Full Business Case Bro Ddyfi Community Hospital Health and Well-being Project 17 May 2018 Version 5 Date Version Issued to: 29.01.18 1 Wayne Tannahill – Draft 29.04.18 2 Wayne Tannahill, Hayley Thomas, Sarah Pritchard – Draft for comment 04.05.18 3 Hayley Thomas – Draft for approval 14.05.18 4 Issued for FP&P 17.05.18 5 Issued for Board approval Bro Ddyfi Community Hospital, Machynlleth: Full Business Case: Powys Teaching Health Board Contents 1 Document Purpose & Structure .................................................................................................................. 8 2 Executive Summary ................................................................................................................................... 10 Introduction ........................................................................................................................................ 10 Strategic Case .................................................................................................................................... 10 Economic case .................................................................................................................................. 19 Commercial case ............................................................................................................................... 25 Financial case .................................................................................................................................... 27 Management Case ............................................................................................................................. 28 Recommendation .............................................................................................................................. 30 3 The Strategic Case ..................................................................................................................................... 32 Part A: Strategic Outline Case .......................................................................................................... 33 Part B: Strategic Context .................................................................................................................. 42 Part C: The Case for Change ............................................................................................................ 64 4 The Economic Case ................................................................................................................................... 83 Introduction ........................................................................................................................................ 83 Critical Success Factors ................................................................................................................... 83 OBC Long-List of Options ................................................................................................................ 83 Economic Appraisal of Short-Listed Options ............................................................................... 102 5 The Commercial Case .............................................................................................................................. 111 Introduction ...................................................................................................................................... 111 Procurement Process ..................................................................................................................... 111 Required Services ........................................................................................................................... 114 Contractual Arrangements ............................................................................................................. 114 Personnel Implications (including TUPE) ..................................................................................... 121 Accountancy Treatment .................................................................................................................. 121 6 The Financial Case ................................................................................................................................... 122 Introduction ...................................................................................................................................... 122 Bro Ddyfi Community Hospital, Machynlleth: Full Business Case: Powys Teaching Health Board Capital Cost Appraisal .................................................................................................................... 122 Revenue Affordability ..................................................................................................................... 124 Financial Appraisal .......................................................................................................................... 125 Assessing Affordability................................................................................................................... 126 Assumptions that underpin affordability ...................................................................................... 126 7 The Management Case ............................................................................................................................ 127 Introduction ...................................................................................................................................... 127 Project Management Arrangements .............................................................................................. 127 Use of Special Advisers .................................................................................................................. 133 Arrangements for Change Management ....................................................................................... 135 Arrangements for Benefits Realisation ......................................................................................... 138 Arrangements for Risk Management ............................................................................................. 139 Arrangements for Post Project Evaluation ................................................................................... 139 8 Appendices ............................................................................................................................................... 141 Appendix A: Compliance Project Proposal ................................................................................... 141 Appendix B: 6 Facet Survey Report ............................................................................................... 141 Appendix C: Condition Photographs ............................................................................................. 141 Appendix D: Utilisation Study ........................................................................................................ 141 Appendix E: HDUHB Letter of Support .......................................................................................... 141 Appendix F: Design Annexe ........................................................................................................... 141 Appendix G: Risk Register ............................................................................................................. 141 Appendix H: Phasing Proposals .................................................................................................... 141 Appendix I: Sensitivity Analysis .................................................................................................... 141 Appendix J: Economic Appraisals ................................................................................................. 141 Appendix K: SCAPE Minor Works Framework Agreement .......................................................... 141 Appendix L: SCAPE Social impact ................................................................................................ 141 Appendix M: Llandrindod Social impact Report ........................................................................... 141 Appendix N: Master Programme .................................................................................................... 141 Bro Ddyfi Community Hospital, Machynlleth: Full Business Case: Powys Teaching Health Board Appendix O: Financial Appraisals ................................................................................................. 141 Appendix P: Alternative Energies Paper ....................................................................................... 141 Appendix Q: Benefits Realisation Plan ......................................................................................... 141 List of Tables Table 1: Identified clinical room requirement for Primary Care ............................................................................. 38 Table 2: District Hospitals serving Powys residents, including distance and journey time from BDCH ................. 46 Table 3: Local Primary Care Services in Machynlleth ........................................................................................... 47 Table 4: Powys Dementia Plan Pledges ............................................................................................................... 49 Table 5: PTHB Key Aims and Strategic Objectives ............................................................................................... 60 Table 6: Existing Occupants 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