ESTATES STRATEGY

2015 - 2020

September 2015

CONTENTS

SECTION TITLE PAGE NO.

1. EXECUTIVE SUMMARY

2. INTRODUCTION

3. THE ESTATE STRATEGY PROCESS

4. WHERE ARE WE NOW?

 The Trust’s existing estate  Appraisal of the condition & performance of the estate  Backlog costs  Estates key performance indicators

5. WHERE DO WE WANT TO BE?

 The Trust clinical strategy (Pam)  Drivers for change (Pam)  Estate Key Targets for change

6. HOW DO WE GET THERE?

 Delivering the aims of the Estate Strategy  The business case process  Key financial assumptions  Stakeholder involvement  Risk  Estates Plan

7. CONCLUSION

8. APPENDICES

Appendix 1 – Community Properties

Appendix 2 – Residential Properties

Appendix 3 – Trust Occupied Areas not on the Main Site

Page 2

1. EXECUTIVE SUMMARY

This report describes the Estates Strategy for Northern Lincolnshire & Goole NHS Foundation Trust for the period 2015 – 2020. The aim of the Strategy is to ensure that the Trust provides safe, secure, high-quality healthcare buildings to support current and future needs.

The main priority for the strategy is to increase the site utilisation by reducing estate and backlog maintenance costs, whilst improving the environment.

The delivery of these plans will require financial investment along with changes in working styles and challenges to the work for the whole organisation.

The process adopted for developing the Estate Strategy has been in accordance with the guidance and processes described in the Department of Health document, developing an Estates Strategy. This process asks three basic questions in relation to the Trust Estate:

 Where are we now?  Where do we want to be?  How do we get there?

Where are we now?

The Northern Lincolnshire and Goole Hospital NHS Foundation Trust covers a wide geographical area. The Trust has a total of 874 beds, a gross floor area of 142,535 m2.

It operates out of three main hospital campus sites and several community premises. The Trust delivers District General Hospital services on the Grimsby and Scunthorpe sites which include Emergency Departments (ED’s) and ITU whereas the smaller Goole District Hospital operates a lesser portfolio of services and has a Minor Injuries Unit rather than a full ED. All three sites provide inpatient, day case and outpatient services.

The first stage of developing the Estate Strategy included a comprehensive appraisal of the condition and performance of the existing estate, in accordance with Estate Code, covering:

 Physical condition;  Compliance with Fire, Health & Safety & other statutory standards;  Environmental Management;  Functional suitability;  Space utilisation;  Quality; and  Adaptability

The results of the appraisal are summarised in Table 1, the figures included within the table is the amount of investment required to bring Trusts estate up to condition B; where condition B is defined as “a facility requiring general maintenance investment only”, which in terms of physical condition is “sound, operationally safe and exhibits only minor deterioration” and in terms of compliance the estate “complies with all necessary mandatory fire safety requirements and statutory safety legislation with minor deviations of a non-serious nature”. The condition is broken down into the six categories listed above covers the entire estates from buildings to road/pathways and infrastructure such as water and

Page 3 gas main pipework; a full breakdown is detailed in the six facet survey section commencing on page 14.

Table 1 – Estate Code Appraisal

The results show in terms of the overall estate:

Appraisal Costs by Sites For : Diana Princess of Wales Hospital,RJL30 Yearly Allocation Site Cost to B Year 2015/16 Year 2016/17 Year 2017/18 Year 2018/19 Year 2019/20 Year 2020/21 Diana Princess of Wales Hospital,RJL30 £37,215,954 £136,352.00 £415,500.00 £762,088.95 £762,088.95 £762,088.95 £762,088.95 50.81% £550,000.00 £550,000.00 £686,352.00 £965,500.00

Appraisal Costs by Sites For : Scunthorpe General Hospital,RJL32 Yearly Allocation Site Cost to B Year 2015/16 Year 2016/17 Year 2017/18 Year 2018/19 Year 2019/20 Year 2020/21 Scunthorpe General Hospital,RJL32 £30,255,786 £744,169.00 £639,006.00 £619,562.25 £619,562.25 £619,562.25 £619,562.25 41.30% £291,000.00 £930,006.00

Appraisal Costs by Sites For : Goole and District Hospital,RJL31 Yearly Allocation Site Cost to B Year 2015/16 Year 2016/17 Year 2017/18 Year 2018/19 Year 2019/20 Year 2020/21 Goole and District Hospital,RJL31 £5,779,461 £55,708.00 £115,000.00 £118,348.80 £118,348.80 £118,348.80 £118,348.80 7.89%

Appraisal Costs For Trust Community Properties Yearly Allocation Site Cost to B Year 2015/16 Year 2016/17 Year 2017/18 Year 2018/19 Year 2019/20 Year 2020/21 Community Properties £1,094,245 £0.00 £15,000.00 £22,407.38 £22,407.38 £22,407.38 £22,407.38 1.49%

Where do we want to be?

The Trust will need to address the current poor condition and performance of the estate and move toward the provision of safe, secure, appropriately positioned and high-quality healthcare buildings that are used efficiently and effectively for the delivery of modern healthcare services. However, the Estate Strategy and any future investment must be “service and user led” with patients being at the centre of any proposed changes.

Changes are taking place both within the local health economy and nationally to ensure the NHS is fit for the future. The NHS recently published its Five Year Forward View highlighting the challenges faced. The document does advocate many planning themes which are already contained within the Trust’s existing strategy.

A number of key documents set out the future strategic direction for the Trust and its partners and are key drivers in shaping this Estates Strategy.

 Northern Lincolnshire & Goole NHS FT 5 Year Strategic Direction;  Healthy Lives Healthy Futures, Options for Future Service Configuration; and  Northern Lincolnshire & Goole NHS FT Operational Plan 2015-16  North Lincolnshire & North East Lincolnshire Strategic Estates Review

Page 4

Strategic Direction

The culture created within the Trust places the quality of care for our patients and their families at the heart of service delivery. The staff within the Trust deliver services ensuring continued improvement across the three key aspects of patient safety, clinical effectiveness and patient experience.

As part of the Trust 5 Year Strategy, the Trust Board reinforced previous findings that the local health services as currently configured across Northern Lincolnshire are not sustainable in the medium to long term, under the current NHS payments system. However, no compelling case for change had been made for a radical downgrading, rationalisation or centralisation programme of the Trust’s services. The Trust instead identified a programme of clinician-led integration of pathways and services, with the principal aim of controlling net demand growth, through this means limiting future cost growth and delivering sustainability. This would build on the work already underway across local providers of primary, secondary, community, social and mental health care.

The Trusts recently published Operational Plan for 2015-16 reinforced its 5 Year Strategy and reemphasised the following core strategic principles;

i) To deliver services efficiently without impacting adversely on the quality of care. The Trust has a robust internal 5 year sustainability programme of efficiency improvements, structured intensively in the early years. This will deliver optimum efficiency across the whole of the Trust cost base, and support the redesign process.

ii) Working together across the health and care spectrum provides the greatest opportunity to control demand, alleviating the cost pressures arising from demand growth. Integration improves the quality of care provided by removing organizational boundaries, enabling clinical teams to work seamlessly across the patient journey.

The Better Care Fund initiatives are a good example of this. Acute, community, primary and social teams working together with the individuals and their families to deliver a package of care that meets their needs. This multi-disciplinary approach delivers reduced need for the individual to navigate across differing organisations at differing times reducing follow up appointments and avoiding admissions where clinically appropriate.

iii) Radical transformation where needed. The Trust is prepared to act to improve patient care or to deliver more efficient and effective services. Both Hyper Acute Stroke and ENT services were consulted upon during 2014-15 with the outcomes being to consolidate on one site.

To enable delivery of the core principles above, the Trust refined and strengthen the following strategic enablers;-

 The Trust continues to develop a true patient first workforce whose services are delivered through a single, engaged and empowered team that has a voice and strives for uniqueness, innovation, quality and safety.

 The IM&T strategy builds upon the innovative culture of system development the Trust continues to achieve. Harnessing the strengthening reputation and developing skills base, the strategic goal is to develop a local IM&T solution which meets the service needs

Page 5

and enables the secure sharing of information across the patient journey, removing organisational barriers.

 Delivery of truly integrated service provision is reliant upon the workforce of Northern Lincolnshire being able to work as a multi-disciplinary team regardless of where the patient is. With prime clinical space at a premium, maximum utilisation of the estate is key to deliver value. The strategy aims to enable service provision to be delivered in the most clinically appropriate locations regardless of organisational ownership.

Whilst the estate is highlighted above as a key enabler, the use and quality of the Trust estate runs through each of the above strands in one form or another, as defined by this strategy. The Trust needs to develop innovative and forward looking solutions that will achieve a productive estate and aim to:

 Improved accessibility to healthcare for patients;  Disinvest in assets with high operating costs, back log maintenance requirements;  Improve estates asset performance on all key performance indicators;  Promote and facilitate new ways of working;  Improve utilisation by collaborating with the whole health community and public sector;  Dispose of any surplus land;  Integrate services with the wider health community;  Release capital from underutilised assets;  Provide staff accommodation to support recruitment and retention;  Provide modern facilities such as restaurants and retail outlets that will support 7-day working.

The Trust’s vision and plans for change over the next five years cannot be achieved without significant change and investment in the estate. Table 2 below shows the impact of this investment and change in terms of the key measures of the estate condition and performance as defined in Estate code across the three hospital sites.

Table 2 – Impact of Invest

Assessment of Current Trust Wide Position % of total floor area of buildings falling below standard B Target Diana, Scunthorpe Goole Trust Trust wide Princess of General wide Wales Hospital Physical 7.74% 20.11% 13.26% 17.69% 13.27% Condition Functional Suitability 18.41% 9.49% 1.76% 9.02% 6.77%

Space 9.24% 5.23% 40% 86.79% 100% Utilisation Quality 7.19% 10.67% 6.01% 13.18% 16.48%

Statutory 36.1% 14.68% 22.72% 34.89% 26.17% Compliance

Environmental 55.55% 11.11% 11.11% 2.44% 1.83% Performance

Page 6

Table 2, above, shows the improvement needed in the key measures of the estate condition and performance as defined in estate code if the trust is to perform with similar NHS Trusts.

How do we get there?

The Estates Strategy responds to the challenges and strategic aims as described above through a series of proposed changes to the estate and capital investment projects. The key themes applicable to this strategy are summarised as;-

 Refurbishment / Reconfiguration / Relocation of business critical services to ensure fitness for purpose;

 Investments in service developments which support delivery of the sustainability programme;  Continual programme of investment ensuring the core fabric of the Trust estate is maintained in those areas where continued utilisation is confirmed.

Strategic Plan

The strategy described in this report will be delivered through the Strategic Plan which will include a capital investment programme (Gantt chart). This will be a graphical representation of the Trust Capital Investment requirements and will be modelled to show anticipated construction periods pertaining to each scheme.

Integral to the new developments and refurbishments is the Trust disposal of surplus land plans which are shown on the Gantt chart.

2. INTRODUCTION

This report describes an estates Strategy for Northern Lincolnshire & Goole NHS Foundation Trust for the period 2015 – 2020. The Trust covers a wide geographical area with a total of 874 beds, and a gross core site floor area of 142,535 m2

The aims of the Estate Strategy are:

 To support the achievement of the Trusts Clinical Strategy;  to provide safe, secure and quality healthcare facilities which complement and support the provision of sustainable high quality care;  to ensure the Trust Estates is used efficiently, coherently and strategically to support future clinical and corporate requirements;  to support the alignment of Trust Strategies e.g. align with the Trusts IM&T, Workforce & Organisational Development and Strategy & Planning etc.

These aims will be delivered through:

 An improvement in the condition and performance of the estate as reported to the Department of Health annually;  refurbishment/redevelopment of the Trusts clinical estate aligned to the Capital Investment plan;

Page 7

 refurbishment/redevelopment of the Trusts staff accommodation;  disposal of property and land surplus to future clinical requirements;  redevelopment and relocation of the Trusts Retail and Catering facilities; and  working in collaboration with the wider healthcare community and public sector.

The success measures of the Estates Strategy are:

 Improved space utilisation, functional suitability, quality, adaptability and environmental management of the estate;  reduced need for expenditure on backlog maintenance;  Capital receipts received from land disposal;

 staff, patient and visitor feedback;  Patient Led Assessments of the Care Environment reports;  increased occupancy of Trust accommodation;  Premises Assurance Model (PAM) completion; and  ERIC annual return data

The Estates Strategy cannot be developed in isolation. The strategy is closely aligned to the strategic direction, enabling robust service planning as the Trust and wider community move forward.

An Estate Strategy should provide the following benefits:

 Estates development that supports the Trusts Clinical Strategy;  a board level commitment to sustainable development and carbon reduction initiatives;  an opportunity to dispose of any surplus land;  an opportunity to reduce underutilised areas of the estate;  a means of targeting investments to minimise the risk associated with the Estate;  an opportunity to recruit and retain staff by offering a good standard of staff accommodation.

The plan for of the Estates Strategy will be based on the following key financial assumptions:

 Approximately £8.1 million of cash from depreciation is available per annum. The Trust will need to invest significantly above the £8.1m depreciation level over 2016/17 and 2017/18 to secure core improvements to the estate, therefore this means that estates development and improvement will be dependent on the wider funding position facing the organisation..

 Asset disposal through land sale may be used to top up this value, though only as part of an approved financial plan signed off by the Trust Board – there is no automatic process of adding disposal proceeds to the capital programme. At this stage, the most material potential disposal receipt would arise from surplus land at the DPoW site, where a project managing disposal is already in place.

 The Trust has secured loans via the ITFF specifically to support the investments in estates energy efficiency improvements and to undertake a programme of purchase, refurbishment and expansion of residential accommodation for staff across both DGH sites. Project structures exist to manage both of these projects. Again it should be noted that expenditure plans remain subject to Trust Board sign off, as part of the wider financial plan.

Page 8

 The Trust has set a total of £17.2m as an outline planning total for the 2015/16 capital programme. The schedule of proposed spending is designed to support strategic development priorities.

 Future capital programme resourcing will be derived through balancing available cash with strategic development priorities for asset replacement, risk management, quality improvement, strategic transformation and business advantage. The programme will be built in to a wider service and finance plan at least on an annual basis.

 Any changes to agreed programmes in year will be authorised through the Strategy & Planning Committee, Trust Resources Committee and where of significant materiality by the Trust Board. As a guide, the removal or addition of a major scheme, an overspend of more than 20% of a major scheme’s value, or material transfer of resources between the main elements of the programme (major schemes, Estates maintenance, equipment and IM&T) will require Trust Board approval.

 Revenue affordability will be the key driver for determining the overall capital financing portfolio, and this may involve some element of external oversight, from regulators or as part of joint working across the local health community, as appropriate.

This document builds on the following Estates Strategy 2012 – 2015 deliverables;

 Improved utilisation of the Trust Estate;  Investment in the Trust Estates in order to reduce the backlog maintenance and to maintain control of the sites services, which are rapidly reaching the end of useful life;  Improve the energy efficiency of the Trust building through the Trust Carbon Management and Trust Travel Plan.

3. THE ESTATES STRATEGY PROCESS

The estate strategy described in this report has been developed in accordance with the guidance and process described in the Department of Health’s document ‘Developing an Estates strategy’.

The process asks three basic questions in relation to the Trust’s estate:

 Where are we now?  Where do we want to be?  How do we get there?

Where are we now?

This initial stage was aimed at developing a comprehensive understanding of how well the current estate supports delivery of current services. This was achieved through an appraisal of the condition and performance of the estate on accordance with NHS Estate Code 2014.

Where do we want to be?

The Trust submitted it Strategic Direction in June 2014. The three key themes contained within the strategy include;

Page 9

1. Maintain and/or improve the quality of care provided; 2. Ensure the Trust is as efficient as it can be; and 3. Integrate where it is beneficial to do so

The aim of this strategy is to ensure, in line with the above, that the core fabric of the estate is maintained and optimal utilisation is achieved supporting delivery of high quality services

The Directorate of Planning & Strategy is co-ordinating the work on developing a long term vision of clinical services. This has enabled a robust and consistent Estates Strategy.

How do we get there?

This final stage in the process involved using the information and outputs from the two previous stages to develop an Estates Plan that includes a capital investment programme for modernising the estate. A prioritised schedule of capital projects, mapped across to the Trust Clinical Strategy, will enable clarity of future estate developments and the Estate Plan to be finalised. A key consideration of this will be the affordability of the proposed capital programme in terms of both capital and revenue funding.

The Trust will agree each year an appropriate programme of investment balancing available resources with required outcomes. The transformation, improvement and maintenance of the Trust estate will form a key part of this programme, but will be part of a balanced prioritisation process with other elements of the programme.

The Trust will seek to maintain an adequate revenue budget to allow for ongoing maintenance and improvement of the Trust estate, particularly as regards the management of key risks. The risk Register will be used as the definitive statement of risk used to support the prioritisation and resource allocation process.

The availability of cash will inevitably play a limiting role in the speed with which the Trust’s estates objectives can be delivered. This is recognised by the Trust Board, who have the task of managing resources.

4. WHERE ARE WE NOW

The Northern Lincolnshire and Goole Hospital NHS Foundation Trust covers a wide geographical area. The Trust has a total of 874 beds, a gross floor area of 142,535 m2.

It operates out of three main hospital sites and several community premises. The Trust delivers District General Hospital services on the Grimsby and Scunthorpe sites which include A&E and ITU whereas the smaller Goole District Hospital operates a lesser portfolio of services and has a Minor Injuries Unit rather than a full A&E. All three sites provide inpatient, day case and outpatient services.

Diana Princess of Wales Hospital, Grimsby

The Trust holds freehold for the site which has 439 beds; a gross floor area of 72,136 m2 and covers a land area of 17.59 hectares. The site has a main road access from Scartho Road, with further entrances on Second Avenue and Scartho Top. It has a possible additional entrance onto Scartho Road via a restricted height archway on the older part of the site but this has not been used for some while. A second entrance also exists from the site onto Second Avenue which is gated and will be used by patients and staff to access the Assisted Living Centre. The Trust is in the process of Page 10 disposing of 16.16 acres of surplus land to the South side of the hospital, therefore will significantly reduce future expansion opportunities.

DPoW Site Plan – Figure 1

17 STAFF

IT

65 STAFF

5 DISABLED STAFF 19

15 STAFF

WHEELCHAIRS PHARMACY STORE MAC NURSES RESTCOTE 1

TRAINING AND PHOENIX CLUB REPRO DEVELOPMENT GRAPHICS 8 GARTH ANDERSON SOUTHHOLME

EASTHOLME INTERNAL AUDIT 2 9 MANUAL HANDLING TRAINING 3 ROOMS MEDICAL ELECTRONICS

MEDICAL ILLUSTRATION

OCCUPATIONAL 5 4 HEALTH

WEST ARCH

CLINICAL 6 PSYCHOLOGY EDUCATION & LIBRARY

CHILD & 50 Staff 7 FAMILY

52 STAFF GOVERNANCE ANNEXE

54 STAFF

Scunthorpe General Hospital, Scunthorpe

The Trust holds freehold for the site which has 406 beds a gross floor area of 54,642 m2 and covers a land area of 10.82 hectares. The site has two access roads from Cliff Gardens and two from Church Lane. The site has extremely limited parking on site. The Trust owns an adjacent plot of land where additional off site staff parking is provided, however some of this is a nature reserve and would be very unlikely to be available for further development.

The site is within a residential area of Scunthorpe and is surrounded by residential properties therefore is land locked within its current boundaries and has no room for expansion.

SGH Site Plan – Figure 2

ADMIN A & E BLOCK

DERMATOLOGY

OUTPATIENTS X-RAY

BOILER CORONATION BLOCK LINDSEY PATHOLOGY SUITE HOUSE STEPPING STONES WARD 2

Scunthorpe General Hospital HOSPITAL RADIO MODULAR WARD 5 BUILDING

WARDS 16/17

WORKSHOPS BUTERWICK HOUSE

SERVICE QUEENS CENTRE TRAINING BUILDING & DEVELOPMENT Reservoir (covered) MENTAL HEALTH

Croxton House Belton House Hall

IT DEPT

Elsham House

Page 11

Goole and District Hospital, Goole

The Trust holds freehold for the site which has 29 beds a gross floor area of 15,757 m2 and a land area of 6.07 hectares. The site also has a primary care centre onsite and has significant space for future expansion should it be required.

The site has a single entrance and a single exit point onto Woodland Avenue.

GDH Site Plan – Figure 3

Staff Residence

The Trust owns staff residential accommodation on the Grimsby site, such property providing accommodation for members of staff in training as well as trained staff. Accommodation is provided on site in 7 blocks of flats (60 flats), and 14 semi-detached houses.

At Scunthorpe General Hospital the Trust has purchased staff accommodation back from Riverside Ltd in January 2015. The total stock equates to 108 units made up of self-contained flats and en-suite rooms.

On the Goole site, 6 staff houses are provided on site in semi-detached format.

A schedule of residential properties is shown in Appendix 1

Community Premises

The Trust occupies property within the community upon two distinct basis:

1. Where community clinical services or support to such services are located; and 2. Where staff delivering or supporting acute or secondary care services are located.

In relation to point 1 above, the Trust provides Community Services within the North Lincolnshire locality following transfer of a number of services from NHS North Lincolnshire in April 2011 as part of the Transforming Community Services programme. Community services such as dental and therapies are also provided in North east Lincolnshire.

Page 12

The majority of the existing community estate was inherited as part of the above mentioned programme and as such the properties occupied for the delivery of services by the Community group vary in size, condition and location and are numerous. Ownership of community properties, of which the Trust delivers services from (nearing 120 in number), is mixed, with the Trust occupying space owned or leased by a number of organisations including: NHS Property Services Ltd, Local Authorities, General Practitioners (GP’s) and private landlords.

At the time of drafting this Strategy a project is underway to consider the following six questions pertinent to the Community Estate:

1. From which properties do we deliver services? 2. Are the properties efficient, safe, sustainable, fit for purpose (in line with Estate Code) and are they providing value for money? 3. Are the properties appropriately strategically positioned and aligned to the Trust Clinical Services Strategy? 4. Are properties used or able to be utilised flexibly and in the most efficient manner? 5. Are appropriate agreements in place with property owners? 6. Do opportunities exist to rationalise the community estate by surrender or co-location of services or with other public sector bodies?

A schedule of community properties, the type of occupancy, the Agreement required and their current ownership is shown in Appendix 2.

In relation to point 2 above, the Trust has interests in a number of properties off the main hospital sites again under differing ownerships and with a range of Agreements. As part of the ongoing project the above six questions will be asked in relation to those properties also.

A schedule of “offsite” community properties and their current status is shown in Appendix 3

EVALUATION OF THE EXISTING ESTATE: THE SIX FACET SURVEY A six Facet Property Appraisal was carried out on various properties at Northern Lincolnshire and Goole NHS Foundation Trust during November and December 2014. The survey covered the Condition of the properties, (including the fabric of the buildings, fixtures and fittings and the electrical and mechanical installations), Statutory Compliance, Space Utilisation, Functional Suitability, Quality of Environment and Environmental Management. The results are presented in tabular form on MICAD spreadsheets with total costs and Risk analyses of the Condition and Statutory costs. The results of these surveys are summarised in the following tables. The current size of the estate (end of March 2015) is summarised in Table 3.

Page 13

Table 3: The current size of the estate

Site Area sq.m (GIA) 87,096.18 Diana Princess of Wales Hospital

Scunthorpe General Hospital 59,049.58

Goole & District Hospital 19,483.05 165,628.81 Total

The area of the Estate has been utilised to allow for an analysis of overall condition ratings of the various facets as an overall percentage of the Estate area.

Physical Condition The appraisal was carried out addressing each of the main physical elements pertaining to NHS building stock listed in ‘Land and Property Appraisal’ (and previously in Estate Code) as indicated in below. The scope covers all building, M & E elements including infrastructure and external works.

PHYSICAL CONDITION

BUILDING MECHANICAL ELECTRICAL  Structure  Heating system  Electrical system  External fabric  Steam system  Telecommunications  Roof  Ventilation system  Alarms and detection systems  Internal fabric  Piped medical gases and vacuum pumps  Fixed plant  Internal fittings and fixtures  Hot and cold water  Building systems management control  External works - system grounds and  Lifts and hoists

gardens  Boilers and calorifiers

 Drainage and  Fixed plant and sewerage and equipment water supply

 Fuel storage and

distribution

Page 14

The average overall condition of each element will be assessed against the categories and definitions as detailed in Land and Property Appraisal, summarised below:

A As new (less than two years old) and can be expected to perform adequately to its full normal life.

B Sound, operationally safe and exhibits only minor deterioration.

B (C) Currently as B but will fall below B within five years.

C Operational but major repair or replacement is currently needed to bring up to condition B.

D Operationally unsound and in imminent danger of breakdown.

X Supplementary rating added to C or D to indicate that a full rebuild, relocation or replacement is needed (i.e. repairs are impractical or too expensive to be tenable).

Overall average building conditions can be summarised as:

A A facility of excellent quality.

B A facility requiring general maintenance investment only.

C A less than acceptable facility requiring capital investment.

AD very Poor facility requiring significant capital investment or replacement.

The results of the physical condition appraisal are summarised below at site level in Tables 4 to 6.

Page 15

Table 4: Diana Princess of Wales Hospital – Physical Condition of the Estate DPoW-Physical Condition EstateCode A B B(C) C D Category & Currently Acceptable Acceptable Requires Unacceptable Definition New Condition (within 5 Investment Condition years) Area sq.m 0 36,601 29,958 5,562 21.64 Percentage of the estate 0% 50.73% 41.53% 7.71% 0.03% (area) in each category

Table 5: Scunthorpe General Hospital – Physical Condition of the Estate SGH-Physical Condition EstateCode A B B(C) C D Category & Currently Acceptable Acceptable Requires Unacceptable Definition New Condition (within 5 Investment Condition years) Area sq.m 0 37,703 6,011 10,928 0 Percentage of the estate 0% 68.58% 11.31% 20.11% 0% (area) in each category

Page 16

Table 6: Goole and District Hospital – Physical Condition of the Estate GDH-Physical Condition EstateCode A B B(C) C D Category & Currently Acceptable Acceptable Requires Unacceptable Definition New Condition (within 5 Investment Condition years) Area sq.m 0 14,454 2,048 2,048 0 Percentage of the estate 0% 74.19% 12.55% 13.26% 0% (area) in each category

The Appraisal shows that there is only a very small percentage of the estate in an unacceptable condition 0.03% total area at Diana Princess of Wales Hospital site only. The Estate area requiring investment is fairly low as an overall percentage of sites with Scunthorpe General Hospital site requiring the most significant investment on an area percentage of 20.11% of total area, with Goole and District Hospital at 13.26% of total area and Diane Princess of Wales Hospital at only 7.71% of total area.

Compliance with Fire and Statutory Safety

The Property Appraisal addressed Statutory Requirements; these covered the following:

STATUTORY REQUIREMENTS

FIRE HEALTH & SAFETY

 Compartmentation  Health and Safety at Work etc. Act and Workplace (including surface  Fire doors temperature of heat-emitting devices)  Means of escape  Electrical services  Alarm and detection systems  Asbestos  Textiles and furniture  Control of Legionellae

 Food Hygiene  COSHH  Disability Discrimination Act  Pressurised systems  Work Equipment

Page 17

Where any of the above Fire and Health and Safety elements do not achieve condition B, cost estimates involved in remedying any deficiencies have been identified. The average overall compliance of each element will be assessed against the categories and definitions as detailed in Land and Property Appraisal, summarised below:

A Complies fully with current mandatory fire safety requirements and statutory safety legislation.

B Complies with all necessary mandatory fire safety requirements and statutory safety legislation with minor deviations of a non-serious nature.

B(C) Currently as B but will fail below B within five years as a consequence of unabated deterioration or knowledge of impending fire safety requirements or statutory safety legislation.

C Contravention of one or more mandatory fire safety requirements and statutory safety legislation, which falls short of B.

D Dangerously below condition A and B.

The results of the statutory appraisals are summarised below at site level in Figures 7 to 11.

Table 7: Diana Princess of Wales Hospital – Compliance with Statutory Safety DPoW-Statutory Safety Estate Code A B C D Category & Non-Compliant Compliant Fully On One Or Dangerously Non- Definition With Minor Compliant More Compliant Deviations Standards Area sq.m 0 58,430 10,820 2,885 Percentage of the estate (area) in each 0% 75.40% 19.73% 4.87% category

Page 18

Table 8: Diana Princess of Wales Hospital – Compliance with Fire Safety

Fire Safety

A B C D Estate Code Non-Compliant Category & Compliant With Dangerously Fully Compliant On One Or More Definition Minor Deviations Non-Compliant Standards

Area sq.m 0 77,356 7,959 2,094

Percentage of the estate 0% 88.50% 9.10% 2.40% (area) in each category

Table 9: Scunthorpe General Hospital – Compliance with Statutory Safety

SGH-Statutory Safety EstateCode A B C D Category & Definition Non-Compliant Compliant Fully On One Or Dangerously Non- With Minor Compliant More Compliant Deviations Standards Area sq.m 0 50,653 3,934 54.64 Percentage of the estate (area) in each 0% 93.25% 6.75% 0% category

Table 10: Scunthorpe General Hospital – Compliance with Fire Safety

Fire Safety

A B C D Estate Code Non-Compliant Category & Compliant With Dangerously Fully Compliant On One Or More Definition Minor Deviations Non-Compliant Standards

Area sq.m 0 55,014 4,602 135

Percentage of the estate 0% 92.07% 7.70% 0.23% (area) in each category

Page 19

Table 11: Goole and District Hospital – Compliance with Statutory Safety

GDH-Statutory Safety EstateCode A B C D Category & Definition Non-Compliant Compliant Fully On One Or Dangerously Non- With Minor Compliant More Compliant Deviations Standards Area sq.m 0 14,023 1,733 0 Percentage of the estate (area) in each 0% 92.42% 7.58% 0% category

Table 12: Goole and District Hospital – Compliance with Fire Safety

Fire Safety

A B C D Estate Code Non-Compliant Category & Compliant With Dangerously Fully Compliant On One Or More Definition Minor Deviations Non-Compliant Standards

Area sq.m 0 16,533 2,950 0

Percentage of the Estate 0% 84.86% 15.14% 0% (area) in each category

The Appraisal shows that there is only a very small percentage of the Estate with identified issues which are classified as dangerously non-compliant for the Diana Princess of Wales Hospital and Scunthorpe General Hospital.

Backlog Costs Backlog Maintenance and Statutory costs are graded as Low, Moderate, Significant and High Risk. The division of Low, Moderate, Significant and High Risks plus the calculation for Risk Adjusted totals were carried out as per the NHS Estates guide ‘A Risk-Based Methodology for Establishing and Managing Backlog’. The Risk Adjusted totals take into account the perceived ‘Risk’ of the defect in terms of ‘Likelihood’ and ‘Severity’, the estimated cost for rectification and, in the case of Low or Moderate Risks, the estimated remaining life of the building. For Low and Moderate Risks the projected costs are divided by the estimated life expectancy of the building as prescribed in the Guide. The Risk adjusted backlog formula is based on the premise that the eradication of safety-critical backlog will have greater impact on the Risk Adjusted figure than non-critical backlog (and hence will focus attention on reducing ’High’ and ‘Significant’ risk sub-elements). Similarly, the higher the Page 20 remaining life of each building/block the longer the period in which the lower risk sub-elements can be addressed and therefore the lower the risk adjusted backlog figure. The backlog and risk adjusted backlog are summarised below at site level in Table 13 to 16.

Table 13: Diana Princess of Wales Hospital – Backlog Costs Backlog Costs Facet Low Moderate Significant High Total Total Risk Adjusted £ Risk Risk Risk Risk £ Physical £ 512,497 8,968,703 7,174,962 8,968,703 25,624,866 16,617,726 % of Condition 2% 35% 28.00% 35% 100% 65% Total £ 109,563 913,025 547,815 2,081,969 3,652,372 2,606,855 Compliance with Fire / % of Statutory 3% 25% 15% 57% 100% 71% Total £ 622,060 9,881,728 7,722,777 11,050,673 29,277,238 19,298,639 Total % of 2.12% 33.75% 26.38% 37.74% 100% 66% Total

Table 14: Scunthorpe General Hospital – Backlog Costs Backlog Costs Facet Low Moderate Significant High Total Total Risk Adjusted £ Risk Risk Risk Risk £ Physical £ 432,103 7,561,804 6,049,443 7,561,804 21,605,155 14,010,943

Condition % of Total 2% 35% 28% 35% 100% 65%

£ 90,955 757,957 418,535 1,728,142 2,995,589 2,189,123 Compliance with Fire / Statutory % of Total 3% 25% 14% 58% 100% 73%

£ 523,058 8,319,761 6,467,979 9,289,946 24,600,744 16,200,066 Total % of Total 2.13% 33.82% 26.29% 37.76% 100% 66%

Table 15: Goole and District Hospital – Backlog Costs Backlog Costs Facet Low Moderate Significant High Total Total Risk Adjusted £ Risk Risk Risk Risk £ Physical £ 96,446.88 1,687,820 1,350,256 1,687,820 4,822,344 3,127,290

Condition % of Total 2% 35% 28% 35% 100% 65%

£ 25,863.51 215,529 129,318 491,407 862,117 632,794 Compliance with Fire / Statutory % of Total 3% 25% 15% 57% 100% 73%

£ 122,310.39 1,903,350 1,479,574 2,179,227 5,684,461 3,760,084 Total % of Total 2.15% 33.48% 26.03% 38.34% 100% 66%

Page 21

Table 16: Community Properties – Backlog Costs

Backlog Costs

Facet Low Moderate Significant High Total Total Risk Adjusted £ Risk Risk Risk Risk £ Physical Condition £ 60,166.50 892,469.75 50,138.75 0.00 1,002,775 97,770.56 % of Total 6% 89% 5% 0% 100% 10% Compliance with Fire/ Statutory £ 0.00 16,843.50 71,806.50 0.00 88,650 72,648.68 % of Total 0% 19% 81% 0% 100% 82% Total £ 60,166.50 909,313.25 121,945.25 0.00 1,091,425 170,419.24 % of Total 6% 83.31% 11.17% 0.00% 100% 15.61%

The total backlog cost for all the surveyed Estate is £60,451,061 the appraisal identifies significant high risk backlog costs which results in a relatively high risk adjusted backlog cost of £16,791,527.

Significant high risk items have been identified at all sites with a high risk percentage based on block areas of 37.74% of the site for Diana Princess of Wales Hospital site, 37.76% for the Scunthorpe General Hospital site and 38.34% for the Goole and District Hospital site, Environmental Management Elements for conducting an appraisal of Environmental Management were reported at site level:

ENVIRONMENTAL MANAGEMENT

PROCUREMENT ENERGY WATER WASTE TRANSPORT PERFORMANCE CONSUMPTION MANAGEMENT MANAGEMENT

i) A general overview of the site was gained from an analysis of the relevant Performance Indicator data (i.e. energy usage per unit volume - GJ/100 cubic metres). ii) The energy performance was compared with published performance bands to determine the category A. B. C. D. iii) Water consumption, Waste management and Transport management practice and performance was reviewed in terms of Best Practice, Good Practice or Poor Practice; any improvements in environmental management will be considered at site level as appropriate. iv) Water, Waste and Transport will be categorised as A, B, C and D. The environmental management facet results are summarised below at site level in Tables 17 to 19.

Table 17: Diana Princess of Wales Hospital – Environmental Management

Page 22

Environmental Management

Estate Code A B C D Category & Excellent Acceptable Improvement Poor Definition Performance Performance Needed Performance

Area sq.m 0 38,848 48,561 0

Percentage of the Estate 0% 44.44% 55.56% 0% (area) in each category

Table 18: Scunthorpe General Hospital – Environmental Management

Environmental Management

Estate Code A B C D Category & Excellent Acceptable Improvement Poor Definition Performance Performance Needed Performance

Area sq.m 6,639 46,473 6,639 0

Percentage of the Estate 11.11% 77.78% 11.11% 0% (area) in each category

Table 19: Goole and District Hospital – Environmental Management

Environmental Management

Estate Code A B C D Category & Excellent Acceptable Improvement Poor Definition Performance Performance Needed Performance

Area sq.m 4,329 12,989 2,165 0

Percentage of the Estate 22.22% 66.67% 11.11% 0% (area) in each category

Page 23

The appraisal has identified improvements needed for environmental management at all the surveyed sites.

Functional Suitability

An assessment of Functional Suitability was carried out for each floor. The following factors were considered.

FUNCTIONAL SUITABILITY

INTERNAL SPACE SUPPORT FACILITIES LOCATION RELATIONSHIPS  Adequate toilets and  Distance to key linked  Critical dimensions bathrooms for the number facilities not excessive are suitable for the of users  Relationship to car function  Adequate storage space parking areas is clear  Observation of and reasonably close  Adequate seating and dependent patients waiting space  Access to public by staff transport links is good  Provision has been made  Separate sex bed / for disabled people  Access via vertical or cubicle areas and horizontal toilet facilities communication (lifts,  Security is stairs) is good maintained for both staff and patients

The Functional Suitability facet results are summarised below at site level in Table 20 to 22.

Table 20: Diana Princess of Wales Hospital – Functional Suitability

Functional Suitability

A B C D Estate Code Category & Very Satisfactory Satisfactory Not Satisfactory Unacceptable In Definition No Change Minor Change Major Change Present Needed Needed Needed Condition

Area sq.m 0 71,314 16,095 0

Percentage of the Estate 0% 81.59% 18.41% 0% (area) in each category

Page 24

Table 21: Scunthorpe General Hospital – Functional Suitability

Functional Suitability

A B C D Estate Code Category & Very Satisfactory Satisfactory Not Satisfactory Unacceptable In Definition No Change Minor Change Major Change Present Needed Needed Needed Condition

Area sq.m 0 54,082 5,669 0

Percentage of the Estate 0% 90.51% 9.49% 0% (area) in each category

Table 22: Goole and District Hospital – Functional Suitability

Functional Suitability

A B C D Estate Code Category & Very Satisfactory Satisfactory Not Satisfactory Unacceptable In Definition No Change Minor Change Major Change Present Needed Needed Needed Condition

Area sq.m 0 19,141 342 0

Percentage of the Estate 0% 98.24% 1.76% 0% (area) in each category

The appraisal identified large areas of the Estate at all surveyed sites which required minor changes to improve functional suitability, only a small percentage of areas at all the surveyed sites required major changes with the most significant being 18.41% of the total site area for Diana Princess of Wales Hospital site.

Space Utilisation

The objective of the space utilisation survey was to assess how well the available space is being used in order to satisfy the reasonable demands of the present function and planned requirements. The identification of under-used space and spare capacity may enable substantial revenue savings to be made which can then be reinvested to enhance or extend the service. i) Space utilisation will be assessed under (a) Current Use and (b) Use Over Time for each floor and be scored A, B, C or D. Page 25

SPACE UTILISATION

CURRENT USE USE OVER TIME  Empty (E)  Empty for the majority of time (E)  Underused (U)  Underused for long periods (U)  Fully Utilised (F)  Fully used most of the time (F)  Overcrowded (O)  Overcrowded for more than half of the time (O)

The Space Utilisation facet results are summarised below at site level in Tables 23 to 25.

Table 23: Diana Princess of Wales Hospital – Space Utilisation

Space Utilisation

Estate Code E U F O Category & Definition Empty / Not Used Under Utilised Fully Utilised Overcrowded

Area sq.m 7,238 835 64,304 15,032

Percentage of the Estate 8.28% 0.96% 73.57% 17.20% (area) in each category

Table 24: Scunthorpe General Hospital – Space Utilisation

Space Utilisation

Estate Code E U F O Category & Definition Empty / Not Used Under Utilised Fully Utilised Overcrowded

Area sq.m 1,171 1,953 52,331 4,296

Percentage of the Estate 1.96% 3.27% 87.58% 7.19% (area) in each category

Page 26

Table 25: Goole and District Hospital – Space Utilisation

Space Utilisation

Estate Code E U F O Category & Definition Empty / Not Used Under Utilised Fully Utilised Overcrowded

Area sq.m 2,165 5,628 11,690 0

Percentage of the Estate 11.11% 28.89% 60.00% 0% (area) in each category

The appraisal identified areas which were underutilised at all the surveyed sites areas which were over-utilised were also identified at the Diana Princess of Wales Hospital and Scunthorpe General Hospital sites with 17.20% and 7.19% of the total site area classified as overcrowded for these sites respectively.

Quality

The Quality Facet comprised a detailed assessment of each of the buildings covering the 28 sub- elements under amenity, comfort engineering and design at each floor.

QUALITY

AMENITY (FUNCTION) COMFORT ENGINEERING DESIGN  Attractive main  Artificial lighting  Colour is creatively entrance / reception enhances overall and therapeutically area / department design used for definition and variety  Privacy and dignity  Comfort conditions are issues are achieved in heating  Landscaping is addressed  Comfort conditions are attractive  Confidential achieved in ventilation  Planting is optimised conversations can  Acoustic privacy is for all seasons be held achieved satisfactorily  Natural daylight is  Noise levels are  Toilet facilities are used to optimum acceptable well provided effect  Persistent odours are  Appropriate storage absent  Appropriate finishes provision has been are used for floors,

Page 27

made ceilings and walls

 Disabled users are  Furniture co- catered for ordinates well with  Appropriate overall design facilities are  Art and craft work is provided for integrated into children overall design  Seating and waiting areas are sufficient  Interior is reassuring and non-clinical  Appropriate safety where appropriate and security measures are in  Wherever possible place patients and staff  Wayfinding is have pleasing views visible, legible and from both inside and consistent outside the building  Adequate car  First impressions of parking facilities entrance / reception areas are welcoming  Accessible by public and private transport

The Quality facet results are summarised below at site level in Table 26 to 28.

Table 26: Diana Princess of Wales Hospital – Quality of the Estate

Quality

A B C D Estate Code Less Than A Very Poor Category & Acceptable Excellent Quality Acceptable Quality Definition Major Investment Environment Needed

Area sq.m 0 81,127 6,282 0

Percentage of the Estate 0% 92.81% 7.19% 0% (area) in each category

Page 28

Table 27: Scunthorpe General Hospital – Quality of the Estate

Quality

A B C D Estate Code Less Than A Very Poor Category & Acceptable Excellent Quality Acceptable Quality Definition Major Investment Environment Needed

Area sq.m 0 53,374 6,377 0

Percentage of the Estate 0% 89.33% 10.67% 0% (area) in each category

Table 28: Goole and District Hospital – Quality of the Estate

Quality

A B C D Estate Code Less Than A Very Poor Category & Acceptable Excellent Quality Acceptable Quality Definition Major Investment Environment Needed

Area sq.m 0 18,312 1,171 0

Percentage of the Estate 0% 93.99% 6.01% 0% (area) in each category

The appraisal identified no significantly poor quality environments, all sites had some areas which were recommended for improvements to the quality of the environment.

5. WHERE DO WE WANT TO BE

Clearly, the Trust will need to address the current poor condition and performance of the estate and move towards the provision of safe, secure, high-quality healthcare buildings appropriate for the delivery of modern healthcare services. However, the Estate Strategy and any proposed investment in the estate must be “service led” with the patient at the centre of any proposed changes. It is widely recognised that the specialist nature of healthcare services necessitates that buildings must be planned on the basis of “form must follow function” if they are to achieve this aim.

Changes are taking place both within the local health economy and across the country to ensure that the NHS is in the best possible shape to meet future health needs and improve people’s health and

Page 29 well-being. A number of key documents set out the future strategic direction and vision for the Trust and its commissioners and have been influential in shaping this Estate Strategy:

• The Trust’s Operational Plan • Integrated Business Plans for each of the Directorates and Groups.

The changes to healthcare services described within these documents are part of a wider programme of change across the country driven by:

• Changes in people’s health needs; • Increasing public expectation in terms of access to a comprehensive range of high quality, efficient and effective healthcare services and choice on how they use services; • Advances in medical and nursing practice that enable patients to be treated in new and different ways; • Developments in medical, communications and information technology that make care closer to home a plausible reality

• National initiatives aimed at making the NHS more effective and efficient - The NHS Plan and the NHS Improvement Plan; “Our NHS, Our Future – Next Stage Review”; NHS Operating Framework.

In response to these drivers for change, the Trust Board has set the following strategic aims; Focusing on the needs of people who use our services:

• Organisational aims: • Achieve a savings total of £12 to £15m per year in 2015/16 and 2016/17, and £6m to £10m in following years.

For people that use our services and their careers, this means that we will strive to achieve excellence in all we do, to achieve the best possible outcomes through the delivery of high quality, consistent services, with personalised and accessible care. Clearly, in response to these aims we need to develop innovative and forward looking solutions that will achieve a productive estate and aims to:

• Improve access and service user experience; • Provide in-patient accommodation that is clinically suitable, effective and meeting or exceeding relevant minimum standards; • Minimise risk and promote safety for people who use our services, our staff and visitors; • Disinvest from assets with high operating costs, backlog maintenance requirements, or short remaining life where these do not meet future service requirements; • Seek optimum solutions through co-location, integration and shared resources across service streams; • Improve estates asset performance on all key performance indicators; • Release capital from the disposal of assets that are no longer required for current and future services; • Develop supporting infrastructure for optimum operational effectiveness; • Develop / procure flexible accommodation for locality based services; • Integrate services with other health / social care facilities wherever possible; • Ensure affordable investment plans, based on activity models, as part of the Service Line model;

Page 30

• Develop inherent flexibility in our owned and leased properties, to enhance our responsiveness to market changes or activity adjustments, for both positive and negative variations.

Against the background described above, the Trust is undertaking work in the following key areas:

• Healthy Lives Healthy Futures Programme • Developing an active marketing and communication strategy to expand a range of services to increase market share.

Targets for change:

The estate strategy will target improvement in the estate as follows:

• Improvements in the quality of the operational estate over time (which can be measured through reductions in backlog maintenance costs/risks; • Improvements in statutory compliance and reduction in risk (which can be measured through reductions in non-compliance with statutory legislation and incident rates); • Improvements in energy performance, utilising the Energy performance Contract with British Gas (in line with mandatory targets for NHS organisations in England) compliant with BREEAM Healthcare in carbon emission, water consumption, waste and transport management; • Reductions in the revenue cost of the operational estate over time (which can be measured by mapping trends in overall maintenance costs, utilities costs and the Trust’s income-to-asset value ratio); • Improvements in the use of the estate over time, that is, eliminating under-used and surplus assets (which can be measured by comparing building floor area with total site area and by income-to-asset value ratio);

The Trust’s vision and ambitious agenda for change over the next decade simply cannot be achieved without significant change and investment in its estate.

Model of Service Delivery:

• Collaboration is now central to the way in which the Trust manages and delivers across all its service lines. Rigid boundaries between the Trust, Local Authority organisations, voluntary, and community agencies are becoming more permeable as the people who use services require more innovative ways of developing and delivering services. The most familiar form of collaborative arrangement that the Trust uses is that of partnership. The Trust has established partnerships of various forms with those with whom it has a shared commitment to improve the mental health and well-being of particular groups and communities;

• The Trust is committed to working in this way to benefit all those who need and use the Trust’s services and has established methods to achieve this, from the formal arrangements of integration between Local Authority and Trust partners;

Therefore, the Trust will continue the emphasis on working collaboratively and in partnership with a wide range of public bodies, voluntary organisations and the independent sector. This should enable properties to be selected on the basis of strategic fit and need rather than ownership or tenancy. Again, the aim being to ensure that the identification of spokes is service led with the patient at the centre of decision making. Page 31

6. HOW DO WE GET THERE

This final section will seek to set a series of inter-linking and cross cutting projects intended to move forward the reduction in estates, backlog and costs whilst continually addressing the future needs of the Trust services.

Strategic Planning

The Trust has limited capital to invest in its estate and services so the aim of this strategy is to ensure investment decisions are taken in a context that will achieve the Trust’s goals and commissioners’ intentions going forward and which mitigate risk. The Trust’s Strategy & Planning group set up to consider and make recommendations around the services the Trust should invest and divest itself along with recognising new business opportunities. The output from this forum has been used to make some planning assumptions that have been used to formulate this strategy.

Areas for possible development have been identified via the strategic planning process; the Estates Rationalisation project has identified areas for development and contraction. Key backlog maintenance issues have also been identified within the outline plan.

DPoW

Areas for review

Figure 4 – DPOW Southside Figure 5 – DPOW Northside

Projects Proposed:

• Disposal of surplus land to the Southside of Diana, Princess of Wales Hospital, figure 4; • Demolition and reconfiguration of the land to the Northside of Diana Princess of Wales Hospital, figure 5; • Construction of new staff accommodation to support staff recruitment and retention;

Page 32

• Re-configure, upgrade and improve the existing on-site catering facilities, to both improve the overall dining experience for patients, staff and visitors and the overall profile and attractiveness of the site; • Conclusion of the reconfiguration of the remaining hospital wards on ‘C’ Floor including the Coronary Care Unit; • Continued upgrade of hot water service pipework on A, B and C floors; • Centralisation of Pharmacy Aseptic Facilities; • Upgrade of theatres 5 and 6, including the creation of two lay-up rooms and an additional laminar flow in theatre 3. • Creation of an Ophthalmic Suite • Development of an additional MRI and CT • Development of an Assisted Living Centre (ALC) Completed 2015 • New Cardiology Day Case Unit to be sited in the old OPD area; Completed 2015 • Create a Home from Home facility on ward A1 through a joint venture with NAVIGO; Completed 2015

The above represents a summary of the larger schemes and is not listed in any specific order of priority.

As previously identified the Trust has areas of its estate that are underutilised. The Grimsby site is by far the biggest site and lends itself to being reduced. The agreed strategy to reconfigure the Northside of the site has been a stated intention for a number of years.

SGH

Areas for review

Figure 6

ADMIN A & E BLOCK

DERMATOLOGY

OUTPATIENTS X-RAY

DEMOLITION

BOILER REFURBISHMENT CORONATION BLOCK LINDSEY PATHOLOGY SUITE HOUSE STEPPING STONES WARD 2

Scunthorpe General Hospital HOSPITAL RADIO MODULAR WARD 5 BUILDING

WARDS 16/17

WORKSHOPS BUTERWICK HOUSE

SERVICE QUEENS CENTRE TRAINING BUILDING & DEVELOPMENT Reservoir (covered) MENTAL HEALTH

Croxton House Belton House Hall

IT DEPT

Elsham House

Projects Proposed:

• Relocation of existing Endoscopy Services into vacant Carer Unit; • Reconfiguration of theatres • Reconfiguration of the Critical Care Unit (CCU) • Relocate Belton House • Implement Scunthorpe Accommodation Strategy • Optimise use of clinical space;

Page 33

• Re-purpose Coronation block; • Relocate remaining services in Coronation block to fully empty block; • Demolish Belton and Croxton House. • Development of an additional MRI and CT

The above represents a summary of the larger schemes and is not listed in any specific order of priority.

Goole

Areas for review

Figure 7

• Redevelopment of Goole site to accommodate output of work on the Goole Health Campus Project; • Review site usage against commissioning intentions; • Expand Community base

Along with the new developments there is a need to reduce the overall size of the estate so the following additional Facilities lead projects have also been developed.

Backlog Maintenance

Investment is a necessity in order to reduce the backlog maintenance and to maintain control of the sites’ services, which are rapidly reaching the end of their useful life. The Trust is currently planning for a recurrent £1.5 million capital backlog investment which is below the minimum required to maintain the current estate, however with the estate reductions planned within this strategy this will reduce the current backlog level and with careful risk assessment of remaining backlog items it should be possible to maintain the current backlog levels. Key backlog projects areas currently planned are shown in table 12.

Page 34

Table 29 - Backlog Key Themes

Backlog Item 2015/16 £’000 Water Infrastructure 130 Fire Compliance 120 Electrical Infrastructure 96 H&S Equality Act Compliance 90 Lifts 300 Engineering Plant Replacement 564 Replacement of Coal Fired Boilers 0 Upgrade of the Steam Plant 0 Theatre Upgrades 550

Sustainability

Any new developments both within the main hospital estate or community must look to ensure both energy sustainability and local sustainability is taken into account. The Trust has a Carbon Management Plan that details energy schemes as well as waste schemes to reduce the cost on the impact on Trust finances.

An extensive project is currently underway to improve the energy efficiency of the Trust’s buildings, this Energy Performance Contract is expected to offer to reduce energy expenditure by 13% and reduce £3.4m of backlog maintenance.

The Trust also is currently revising its Travel Plan that will support the Trust in ensuring that its staff, visitors and patients are able to access its services with as little problem as possible.

Estates Reduction

The plans and projects identified earlier will deliver reduction in the use of specific areas of the Trust’s estate, leaving these to be disposed of or demolished which will reduce estate costs. The specific reductions identified currently are:

1. Vacate the Northside and disposal of surplus land at DPoW; 2. Vacate and demolish Belton, Elsham and Croxton House at SGH; 3. Develop vacant space at Goole to improve utilisation

Residential Properties

The Trust owns residential accommodation at SGH consisting of 11 blocks of single bed student accommodation and one bed flats; there are also a small number of accommodation which is used for on call purposes only whilst at the Goole site the Trust owns 6 semi-detached houses within the curtilage of the site.

Page 35

At DPoW site the Trust owns 7 residential blocks consisting of student one bed rooms and single bedroom flats, there are also five semi-detached houses on the DPoW site; the four semi-detached houses at Juniper Way are within the land sale boundary and as such will be no longer Trust housing stock once the land sale is complete.

Community Properties

On completion of the project alluded to above with regard to Community properties, comprehensive and validated detail will be available to inform strategic decision making to ensure that the Trust delivers services from flexible properties commensurate in condition and strategic location to the needs of the community.

Post “Transforming Community Services” several leased community properties have now come under the remit of this Estates Strategy (Appendix 1). When added to the existing Trust community estate (Appendix 3), this provides scope to rationalise the usage, reduce costs and improve the environment for these services.

North East Lincolnshire also has a large portfolio of community estate which is underutilised. Work is ongoing with commissioners to identify suitable services within the Trust’s hospital site that could potentially make the move into community freeing up Trust estate for disposal and increase utilisation of newer, more functional, efficient and sustainable community estates.

Financial Planning

The Estates Strategy has listed various projects and rationalisation schemes that will require financial investment in order to undertake the work listed is a brief financial assessment of investment required. Estimates have been provided where costs are not fully understood, colours indicate years in which projects plan to be undertaken.

Table 30 – Financial Investment

Element 2015/16 2016/17 2017/18 2018/19 2019/20

Major Schemes 5.5 5.4 5.0 4.0 4.0 Backlog Maintenance 1.7 2.0 2.0 2.0 2.0 Accommodation 1.1 15.6 0.3 0.3 0.0 Energy 5.0 0.2 1.5 0.0 0.0 Total 13.4 23.3 8.8 6.3 6.0

7. CONCLUSION

The Trust faces changes to its services at an unprecedented level and unless the estate can be reduced or reconfigured the Trust will be unable to meet these new demands. The strategy explained in this document is one that has been arrived at in conjunction with the Trust’s Strategic Plan.

The Estate is overall in poor condition with and total risk adjusted backlog of £16,791,527. The majority of areas will require lifecycle replacements to some items with a total impending backlog (years 1-5) of £26,662,394 for the whole Estate.

There are Statutory items that require immediate remedial action in the majority of blocks with a total cost of £3,660,360 for the whole Estate.

Page 36

As part of this Strategy, statutory compliance items will be carried out first, followed by high risk backlog items under physical condition, followed by significant then moderate and low risk items. The Trust will also address the significant issues identified under Function, Quality, Space and Environmental as discussed below during any Capital works to address backlog issues and as part of the wider Health Estate review.

A significant item identified is a £12,947,439 cost for functional suitability for the whole Estate. This is primarily due to changes in service provision, changes in work practices and expansions in teams within buildings that are simply too small for function or were constructed and designed for another function which does not provide a suitable layout and space for services. Older estate is often difficult to reconfigure to provide correct layouts and facilities suitable for today’s work methods and services and costs have been allowed to reflect this. Space provision is also an issue to some areas with total remedial costs at £722,700 at the Scunthorpe General Hospital site only.

Quality of the environment to many blocks is an issue with a cost of £189,246 identified for the whole Estate with recommendations including improvements to general appearance and comfort engineering being common issues.

A cost of £35,000 has been identified for environmental management this includes site wide improvements to management of issues including energy, water, transport and waste.

Total costs for the entire surveyed Estate for all 6 facets are £73,251,201 for a 5 year programme.

8. APPENDICES

Page 37

Appendix 1 – Residential Properties

Details of On- Site NLAG Accommodation Properties Net Book Value as at 31/12/2011 Freehold / Leasehold Leasehold Expiry Date Future Plans £k 138 Scartho Road 51,164 Freehold - Retain - office accommodation 140 Scartho Road 150,000 Freehold - Retain - on call accommodation 142 Scartho Road 120,00 Freehold - Retain 144 Scartho Road 105,400 Leasehold 13 May 2024 Retain Croxton Freehold - Demolish Alkbourough Freehold - Retain - Refurbish Edward Jenner Freehold - Retain - Refurbish Saxby Freehold - Retain - Refurbish Keelby Freehold - Retain - Refurbish Elsham Freehold - Demolish

Page 38

Appendix 2 – Community Estate (Community & Therapies)

Premises Status - Exclusive or Type of Occupancy Owner Detail Sessional Agreement Required to Formalise 1 Prince Albert Gardens, Grimsby, DN31 3AG Exclusive Lease 7KS South Park Enterprise College, 45a Newdown Sessional Licence Road, Scunthorpe, DN17 2TX Allerton Primary School, Allerton Drive, Immingham, Sessional Licence Local Authority DN40 2HP Ashby Clinic, Collum Lane, Scunthorpe, DN16 2SZ Sessional Licence NHS Property Services Ltd. Ashby Clinic, Collum Lane, Scunthorpe, DN16 2SZ Exclusive Lease NHS Property Services Ltd. Axholme Academy, Wharf Road, Crowle, DN17 4HU Sessional Licence Axholme Academy Barnard Court, Old Courts Road, Brigg, DN20 8LA Sessional Licence Rotherham, Doncaster and South Humber NHS FT Barnard Court, Old Courts Road, Brigg, DN20 8LA Exclusive Lease Rotherham, Doncaster and South Humber NHS FT Barnetby Medical Centre, Victoria Road, Barnetby, Sessional Licence GP DN38 6HZ Barton Children’s Centre, Castledyke West, Barton, Sessional Licence Local Authority DN18 5AP Baysgarth School, Barrow Road, Barton, DN18 6AE Sessional Licence Local Authority Birkwood Medical Centre, Westward Ho, Grimsby, Sessional Licence GP DN34 5BH Bottesford Civic Hall, Bramley Crescent, Bottesford, Sessional Licence Local Authority DN16 3SN Brigg Children’s Centre, Grammar School Road, Brigg, Sessional Licence Local Authority DN20 8AS Broughton Surgery, 27 Brooklands Avenue, Broughton, Sessional Licence GP DN20 0DY Bursar Primary School, Bursar Street, Cleethorpes, Sessional Licence Local Authority DN35 8DS Cambridge Park Academy, Cambridge Road, Grimsby, Sessional Licence Local Authority DN34 5EB Canon Peter Hall School, Pelham Road, Immingham, Sessional Licence Local Authority DN40 1JS

Page 39

Churchview Medical Centre, Cartergate, Grimsby, Sessional Licence GP DN31 1QZ Cleethorpes Primary Care Centre, St Hughs Avenue, Exclusive Lease NHS Property Services Ltd. Cleethorpes, DN35 8EB Congregational Church Hall, Ferry Road West, Sessional Licence The Congregational Church Scunthorpe, DN15 8QE Cromwell Primary Care Centre, Cromwell Road, Exclusive Lease NHS Property Services Ltd. Grimsby, DN31 2BH Cromwell Primary Care Centre, Cromwell Road, Sessional Licence NHS Property Services Ltd. Grimsby, DN31 2BH Crowle Children’s Centre, Manor Road, Crowle, DN17 Sessional Licence Local Authority 4ET Crowle Community Hub, Chancery Lane, Crowle, DN17 Exclusive Lease Local Authority 4HN Edward Heneage Academy, Edward Street, Grimsby, Sessional Licence David Ross Education Trust DN32 9HL Epworth Children’s Centre, Birchfield Road, Epworth, Sessional Licence Local Authority DN9 1DL Epworth Leisure Centre, Burnham Road, Epworth, Sessional Licence Local Authority North Lincolnshire, DN9 1BZ Frederick Gough School, Grange Lane South, Sessional Licence Local Authority Scunthorpe, DN16 3NG Freshney Green Primary Care Centre, Sorrel Road, Sessional Licence NHS Property Services Ltd. Grimsby, DN34 4GB Frodingham Children’s Centre, Rowland Road, Sessional Licence Local Authority Scunthorpe, DN16 1ST Grimsby Leisure Centre, Cromwell Road, Grimsby, Sessional Licence Local Authority DN31 2BH Haldenby House, Doncaster Road, Scunthorpe, DN15 Exclusive Lease NHS Property Services Ltd. 7DQ Henderson Avenue Children’s Centre, Henderson Sessional Licence Local Authority Avenue, Scunthorpe, DN15 7RW Henderson Avenue Children’s Centre, Henderson Sessional Licence Local Authority Avenue, Scunthorpe, DN15 7RW Hibaldstow Medical Practice, 11 Church Street, Sessional Licence GP Hibaldstow, DN20 8ED Hope Street Clinic, Hope Street, Grimsby, DN32 7QL Exclusive Lease NHS Property Services Ltd.

Page 40

Hope Street Clinic, Hope Street, Grimsby, DN32 7QL Sessional Licence NHS Property Services Ltd. Humberston Park School, St Thomas Close, Grimsby, Sessional Licence Local Authority DN36 4HS Huntcliff School, Redbourne Mere, Kirton Lindsey, Sessional Licence Local Authority DN21 4NN Immingham Children’s Centre, Margaret Street, Sessional Licence Local Authority Immingham, DN40 1LD Ironstone Centre, West Street, Scunthorpe, DN15 6EG Exclusive Lease NHS Property Services Ltd. Keadby Children’s Centre, Station Road, Keadby, Sessional Licence Local Authority DN17 3BN Kirton Children’s Centre, Cornwall Street, Kirton Sessional Licence Local Authority Lindsey, DN21 4PQ Kirton Lindsey Surgery, Traingate, Kirton Lindsey, Sessional Licence GP DN21 4PQ Kirton Lindsey Surgery, Traingate, Kirton Lindsey, Exclusive Lease GP DN21 4PQ Kirton Lindsey Surgery, Traingate, Kirton Lindsey, Sessional Licence GP DN21 4PQ Lindsey Lodge Hospice, Burringham Road, Scunthorpe, Exclusive Lease Lindsey Lodge Hospice DN17 2AA Littlecoates Academy, Harlow Street, Grimsby, DN31 Sessional Licence Local Authority 2QX Manor Farm Children’s Centre, Priory Lane, Sessional Licence Local Authority Scunthorpe, DN17 1HE Melior School, Chandos Road, Scunthorpe, DN17 1HA Sessional Licence Local Authority Messingham Family Health Centre, 33 Wendover Sessional Licence GP Road, Scunthorpe, DN17 3SN Open Door, Albion Street, Grimsby, DN32 7DL Sessional Licence The Big Life Outwood Brumby School, Cemetery Road, Sessional Licence Local Authority Scunthorpe, DN16 1NT Outwood Foxhills School, 2 Foxhills Road, Scunthorpe, Sessional Licence Local Authority DN15 8LJ Parkwood Children’s Centre, Plymouth Road, Exclusive Lease Local Authority Scunthorpe, DN17 1SS Pilgrim Primary Care Centre, Pelham Sessional Licence NHS Property Services Ltd. Road,Immingham,DN40 1JW

Page 41

Providence House, Holydyke, Barton, DN18 5PR Exclusive Lease Local Authority Queensway Children’s Centre, Binbrook Way, Exclusive Lease Local Authority Grimsby, DN37 9AT Resource Centre, Queen Street, Grimsby, DN31 1QG Exclusive Lease Local Authority Reynolds Academy, Machray Place, Cleethorpes, Sessional Licence Local Authority DN35 7LJ Riverside Surgery, Barnard Avenue, Brigg, DN20 8AS Sessional Licence GP Scartho Medical Centre, Springfield Road, Grimsby, Exclusive Lease GP DN33 3JF Scartho Medical Centre, Springfield Road, Grimsby, Sessional Licence NHS Property Services Ltd. DN33 3JF Scawby House, Health Place, Wrawby Road, Brigg, Exclusive Lease NHS Property Services Ltd. DN20 8GS Side By Side Children’s Centre, Enderby Road, Sessional Licence Local Authority Scunthorpe, DN17 2JL South Axholme Medical Practice, Pinfold Surgery, Sessional Licence GP Station Road, Owston Ferry, DN9 1AW South Axholme School, Burnham Road, Epworth, DN9 Sessional Licence Local Authority 1BY St Bedes School, Collum Avenue, Scunthorpe, DN15 Sessional Licence Local Authority 7DF St Hughs School, Bushfield Road, Scunthorpe, DN16 Sessional Licence Local Authority 1NB St Lawrences School, Doncaster Road, Scunthorpe, Sessional Licence Local Authority DN15 7DF St Lukes Primary School, Grange Lane North, Sessional Licence Local Authority Scunthorpe, DN16 1BN St Nicholas House, Shelford Street, Scunthorpe, DN15 Exclusive Lease Rotherham, Doncaster and South Humber 6NU NHS FT St Nicholas Primary School, Church Lane, Ulceby, Sessional Licence Local Authority DN39 6TB Stirling Medical Centre, Stirling Street,Grimsby,DN31 Sessional Licence GP 3AE The Beacon, Solomon Court, Cleethorpes, DN35 9HL Exclusive Lease Care Plus Group The Marshes Medical Practice, Butt Lane, Snaith, Sessional Licence GP DN14 9DY

Page 42

Scunthorpe PODS, Ashby Road, Scunthorpe, North Sessional Licence Local Authority Lincolnshire, DN16 1AA The Vale of Ancholme Academy, Grammar School Sessional Licence School Partnership Trust Road, Brigg, DN20 8BA The Willows Care Home, Willow Drive, Barton, DN18 Exclusive Lease Local Authority 5HR Trent View Medical Practice, Chancery Lane, Crowle, Sessional Licence GP DN17 HN Unit 4 Cupola Way, Scunthorpe, DN15 9YJ Exclusive Lease Local Authority Viking Resource Centre,6-8 Fairfield Drive, Barton, Sessional Licence Local Authority DN18 6ER Weelsby View Health Centre, Ladysmith Road, Sessional Licence NHS Property Services Ltd. Grimsby, North East Lincolnshire, DN32 9SW West Common Lane Medical Centre, Dorchester Sessional Licence GP Road,Scunthorpe,DN17 1YH West Street Children’s Centre, West Street, Sessional Licence Local Authority Scunthorpe, DN15 6HS West Town Surgery, 80 High Street, Barton, DN18 5PU Sessional Licence GP Winterton Children’s Centre, West Street, Winterton, Sessional Licence Local Authority DN15 9QG Winterton Medical Practice, Manlake Avenue, Sessional Licence GP Winterton, DN15 9TA Winterton School, Newport Drive, Winterton, DN15 Sessional Licence Local Authority 9QD

Page 43

Appendix 3 – Trust Occupied Areas not on the Main Site (Central Operations / Diagnostics / Medicine / S&CC / W&C)

Type of Occupancy Status – Exclusive Property & Address Agreement Required Owner Detail or Sessional to Formalise Alford Group, Alford Village, Lincolnshire Sessional Licence GP Ashby Midwifery Centre, Ashby, Scunthorpe Exclusive Lease Private Landlord Rotherham, Doncaster and South Humber Barnard Court, Old Courts Road, Brigg, DN20 8LA Exclusive Lease NHS FT Barton Leisure Centre, Brigg Rd, Baysgarth Park, Sessional Licence Local Authority Barton-upon-Humber, South Humberside, DN18 5DT Barton Midwifery Centre, Barton Exclusive N/A NLaG NHS FT Beacon Medical, Cleethorpes Primary Care Centre, St Hughes Avenue, Cleethorpes, North East Lincolnshire, Sessional Licence GP DN35 8EB Binbrook GP Practice, Binbrook Sessional Licence GP Boston Pilgrim Hospital, Sibsey Road, Boston, Sessional Licence United Lincoln Hospitals NHS Trust Lincolnshire, PE21 9QS Brigg Leisure Centre, Scawby Road, Brigg, North Sessional Licence Local Authority Lincolnshire, DN20 9JH Broadway, Grimsby Sessional Licence Local Authority Caistor GP Practice, Caistor Sessional Licence GP Central Surgery - King Street, Barton Upon Humber, Sessional Licence GP North Lincolnshire, DN18 5ER Central, Edward Street, Grimsby Sessional Licence GP Centre 4 (Support Group), Wootton Road, Nunsthorpe, Sessional Licence 2nd Avenue Resource Centre Grimsby, DN33 1HE Rotherham, Doncaster and South Humber Child Development Centre, Shelford Street, Scunthorpe Sessional Licence NHS FT County Hospital Louth High Holme Road, Louth, Sessional Licence NHS Property Services Ltd. Lincolnshire LN11 0EU Cromwell Primary Care Centre, Cromwell Road, Sessional Licence NHS Property Services Ltd. Grimsby, DN31 2BH Crowle Children’s’ Centre, Manor Road, Crowle, DN17 Exclusive Lease Local Authority

Page 44

4ET East Marsh Children’s' Centre, 203 Victor Street, Sessional Licence Local Authority Grimsby, DN32 7QB Epworth Clinic, Morland Way, Epworth, DN9 1HT Sessional N/A NLaG NHS FT Epworth Leisure Centre, Burnham Road, Epworth, Sessional Licence Local Authority North Lincolnshire, DN9 1BZ Fairfield School, Mendip Avenue, Grimsby,DN33 3AE Sessional Licence Local Authority Freshney Green Primary Care Centre, Sorrel Road, Sessional Licence NHS Property Services Ltd. Grimsby, DN34 4GB Hawthorn Surgery, Scotten Road, Scotter, Sessional Licence GP Gainsborough, DN21 3SB Health Place, Wrawby Road, South Humberside, Brigg, Sessional Licence NHS Property Services Ltd. DN20 8GS Henderson Avenue Children’s' Centre, Henderson Exclusive Lease Local Authority Avenue, Scunthorpe, DN15 7RW Highgate, Trinity Road, Cleethorpes Sessional Licence ? TBC Holton Le Clay Medical Practice, Lancaster Gate, Sessional Licence GP Holton-le-Clay, Grimsby, South Humberside, DN36 5YS Humberston Park School, St Thomas Close, Grimsby, Sessional Licence Local Authority DN36 4HS Immingham Children’s’ Centre, Margaret Street, Sessional Licence Local Authority Immingham, DN40 1LD James Street Family Practice, 49 James Street, Louth, Sessional Licence GP Louth, Lincolnshire, LN11 0JN Learning Development Centre, Enderby Road, Sessional Licence Local Authority Scunthorpe, DN17 2JL Lincoln County Hospital, Greetwell Road, Lincoln, LN2 Sessional Licence United Lincoln Hospitals NHS Trust 5QY Louth County Hospital, High Holme Road, Louth, Sessional Licence NHS Property Services Ltd. Lincolnshire, LN11 0EU Manby GP, Middlegate, Manby, Louth, LN11 8EB Sessional Licence GP Marisco Medical Practice, Stanley Avenue, Sessional Licence GP Mablethorpe, Lincolnshire, LN12 1DP Market Rasen Surgery, Mill Road, Market Rasen, LN8 Sessional Licence GP 3BP Page 45

Newmarket Medical Practice,153 Newmarket, Sessional Licence GP Louth,LN11 9EH Nunsthorpe & Bradley Children’s' Centre, Sutcliffe Sessional Licence Local Authority Avenue, Grimsby Pilgrim Primary Care Centre, Pelham Road, Sessional Licence NHS Property Services Ltd. Immingham, DN40 1JW Queensway Children’s Centre, Binbrook Way, Grimsby, Sessional Licence Local Authority DN37 9AT Reynolds Street Children’s' Centre, Machray Place, Sessional Licence Local Authority Cleethorpes, North East Lincolnshire, DN35 7LJ Riverside Children’s' Centre, Sorrel Road, Grimsby, Sessional Licence Local Authority North East Lincolnshire, DN34 9AT Scartho Medical Centre, Springfield Road, Grimsby, Sessional Licence NHS Property Services Ltd. DN33 3JF Scunthorpe PODS, Ashby Road, Scunthorpe, North Sessional Licence Local Authority Lincolnshire, DN16 1AA Snaith GP Centre, Butt Lane, Snaith, Goole, DN14 9DY Sessional Licence GP St Hughs School, Bushfield Road, Scunthorpe, DN16 Sessional Licence Local Authority 1NB St Lukes Primary School, Grange Lane North, Sessional Licence Local Authority Scunthorpe, DN16 1BN Taylors Avenue Medical Centre, Taylors Avenue, Sessional Licence GP Cleethorpes, DN35 0LJ The Kidgate Surgery, 32 Queen Street, Louth, LN11 Sessional Licence GP 9AU The Marshes Surgery, Station Road, Rawcliffe, Goole, Sessional Licence GP DN14 8QR United Lincolnshire Hospitals, High Holme Road, Louth, Sessional Licence NHS Property Services Ltd. LN11 0EU United Lincolnshire Hospitals, Woldside, Louth, LN11 Sessional Licence NHS Property Services Ltd. 0EU Weelsby View Health Centre, Ladysmith Road, Sessional Licence NHS Property Services Ltd. Grimsby, North East Lincolnshire, DN32 9SW West Marsh Children’s Centre, Macaulay Street, Sessional Licence Local Authority Grimsby, North East Lincolnshire, DN31 2ES

Page 46