NHS Birmingham South Central Estates Strategy. Interim Document Focussing on Primary Care Estate

Transcription

1 NHS Birmingham South Central Estates Strategy Interim Document Focussing on Primary Care Estate

2 Contents 1. Introduction and Objectives 2. Background 3. Planning Summary 4. The Current Estate 5. Key short term priorities 6. Implementation and Next Steps 7. Appendices

3 Introduction and Background

4 Introduction and Objectives Each CCG in England and Wales has been tasked by the Department of Health with creating an Estates Strategy. A detailed strategy will take several months to complete, as it will involve engaging with a large range of Stakeholders in the NHS and some relevant external bodies. An initial strategy, focusing on Primary Care is required to be completed at the end of the 2015 Calendar Year. A second iteration will be produced in Spring 2016 that will reflect engagement with the Acute and Community Trusts about their estate and with the local council about their estate plans This, therefore, is that initial strategy, and it will be used to underpin bids made by the CCG to access funds from the Primary Care Transformation Fund for the 2016/17 financial year. The objective is a pragmatic plan that delivers change. Contents include: - A review of the existing health estate, including condition; - Vison for future estate based on commissioning/service priorities; - List of priority estate projects for further analysis and implementation; - Summary of specific next steps.

5 Background Birmingham is the youngest city in Europe with 66% of the population under the age of 44 The City ranks 9 th for deprivation out of 345 localities in England 6 in 10 people live in 20% deprived neighbourhoods in England It is the most ethnically diverse city in the UK with a 68% White population, 20% Asian and 7% Black Three CCGs commission health services for the city, Birmingham South Central, Birmingham Cross City, and Sandwell & West Birmingham

6 Birmingham South Central CCG - Our vision for the future The NHS Five Year Forward View explains why change is needed, what that change might look like including new, flexible models of care and how it can be achieved. Our own plans for 2015/16 and beyond reflect this nationwide vision of joined-up health services tailored to the local population. And whatever we do now and in the future, we will stick to our overall mission to provide the people of Birmingham South Central with the best care, in the best place, at the best time and the values that guide everything we do. These are written into our constitution.

7 Birmingham South Central CCG Plan on a Page

8 Birmingham South Central CCG - Our Member Practices We have 55 general practices in BSC covering a population of 300,000. Their experience has played a massive part in ensuring we commission services that meet local people s health needs. Our member practices form five clinical networks: Central, Edgbaston, Kings Norton, Northfield, Pershore Road

9 Planning Summary

10 Planning Summary A Local Estates Forum has been established involving the three CCGs that cover Birmingham, plus the Community Trust, Community Health Partnerships, NHS Property Services and Birmingham Council. Other bodies may be added to ensure a comprehensive coverage of the different healthcare Estates and Objectives The strategy will consider Estates development and maximising effective utilisation, with an aim to reduce void areas in funded buildings, and potential rationalisation of under utilised or unsuitable premises. Population growth, NHS England s 5 year forward view, and the commissioning objectives and priorities of the CCG will be key considerations in developing the plan.

11 Planning Summary Estates Strategy The Department of Health has issued guidance to CCGs outlining the requirement for an Estates Strategy and the issues they expect to be addressed; These issues include changes in demography and population demand, changes in the way health care is provided reflecting the plans for integrated health and social care, greater levels of care within communities and new commissioning models; A key driver for the DH is to rationalise the estate with a view to seeking efficiencies and savings; The move to extended hours working in Primary Care, sometimes via the development of GP Federations All this in an environment where there are increased pressures on affordability and funding constraints

12 Planning Summary - Draft Strategy The final Estates Strategy document will not be completed until later in 2016, and this initial draft document is intended to give a focus on Primary Care that will feed into the final strategy. This initial strategy will allow the CCG to develop a more strategic approach to the development of the primary care estate, and priorities for support under the Primary Care Transformation Fund. It is expected that proposals will be required by the end of February 2016 for the next tranche of this resource. The document considers the current Primary Care Estate, including information currently available relating to condition and capacity issues, and sets out the significant void and bookable space areas in the LIFT and NHSPS buildings within BSC.

13 Current Estate

14 The Current Primary Care Estate and Cost There are 55 General Practices for which Birmingham South Central are responsible, that occupy 57 buildings There are 4 LIFT buildings, 3 of which have significant vacant space There are 4 NHSPS buildings Around 57% of premises are owned by GP practices, and 43% are leased or rented (including LIFT and NHSPS) The condition and capacity of the estate is variable In addition, there are numerous additional premises used by NHS providers, local authority and third sector Area of Expenditure Annual Budget m Primary Care Medical budgets 5.9 CHP & NHSPS 2.3 Running Costs - Bartholomew House 0.2 Total 8.4

15 Current Estate Composition of the Estate Based on an analysis from 2013, The primary care estate comprises a wide spectrum of buildings, from converted residential and retail properties, older NHS clinic type facilities, through to modern, purpose- built integrated health centres. LIFT and NHSPS properties include areas of Void space (ie not currently in use but available), and areas of Bookable space which is currently underutilised (although information is limited) Partners including Local Authority, Birmingham Community Healthcare and others are also seeking to make best use of available space, and rationalise where possible. A summary of primary care premises are included in the Appendix.

16 Current Estate Tenure & condition Premises Tenure 2013 Premises analysis 13% 15% 15% 57% Freehold Leasehold NHSPS Leasehold CHP LIFT 32% 29% Flexible, high quality Functional, adequate Leasehold Other 39% Restrictive, poor quality

17 Current Estate - Primary Care Transformation Fund NHS England has approved, with BSC support, 4 premises development schemes for completion in 2015/16. These will deliver 11 additional clinical rooms, with an overall capital investment of 1.5m. Revenue Costs - the 4 premises improvements have an estimated revenue impact of 62k pa, reduced to 27k pa for 10 years due to rent abatement. These schemes demonstrate that the PCTF is able to deliver additional clinical accommodation in areas of need, offering VfM and the ability to improve on functional and statutory problems within the primary care estate.

18 Current Estate - Primary Care Transformation Fund BSC Schemes GP Practice Birmingham Heartlands Surgery Druid's Heath Surgery Weoley Park Surgery West Heath Medical Centre Project outline Two-storey extension and internal works to provide 2 additional ground floor clinical rooms, relocate staff office and medical Extension records and internal to first works floor, to reconfigure provide 2 additional ground floor clinical rooms, reconfigure reception, waiting and main entrance Extension to and improve internal patient works flow to provide through 3 additional ground floor clinical rooms, reconfigure reception, waiting and main entrance Extension to to improve side of building patient to flow provide through 4 additional clinical rooms and improved disabled WC access Total Project Cost NHS Grant Contribution GP Contribution Additional clinical rooms Total Rent Increase p.a. Rent increase from April 2016 p.a 268, ,880 91, ,000 5, , , , ,000 7, , , , ,000 5, , , , ,000 9,240 1,491, , , ,000 27,280

19 Current Estate - Void and Bookable Rooms LIFT Buildings The CCG has significant levels of void and bookable space available within CHP buildings Building - CHP Total Building Cost Void Cost Bookable Cost CCG Attwood Green Health Centre Sparkbrook Primary Care Centre Sparkhill Primary Care Centre West Heath Primary Care Centre 2,108, , ,569 South Central 1,345, ,932 82,455 South Central 1,398,004 72, ,029 South Central 370, ,693 South Central Totals 1,028, ,747 1,865,249

20 Current Estate - Void and Bookable Rooms NHSPS Buildings Full information on NHS Property services premises is not currently available Building - NHSPS Total Building Cost* Void Cost Bookable Cost CCG Balsall Heath Health Centre Hawksley Health Centre Greet Health Centre Selly Oak health Centre 257, , South Central 262, tbc - South Central 288, , South Central 130, tbc - South Central Totals 100, ,000.00

21 Current Estate CCG Headquarters - Bartholomew House The CCG management team occupies second floor accommodation at Barthlomew House, Hagley Road, Birmingham 4 years remain on the current lease, expires December Recently refurbished (2015), including creation of break out space and large meeting rooms, and lighting upgrade. Some (limited)scope for expansion Current costs c. 210k pa including service costs

22 Key Short Term Priorities

23 Key Short Term Priorities To obtain a firm baseline on condition and capacity The local LIFT company undertook an analysis of General Practice Surgeries in 2013, but to provide an up to date baseline, the CCG has secured funding for a new survey to be undertaken in Dec 2015 and Jan 2016 of all Primary Care buildings to give an abridged 6 facet summary of condition and capacity To explore options to increase utilisation of void and bookable space - In Birmingham there are a number of buildings that are not fully utilised and have large areas reserved for bookable rooms. The CCG bears the rental costs of void properties and of bookable rooms not used. Improved utilisation of these buildings must be a priority in the short and medium term To support urgent care delivery - A new Urgent Care Centre in the Selly Oak area of the city is a key priority to assist in keeping people out of hospital and providing extended hours access to Primary Care services. This development has stalled because the investment regulations are restricted in terms of how PCTF monies can be used to invest in new properties not owned by the NHS. New regulations are in the process of being developed that will facilitate these types of development, with the NHS securing recurrent benefits from rent abatement following similar principles to that already applying to Improvement Grants.

24 Key Short Term Priorities To agree appropriate HuB locations for The Prime Minister s Challenge Fund - the My Healthcare project has identified three hubs to offer convenient extended hours Primary Care Services, and we need to ensure the Estate facilities associated with those hubs are of a sufficient quality and capacity to enable achievement of those objectives. To identify opportunities under the Transformation Fund - 4 practices have had Surgery developments funded through the Primary Care Transformation Fund in 2015/16 and the CCG will be looking to develop more surgeries, that have the potential to offer increased access to clinical services, through the remaining 3 years of this fund. To agree criteria for assessment and prioritisation of PCTF funds and the process for managing applications for 2016/17 funds. It is noted that there are plans to make regulations more flexible in a way that will give opportunities for more ambitious projects than simply Improvement Grants through this fund. And the CCG will assess the current and optimum estate in each locality to explore what developments could be considered that provide real transformation in Primary Care provision.

25 Key Short Term Priorities Agree a process with Birmingham Community Healthcare to develop a joint Estate strategy that enables savings to be explored for the NHS as a whole, rather than for one organisation at the expense of another. It is the case that the Trust have excess capacity and are looking at Estate rationalisation as part of their strategy. Consider a subsidy policy to be applied in respect of CHP accommodation, to ensure equity and to facilitate best use of available space and to attract new tenants. This includes GP accommodation, including an approach to service charges. Resolve issues relating to property cost charges and reimbursement relating to GP practices in NHSPS and CHP premises. There is currently a lack of clarity around the charges that the CCG is bearing.

26 Key Priority Replacement for Katie Road Walk in Centre The CCG is supporting the development of a new Urgent Care centre in the Selly Oak area of the city to replace the current walk in centre at Katie Road, which has seen significant increasing activity resulting in shortage of space. The proposal includes an Urgent Care Centre - a key priority to assist in keeping people out of hospital and providing extended hours access to Primary Care services. It will also support a range of diagnostics and provide 24/7 services. This development has stalled because the investment regulations are restricted in terms of how PCTF monies can be used to invest in new properties not owned by the NHS. New regulations are in the process of being developed that will facilitate these types of development, with the NHS securing recurrent benefits from rent abatement following similar principles to that already applying to Improvement Grants.

27 Key Priority - Prime Minister s Challenge Fund My Healthcare A group of 23 of our member practices were successful with a bid to be part of the Prime Minister s Challenge Fund, making it easier for people to access primary care. The My Healthcare project is a model of care developed over a number of years using feedback from local people and healthcare workers. Three general practice hubs offer more convenient appointments to patients registered with My Healthcare practices. We re working with a variety of partners, including urgent care and community care providers. Each hub offers a single point of contact to a range of pharmacy, nursing, lifestyle and wellbeing, voluntary and health promotion services and specialist clinics. The hub at West Heath Surgery went live on 1 July 2015, and the River Brook Medical Centre and Fernley Medical Centre went live in the first week of September. Patients benefit from being able to get care locally between 8am and 8pm seven days a week, and the hub approach help practices manage their workload. The additional hours equate to over 93,000 extra appointments each year.

28 Prime Minister s Challenge Fund Premises Issues All three existing Hubs will need to be fit for purpose including both condition and capacity as the service develops o Particular need for review of capacity and condition for Fernley Medical Centre Hub Potential for two additional hub locations as model expands across all 55 practices Edgbaston and Small Heath currently being explored and may provide an opportunity to use void space. Relationship with Urgent Care Centre Development as part of replacement for Katie Road

29 Key Priorities Developments in process or given provisional PCTF status Khattak Memorial Surgery New Development supported by NHSE and BSC outside PCTF Khattak Memorial Surgery The practice had already received the support of the NHSE Area Team premises committee for the main primary care services element of this new build prior to BSC taking on fully delegated primary Care commissioning responsibility. Urgent Care Centre and Pearl Medical Centre Developments supported in principle but subject to further work through the PCTF BSC Urgent Care Centre New urgent care centre to support South Birmingham GP Federation - providing a Supported in principle but subject to potential 24/7 urgent care centre/multispecialty intermediate care centre with diagnostics further work - supporting management of patients out of hopspital. Pearl Medical Centre New development 1300m2 will significantly improve premises and therefore clinical service capacity and access. Supported in principle but subject to further work

30 Key Priorities BSC Practice Expressions of Interest to Develop/ Extend Woodland Road Surgery (Northfield Network) Dr Allen and Partners Expression of Interest for new premises Harborne Medical Practice (Edgbaston Network) Dr Elliott and Partners Expression of Interest to extend existing premises. Karis Medical Centre (Edgbaston Network) Dr Forrest and Partners Expression of Interest to extend existing premises. Other areas of focus: Alvechurch longstanding accommodation issues in Alvechurch need addressing in conjunction with Redditch & Bromsgrove CCG.

31 Key Priorities Improving patient experience & Access Wi-Fi scheme The CCG is developing proposals to extend wi-fi access to all primary care premises in BSC The scheme would facilitate: Access for visiting healthcare professionals Access for patients Access for meeting purposes, eg CCG/Network meetings Access for practice staff Costs and benefits are currently being assessed with a view to a proposal being developed for PCTF funds in 2016.

32 Implementation and Next Steps

33 Implementation and Next Steps Applications for funding from the next tranche of PCTF monies have to be submitted to NHS England at the end of February The national criteria for 2016/17 is; increased capacity for primary care services out of hospital; commitment to a wider range of services as set out in the CCG s commissioning intentions to reduce unplanned admissions to hospital; improving seven day access to effective care; increased training capacity. The CCG will generate some bids based on it s objectives but will also invite expressions of interest from practices for development plans that meet the National and Local objectives An Options Appraisal and Business Case will be produced for the Urgent Care Centre in Selly Oak to secure approval for the Capital Funds needed A programme of work will be agreed with CHP and NHSPS to evaluate the void spaces opportunities and to review the volume of rooms held as bookable, and the charging process for those rooms

34 Implementation and Next Steps (2) A work programme will be agreed with the other two CCGs in Birmingham and other stakeholders towards the completion of the comprehensive Estate Strategy needed in 2016 Funding will be applied for from the Primary Care Transformation Fund to undertake Options Appraisals for each of the 5 Clinical Networks of the CCG. This will give examples and costs of a number of opportunities to transform the facilities in localities, optimise Primary Care delivery in consultation with stakeholders, and develop the principles outlined in the five year forward view.

35 Appendices

36 Appendices Appendix 1 Schedule to show headline information on practice costs and draft baseline assessment

37 Contact Points For further information please contact: John Guggenheim, Chief Finance Officer, Birmingham South Central CCG, Simon Doble, Senior Commissioning Manager, Birmingham South Central CCG, Bartholomew House, 142 Hagley Rd, Birmingham, B16 9PA

38 Appendix 1 Network List Size October 2015 Practice Name Post Code Tenure Rent p.a. Draft Premises Category Edgbaston 10,844 Bath Row MP, Atwood Green Health Centre B15 1LZ Leasehold - CHP LIFT 233,315 Flexible, high quality Edgbaston 8,018 Bellevue Medical Centre B5 7LX Freehold 141,350 Flexible, high quality Edgbaston 8,808 Bournbrook Varsity MC B29 7DU Freehold 113,277 Flexible, high quality Edgbaston 10,555 Harborne Medical Practice B17 0HG Freehold 96,500 Flexible, high quality Edgbaston 12,858 Karis Medical Centre B16 9AL Freehold 121,000 Functional, adequate Edgbaston 6,536 The Wand Medical Practice B12 0UF Leasehold - other 212,400 Flexible, high quality Kings Norton 3,936 Druids Heath Surgery B14 5SB Freehold 29,000 Functional, adequate Kings Norton as above Druid's Heath (branch), Hillmeads MC B38 9NE Leasehold - other 14,908 Restrictive, poor quality Kings Norton 2,050 Druid's Heath (branch) Maypole Health Centre B14 5DJ Leasehold - other Functional, adequate Kings Norton 2,425 Grange Hill Surgery B38 8RF Freehold 25,400 Kings Norton 4,872 Hawkesley Medical Practice B38 9TJ Leasehold - NHSPS 84,901 Functional, adequate Kings Norton 9,803 Kings Norton Surgery B38 8QS Freehold 30,150 Functional, adequate Kings Norton as above Kings Norton Surgery (branch), Ashtree MC B30 2NW Freehold 24,200 Functional, adequate Kings Norton 9,021 Northwood Medical Practice B31 5ER Leasehold - other 107,500 Functional, adequate Kings Norton as above Northwood Medical Practice (branch) B48 7LB Freehold Restrictive, poor quality Kings Norton 9,401 Wychall Lane Surgery B38 8TE Freehold 97,874 Functional, adequate Northfield 9,350 Cofton Medical Centre B31 4TU Freehold 70,725 Functional, adequate Northfield 4,155 Frankley Health Centre B45 0EU Leasehold - NHSPS 24,027 Functional, adequate Northfield 8,847 Hollymoor Medical Centre B31 2QT Leasehold - other 198,821 Flexible, high quality Northfield 4,877 Weoley Park Surgery B29 5HJ Freehold 18,500 Functional, adequate Northfield 3,049 West Heath PCC B38 8AX Leasehold - CHP LIFT 78,608 Flexible, high quality Northfield 4,997 West Heath Road MC B31 3HB Freehold 91,875 Flexible, high quality Northfield 6,036 Woodland Rd Surgery B31 2HZ Freehold 31,700 Restrictive, poor quality Northfield 5,602 Northfield HC (Ali) B31 1QT Leasehold - other 54,228 Functional, adequate Northfield 3,131 Ley Hill surgery B31 1TR Leasehold - other 92,610 Flexible, high quality Pershore 1,720 Bournville Surgery B30 2AA Leasehold - other 17,400 Restrictive, poor quality Pershore 9,196 Kingsfield Medical Centre B14 6AA Freehold 72,000 Flexible, high quality Pershore 5,988 Riverbrook Medical Centre B30 2SH Freehold 69,250 Functional, adequate Pershore 5,059 Selly Oak Health Centre B29 6JG Leasehold - NHSPS 44,674 Restrictive, poor quality Pershore 4,801 Selly Park Surgery B29 7NT Freehold 27,100 Restrictive, poor quality Pershore South Birmingham GP WIC B29 6JG Leasehold - NHSPS Restrictive, poor quality Pershore 2,145 South Maypole Surgery (Southdoc) B14 5NG Freehold 26,800 Restrictive, poor quality Pershore 2,552 University Southgate Practice B29 7BL Freehold 21,250 Restrictive, poor quality Pershore 2,170 Vicarage Road Surgery B14 7NH Freehold 17,000 Restrictive, poor quality Pershore 1,920 Cranes Park surgery B26 3SE Freehold 12,000 Restrictive, poor quality Pershore 4,274 Maypole Health Centre (Y) B14 5DJ Leasehold - other 107,075 Functional, adequate Central 3,257 Balsall Heath Health Centre (S) B12 9LP Leasehold - NHSPS 30,240 Functional, adequate Central 5,417 Balsall Heath Health Centre (W) B12 9LP Leasehold - NHSPS 40,844 Functional, adequate

39 Central 3,102 Bham Heartlands Surgery B9 4LS Freehold 23,500 Functional, adequate Central 5,151 Charles Road Surgery B10 9AB Freehold 27,100 Restrictive, poor quality Central 3,445 College Road Surgery B13 9LH Freehold 20,000 Restrictive, poor quality Central 6,704 Fernley Medical Centre B11 4AN Freehold 30,500 Restrictive, poor quality Central 5,797 Firstcare Health Centre B12 9LP Leasehold - NHSPS 76,000 Flexible, high quality Central 4,962 Greet Medical Centre B11 3ND Leasehold - NHSPS 35,000 Flexible, high quality Central 3,736 Highgate Medical Centre B12 0YA Leasehold - NHSPS 33,893 Functional, adequate Central 4,539 Khattak Memorial Surgery B11 1TX Freehold 9,625 Restrictive, poor quality Central as above Khattak Surgery (branch) B10 9NL Freehold 7,800 Restrictive, poor quality Central 3,615 Moor Green Lane MC B13 8QS Freehold 28,584 Functional, adequate Central 6,749 Oakwood Surgery, Sparkhill PCC B11 4BW Leasehold - CHP LIFT 81,285 Flexible, high quality Central 4,719 Pak Health Centre B8 3DZ Freehold 47,850 Functional, adequate Central 8,378 Park Medical Centre B10 0JL Functional, adequate Central 10,187 Pearl Medical Centre B8 2HB Freehold 33,600 Restrictive, poor quality Central 5,014 Sparkbrook Community & HC B11 1JU Leasehold - CHP LIFT 48,392 Flexible, high quality Central as above Sparkbrook Community & HC (branch) School Road B13 9TX Freehold 18,000 Restrictive, poor quality Central 3,146 Springfield Medical Practice B11 4DG Freehold 54,975 Flexible, high quality Central 4,556 Springfield Surgery, Sparkhill PCC B11 4BW Leasehold - CHP LIFT 85,800 Functional, adequate Central 3,962 Strensham Road Surgery B12 9RR Freehold 14,000 Restrictive, poor quality Central 2,775 The Balaji Surgery, Sparkbrook Ctty & HC B11 1LU Leasehold - CHP LIFT 36,960 Flexible, high quality Central 5,041 The Hill General Practice, Sparkhill PCC B11 4BW Leasehold - CHP LIFT 103,706 Flexible, high quality Central 6,295 The Limes Medical Centre B10 0BS Freehold 49,579 Functional, adequate Central as above The Limes Medical Centre (branch), Finch Road PCC B19 1HS Leasehold - CHP LIFT 29,408 Flexible, high quality Central 2,602 Weatheroak Medical Practice B11 4RA Freehold 39,375 Restrictive, poor quality