Property and Asset Management Strategy Interim Report 2018 - NHS 24
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PAMS 2018 update V3.0
Property and Asset Management
Strategy
Interim Report
2018PAMS 2018 update V3.0
NHS 24 Property & Asset Management Strategy (PAMS)
Interim Report 2018
The interim PAMS report for 2018/19 provides an update to the previous full PAMS, 2017-
2022, taking into account the relevant National and NHS 24 strategic objectives and
reflecting the current position and future plans.
1. Where are we now?
Property
1.1 The property characteristics of the NHS 24 estate have an influence upon the
maintenance programme and repair costs. As NHS 24 occupies modern, purpose
built accommodation, maintenance costs are currently relatively low and lease
conditions require that adequate maintenance be undertaken annually to maintain the
properties in a satisfactory condition. However, as the properties age then the costs
of keeping them in a satisfactory condition will inevitably increase. Planned,
preventative maintenance is used as a cost-effective practice of keeping properties
and equipment ready for operation when required.
1.2 NHS 24 shares leased accommodation with NHS Greater Glasgow and Clyde Health
Board and the Scottish Ambulance Service (SAS) at Caledonia House and SAS and
Healthcare Improvement Scotland at Norseman House, South Queensferry.
Service demands on both NHS 24 and SAS continue to influence the need for
investment, particularly in Caledonia House, where proposals to improve utilisation,
functionality and quality are being developed for implementation in 2018/19. This is
now being discussed within the organisations with the aim to develop a collaborative
plan for implementation during 2018/19.
1.3 NHS 24 spent approximately £2.2 million on direct property costs in 2017/18, which
represents about 3% of the Board's net operating costs. This is an 11% reduction in
property costs, primarily achieved through a rent free period negotiated as part of the
lease renewal at Norseman House, combined with energy reductions across the
estate.
1.4 Property condition and performance continued to improve in 2017/18 with the
relocation of the Dumfries and Galloway local office to the new Dumfries and
Galloway Royal Infirmary. The new facility provides additional seating capacity
allowing increased Nurse Recruitment within the local area along with access to
improved welfare facilities for staff.
Planning has commenced with NHS Orkney to allow NHS 24 a smooth transition and
relocation to the new Balfour Hospital in early 2019.
1.5 A condition survey was carried out for Norseman House in August 2017 as part of the
Health Facilities Scotland phase 9 survey programme funded by the Scottish
Government. Following this survey, Norseman House has been assessed as
Condition B. This is defined as "satisfactory condition/performance, evidence of only
minor deterioration, is operational and performing as intended".
1.6 There is no change to the condition and performance of other NHS 24 properties
from that reported in last year's PAMS and they continue to achieve a "satisfactory"
B rating, with the exception of Dumfries and Galloway which is now rated A (as new).PAMS 2018 update V3.0
1.7 NHS 24 statutory compliance standards remain high. The property risk register
continues to be routinely monitored to ensure risks are effectively managed.
1.8 In 2017/18, there was continued progress in improving environmental performance.
The Sustainability Development Action Plan (SDAP) was submitted to the SGHSCD
as required by 31 October. The 2017/18 SDAP action plan, which delivers activity
relating to the Board's Sustainability Policy, continues to make good progress in the
following areas.
1.8.1 Carbon Reduction
The replacement of the Air Conditioning plant in Norseman House is estimated to
provide £50,000 savings p.a. and a reduction of 26% in energy consumption (kWh)
and CO2e for Norseman House.
The annual electricity usage for 2017/18 (kWh) has reduced by 9.84% resulting in a
23% CO2 reduction from 2016/17 and costs have reduced by 16.38%.
The gains from this project plus NHS 24's site waste recycling activity means the
energy consumption (3%) and carbon reduction (1%) targets have been achieved for
2017/18.
1.8.2 Travel
There has been a significant drop in travel by car over the last 3 years leading to a
reduction in CO2 emissions of 15% since 2014/15. The SDAP target to reduce car
mileage in 2017/18 to 310,000 miles has been achieved.
The National Sustainability Steering Group have appointed and commissioned Green
Business UK to deliver the new Sustainability Assessment Tool. As part of their
commission, they will be carrying out baseline audits of each Board. NHS 24
completed its assessment in May 2018 with the outcome expected to be reported in
July 2018.
New technology implementation
1.9 Previous NHS 24 PAMS documents have reported that the key asset strategy in
supporting NHS 24's vision is the replacement of its technical infrastructure to
support the delivery of services now and in the future through the implementation of
new technology infrastructure. The benefits it will deliver will enhance patient services
and improve corporate systems to ensure safe and reliable services are delivered.
1.10 In May 2017, NHS 24 progressed the implementation of the new technology to
deliver the full SAP solution, within a Model Office environment, with NHS Ayrshire
and Arran. The final phase of the implementation was successful and completed in
full in October 2017. NHS 24 is continuing to work through some technical and
operational issues to fully embed and further refine the system and our processes.
Despite the challenges, which are to be expected with an implementation of this
scale, patient safety and organisational delivery were maintained throughout the
year.
Significant progress has also been made in developing new direct contracts with both
our key suppliers for the technology infrastructure and applications. The Board
anticipate these contracts will be finalised by the end of May 2018.PAMS 2018 update V3.0
2. Where do we want to be?
2.1 Delivery of safe, effective and person centered care to the people of Scotland
remains the top priority for NHS 24. NHS 24 is the national contact organisation for
NHS Scotland and is responsible for providing a range of telehealth services to
people across Scotland, primarily using telephony and on-line digital hub services.
NHS 24 also supports and facilitates developments in telehealth and telecare to help
improve the health and wellbeing of the population. Using digital technology and
adopting a multichannel approach will enable NHS 24 to make an important
contribution to achieving Scotland's 2020 vision.
2.2 NHS 24 has set out an ambitious strategy from 2017-2021, fully aligned to the
national health and social care strategic policy landscape. Our strategy sets out how
we can support greater health and social care integration, different and improved
models for delivering frontline services to patients, working in partnerships across
acute, urgent, primary and community care.
2.3 This was supported, in June 2017, with the Board approval of the NHS 24 Strategic
Development Programme Business case. The overarching aim of the strategy is to
create capacity and capability within NHS 24 to support NHS Scotland in managing
the ever increasing demands for healthcare services by offering a number of
additional routes to access services. This offer from NHS 24 will broaden the choices
and channels for service access for the public and patients in a cost effective way.
2.4 The organisation has also been working with the other National Boards during
2017/18 to develop a Collaborative Proposal to support the delivery of the National
Health and Social Care Delivery Plan aims. This will integrate with and support the
Regional Plans being developed across the territorial NHS Boards.
2.5.1 NHS 24 worked collaboratively with NHS Lothian and East Lothian Health & Social
Care Partnership as well as NHS Lanarkshire during 2017/18 and introduced a test of
change in two GP practices; ‘In-hours GP Triage’ which provided a triage service for
those patients calling for a same-day appointment. This test of change is intended to
support primary care demand management in reducing pressure on local GP time
and as appropriate signposting to alternative care providers such as pharmacy, and
providing self-care advice. A Service Improvement Plan has been developed to
support the sustainability and scalability of this service model, and includes further
technical design to enable growth of the model. Ongoing evaluation of effectiveness
and learning from the tests of change are starting to demonstrate positive outcomes
for both partners and patients.
2.5.2 During 2017/18 NHS 24 completed a Digital Transformation Service review which
recommended the integration of our Health Information Service and the Scottish
Centre for Telehealth and Telehealth to create a single digital function. This
integration will complete during 2018/19. Work has also progressed during 2017/18
to develop a Digital Strategy for NHS 24. The integration of the two services will
support the effective delivery of the aims and objectives agreed in the Digital
Strategy.
2.5.3 Throughout 2018/19, NHS 24 will continue to deliver and develop safe and effective
unscheduled care services to the population of Scotland, as efficiently and effectively
as possible, utilising the skills of different staffing groups in the most appropriate way.PAMS 2018 update V3.0
3. How do we get there?
3.1 NHS 24's Service Transformation Programme is a single strategic programme of
work to deliver broad organisational change across NHS Scotland enabled by the
infrastructure and technology in place within NHS 24. The Service Transformation
Programme will ensure the delivery of the NHS 24 five-year strategy.
3.2 The transition to the new technology platform will enable the function of NHS 24's
digital services in future as well as how NHS 24 manages new development requests
going forward.
3.3 The NHS Scotland national boards provide services where improved quality, value
and efficiency is best achieved through a national approach. Working more closely
together and with our key partners in the Scottish Government, territorial boards,
regions and integration joint boards (IJBs) NHS 24 will support the transformational
change required to improve services and strengthen leadership to protect and
improve Scotland’s health and reduce demand on services.
3.4 The NHS 24 contribution to the collaborative proposal is fully in line with the NHS 24
Strategy aims and objectives.
3.5 As other business legacy systems (e.g. e-mail messaging), which sit outwith the new
technology platform, come to the end of their life there is a requirement to
migrate/update and replace those systems. A 5 year investment programme is being
developed which is designed to keep other essential IT related business systems
updated, supported and functional to meet business needs in future.
3.6 The preferred strategic option for the future use of property assets is the
consolidation of functions and associated gains in efficiency and cost effectiveness,
with investment to meet future requirements where required and if possible.
3.7 In recognition of the imperatives and priorities within NHS Scotland, the National
Boards have established an Asset Management collaborative working arrangement
to explore collaboration possibilities, efficiencies, financial savings, sharing of
intelligence and learning. NHS 24 has engaged during 2017/18 with Health Facilities
Scotland to contribute to the National Board Estate Rationalisation Programme and
National Facilities and Estates programme.
3.8 During 2018/19 NHS 24 will contribute to the Facilities eHealth Strategy led by Health
Facilities Scotland. The strategy recognises the historically fragmented development
of eHealth Services in relation to estates and facilities across Boards, which has
resulted in many different eHealth products and services across Boards.
As a result of the situation that currently exists, the Facilities eHealth Strategy will
require to be implemented over a number of years on a phased basis, driven by the
priorities and needs of Facilities Services and based on robust business cases.PAMS 2018 update V3.0
Property and Asset Management
Strategy – Annex
Strategic Assessment
Management 2018PAMS 2018 update V3.0
Strategic Assessment Management
1.1 NHS 24 recognises the need to develop modern working practices to enable
employees to maximise their performance and productivity whilst maintaining a good
work life balance. In addition, new technologies are making it easier to access
information remotely, and work from a variety of locations, supporting service delivery
leading to an improved service for patients. This approach is underpinned by both
physical and cultural adaptations.
1.2 Property Improvement Plan (PIP) to 2022
The Property Improvement Plan (PIP) is primarily focused on site based
modifications and improvements that will meet the Strategic Asset Management
objectives outlined in the 2017-2022 PAMS. The focus of the PIP therefore, is the
optimisation of accommodation in Caledonia House, Norseman House and Clyde in
respect of layout, capacity, functionality, staff experience, adaptability and cost
reduction.
1.3 Asset Investment Plan to 2022
In order to deliver the IT asset improvement and the PIP, the organisation has
developed a prioritised investment plan for the period to 2022 as described in table 1
below.
1.4 Asset Investment 2018/19
NHS 24 expects to expand its in hours service provision to such an extent that space
utilisation in its main centres will significantly improve. In addition, the Board has
recognised that there will be pressure on existing accommodation coming from
current and future out of hours service demand and SAS growth. NHS 24 is therefore
embarking upon a programme that should address current and future property needs
required to deliver these actions.
In addition, NHS 24 is investigating the potential for creating a more "agile" working
environment for Headquarters staff, while removing any barriers to the whole ground
floor space being able to operate as a contact centre during out of hours periods. In
recognition of this work, a larger property investment sum is included in 2018/19.
Table 1 Property Investment
Total
Capital
Investment Projects 2018/19 2019/20 2020/21 2021/22 Expend
Refurbishment/Upgrade/
Resilience:-
Facilities and IT Projects 674,884 244,000 244,000 244,000 1,406,884
Backlog Maintenance 50,116 0 0 0 50,116
Carbon Reduction Initiatives 25,000 25,000 25,000 25,000 100,000
Totals 750,000 269,000 269,000 269,000 1,557,000
1.5 NHS 24's Finance and Performance Committee continues to have responsibility for
performing the governance role in relation to property and asset management plans.You can also read
