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                           REPORT TO BOARD

Report Author:       Julian Alexander, Head of Estates Management

Lead Director:       Ben Sturgess, Acting Director of Finance and Information

Contact Details:     020 7716 7169. ben.strugess@lambethpct.nhs.uk


Date of meeting:     19th September 2007

Subject:             UPDATE ON LAMBETH PCT STRATEGIC
                     CAPITAL DEVELOPMENT PROGRAMME,
                     INCLUDING LSL LIFT
                                Regular Report

RECOMMENDATIONS
The Board is asked to:

1.   Note progress with the PCTs 2007/08 Strategic Capital Development
     Programme as approved at the Board in March 2007, including the
     status of individual capital development schemes (incorporating GP and
     PCT premises, and premises to be developed through LSL LIFT).

2.   Note progress in the Lambeth, Southwark and Lewisham LIFT initiative.

3.   Note the progress update for the Lambeth, Southwark and Lewisham
     Facilities Management Service, hosted by Lambeth PCT.


SUMMARY
1.0 This paper updates the Board on progress with the PCT Strategic
    Capital Development Programme for 2007/08, which comprises the
    following three elements:

            Maintenance of the PCT estate including reduction of backlog
             maintenance, and investment in GP premises.

            Development of new premises, meeting both the service vision
             as detailed in the Strategic Service Development Plan (SSDP
             2005), and NHS Plan targets.

            Development of new premises through the LSL LIFT initiative.



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2.0   The paper encompasses the whole of the PCTs Strategic Capital
      Development Programme; including LIFT. It builds on the last report
      presented to the Board meeting held on the 16th July 2007.

3.0   The paper includes the July progress update for the Lambeth,
      Southwark and Lewisham Facilities Management Services hosted by
      Lambeth PCT.

Resource Implications:       Updated budget and forecast outturn positions
                              following March 2007 PCT Board approval to
                              the 2007/08 Strategic Capital Development
                              Programme, were reported to the last
                              Strategic Capital Group meeting which was
                              held on the 9th August 2007.

                             As at September 2007, planned capital
                              expenditure for 2007/08 totals £4.2 million and
                              includes Gracefield Gardens ICT & fit out,
                              Streatham Hill Sexual Health Clinic, IP
                              Telephony Business Case.

                             Revenue funding (rent and rates) has been
                              earmarked within the Strategic Capital
                              Development Programme for the following
                              schemes approved by the PCT Board,
                              following Business Case submission:
                                  o Central Streatham/Gracefield Gardens
                                  o Springfield
                                  o Vassall Medical Centre
                                  o Hurley Riverside
                                  o Leigham Court Rd (Dr Ung)
                                  o Streatham Vale/Woodgate Drive
                                  o Norwood inc the Deerbrook Practice
                                  o Streatham Hill Sexual Health Clinic
                              Detailed funding implications are included
                              within each scheme Business Case.

                             The Facilities Management Service total
                              source of funding for 2007/08 is £6.1m. The
                              overall budgetary framework for the Facilities
                              Management Service has now been agreed.
Public & User              Patient and community involvement is included
Involvement:                 within the remit of the Steering Group for each
                             capital development scheme, and a separate
                             community group has been established for the
                             Myatts Field LIFT scheme.
Staff Involvement:          Staff, GPs and clinicians are represented
                              within the Steering Group for each capital
                              development scheme.



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Equalities & Diversity       Improvements in the quality of primary and
and Health Inequalities       community premises will support access to and
Implications:                 the quality of services to Lambeth residents.
Related Standards for        C4E, C20A, C20B, C21. Monitored through the
Better Health                 PCT Strategic Capital Group and the LSL
                              Facilities Service User Group (SUG)




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                        Board Meeting 16th July 2007

  UPDATE ON LAMBETH PCT STRATEGIC CAPITAL
 DEVELOPMENT PROGRAMME, INCLUDING LSL LIFT
1.    Aim of paper
1.1   This paper aims to:

      (i)     Update the Board on the progress of the PCTs Strategic Capital
              Development Programme for 2007/08 following approval at the
              March 2007 PCT Board meeting. The Strategic Capital
              Development programme is based on the following three
              components:

                    Maintenance of the PCT estate including reduction of
                     backlog maintenance, and investment in GP premises
                     improvements.

                    Development of new premises meeting both the service
                     vision, as detailed in the Strategic Service Development
                     Plan (SSDP 2005), and NHS Plan targets.

                    Development of new premises through the LSL LIFT
                     initiative.

      (ii)    Build on earlier reports to the Board, the last report having being
              presented to the Board meeting held on 16th July 2007.

      (iii)   Update the Board on the status and progress made by the
              Lambeth, Southwark and Lewisham Facilities Management
              Services hosted by Lambeth PCT since April.

2.    ESTATES MAINTENANCE, PCT AND GP PREMISES

2.1   Lambeth PCT currently has a legal interest in 25 premises which
      require ongoing investment to ensure that they remain “fit for purpose”,
      and comply with statutory and NHS regulations, including PEAT and
      Healthcare Standards.



2.2   Within Lambeth there are 49 GP premises (including GP practices
      within Health Centres) for which Lambeth PCT supports both in respect
      of the reimbursement of rent and rates payments, and in the
      improvement and development of GP premises meeting NHS and
      Statutory guidelines and regulations




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2.3   The 2007/08 Strategic Capital Development Programme is managed
      through the Lambeth PCT Strategic Capital Group, and supported by
      the Operational Capital and Environment Group and the Locality
      Administration Managers (LAM‟s) Group. The Strategic Capital Group
      meets every six weeks, with the last meeting taking place on the 9 th
      August 2007.

2.4   The Strategic Capital Development Programme for 2007/08 was
      approved at the March 2007 PCT Board. The Programme was based
      on the following key overarching priorities:

       Existing Commitments:
         Existing Rent and Rates
         New rent and rates commitments as approved by the PCT
            Board
         Non-recurrent scheme costs as already approved by the PCT
            Board
       LIFT - continued LIFT development, including Project Director and
        advisors costs
       Compliance with statutory and NHS regulations, including PEAT
        and Standards for Better Health
       Investment in Planned Maintenance Programme (PPM), to reduce
        reactive maintenance costs
       Improvements/new developments meeting service need as detailed
        in the PCT Strategic Service Development Plan
       Meet NHS Plan objectives, including refurbishment of GP premises,
        and the development of new Primary Care Centres

      A full list of approved schemes was included within the Update
      Paper presented to the March 2007 PCT Board.

2.5   The PCT is considering fast tracking its work on rolling out IP
      Telephony across the PCT in support of the Customer Services
      Review. The Shared Information Service and the PCT‟s Customer
      Services Project Team have developed business case and the Board
      meeting agreed that the business case would be approved through
      Chairs Action in order that the PCT could deliver its IPT solution in line
      with the PCTs Customer services review implementation and the
      opening of Gracefield Gardens in Autumn 2007.



3.    DEVELOPMENT OF NEW PREMISES.

3.1   Lambeth PCT currently has a substantial programme of developing
      new health premises, and key areas of development since the last PCT
      Board report are summarised as follows:

          St Georges Wharf – Opened in March 2007, with the formal
           opening taking place on the 29th June 2007.


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          Leigham Court Avenue (Dr Ung) – Opened on the 25th June 2007
          Springfield – Building open to patients on the 16th July 2007
          Gracefield Gardens (LSL LIFT) – Due to delays in the delivery
           and commissioning of the electricity sub-station, the building will
           now open to patients in November 2007.
          Vassall Medical Centre – Due to delays on site, the opening date
           has slipped into January 2008
          Deerbrook practice – Final negotiations being concluded with
           legal completion to take place in September 2007.
          Streatham Vale – Final negotiations being concluded.
          Mary Seacole House/Future Clapham – Preferred bidder to be
           selected following receipt of final tenders in September 2007. A
           separate paper and Business Case is to be presented to the
           September 2007 PCT Board.
          Clapham Park Regeneration – Meetings are taking place to
           finalise the health requirements for the scheme.

      A full report detailing progress of all the PCTs proposed capital
      development schemes is available on request.

4.    LSL LIFT.

4.1   Financial close was achieved on the 6th December 2006, establishing
      a new joint venture company, Building Better Health Lambeth,
      Southwark and Lewisham Ltd, otherwise to be known as LSL LIFTCo.
      The LSL LIFTCo Board is now well established, meeting monthly.

4.2   The LSL LIFT Strategic Partnering Board (SPB) is fully established
      following Financial Close, chaired by Colin Roberts. Angela Dawe is
      the Lambeth PCT representative. There are a number of project groups
      in place to oversee LSL LIFTCo, and to manage the development of
      Lambeth PCTs new capital development schemes in accordance with
      national guidance and with the service vision set out within the
      Strategic Service Development Plan 2005.

      The last meeting of the SPB took place on the 17th July 2007, and the
      next meeting is planned for the 18th September 2007.

4.3   The Strategic Partnership Board is responsible for ensuring delivery of
      the remaining four Tranche 1 schemes (three of which are in Lambeth).
      The remaining four Tranche 1 schemes are:
          Streatham Common Primary Care Centre (Lambeth PCT)
          Myatts Field Primary Care Centre (Lambeth PCT)
          Crown Dale Primary Care Centre (Lambeth PCT)
          Dulwich Hospital (Southwark PCT)

4.4   Lambeth PCT commissioned Building Better Health Services Ltd
      (BBHSL) to produce the Stage 1 Business Case for the three remaining
      Lambeth PCT Tranche 1 schemes, and this was approved by the PCT
      Board and LSL LIFTCo Board in March 2007. The Business case was


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      considered by NHS London Strategic Health Authority (SHA) Capital
      Investment Committee on the 27th June 2007, where approval to the
      development of the Myatts Field and Streatham Common Primary Care
      Centre schemes was approved. The only conditions imposed on this
      approval related to the Myatts Field scheme, where NHS London
      wished to see more doctors based within the centre and provision for
      diagnostic services.

4.5   In relation to the third scheme, Crowndale Primary Care Centre,
      discussions have taken place between Lambeth PCT and NHS London
      following the Capital Investment Committee meeting. The outcome of
      these discussions is that NHS London may in principle support the
      development of the Crowndale Primary Care Centre, linked to the
      development of a new Neighbourhood Resource Centre/“hub”, to be
      developed in Norwood. However, given that the proposal for a new
      Norwood Neighbourhood Centre is still at an early stage, it was agreed
      that Crowndale would be developed in a future tranche of schemes
      alongside a new Norwood development. Accordingly, Crowndale has
      been removed from the current Stage 1 Business Case.

4.6   With the removal of Crowndale, the Business Case has “materially”
      changed from the one approved at the March 2007 PCT Board. The
      Business Case has now been revised and a separate paper is to be
      presented to the September 2007 PCT Board for approval of the
      Business Case. The planned timetable for the Business Case is as
      follows;

         PCT Board approval: 19th September 2007
         Planning application submission: November 2007
         Receipt of planning approval: March 2008
         Finalising financial and legal matters: March 2008 to July 2008
         Financial Close: July 2008
         Estimated construction completion: January 2010

4.7   Strategic Services Development Plan (SSDP)
      Following approval by the three PCTs, the Strategic Partnering Board
      (SPB) and the South East London Strategic Health Authority Capital
      Review Group, the final version of the SSDP 2005 (which built on the
      first SSDP produced in December 2002) was adopted in January 2006.


4.8   The Strategic Partnering Board (SPB) has agreed that the development
      of a new SSDP 2006 is a priority, and a process for its production has
      been approved, with Building Better Health appointed to lead the
      process. The SSDP will be geographically focussed, and will be
      informed by the PCTs Commissioning Strategy Plan, „A Picture of
      Health’ and emerging London-wide thinking around service models.

4.9   A Steering Group has been established with Angela Dawe representing
      Lambeth PCT. A series of meetings have been taking place to review


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          progress and to agree electronic mapping requirements for the new
          SSDP, with meetings having taken place on 2nd and the 21st August
          2007. It has been agreed that the timetable for the new SSDP be linked
          to the further development of the PCTs 5 year Commissioning Strategy
          Plan.

5.        LSL Facilities Management – Hosted Service

5.1       Under arrangements for taking forward the LSL Support Service
          Review, the PCT Board approved that Lambeth PCT will host the
          former SSP Facilities Service (FMS), led by Debbie Carson, Director of
          Facilities, reporting to Andrew Eyres Director of Finance and
          Information from 1st April 2006.

5.2       The hosted Facilities Management Service reports to an LSL-wide
          Facilities Service User Group (SUG) comprising finance, estates and
          service leads from each PCT. The last meeting took place on the 28 th
          August 2007, where it was agreed that in future the group would meet
          quarterly, as opposed to every six weeks. Dates for future meetings are
          currently being arranged.

5.3       The Directorate‟s Service Delivery Plan gives full details of its 2007/08
          Objectives. Actions to be completed in the first two quarters of 2007/08
          are:

          Agreement of PCT 2007/08 Capital Programmes - completed
          Access and training for the PCT‟s and Head of Estates to MICAD -
           ongoing
          Implementation of site specific budgets – ongoing
          Raising the profile of the PCTs procurement initiatives and
           establishment of a new procurement working group - ongoing
          Completion and communication of service reviews - ongoing.
          Development of new strategic and operational key performance
           indicators – ongoing

5.4       The 2007/08 Key Performance Indicator Report and Business Plan was
          discussed at the Facilities SUG meeting held on the 17th July 2007, and
          a copy of the report is available on request.

6.        Conclusion

          This report sets out the September 2007 position on the PCTs overall
          Strategic Capital Development Programme, provides an LSL LIFT
          update, and details progress with the Facilities Management Service
          hosted by Lambeth PCT.



Julian Alexander
                                                    th
Head of Estates Management                         5 September 2007



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