Operations and Maintenance by wuzhenguang


									                                                                                   Agenda Item 18

                              TRUST BOARD MEETING
                             REPORT SUMMARY SHEET

Title of Report

Executive Summary
This Q2 report provides the Trust Board with information on some productivity and efficiency
measures for Hotel Services, Operations and Maintenance and Sterile Services on the
JCUH and FHN sites.
The report describes any current issues of note, highlighting any appropriate actions
required or underway.
The recent decision by the Trust Board to support the withdrawal from local collaboration to
outsource Sterile Services means that an independent strategy will now be pursued within
the Trust for decontamination services.
Points to note include the appointment of a Building Estates Officer at FHN to commence in
October 2006. The main role for this post is to protect the assets of the Estate by ongoing
management and development.
The refurbishment of wards at FHN is going according to plan, as is the demolition work as
part of the new build programme.

Meeting Date       7th November 2006

Prepared by
Anne Anderson, General Manager Operational Services

Financial Implications
There are no financial implications as a result of this monitoring report. Investment will be
required for SSD to meet decontamination national programme standards. This will be
addressed through the business planning process.

Strategic/Performance Implications
The PEAT scores and MRSA targets continue to have an impact on the Annual Health
Check by the Health Care Commission. Working closely with the Trust’s PFI provider
continues to be a key part of ensuring a clean and safe environment for patients and visitors

Risk management strategy in place to ensure no exposure to Asbestos during demolition
work at FHN as part of new build programme

Patient and Public Involvement
PPI involvement with DDA access issues

Required from Trust Board
Trust Board are asked to note the performance measures and provide any feedback or
additional queries that the Board considers the directorate needs to address.


N. Permain/cingrassia/Operational Services/Trust Board/Oct 2006                       page 1 of 16
                                                                             Agenda Item 18


There have been two key personnel changes that are important to Operational Services
during the quarter. The workforce has been strengthened by a Building Officer
appointment at the Friarage Hospital who from early October is employed to ensure that
the estate is maintained to meet all building regulations and standards. This vacancy has
been a major deficiency over recent months. The General Manager role that was already
in place to support the Director of Operational Services has been developed to directly
manage the three support services of Hotel Services, Estates Services and Sterile
Services and to achieve high standards of performance through effective working
relationships with the PFI providers.

1.0     Patient Catering Services

1.1     James Cook University Hospital (JCUH) PFI Service

The catering services at the James Cook University Hospital continues to provide
patients with a nutritious balanced meal, however there are still some reports that
indicate patients are not been offered a mid morning and afternoon snack. This is to be
raised with SHS (Sovereign Hospital Services) at the monthly Soft Services meetings.

In August 2006 the Trust introduced its own catering audit based on the catering service
contract. As the audits mature trends will be analysed using the data and comments

In August an initial audit was carried out on 16 of the 36 wards. Whilst the overall scores
are pleasing, there were still a low number of non-compliances recorded against the
audit criteria. (See Appendix 1 for sample copy of the audit). Trends show the non-
compliances were mainly due to the ward kitchen fridge recordings not being available,
snacks not been offered during beverage rounds and food not appropriately garnished.

Overall the final scores were satisfactory, some wards for example 27,31 and 32 show
excellent standards while other wards for example 8 and 10 show room for

A more detailed analysis and any actions required will be addressed through the monthly
meetings held with Endeavour and SHS.

Overall percentage compliance for August 2006 catering audit undertaken by the
informed client at JCUH is shown in the graph below

It is hoped that these audits will fill the gaps of patient surveys of the catering services at
James Cook as SHS only undertake patient audits annually. It is the Trust’s intention to
increase the patient surveys to monthly.

N. Permain/cingrassia/Operational Services/Trust Board/Oct 2006                 page 2 of 16
                                                                                                      Agenda Item 18

                                    Informed Client Catering Audit Graph - August 2006






                 2     4        7     8     9    10     11      14      15    18     19   27     28    31      32    37
           %    75    85       75    65    80    65     70      90      80    75     75   95     80    95      95    85


Following the Trust’s recent PEAT (Patient Environment Action Team) score when the
catering services at JCUH went from good to acceptable, the Trust has started
negotiations with SHS to look at improving the quality and presentation of the patient’s

1.2         Patient catering Friarage Hospital

Catering continues to be provided to patients in a safe and nutritious manner. Patients’
comments remain favourable to the service they receive.

The patient satisfaction survey at the FHN is carried out on a weekly basis and collated
to show a monthly figure.

The future catering development project at the FHN is still ongoing with the next meeting
arranged in October 2006 to prepare the business case.

The patient feedback in the patient satisfaction surveys is of a high standard; with 93%
of patients in August feeling the presentation of their meals and beverages was excellent
or good.

                             What is your opinion of the presentation of your meal and beverages?

                                            Very Poor    Poor        Acceptable    Good   Excellent
                      Jul-    Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun-                  Jul-    Aug- Sep-
                       05      05   05   05   05   05   06   06   06   06   06   06                   06       06   06

                      Jul-    Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun-                  Jul-    Aug- Sep-
                       05      05   05   05   05   05   06   06   06   06   06   06                    06      06   06
      Excellent       13       7           22   109     53      93     109   143    94    168   129   102     119
      Good            12       7           12    96     46      64      70    95    71    115   85    69       84
      Acceptable       1       2           3     26     12      15      15    18    18    26    18    22       11
      Poor             1       0           0     2      0       1       1     4      3     4     0     1       2
      Very Poor        1       1           0     1      2       1       4     4      4     3     1     0       1

N. Permain/cingrassia/Operational Services/Trust Board/Oct 2006                                             page 3 of 16
                                                                                                                                         Agenda Item 18

2.0                Cleaning Services

2.1                PFI James Cook

The new PEAT monitoring regime at JCUH, to be conducted by the Matron’s as part of
the redesigned roles, will be introduced in January 2007 once all the staff are in post.
The new regime will be carried out on a monthly basis with the results being collated by
Hotel Services. All matrons have been consulted and have agreed the new paperwork
for the monitoring.

There are some outstanding operational issues in cleaning services. Also a number of
service failures against the contractors show an increase in some areas. For example
the number of service failures in August on KPI 116 Curtains and blinds in clinical units,
has been the highest to date.

Rectification of this is being discussed at the contractual SHS Soft Services meetings.

2.2                Cleaning Services Friarage

Cleaning services continue to perform to an acceptable standard as defined by PEAT.

Now that the new development is operationally functioning, the cleaning services
department are able to ensure that both clinical and non-clinical areas are routinely

The senior managers monitoring of corporate areas shows a steady level of scoring
against the PEAT regime with the majority of areas scoring 3 (acceptable) in recent
months, with the exception of zone two in July when it fell to 2 but increased again in

Managers in Operational Services carry out the corporate monitoring. When the
monitoring carried out by the team of two, one manager is responsible for following up
hotel service issues e.g. cleanliness and the second member is responsible for following
up any estate issues.

                                        Senior Managers Corporate PEAT Environm ental Monitoring

      PEAT score

                            Jul-05 Aug-       Sep-     Oct-      Nov-     Dec-     Jan-     Feb-     Mar-     Apr- May-         Jun- Jul-06 Aug-
                                    05         05       05        05       05       06       06       06       06   06           06          06
                            Jul-05   Aug-05   Sep-05   Oct -05   Nov-05   Dec-05   Jan-06   Feb-06   Mar-06   Apr-06   May-06   Jun-06    Jul-06   Aug-06

                   Zone 1                                 3        3        2        2                          3                 3         3        3

                   Zone 2     2                                             3        4                          3                           2        3

                   Zone 3              3                                    3        4        3                                             3        3

                   Zone 4              4                                             3                 2        3                 3         3        3

                   Zone 5                                 3                          4                                                      3        3


N. Permain/cingrassia/Operational Services/Trust Board/Oct 2006                                                                           page 4 of 16
                                                                                                 Agenda Item 18

There have been some short term problems with the existing temporary corridor and the
decommissioning of the remaining old buildings that can sometimes affect cleaning
during peak hours.

3.0         Ward Housekeeping service

3.1         PFI James Cook

Ward housekeeping continues to perform as per the contract, however there are many
service failures events recorded in the KPIs under ward house keeping – this is being
monitored and discussed at the contractual SHS soft services meetings.

It is felt by the Trust that the ward housekeeping service could absorb the routine
cleaning of the patient line equipment and this is still under discussion within the A4C
benefits realisation programme.

Concern has been raised with Endeavour that no formal variation report has been
received to date. Further discussions are underway to bring this issue to a conclusion.

3.2         Friarage Hospital

Ward Housekeeping services continue to perform to a high standard which is received
favourably by patients and staff at ward level, as shown in the patient satisfaction

98.7% of patients found their ward housekeepers to be polite, courteous and helpful.

                                  Was your ward housekeeper polite, courteous & helpful?





            Jul-05 Aug-     Sep- Oct-05 Nov-   Dec- Jan-06 Feb-    Mar- Apr-06 May- Jun-06 Jul-06 Aug-           Sep-
                    05       05          05     05          06      06          06                 06             06

                     Aug-   Sep-        Nov-   Dec-        Feb-    Mar-        May-               Aug-           Sep-
            Jul-05               Oct-05             Jan-06              Apr-06      Jun-06 Jul-06
                      05     05          05     05          06      06          06                 06             06
   No         0       0            0      1     0      0      0      0     0      0        0       0     3
   Yes       30      17            38    220   113    173    195   265    193    322       239     195   233

4.0         Switchboard

4.1         PFI – James Cook

The numbers of calls have reduced in Q2/06; this could be a seasonal trend, as August
tends to be a quieter month with staff holidays. There were a similar number of calls
received the same quarter in 05/06 as shown in the chart below.

N. Permain/cingrassia/Operational Services/Trust Board/Oct 2006                                   page 5 of 16
                                                                                       Agenda Item 18

                                Total number of calls per quarter at JCUH

                                    Q2 05/06      Q3 05/06      Q4 05/06    Q1 06/07   Q2 06/07
   Total number of incoming calls    481637        472474       510241      486976     321128
   per quarter

4.2      Friarage Hospital

The new VIP (‘Voice Integrated Products’) switchboard system is fully installed and went
live to internal users on the 5th July. The full system including external calls went live on
the 21st August 2006.

Concern has been raised with both the company and ICT department on a number of
critical issues, which are affecting the functionality and accuracy to our users particularly
external calls. We are also very aware of the concern of external bodies about the recent
levels of service but the internal team are working very hard to correct errors and add
new key words to the ‘dictionary’ of recognised terms on the automated system.

It is important to recognise that this system has been introduced as a way of enabling
the Trust to reduce to introduce permanent reception cover on the new main reception at
the hospital without incurring additional cost. The lack of manned reception has always
been criticised as giving a poor service from a patient perspective. Achieving good
telephone response via the new automated system and a manned reception would be
an excellent outcome of the use of new technology.

The Acting Hospital Manager for The FHN is closely involved in ensuring that the
scheme operated, but also has the authority to suspend operations if performance does
not continue to improve.

5.0      Operations and Maintenance

5.1      Disability Discrimination Act (DDA)

Improvements have been realised at the JCUH hospital, at both the North Entrance and
also behind spinal Injuries, to provide better access to disabled car parking in
compliance with DDA Legislation. This work is now complete.

With respect to other improvement throughout the JCUH hospital, examples include
changes to bathroom fittings within disabled toilets and doors to the Spinal Injuries Unit.
The Trust is endeavouring to provide suitable and compliant facilities for both wheelchair
and ambulant disabled users. However a delay will be encountered on some work due
to ongoing negotiations.

The Friarage Development Team were aware at an early stage of the development that
compliance with DDA legislation is essential and assurance was given that adequate
arrangements are in place.

N. Permain/cingrassia/Operational Services/Trust Board/Oct 2006                           page 6 of 16
                                                                            Agenda Item 18

An assessment was conducted to upgrade toilets, this being the first stage of an ongoing
improvement and work was concluded on the first stage this quarter. The next quarter
will include 3-storey lift in the MDHU and also to put an induction system in the
conference room at the Friarage and outpatients reception counter.

A DDA forum was established in July 2006 to share ideas and action any change that
can be made in response to issues raised by the Patient Public Forum and concerns or
complaints both formal and informal received into the Trust. The forum currently meets
on a monthly basis and intends to report to the Patient Experience Group.

5.2     Medical Gas

The first meeting of the Medical Gas Group was convened end June 2006 with
participants raising a number of issues requiring further investigation within the Trust.

Medical Gas Training – Risk Management are compiling a register of key nursing staff to
undergo medical gas training sessions

Work has commenced to alter the surgical air pressure in the Ophthalmology Day Unit
Theatre. This is required to enable the safe use of the ‘Accurus’ machine used to treat
detached retinas of the eye, as the machine air pressures parameters are not compliant
with the mains piped surgical air. The scheme has been thoroughly risk assessed and all
parties concerned have worked hard to reach a workable solution.

Following concerns raised by IPC (Infection Prevention and Control) staff about the
condition of the floor coverings in two shower areas, some work has been commenced
to scope out what changes can be made to improve the areas. Once the solution is
proven to be effective a roll out programme will be agreed to improve all showers with
the same problems.

5.3     Estates Department Friarage

The maintenance requests and the PPM (Planned Preventative Maintenance) is an
indication of the normal standing workload of the department.

The out-of-hours emergencies have decreased during this quarter, indicating that the
normal maintenance has become more effective although further reductions in
emergency call outs are expected when this category is more clearly defined.

Likewise, isolations are fewer now that the FHN Development is reaching finalisation.

The isolation requests involve organising the safe isolation of services to ensure
minimum disruption and without detriment to the patient, thus the majority of this type of
work means working outside normal hours. The isolation requests have reduced this
quarter in comparison to the 741 conducted April to June 2006 when the development
was at its peak and the number of isolations is expected to fall further in the next quarter.

N. Permain/cingrassia/Operational Services/Trust Board/Oct 2006               page 7 of 16
                                                                                     Agenda Item 18

                       July-September 2006 Friarage Maintenance

                                                              General Maintenance
                       49                                     Planned Preventative
                      322                                     Out of Hours
                                                              Emergency Calls
                                              1830            Isolation Work

5.4      Friarage Emergency Call Outs

Emergency call outs outside of routine hours have been closely monitored through a log
system during this quarter. Of a total of 34 calls received in Q2/06, 95% were considered
essential and attended to, these comprising 7 electrical jobs, 12 plumbing, 10 alarms or
nurse call systems and 5 of technical nature.

The department have identified some abortive calls that were not deemed emergency
and further work integrating with other FHN departments would reduce this type of calls
further. Better assessment/analysis of calls received during out of hours could reduce
the number of call outs. Work is ongoing with the Hospital out-of-hours manager to
better assess each emergency call.

5.5      Friarage Estates Operations and Maintenance

During Q2/06 the following activities were achieved:

a) Ward Block Top Floor: A 10 week rolling programme commenced in July to re-floor
   and redecorate Ainderby Ward, Romanby Ward and MAU. Work will include
   replacement of ceilings above the nurse’s station in each area.
b) Decoration of coffee lounge and dining room is completed, including floor coverings
c) Installation of UPS for all Theatres and A+E department is ongoing
d) Commissioning of the site wide Building Management system is proceeding
e) Installation of ‘blue light’ low level lighting to deter the inappropriate use of the public

f)    An apprentice, Mr. Louis Fernandez has been appointed to work with the Friarage
      estates team. This acquisition will give the Estates Department some future
      contingency plan and was secured through the Northern & Yorkshire NHS
      Assessment Centre who pays the salary for first two years while at University to
      acquire “multi-craft Engineer Electrical” qualifications. The Trust pays the salary for
      the final 2 years of the 4-year programme.

5.6      Asbestos Issues

A formal interview with H&SE was conducted 20th July 2006 at which time the Trust
submitted details of the measures introduced to ensure the safety of all staff following
identification of the presence of asbestos within the Friarage hospital old build.

N. Permain/cingrassia/Operational Services/Trust Board/Oct 2006                       page 8 of 16
                                                                                Agenda Item 18

Meetings were held with the Health & Safety Executive when the incident first arose and
following advice received Estates Staff are now fully appraised of the correct procedure
should there be a further occurrence of asbestos identified on the premises.

An Asbestos Management Group convened for an inaugural meeting on 5th September
and will meet 4 times a year. Terms of Reference are to be agreed at the next meeting.

6.0      PFI Monitoring and Estate Assessment

Eggleston Court – Initially several problems were experienced and expensive
maintenance/repair costs incurred especially with regard to heating system. These
problems have been successfully addressed with the placing of a maintenance contract
with Dalkia.

Brackenhoe School Grounds and Gardens are maintained via contract with
Middlesbrough Borough Council. Building fabric and mechanical/ electrical services
maintenance are on an ad-hoc basis. The gas supply to site has been isolated. Electric
and water supply services have been isolated in part but leaving services to security
personnel and essential services e.g. security lighting.

Coulby Newham – The NHS have vacated this property and the Trust’s Property &
Design department advise a long term lease and similar interim arrangements as for
Brackenhoe property. Water and Gas have therefore been isolated and signage will be

St. Luke’s Cottages – Maintenance is arranged on an ad-hoc basis. Empty properties’
gardens are maintained by Middlesbrough Borough Council. Pest Control was recently
addressed by the Council.
      April to September 2006                                     Man-hours    Maintenance
      Egglestone Court                                                 19 .0         2414.26
      St. Luke’s Cottages                                                8.5          900.00
      Brackenhoe School                                                 12.0         2941.68
      Coulby Newham                                                      5.5          240.00
      Adjoining properties (St. Luke’s) including Bath &                12.5         8322.40
      Wells Villas
      24 Bellevue Grove                                                  3.0            0.0
      17 Harewood Court, Riverside                                       4.5        1350.00
      Total                                                              65       £16168.34

Note: The above “maintenance” costs do not include “lease” charges.
      Egglestone Court costs are Dalkia maintenance contract
      St. Luke’s Cottages include Middlesbrough Borough Council charges
      Brackenhoe include Middlesbrough Borough Council charges

The Internal Liaison Officer, through regular inspections of the estate/property, monitors
the upkeep and workmanship of Sovereign Hospital Services and/or its subcontractors

N. Permain/cingrassia/Operational Services/Trust Board/Oct 2006                   page 9 of 16
                                                                         Agenda Item 18

It should be noted that when unexpected emergency priorities require attention, the
inspections become secondary and due to the enormity of the hospital a more regular
inspection regime is not always possible. Due to the annual holiday period July/August
the number of inspections have noticeably fallen this quarter

Access to ‘Geneva’ (SHS electronic monitoring system) is now available to the Internal
Liaison Officer. This means that the status of and progress of all jobs can be tracked.

6.1     Minor New Works
Following much work in liaising with wards and departments with respect to reducing the
number of requests received, it is evident that more vigilance on expenditure is required.
Close monitoring by the operations and maintenance tea, has reduced the number of
requests over this quarter. However the July heat wave and the need for cooling fans
for patient comfort brought the total requests in July to 135 whereas last year July
requests totalled 80.

There have been some delay issues in both receiving quotations and work being
completed – Endeavour were requested to review and remedy this with Sovereign
Hospital Services and improvement is being realised.

Two problems are currently being addressed with SHS through Endeavour:-

        SHS appearing not to seek competitive pricing, resulting in the Trust regularly
      receiving high quotations

        SHS appearing not to make any checks on their sub-contractors, neither costs
      nor work completed, some work has been unsatisfactory.

40% of the total requests (currently at 3595) represent either electrical checks or
additional power points. This type of work cannot be reduced, as it is essential from a
health and safety viewpoint that the work is monitored and conducted at the highest level
of competency.

25% represents cosmetic improvements (e.g. pictures on wall) and attaching essentials
(suction bottle brackets or gel dispensers)

13.5% of the total requests represent replacement locks and duplicate keys – since
wards and departments were informed of the number of requests and expenditure
associated with duplicate keys and replacement locks, fewer requests have been
received. Departments must take more responsibility for safe custody of keys.

7.0     Environmental

7.1     Heating and Cooling

The prolonged heat wave during Q2/06 provided some real challenges in trying to
maintain services and manage expectations. A range of measures were implemented to
tackle a variety of issues that created problems for patient and staff during this time.
These included:

       The purchase of additional fans placed in areas where patients were more
vulnerable to the increased temperature

        The hire of temporary air conditioning units

N. Permain/cingrassia/Operational Services/Trust Board/Oct 2006            page 10 of 16
                                                                            Agenda Item 18

        Installation of protective film and shutting off the existing water circulation in
        system and opening the windows at night to help reduce ambient temperature
        the following morning.

7.2     Friarage Hospital

During this quarter the new Energy Centre/Building Management Scheme underwent its
initial commissioning. As a result of these activities a number of problems were
discovered with heating systems and their temperature controls. These problems may
have resulted in short term overheating situations within the departments that they
served. The most effective test will occur during the forthcoming winter months when
the system will be tested under operational conditions.

7.3     Environmental Competition 2007

Work has commenced in compiling a 2007 Environmental Quiz following the success in
raising awareness through the 2006 competition. Sponsorship will be sought from
appropriate companies. Questions are being finalised and it has been agreed to ensure
there is a “Ward Prize”.

8.0     Waste and Recycling

8.1     James Cook University Hospital

A trial to recycling cardboard has proved successful and is therefore is ongoing.

Middlesbrough Borough Council Environmental Manager has offered the Trust recycling
assistance. The Council are enthusiastic in working with the Trust on this issue. The
first initiative will be to ensure Residences at JCUH receive a council recycling collection.

Sovereign Hospital Services has agreed to the purchase of two suitable receptacles for
recycling of aluminium cans and bottles for the restaurant location. The Trust will
purchase two receptacles for the North Entrance. Unfortunately, the Trust’s fire officer
expressed concern as the item may not be totally fire retardant and further research is
ongoing for a better product.

8.2     Friarage Hospital

A survey identified that better segregation of waste would realise savings.

Improved labelling to better identify clinical waste from domestic waste was purchased
during this quarter and delivered to the FHN for implementation on all

9.0     Energy

9.1     James Cook University Hospital

Total Energy consumption for the first six months of the year was 3% lower than the
same period last year. However, costs have risen by 16%. With respect to the
expenditure, the market is still extremely volatile although recently prices have eased

The programme to raise staff awareness has commenced. The Energy Saving Trust
Advice Centre has given some free advice. An exhibition stand manned by the Energy

N. Permain/cingrassia/Operational Services/Trust Board/Oct 2006               page 11 of 16
                                                                                 Agenda Item 18

Saving Trust is planned to take place in the Atrium during October when staff, visitors
and possibly patients will be able to seek advice on energy saving matters. It is thought
that by raising awareness through staff, visitors and patients what they can learn for their
home dwellings can be adapted for at-work awareness and savings.           A similar event
will be organised for the FHN during the next quarter.

A Trust initiative will be launched by the Energy team, focusing on outside of routine
hours, to raise awareness with office staff in ensuring computers and photocopying
equipment are switched off and not left on “standby”. The Murray Building, Academic
Centre and Ripon Block will be assessed next quarter.

Dalkia continue to be active in all positive suggestions to improve the energy facility at
the JCUH and the company are willing participants in initiatives and developments.

9.2     Friarage Hospital

Oil consumption at the FHN stopped during July 2006.
The commissioning of the new energy centre is now complete

9.3     Dalkia Performance Indicators (JCUH only)

Dalkia continue to deliver an excellent service, as indicated on the key performance
indicators, which are compiled from statistics measured against each of the topics: -

               Availability of Steam Boiler Plant          Boiler Water Quality
               Steam Pressure                              Softened Water Quality
               Availability of MTHW Boiler Plant           Planned Maintenance
               MTHW Flow Temperature                       Availability of Standby Generators
               Response to Call Out                        Safety

A survey has been conducted and a Trust Action Plan formed to reduce energy
consumption in the coming year. The Energy Action Plan must have senior management
commitment to be effective in order to achieve the Government targets and also to
reduce the Trust’s energy costs.

When Geoffrey Robinson Company commence work in maintaining the boiler house and
energy system at the Friarage, similar performance indicators will be set.

10.0    Utilities

There was no increase in water consumption during Q2/06 in fact it was reduced by
0.3%. However, expenditure has risen by 5%.

The Trust continues to remain within best practice targets for water consumption. The
following graphs show the consumption and associated costs for the water over the past
few years.

N. Permain/cingrassia/Operational Services/Trust Board/Oct 2006                   page 12 of 16
                                                                                                                                                       Agenda Item 18

                                                               Total Water Consumption

        Metres cubed



                                    April         May         June       July       Aug       Sept      Oct       Nov       Dec      Jan       Feb       Mar

                          2004/05   21647     22620       22232      22501         20257    21081      20921    23353     22527      22628     21576     22783
                          2005/06   22458     21787       20199      20961         22220    20308      21768    20800     19986      20770     19253     22790
                          2006/07   21687     21630       21336      22420         22460    22221

                                                                          Total Water Costs





                                            Apr         May      June       July      Aug       Sept      Oct       Nov       Dec       Jan      Feb       Mar

                            2004/ 2005   26827      28899        27815      29126     26079     26952     27272     30247    28862     28303     27520     30010

                            2005/ 2006   31876      30277        29287      29484     31653     29302     30406     29342    28772     28729     26869     31629

                            2006/ 2007   36305      35081        32042      36317     33397     34628

11.0        Transport Management

The Group has been pro-active and over the past few years have achieved: -

       a) Raising Awareness of Transport and Driving legislation
       b) The implementation of two Trust policies and procedures
       c) Implementation of Defensive Driver Training Programmes
       d) Focus on pedestrian site safety and disabled facilities
       e) On-site signage and traffic management
       f)              Compilation of a database to assess commercial vehicle movement
       g) Compilation of commercial vehicle replacement plan
       h) Reduction in commercial vehicle costs by moving from ‘owned vehicles’ to
          ‘leased vehicles’ and restricting use of expensive vehicle hire
       i)              Restructuring of leased car management to achieve greater efficiency

The Group will reduce meetings during 2007 to quarterly and all Group members will be
asked to review the two Policies and Procedures (HS36 and HS38) with a view to
amending those early 2007.

N. Permain/cingrassia/Operational Services/Trust Board/Oct 2006                                                                                          page 13 of 16
                                                                         Agenda Item 18

11.1    Commercial Vehicles

The commercial fleet continues to be managed by Abbey Associates who provide an
excellent service, considered economical at £60 per vehicle administration fee.
Leased charges of the commercial vehicles average £49,914 per annum. It should be
realised that through Lease rather than Purchase, the Trust does not lose substantial
capital monies due to vehicle devaluations

There are no high maintenance charges because the vehicles are relatively new and are
returned to lease companies prior to MOT requirement. However, all vehicles meet
“emission” regulations and the commercial fleet are in compliance with Government

11.2    Leased Vehicles

Again, Abbey Associates administrate a leased car programme for key members of staff
- the main costs are to the employee, deducted from salary. At the end of this quarter 90
employees participate in the scheme.

11.3    Defensive Driver Training

Another seminar training day was conducted on 26th September, 28 employees attended
and 2 core drivers received in-vehicle assessments. The programme continues to be
well received and already the training session arranged for 13th and 14th November are
fully booked.   The implementation of the driver-training scheme proves the Trust’s
commitment to ensuring the safety of its employees whilst driving while conduct their

12.0    Sterile Services Department

The Trust Board has recently supported the decision to withdraw from the local
collaboration for procuring Sterile Services from the private sector. The Trust will now
pursue an independent strategy for the provision of decontamination services. In
pursuing an independent strategy the Trust has agreed that there must be specific
support to the department over the coming months and years. This support needs to
focus on:

   Commitment to an investment programme to ensure equipment is up to date and
    fully functional, there is sufficient instrumentation to maintain turnaround times and
    full EEC standards are maintained

   Investment in the development of management and supervisory capabilities

   Engaging periodic expert external advice to audit standards and advise on future

   Seeking new income by provision of services to PCT’s and other hospitals

This will mean a lot of hard work in the coming months to ensure compliance and there
full commitment from the team to move this forward.

N. Permain/cingrassia/Operational Services/Trust Board/Oct 2006            page 14 of 16
                                                                                                                                                           Agenda Item 18

Total tray production figures show an increase for August 2006. This is attributed to the
number of instruments returned for decontamination that had not been used where the
expiry date had passed.

The new IT software at JCUH provides the facility to monitor a number of measures.
Turnaround times for specialties was analysed in Q2/06 as a way of testing out the
efficacy of the system information.

An initial analysis of sets processed on a fast track basis has confirmed that there is a
need to change the process in place for responding to Ophthalmology sets. The graphs
show the number of sets processed for Ophthalmology between sis to ten hours is totally
disproportionate to sets for other specialities. This is due to a number of factors, which
the SSD Manager is working through with the relevant users.

                                                                    August trays fast tracked Over 6-10 Hours



   No. of Trays





                      0                                             Ophthalmol                                                    Orthopaedi Wards and
                            maternity   Gynae   Urology   General              maxs facs   Neuro   Plastics   vascular   Cardio                        oral surgery   SDU   ENT
                                                                       ogy                                                            cs      depts
                  Series2      4                 118        14         627        27        22       57         10         3         91          2           2

N. Permain/cingrassia/Operational Services/Trust Board/Oct 2006                                                                                                  page 15 of 16
                                                                             Agenda Item 18

           DDA – Disability Discrimination Act

           EUETs – European Union Emission Transmissions

           FHN – Friarage Hospital Northallerton

           JCUH – James Cook University Hospital

           ICT – Information and Communication Technology

           IPC – Infection Prevention and Control

           KPI – Key Performance Indicator

           MDHU – Military Defense Hospital Unit

           MRSA – Methicillin Resistant Staphylococcus Aureus

           PEAT – Patient Environment Action Team

           PCT – Primary Care Trust

           PFI – Private finance Initiative

           PPM – Planned Preventative Maintenance

           Q2 – Quarter 2

           SHS – Sovereign Hospital Services

           SSD – Sterile Services Department

           UPS – Uninterrupted Power Supply

           VIP – ‘Voice Integrated Products’

           N. Permain/cingrassia/Operational Services/Trust Board/Oct 2006    page 16 of 16

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