Document Sample

                FINANCIAL CLOSE 3
                   TRANCHE 1B


                    STAGE 1
                 BUSINESS CASE


                   NOVEMBER 2007

Sally Ironfield – SPB/LIFT Project Manager
                                             V6 11/07
Bradford & Airedale Care Partnerships Ltd was formed in October 2004 as a
Local Improvement Finance Trust (LIFT). LIFT is a joint venture between the
Department of Health, local health and social care organisations and the
private sector.

To date two tranches of schemes have reached financial close encompassing
six individual developments, the first three in October 2004, the second three
in July 2006. Four of these facilities are now fully operational with the
remaining two on programme to become operational in January 2008.

Whilst the tPCT is the only local public sector shareholder, a number of other
stakeholders are key to the success of LIFT. These stakeholders include:

                 Bradford Metropolitan District Council
                 Bradford District Care Trust
                 NHS Yorkshire & The Humber (SHA)
                 Bradford Teaching Hospitals NHS Foundation Trust
                 Airedale NHS Trust
                 Yorkshire Ambulance Service NHS Trust

The LIFT programme aims to provide new or refurbished premises for
services currently housed in unsuitable facilities, and to ensure that services
can be provided close to the patient’s home in the most appropriate setting.
The LIFT programme will work alongside the service improvement and re-
development works under pinning NHS reform.

The third financial close for the Bradford & Airedale LIFT programme is
comprised of a single scheme with a capital value of c.£11.6million , which
has been identified as a significant need since the original Strategic Service
Delivery Plan in 2002. The former Airedale PCT noted the critical nature of
this scheme for the future of primary care services within the Bingley locality,
and it remains so recognised by the new single tPCT.

The scheme presented for approval herein is the Bingley Locality Hub.

The Locality Hub
The hub will replace the existing Bingley Health Centre and Bingley Hospital
facilities as well as two GP-owned practice premises. These current facilities
are overcrowded, out dated and functionally unsuitable for the long term
provision of services.

The new Locality Hub will provide additional accommodation to allow for
short-medium term expansion of services as well as providing the option of a
future extension of an additional 10% capacity should this be required in
future years. The Locality Hub will provide flexible accommodation for the
provision of a range of services by a range of providers which will be able to
adjust to changing types and levels of demand over the life of the lease.

The facility will be owned by the LIFT Company and maintained internally and
externally for the 25 year term of the Lease Plus Agreement. Bradford &
Airedale tPCT will take the headlease on the Locality hub with GP practices
holding underleases. It is the intention that these underleases will be signed
prior to Financial Close. It is not intended that Airedale NHS Trust and
Bradford District Care Trust will hold underleases for the areas occupied by
the services delivered by these providers. Instead local service tariffs will be
negotiated to reflect premises costs whilst retaining optimum flexibility of
service provider for the Practice Based Commissioners.

The full revenue cost of the scheme has been provided for within the tPCT’s
financial plans and the proposed Lease Plus Payment is within the tPCT’s
Affordability Cap.

A detailed and challenging Value for Money assessment shall be undertaken
prior to Stage 2 Approval submissions.

The Business Case has been developed in accordance with advice from the
SHA in respect of the application of current and pending Department of Health
guidance and the incumbent approvals processes. It is recognised that the
subsequent introduction of revised guidance by the DH may affect the
submissions for Stage 2.

Service Benefits & Objectives
A Benefits Realisation Plan has been drafted for the Bingley scheme outlining
benefits, outcomes and objectives of the scheme and is attached for
information. At this stage the plan is still in draft form and will remain under
review for final amendment prior to Stage 2.

All aspects of the Benefits Realisation Plan have been jointly established by
both tPCT representatives, service providers and their staff, along with the
patient user group.

Closer working between the various clinical teams will facilitate improved
communications and it is intended that the co-location of services will enable
a co-ordinated approach to care. Discussions continue with providers to
establish a protocol to enable patients requiring multiple service appointments
to have these co-ordinated by the teams at the hub to minimise confusion and
increase access to these services for these users.

The improvement in morale and in the more generic ‘user friendly’
environment will improve the patient experience of their healthcare and the
addition of a community café facility aims to reduce the perceived stigma of
adults with learning disabilities and users of mental health services, as well as
increase the engagement of the community with the facility itself and with their
self-care/self-responsibility for choices affecting their own health and well-

In short the broad objectives of the scheme are:

           Improving the health of the population
           Care provision in the right setting at the right time
           Deliver within budget
           Citizenship, social inclusion and diversity

Whilst providing clear links with the wider objectives of the tPCT as a whole,
the delivery of the scheme is also key in the strategic delivery of the following
national drivers for change;

           Choose & Book
           Practice based Commissioning
           Choosing Health
           Long-term Conditions NSF
           Every Child Matters
           ‘Our Health, Our Care , Our Say: a new direction for
            community services’


Lingjuan Ma Lingjuan Ma MS
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