 with 2001/02. It can be seen that the Health Board’s modernisation programme over the last 11 years has resulted in a reduction of ‘Pre 1948’ facilities from 23% to 9% and an increase in Post 1995’ facilities from 7% to 18%.

7% 9% 18% 2% 23% 15%

24% 19%

20% 18%

7%

17% 21%

2001/02 2011/12

Pre 1948 1948 to 1954 1955 to 1964 1965 to 1974 1975 to 1984 1985 to 1994 1995 to Present

Figure 1: Age profile of the estate in 2001/02 and 2011/12

Estate Condition and Performance Report 2011/12 75 APPENDIX VII

2.0 Condition of the estate 2.1 Backlog maintenance

2.1.1 Figure 2 identifies the 2011/12 Risk Adjusted Backlog (RAB) costs and compares them with the figures submitted for 2010/11. 2.1.2 Also shown are the backlog costs broken down by risk category that, in conjunction with the estimated remaining life of the building, are used to calculate the RAB costs. It can be seen that, compared with the previous year, the RAB costs have decreased by approximately £2.3m.

High risk Significant Moderate risk Low risk Risk adjusted Risk adjusted Variation in Site Name backlog risk backlog backlog backlog backlog backlog risk adjusted cost cost cost cost cost cost backlog 2011-12 2010-11 (£) (£) (£) (£) (£) (£) (£) Aberaeron Hospital 0 17,456 183,890 1,553,184 191,163 210,372 -19,209 Amman Valley Hospital 0 217,833 202,536 267,725 240,226 191,021 49,205 Bro Cerwyn & St Brynach 0 650 77,474 43,031 4,194 4,093 101 Bronglais General Hospital 1,072,500 1,790,368 2,710,552 2,821,636 3,067,764 4,126,630 -1,058,866 Cardigan & District Memorial 0 5,134,664 24,431 426,685 5,166,887 5,169,365 -2,478 Glangwili Hospital 26,000 4,859,877 6,369,856 2,724,153 5,299,241 7,414,141 -2,114,900 Hafen Derwen 0 57,460 212,805 139,905 71,026 74,140 -3,114 Llandovery Hospital 20,375 108,752 166,454 145,824 142,138 107,222 34,916 Mynydd Mawr Hospital 0 765,130 138,751 145,081 777,470 720,614 56,856 Prince Philip Hospital 13,000 4,351,513 1,219,288 859,066 4,436,180 3,715,058 721,122 South Pembrokeshire 0 192,725 112,359 268,071 204,253 203,914 339 Tenby Hospital 0 0 19,500 0 453 443 10 Tregaron Hospital 0 2,809,382 146,860 214,504 2,831,967 3,076,880 -244,913 Withybush General Hospital 32,500 4,065,716 3,986,284 2,395,572 4,434,103 4,219,341 214,762 HD - Aggregated Sites 0 474,824 1,391,046 1,365,126 656,216 648,585 7,631 Health Board Totals 1,164,375 24,846,350 16,962,086 13,369,563 27,523,281 29,881,820 -2,358,539

Figure 2: Risk adjusted backlog (RAB) costs and costs by risk band

2.2 Performance based on the national performance indicators

2.2.1 Figure 3 opposite, shows the Health Board’s 2011/12 performance for the essential estate based on the five national performance indicators and compares it with the 2010/11 figures. Figures relate to the percentage of the estate in condition category ‘B’ for Physical condition, Statutory and safety compliance (Excluding Fire safety which is measured separately, also on the basis of the percentage of the estate in condition category ‘B’), and Space utilisation. Figures for Functional suitability relate to the percentage of the estate in condition category ‘F’. Energy performance is based on consumption measured in terms of kWh/m2.

76 Estate Condition and Performance Report 2011/12 APPENDIX VII

National Performance Indicator 2011/12 2010/11

Physical condition 86% 85%

Statutory and safety compliance 86% 86%

Fire safety* 91% 91%

Functional suitability 89% 89%

Space utilisation 96% 96%

465 493 Energy performance kWh/m2 kWh/m2 * Compliance with statutory Fire Safety legislation is not included under the Statutory and safety compliance National Performance Indicator

Key

90% (current target) or above (Energy performance: 410 kWh/m2 or below)

75-89% (Energy performance: 411-479 kWh/m2)

74% or below (Energy performance: 480 kWh/m2 or above)

Figure 3: Health Board performance matrix for national performance indicators

2.2.2 The performance of Hywel Dda Health Board against that of other Health Boards/Trusts in Wales is graphically represented in Appendix XII.

3.0 Energy Performance

3.1 In 2011/12 hospitals in the Health Board recorded a net energy consumption of 76 million kWh compared with 80 million kWh last year, a decrease of 5.09%.

3.2 With reference to Figure 4 overleaf, the overall PI is 465 kWh/m2 which is a reduction from last year’s figure of 493 kWh/m2. 3.3 There has been an overall decrease in energy consumption reported at all major sites, with the overall corresponding energy performance indicator also improving and is now in the amber zone. All the Health Board’s major sites, however, with the exception of Withybush General Hospital, are well above the red zone threshold, indicating that there is considerable scope for improvements in energy efficiency. There is a heavier reliance on oil as a fuel in Hywel Dda than at other Health Boards, and this contributes to the relatively high PI result for this LHB.

Estate Condition and Performance Report 2011/12 77 APPENDIX VII

Hospital Net Hospital Change on Energy Previous Year Site PI

Consumption

(kWh) (%) (kWh/m2)

Aberaeron Hospital 192,500 -19.23% 273 Amman Valley Hospital 817,778 -9.19% 430 Bro Cerwyn & St Brynach Day 1,345,062 1.56% 352 Bronglais General Hospital 10,915,432 -11.14% 484 Cardigan & District Memorial 704,166 -12.48% 376 Glangwili General Hospital* 22,094,498 -7.48% 470 Hafan Derwen 2,626,666 -2.72% 329 Llandovery Hospital 550,556 -9.37% 516 Mynydd Mawr Hospital 1,055,555 -24.03% 458 Prince Philip Hospital* 15,051,998 -3.16% 531 South Pembrokeshire Hospital 3,299,991 102.88% 641 Tenby Hospital 205,833 -22.25% 191 Tregaron Hospital 793,889 2.07% 479 Withybush General Hospital 16,760,548 -7.75% 431 Health Board Totals 76,414,472 -5.09% 465

* Site with CHP installed Key

Energy performance: 410 kWh/m2 or below

Energy performance: 411-479 kWh/m2

Energy performance: 480 kWh/m2 and above

Figure 4: Individual hospital net energy PIs

4.0 Summary

4.1 With the exception of Energy performance, which has moved from the red band to the amber band, the performance of the Hywel Dda Health Board against the five Welsh Government national estate performance indicator targets remains unchanged compared with last year. It is noted that the Space utilisation target has again been met pointing to the fact that there is scope for improvement with all the other indicators. It is noted that Fire safety, currently not one of the national performance indicators, is fully compliant. 4.2 The Health Board has been successful in significantly reducing its High Risk Backlog in the financial year. The Theatre Lift scheme at Bronglais remains as high risk backlog (circa £1m) and continues to be subject to future approval. The reduction in RAB costs still leaves the Health Board with significant backlog maintenance problems at six of its hospitals although investment plans have been agreed to continue to reduce Significant backlog. 4.3 In terms of energy efficiency there has been some improvement on the previous year’s performance. However, the major sites are predominantly poor performers. This is because past performance has been poor and even greater savings are needed to improve the energy

78 Estate Condition and Performance Report 2011/12 APPENDIX VII efficiency indicator. The Health Board has plans for major investments in energy saving initiatives and capital projects to improve energy efficiency which, when implemented, will lead to a considerable and much needed improvement in energy performance. It is understood that the Welsh Government has approved in principle a £13m Energy Performance Contract. Work is on-going to develop business cases and design to deliver on the energy and carbon priorities by 2013/14.

Estate Condition and Performance Report 2011/12 79

APPENDIX VIII

Summary of Health Board/Trust information

POWYS TEACHING HEALTH BOARD

Estate Condition and Performance Report 2011/12 81

APPENDIX VIII

Organisation: Powys Teaching Health Board

1.0 Estate profile

1.1 The Health Board’s estate covers a total land area of 40 Hectares with buildings having a total gross internal floor area of 46,000m2.

1.2 The profile of Health Board premises includes the following: • Community Hospitals: 10 • Other Patient Facilities: 1

1.3 The percentage of building area and land area categorised as ‘essential’ is 100% in both cases, remaining unchanged from last year. 1.4 Figure 1 1 compares the age profile of the Health Board’s estate in 2011/12 with 2001/02. It can be seen that the percentage of the estate pre dating 1948 has remained virtually unchanged during this period although there has been an increase in ‘Post 1995’ facilities from 11% to 22%.

11% 22%

22% 48% 50%

14%

13% 13% 4% 3%

2001/02 2011/12

Pre 1948 1948 to 1954 1955 to 1964 1965 to 1974 1975 to 1984 1985 to 1994 1995 to Present

Figure 1: Age profile of the estate in 2001/02 and 2011/12

2.0 Condition of the estate 2.1 Backlog maintenance

2.1.1 Figure 2 overleaf, identifies the 2011/12 Risk Adjusted Backlog (RAB) costs and compares them with the figures submitted for 2010/11. 2.1.2 Also shown are the backlog costs broken down by risk category that, in conjunction with the estimated remaining life of the building, are used to calculate the RAB costs. It can be seen that, compared with the previous year, the RAB costs have increased by over £250,000.

Estate Condition and Performance Report 2011/12 83 APPENDIX VIII

High risk Significant Moderate risk Low risk Risk adjusted Risk adjusted Variation in Site Name backlog risk backlog backlog backlog backlog backlog risk cost cost cost cost cost cost adjusted 2011-12 2010-11 backlog (£) (£) (£) (£) (£) (£) (£) Brecon War Memorial 95,640 109,453 431,534 30,000 222,844 185,436 37,408 Broddyfi Community Hospital 77,000 154,651 179,381 42,000 241,714 232,450 9,264 Bronllys Hospital 350,000 2,691,566 969,438 62,706 3,093,173 2,888,675 204,498 Builth Wells Cottage Hospital 56,000 64,425 321,943 0 134,422 137,839 -3,417 Knighton Hospital 22,000 37,641 128,287 25,244 67,721 134,300 -66,579 Llandrindod Wells Hospital 182,000 351,639 542,968 87,645 563,668 510,350 53,318 Llanidloes & District Hospital 51,000 83,716 310,033 734 150,254 163,480 -13,226 Montgomery County 89,000 126,779 93,169 40,000 221,832 179,830 42,002 Victoria Memorial Hospital 48,000 42,842 171,835 0 95,615 92,487 3,128 Ystradgynlais Hospital 20,000 41,792 167,668 0 69,776 79,776 -10,000 Powys - Aggregated Sites 0 315,935 241,287 0 335,115 335,115 0 Health Board Totals 990,640 4,020,439 3,557,543 288,329 5,196,134 4,939,738 256,396

Figure 2: Risk adjusted backlog (RAB) costs and costs by risk band

2.2 Performance based on the national performance indicators

2.2.1 Figure 3 shows the Health Board’s 2011/12 performance for the essential estate based on the five national performance indicators and compares it with the 2010/11 figures. Figures relate to the percentage of the estate in condition category ‘B’ for Physical condition, Statutory and safety compliance (excluding Fire safety which is measured separately, also on the basis of the percentage of the estate in condition category ‘B’), and Space utilisation. Figures for Functional suitability relate to the percentage of the estate in condition category ‘F’. Energy performance is based on consumption measured in terms of kWh/m2.

National Performance Indicator 2011/12 2010/11

Physical condition 68% 68%

Statutory and safety compliance 81% 81%

Fire safety* 80% 80%

Functional suitability 82% 82%

Space utilisation 100% 100%

419 433 Energy performance kWh/m2 kWh/m2 * Compliance with statutory Fire Safety legislation is not included under the Statutory and safety compliance National Performance Indicator

Key

90% (current target) or above (Energy performance: 410 kWh/m2 or below)

75-89% (Energy performance: 411-479 kWh/m2)

74% or below (Energy performance: 480 kWh/m2 or above)

Figure 3: Health Board performance matrix for national performance indicators

84 Estate Condition and Performance Report 2011/12 APPENDIX VIII

2.2.2 The performance of Powys Health Board against that of other Health Boards/Trusts in Wales is graphically represented in Appendix XII.

3.0 Energy Performance

3.1 In 2011/12 hospitals in the Health Board recorded a net energy consumption of 18 million kWh compared with 18.7 million kWh last year, a decrease of 3.4%.

3.2 With reference to Figure 4, the overall PI is now 419 kWh/m2 compared with the corrected figure of 433 kWh/m2 for last year. 3.3 The Health Board has reported figures which show an overall reduction in net energy consumption. However, at individual site level there are examples of considerable increases, most noticeably at Ystradgynlais Hospital, where an increase of 22% has been reported. This contrasts with the previous year when at the same hospital a reduction of 25% was reported. Similarly, Victoria Memorial Hospital reported a decrease of 18% in the previous reporting period and this year shows an increase of 10%. Clearly, there is a problem with either the metering or reporting of energy consumption, which is compromising meaningful year-on-year comparisons.

Hospital Net Hospital Energy Change on Site PI Consumption Previous Year

(kWh) (%) (kWh/m2) Brecon War Memorial Hospital 2,896,902 6.15% 490 Broddyfi Community Hospital 1,325,672 -10.76% 382 Bronllys Hospital 5,200,978 -4.82% 395 Builth Wells Cottage Hospital 362,238 -59.80% 188 Knighton Hospital 683,536 -13.88% 384 Llandrindod Wells Hospital 2,424,122 -2.95% 548 Llanidloes & District Hospital 930,166 -6.99% 462 Montgomery County Infirmary 1,153,366 -3.28% 389 Victoria Memorial Hospital 1,171,507 10.09% 406 Ystradgynlais Community Hospital 1,882,645 22.52% 418 Health Board Totals 18,031,132 -3.40% 419

Key

Energy performance: 410 kWh/m2 or below

Energy performance: 411-479 kWh/m2

Energy performance: 480 kWh/m2 and above

Figure 4: Individual hospital net energy PIs

4.0 Summary

4.1 The Powys Teaching Health Board’s performance against the five Welsh Government national estate performance indicator targets remains unchanged from last year. This points to the fact that there is significant scope for improvement in performance, particularly in respect of Physical condition.

Estate Condition and Performance Report 2011/12 85 APPENDIX VIII

4.2 RAB costs have increased again this year compared with last year, largely as a result of deterioration at Bronllys Hospital which accounts for 60% (£3.1m) of the total RAB costs reported by the Health Board. 4.3 As noted previously, anomalies in reporting energy consumption figures are compromising year- on-year comparisons. The underlying problems leading to this reporting should be rectified by the Health Board.

86 Estate Condition and Performance Report 2011/12 APPENDIX IX

Summary of Health Board/Trust information

VELINDRE NHS TRUST

Estate Condition and Performance Report 2011/12 87

APPENDIX IX

Organisation: Velindre NHS Trust

1.0 Estate profile

1.1 Whilst the estate, for which Velindre NHS Trust is responsible, is diverse and spread across Wales, the focus of the EFPMS is on Velindre Cancer Centre, the Trust’s only hospital. Covering a total land area of 4 Hectares, the hospital has a gross internal floor area of 15,724m2. 1.2 The percentage of building area and land area categorised as ‘essential’ is 100%, remaining unchanged from last year. 1.3 Figure 1 compares the age profile of the Trust’s estate in 2011/12 with 2001/02. It can be seen that over the last 11 years, there has been very little change in terms of the percentage of the estate pre dating 1948 and post dating 1995.

1%

32% 30% 25% 33%

4%

12% 10% 20% 27% 6%

2001/02 2011/12

Pre 1948 1948 to 1954 1955 to 1964 1965 to 1974 1975 to 1984 1985 to 1994 1995 to Present

Figure 1: Age profile of the estate in 2001/02 and 2011/12

2.0 Condition of the estate 2.1 Backlog maintenance

2.1.1 Figure 2 identifies the 2011/12 Risk Adjusted Backlog (RAB) costs and compares them with the figures submitted for 2010/11.

High risk Significant Moderate risk Low risk Risk adjusted Risk adjusted Variation in Site Name backlog risk backlog backlog backlog backlog backlog risk cost cost cost cost cost cost adjusted 2011-12 2010-11 backlog (£) (£) (£) (£) (£) (£) (£) Velindre Hospital 0 672,178 1,115,557 1,103,121 887,944 438,647 449,297

Trust Totals 0 672,178 1,115,557 1,103,121 887,944 438,647 449,297

Figure 2: Risk adjusted backlog (RAB) costs and costs by risk band

Estate Condition and Performance Report 2011/12 89 APPENDIX IX

2.1.2 Also shown are the backlog costs broken down by risk category that, in conjunction with the estimated remaining life of the building, are used to calculate the RAB costs. It can be seen that, compared with the previous year, the RAB costs have increased by approximately £450,000.

2.2 Performance based on the national performance indicators 2.2.1 Figure 3 shows the Trust’s 2011/12 performance for the essential estate based on the five national performance indicators and compares it with the 2010/11 figures. Figures relate to the percentage of the estate in condition category ‘B’ for Physical condition, Statutory and safety compliance (excluding Fire safety which is measured separately, also on the basis of the percentage of the estate in condition category ‘B’), and Space utilisation. Figures for Functional suitability relate to the percentage of the estate in condition category ‘F’. Energy performance is based on consumption measured in terms of kWh/m2.

National Performance Indicator 2011/12 2010/11

Physical condition 85% 84%

Statutory and safety compliance 88% 87%

Fire safety* 84% 82%

Functional suitability 90% 89%

Space utilisation 90% 90%

398 482 Energy performance kWh/m2 kWh/m2

* Compliance with statutory Fire Safety legislation is not included under the Statutory and safety compliance National Performance Indicator

Key

90% (current target) or above (Energy performance: 410 kWh/m2 or below)

75-89% (Energy performance: 411-479 kWh/m2)

74% or below (Energy performance: 480 kWh/m2 or above)

Figure 3: Health Board performance matrix for national performance indicators

2.2.2 The performance of Velindre NHS Trust against that of other Health Boards/Trusts in Wales is graphically represented in Appendix XII.

3.0 Energy Performance

3.1 In 2011/12 the only hospital in the Trust recorded a net energy consumption of 6 million kWh compared with 7 million kWh last year, a reduction of 12%.

90 Estate Condition and Performance Report 2011/12 APPENDIX IX

3.2 With reference to Figure 4, the PI for the Velindre Hospital site is now 398 kWh/m2 compared with last year’s figure of 482 kWh/m2. 3.3 There has been a significant improvement in both the energy consumption and the energy efficiency performance indicator. This is thought to be a reflection of a reduction in gas consumption as a result of a new hot water generation system installed at the hospital and an increase in gross internal area which, combining with the reduction in energy consumption, has improved the energy efficiency performance indicator.

Hospital Net Hospital Energy Change on Site PI Consumption Previous Year

(kWh) (%) (kWh/m2) Velindre Hospital 6,254,236 -11.91% 398 Trust Totals 6,254,236 -11.91% 398

Key

Energy performance: 410 kWh/m2 or below

Energy performance: 411-479 kWh/m2

Energy performance: 480 kWh/m2 and above

Figure 4: Velindre Hospital net energy PI

4.0 Summary

4.1 The performance of Velindre NHS Trust against the five Welsh Government national estate performance indicator targets has shown improvements in all of the targets. Both Functional suitability and Space utilisation targets have been met and move into the green band. Most noticeably the Energy performance target has been met and has moved from the red band into the green band. There have been slight improvements in the Physical condition and Statutory compliance targets although they remain in the amber band. Fire safety, which is currently not included amongst the national performance indicators, remains in the amber band. 4.2 It is noted that the Trust’s RAB costs have increased by approximately 100%. 4.3 This year’s figures show a significant improvement in energy consumption and energy efficiency, mainly due to the investment that has been made in a new hot water generation system for the hospital, which should encourage the Trust to invest more in subsequent years.

Estate Condition and Performance Report 2011/12 91

APPENDIX X

Summary of Health Board/Trust information

WELSH AMBULANCE SERVICES NHS TRUST

Estate Condition and Performance Report 2011/12 93

APPENDIX X

Organisation: Welsh Ambulance Services NHS Trust

1.0 Estate profile

1.1 The Trust’s estate covers a total land area of 21 Hectares with buildings having a total gross internal floor area of 39,368m2. 1.2 The profile of Trust premises consists of 108 Support Facilities. 1.3 The percentage of the building area and land area categorised as ‘essential’ is 65% for both building and land, remaining unchanged from last year. 1.4 Figure 1 compares the age profile of the Trust’s estate in 2011/12 with 2001/02. It can be seen that over the 11-year period the profile has remained virtually unchanged, with only a 4% increase in post 1995 properties replacing older properties.

9% 8% 16% 20%

20% 14%

15% 15%

16%

11% 15% 11% 14% 16%

2001/02 2011/12

Pre 1948 1948 to 1954 1955 to 1964 1965 to 1974 1975 to 1984 1985 to 1994 1995 to Present

Figure 1: Age profile of the estate in 2001/02 and 2011/12

2.0 Condition of the estate 2.1 Backlog maintenance

2.1.1 Figure 2 overleaf, identifies the 2011/12 Risk Adjusted Backlog (RAB) costs and compares them with the figures submitted for 2010/11. 2.1.2 Also shown are the backlog costs broken down by risk category that, in conjunction with the estimated remaining life of the building, are used to calculate the RAB costs. It can be seen that, compared with the previous year, the RAB costs have increased by over £500,000. On a regional basis, the North Region RAB costs increase of £923k has been mitigated by reductions in the other two Regions.

Estate Condition and Performance Report 2011/12 95 APPENDIX X

High risk Significant Moderate risk Low risk Risk adjusted Risk adjusted Variation in Region backlog risk backlog backlog backlog backlog backlog risk cost cost cost cost cost cost adjusted backlog 2011-12 2010-11 (£) (£) (£) (£) (£) (£) (£) Central & West Region 411,174 2,336,647 2,452,843 859,877 3,175,900 3,380,403 -204,503 North Region 511,650 2,000,730 1,593,405 1,117,671 2,856,500 1,933,136 923,364 South East Wales 719,346 1,172,462 1,255,546 664,324 2,089,760 2,235,072 -145,312 Trust Totals 1,642,170 5,509,839 5,301,794 2,641,872 8,122,160 7,548,611 573,549

Figure 2: Risk adjusted backlog (RAB) costs and costs by risk band

2.2 Performance based on the national performance indicators

2.2.1 Figure 3 shows the Trust’s 2011/12 performance for the essential estate based on the five national performance indicators and compares them with the 2010/11 figures. Figures relate to the percentage of the estate in condition category ‘B’ for Physical condition, Statutory and safety compliance (excluding Fire safety which is measured separately also on the basis of the percentage of the estate in condition category ‘B’), and Space utilisation. Figures for Functional suitability relate to the percentage of the estate in condition category ‘F’. Energy performance is based on consumption measured in terms of kWh/m2.

National Performance Indicator 2011/12 2010/11

Physical condition 32% 41%

Statutory and safety compliance 64% 64%

Fire safety* 90% 90%

Functional suitability 35% 35%

Space utilisation 94% 94%

256 251 Energy performance kWh/m2 kWh/m2

* Compliance with statutory Fire Safety legislation is not included under the Statutory and safety compliance National Performance Indicator

Key

90% (current target) or above (Energy performance: 410 kWh/m2 or below)

75-89% (Energy performance: 411-479 kWh/m2)

74% or below (Energy performance: 480 kWh/m2 or above)

Figure 3: Health Board performance matrix for national performance indicators

2.2.2 The performance of the Welsh Ambulance Services NHS Trust against that of other Health Boards/Trusts in Wales is graphically represented in Appendix XII.

96 Estate Condition and Performance Report 2011/12 APPENDIX X

3.0 Energy Performance

3.1 In 2011/12 stations or sites in the Welsh Ambulance Services NHS Trust recorded a net energy consumption of 10 million kWh compared with a corrected figure for last year of 10.4 million kWh, a decrease of 3.21%.

Figure 4 shows the overall energy performance indicator of 255 kWh/m2 compared with last year’s figure of 252 kWh/m2. The returns show an improvement in net energy. However, the overall performance indicator has marginally increased mainly because of changes to the gross internal floor area.

Net Energy Change on Region Site PI Consumption Previous Year (kWh) (%) (kWh/m2) Central & West Region 2,256,638 1.60% 172 North Region 4,313,347 -3.49% 333 South East Region 3,496,768 -5.76% 262 Trust Totals 10,066,753 -3.21% 255.71

Key

Energy performance: 410 kWh/m2 or below

Energy performance: 411-479 kWh/m2

Energy performance: 480 kWh/m2 and above

Figure 4: Individual hospital net energy PIs

4.0 Summary

4.1 The performance of the Welsh Ambulance Services NHS Trust against the five Welsh Government national estate performance indicators presents a mixed picture which remains essentially unchanged from last year. Space utilisation and Energy performance targets have been met or exceeded. It is noted that Fire safety, currently not one of the national performance indicators, is compliant. Performance against the Physical condition, Statutory and safety compliance and Functional suitability targets remains particularly poor, pointing to significant scope for improvement. As reported last year, the Trust will need to implement a radical modernisation programme in order to meet the remaining performance targets. 4.2 The increase in RAB costs is noted. 4.3 The improvement in net energy consumption is noted, however, it is recognised that whilst the Welsh Ambulance Services NHS Trust performance appears to be good, this is in comparison to a PI that is primarily focussed on hospitals. Therefore the Trust estate does not fit neatly into this category for comparison. Whilst it is accepted that the Trust is actively supporting on going energy efficiency measures, there is still significant scope for further improvement in energy efficiency throughout the Trust estate.

Estate Condition and Performance Report 2011/12 97

APPENDIX XI

Details of non-essential Health Board/Trust property

Estate Condition and Performance Report 2011/12 99

APPENDIX XI

Non-Essential Health Board/ Trust Property

Hospital Physical Statutory & Fire Safety Backlog Date of Cost to 'B' Safety Cost Cost to 'B' Maintenance Closure to 'B' Cost

(£) (£) (£) (£)

Aberdare General Hospital 7,786,001.00 0.00 0.00 7,786,001

Blaenavon Health Care Unit 140,743.00 43,821.00 3,103.00 187,667

Caerphilly District Miners Hospital 0.00 0.00 0.00 0

Cardigan & District Memorial 5,141,487.00 409,019.00 35,274.00 5,585,780

Cefn Coed Hospital 6,418,141.00 450,760.00 115,000.00 6,983,901

Fairwood Hospital 0.00 0.00 0.00 0

Gellinudd Hospital 11,611.00 0.00 0.00 11,611

Hill House Hospital 201,183.00 0.00 21,115.00 222,298

HM Stanley Hospital 2,600,000.00 425,000.00 95,000.00 3,120,000

Maesgwyn Hospital 101,514.00 93,145.00 18,000.00 212,659

Mountain Ash General Hospital 6,372,280.00 86,000.00 833,000.00 7,291,280

Redwood Memorial Hospital 40,656.00 35,736.00 10,211.00 86,603

St Tydfil's Hospital 2,082,630.00 20,400.00 0.00 2,103,030

Whitchurch Hospital 5,539,179.00 557,071.00 0.00 6,096,250

Ystrad Mynach Hospital 0.00 0.00 0.00 0.00

Totals 36,435,425 2,120,952 1,130,703 39,687,080

Estate Condition and Performance Report 2011/12 101

APPENDIX XII

Performance Indicators and Targets

Estate Condition and Performance Report 2011/12 103

APPENDIX XII

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0 ndre ABM Powys Powys WAST Service elindre V Veli Cwm Taf Cwm Taf adwaladr Abertawe Hywel Dda Hywel Dda eurin Bevan eurin rdiff and Vale and Vale rdiff lsh Ambulance Aneurin Bevan An Betsi Cadwaladr Cardiff and Vale Cardiff Bro Morgannwg Betsi C Ca We

Physical Condition A + B (%) 90% category 'B' or above

Figure 1: Physical Condition (Categories A & B %)

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0 ndre ABM Powys Powys WAST Service elindre V Veli Cwm Taf Cwm Taf adwaladr Abertawe Hywel Dda Hywel Dda neurin Bevan neurin rdiff and Vale and Vale rdiff lsh Ambulance Aneurin Bevan A Betsi Cadwaladr Cardiff and Vale Cardiff Bro Morgannwg Betsi C Ca We Statutory Safety (Compliance) 2010-11 90% category 'B' or above

Figure 2: Statutory & Safety Compliance (Categories A & B %)

Estate Condition and Performance Report 2011/12 105 APPENDIX XII

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50 (%)

40

30

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0 Powys Service elindre V Cwm Taf Abertawe Hywel Dda lsh Ambulance Aneurin Bevan Betsi Cadwaladr Cardiff and Vale Cardiff Bro Morgannwg We

Figure 3: Fire Safety Compliance

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0 ndre ABM Powys Powys Service elindre bulance Veli V Cwm Taf Cwm Taf adwaladr Abertawe Hywel Dda Hywel Dda Service rdiff and Vale and Vale rdiff Aneurin Bevan lsh Ambulance Aneurin Bevan Betsi C Ca Betsi Cadwaladr Cardiff and Vale Cardiff Bro Morgannwg Welsh Am We

Functional Suitability (A + B) 90% category 'B' or above

Figure 4: Functional Suitability

106 Estate Condition and Performance Report 2011/12 APPENDIX XII

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0 Powys Service elindre V Cwm Taf Abertawe Hywel Dda lsh Ambulance Aneurin Bevan Betsi Cadwaladr Cardiff and Vale Cardiff Bro Morgannwg We

Space Utilisation (Fully Used) 90% category 'B' or above

Figure 5: Space Utilisation

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0 ndre ABM Powys WAST Powys Service elindre Veli Cwm Taf V adwaladr Cwm Taf Hywel Dda Hywel Dda Morgannwg neurin Bevan neurin rdiff and Vale and Vale rdiff A Abertawe Bro lsh Ambulance Aneurin Bevan Betsi C Ca Betsi Cadwaladr Cardiff and Vale Cardiff We Essential Buildings - % All Wales Average

Figure 6: Essential Buildings

Estate Condition and Performance Report 2011/12 107 APPENDIX XII

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0 ndre ABM Powys WAST Powys Service elindre Veli Cwm Taf V adwaladr Cwm Taf Abertawe Hywel Dda Hywel Dda neurin Bevan neurin rdiff and Vale and Vale rdiff A lsh Ambulance Aneurin Bevan Betsi C Ca Betsi Cadwaladr Cardiff and Vale Cardiff Bro Morgannwg We Essential Land - % All Wales Average

Figure 7: Essential Land

108 Estate Condition and Performance Report 2011/12 © Copyright NHS Wales Shared Services Partnership - Facilities Services 2012.

All Rights Reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior permission of the copyright owner.

Designed by Keith James.

Printed by iCOM Works Ltd

Cover photographs: 1, Port Talbot Resource Centre – Courtesy of NWSSP-Facilities Services. 1 2, Ysbyty Cwm Cynon – Courtesy of 2 HLM Architects and VINCI PO Box 182, 3 Construction. Bevan House, 24-30 Lambourne Crescent, Llanishen 3, Tyˆ Lidiard CAMS - Princess of Wales Cardiff CF14 5GS Hospital – Courtesy of Abertawe Bro Morgannwg University Health Board. PO Box 182, Tyˆ Bevan, 24-30 Cilgant Lambourne, Llanisien Caerdydd CF14 5GS