ESTATES STRATEGY 2015 2020 - September 2015
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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 21. 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 3gas 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 4Strategic 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 5and 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 6Table 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 91. 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 10disposing 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 DISABLE STAFF 19
D
15 STAFF
WHEELCHAIRS PHARMACY
STORE
MAC NURSES
RESTCOTE 1
TRAINING AND
PHOENIX CLUB
REPRO DEVELOPMENT
GRAPHICS 8 GARTH ANDERSON
SOUTHHOLME
INTERNAL
AUDIT
9
EASTHOLME
2
MEDICAL
3 MANUAL HANDLING TRAINING
ROOMS
ELECTRONICS
MEDICAL
ILLUSTRATION
5 4
OCCUPATIONAL
HEALTH
WEST ARCH
6 CLINICAL
PSYCHOLOGY
EDUCATION & LIBRARY
50 Staff 7 CHILD &
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 11Goole 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 12The 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 13Table 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 14The 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.
ADvery 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 15Table 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 16Table 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 17Where 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 18Table 8: Diana Princess of Wales Hospital – Compliance with Fire Safety
Fire Safety
A B C D
Estate Code
Category & Non-Compliant
Compliant With Dangerously
Definition Fully Compliant On One Or More
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
Category & Non-Compliant
Compliant With Dangerously
Definition Fully Compliant On One Or More
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 19Table 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
Category & Non-Compliant
Compliant With Dangerously
Definition Fully Compliant On One Or More
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 20remaining 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 21Table 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 22Environmental 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 23The 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 24Table 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 25SPACE 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 26Table 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 effect
well provided
Persistent odours are
Appropriate storage Appropriate finishes
absent
provision has been are used for floors,
Page 27made 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
Category & A Very Poor
Acceptable
Definition Excellent Quality Acceptable Quality
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 28Table 27: Scunthorpe General Hospital – Quality of the Estate
Quality
A B C D
Estate Code Less Than
Category & A Very Poor
Acceptable
Definition Excellent Quality Acceptable Quality
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
Category & A Very Poor
Acceptable
Definition Excellent Quality Acceptable Quality
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 29well-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.
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