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Enfield Estates and Facilities Report 1. Introduction This paper is intended to give the Board an overview on certain aspects of the Trusts Estates and Facilities responsibilities and highlights some areas requiring attention. Following the transfer of the Estates management responsibilities from the Provider arm of the organisation to the Commissioners from 1 April, a review of the Estates and Facilities functions has been undertaken to establish that the Trust is meeting its obligations in terms of statutory and legislative requirements. The review has focused on the management of established contracts, estates upkeep, facilities management and statutory compliance. 2. Estates Maintenance Contracts – Hard FM (Facilities Management) The Hard FM for the Trust sites is generally managed through established contracts with recognised maintenance contractors, as follows; Mitie – Bowes Road Clinic, Evergreen PCC, Moorfields HC, Ridge House Clinic, St Michaels Hospital site, Wenlock House and Holbrook House (part shared with landlord). Lorne Stewart – All PCT occupied property on the Chase Farm site. Integral – Forest PCC There are three other sites which have the building maintenance covered as part of the Lease arrangements with the landlord, these are; Freezywater, Highlands HC and Eagle House The contracts with Mitie and Lorne Stewart have been established for a number of years but are due to expire in the spring of 2010. Historically the management responsibility for these contracts was commissioned out to the Estates Department of Barnet, Enfield and Haringey Mental Health Trust who managed the contracts on the Trusts behalf. This arrangement ceased in 2008 and the contract management responsibility was taken on by Provider services. Having reviewed the contracts in place with the maintenance providers it is clear that the terms and conditions including performance standards are pretty robust and that the contractors are keen to engage in regular dialogue with the Trust. Following review meetings with both of the main contractors (Mitie and Lorne Stewart) I was reassured that they are generally complying with the terms of the contract and both are keen to continue providing support post 2010. However whilst It is clear that the maintenance contracts in place appear robust there does not appear to have been any formal contract management processes established for sometime. The Trust therefore does not presently have any documentation that clearly details performance against contract or give the necessary assurances regarding compliance with statutory requirements. This is therefore a risk and was also highlighted as one of the main concerns in the recent due diligence report provided by Inventures. Inventures were commissioned by the Trust to undertake a due diligence exercise in respect of the building maintenance contracts and their findings have been reported separately. This issue is being addressed as a priority and we are establishing a more formal contract management process with the maintenance contractors to ensure that statutory compliance is being met on our sites as well as providing a value for money service. This process will for the immediate future be managed by the Commissioners but given that many of the operational aspects of these contracts impact directly on Provider services there will be a need to work closely with the DPO. As the Trusts assets sit currently with the Commissioners of services there is a need to establish a formal lease/licence arrangement or memorandum of occupation between the Commissioner and the DPO and this is currently being progressed which will define the Estates responsibilities for both parties. 3. Backlog Maintenance Programme/Health & Safety As part of the review it is apparent that there has not been any formal backlog maintenance programme in place for sometime and this may have contributed to the poor condition of some of the Trusts Estate. Trusts are required to ensure that their sites are being properly maintained to an acceptable standard and whilst this has occurred in part through the established contracts this does not appear to have happened in a structured way. Formal building condition surveys were undertaken a few years ago which should have informed the backlog maintenance programme for the Trust but it would seem that this has not happened. This may partly be due to a lack of established funding to support such works as it would seem that in the past Provider services have met the cost of necessary maintenance works from their operational revenue budgets. The lack of funding to support backlog maintenance including Health & Safety needs addressing and this was also identified as a concern by Inventures. The Trusts Premises and Capital Group will be addressing this issue and will take into account the Trusts needs in terms of backlog maintenance with a view to providing a clear funding stream. 4. Hotel Services – Soft FM The majority of the soft facilities services are directly managed by the Provider arm of the organisation and this arrangement has continued since 1 April. It will be necessary for the soft FM services to be reviewed to ensure that value for money (VFM) is being achieved as well as compliance with statutory requirements and HCC standards. In particular the current cleaning arrangements and associated specifications for the clinics should be reviewed to ensure that they comply with “Better Cleaning Standards” as this will need to be evidenced as part of HCC standards. There are some contracted out services such as Domestic Waste and Clinical Waste and these contracts should also be reviewed to ensure that Waste regulations are being met. SLAs are currently in place with the Acute Trust for services provided by Medirest (soft FM Provider) at St Michaels and this should be reviewed to ensure that the Provider is receiving VFM. Consideration may also need to be given to reviewing the current switchboard arrangement that is hosted by the Acute Trust for St Michaels to again ensure that VFM is being achieved. Provider services recognise that they will need to give consideration to the contract management aspects of their Hotel Services to ensure that they have sufficient capacity and expertise and this will be addressed over the coming months. 5. Wenlock House As part of the review one of our sites, Wenlock House, has been identified as a building with a number of high risk issues. This is largely due to the fact that the building condition is generally poor but also because we host a critical service (Health Informatics Service – HIS) from this site and their business continuity is currently at risk due to the condition of the building. The Trust is currently tied into a full repairing lease with the landlord of the building until the summer of 2010 and we are exploring options around the continuation of the lease. There are a number of complex factors to take into consideration around the future use of this site and the Trust has engaged Barnet PCT Estates Department to assist in exploring options around the future use of the building. There are clearly time constraints given that the lease expires next year and so therefore future options will be worked up over the next few months for Trust consideration. 6. Estates Governance Arrangements As indicated earlier this review has identified a number of weaknesses in the governance arrangements that are in place to manage the Trusts estate and these need addressing. We are already putting in place a more formal contract management process around the established contracts with our Hard FM providers and this will for the immediate future be managed by the Primary Care Commissioners. The Premises and Capital Group has recently met for the first time in a while and in line with the revised Terms of Reference will continue to meet on a regular basis. This Group will be responsible for determining the future allocation of capital monies and as part of this process will ensure that the Trusts backlog maintenance requirements (including Health & Safety issues) are met. The Premises and Capital Group will provide formal minutes and its recommendations/actions will be reported into the Trusts Finance Committee. The future Estates Management function for the Trust will need reviewing and we will be working with our internal auditors as well as partner organisations over the next few months to consider options for the future that will best meet the needs for Enfield. 7. Conclusion There are clearly areas of concern that need addressing and we are starting to put in place a more structured approach to our Estates management that will support this process and the establishment of the Premises and Capital Group will also provide accountability. This process will ensure that we minimise the risk issues associated with some of our sites as well as enabling the Trust to meets its statutory responsibilities. There is also a need to establish a clear understanding of Estates responsibilities between the Commissioner and the DPO and this will also be addressed as a priority. 8. Recommendation The Board are asked to note the findings of the Estates and Facilities review and the actions currently being implemented.
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