Estates Strategy North West Ambulance Service 2013/ /18

Transcription

1 Estates Strategy North West Ambulance Service 2013/ /18 Reference: EF.NM. 009 Estates Strategy Page: Page 1 of 27 Author: Assistant Director Estates and Fleet Version: 1.0

2 Recommended by Approved by Executive Management Team Board of Directors Approval date 27/03/13 Version number 1.0 Review date April 2015 Responsible Director Responsible Manager (Sponsor) For use by Finance Director Assistant Director Estates and Fleet All Trust employees This policy is available in alternative formats on request. Please contact the Estates Team on Estates Strategy Page: Page 2 of 27

3 Change record form Version Description Author Date 0.1 Development of up to date document to cover the years 2013/ / Amendments following EMT 18/03/ Issue following Board approval 27/03/13 Neil Maher 14/03/13 Neil Maher 20/03/13 Neil Maher 28/03/13 Estates Strategy Page: Page 3 of 27

4 Contents Page No 1. Introduction 5 2. Background Trust Overview Age Profile of the Estate Property Condition (Six Facet Surveys) Estates Strategy 2009/ /14 Progress Report Financial and Economic outlook Current Operational Model The Way Forward 8 3. Future Provision Supporting Service Delivery Key Drivers Stations Emergency Operations Centres (EOC) Workshops HART/USAR/ Resilience Corporate and Headquarters Services Partnership with other services Sustainability and Energy Carbon Reduction and Energy Management Energy Performance of Buildings Performance Measures and Benchmarking Health, Safety and Hygiene The Estates Policy Premises Cleaning Waste Management Legionella Prevention Asbestos Management Financial Plan Depreciation, revenue and capital funding Capital Programme Cost Improvement Programme (CIP) Delivery Plan Estates Rationalisation Strategic Implementation Plan Design Considerations Estates Rationalisation Project Board and Team Annual Estates Plan Stakeholder Engagement and Communications Equality Impact Assessment Conclusion 19 Appendix 1: Definitions of six facet survey criteria 20 Appendix 2: NWAS Emergency Service Resource Deployment Strategic Outline 21 Appendix 3: Hub & Spoke Programme Flow Chart 22 Appendix 4: Estates Five Year Capital Programme ( ) 23 Appendix 5: Equality Impact Assessment 25 Estates Strategy Page: Page 4 of 27

5 1. Introduction The Estates Strategy must be closely aligned to the Trust objectives and strategies as they develop. The Trust faces a number of challenging strategic and operational issues over the short, medium and longer term all of which must be clearly understood in the current and future economic climate. The Estates Strategy is principally concerned with the Trust s usage of its estate and the capital investment over the next five years to ensure that the Trust can achieve its service objectives. The strategy covers all the Trust s estate. 2. Background 2.1 Trust Overview For operational estate purposes the area covered by the North West Ambulance Service NHS Trust (NWAS) is divided into 3 Groups, namely; Cumbria & Lancashire, Cheshire & Merseyside, and Greater Manchester. The tables below summarises some key Trust data. The Trust: Geographical Area Employees (Whole Time Equivalent) 15,165 km² 4,714 WTE (2012/13) Table 1 Trust data sourced from the NWAS Integrated Business Plan, (February 2013) Type Number and Details Stations (inc. HART) 111 Control /Operations Centres 3 Emergency Operations Centres (Broughton, Elm House, Parkway) 1 Support Centre (Carlisle) PTS Control Centres (Broughton, Carlisle, Countess of Chester Hospital, Parkway, and other NHS hospital sites) Workshops 13 Training/admin buildings Mast sites Headquarters (Ladybridge Hall and HQ Lodge), Cumbria Office (Salkeld Hall), Cheshire & Merseyside Office (Elm House), Greater Manchester Office (Whitefield), Lancashire Office (Broughton), Mersey Finance, Bolton Finance, The Centre (Preston), Accrington Training Centre 2 (Billinge, Broughton) Transport Logistics 1 Table 2 Summary of the NWAS Estate (at March 2013) Estates Strategy Page: Page 5 of 27

6 2.2 Age Profile of the Estate The current NWAS estate is a mix of buildings that has evolved over the last 150 years. The vast majority of the operational ambulance station stock is over 25 years old. The stations are a mix of owned and leasehold premises in locations that were determined many years ago to meet the service needs of the second half of the 20th century. Age Profile % of Estate Age Profile to present 3.2% Age Profile to % Age Profile to % Age Profile to % Age Profile to % Age Profile to % Age Profile to % Age Profile - pre % Table 3 Age profile of NWAS estate reported in ERIC Return (June 2012) 2.3 Property Condition (Six Facet Surveys) The Trust has a statutory duty to safeguard the assets of the Trust. In order to establish the exact levels of backlog maintenance within the current estate Drivers Jonas were appointed to carry out a full 6-facet survey in The results of the surveys gave the estates team a clear indication of where expenditure should be focused over the following 5 years. Each property was appraised against six criteria; physical condition, functional suitability, space utilisation, quality, energy performance, and statutory performance. Further details on each of these can be found in Appendix 1. Survey findings suggested the disposal of a number of sites based on their functional suitability and/or physical condition. An interim assessment of work carried out following the 6 facet survey was carried out in 2012 to assess the effectiveness of the capital expenditure, and the proposal is to carry out this exercise on an annual basis. The facet survey report provides the estates team with a comprehensive and clear understanding and independent assessment of the condition of the Trust s estate. This will allow the Trust to take informed decisions in relation to capital expenditure on refurbishment projects and ensure that expenditure is targeted at areas of greatest need. Estates Strategy Page: Page 6 of 27

7 2.4 Estates Strategy 2009/ /14 Progress The Estates Strategy for the period 2009/ /14 set out a number of key work areas for the Estates Department and the following have been achieved; 1. Development of a future service model for the estate. 2. Review of the requirements for control centres. 3. Determination of the Sustainable Development Plan. 4. Provision of a standard NWAS resilience and alarm management infrastructure across all control centres. 5. Provision of HART facilities in Manchester and Liverpool. 6. Review of the requirements for workshops. 7. Development of a legionella plan. 8. Development of an asbestos plan. 2.5 Financial and Economic outlook The financial and economic outlook will be the overall driver for efficiencies in the estate towards: More co-location/partnership initiatives e.g. with other blue light services/public bodies. Reduction in the number of sites. More operating efficiencies derived from the proposed reduction in the estate footprint. This strategy clarifies the key issues and actions required over the next five year period. The strategy will need to be reviewed as other Trust strategies develop. The strategy will be used as the basis for determining the annual estates plan for the Trust. 2.6 Current Operational Model Currently the Trust operates a traditional ambulance station estate. In considering how the estate will support front line service delivery into the future under Taking Healthcare to the Patient and Transforming NHS ambulance services, it is critical that the Trust determines the future service models. Estates Strategy Page: Page 7 of 27

8 2.7 The Way Forward The Trust s Integrated Business Plan sets out the future direction of the service. The key elements of this vision and strategy are; the redesign of ambulance responses to more appropriately meet the needs of patients, and a differentiation of service and response models appropriate to urban, rural and remote areas of the North West. Both of these elements require a review of the supporting estate. Key to improving patient care is the development of deployment plans that position ambulance resources as close as possible to patients at the time of despatch. This concept of intelligent deployment plans based upon accurate and reliable activity data is called Patient Centred Deployment (PCD). The foundations to support PCD are represented in the two pillar diagram shown in Figure 1. The Estates Strategy focuses on providing the Estate Infrastructure and Workshop elements of PCD. The Service Modernisation Partnership Group produced the NWAS Emergency Service Resource Deployment Strategic Outline (included in Appendix 2) which supports the development of PCD. Further details can be found in the Estates Rationalisation Strategic Implementation Plan which was approved by the Board of Directors in July Figure 1 - Patient Centred Deployment model The hub and spoke configuration supports PCD particularly in concentrated high activity and dynamically changing urban areas. A more traditional ambulance station deployment would be more appropriate in the less densely populated and widely dispersed areas such as Cumbria and Cheshire. The definition for hub and spokes is presented in the Estates Rationalisation Strategic Implementation Plan. Estates Strategy Page: Page 8 of 27

9 3. Future Provision 3.1 Supporting Service Delivery The successful implementation of this Estates strategy will enable the provision of safe, secure, high quality buildings and an infrastructure capable of supporting current and future models of service delivery. The Trust estate will be maintained over the next 5 years in such a way that it will be designed to be flexible and adaptable with the ability to change appropriately to the needs of the Trust across the communities it serves. In order to support the new service model the focus of estates activities will include: The development of modern bases, which will provide the full range of facilities required to support the service strategy. The capacity to support a more diverse vehicle base. The potential to introduce a hub and spoke model across the region, based on a single large ambulance station at the hub, and spokes consisting of serviced and un-serviced ambulance standby points. Facilities for training, both centralised and out in the field Facilities for vehicle fleet maintenance and deep cleaning service that will complement and improve vehicle availability and reduce ambulance crew downtime. A modern, well maintained estate that allows estates maintenance costs to be controlled and avoids the need to invest significantly in backlog. Implementation of the Trust s Sustainable Development Plan that delivers the NHS Carbon Reduction Strategy for England. The provision of appropriate facilities for the corporate functions within NWAS. The provision of appropriate facilities to support the Control functions for Emergency and Planned Care Services. Opportunities for rationalisation, co-location and reduction in cost. 3.2 Key Drivers Patient Centred Deployment (PCD) NWAS must provide an efficient, timely, clinically safe service for its patients. Key to improving patient care is the development of deployment plans that position ambulance resources as close as possible to patients at the time of despatch. This concept of intelligent deployment plans based upon accurate and reliable activity data is called Patient Centred Deployment (PCD). To support PCD, resources are deployed within an area to maximize coverage and performance. Estates Strategy Page: Page 9 of 27

10 3.2.2 Financial and Economic Outlook The future economic environment requires levels of cost reductions beyond those historically delivered and the Trust s Integrated Business Plan ( ) reflects a strategy to deliver 5% savings in 2013/14, 5% in 2014/15 and 4.2% in later years. Therefore, a key requirement is to deliver efficiencies in the estates to support the continued frontline service delivery Environmental Factors On 27th January 2009 the NHS Sustainable Development Unit published a new NHS Carbon Reduction Strategy for England Saving Carbon, Improving Health. The guidance was developed, after a period of extensive consultation, in response to the global challenge of climate change and to promote systematic action by the NHS to meet the legally binding target agreed in the 2008 Climate Change Act for an 80% reduction in Carbon Dioxide emissions by 2050 and a minimum reduction of 26% by 2020 against a 1990 baseline. In response to this requirement the Trust produced the Sustainable Development Management Plan, which sets out the Trust s plans to achieve the targets set in NHS Carbon Reduction Strategy for England (this is covered in section 4 of this strategy) Legal and Regulatory Framework The Trust is required to comply with all statutory and regulatory requirements. In the field of Estates this is constantly developing, particularly with regards to Health, Safety and Environmental legislation. There is specific legislation related to the estate associated with asbestos, legionella and waste that pose risks to the Trust, staff, visitors and patients. Management of these risks and the associated policies and procedures will continue and will be reflected in the Annual Estates Action Plans. 3.3 Stations In March 2011, a report on the Rationalisation of Stations was submitted to the Board of Directors. The report set out the overall approach to the rationalisation of ambulance stations, the criteria for reviewing the future requirements for stations, and an initial list of stations for review. Since April 2012 the following stations have been closed or relocated: Belle Vue Barnoldswick Stretford Wardle Newton le Willows Formby Also during this period a new station located at Westmorland General Hospital has been developed. Estates Strategy Page: Page 10 of 27

11 The focus has now moved to developing the hub and spoke configuration because it supports the objectives of PCD. This is the most appropriate operational model for the mainly urban geographical areas which experience concentrated activity. The Estates Rationalisation Strategic Implementation Plan, approved by the Board of Directors in July 2012, details the planned development of the hub and spoke model. Three areas have been identified for the development of Phase 1 of the Hub and Spoke model: Huyton/Whiston group Manchester group Blackpool group It is anticipated that subsequent phases, as defined in the Strategic Implementation Plan, will follow. The process for identifying options and developing the Hub and Spoke model is outlined in the flowchart which forms Appendix 3 of this document. However, the Hub and Spoke model is not necessarily suited to all areas covered by NWAS. The longer distances in the rural areas combined with the smaller communities does not lend itself to this approach. The approach which will be adopted in these areas (mainly Cumbria and Cheshire) will be to look at: Opportunities to share facilities with other blue light services/public bodies. Refurbishment/replacement of the existing NWAS facilities. 3.4 Emergency Operations Centres (EOC) In recent years the number of EOCs (formerly known as Emergency Control Centres (ECC)) has been reduced from four to three. EOCs are established in Cheshire and Mersey, Lancashire and Greater Manchester, and the former Cumbria ECC operates as the NWAS Support Centre. Greater Manchester control relocated to the newly refurbished Parkway in early Currently a review is being undertaken by the consultants Detica into the future options for the EOC, and will be presented to the Board of Directors in March The outcome of this review will inform the Estates Strategy over the next five years. Robert Whetham Associates (M&E Consulting Engineers) were engaged in 2009 to assist the Trust in reviewing the EOC electrical infrastructure. They were to make recommendations for providing a Trust standard for resilience to support the centres, and produce a plan to provide that standard. The review was completed in October 2009 and a risk assessed priority established. Work to implement the changes needed to provide 30 minute UPS, N+1 resilience, and alarm management across all EOCs was completed in 2009/10. The outstanding actions were to be addressed via the capital programme 2012/13 and this has been achieved with all EOC Resilience works due to be completed by the end of March Estates Strategy Page: Page 11 of 27

12 PTS control centres are located at Salkeld Hall, Broughton, Elm House, Parkway and Chester. Work continues to rationalise the PTS control room infrastructure. The Parkway site achieved the centralisation of the PTS control rooms in the Greater Manchester area. However, this facility will no longer be required from 1 st April 2013 due to the loss of the PTS contract in Manchester. Plans are currently being considered as to the appropriate use of the space that will be vacated. 3.5 Workshops The Fleet & Workshop Review was approved by the Board of Directors in June The stated aim of the review was to determine short, medium and long term objectives to reconfigure the Trust s workshops to support the current and future operational models. To date the short term objective to permanently close Ellesmere Port and Burnley workshops has been achieved. The objectives for the medium term involve the consolidation of workshop facilities to form larger workshop bases and work to achieve these medium term objectives is incorporated within this Estates strategy. A Full Business Case (FBC) for a Centralised Workshop in the Cheshire & Mersey Area is currently being developed. The proposal is designed to both improve the quality of service delivery, and help achieve better value for money by introducing new ways of working within the fleet and workshops. This facility will involve the closure of 5 existing workshops (Macclesfield, Northwich, Anfield, St Helens and Runcorn). The consolidation of Greater Manchester workshops was approved by the EMT in January This involves the expansion of the Bury workshop and closure of the Salford workshop which is scheduled for the first quarter of 2013/ HART/USAR/ Resilience In line with the Home Office National Capability Programme, NWAS hosts two Hazardous Area Response Teams (HART). The Manchester HART and Trust Resilience team operate from Trafford Park. The Liverpool HART team is set up in extended and converted facilities on the site of the Mersey Fire and Rescue Service Training centre in Croxteth. 3.7 Corporate and Headquarters Services Three area offices and a headquarters are established at Elm House, Broughton, Whitefield, and Ladybridge Hall respectively. A review of operational usage will be undertaken as part of the estates rationalisation programme. Support services are currently distributed across a number of sites. These will be reviewed with the aim of rationalising and reducing the number of sites. Estates Strategy Page: Page 12 of 27

13 3.8 Partnership with other services The Estates team will continue to investigate opportunities to develop the estate in conjunction with other organisations should the opportunities arise. These will include other NHS Trusts, local government organisations as well as private sector developers. The Trust has recently completed a number of initiatives: Closure of Formby Ambulance Station and co-located with Mersey Fire and Rescue Services at the new Formby Community Fire Station. Closure of Newton le Willows Ambulance Station and co-located with Mersey Fire and Rescue Services at the new Newton le Willows Community Fire Station. Closure of Barnoldswick Ambulance Station and co-located with Lancashire Police at the Police Station at Barnoldswick. Closure of Stretford Ambulance Station and co-located with Greater Manchester Police at the Police Station at Stretford. Closure of Wardle Ambulance Station and co-located at the local hospital. A number of further initiatives are planned for 2013/14: The partnership initiatives have a number of benefits: 1. Reduction in estate running costs. 2. Avoidance of the need for NWAS to invest capital monies in new facilities in the future. 3. Reduction in backlog maintenance. 4. Sale proceeds from NWAS sites to invest in new facilities. 5. Staff relocated into new modern facilities. 6. Increased opportunities for partnership working with other blue light services/public bodies. 4. Sustainability and Energy 4.1 Carbon Reduction and Energy Management The NHS Carbon Reduction Strategy was developed to address the UK Government s target of 80% reduction in CO 2 emissions by 2050 compared to 1990 emission levels. Other drivers to improve the energy and environmental performance of the Trust s estate include the Carbon Reduction Commitment, the Waste Electrical and Electronic Equipment regulations and the European Union s Energy Performance of Buildings Directive. In March 2010 the Board of Directors approved the Sustainable Development Management Plan (SDMP). The stated aims of the SDMP are to; identify measures which can be taken in order to achieve the carbon reduction targets set out in the NHS Carbon Reduction Strategy, and formalise good environmental management practice throughout the Trust. The implementation of the SDMP and progress towards the objectives is reported to the Communities Sub-committee on a regular basis. The SDMP is subject to external auditing by Mersey Internal Audit (MIAA) and the audit is being undertaken during the year 2012/13. Estates Strategy Page: Page 13 of 27

14 The SDMP will be reviewed by the Estates Manager (Environmental) following receipt of the audit findings. Plans are in place to reduce carbon emissions and improve environmental sustainability, and over the next 10 years the Trust expects to save a minimum of 180,000 as a result of these measures. This figure is based on trialling new energy saving technology including LED lighting, voltage optimisation, PV/solar systems, energy efficient heating systems and energy management systems. Subject to the success of these trials the technology will be phased in across the portfolio and therefore substantially increase the projected savings. The Estates Team has also worked with the Fleet Team as part of the Vehicle Power Management project. An additional 53 shorelines were installed which facilitated a reduction in the use of the vehicle run-lock facility. The widespread use of run-lock practices has an environmental impact (poor air quality and increased carbon footprint) and increased fuel and maintenance costs and therefore it is advantageous to restrict the use of run-lock wherever possible. Analysis undertaken by Fleet and Operations as part of the trial identified a potential reduction for the entire A&E fleet of 3,140 tonnes of carbon emissions into the atmosphere based on initial tests/findings following the implementation of the changes. 4.2 Energy Performance of Buildings The 6 facet survey identified 74% of the building stock has a below average standard of energy performance. This is reflected in the age profile of the estate with approximately 95% of the buildings being over 25 years old and constructed when building energy performance was given little consideration. The findings of the facet surveys drive investment into improving energy performance which will be prioritised on measures that have the greatest impact upon reducing the Trust s CO 2 emissions. Unless driven by the need of legislative compliance, all measures are subject to financial feasibility studies to ensure a good return on investment. 5. Performance Measures and Benchmarking Achieving service quality is more than performing well financially. There is a need for measures across all aspects of performance relating to the estates function. On a monthly basis the reactive maintenance of the Estate is reviewed at Estates and Fleet Senior Management Team meetings. Separate contract meetings are regularly held with the Measured Term Maintenance Contractor to review their performance. There must also be measures which relate to the overall strategic direction that has been set in order to provide a comprehensive view of performance in that respect. To this end, estate measures will include: Estates Strategy Page: Page 14 of 27

15 Progress against outcomes of 6 facet survey indicators. Progress against NHS Carbon Reduction Strategy. Progress against compliance with new legislation. Asset utilisation (space efficiency; cost of occupation; asset productivity; asset deployment; quality). The Trust is a member of the National Heads of Estates and Facilities forum along with all NHS Ambulance Trusts across the country. NWAS actively participates in benchmarking between member organisations, as well as benchmarking against the Department of Health s annual Estates Returns Information Collection (ERIC). 6. Health, Safety and Hygiene 6.1 The Estates Policy The Estates Policy defines responsibilities and accountability for the delivery of a quality Estates function and encourages a partnership approach with all stakeholders. The focus of the Policy is on the provision and maintenance of properties which support service delivery and are safe, hygienic, legally compliant, and sustainable. 6.2 Premises Cleaning The Care Quality Commission as part of its inspection programme seeks to ensure that NHS Trusts are meeting the requirements of the Health and Social Care Act 2008 with particular regard to healthcare associated infections (HCAI s). In order to meet with those requirements NWAS is expected to provide and maintain premises which are safe, kept in good repair, fit for purpose and which facilitate the prevention of HCAI s. A new Trust- wide premises cleaning contract has been in place since January 2013 with the aim of ensuring consistent, quality, cleaning of buildings. The performance of the cleaning contractor and cleanliness is monitored internally by Operational Managers, the Estates Department Support Services Manager, and Infection Prevention and Control specialists from within the Healthcare Governance department. Formal reporting to the Quality Committee, the Executive Management Team, and the Board of Directors is due to be in place from the first quarter of 2013/14 following service mobilisation. 6.3 Waste Management The Waste Management Policy, approved by the Board of Directors in 2009, sets out the Trust s approach to Waste Management taking into consideration legislative, health, safety and environmental factors. The cross-departmental Waste Management Group has been established to continually review waste policy and procedures and this group reports to the Health and Safety Management Group. Estates Strategy Page: Page 15 of 27

16 6.4 Legionella Prevention A Trust Policy for the control and prevention of Legionella is in place and has been implemented to ensure that the requirements of HSE Approved Code of Practice L8 and NHS HTM (where appropriate) are met. All Trust premises have a Legionella risk assessment which is updated at intervals specified in the Legionella management plan. Monthly water monitoring is undertaken and the results are regularly reviewed at monthly Water Hygiene Management meetings. 6.5 Asbestos Management A Trust Asbestos Policy is in place which sets out responsibilities and obligations under the Control of Asbestos Regulations. All Trust premises have an Asbestos Register and the Asbestos Containing Materials are re-inspected at regular intervals. 7. Financial Plan 7.1 Depreciation, revenue and capital funding The estate is an asset of the Trust. It consists of a mix of buildings in good condition, some in fair condition and others in poor condition. The asset value of the estate is 38,335,520. The total depreciation value of the Trust s estate for 2012/13 was 1,023,750. The depreciation value is an indicator of the cost to re-instate and maintain the value of that asset. The Planned Capital Expenditure for the estate in 2012/13 is 2,357,085. The revenue available for the estate in 2012/13 was 1,496,700. The Planned Capital Expenditure for the estate in 2013/14 is yet to be approved by the Board however it will be in the region of 2,600,000. The revenue available for the estate in 2013/14 is 1,496, Capital Programme The Estates Team prepare annual and five-year capital and revenue investment plans with the aim of producing an Estate that will enable the provision of safe, secure, high quality buildings and an infrastructure capable of supporting current and future models of service delivery. Expenditure will be in line with the Trust s Integrated Business Plan ( ). The five-year Capital Programme is reviewed and updated regularly and the current plan forms Appendix 4. Estates Strategy Page: Page 16 of 27

17 7.3 Cost Improvement Programme (CIP) The Trust must always demonstrate that it is giving optimum value in all areas of business. All NHS Trusts are subject to mandatory efficiency targets. As set out in the Trusts Integrated Business Plan, the Trust anticipates year on year savings of between 4% and 5.5% as a percentage of turnover. As such the target will be to drive through efficiencies from the estates, to achieve reduction in running costs over the period 2013/ /18. The key elements of this plan will be: Rationalisation Reduction in running costs Energy efficiency 8. Delivery Plan In order to deliver the Future Provision detailed in Section 3 of this strategy, and taking into consideration the issues outlined in Sections 4 and 5, the delivery plan must be in place to enable successful implementation. Key parts of this plan are detailed in this section. 8.1 Estates Rationalisation Strategic Implementation Plan The Estates Rationalisation Strategic Implementation Plan (ERSIP), approved by the Board of Directors in July 2012, sets out the approach which will be taken to ensure the estate infrastructure meets the requirements of Patient Centred Deployment (PCD). 8.2 Design Considerations The ERSIP also outlines the types of buildings and facilities which can be expected as the estate infrastructure adapts to meet the needs of the Trust and the service delivery models. The Design Considerations for Ambulance Stations and Ambulance Deployment Points document was approved by the Estates Rationalisation Project Board in December This document provides an outline specification for the planning and commissioning of new NWAS ambulance stations and deployment points for use by all NWAS operational staff. 8.3 Estates Rationalisation Project Board and Estates Rationalisation Project Team The ERSIP forms the strategic approach and direction, with the design considerations defining what will physically be provided. The Estates Rationalisation Project Board and Project Team provide the structure for the delivery of the ERSIP. These groups meet regularly and provide the mechanism for delivery of a significant part of the Estates Strategy. Their remit, functions and composition is detailed in the Terms of Reference document. The Estates Rationalisation Project Board provides direction, advice and recommendations regarding proposals for the rationalisation of the estate. The Estates Rationalisation Project Estates Strategy Page: Page 17 of 27

18 Team is responsible for progressing the individual schemes within the Estates Rationalisation Project Plan. 8.4 Annual Estates Plan In order to plan and monitor the progress of individual activities and projects the Estates Team produce an annual estates plan that will highlight to the Board of Directors the plans for the following financial year. This includes: The Estates Capital programme. Estates Rationalisation programme. Planned maintenance programmes. Areas of development for the Estates Team. Full review of the risk register for the estate with an action plan for removal/management of the risk(s). Tasks necessary to ensure legislative requirements are met. Projects carried over from the previous year. 9. Stakeholder Engagement and Communications The successful implementation of the estates strategy will be dependent on effective engagement with staff, staff side and external stakeholders in all elements of its development. In particular, involvement will be essential in the review of the existing estates and the vision and design of the future estates provision. This will ensure they are fit for purpose for delivering effective patient care and provide an appropriate working environment for staff. The Future Focus: Right Care Right Time Right Place document, produced by the Corporate Communications Department, outlines the hub and spoke configuration and explains how this model of service delivery links to serving communities and patients. There is a Communications Plan in place for the Estates Rationalisation projects and the plans will continue to be used and developed. 10. Equality impact assessment The Trust will ensure that all premises and their grounds comply with relevant legislation. All new building specifications will have the potential to impact both staff and services with regards to equality. Therefore, there is a requirement to carry out a detailed Equality Impact Assessment; this will be carried out in consultation with the Assistant Director of Equality & Diversity. The Equality Impact Assessment for the estate strategy is at Appendix 5. Estates Strategy Page: Page 18 of 27

19 11. Conclusion This Estates Strategy is intended to support the service delivery models which are appropriate for Patient Centred Deployment (PCD). In some cases the most suitable service delivery model is the Hub and Spoke configuration. This document outlines some of the estates activities which are necessary for the delivery of the strategy and the enabling structures. Key issues to be addressed, as identified in this document, are; Estates Rationalisation and the Strategic Implementation Plan Maintenance of the Estate Compliance with legislation Improved Energy Management and Carbon Reduction Continuous monitoring of the performance of the Estate In order to ensure successful delivery of the strategy annual plans will be agreed prior to the commencement of the financial year and will reflect the resource assumptions for delivery of the business plans of the Trust, based upon agreed capital and revenue funding. Annual plans and risk assessments will be subject to an ongoing review of progress in order to ascertain necessary variations to the strategy because of changes in expected demand and internal and external environment. Estates Strategy Page: Page 19 of 27

20 Appendix 1: Definitions of six facet survey criteria Physical Condition - The physical condition of all elements pertaining to the building stock of the Trust Functional Suitability - The appropriate provision of space, building fabric, services, amenities and equipment. Space Utilisation - The objective of the space utilisation survey is to assess whether the space available matches the needs of the service and its functional and future planned requirements. The exercise should identify surplus requirements as well as the need for expansion or space re-provision. Quality This is a rating of the overall quality of the working environment. This takes into account factors such as overcrowding, lighting, heating, staff facilities, layout, interior design. Energy Performance - To classify the overall energy efficiency of buildings indicating energy usage per unit volume GJ/100 cubic metres. Statutory Performance - Compliance of premises with statutory requirements of Fire Safety Regulations, Environmental Protection Act, Health and Safety at Work Act, Waste Management Regulations and other Statutory Obligations. Estates Strategy Page: Page 20 of 27

21 Appendix 2: NWAS Emergency Service Resource Deployment Strategic Outline (from Service Modernisation Partnership Group) NORTH WEST AMBULANCE SERVICE NHS TRUST EMERGENCY SERVICE RESOURCE DEPLOYMENT STRATEGIC OUTLINE This document is designed to assist in the development and implementation of a North West Ambulance NHS Trust (NWAS) estates strategy relating to the emergency service and therefore provides an outline of how the mobile resources (Ambulances, Rapid Response Vehicles, etc) can be tactically positioned to ensure the optimum clinical response to those requiring a response is achieved. The Trust has more than one hundred ambulance station sites scattered across its five counties. These locations have in most cases been in the same locations for many years, one or two since the late nineteenth century. The principles below will determine the physical estate positioning: The positioning of the resources should be determined from a regional 999 demand analysis, disregarding county borders. The resources will be deployed utilising a dynamic deployment model with resources positioned within a number of plan areas across the Trust. The building profile will be of the hub and spoke system. The hubs, set around a common specification, will be the home of the resource in that area and will be the place where staff start and end their tour of duty. The hubs will be the location of make ready systems and contain all the facilities for the staff based at that site including training rooms, etc. Resources will decant from the hubs to the deployment locations as determined by the dynamic deployment system. The spokes have at their end either a social deployment point or a simple deployment point (stand-by location); again both would be set around a common specification. The view is that a hub will in most cases be an Ambulance Service only location whereby the spokes could be a shared/joint premises or a small Ambulance Service only location. Estates Strategy Page: Page 21 of 27

22 Appendix 3: Hub & Spoke Programme Flow Chart Identified hub and spoke area. Map location Demand analysis Identify Hub Identify spoke requirements dynamic fixed via mapping Size requirement Vehicle Staff Facilities Identify Options Identify Options Assess options Financial Estate Assess options Operational Financial Estates Operational OBC EMT/Board Approval Estates Strategy Page: Page 22 of 27

23 Appendix 4: Estates Five Year Capital Programme ( ). As at December Estate 5 Year Capital Programme Year /14 Year /15 Year / 16 Year / 17 Year / 18 Scheme Budget Scheme Budget Scheme Budget Scheme Budget Scheme Budget Atherton 81,920 Accrington AS / Training 86,300 Altrincham 159,940 Arrowe Park 11,700 Ashton 132,400 Bolton South 250,000 Bebington 63,330 Blackburn 144,518 Broughton AS 21,840 Birkenhead 169,260 Bury Workshop 55,320 Bootle 112,110 Bolton North 32,570 Broughton House Emergency Control 112,320 Blackrod 40,490 Room Keswick 41,440 Burnley AS and Vehicle Service Centre 139,600 Brough 31,950 Broughton HQ 103,180 Central Stores 51,370 Kirkby 49,152 Crewe 108,300 Burscough 44,750 Middleton 54,620 Fazakerley 135,020 Crompton 90,900 Broughton House PTS Control Room Broughton House Training Centre 63,280 Central Transport 27,940 27,110 Hazel Grove 50,000 Rochdale 101,134 Fleetwood 62,060 Grange 8,830 Crosby 54,730 Manchester North 36,490 Lytham 63,380 Heswall 33,500 Dukinfield 124,000 Mersey Headquarters 344,000 None backlog schemes Northwich 143,200 Knutsford 30,290 Glossop 88,230 Mersey PTS Control 76,550 ECC Resilience 100,000 Sharston 92,756 Morecambe 44,550 Ladybridge Hall HQ 131,190 Millom 31,450 Elm House - upgrading of kitchens and new 60,000 South Liverpool 92,792 Preston 157,750 Ladybridge Hall 360,540 Moreton 40,650 sliding gates Kendal 133,500 Stacksteads 29,304 Sale 68,180 Lancaster 73,910 Nelson 58,960 Widnes - sliding gate 13,000 Standish 52,908 Salford 216,796 Macclesfield 145,250 Oldham 168,513 Toxteth 102,812 St Helens 143,380 Rossendale 59,630 Ramsbottom 44,700 Estates Strategy Page: Page 23 of 27 Author: Assistant Director Estates and Fleet Version: 1.0

24 carried forward schemes Swinton 51,265 Sandbach 42,050 Sedbergh 15,650 Chester 140,000 Wigan 152,500 Wardle 44,040 Thornton 65,150 Elles Port 185,600 Wesham 55,500 Urmston 37,620 Runcorn 68,300 Winery Lane The Centre 50,150 Wallasey 120,900 Walmer Bridge 62,820 Warrington 125,017 Estate rationalisation (to be defined in line with SIP when agreed) Estate rationalisation (to be defined in line with SIP when agreed) Estate rationalisation (to be defined in line with SIP when agreed) Estate rationalisation (to be defined in line with SIP when agreed) Estate rationalisation (to be defined in line with SIP when agreed) sub total 1,333,986 sub total 1,283,872 sub total 1,411,669 sub total 1,568,650 sub total 1,699,930 VAT 266,797 VAT 256,774 VAT 282,334 VAT 313,730 VAT 339,986 BUDGET 1,600,783 BUDGET 1,540,646 BUDGET 1,694,003 BUDGET 1,882,380 BUDGET 2,039,916 Estates Strategy Page: Page 24 of 27

25 Appendix 5: Equality Impact Assessment Name of strategy, Service or Function Estate Strategy NWAS Equality Impact Assessment carried out by (include name and job title): Neil Maher Assistant Director of Estates and Fleet Date of Equality Impact Assessment Step 1: Description and Aims of Policy, Service or Function Overall aims To define and explain the Strategy for the Trust Estates function over the five year period from 2013/14 to 2018/19. Key elements of policy, service, process The strategy is written for the Estates department and Trust to be systematic in its approach in the control of the quality and control of the Estate. Who does the policy, service or function affect? All Trust staff Visitors Contractors How do you intend to implement the policy or service change (if applicable) The strategy requires approval by the EMT and Board of Directors. It will be made available by intranet for all internal staff. The Startegy will be reviewed and amended to take into account any future service developments. Step 2: Data Gathering Summary of data available and considered All data and informatics has been gathered from existing Estate records Estates Strategy Page: Page 25 of 27 Author: Assistant Director Estates and Fleet Version: 1.0

26 Outcomes of data analysis Equality Group Gender Race/Ethnicity Disability Evidence of Impact Inappropriate gender mix facilities reflection of organisation of mid 20 th century. None The strategy is a written document and there may be an impact on those with visual impairments or those with conditions such as dyslexia. With regards to the estate and disability: Sexual Orientation Religion or belief Age General (Human Rights) Step 3: Consultation None None None None We will eliminate unlawful discrimination. Advance equality of opportunity. Foster good relations when exercising their functions. Please note you may want to return to this section following Steps 4 & 5 Summary of consultation methods Internal E+D Co-Coordinator Estates Managers Health and safety Practitioners and Managers. Operations. Outcomes of consultation Equality Group Gender Race/Ethnicity Disability Evidence of Impact Part of capital programme gender mix will be addressed to reflect mix of organisation. None The policy is a written document and there may be an impact on those with Estates Strategy Page: Page 26 of 27

27 visual impairments or those with conditions such as dyslexia. This document will be available in alternative formats upon request by contacting the Estates Department. Amend the estate managers planning check list used to develop new builds, upgrades and extensions to incorporate DDA, thereby capital programmes will check and adjust DDA facilities as they develop. Sexual Orientation Religion or belief Age General (Human Rights) None None None None Estates Strategy Page: Page 27 of 27