Waltham Forest CCG Estates Strategy 2016-2026 Document control version: Issue Date Version Issued to Amendments 1 31.12.15 A NHSE B.1 24.03.16 Bv1 FM/TP B.2 01.04.16 Bv2 FM C 26.04.16 C Public Various changes from engagement D 29.04.16 D Commissioning Typos and updated Team information 1 Table of contents 1. Introduction and national context ....................................................................... 7 2. Local context ..................................................................................................... 7 2.1. Primary care commissioning strategy .......................................................... 8 2.2. Financial challenges .................................................................................... 9 2.3. Population growth ....................................................................................... 9 2.4. Disparate nature of estates ‘management’ ................................................ 12 2.5. Digital and IT strategies............................................................................. 12 2.6. Workforce ................................................................................................. 13 2.7. Overview of existing estate ....................................................................... 14 2.8. Responses to national drivers for change ................................................. 15 2.9. Estates gap analysis ................................................................................. 16 3. Delivering the strategy ..................................................................................... 16 3.1. WFCCG response to the estates challenge............................................... 17 4. Waltham Forest local overview ........................................................................ 18 4.1 The local borough .......................................................................................... 18 4.2 Factors contributing to poor health ............................................................ 19 5 Our vision ........................................................................................................ 20 5.1 Estates assumptions for primary care ....................................................... 20 6 The current estate ........................................................................................... 22 6.1 Overview and demand modelling .............................................................. 23 6.2 Occupation and utilisation ......................................................................... 24 6.3 GP premises estate ................................................................................... 25 6.4 Current challenges and opportunities – acute sector ................................. 26 7 Regeneration overview .................................................................................... 26 7.1 Blackhorse Lane area (including Sutherland Road) ................................... 26 7.2 Leyton/Lea Bridge ..................................................................................... 27 7.3 Walthamstow regeneration ........................................................................ 27 7.4 Wood Street Regeneration ........................................................................ 28 8 Possible income streams for capital spend ...................................................... 28 8.1 Section 106 ............................................................................................... 28 8.2 CIL (Community Infrastructure Levy) contributions .................................... 29 8.3 Primary Care Transformation Fund (PCTF) schemes ............................... 29 2 8.4 PCTF schemes 2016 onwards .................................................................. 29 9 Gap analysis .................................................................................................... 30 10 Estates options for change .............................................................................. 31 10.1 Overview ............................................................................................... 31 10.2 Overview of Chingford locality ............................................................... 31 10.3 Overview of Walthamstow locality .......................................................... 34 10.4 Overview of Leytonstone/Leyton locality ...................................................... 39 11 Possible hub map ............................................................................................ 42 12 Provider property owner estates strategies ...................................................... 43 12.1 Community Health Partnerships (CHP) ................................................. 43 12.2 NHS Property Services (NHS PS) ......................................................... 43 12.3 North East London NHS Foundation Trust ............................................. 43 12.4 Evaluation process and criteria .............................................................. 45 13 Delivering the strategy ..................................................................................... 45 13.1 Financial impact ..................................................................................... 45 13.2 Outline implementation plan .................................................................. 46 a. Programme plan and milestones .................................................................. 46 b. Resources .................................................................................................... 47 c. Enablers of change and managing constraints ............................................. 47 d. Consultation plan .......................................................................................... 48 e. Risks and mitigations .................................................................................... 48 Appendix A Summary of Community Estate Appendix B Summary of GP Premises Appendix C Summary of GP Premises 6 Facet Surveys Appendix D Waltham Forest JSNA Summary of key issues& Waltham Forest CCG Primary Care Strategy Summary of areas of focus Appendix E Summary of Digital Strategy Appendix F Capital revenue cost implications Appendix G Summary of Voids WFCCG Appendix H Children and family centres proposed sites map Appendix I Estates Strategy comms engagement plan Please note, all appendices are available by request from: [email protected] 3 Glossary of key terms Term Acronym General Practitioner GP Waltham Forest Clinical Commissioning Group WFCCG Estates Working Group EWG Transforming Services Together TST National Health Service; England NHSE Integrated Care Model ICM Clinical Commissioning Group CCG Primary Care Infrastructure Funding (funding PCIF via NHSE to premises development) Improvement Grant (funding via NHSE to IG premises development) Primary Care Transformation Fund (funding via PCTF NHSE to premises development) Waltham Forest, East London commissioning WEL groups North East London Foundation Trust NELFT NHS Property Services NHSPS Bart’s Health NHS Trust BH London Borough of Waltham Forest or Local LBWF or LA Authority Accident and Emergency Department A&E 4 Executive Summary The Estates Strategy responds to and supports the delivery of the key outcomes of the Primary Care Strategy. This document is for consultation with key stakeholders. Over the coming three months to the end of June 2016 it will be shared and discussed with a variety of key partners to test assumptions, check priorities and align strategic intentions. As such it will be subject to testing ideas and developing implementation plans to meet estates challenges. Some initial feedback has already been received and incorporated. Primary care is where the majority of contact with patients takes place in the NHS in Waltham Forest and should meet the majority of people’s health needs. However, there are a number of challenges which face the borough and there is a need to define and implement efficient use of estates; Increasing population in certain wards of the borough, with specific residential and commercial building solutions currently planned or in development An aging local population and increasing volumes of long term conditions Increasing costs of estates, with potential void space costs rising Potentially less General Practitioners (GPs) operating and a dependence on the traditional GP model Increased costs in attracting workforce to the borough due to high cost of living within the area Increasing usage and costs of implementing effective information technology solutions for healthcare In response to the challenge Waltham Forest CCG (WFCCG) has established a multi- organisational Estates Working Group (EWG) to develop an approach and a set of agreed documents to address the problems and improve our estate to support sustainable and effective healthcare. The EWG is a decision making body which includes key partners such as the London Borough of Waltham Forest, NHS England (NHSE) representatives and local landlords. For Waltham Forest CCG to address the estate challenge, it means:- Developing and nurturing existing and new networks, and as opportunities arise developing new health networks and ‘hubs’, and new models of care aligned to the NHSE 5 year forward view. As a result of the above pressures, likely organic reduction in the number of GP practices to achieve more sustainable, at scale, services, with the expectation of a minimum 10,000 patient list size. Improving