Property and Asset Management Strategy Supporting Information for 2015 PAMS DRAFT

Transcription

1 Property and Asset Management Strategy Supporting Information for 2015 PAMS DRAFT This document contains supporting and additional information for the 2015 PAMS document. For further information on any aspect of the PAMS document or this document please contact: Mr. J. Rotheram, Director of Estates, Facilities & Capital Services, NHS Fife. Tel:

2 1. Appendices 1.1. NHS Fife Board Report i. Table 1: An analysis of the existing estate by area ii. Chart 1B: Physical Condition Percentage of Square Metres with Overall Block Condition iii. Table 2: The physical condition of the estate iv. Table 3: Physical Condition Risk profiled backlog costs v. Table 5: Statutory Compliance Risk profiled backlog costs vi. Table 7: Energy Performance Certificate vii. Table 8: Results from the appraisal of functional suitability viii. Table 9: Results from the appraisal of space utilisation ix. Table 10: Results from the appraisal of Quality x. Table 14: Age Profile of Properties xi. Table 15: Summary of Property Appraisal Results 1.2. Site Plans i. Forth Park Hospital ii. Lynebank Hospital iii. Stratheden Hospital iv. Cameron Hospital v. Netherlea Hospital 1.3. NHS Fife Capital Planning Group i. Role and Remit ii. Completed Projects iii. Planned Projects iv. 10 Year Investment Plan v. Draft PAMS Implementation Plan Energy Performance i. NHS Fife Site Energy Performance Report Example 1.5. Information Management & Technology i. NHS Fife ehealth Strategy 1.6. Transport & Travel Planning i. NHS Fife Transport Report 1.7. Medical Equipment i. NHS Fife Medical Equipment Report 1.8. Primary Care Data i. GP Premises ii. Dental Premises iii. Pharmacy Premises iv. Optician Premises 1.9. NHS Fife & Primary Care Premises i. NHS Fife Premises Status Summary ii. GP Premises iii. Dental Premises iv. Optician Premises v. Pharmacy Premises

3 1.1 i. Table 1: An analysis of the existing estate by area Area (Sq.m) % of Total Area Value 01 Acute Hospital 118, ,448, Childrens Hospital Maternity Hospital Specialist Hospital Mental Health Hospital 33, ,856, Community Hospital 16, ,167, Older People Hospital 15, ,868, Multi Service Hospital Health Centre 18, ,601, Clinics (including Day Hospitals and Resource Centres) 11, ,029, Offices 16, , Support Facilities 32, , Staff Residential Accommodation 2, , Patient Residential Accommodation GP Practice Dental Practice Pharmacy Optician Care Home Non NHS Functions Other 25, , UnReported 5, ,457, TOTALS 296, ,511, NB: Value is Net Book Value using only Block '00'. Blocks with Code No '00' have been excluded from the Area calculation. 3rd Party Tenure has been excluded from this table. Land Values are included within the Net Book Values.

4 1.1 ii. Chart 1B: Physical Condition Percentage of Square Metres with Overall Block Condition NB: Third Party Ownership tenure has been excluded. Block No 00 has been excluded.

5 1.1 iii. Table 2: The physical condition of the estate Physical Condition Backlog (and Impending Backlog) Cost/Percentage of Total A-New B-Acceptable Condition C-Requires Investment D-Unacceptable Condition Unreported Type Cost % Cost % Cost % Cost % Cost % Total 01 Acute Hospital ,619, ,064, , ,876, Childrens Hospital Maternity Hospital Specialist Hospital Mental Health Hospital ,120, ,751, , ,928, Community Hospital , , , , Older People Hospital ,550, ,416, , ,425, Multi Service Hospital Health Centre ,142, , , ,924, Clinics (including Day Hospitals , ,618, , ,429, and Resource Centres) 23 Offices ,173, ,828, , ,080, Support Facilities ,715, ,902, , ,296, Staff Residential Accommodation , , , , Patient Residential Accommodation 41 GP Practice Dental Practice Pharmacy Optician Care Home Non NHS Functions Other ,327, ,463, ,939, ,730, UnReported % of Overall Total ,211, ,500, ,489, ,202, NB: 3rd Party Tenure and PFI Tenure have been excluded from this table. Blocks with Code No'00' have been included.

6 1.1 iv. Table 3: Physical Condition Risk profiled backlog costs Physical Condition Backlog Cost/Percentage of Total Type Low % Moderate % Significant % High % Unreported % Total 01 Acute Hospital 1,395, ,224, ,631, , ,256, Childrens Hospital Maternity Hospital Specialist Hospital Mental Health Hospital 454, ,008, ,335, , ,807, Community Hospital 67, , , , , Older People Hospital 650, , ,229, , ,875, Multi Service Hospital Health Centre 5, , , , , Clinics (including Day Hospitals 255, , ,002, , ,654, and Resource Centres) 23 Offices 644, , , ,906, Support Facilities 1,519, ,684, ,355, , ,580, Staff Residential Accommodation 55, , , , Patient Residential Accommodation 41 GP Practice Dental Practice Pharmacy Optician Care Home Non NHS Functions Other 406, ,394, ,940, , ,403, UnReported % of Overall Total 5,456, ,434, ,673, ,427, ,990, NB: This table includes only Costs where the Physical Condition grading is Not A or B. 3rd Party Ownership and PFI Tenures are excluded from this table. Blocks with Code '00' have been included.

7 1.1 v Table 5: Statutory Compliance Risk profiled backlog costs Statutory Compliance Cost/Percentage of Total Type Low % Moderate % Significant % High % Unreported % Total 01 Acute Hospital 401, ,424, ,039, ,865, Childrens Hospital Maternity Hospital Specialist Hospital Mental Health Hospital , , , Community Hospital , , , Older People Hospital 38, , , ,292, Multi Service Hospital Health Centre 233, , , , , Clinics (including Day Hospitals 51, , , , and Resource Centres) 23 Offices 3, , , , Support Facilities 7, , , , Staff Residential Accommodation 3, , , , Patient Residential Accommodation 41 GP Practice Dental Practice Pharmacy Optician Care Home Non NHS Functions Other 2, , , , UnReported 56, , , % of Overall Total 798, ,353, ,744, , ,900, NB: This table includes all Statutory Compliance (A,B,C,D) including unreported. Third Party Ownership and PFI tenure are excluded. Blocks with code '00' are included in this table.

8 1.1 vi. Table 7: Energy Performance Certificate Type EPC Ratings C or Better D E F G Not Required Unreported Area sq m No of Bldgs. Area sq m No of Bldgs. Area sq m No of Bldgs. 01 Acute Hospital 50, , , , Childrens Hospital Maternity Hospital Specialist Hospital Mental Health Hospital , , , Community Hospital 10, , Older People Hospital , , Multi Service Hospital Health Centre 1, , , , Clinics (including Day 2, , , , , Hospitals and Resource 23 Offices 1, , , , Support Facilities , , , Staff Residential , Accommodation 26 Patient Residential Accommodation 41 GP Practice Dental Practice Pharmacy Optician Care Home Non NHS Functions Other , , UnReported , TOTALS 66, , , , , This table shows the total GIA and the number of all blocks with a record in the Block Condition table with a facet of 9 - Environment. All condition ratings are included plus Unreported, but A, B and C condition ratings are shown added together in one column. Blocks with Block No 00 are excluded. Area sq m No of Bldgs. Area sq m No of Bldgs. Area sq m No of Bldgs. Area sq m No of Bldg s.

9 1.1 vii. Table 8: Results from the appraisal of functional suitability Functional Suitability A Very Satisfactory B - Satisfactory C Not Satisfactory D - Unacceptable Unreported Type Area sq m % Area Sq m % Area sq m % Area sq m % Area sq m % Total 01 Acute Hospital 50, , , , , Childrens Hospital Maternity Hospital Specialist Hospital Mental Health Hospital 4, , , , Community Hospital 10, , , Older People Hospital , , , Multi Service Hospital Health Centre 3, , , , Clinics (including Day Hospitals and 2, , , , Resource Centres) 23 Offices , , Support Facilities 5, , , , Staff Residential Accommodation , , Patient Residential Accommodation GP Practice Dental Practice Pharmacy Optician Care Home Non NHS Functions Other , , , , UnReported , , % of Overall Total 77, , , , , NB: This table is based on ratings allocated against Rooms/Areas. Third Party Ownership Tenure has been excluded.

10 1. viii. Table 9: Results from the appraisal of space utilisation Space Utilisation E Empty Not Used U Under Utilised F Fully Utilised O - Overcrowded Unreported Type Area sq m % Area Sq m % Area sq m % Area sq m % Area sq m % Total 01 Acute Hospital , , , , Childrens Hospital Maternity Hospital Specialist Hospital Mental Health Hospital , , , Community Hospital , , Older People Hospital 1, , , Multi Service Hospital Health Centre 1, , , , Clinics (including Day Hospitals and Resource , , Centres) 23 Offices , , Support Facilities , , , , Staff Residential Accommodation , , Patient Residential Accommodation GP Practice Dental Practice Pharmacy Optician Care Home Non NHS Functions Other 21, , , UnReported , , % of Overall Total 25, , , , , NB: This table is based on the ratings allocated against Room Areas. Third Party Ownership is excluded.

11 1.1 ix. Table 10: Results from the appraisal of Quality Quality A Very Satisfactory B - Satisfactory C Not Satisfactory D - Unacceptable Unreported Type Area sq m % Area Sq m % Area sq m % Area sq m % Area sq m % Total 01 Acute Hospital 50, , , , , Childrens Hospital Maternity Hospital Specialist Hospital Mental Health Hospital 4, , , , Community Hospital 10, , , Older People Hospital , , , , Multi Service Hospital Health Centre 3, , , , Clinics (including Day Hospitals and Resource 3, , , , Centres) 23 Offices , , , Support Facilities 5, , , , Staff Residential Accommodation , , Patient Residential Accommodation GP Practice Dental Practice Pharmacy Optician Care Home Non NHS Functions Other , , , , UnReported , , % of Overall Total 77, , , , , NB: This table is based on ratings allocated against Rooms/Areas. Third Party Ownership Tenure has been excluded.

12 1.1 x. Table 14: Age Profile of Properties Count of Blocks Area (m 2 ) Backlog Cost Pre , ,249, , ,060, , ,448, , ,672, or more recent 32 81, , UnReported ,454, TOTALS , ,052,229.95

13 1.1 xi. Table 15: Summary of Property Appraisal Results Functional Type Gia Sq.m GIA as % of Total Area Backlog Expenditure Required Low Risk Moderate Risk Significant Risk High Risk Unreported Total 01 Acute Hospital 118, ,796, ,648, ,671, , ,122, Childrens Hospital Maternity Hospital Specialist Hospital Mental Health Hospital 33, , ,255, ,999, , ,719, Community Hospital 16, , , , , , Older People Hospital 15, , , ,176, , ,167, Multi Service Hospital Health Centre 18, , , , , ,560, Clinics (including Day Hospitals and 11, , , ,374, , ,107, Resource Centres) 23 Offices 16, , , , ,947, Support Facilities 32, ,527, ,694, ,382, , ,625, Staff Residential Accommodation 2, , , , , Patient Residential Accommodation GP Practice Dental Practice Pharmacy Optician Care Home Non NHS Functions Other 25, , ,528, ,979, , ,577, UnReported 5, , , , ,407, TOTALS 296, ,294, ,325, ,001, ,430, ,052, NB: Block 00 has been excluded from the area calculation but included in the backlog costs. Backlog Costs include Physical Condition C, D or Unreported and all Statutory Compliance conditions ratings. All other costs have been excluded. Third Party Ownership has been excluded.

14 1.2 i. Forth Park Hospital Site Plan 2014/15 PAMS Appendices

15 1.2 ii. Lynebank Hospital Site Plan 2014/15 PAMS Appendices

16 1.2 iii. Stratheden Hospital Site Plan 2014/15 PAMS Appendices

17 1.2 iv. Cameron Hospital Site Plan 2014/15 PAMS Appendices

18 1.2 v. Netherlea Hospital Site Plan 2014/15 PAMS Appendices

19 1.3 i NHS Fife Capital Planning Group Role and Remit Remit The remit of the group is to: Prepare the 5 year Capital Plan by recognising all the strategic developments and the ongoing capital commitments for submission in due course to the NHS Fife Executive Directors and Finance and Resources Committee for recommending approval to the NHS Fife Board. In line with the approved 5 year Capital Programme and taking cognizance of the Capital Allocation, prepare the Annual Property Asset Management Strategy for submission for consideration by the Capital Planning Group then Executive Directors and thereafter recommendation of approval by the Finance and Resources Committee to the Board. Routinely monitor the progress and expenditure of individual capital schemes against the funding available. Identify any in-year slippage and make proposals through the Executive Directors to the Finance and Resources Committee for any substitution of schemes or banking with the Scottish Government Health and Social Care Directorate for utilisation in subsequent years. Update Capital Programme in year for any additional allocations received. Ensure that any revenue consequences associated with the approval of a Capital Scheme have been provided for within the board s overall Financial Framework. Receive information from various capital subgroups to inform the overall process ehealth, Medical Equipment, Radiology, Transport, Statutory Compliance, and Capital Building Works. Keep under review all property acquisitions, disposals and leases. Commission and review proposals for changes in the use of accommodation within and across services. Receive and consider mini Business-cases for projects in excess of 100,000. The Group also considers other matters perceived to fall within its remit and any other issues remitted to it from time to time by the Finance and Resources Committee. Authority The Group has the authority by the Executive Directors to monitor and prepare Capital Plans and Programmes to address the strategic priorities of NHS Fife. All aspects of Capital Planning and allocation process are addressed by the group to inform the Executive Directors and the Finance and Resources Committee and facilitate decision making. Reporting Arrangements The group prepares regular and ad hoc reports as required to inform Executive Directors, the Finance and Resources Committee and the NHS Fife Board for approval, in line with the constitution and terms of reference for the Finance and Resources Committee within the Code of Corporate Governance.

20 1.3 ii Completed Capital Projects, Initiatives and 2020 Vision Year 2013/14 Service Strategy Site(s) Project or Initiative Disposals Right for Fife St Andrews Memorial Hospital Planning consent secured for sale of hospital on open market. Sale completed November Getting Better in Fife Forth Park Hospital Initial sale of hospital on open market unsuccessful. SFT assisting with plans to demolish and re-market site. Netherlea Hospital Initial sale of hospital on open market unsuccessful. SFT advising with plans to remarket site. Barrie Street Clinic Sale of Clinic. Initial sale of clinic on open market unsuccessful. Plan to re-market Spring Castlehill Clinic Clinic sold December Residence, Back Lebanon, Residence sold November Adamson Hospital Houses, 4, 5 and 6 Stratheden Court, Cupar Houses 4 and 6 Stratheden Court sold December Stratheden Court unsuccessful and plan to re-market Spring Acquisitions Getting Better in Fife Glenwood Health Centre New build completed February Site occupied March Service Improvement Asset Performance Statutory Compliance Right for Fife GH&MS Project Victoria Hospital Alterations to existing retained estate services and accommodation. Getting Better in Fife Care of the Elderly Hospital at Home CHP Premises Cameron Hospital Glenrothes Hospital Review of bed model with a view to rationalising use of accommodation and services. Getting Better in Fife Gallatown Development, Kirkcaldy Business Case under consideration for potential development Kelty Health Centre Lochgelly Health Centre Business Case under consideration for potential development Business Case under consideration for potential development Mental Health Strategy Stratheden Hospital Whytemans Brae Hospital Queen Margaret Hospital Review of functional suitability and space utilisation of properties in line with NHS Fife Mental Health Strategy, incorporating effects and requirements of Getting Better in Fife. Rationalisation and disinvestment in landholdings at various sites. Mental Health Strategy IPCU, Stratheden Hospital Business Case Development to support new IPCU on vacant land east of Stratheden Hospital site. Environmental Performance Stratheden Hospital Decentralisation of existing steam boiler plant. Environmental Performance Lynebank Hospital Decentralisation of existing LTHW boiler plant. Environmental Performance Various Health Centres and Clinics New gas fired boilers replacing inefficient plant and equipment. Statutory Compliance NHS Fife Dental Clinics Continuation of improvement to Local Decontamination Units in Primary and Secondary Care. Initial estimate of 600k for modifications to existing premises. Required spend to be prioritised over time as allocation allows.

21 1.3 ii Completed Capital Projects, Initiatives and 2020 Vision (contd.) Year 2014/15 Service Strategy Site(s) Project or Initiative Disposals Getting Better in Fife Old Glenwood Health Centre Site to be declared surplus, building to be demolished and PTH guidance followed. Acquisitions Service Improvement Asset Performance Statutory Compliance Forth Park Hospital Initial sale of hospital on open market unsuccessful. SFT assisting with plans to develop and re-market site. Netherlea Hospital Initial sale of hospital on open market unsuccessful. SFT advising with plans to remarket site. Barrie Street Clinic Initial sale of clinic on open market unsuccessful. Plan to re-market Spring Carnegie Clinic Abbeyview Clinic House 5 Stratheden Court, Cupar 5 Stratheden Court sold June Transfer of services to Queen Margaret Hospital after completion of works at QMH. Transfer of services to Queen Margaret Hospital after completion of works at QMH. GH&MS Project Queen Margaret Hospital Conversion to Ambulatory Care and Diagnostic Centre. Mental Health Strategy IPCU, Stratheden Hospital Business Case Development to support new build IPCU on east of Stratheden Hospital site. Getting Better in Fife Fair Isle Clinic Investigate options for the delivery of Community Services from Fair Isle Clinic. Environmental Performance Queen Margaret Hospital Partnership with Fife Council to utilise District Heating Scheme at Queen Margaret Hospital. Business Case Development to support project with assistance from SFT. Environmental Performance Cameron Hospital Investigate potential to replace/decentralise existing steam boilers. Physical Condition All NHS Fife sites Review all Physical Condition items below 5000 in cost within 3i database. If appropriate, create jobs within Apollo Maintenance Management System. Potential reduction in backlog cost of around 1.5 million. Backlog Maintenance All NHS Fife sites Review and update all condition categories and costs for backlog maintenance of building assets. Functional Suitability, Space Utilisation and Quality facets All NHS Fife sites Review categories for functional suitability, space utilisation and quality facets. Statutory Compliance All NHS Fife sites Review and update risk ratings for all assets within EAMS.

22 1.3 iii Planned Capital Projects, Initiatives and 2020 Vision Year 2015/16 Service Strategy Site(s) Project or Initiative Disposals Getting Better in Fife Carnegie Clinic Declare property surplus and apply PTH procedures. Abbeyview Clinic Townhill Day Hospital Acquisitions Primary Care Clinical Review Gallatown Primary Care Centre IAD to be developed. Service Improvement Asset Performance Statutory Compliance Kincardine Health Centre Declare property surplus and apply PTH procedures. Declare property surplus and apply PTH procedures. IAD to be developed. Primary Care Clinical Review Primary Care facilities Review and development of options. Mental Health Strategy IPCU, Stratheden Hospital Business Case Development to support new build IPCU on east of Stratheden Hospital site. Environmental Performance Queen Margaret Hospital Investigate potential for Combined Heat & Power to be installed at Queen Margaret Hospital. Backlog Maintenance All NHS Fife sites Review and update all condition categories and costs for backlog maintenance of building assets. Functional Suitability, Space All NHS Fife sites Review categories for functional suitability, space utilisation and quality facets. Utilisation and Quality facets Statutory Compliance All NHS Fife sites Review and update risk ratings for all assets within EAMS. Year 2016/17 to 2019/20 Service Strategy Site(s) Project or Initiative Disposals Acquisitions Primary Care Clinical Review Lochgelly Health Centre IAD to be developed. Service Improvement Asset Performance Statutory Compliance Acute Care Clinical Review Victoria Hospital Refurbishment of Tower Block. Backlog Maintenance All NHS Fife sites Review and update all condition categories and costs for backlog maintenance of building assets. Statutory Compliance All NHS Fife sites Review and update risk ratings for all assets within EAMS.

23 1.3 iv. 10 Year Investment Plan Projects: Total Capital Value 2015/ / / / / / / / / /25 Comments (Equivalent capital spend should be profiled over the anticipated construction investment period) Gallatown Health Centre Kincardine Health Centre Lochgelly Health Centre Capital / Board Funding Projects: New Investment Projects: Total Capital 2015/ / / / / / / / / /25 Value Stratheden IPCU GHMS Queen Margaret Hospital GHMS Victoria Hospital Aseptic Suite GHMS Carnegie Unit GHMS Dental Service Investment in Existing Estate: Total Capital Value 2015/ / / / / / / / / /25 (including refurbishment schemes, direct backlog maintenance projects, environmental improvements projects etc) Backlog Refurbishment / upgrade Minor Capital/Scheme Development Environmental Improvements Victoria MTHW Environmental Improvements QMH Boiler Replacement Environmental Improvements Cameron Decentralistaion Condemned Equipment Total Capital Investment in Other Assets: 2015/ / / / / / / / / /25 Value Medical Equipment Medical Equipment Radiology Equipment IM&T IM&T Telephone System Transport Any Other Investment Plans Projects: Total Capital 2015/ / / / / / / / / /25 Value VHK Tower Block Patient Admin System Planned Disposals Properties: Lynebank Hospital Land Forth Park Hospital Glenwood Health Centre Netherlea Hospital Barrie Street Clinic Townhill Day Hospital Stratheden Hospital Field Abbeyview Clinic Cameron Hospital Lodges SUMMARY 10 Year Investment Plan ( millions) Investment Projects likely to be revenue based (Hub, NPD, etc) - include total capital value, upfront costs, and equivalent capital spend Total Value 2015/ / / / / / / / / /25 Total Value 2015/ / / / / / / / / /25 Total Investment Include current anticipated / estimated disposal value

24 1.3 v Draft PAMS Implementation Plan 2015 No. OBJECTIVES ACTIONS STATUS PERSON Not yet started In progress RESPONSIBLE Complete HAPS - Head of Asset Planning and Sustainability, HPCA - Head of Primary Care Administration, FM Facilities Managers, HoE Head of Estates, EM Estates Managers, Facilities CAD Officer, ProM - Property Manager, Service Managers, ProjM Project Manager 1. Update existing information for Functional Suitability Category. Initiate discussion with Facilities Managers. Prepare reports for all properties. Investigate potential to input information on a room by room basis. Update existing information. 2. Update existing information for Quality Category. Initiate discussion with Facilities Managers. Prepare reports for all properties. Investigate potential to input information on a room by room basis. Update existing information. 3. Update existing information for Space Utilisation Category. 4. Update existing information for Physical Condition Category. 5. Update existing information for Statutory Standards Category. Initiate discussion with Facilities Managers. Prepare reports for all properties. Investigate potential to input information on a room by room basis. Update existing information. Review Phase 6 information with Estates Managers. Confirm status with Survey Partner. Update existing information. Review Phase 6 information with Estates Managers. Confirm status with Survey Partner. Update existing information. TIMESCALE HAPS / FM s / PM March 2016 HAPS / FM s / PM March 2016 HAPS / FM s / PM March 2016 HAPS / EM s Sept HAPS / EM s March Update existing information for Environmental Review existing information with Estates Managers. HAPS / EM s March 2016 Performance Category. Update existing information. 7. Update existing GIA data for all properties. Review existing information with Estates/Facilities Managers. FCO March 2016 Update existing information. 8. Update existing information for Primary Care Review existing information with Primary Care Managers. HAPS / HPCA March 2016 premises. Update existing information. 9. Dispose of surplus properties. Review existing surplus properties. HAPS / ProM March 2016 Progress Property Transactions Handbook guidance. 10. Determine future use of Fair Isle Clinic. Develop options paper for future use of Fair Isle Clinic. FM / SM Dec Present results to Capital Planning Group. 11. New IPCU at Stratheden Hospital. Approval of Business Case required. Commence works once approval to proceed has been given. ProjM June 2015 Ongoing 12. New Ambulatory Care and Diagnostic Centre at Progress works to completion. ProjM Ongoing Queen Margaret Hospital. 13. New Kincardine Health Centre. Develop IAD. FM / SM March 2016 Business Case development upon approval of IAD. 14. Gallatown Development, Kirkcaldy. Develop IAD. Business Case development upon approval of IAD. FM / SM March 2016

25 1.4 i NHS Fife Site Energy Performance Report Example 4.16 HEAT Target - Energy Performance Adamson Hospital Cameron Hospital Glenrothes Hospital Lynebank Hospital Phase 3, Victoria Hospital Queen Margaret Hospital Randolph Wemyss Memorial Hospital St Andrew s Community Hospital Stratheden Hospital Victoria Hospital Whytemans Brae Hospital Apr-14 May-14 Jun-14 Jul-14 Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15 Actual Fossil Consumption Actual Electricity Consumption Weather Compensated Performance against Base Year % % % % % % % -7.04% 0.13% 5.54% 8.03% 10.04% Performance against Target % % % % % % -8.18% -2.25% 5.29% 10.98% 13.60% 15.71% Actual Fossil Consumption Actual Electricity Consumption Weather Compensated Performance against Base Year % % % % % % % % % % % % Performance against Target % % % % % % % % % % % % Actual Fossil Consumption Actual Electricity Consumption Weather Compensated Performance against Base Year % % % % % % % % % % % % Performance against Target -8.42% % % % % % % % % % % % Actual Fossil Consumption Actual Electricity Consumption Weather Compensated Performance against Base Year % % % % % % % % % % % % Performance against Target % % % % % % % % % % % % Actual Fossil Consumption Actual Electricity Consumption Weather Compensated Performance against Base Year 34.07% 6.49% -3.71% -5.84% -5.28% -3.24% -1.88% -4.70% -5.81% -5.00% -6.06% -7.65% Performance against Target 36.80% 8.65% -1.76% -3.92% -3.36% -1.27% 0.11% -2.77% -3.89% -3.07% -4.15% -5.78% Actual Fossil Consumption Actual Electricity Consumption Weather Compensated Performance against Base Year % % % % % % % % % % % % Performance against Target -8.35% % % % % % -9.29% -6.76% -5.77% % -8.18% -7.67% Actual Fossil Consumption Actual Electricity Consumption Weather Compensated Performance against Base Year % % % % % % % % % -8.28% -5.41% -5.29% Performance against Target % % % % % % % % % -3.55% -0.54% -0.42% Actual Fossil Consumption Actual Electricity Consumption Weather Compensated Performance against Base Year 8.63% 11.95% -0.61% -3.69% -4.83% -6.38% -3.46% 0.14% -1.27% -0.48% -0.62% -0.11% Performance against Target 13.09% 16.55% 3.46% 0.26% -0.93% -2.54% 0.50% 4.25% 2.77% 3.60% 3.46% 3.99% Actual Fossil Consumption Actual Electricity Consumption Weather Compensated Performance against Base Year -6.39% % % % % % % % % % % % Performance against Target -1.57% -5.67% % % % % % % % % % % Actual Fossil Consumption Actual Electricity Consumption Weather Compensated Performance against Base Year 90.92% % % % % % % % % % % % Performance against Target % % % % % % % % % % % % Actual Fossil Consumption Actual Electricity Consumption Weather Compensated Performance against Base Year % % % % % % % % % % % % Performance against Target % % % % % % % % % % % % Base Year Actual Energy Target Energy /14 Actual Energy Weather Compensated W.C. Performance against Base Year W.C. Performance against Target 16 May % % % % % % % % % % % % 7.82% -9.32% % % % % % % % % % %

26 1.5 i. ehealth Strategy The ehealth Strategy ( ) provides the outline plan for NHS Fife to delivery its commitments. This is closely aligned with delivering the NHSS Quality and ehealth Strategies and provides continuity for building on our successes from the previous strategy in This plan provides an opportunity to focus on goals and outcomes that directly support the key objectives for NHS Fife underpinning improvements in the delivery of care and measurable and specific outcomes to help make our service more effective and efficiently over this next period. NHS Fife will continue the application of IT innovation ensuring this remains embedded in daily working practice and directly contributes to service plans delivering improvement with measurable outcomes. This is an approach we have pursued since our original plan in 2003, delivered in our focus since 2008, and the difference in is outcomes will be measurable and agreed within the plan. NHS Fife is making steady progress in relation to the ehealth Strategy. The key areas are monitored through Common Progress Measures and Nationally benchmarked. The ehealth / IT Infrastructure The infrastructure required to support the multitude of systems and applications that now depend on it is continuously being upgraded. This is required to keep up with the standards required for speed, resilience, data integrity and security. There is a small but significant move towards more direct patient care devices requiring connection to the hospitals networks. This, along with other technologies such as IP telephony and IP Television, means that the data network has far more pressure on it now than ever before. The wireless network has also seen a significant growth in usage and the coverage that this provides has been extended so that all the main sites have some, if not complete, coverage. The move towards the replacement of small printers with multi-function devices continues in place as per the last 3 years, moving from an average of 1:8 users per printer device to 1:50 per device. This is contributing to significant reduction in the organisation s carbon footprint. The 2014/15 Capital plan for the ehealth Department has been recently reviewed by the Senior ehealth Management which has resulted in a major change in how the funds are to be allocated in this and future financial years. The main focus for the next 12 months will be the elimination of Windows XP Computers both desktops and laptops. This is necessary because of the withdrawal of support for the XP operating system from Microsoft. 300 PC s have already been purchased with a further 950 this financial year. In addition 150 Laptops will be purchased along with docking stations and monitors. Where possible existing monitors will be reused. Another key are of the ICT infrastructure for the remaining of this financial year is the urgent replacement of the air conditioning in the main data centre at the Victoria Hospital. The ehealth Infrastructure also incorporates all Telephony. The last few years NHS Fife has been converging the data and phone networks and will continue with this approach where the opportunities arise. This is in the form of utilising the data cabling network for phones rather than installing separate phone cabling. Where this has been implemented it provides a much more flexible system and allows quicker deployment of phones. The existing main telephony system will go End of Life in 2017 which will directly impact 5 of NHSFife s hospitals: Victoria, Kirkcaldy (Phases 1, 2 & outside buildings only) Queen Margaret, Dunfermline Lynebank, Dunfermline Cameron, Cameron Bridge, Windygates Stratheden, Cupar There are opportunities to combine the work required at Queen Margaret Hospital with the current redevelopment of Queen Margaret which will take place over the next 2/3 years. NHS Fife is now taking the steps to procure the new system (one of the biggest ehealth tenders within this strategy period), with the view to start the replacement work by summer 2015 in order to finish before the end of The estimated cost of the project is 2.8m. The estimated budget cost is 2.8 million which includes any additional network kit to be purchased

27 ehealth Systems The national strategy (NHS Scotland ehealth Strategy ) underpins all ehealth activities embarked on within NHS Fife. A number of systems have been implemented as a result. There is an ongoing programme that is delivering many of the building blocks that are required as the organisation moves towards the delivery of an Electronic Patient Record (EPR), including a solution for neonates, electronic referrals for optometrists, a patient early warning solution and clinical systems for community staff. These, together with the existing systems including document management, and electronic ordering (for laboratory and radiology investigations), give the building blocks to move towards an EPR. NHS Fife continues improving and expanding the use of the clinical portal. This is an important solution bringing together as much of this patient information as possible in one place. The use of the clinical portal continues to expand as does its capabilities. The next table reports progress in NHS Fife in line with ehealth Delivery Plan : Project ID Status 1 Single Sign On Complete 2 e-provisioning Underway 3 Referral Management/Clinical Communications Underway 4 Clinical Portal Live 5 Clinical Portal/eForms Underway 6 Mobile Devices Access Complete 7 Medicine Management H@H Underway 8 MiDIS and Mobile Working Live 9 OASIS Replacement Underway 10 TIARA9 Live 11 Single ecase Note Underway 12 eprescribing/hepma Underway 13 Digital Dictation Live 14 Clinisys Electronic Ordering & icris Electronic Ordering Live 15 Dashboard development & Rollout Live 16 Electronic Early Warning Scores Live 17 WARDVIEW Underway 18 Fairwarning/Privacy Breach Complete 19 GP Systems Underway 20 Telehealth Underway 22 Chemocare Live 23 Mental Health and Psychological Services Underway 24 Eyecare Live 25 ereporting Underway 26 MyLittleOne Live In terms of Clinical Systems, the priorities for 2014/2015 are: ICASS (Integrated Community Assessment and Support Services): H@H (Hospital at Home), EMIS (Primary Care Clinical System) and MIDIS (Multi Disciplinary Information System- Supports Community, essa and Child Protection) in support via Clinical Portal ecasenote for single paper record Medicine Reconciliation within Clinical Portal HEPMA Electronic Discharge Letter (Interim Discharge) from Clinical Portal, including medicine reconciliation to Electronic Document Transfer (EDT) Wardview to support patient flow across all Hospitals Results reconciliation to Clinical Portal V5 as a key clinical priority Updating Referral Management System Electronic Ordering for Laboratories and Radiology ehealth solutions for Mental Health and Psychological Therapies HEAT targets and development of ehealth capability across NHS Fife Planning for OASIS replacement Migrating technology to be able to support staff using mobile platforms, tablets & smartphones

28 Non-clinical systems Although clinical systems by nature capture most of the attention within the ehealth strategy, there are also key initiatives in the non-clinical spectrum of great significant from the Property and Asset Management Strategy perspective. Some of the key non-clinical innovations are: ehealth Self-service Portal- this initiative will allow the delivery of an extraordinary ehealth customer experience through a customer-friendly IT/eHealth self-service portal, reducing the NHS Fife service desk volume by as much as 65%, simply by users utilising the self-service portal for standard requests, such as password resets, new accounts, needs for standard equipment (PCs, laptops, phones) and standard software (improved asset management), but also allowing self resolution of some issues and speedy escalation or request of further problems or requirements. This systems will also provide powerful dashboards and reporting, and superior mobility to the ehealth team, hence a more efficient service on the go as well as providing PinkVERIFY certified ITIL processes such as: Incident Management, Change Management, Problem Management and ICT asset management. ICT asset management the new ehealth Service Management system (Cherwell) will also provide opportunities for better Asset Management by linking the entire asset life-cycle but also allowing a sleek administration of IT assets and integrating with Altiris (Symantec), our current system for managing the configuration and administration of computers and software in a semi automated way. eees - this project aims to introduce a single national HR system for all boards in NHS Scotland. The system will hold and manage employment information for all staff employed by NHS Scotland s 22 Health/Special Health Boards. NHS Fife is starting the pilot within the ehealth Department within the forthcoming months. It is worth mentioning this solution in the context of the Property and Asset Management Strategy, because contains modules that will help managing resources (e.g. ICT assets) assigned to staff. This also will allow a reliable way to cross charge for user usage of relevant ICT assets (e.g. MFDs) even if they move to other departments. There are also plans to invest in non-clinical systems with a significant contribution to efficiency savings across the NHS Fife. An example is Job Planning and e-rostering (part of the Allocate Software family of products) these systems will facilitate delivering intelligent, end-to-end staff management but also improving and balancing healthcare service needs and resources (all staff groups and types). e-jobplan and erostering are two sides of the same coin e- JobPlan defines the activities that consultants are contracted to deliver, and when they plan to do this; erostering operationalises this data and helps manage changes to the plan, recording what actually was delivered; eroster is also be used for rostering needs within other staff groups and types (e.g. nurses, bank staff, etc.).

29 The image part with relationship ID rid26 was not found in the file. 2014/15 PAMS Appendices IT Management and Inventories All IT assets across the whole of the NHS Fife board area are managed by the ehealth Department. The core GP IT infrastructure is also funded and supported by the NHS Fife. Although ehealth funds much of the purchased IT equipment and software, departments can and do provide their own funding. To ensure compatibility with the ehealth Strategy and the infrastructure users are provided with a service catalogue from which they can purchase pre agreed products (available from the Self-service Portal from March 2015). All IT procurement requires to be approved for use by the ehealth Department whether from the service catalogue or a non-standard purchase; this includes hardware and software. The Altiris Client Management suite (Symantec) combined with Active Directory and Assyst (current ehealth Service Management system to be replaced by Cherwell by March 2015) are used to track and manage all assets connected to the network. The current model to hold ehealth assets data is under review and has been improved as part of the specifications for the new ehealth Service management System (Cherwell). The sources, flows and repository(s) of ICT asset information has been clearly defined as part of the design exercise. Cherwell CMDB (Configuration/Asset management data base) will be integrated with Active Directory and automated asset discovery tools: currently Altiris/Symantec software, and Airwatch for mobile devices. Multi-functional devices are managed across the Board using Equitrac; they can also be discovered via Altiris. A total of 6750 devices (including PCs, laptops and Windows tablets), 1044 printers, 87 MFDs (Multi Functional Devices) and 282 non-windows mobile devices (e.g. ipads and Android devices) are currently managed in this way. The following figure illustrates the ehealth CMDB/Asset management model. IT Independent Health Care Contractors All of the IT assets within the GP Practices in NHS Fife are managed by the ehealth Department via a Service Level Agreement. The service is funded in its entirety via GMS Funding managed by the Primary Care Manager.

30 IT Assets The ehealth Department endeavours to replace assets as they become obsolete however there is a historical under funding of the replacement programme. Departments are in some circumstances left to provide funding for their own equipment which is not a satisfactory situation. The next figure presents the distribution of the investment plan for 2014/2015 on key categories of ICT assets. Computer Estate This year, due to predictable pressures to upgrade the entire NHS Fife computer estate to Windows 7 (Windows XP will be no longer supported from March 2015), NHS Fife is undertaking a special replacement project which, in some cases, involves replacing obsolete olete PCs and Laptops, not only upgrading the operating system. The vast majority of the NHS Fife computer estate is working on Windows XP. The project must be completed by October 2015 and requires 3,120 machines to be replaced and 3,000 machines to upgraded, with an estimated cost of 445K in 2014/15 and 535K in 2015/2016 for this purpose. Printers In order to consolidate printing equipment and reduce the overall number of printers across the organisation a printing strategy has been put in place which emphasises the use of networking multi functional devices are opposed to small desktop printers. At the present time, NHS Fife has a fleet of 87 MFDs (Multi Functional Devices) across different sites; the current fleet is mainly located at Victoria Hospital in areas with high printing demand. For 2015 the strategy continues to be replacing stand alone printers with MFDs. In order to achieve this, ehealth and Facilities are conducting an assessment and identifying potential savings, e.g. Cameron Hospital is replacing 70 stand alone printers with 3 MFDs representing financial savings and positively contributing to the environmental targets. Telecomunications The two main projects for Telecoms will be as mentioned earlier the Scottish Government telephony project, which will last over two financial years, and the replacement of some GP/Health Centre switchboards which is independent to the Scottish Government procurement. The new Telephone System cost is 2.5m. This funding is the first tranche of total funding of 4.5m for a replacement Telephone System for the major hospital sites within NHS Fife. An Initial Agreement Document (IAD) has already been

31 approved by NHS Fife and the SGHSCD Capital Investment Group (CIG). The Full Business Case is due for completion and approval in December 2014/January The funding has been split between 2015/16 and 2016/17 and discussions will be required to ascertain if the project expenditure can mirror the funding profile. Networks Most of the NHS Fife3 network kit is Cisco. There won t be any change to that in the next two years. The plan will be to replace the older core equipment at Victoria and Queen Margaret (approximate cost of 300k) over the next two financial years, subject to budget availability. There will also be network improvements caused by the replacement of the telecommunications system and a range of refurbishments, especially at Queen Margaret Hospital. Servers The strategy for Servers will continue to be a move towards virtualisation of physical servers. This involves the replacement of some of the existent physical servers but also to encourage virtualisation as part of the assessment of any new system. The majority of the systems introduced within the last few years, denotes a trend towards the use of external servers (e.g. externally hosted, systems based on web access to external servers and cloud computing). Data centre Servers Estate Virtual 80% Physical 20% NHS Fife currently has 2 main Data Centres, located at Victoria Hospital and Queen Margaret Hospital; this last one will be decommissioned in 2015 and a different approach is under evaluation, specifically exploring data centre sharing options with local authorities and other NHS Boards. ehealth Management Costs The total budget for IM & T including all resources, revenue spends on equipment and external contracts 10.9m (90% Revenue and 10% Capital). Further details on the specific inventories, investments and expenditure can be found in the IM&T survey reported every 2 years to NSS. IT Maintenance Costs The majority of the IT equipment is maintained in-house or via manufacturer s warranty. Generally speaking PCs or peripheral devices are not covered by maintenance contracts; however the Multi Functional Devices (MFD's) are covered by a support agreement in line with the National framework. Most of new general use printers are also being purchased with a support agreement. Other hardware such as servers and specialist items will typically have a maintenance contract in place. The total expected maintenance cost for 2014/15 is 3,9m. IT Asset Management Methodology The NHS Fife ehealth Asset Management methodology is centred in the asset lifecycle and follows best practices frameworks and standards, in particular ITIL and CobIT where introduced and actively applied since The asset management process is also under regular review as part of the ongoing ISO27001 Certification surveillance audits. Above all, the NHS Fife Financial Operating procedures and related policies govern the principals of the ehealth Asset management methodology. The main purpose of the Service Asset and Configuration Management (as named in ITIL) is to maintain information about ICT assets (also called Configuration Items or CIs ) required to deliver the ICT/eHealth service, including the relationships between assets.

32 The key areas of focus in the current IT/eHealth Asset Management methodology are: Procurement procedures Cost management Contract management Software licenses management Asset maintenance and CMDB updates Asset retirement Links to other ICT services and processes, e.g. ehealth change management, configuration management, software management and incident management. Failure to follow this approach purchasing ICT/eHealth equipment or software may lead to the said asset not being authorised for use by NHS Fife and therefore may be a waste of public money and resources. This may occur if it is incompatible with the infrastructure or it is at variance with the standards currently allowed and agreed, or a similar and suitable solution or asset is already available within the organisation, hence the avoidance of double spending. As described in previous sections, NHS Fife relies on a combination of tools (Assist/Cherwell, Altiris/Symantec, AD, Solarwinds, and manual procedures in order to manage the ICT/eHealth assets. Through this process, ehealth performs regular checks, ensuring that the information contained in the asset management system is accurate and represents the actual ICT estate. IT Risk Assessment ehealth risks are managed by the ehealth Risk Group and all risks are logged in the organisations risk recording system with appropriate risk levels. This includes any risks to the physical equipment, logical assets (e.g. systems and software) or that may be caused by the condition of the equipment, the physical environment (e.g. data centre) or the system. IT Environmental Management: sustainable, green ehealth. The NHS Fife Green ehealth refers to the commitment of the NHS Fife to provide environmentally sustainable IT and Telecommunications, in order to reduce the environmental impact of our IT and Telecommunications operations.

33 These includes the practice of designing, manufacturing, using, and disposing of computers, servers, and associated subsystems - such as monitors, printers, storage devices, networking and communications systems - efficiently and effectively with minimal or no impact on the environment. The main goals of Green ehealth are: Reduce the use of hazardous materials like toners Maximize energy efficiency during the ICT product's lifetime To promote the recyclability or biodegradability of decommissioned ICT To reduce the usage of paper and to minimise CO2 emissions. NHS FIFE Green ehealth approaches ehealth products longevity We are conscious one of the biggest contributions to green computing usually is to prolong the equipment's lifetime, including upgradability and modularity. Data centre design Data centre facilities are heavy consumers of energy. NHS Fife has redesigned one of the main data centres in the last few years. All energy use aspects were considered and an eco friendly design was selected from all bids. Both of the data Centres have environmentally green air cooling systems installed. Environmental Virtualisation Virtualization refers to the abstraction of computer resources by sharing physical hardware between several individual logical systems, thereby unplugging the original hardware and reducing power and cooling consumption. NHS Fife has been progressively moving in this direction and currently 80% of the servers infrastructure is virtual. Desktop virtualisation has also been considered, however has been found no feasible at the present time but we will continue monitoring state-of-the-art technology in the future for this purpose. Terminal servers NHS Fife still supports Citrix. When using the system, users at a terminal connect to a central server; all of the actual computing is done on the server, but the end user experiences the operating system on the terminal. This reduces up to 1/8 the amount of energy of a normal workstation, resulting in a decrease of energy costs and consumption. Power management When possible NHS Fife supports ICT and Telecommunications equipment compliant with ACPI (Advanced Configuration and Power Interface), an open industry standard that allows an operating system to directly control the power-saving aspects of its underlying hardware. This allows a system to automatically turn off components such as monitors and hard drives after set periods of inactivity. In addition, a system may hibernate, where most components (including the CPU and the system RAM) are turned off. By default all IT equipment that has environmental power settings have these set to the most practical settings before deployment. Many of our deployed services utilise virtualisation which has reduced the number of physical servers in the data centres therefore reducing the power consumption within the server environment. Materials recycling NHS Fife engages with 3rd parties for disposal and recycling of computing equipment, including but not exclusively ICT and Telecommunications equipment and toners. This action can keep harmful materials such as lead, mercury, and hexavalent chromium out of landfills, and can also replace equipment that otherwise would need to be manufactured, saving further energy and emissions. All condemned IT hardware is disposed of securely and safely as described in the Condemnation of IT Hardware Procedure. This ensures that NHS Fife, ehealth Infrastructure Department has the appropriate arrangements in place.

34 Telecommunications NHS Fife is committed to provide more teleconferencing and telepresence technologies, including OCS. The advantages are many; increased worker satisfaction, reduction of greenhouse gas emissions related to travel, and increased profit margins as a result of lower overhead costs for office space, heat, lighting, etc. These also offer savings opportunities. Voice over IP (VoIP) reduces the telephony wiring infrastructure by sharing the existing Ethernet copper. VoIP and phone extension mobility also made hot desking more practical. Multi functional devices Combining printing, photocopying and faxing in a single machine reduces CO 2 emissions and paper usage. NHS Fife is implementing a strategy for reducing the amount of individual and departmental printers, photocopiers and faxes by providing more efficient shared devices (MFDs). Since the project started in October 2011, NHS Fife has already saved 10m sheets of paper (1,184 trees) and avoidance of manufacturing CO2 (required to produce paper) of KgCO 2. NHS Fife continues actively monitoring the environmental effects of printing since The reports on energy use and CO 2 savings show a slight increment on energy usage since 2012 on printers with a corresponding increment on CO 2 savings. 60.0% Energy consumtion (monthly average) 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% Operation Time (% of total time) Panel Off Time (% of total time) Sleep Mode Time (% of total time) Standby / Ready Time (% of total time) Low Power Time (% of total time)

35 Within the last year we observed a slight decline in the use of duplex functionality across the Board. This is caused by different user needs and preferences. The default printing mode has been is set as duplex and different user awareness campaigns have been released thorugh the year and will continue to encourage printing double side and not to print if can be avoided. The use of mobile devices is also allowing a reduction in printing (e.g. papers for meetings etc.). there is a National target measured via the Common Progress Measures, showing performance and trends in line with the Paper Light Hospitals target. The usage of electronica health records will also continue contrinuting to this element of the ehealth Strategy. 100% 80% 60% 40% 20% 0% Duplex % , , , ,000 - Environmental savings (monthly average) Sheets of Paper Saved Trees Saved 5,000 4,000 3,000 Manufacturing CO2 Avoidance (KgCO) - montly average- 4,668 4,236 3,117 2,000 1,

36 1.6 i. NHS Fife Transport All commercial vehicles operated within NHS Fife are managed by the Transport Department, which is a part of Estates Facilities & Capital Services Directorate. The Current fleet consists of 103 vehicles. Vehicle data is held on Chevin Roadbase transport software. Vehicles are sourced through national contracts and the Government Procurement Service, using their multi quote system. Where possible all vehicles are sourced locally. The fleet at present is 70% purchased and 30% leased. Purchasing is dependent on capital funds available at the start of the financial year. At present the policy for vehicles is open procurement method. This system is best suited to NHS Fife s needs, it allows purchase the most cost efficient vehicle available for the funding available, rather than be committed to a fixed price/supply vehicle contract. Routine maintenance and all mandatory checks are pre planned 12 months in advance as recommended by Driver & Vehicle Standards Agency, (DVSA). Maintenance is carried out by several suppliers, including Fife Council. All new vehicles remain with franchised approved dealers during warranty period, normally three years. Fleet Complement Vans - These vehicles are used for a variety of functions by various departments in NHS Fife. Their tasks include meals delivery, labs/courier service, estates, horticulture, clinical waste, dental service and chilled vaccine delivery. Lorries - This type of vehicle is required to carry heavier loads and come under the O licence regulations and therefore require regular planned safety checks. The drivers require c licences, Certificate of Professional Competence and regular medical assessment. These vehicles are used to carry laundry, stores, clinical waste and carry heavy/bulky cargo such as, beds, furniture, and pallets of goods. The clinical waste drivers also require ADR vocational training every five years and may be subject to roadside checks by enforcement authorities. Patient Carrying Vehicles - These vehicles are used primarily for transport of children to Child Assessment Centres in Fife. As such they are built to a child friendly specification. This reduces the amount of awkward lifting required to be carried out by staff. The seats in the most recent four are on tracks to allow for sufficient spacing between passengers where required. The vehicles are 14/15 seat capacity reduced to 8/9 to allow for extra space required. As passenger carrying vehicles they are, voluntarily, subject to Public Service Vehicle inspection regulations and drivers must also hold Midas training certificate. Cars - The cars are used primarily for light goods, patient /staff transfer, case notes, NHS Fife Primary Care Emergency Service etc. 2 vehicles are used as pool cars and two are 4x4, one used by security which is redirected for bad weather duties as and when required. Condition - A number of vehicles are showing signs of significant wear and damage, with at least 5 becoming uneconomical to repair throughout the year and requiring disposal to auction. Recent Initiatives A number of developments have been implemented over the last few years to reduce cost and contribute to carbon emissions targets, including; A reduction in large vehicles; Improved fleet utilisation with corresponding reductions in miles travelled by the fleet vehicles; Review of latest technology and vehicle improvements, incorporating national targets and industry KPIs; Use of tracking, speed limiters and fuel saving equipment, providing reduced fuel consumption; Implementation of multipurpose vehicles to further increase utilisation. These developments over the last few years have resulted in a reduction in miles travelled by Fleet vehicles while improvements in vehicle stock has resulted in more efficient vehicles being used and a significant improvement in miles travelled per unit of fuel. NHS Fife in association with National Procurement, Government Procurement Service, and Health Facilities Scotland and various advisory panels and manufacturer liaison visits have resulted in the following: Cost effective insurance with reduced premiums ; Environmental Improvements; Improved fuel efficiency. NHS Fife services are continually benchmarked through the HFS Travel Planning & Transport Services Expert Group. There are also formal meetings between Health Boards to discuss working practices and legislative matters on a Shared Service fleet management basis. Where possible there is engagement with local authority partners where experiences are shared, and information exchanged.

37 NHS Fife also engages with third party suppliers and transport operators to maintain knowledge of various improvements, new technology, best value products and efficient vehicles. There is also a good relationship with the Freight Transport Association and Fife Police regarding training and prior notification of regulation changes, which may affect NHS Fife. NHS Fife has presence on the HFS Travel Planning & Transport Services Expert Group, National Procurement Commodity Advisory Panels, where we both give and receive advice on pertinent transport matters, including insurance and vehicle purchasing/leasing and new technology such as in-cab telematics systems. Travel Planning Travel planning is a management process that brings together transport and other business issues in a co-ordinated strategy within an organisation. A Travel Plan sets out measures and initiatives that aim to provide practical alternatives to single occupancy car use, i.e. a choice of other, easy and convenient methods of travelling. Travel planning also aims to make travelling by car, where necessary, more sustainable as well as reducing the need to travel at all through the use of technology, thus realising energy and time savings or reducing pollution of the local environment. Successfully implemented measures and initiatives within a Travel Plan also have a positive influence on the accessibility of an organisation. This increases the pool of potential employees available for recruitment and reduces stress through less congestion. A Travel Plan has the potential to realise cost savings for both the organisation and the individual and to improve access to serve the wider community. In August 2006 NHS Fife Board published A STRATEGIC TRAVEL PLAN FRAMEWORK FOR NHS FIFE, Since then a number of site-specific travel plans have been developed, focusing on issues relevant to those sites, however many of the measures contained therein are common since they are intended to achieve the following aims: Increase social inclusion by improving transport links for patients and visitors to our facilities, Increased access to health care services and facilities for all, Improved health of employees, patients and visitors by encouraging more active travel (walking, cycling), Reduced transport based pollutants entering our local environment, Reduced traffic congestion, Reduced road traffic accidents, Increased opportunities for employment and education. Travel Plan Measures introduced across NHS Fife Since 2006, a number of measures have been introduced this section aims to summarise these to date, with subsequent annual updates demonstrating how the organisation is shifting to more sustainable methods of travel. NHS Fife works closely with partner organisations, including Fife Council Transportation Services (FCTS), Police Scotland, the south-east Scotland regional transport partnership (SEStran), Stagecoach East Scotland (SES), Sustrans and Cycling Scotland. Public Transport NHS Fife, together with FCTS and SES, produces the How To Get To.. series of leaflets, which summarise Public Transport that serves Ninewells Hospital (Dundee), QMH, SACH and VHK sites - these major sites all have on-site bus-stops with shelters. The cost for producing the leaflets is shared equally between NHS Fife, FCTS and SES, with NHS Fife receiving 75% of each print run. Leaflets are available from hospitals, GP surgeries and health centres, as well as Fife Council buildings. Buses also serve Adamson, Cameron, Glenrothes, Lynebank and Randolph Wemyss hospitals, with health centres and GP surgeries having stops also adjacent or nearby. At all sites, timetables for relevant bus/train routes are usually available in reception areas. NHS Fife has dedicated on-line Traveline Scotland journey planners for QMH, SACH, VHK sites (both on the intranet and on the public facing website), where users can enter their home postcode and preferred date/time of travel to produce a dedicated journey plan that details bus stop locations, necessary changes etc. The NHS Fife intranet (for staff) also has links to downloadable apps (usually free) for some smart phones. Walking & Cycling NHS Fife operates a Cycle to Work salary sacrifice scheme: to date there have been four windows, each attract ting users before funding was fully allocated. Of the 116 scheme members, 50 are based in Kirkcaldy, with the remainder based all around Fife. Downloadable cycle/walking maps are available on the NHS Fife intranet to cover Dunfermline, Glenrothes, Kirkcaldy, Levenmouth and St Andrews areas. The Kirkcaldy area map is also available on the internet as part of

38 the Make Your Move Kirkcaldy campaign. Cycling route planners are also available on the intranet & internet, with downloadable apps for smart phones also available. In October 2012 NHS Fife gained the Cycle Friendly Employer award from Cycling Scotland for each of its Glenrothes, QMH, Lynebank, SACH, Stratheden and VHK sites: current cycle parking provision is summarised below. Site Cycle lockers Covered storage Uncovered storage Adamson Hospital 10 4 Cameron Hospital 4 Glenrothes Hospital 8 Lynebank Hospital 10 Queen Margaret Hospital 20 St Andrews Community Hospital 5 18 Stratheden Hospital 10 Victoria Hospital 10 + (bulk locker) 30 Total Car-sharing NHS Fife has operated a free, voluntary staff car-sharing scheme since Take-up has slowly risen since the scheme was introduced, as shown below. Membership increases within the last few years can be directly attributed to marketing campaigns (e.g. national lift share week, on-site roadshows etc.) however growth still remains slow. Year New members Members removed Cumulative total registered in year in year members Parking provision & management NHS Fife has a staff parking policy (GP/C8), which advises staff as to where they should and should not park. In general, beyond dedicated blue badge and operational user (i.e. key staff) spaces, most on-site parking across NHS Fife sites is available for both the general public and staff, with the latter encouraged to use facilities further away from entrances. At QMH and VHK, there are protected spaces for non-staff use (i.e. patients and visitors), located close to entrances. The table below summarises parking provision across NHS Fife sites. Site Blue badge Patient/visitor Short stay Total spaces spaces spaces spaces Adamson Hospital Cameron Hospital Glenrothes Hospital 2 64 Lynebank Hospital Queen Margaret Hospital Randolph Wemyss Hospital 3 39 St Andrews Community Hospital Stratheden Hospital Victoria Hospital Total Please note the figures for QMH and VHK will change as a result of the of the GHMS reconfiguration. Both Car Park 2 at QMH and Car Park B at VHK are controlled by barriers, which are raised manually at 09:00 on weekdays this means that staff (who usually start by then) are discouraged from using these spaces. Car Park H at VHK is also intended for outpatients and access is controlled by means of showing a valid appointment letter.

39 Security staff routinely sticker/and or leaflet inappropriately parked vehicles, with the aim being to educate and encourage behavioural change where possible, to achieve staff buy-in. Operational user parking on both sites is managed by swipecard to gain access to dedicated, barriered parking (72 spaces within Car Park 4 at QMH and 84 spaces within Car Park K at VHK). Blue badge parking on both sites is covered by traffic regulation orders (TROs), as are on-site double yellow lines within these sites.

40 1.7 i Medical Equipment Medical equipment is essential for the delivery of healthcare. A report by Audit Scotland titled Equipped to Care: Managing medical equipment in the NHS in Scotland was published in March The report highlighted the following: That medical equipment is essential to patient care; That the correct equipment needs to be available in the right place at the right time; That properly trained staff must be available to use the equipment; The need for NHS organisations to have adequate systems in place to manage their medical equipment; The importance of these issues with the establishment of a formal duty of clinical governance; That given the strategic importance of medical equipment overall responsibility needs to be taken at Board level. A subsequent report was published in February 2004 entitled Better equipped to care? This reviewed progress across Scotland since the first report. Its main findings were: Strategic management of medical equipment needs to be given a higher priority; More needs to be done to manage medical equipment risks; Information to support the management of medical equipment needs to improve. These reports and guidance from the UK Medicines and Healthcare products Regulatory Agency (MHRA) have guided arrangements for the management of medical equipment in NHS Fife. Policies and Procedures Compliance with CEL 35 (2010) requires, Boards to manage their medical equipment effectively, with supporting strategies governance and reporting arrangements. Boards to have clear knowledge of their medical equipment (condition, lifecycle replacement programme, value, and cost of ownership). NHS Fife has written policies and procedures to cover the various stages in the life cycle of equipment. Our Good Practice Guide to Managing Equipment is currently being updated to reflect changes in practice. This guide is underpinned by the following up to date written procedures: Equipment Procurement; Accessing Equipment; Equipment Inventory; Equipment on Loan or Free Issue; Equipment permanent Location Change; Condemnation of equipment; Transfer of liability for Written-Off Equipment Equipment Maintenance. There is also a separate policy for the management of Electro-Medical equipment. This outlines the responsibilities of Medical Physics, Estates, the Department Equipment Controllers and links to the EMG and the other Equipment Policies. It also includes the Code of Practice to Ensure Safety in the Servicing and Maintenance of Anaesthetic and Respiratory Equipment. Equipment Management Group There is an established Equipment Management Group (EMG) in NHS Fife which meets on a monthly basis. This has responsibility for the management of medical equipment throughout NHS Fife. There is a formal role and remit for the EMG. Its roles and responsibilities are: To carry operational responsibility for medical equipment policy development and implementation; Agree policies on standardisation of equipment between units and sites where appropriate; Ensure Equipment Asset Register and Maintenance register are appropriately maintained by providing the necessary information; Oversee the needs assessment process and initial prioritisation for medical equipment; Prioritise the funding allocated by NHS Fife for procurement of Capital equipment and recommend the same for approval by the Capital Planning Group; To agree the equipment specification and agree the final business case; Take into account the impact of the procurement on the wider services within NHS Fife; To review a rolling programme of equipment replacement and to advise on the consequences;

41 To oversee the procurement of medical equipment; To review incidents involving equipment failure or misuse and recommend, alter, change practice or equipment to reduce the risk of repetition; To ensure that appropriate training is organised for staff working with equipment; Ensure appropriate policies and procedures are in place for all aspects of equipment procurement, use, maintenance, repair, decontamination, disposal and replacement and that staff are aware of all these policies. The Group is chaired by NHS Fife s Equipment Manger and all Directorates are represented on the EMG. There is also representation from Procurement, Estates, Finance, Infection Control, Risk Management and Training. The Equipment Manager is a member of the Capital Planning Group. Department Equipment Controllers Each ward or department formally nominates a person to carry out the duties of the Department Equipment Controller (DEC). Overall responsibility for Equipment Control lies with the line manager/charge nurse. The duties of the DEC include: Maintain an up to date list of all equipment in the department; Participate in equipment selection arrangements; Ensure new equipment is commissioned before use; Be responsible for User equipment servicing; Record all events and build a history of each item in conjunction with Estates Department; Ensure equipment is maintained in accordance with manufacturer s recommendations; Record movement of equipment. A record of all Department Equipment Controllers is held within Estates Department. Management and Inventories A comprehensive asset and maintenance register is required to enable us to know what equipment we are looking after and provide its service history. In NHS Fife this information is managed by the Estates Department utilising Apollo: a commercial asset management database. All new equipment is given an electronic asset tag and is logged by Estates Department in Apollo and also locally by the Department Equipment Controller. A future development for the Medical Equipment Group will be to determine a Procurement Strategy for devices. The chart above highlights that 40% of infusion devices are more than 10 years old. An assessment of condition and suitability of these devices should be carried out as soon as practicable. Procurement of Medical Equipment The process for procuring medical equipment is laid out in the aforementioned Equipment Procurement Policy and the Board s Financial Operating Procedures. The capital equipment budget is managed and allocated by the EMG. EMG maintains a list of requests for new or replacement equipment that has been identified by departments. All requests are scored using the same grading matrix and held on a list to be allocated when funding is available. EMG monitors the procurement of the equipment and ensures all processes are carried out effectively. National contracts are utilised where these exist. If no national contract exists then appropriate tendering procedures are used dependant on the value of the equipment. There is also a Condemnation budget. Requests to this budget are managed by Finance. Imaging Equipment Due to the high value of all Imaging Equipment a percentage of the equipment budget has been ring fenced annually for the purchase of Imaging Equipment. This has enabled a planned equipment replacement programme to be identified and equipment replaced on a rolling basis. This work has been done in conjunction with the National Imaging Equipment Group of Health Facilities Scotland in order to improve the cost effectiveness of purchasing and maintaining this type of equipment. This replacement programme will be ongoing. Renal Dialysis In conjunction with our Technical Services Manager from NHS Lothian all dialysis machines are identified with planned replacement dates and this information is shared with the Equipment Management Group to ensure appropriate allocation of funding. Infusion Devices Work has been done in Fife to standardise on one Infusion Device. Staff training has been done on the device. This will improve patient safety and reduce the possibility of errors.

42 Safety Action Notices NHS Fife has a distribution system for the dissemination of all safety warnings received. This work is undertaken by Corporate Services. Equipment Incidents All reportable incidents in NHS Fife are recorded using Datix. Each month a report on all those relating to equipment is issued to the EMG. These are then reviewed at our monthly meeting to ensure that all appropriate action has been taken. This may involve for example ensuring that the incident has been reported nationally or that additional staff training has been delivered.

43 1.8 i. Primary Care GP Data NHS Fife - Desk Top Study - GP Practices Property Assets NUMBER Number of Properties/Sites: 33 Floor Area (000's sq.m) Net Book Value ( m) Age Profile (%): Over 50 years old 12% years old years old 76% 25 Up to 10 years old 12% 4 Tenure Types (%): Owned 79% 26 Leased 21% 7 PPP/PFI 0 0 Other 0 0 Condition Ranking - % of total in each category: A 18% 6 B 79% 26 C 3% 1 D 0% 0 Functional Ranking - % in each category: A 15% 5 B 70% 23 C 12% 4 D 3% 1 Quality Ranking - % in each category: A 18% 6 B 76% 25 C 3% 1 D 3% 1 Space Ranking - % in each category Empty Nil Underused 9% Fully used 82% Overcrowded 9% Backlog Cost ( m): Clinical areas Non Clinical Areas Low Risk Items Moderate Risk Items Significant Risk Items High Risk Items Total Backlog Estimated capital receipts from property disposals over the next 5 years % of the estate (by area) surveyed in last year % of the estate (by area) surveyed in 5 years 100% by DV for rent purposes Average SCART Score: Energy Consumption (GJ) Heated Volume (100m 3 ) Energy Performance (GJ/100m 3 ) CO 2 Emissions (000's Tonnes) Water Consumption (m3/m2) Waste Volume (Tonnes): Waste Recycled (Tonnes) Managerial Technician Number of Estates & Facilities Staff

44 1.8 ii. Primary Care Dental Practice Data NHS Fife - Desk Top Study - Dental Practices Property Assets NUMBER Number of Properties/Sites: 57 Floor Area (000's sq.m) 5910 Net Book Value ( m) Age Profile (%): Over 50 years old 74% years old 14% years old 5% 3 Up to 10 years old 7% 4 Tenure Types (%): Owned 81% 46 Leased 19% 11 PPP/PFI 0 0 Other 0 0 Condition Ranking - % of total in each category: A 12% 7 B 84% 48 C 4% 2 D 0 0 Functional Ranking - % in each category: A 26% 15 B 70% 40 C 4% 2 D 0 0 Quality Ranking - % in each category: A 33% 19 B 63% 36 C 4% 2 D 0 0 Space Ranking - % in each category Empty 0 0 Underused 24% 14 Fully used 72% 41 Overcrowded 4% 2 Backlog Cost ( m): Clinical areas Non Clinical Areas Low Risk Items Moderate Risk Items Significant Risk Items High Risk Items Total Backlog Estimated capital receipts from property disposals over the next 5 years % of the estate (by area) surveyed in last year % of the estate (by area) surveyed in 5 years 100% by DV for rent purposes Average SCART Score: Energy Consumption (GJ) Heated Volume (100m 3 ) Energy Performance (GJ/100m 3 ) CO 2 Emissions (000's Tonnes) Water Consumption (m3/m2) Waste Volume (Tonnes): Waste Recycled (Tonnes) Managerial Technician Number of Estates & Facilities Staff

45 1.8 iii. Primary Care Pharmacy Premises Data NHS Fife - Desk Top Study - Pharmacies Property Assets NUMBER Number of Properties/Sites: 81 Floor Area (000's sq.m) Net Book Value ( m) Age Profile (%): Over 50 years old 53% years old 20% years old 22% 18 Up to 10 years old 5% 4 Tenure Types (%): Owned Leased PPP/PFI Other Condition Ranking - % of total in each category: A 35% 28 B 58% 47 C 7% 6 D 0 0 Functional Ranking - % in each category: A 32% 26 B 54% 44 C 14% 11 D 0 0 Quality Ranking - % in each category: A 32% 26 B 61% 49 C 7% 6 D 0 0 Space Ranking - % in each category Empty 0 Underused 0 Fully used 100% Overcrowded 0 Backlog Cost ( m): Clinical areas Non Clinical Areas Low Risk Items Moderate Risk Items Significant Risk Items High Risk Items Total Backlog Estimated capital receipts from property disposals over the next 5 years % of the estate (by area) surveyed in last year % of the estate (by area) surveyed in 5 years Average SCART Score: Energy Consumption (GJ) Heated Volume (100m 3 ) Energy Performance (GJ/100m 3 ) CO 2 Emissions (000's Tonnes) Water Consumption (m3/m2) Waste Volume (Tonnes): Waste Recycled (Tonnes) Managerial Technician Number of Estates & Facilities Staff

46 1.8 iv. Primary Care Optician Premises Data NHS Fife - Desk Top Study - Opticians Property Assets NUMBER Number of Properties/Sites: 47 Floor Area (000's sq.m) Net Book Value ( m) Age Profile (%): Over 50 years old 77% years old 17% years old 0 0 Up to 10 years old 6% 3 Tenure Types (%): Owned Leased PPP/PFI Other Condition Ranking - % of total in each category: A 26% 12 B 74% 35 C 0 0 D 0 0 Functional Ranking - % in each category: A 23% 11 B 77% 36 C 0 0 D 0 0 Quality Ranking - % in each category: A 62% 29 B 38% 18 C 0 0 D 0 0 Space Ranking - % in each category Empty Underused Fully used Overcrowded Backlog Cost ( m): Clinical areas Non Clinical Areas Low Risk Items Moderate Risk Items Significant Risk Items High Risk Items Total Backlog Estimated capital receipts from property disposals over the next 5 years % of the estate (by area) surveyed in last year % of the estate (by area) surveyed in 5 years Average SCART Score: Energy Consumption (GJ) Heated Volume (100m 3 ) Energy Performance (GJ/100m 3 ) CO 2 Emissions (000's Tonnes) Water Consumption (m3/m2) Waste Volume (Tonnes): Waste Recycled (Tonnes) Managerial Technician Number of Estates & Facilities Staff

47 1.9 i. NHS Fife Premises Status Summary Name Physical Condition Statutory Compliance Functional Suitability Space Utilisation Quality Tenure Status Adamson Hospital B B A F A Owned Occupied Cameron Hospital B B B F B Owned Occupied Forth Park Maternity Hospital C C C E C Owned Vacant Glenrothes Hospital B B B F B Owned Occupied Lynebank Hospital B B B F B Owned Occupied Netherlea Hospital C C C E C Owned Vacant Queen Margaret Hospital B B B F B Owned Occupied Randolph Wemyss Memorial Hospital B B B F B Owned Occupied St Andrews Community Hospital A A A F A PPP Occupied Stratheden Hospital B B B F B Owned Occupied Victoria Hospital B B B F B Owned Occupied Victoria Hospital, Phase 3 A A A F A PPP Occupied Whyteman s Brae Hospital B B B F B Owned Occupied Townhill Day Hospital B B B F B Owned Occupied Weston Day Hospital B B B F B Owned Occupied Bennochy Medical Centre B B B F B Leased to Others Occupied Cardenden Health Centre B B B F B Owned Occupied Cupar Health Centre B B B F B Owned Occupied Dalgety Bay Health Centre B B B F B Owned Occupied Glenwood Health Centre C C D E C Owned Vacant New Glenwood Health Centre A A A F A Owned Occupied Kelty Health Centre B B B F B Owned Occupied Kennoway Health Centre B B B F B Owned Occupied Kincardine Health Centre B B B F B Owned Occupied Kinghorn Health Centre B B B F B Owned Occupied Kirkcaldy Health Centre B B B F B Owned Occupied Leven Health Centre B B B F B Owned Occupied Linburn Road Health Centre B B B F B Owned Occupied Lochgelly Health Centre B B B F B Owned Occupied Masterton Health Centre B B B F B Owned Occupied Oakley Health Centre B B B F B Owned Occupied Pitteuchar Health Centre B B B F B Owned Occupied Rosyth Health Centre B B B F B Owned Occupied Skeith Health Centre B B B F B Owned Occupied Valleyfield Health Centre B B B F B Owned Occupied

48 1.9 i. NHS Fife Premises Status Summary Name Physical Condition Statutory Compliance Functional Suitability Space Utilisation Quality Tenure Status Abbeyview Clinic B B B F B Owned Occupied Barrie Street Clinic C C C E C Owned Vacant Carnegie Clinic B B B F B Owned Occupied Cowdenbeath Clinic B B B F B Owned Occupied Dovecot Clinic B B B F B Owned Occupied Fair Isle Road Clinic C B C F C Owned Occupied Hayfield Clinic B B B F B Owned Occupied Kinglassie Clinic B B B F B Leased to NHS Fife Occupied Ladybank Clinic B B B F B Owned Occupied Rosewell Clinic B B B F B Owned Occupied Thornton Clinic B B B F B Leased to NHS Fife Occupied Cowdenbeath Dental Centre B B B F B Owned Occupied Cupar Dental Centre B B B F B Owned Occupied Glenwood Dental Centre B B B F B Owned Occupied Kirkland Dental Centre B B B F B Leased to Others Occupied Leslie Dental Centre B B B F B Owned Occupied Linburn Dental Centre B B B F B Leased to Others Occupied Fife College of Health B B B F B Part Leased to Others Occupied Finance Offices B B B F B Leased to NHS Fife Occupied Forth Child Development Centre B B B F B Leased to NHS Fife Occupied Gordon Cottage (Day Centre) B B B F B Owned Occupied Haldane House Assessment Unit B B B F B Owned Occupied Leven Child Assessment Unit B B B F B Owned Occupied Supplies Service/Transport Dept B B B F B Owned Occupied Hazel Avenue, 34/36 B B B F B Leased to Others Occupied Matthew Street, 18 B B B F B Owned Occupied Fraser Avenue, 76 B B B F B Leased to NHS Fife Occupied

49 1.9 ii GP Premises - Addresses Name Address Town Postcode Skeith Health Centre Crail Road, Cellardyke Anstruther KY10 3FF The Health Centre 12 Carswell Wynd Auchtermuchty KY14 7AW 31 High Street Strathmiglo KY14 7QA The Surgery Main Road Charlestown KY11 3ED Muiredge Surgery Merlin Crescent Buckhaven KY8 1HU 173 Stenhouse Street Cowdenbeath KY4 9DH 94 Main Street Crossgates KY4 8DF Nethertown Surgery Elliot Street Dunfermline KY11 4TF Newpark Medical Practice 163 Robertson Road Dunfermline KY12 0BL Hospital Hill Surgery Izatt Avenue Dunfermline KY11 3BA Millhill Surgery 87 Woodmill Street Dunfermline KY11 4JW Bellyeoman Surgery Bellyeoman Road Dunfermline KY12 0AE North Glen Medical Practice 1 Huntsman s Court Glenrothes KY7 6SX Cos Lane Surgery Woodside Road Glenrothes KY7 4AQ Inverkeithing Medical Group 5 Friary Court Inverkeithing KY11 1NU 30 High Street Aberdour KY3 0TR Nicol Street Surgery 48 Nicol Street Kirkcaldy KY1 1PH St Brycedale Surgery St Brycedale Road Kirkcaldy KY1 1ER Path House 7 Nether Street Kirkcaldy KY1 2PG The Surgery 27 Commercial Road Ladybank KY15 7JS The Surgery Anderson Drive Leslie KY6 3LQ Balmullo Surgery 1 Pitcairn Drive Balmullo KY16 0DZ 11 Main Street Leuchars KY16 0HB Benarty Medical Centre Lochleven Road Lochore KY5 8DA Markinch Medical Practice 19 High Street Markinch KY7 6ER Methilhaven Surgery 361 Methilhaven Road Methil KY8 3HR The Surgery 118 High Street Newburgh KY14 6DA Tayview Medical Practice 16 Victoria Street Newport-on-Tay DD6 8DJ 21 Dougall Street Tayport DD6 9JG Pittenweem Surgery 2 & 9 Routine Row Pittenweem KY10 2LG The Surgery Wadeslea Elie KY9 1EA Primrose Medical Centre 3-5 Jutland Street Rosyth KY11 2ZL The Cannons Ajax Way Methil KY8 3RS

50 1.9 iii Dental Practice Premises - Addresses Name Address Town Postcode Dental Practice 9 East Shore Anstruther KY10 3AB Dental Practice 23 Backdykes Auchtermuchty KY14 7AB Dental Practice 2 Brown Street Buckhaven KY8 1JW Dental Practice 100 Sommerville Street Burntisland KY3 9DH Dental Practice 154 Station Road Cardenden KY5 0BL Dental Practice 1 Foulford Street Cowdenbeath KY4 9NB Dental Practice 98 Bonnygate Cupar KY15 4LB Dental Practice 12 Crossgate Cupar KY15 5HH Dental Practice 17 Kirkgate Cupar KY15 5AN Dental Practice 34 Crossgate Cupar KY15 5AS Dental Practice 7 Moray Way North Dalgety Bay KY11 9NH Dental Practice 7 Bay Centre, Regent's Way Dalgety Bay KY11 9NH Dental Practice 3 Comely Park Dunfermline KY12 7HU Dental Practice 32 Canmore Street Dunfermline KY12 7NT Dental Practice 15 Comely Park Dunfermline KY12 7HU Dental Practice 38 Canmore Street Dunfermline KY12 7NT Dental Practice Century House, East Port Dunfermline KY12 7JA East Wing Surgery 32 Maygate Dunfermline KY12 7NH Dental Practice 6a High Street Dunfermline KY12 7AR Dental Practice 18 St Margaret Street Dunfermline KY12 7PE Dental Practice Lorne House, East Port Dunfermline KY12 7JB Dental Practice 32 Maygate Dunfermline KY12 7NH Dental Practice 16 Park Avenue Dunfermline KY12 7HX Dental Practice 16 New Row Dunfermline KY12 7EF Dental Practice 8 Abbey Park Place Dunfermline KY12 7PD Dental Practice 11 Culzean Place Glenrothes KY7 4RX Dental Practice Unit 5c, Heritage House, North Street Glenrothes KY7 5SE Dental Practice Huntsman's Court, 2 Huntsman's Road Glenrothes KY7 6SE Dental Practice 4 North Street Glenrothes KY7 5NA Dental Practice 15 Jubilee House, Pentland Park Glenrothes KY6 2AH Dental Practice Unit 3c, Heritage House, North Street Glenrothes KY7 5SE Woodside Dental Practice Balbirnie Road Glenrothes KY7 5ED Dental Practice 111 High Street Inverkeithing KY11 1NW Dental Practice 74/76 Main Street Kelty KY4 0AE Dental Practice 10 High Street Kincardine FK10 1RJ Dental Practice 100 High Street Kinghorn KY3 9UE Dental Practice Beauly Place Kirkcaldy KY1 1YA Dental Practice 1 Charlotte Street Kirkcaldy KY1 1RN Dental Practice 25 Links Street Kirkcaldy KY1 1QE Dental Practice 5 Park Road Kirkcaldy KY1 3EL Dental Practice 1/7 Redburn Wynd Kirkcaldy KY1 1HZ Dental Practice 5 South Fergus Place Kirkcaldy KY1 1YA Dental Practice 4 Viceroy Street Kirkcaldy KY2 5HT Dental Practice 308 High Street Leslie KY6 3AT Dental Practice Albion House, Shorehead Leven KY8 4NR Dental Practice 3 Parkhill Terrace, Commercial Road Leven KY8 4LB Dental Practice Banbeath Court, Banbeath Leven KY8 5GY Dental Practice 68 Bank Street Lochgelly KY5 9QN Dental Practice 242 Wellesley Road Methil KY8 3BW Dental Practice 53/55 High Street Newburgh KY14 6AH Dental Practice 26 Union Street Newport-on-Tay DD6 8BP Dental Practice 1 Parkgate Rosyth KY11 2JW Dental Practice 122 Queensferry Road Rosyth KY11 2QZ Dental Practice 2 Lockhart Place St Andrews KY16 9XB Dental Practice 4 St Mary's Place St Andrews KY16 9UY Dental Practice Eden House, 35 Largo Road St Andrews KY16 8NJ Dental Practice 13 Castle Street Tayport DD6 9AE Dental Practice 10 Viewfield Terrace Dunfermline KY12 7HZ

51 1.9 iv Optician Premises - Addresses Name Address Town Postcode Govan Opticians 6a Shore Street Anstruther KY10 3EA PLM 19 Rodger Street Anstruther KY10 3DU Ferrier & MacKinnon 129 High Street Burntisland KY3 9AA Ferrier & MacKinnon 148 High Street Cowdenbeath KY4 9NH Optical Express 319 High Street Cowdenbeath KY4 9QJ McLeish, McPhee & Laing 24 Bonnygate Cupar KY15 4LE PLM 40 Crossgate Cupar KY15 5HS Walkers Opticians 5 Moray Way North Dalgety Bay KY11 9NH Asda Opticians Halbeath Retail Park, Halbeath Road Dunfermline KY11 4LP Boots Opticians Unit 7, Kingsgate Centre Dunfermline KY12 7QA Gunn & Galbraith 49 Queen Anne Street Dunfermline KY12 7BA Ferrier & MacKinnon Chalmers Street Dunfermline KY12 8AT Specsavers 131 High Street Dunfermline KY12 7DR Vision Express Unit 18, Kingsgate Centre Dunfermline KY12 7QU Tesco Opticians Calais Farm Road, Duloch Park Dunfermline KY11 4QX Spex Direct(Scotland)Ltd 3a Dickson Court, Elgin Street Dunfermline KY12 7SG For Eyes Opticians 12 Abbeyview Dunfermline KY11 4HA Boots Opticians 6 Lyon Way Glenrothes KY7 5NW PLM 49 Bighty Avenue Glenrothes KY7 5AD Rach Optometrists 8 Lyon Square Glenrothes KY7 5NR Specsavers 32 Lyon Way Glenrothes KY7 5NN Value Specs 48 Unicorn Way Glenrothes KY7 5NU Ferrier & MacKinnon 14 High Street Inverkeithing KY1 1NN Carrick Opticians 23 Main Street Kelty KY4 0AA Asda Opticians Carberry Road, Mitchelston Estate Kirkcaldy KY1 3NU A & S M Pattison 2 Park Place Kirkcaldy KY1 1XL The Eye Centre 65 High Street Kirkcaldy KY1 1LN The Spectacle Shop 35 Whytescausway Kirkcaldy KY1 1XF Boots Opticians 129 High Street Kirkcaldy KY1 1LR Vision Express Unit 7, Mercat Centre Kirkcaldy KY1 1NX PLM 138 St Clair Street Kirkcaldy KY1 2BX Optical Express 137 High Street Kirkcaldy KY1 1JD Specsavers Opticians 201 High Street Kirkcaldy KY1 1JD D T Hay 56 High Street Leven KY8 4NA McLeish, McPhee & Laing Shorehead Leven KY8 4NR PLM 44 North Street Leven KY8 4LY Specsavers Opticians 68 High Street Leven KY8 4NA Optical Express 26 High Street Leven KY8 4LX Carrick Opticians 19 Bank Street Lochgelly KY5 9QQ McLeish, McPhee & Laing 285 Wellesley Road Methil KY8 3BN Ferrier & MacKinnon 3-5 Cupar Road Newport-on-Tay DD6 8AF I Sight 7 Station Road Oakley KY12 9QF The Eye Centre 10 Aberlour Road Rosyth KY11 2RD Boots Opticians 9 Bell Street St Andrews KY16 9UR Govan Opticians 83 South Street St Andrews KY16 9QW Duncan & Todd Optometrists 147 Market Street St Andrews KY16 9PF Specsavers Opticians 169 South Street St Andrews KY16 9EE Govan Opticians 6a Shore Street Anstruther KY10 3EA PLM 20 Rodger Street Anstruther KY10 3DU

52 1.9 v Pharmacy Premises - Addresses Name Address Town Postcode M Jackson 30 High Street Aberdour KY3 0SW The Central Pharmacy Ltd 23 Rodger Street Anstruther KY10 3DU T&K Brown Ltd Shore Street Anstruther KY10 3AQ Rowlands Pharmacy 42 High Street Auchtermuchty KY14 7AP Rosewell Pharmacy 12 Benarty Square Ballingry KY5 8NR Your Local Boots Pharmacy Merlin Crescent Buckhaven KY8 1HJ Lloyds Pharmacy 239 High Street Burntisland KY3 9AQ B Johnston 191 Station Road Cardenden KY5 0BN Your Local Boots Pharmacy 187 Station Road Cardenden KY5 0BN Charlestown Pharmacy Ltd Charlestown Medical Practice Charlestown KY11 3ED Gordons Chemists 20 Broad Street Cowdenbeath KY4 8HY Boots the Chemist Ltd High Street Cowdenbeath KY4 9QW Wm Morrison Pharmacy 1-2 Raith Centre Cowdenbeath KY4 8PB Crail Pharmacy Ltd High Street Crail KY10 3TE The Co-operative Pharmacy 92 Main Street Crossgates KY4 8DF Rowlands Pharmacy Bonnygate Cupar KY15 4BY Lloyds Pharmacy 19 Crossgate Cupar KY15 5HA Boots the Chemist Ltd 2-6 St Catherine Street Cupar KY15 4BT Rowlands Pharmacy 12 Bay Centre, Regents Way Dalgety Bay KY11 9YD The Co-operative Pharmacy Douglas Street Dunfermline KY12 7EB The Co-operative Pharmacy 3 Abbeyview Dunfermline KY11 4HA Boots the Chemist Ltd High Street Dunfermline KY12 7DL JBB Dick Ltd 28 East Port Dunfermline KY12 7JB Lloyds Pharmacy 43 Bellyeoman Road Dunfermline KY12 0AE The Co-operative Pharmacy St Andrews Street Dunfermline KY11 4QG Asda Pharmacy Ltd Halbeath Retail Park Dunfermline KY11 4LP The Co-operative Pharmacy Elliot Street Dunfermline KY11 4TF Lloyds Pharmacy Unit 6, Block 1, Turnstone Road Dunfermline KY11 8JZ Alderston Pharmacy 6 Alderston Drive Dunfermline KY12 0XU Fisher Pharmacy (Dunfermline) Ltd 85 Woodmill Street Dunfermline KY11 4JN Dysart Pharmacy Unit 21, High Street Dysart KY1 2UG Elie Pharmacy 42 High Street Elie KY9 1DB Lomond Pharmacy The Cross, High Street Falkland KY15 7BU Lloyds Pharmacy 2 Glenwood Centre Glenrothes KY6 1PA JCW McIntyre 8 Cadham Centre Glenrothes KY7 6RU Your Local Boots Pharmacy Cos Lane, Woodside Road Glenrothes KY7 4AQ Superdrug Pharmacy 10 Falkland Gate Glenrothes KY7 5NS Dears Pharmacy 3 Glamis Centre Glenrothes KY7 4RH Boots the Chemist Ltd 14 Lyon Square Glenrothes KY7 5NR High Valleyfield Pharmacy Ltd Chapel Street High Valleyfield KY12 8SJ Lindsay & Gilmour 51 High Street Inverkeithing KY11 1NL Lindsay & Gilmour The Cross Pharmacy, 8 High Street Inverkeithing KY11 1NN The Co-operative Pharmacy 39 Main Street Kelty KY4 0AA Dears Pharmacy 60 Main Street Kelty KY4 0AE Lloyds Pharmacy 19 Bishops Court Kennoway KY8 5LA The Co-operative Pharmacy 31 High Street Kincardine FK10 4RJ Lloyds Pharmacy 63 High Street Kinghorn KY3 9UW Lomond Pharmacy 50 Main Street Kinglassie KY5 0XA Boots the Chemist Ltd High Street Kirkcaldy KY1 1NQ Lloyds Pharmacy 18 High Street Kirkcaldy KY1 1LU Lloyds Pharmacy 1 The Postings Kirkcaldy KY1 1HN Lloyds Pharmacy 28 Mid Street Kirkcaldy KY1 2PN St Clair Pharmacy 233 St Clair Street Kirkcaldy KY1 2BY Asda Pharmacy Ltd Asda Superstore, Carberry Road Kirkcaldy KY1 3NG Boots the Chemist Ltd Unit 11, Fife Retail Park, Chapel Level Kirkcaldy KY2 6QL Lloyds Pharmacy 222 Dunearn Drive Kirkcaldy KY2 6LE Lloyds Pharmacy 2 Viceroy Street Kirkcaldy KY2 5HT W Davidson & Sons Ltd 30 Commercial Road Ladybank KY15 7JS

53 Name Address Town Postcode Lloyds Pharmacy Anderson Drive Leslie KY6 3LQ Leuchars Pharmacy 14 Main Street Leuchars KY16 0HN Boots the Chemist Ltd 47 High Street Leven KY8 4NE T W Buchanan (Chemists) Ltd 30 Commercial Road Leven KY8 4LD Leven Pharmacy Commercial Road Leven KY8 4LD Rosewell Pharmacy Ltd 4 Bank Street Lochgelly KY5 9QQ The Co-operative Pharmacy 66 Bank Street Lochgelly KY5 9QN Rosewell Pharmacy Ltd 60 Lochleven Road Lochore KY5 8DA Lundin Links Pharmacy Ltd 2 Emsdorf Street Lundin Links KY8 6AB Markinch Pharmacy Ltd 53 High Street Markinch KY7 6DQ The Co-operative Pharmacy 303 Wellesley Road Methil KY8 3BS C Buchanan Ltd 345 Methilhaven Road Methil KY8 3HR W Davidson & Sons Ltd 40 High Street Newburgh KY14 6AQ Rowlands Pharmacy 16 Victoria Street Newport-on-Tay DD6 8DJ Oakley Pharmacy Ltd 14 Wardlaw Way Oakley KY12 9QH Pittenweem Pharmacy 7 Market Place Pittenweem KY10 2PH The Co-operative Pharmacy Castlandhill Road Rosyth KY11 2PZ Rowlands Pharmacy 6 Queens Buildings, Queensferry Road Rosyth KY11 2RA Wm Morrison Pharmacy 45 Largo Road St Andrews KY16 8PJ Boots the Chemist Ltd Market Street St Andrews KY16 9PE Rowlands Pharmacy 32 Castle Street Tayport DD6 9AF W Davidson & Sons Ltd 76 Main Street Thornton KY1 4AG Your Local Boots Pharmacy Ajax Way Methil KY8 3RD M Jackson 31 High Street Aberdour KY3 0SW The Central Pharmacy Ltd 24 Rodger Street Anstruther KY10 3DU T&K Brown Ltd Shore Street Anstruther KY10 3AQ Rowlands Pharmacy 43 High Street Auchtermuchty KY14 7AP