Revised Estate Strategy March 2012

Transcription

1 Health South Central Ambulance Service NHS Trust Revised Estate Strategy March 2012

2 Contents Document Quality Management...4 Executive Summary...5 Where are we now?... 6 Where do we want to be?... 7 How Do We Get There? Introduction South Central Ambulance Service Trust Profile Geography and Demography Where are We Now? Taking Healthcare to the Patient Current Service Performance Current Estate Profile Changes since 2009 Strategy Current Projects in Development Recent and Ongoing Disposals Age Profile Six Facet Classifications Ambulance Stations Headquarters/Control Centres Education and Training Facilities Fleet Maintenance Facilities Commercial Services Environmental Impact assessment Where Do We Want to Be? National Drivers for Change SCAS Trust Strategy SCAS Operational Structure Ambulance Stations Headquarters and Emergency Operations Centres Training facilities Fleet Maintenance Facilities March 2012 Page 2

3 3.8 Commercial Services Environmental Strategy How Do We Get There? Disposals Ambulance Stations/Resource Centres Headquarters/Control Centres Training Facilities Fleet Maintenance Facilities Commercial Services Indicative Project Plan Indicative Capital Investment Plan Disposals programme Impact of Investment on Estate Conclusion...52 March 2012 Page 3

4 Document Quality Management Title File ref Revised Estates Strategy C:\Documents and Settings\kleeder\My Documents\1 Bath\Stella Tonks\ SCAS Rev Estate Strategy.doc Date March 2012 Prepared by Checked by Stella Tonks Lesley Powell March 2012 Page 4

5 Executive Summary South Central Ambulance Service NHS Trust (SCAS) was formed on 1 July 2006 from a merger of the former Hampshire, Royal Berkshire, Oxfordshire and Buckinghamshire element of the Two Shires Ambulance Service. The Trust serves a resident population of 4 million people. The area covered has a geographic area of 4,600 square miles. Five years on the Trust is one of the country s leading ambulance services. In , the Trust provided: The fastest response to A8 life threatening emergencies High levels of clinical performance against five national clinical performance indicators hear and treat and see and treat advice and treatment for 43% of 999 callers Strong financial governance consistently achieving its financial duties The Trust s achievements were recognised by the award of Ambulance Trust of the Year at the 2011 Health Business Awards ceremony in December The Trust s strategy seeks to take advantage of the new opportunities that may arise through the NHS reforms outlined in the Government s White Paper Equity and Excellence: Liberating the NHS (2010). In particular, this includes expanding the role of the existing Emergency Operations Centres as a Single Point of Access and gateway for patients to NHS and Social Services. The Trust is currently seeking Foundation Trust status as the next stage of its organisational development. The Trust s Estate Strategy is therefore set within this overarching strategic framework. It follows the established DH guidance for the preparation of Estate Strategies and is organised into three sections addressing the questions Where are we now?, Where do we want to be? and How do we get there? Where are we now? This stage examines the current position and performance of the Trust in relation to the service it provides and the estate used. The original estate strategy in 2007 established a baseline against which the development of the strategy could be measured over time by means of comparison against estate performance indicators. The section documents the progress made in achieving the stated aims set out in the previous strategy and explains the barriers to progress where relevant. Where do we want to be? In this section, the long term service and strategic aims of the Trust are summarised and form the best current vision for future services, to allow the further development of the estate strategy and the delivery of estate performance targets. Since 2009, the prevailing economic situation has affected the Trust s ability to progress its previous priorities and a number of important schemes remain to be implemented. The current priority areas are identified. How Do We Get There? The document concludes by describing a range of prioritised options to enable the Trust to achieve these targets, including outline programmes for projects and capital costs of the developments. March 2012 Page 5

6 Where are we now? The Estates Strategy approved by the Trust Board in March 2009 set out the strategy for the 5 years to 2013/14 and set out a clear path of investment to meet the most pressing operational and strategic priorities. Major capital schemes under way in 2009 were concluded to reconfigure the Headquarters and Control Room function with the establishment of Northern House in Bicester and Southern House in Otterbourne, near Eastleigh. The establishment of the SCAS Hazardous Area Response Team (HART) in achieved a key strategic and operational objective. The team is located in the new Winchester and Eastleigh Resource Centre in Eastleigh, a development that has also enabled the vacation and future disposal of Winchester Ambulance Station, subject to the judicial review process following the recent grant of planning permission. The Trust progressed the implementation of the Make Ready initiative with facilities established at key locations across the four counties. Make Ready, whereby vehicles are prepared and delivered to an Ambulance station to an operational standard, has reduced vehicle downtime. The investment carried out since 2009 has continued to improve the condition of the Trust s estate. Currently: Just under half of the estate is less than 36 years old (48%) 28% of floor area falls below acceptable standards for physical condition. 16% of floor area is not considered functional compared with 44% in 2009 a very significant improvement. The proportion of the estate that is overcrowded has reduced from 43% in 2009 to 24%. Quality standards are improving but there are large key sites that impact on the overall rating resulting in just under a third of the estate being below standard 23% falls below acceptable standards for statutory and non statutory standards. 23% of the estate is considered to be below standard in terms of energy efficiency. Changes since the preparation of the original estate strategy are summarised in the table below. Facet /12 Physical Condition: % below Category B 43 44* 28 Functional suitability: % below Category B Space Utilisation: % Overcrowded Quality: % below Category B 37 41** 30 Statutory/non statutory standards: % below Category B 43 44*** 23 Energy: % below Category B *Note: 7 properties in 2007 that were acceptable for physical condition were disposed of by 2009 **Note: 8 properties in 2007 that were acceptable for quality were disposed of by 2009 March 2012 Page 6

7 ***Note: 8 properties that were acceptable for statutory requirements were disposed of by 2009 The figures above demonstrate the significant improvement in the quality of the Trust s estate over the past five years. Notwithstanding this improvement, a number of schemes proposed in the 2009 strategy have been delayed due to the financial climate and uncertainties arising from the future restructuring of the NHS. In particular, this has affected the proposed development of the South East Hampshire (Portsmouth) Resource Centre and the Milton Keynes Resource Centre. The prevailing economic conditions have also affected the timeline for disposal of surplus property. Where do we want to be? The Trust s long term vision is to continue the transformation from a traditional ambulance service where patient conveyance rates are historically high (nationally) to a service providing timely assessment, safe treatment and quality care at a location appropriate to the needs of the patient. This is encapsulated in the phrase Right care, right time, right place. In partnership with others, the Trust will be providing a Single Point of Access (SPA) for urgent health and social care across the NHS South Central region. The Trust s concept of the Single Point of Access is a Health Hub which integrates the emergency service with the three digit 111 urgent care service, NHS Direct (NHSD), social care and GP Out of Hours (OOH) into a wider directory of services that will channel demand away from the 999 service. The Trust believes that it is well placed to take a lead role in urgent care provision and within 5 years SCAS aims to be the Health Hub and Single Point of Access for NHS services across the region. The estate strategy is being revised against a background of major changes to the commissioning structure in the NHS. It is also being developed in parallel with the Trust s application to become a Foundation Trust, expected to be confirmed in early The Trust s continuing aims as set out in the Integrated Business Plan are: To deliver clinical excellence by improving clinical outcomes, ensuring patient safety and providing a positive patient experience To achieve operational excellence by achieving response times performance standards, resilience and efficiency To deliver effective stakeholder relationships by developing whole system solutions and seamless pathways of care To deliver sound governance, value for money and a strong financial standing To provide leadership, staff engagement and a learning culture To develop further the portfolio of commercially viable and high quality non emergency commercial contracts The Trust has recently undertaken a review of its operational and clinical structure and has implemented key elements of this. Front line staff have been reorganised into teams of about 15 plus a Team Leader and Clinical Mentor. The front line Team Leaders are led by Area Managers covering geographical areas aligned to current commissioning arrangements as follows: March 2012 Page 7

8 Portsmouth Oxfordshire Southampton Buckinghamshire Hampshire Milton Keynes Berkshire Area Managers are led and supported by two Area Directors. The Area Directors cover a Northern (Oxfordshire, Buckinghamshire & Berkshire) and a Southern (Hampshire) cluster of Area Managers. The delivery of front line patient care is supported by the Operational Support Department. The Department is responsible for Fleet, Make Ready, the Central Logistics Unit (CLU), equipment provision and consumables. It also leads on Resilience, Emergency Preparedness, HART, and the Air Ambulance Operation. The future configuration of the estate is designed to support the structure outlined above. For the estate, the overarching strategy remains that of a hub and spoke model with divisional variations according to local needs. The ability to progress the investment plan set out in the 2009 Estate Strategy depended in the main on the ability to realise cash from disposals. During the period since the estate strategy was completed in March 2009 the financial climate has deteriorated significantly. This has affected the planned income stream as the difficult property market has slowed the cash expected from disposals. The sale of the Trust s site at Battle Hospital in Reading has been the main casualty of the prevailing economic climate. How Do We Get There? It is intended that the service direction outlined in the previous section will be worked up into potential development options across the estate. Ambulance Stations (Northern) Buckinghamshire Recommendations: That the Trust consider how best to maintain operational capability at Bletchley and Milton Keynes until a decision can be made on whether to proceed with the Milton Keynes Resource Centre That a business case be prepared to examine the merits of providing a more suitable location for the South Bucks hub based at High Wycombe Oxfordshire Recommendations: That a replacement facility for Oxford City is developed in the longer term. In order to improve accessibility the preferred location would be close to the Peartree roundabout on the A34. March 2012 Page 8

9 Berkshire Recommendations: A business case is prepared to assess the options for the Reading and Bracknell area in the longer term Consider the provision of further standby points in the Tuns area of Slough and on the Berkshire/Bucks border Ambulance Stations (Southern) Hampshire Recommendations: The replacement facility for Portsmouth, Gosport, Fareham and Havant is progressed as a matter of urgent priority. The number of serviced stand by points should be increased. Headquarters/Control Centres Control centres Recommendations That the use of space at the Wokingham Emergency Operations Centre be reviewed during 2012 following short term extension of the lease In view of the likely expansion of the NHS 111 business the Trust should investigate the options of additional space at Bicester and Otterbourne Training Facilities Recommendations Consider options for the long term replacement of Heyford, currently on a short lease pending redevelopment of the site Include education facilities in the new South East Hants (Portsmouth) Resource Centre to relieve pressure on Nursling That the Trust confirms or otherwise the viability of a Berkshire training centre. If a Berkshire Centre is agreed then a feasibility study should be undertaken into potential locations Consider options for the provision of training in the Newbury area Fleet Maintenance Services In house workshops should be strategically located in areas where they can give support to the maximum number of vehicles. These locations include Southampton, Portsmouth, Reading Oxford, Stoke Mandeville and Milton Keynes. The proposal to re provide the Battle hospital operational capability is being updated in the light of the delay in achieving the disposal of this property. Options for the replacement of the Motorcare facility at Battle are currently under consideration. Amongst the options being considered are: March 2012 Page 9

10 Relocation of Motorcare workshop to a stand alone facility in the vicinity of the A33/M4 Relocation of Motorcare workshop to location as above with other service e.g. radio fit out or driver training Merge Motorcare, Oxford City and Stoke Mandeville workshops retaining Bletchley as a satellite and relocate to the High Wycombe area In the short term, the intention would be to reprovide the Motorcare facility in a location in the M4/A33 corridor for a period of five years. The Trust should consider strategic partnerships with other blue light services and/or external maintenance providers in areas remote from the internal workshops. Central Logistics Unit (CLU) The existing facility is currently located at Southampton (Nursling). The revised strategy for Fleet/Equipment confirms that the current location is not optimal and that a more central location is required for a distribution hub. Possible locations are in the High Wycombe area or A34. Logistics (Transcare) The service currently located at Battle Hospital will require to be relocated when the site is sold. Options for the future location are currently under consideration. Patient Transport Services The Trust will continue to tender for PTS contracts as they fall due for renewal. PTS vehicles are usually co located with front line ambulances, however the general direction of travel is one of providing leased accommodation to provide flexibility should Service Level Agreements with PCTs be lost or won. PTS has a key part to play in the efficiencies of acute hospital trusts bed management by providing a responsive patient discharge service. The majority of current PTS contracts are not aligned towards this and it remains an area for further development. Make Ready Plans for the extension of Make Ready are to be considered in the following facilities: Eastleigh Indicative Project Plan Clearly, there are a number of estate related reviews and approved schemes to action and an indicative project plan has been developed to manage this process covering initial priorities including projects that were identified in the 2009 strategy and that have not been able to be progressed: 12/13 13/14 14/15 15/16 16/17 Replace Portsmouth AS Sale of Battle site and relocation of Fleet, PTS, Logistics Review proposals for Milton Keynes and Bletchley Replace Portsmouth AS Sale of Battle site and relocation of Fleet, PTS, Logistics Provide North Training Facility Replace High Wycombe AS Replace Oxford City AS Bracknell/Reading replacement March 2012 Page 10

11 Indicative Investment Plan An indicative investment plan is provided below which identifies known proposals for possible developments. 2012/ s 2013/ s 2014/ s Milton Keynes Resource Centre and Bletchley / s High Wycombe RC , / s Oxford City RC ,200 Battle PTS/Transcare Battle Fleet/radio/DT replacement Reading/Bracknell replacement North Training facility Portsmouth station 600 1, Minor Improvements EOC changes/ Total Expenditure ,800 Indicative disposals programme An indicative plan is provided below which identifies known proposals for disposal and potential capital receipts: 2011/ s 2012/ s 2013/ s Deanshanger 700 Banbury AS 350 Maids Moreton 193 Battle Hospital disposal 3,000 Totton 328 Portsea 300 Winchester AS 1, /15* 000 s Total Receipts 1, / s The Portsea ambulance station site was sold on 8 th December The purchaser of the Winchester ambulance station has now received planning permission and this will be completed in March 2012 subject to no challenges during the judicial review period. * Following the expected establishment of the South East Hampshire Resource Centre, it is expected that the Portsmouth, Gosport and Fareham sites will be disposed of in 2014/15. March 2012 Page 11

12 Impact of Investment on Estate The projected investment over the five year period will have the effect of reducing the percentage of the estate that is below standard as follows; 2012/ / 14* 2014/ /16** 2015/17+ Physical Condition: % below standard Functional suitability: % below standard Space Utilisation: % Overcrowded Quality: % below standard Statutory/non statutory standards: % below standard Environmental Management: % below standard *Reflects proposed establishment of the South East Hampshire Resource Centre and vacation of Battle Hospital site ** Reflects the impact of the new High Wycombe resource centre + Reflects the impact of the new Oxford resource centre Conclusion There have been major changes in the Trust s estate since the preparation of the original estate strategy in 2007 resulting in a significant improvement in the estate performance indicators and backlog maintenance issues. The delivery of a further tranche of proposed projects will continue to improve the condition and quality of the Trust s estate and support the overall future strategy of the Trust as it moves towards Foundation Trust status. March 2012 Page 12

13 1. Introduction 1.1 South Central Ambulance Service Trust Profile South Central Ambulance Service NHS Trust (SCAS) provides emergency 999 pre hospital and urgent care across the counties of Hampshire, Berkshire, Oxfordshire and Buckinghamshire with a resident population of 4 million people. The area covered has a geographic area of 4,600 square miles. The Trust sits within South Central Strategic Health Authority. The Trust is organised into two operational areas: Northern (covering Oxfordshire, Buckinghamshire and Berkshire) and Southern (Hampshire). The SCAS fleet comprises approximately 880 vehicles including emergency ambulances, rapid response cars and motorbikes as well as Patient Transport Service and specialist vehicles, including those used by the Hazardous Area Response Team. Vehicles are serviced and maintained by a number of in house workshop facilities in key geographical locations. In addition, the Trust provides a range of commercially viable services that complement the core business including: Patient Transport Service Community Equipment Loans Service Logistics Service Training Services The Trust employs around 2250 WTE staff and of these approximately 2000 are directly engaged in the delivery of services to patients. The Trust handles around 500,000 emergency 999 calls a year. The Trust s operating income for was 138 million, which consists of 111 million from the emergency core contract and the remainder from non emergency contracts. SCAS is commissioned by a Specialist Commissioner on behalf of three PCT clusters. March 2012 Page 13

14 1.2 Geography and Demography The four counties covered by SCAS contains a mixture of urban areas of high density population such as Portsmouth, Southampton, Reading, Slough, Oxford and Milton Keynes as well as large rural areas such as the New Forest, North Hampshire, West Oxfordshire and parts of Buckinghamshire. Across the region, there is significant variation in the population profile with the inner city areas having greater social deprivation whereas the rural areas often have a more elderly population. The Trust serves a relatively affluent population with life expectancy generally above the national average. Overall, the population in South Central is expected to increase by 3.2% between 2009 and 2012, particularly in the inner city areas of Portsmouth and Southampton. The population distribution is as follows (per PCT area) PCT Population Hampshire 1,285,900 Southampton 234,600 Portsmouth 196,200 West Berkshire (incl Reading) 292,500 East Berkshire 525,867 Oxfordshire 635,500 Buckinghamshire 479,000 Milton Keynes 228,450 TOTAL 3,878,017 March 2012 Page 14

15 2. Where are We Now? 2.1 Taking Healthcare to the Patient The publication of Taking Healthcare to the Patient in 2005 set an agenda for considerable change and improvement in ambulance services across England. There were 31 ambulance services in Following the publication of THTTP a series of mergers were carried out and there are now 12 Ambulance Service Trusts nationally. The twelve services have achieved improvement across a number of key areas including: Major advances in ambulance clinical education and training and the care provided to seriously ill patients Greater attention to the many patients who do not have a life threatening condition Consistently high patient satisfaction levels Significant improvement in the speed of answering 999 calls Significant improvement in technology, infrastructure and emergency preparedness 2.2 Current Service Performance SCAS is currently the highest performing ambulance trust in the country. Its achievements were recognised in December 2011 by the award of Ambulance Trust of the Year in the Health Business Awards. SCAS has continued to improve its non conveyance rates and is the national leader in the field with 42.5% of patients being treated without having to be transported to hospital. Performance indicators Since 1 April 2011, a new set of performance indicators has been introduced for all ambulance trusts in England. In addition to the previous indicators on fast response times for the most seriously ill patients, the new ambulance clinical quality indicators aim to show that ambulance services are using their clinical skills to treat patients or transport them to the most appropriate services. Response times for Category A calls (RED calls) have two targets. RED8 requires an emergency response to reach the incident with 8 minutes from the time the call is connected to the EOC. The national target remains 75%. RED19 indicates a performance target for a conveying response (ambulance or rapid response vehicle) to reach the incident with 19 minutes from the time the call is connected to the EOC. The national target is to respond to 95% of these calls. SCAS performance for the year to date by month is shown below. April 2011 May 2011 June 2011 July 2011 Aug 2011 Sept 2011 RED8 80.5% 78.8% 78.1% 75.6% 77.3% 76.3% RED % 96.3% 96% 95.1% 96.1% 95.9% Emergency 999 service demand on the Trust has increased year on year for the past 10 years and call volumes have risen from around 800 calls per day in April 2004 to over 1100 calls per day in April March 2012 Page 15

16 2.3 Current Estate Profile The Trust currently owns or leases 28 Ambulance Stations/Resource Centres, 3 HQ/Control centres plus additional standby points, aerial sites and support buildings. Oxfordshire Locations 1 Adderbury R.C, Oxon 2 Northern House HQ, Bicester 3 Kidlington R.C, Oxon 4 Oxford City R.C, Oxon 5 Didcot R.C, Oxon Buckinghamshire Locations 6 Milton Keynes A.S, Bucks 7 Bletchley A.S, Bucks 8 Stoke Mandeville A.S, Bucks 9 High Wycombe A.S, Bucks 10 Amersham A.S, Bucks 11 Chalfont A.S, Bucks March 2012 Page 16

17 Berkshire Locations 12 Newbury R.C, Berks 13 BCES (Theale), Berks 14 Battle site (Motorcare, Stores, Transcare), Berks 15 Reading R.C, Berks 16 Ambulance HQ, Berkshire 17 Bracknell R.C, Berks 18 Wexham A.S, Berks March 2012 Page 17

18 Hampshire Locations 19 Andover A.S, Hants 20 Whitchurch A.S, Hants 21 Basingstoke A.S, Hants 22 New Alton A.S, Hants 23 Southern House, Hants 24 Eastleigh & Winchester R.C. Hants 25 Petersfield A.S, Hants 26 Nursling, Hants 27 Ringwood A.S, Hants 28 Berrywood, Unit 3 & 4, Hants 29 Hightown A.S, Hants 30 Hythe A.S, Hants 31 Lymington A.S, Hants 32 Fareham A.S, Hants 33 Gosport A.S, Hants 34 Portsmouth A.S, Hants 35 Havant A.S, Hants March 2012 Page 18

19 2.4 Changes since 2009 Strategy Organisationally SCAS was organised into three Divisions in 2009: Berkshire; Oxfordshire and Buckinghamshire; and Hampshire. In 2011 the Trust moved to an Area structure and is now divided into two operational areas: North (Buckinghamshire, Oxfordshire and Berkshire) and South (Hampshire). The new organisational structure is discussed further in section HQ and Control functions At the time of the preparation of the 2009 strategy, the Trust was in the process of developing replacement HQ and control functions for the Oxfordshire and Buckinghamshire Division at Northern House in Bicester and for Hampshire Division at Southern House, Otterbourne. Both projects were concluded in Hazardous Area Response Team (HART) A key objective in the 2009 Estate Strategy was to establish the SCAS Hazardous Area Response Team (HART). The units are specially recruited and trained personnel who provide the ambulance response to major incidents. HART Vehicles at Winchester & Eastleigh Resource Centre HART units have now been established in twelve locations throughout England. These locations were identified within the Home Office Model Response plan and were based on risk assessment and threat levels as assessed by the security services. March 2012 Page 19

20 For SCAS the location had been determined as Southampton and the unit was required to be within a minute response time of Southampton Docks. A site to the north of Southampton was preferred, as it would enable better coverage for other secondary risk sites in the north of Hampshire i.e. Farnborough as well as Reading, Oxford, the motorway network and other strategic installations. Subsequently the Trust acquired a site in Eastleigh that also included replacement accommodation for the Winchester Ambulance Station and Eastleigh PTS. The Winchester and Eastleigh Resource Centre became operational in January Make Ready As proposed in the previous strategy the investment in Make Ready was completed with facilities now provided from the following locations: Bucks Oxon Berkshire Hampshire Bletchley Adderb ury Wexham Hightown Stoke Mandeville Didcot Bracknell Nursling Kidlington Reading Basingstoke Oxford City Newbury Portsmouth 2.5 Current Projects in Development South East Hampshire /Portsmouth Resource Centre A key priority arising from the 2009 estate strategy was the establishment of the South East Hampshire Ambulance Resource Centre enabling the replacement of some of the poorest estate in the Hampshire Division. The original business case was approved in March However, despite the Trust continuing with negotiations, the preferred site became unavailable because of the landlord deciding to accept an alternative offer. A further site was investigated but was not financially viable. Currently the Trust is exploring the possibility of a third site in Cosham but contingency plans exist for the investment of capital in the existing Portsmouth Ambulance Station in the short term Milton Keynes and Bletchley Resource Centre A further requirement of the 2009 Estate Strategy was the establishment of the Milton Keynes Resource Centre to include the current facilities at Milton Keynes and Bletchley. Due to the uncertainties arising from potential changes in commissioning arrangements by Milton Keynes PCT aligning itself with the Northampton cluster, the business case for the Resource Centre is currently on hold. As an interim solution works will be required to Bletchley. March 2012 Page 20

21 2.6 Recent and Ongoing Disposals Battle Hospital The main site due for disposal is Battle Hospital in Reading. The proposed sale of the Battle Hospital site has been subject to a number of delays. Legal advice has been obtained as to the possibility of selling the SCAS site separate from the other two parcels of land owned by the Royal Berkshire Hospitals NHS Trust. Due to poor access arrangements, the preferred way forward would be to act jointly with the hospital trust to effect a sale. Previous marketing of the site had identified a potential purchaser. However, subsequent enquiries by the potential purchaser have resulted in the identification of poor ground conditions with a consequent reduction in the amount offered. Functions requiring relocation are: Medical loans equipment loans base Motorcare Garage vehicle maintenance and repair Transcare the service transports mail, medical and other supplies, laboratory specimens and clinical waste for customers throughout Berkshire. Patient Transport Service Motorcare Garage Battle Hospital March 2012 Page 21

22 2.6.2 Winchester Ambulance Station The Winchester Ambulance Station site became surplus to requirement as a result of the establishment of the Winchester and Eastleigh Resource Centre. A sale has been agreed and the proposed purchaser received planning permission in December The sale will be completed in March 2012 subject to no challenges being received during the judicial review period Portsea Ambulance Station The sale of the site was concluded on 8 December Banbury Legal difficulties that had arisen with Oxfordshire County Council have now been resolved and the sale is expected to be progressed during Deanshanger The site will be remarketed in summer Totton The site will be remarketed in January 2012 after the successful removal of a legal covenant with Hampshire County Council. 2.7 Age Profile Where information is available, the age of buildings within the portfolio have been collated and the property age profile of the Trust s estate is provided in the histogram below: March 2012 Page 22

23 The change since 2009 reflects the investment in newer mostly leased facilities. 2.8 Six Facet Classifications The initial stage of the strategy process is to establish a baseline to reflect the current performance of the estate using Estatecode methodology. A description of each element is provided below. In each case the Estate has been scored by the Trust s Estates Team against each facet. Facet 1: Physical Condition Facet 2: Functional Suitability Facet 4: Quality Facet 5: Statutory & Non Statutory Requirements Facet 6: Environmental Management (Energy)* GJ/100m³ A As new (that is built within the past two years) and can be expected to perform adequately over its expected shelf life) Very Satisfactory, no change needed. A facility of excellent quality Building complies with all statutory requirements and relevant guidance 35 55/100m3 B Sound, operationally safe and exhibits only minor deterioration. Satisfactory, minor change needed A facility requiring general maintenance investment only Building where action will be needed in the current plan period to comply with relevant guidance and statutory requirements 56 65/100m3 March 2012 Page 23

24 C D X Facet 1: Physical Condition Operational but major repair and replacement will be needed soon that is within three years for building elements and one year for engineering elements Runs a serious risk of imminent breakdown Facet 2: Functional Suitability Not satisfactory, major change needed. Unacceptable in its present condition Facet 4: Quality A less then acceptable facility requiring capital investment. A very poor facility requiring significant capital expenditure or replacement Facet 5: Statutory & Non Statutory Requirements Building with a known contravention of one or more standards, which falls short of B Building areas, which are dangerously below B standard (for example they have been subject to adverse external inspection). Facet 6: Environmental Management (Energy)* GJ/100m³ 66 75/100m /100m3 Supplementary rating to C or D to indicate that nothing but a total rebuild or relocation will suffice (that is improvements are too impractical or to expensive to be tenable). * Estatecode 2001 NHS Estates states that for strategic planning purposes, Trusts can rank their site and/or building block based on energy usage per unit volume figures (without needing to carry out further surveys). This has been used in this case in order to bring together all the information collated by the former Trusts. Different codes are used for Facet 3: Space utilisation Classification E=empty U=under used F=fully used O=overcrowded Facet 3: Space Utilisation Empty or grossly underused at all times (excluding temporary closures) Generally under used; utilisation could be significantly increased A satisfactory level of utilisation Overcrowded, overloaded and facilities generally overstretched. Where available, 6 facet results are given below for the Trust s main sites i.e. HQ buildings, ambulance stations, courier/non patient transport depots and fleet maintenance facilities. Aerial sites and standby points are excluded. March 2012 Page 24

25 2.8.1 Physical condition A broad knowledge of the physical condition of the existing estate buildings, associated engineering services and external works is an essential factor in resource planning for any Trust. Overall Results A pie chart illustrating the results of this assessment by floor area is provided below, alongside the assessment results from the previous strategy in The assessment shows that the percentage of floor area that is below standard is now 28% compared with 44% in 2009 and 43% in Properties in condition C are: Oxford City Ambulance Station Reading Resource Centre Bletchley Ambulance Station Gosport Ambulance Station High Wycombe Ambulance Station Portsmouth ambulance Station The Battle Hospital site has been assessed as C/D. March 2012 Page 25

26 2.8.2 Functional suitability An assessment of building/departmental functional suitability has been carried out to determine how effectively buildings (or part of buildings) support the delivery of a specified service within the Trust. The key factors used to assess properties and departments include; space relationships, the provision of services, amenity for patients (and staff), location, environmental conditions and the property/departments overall effectiveness. Overall Results A pie chart illustrating the results of this assessment by floor area is provided below, alongside the assessment results of the same in Some 84% of the Trust s estate is now considered to be functionally suitable compared with 56% in 2009 and 26% in Properties in condition C are: Bletchley Ambulance Station Reading Resource Centre Gosport Ambulance Station Portsmouth Ambulance Station The Battle Hospital site has been assessed as C/D. March 2012 Page 26

27 2.8.3 Space Utilisation An assessment of the levels of departmental/building utilisation has been undertaken. The objective for the Trust is to hold no more space than is necessary to satisfy the needs of each facility s present function and planned requirements. Equally, premises should provide sufficient space to support the provision of first class health services to patients and facilitate the development of services to meet local need and national priorities. The ideal scenario is for properties to be fully utilised. Overall Results The following pie chart has been produced to identify broad brush rankings for all properties by floor area, alongside the assessment results of the same in The figures for space utilisation show that 18% of the estate is considered to be overcrowded, a major reduction compared with 43% in 2009 and 54% in Properties assessed as overcrowded are: Milton Keynes Ambulance Station High Wycombe Ambulance Station Reading Resource Centre Wexham Ambulance Station Gosport Ambulance Station Portsmouth Ambulance Station The Battle hospital site is considered to be under utilised. March 2012 Page 27

28 2.8.4 Quality An assessment of the quality of the estate takes into account three elements: amenity, comfort engineering and design. Overall Results The following pie chart has been produced to identify broad brush rankings for all properties by floor area, alongside the assessment results of the same in Just under a third of the estate (30%) is considered to be unacceptable in terms of quality compared with 41% in 2009 and 43% in This reflects that fact that a number of new or converted sites have come on stream since the previous estate strategy. In the context of an Ambulance Trust the quality of buildings generally affects staff rather than patients. A patient s experience of the physical environment from which Trust services are provided will be via the ambulance or patient transport. However, the provision of quality accommodation can greatly affect staff morale and therefore Trust performance. Properties in condition C are: Oxford City Resource Centre Bletchley Ambulance Station High Wycombe Ambulance Station Reading Resource Centre Battle Hospital site Gosport Ambulance Station Portsmouth Ambulance Station March 2012 Page 28

29 2.8.5 Statutory and non Statutory Requirements A high level assessment of each property has been undertaken looking at some of the higher risk issues relating to statutory compliance. Properties in Category C are: Oxford City Resource Centre High Wycombe Ambulance Station Nursling Resource Centre Fareham Ambulance Station Gosport Ambulance Station Portsmouth Ambulance Station The one property in Conditions D is: Battle Hospital site March 2012 Page 29

30 2.8.6 Environmental Management For the purposes of strategic planning Estatecode (NHS Estates 2002) provides the following energy rankings A GJ per 100 cubic metres; B 56 65; C 66 75; D ; Overall Results The following pie chart has been produced to identify broad brush rankings for all properties by floor area, alongside the assessment results of the same in Properties in Category C are: Oxford City Resource Centre High Wycombe Ambulance Station Nursling Resource Centre Fareham Ambulance Station Gosport Ambulance Station Portsmouth Ambulance Station The one property in Conditions D is: Battle Hospital site March 2012 Page 30

31 2.8.7 Backlog Maintenance Costs 1 Backlog maintenance cost is the cost to bring estate assets that are in poor condition in terms of their physical condition and/or compliance with mandatory fire safety requirements or statutory safety legislation, up to an acceptable condition. Each element of backlog is risk assessed to determine the likelihood that the risk will be realised and the severity of impact should failure occur, to give a risk categorisation on one of four bands, high, significant, moderate and low risk. Guidance issued by the former NHS Estates recommends that high and significant risk elements should be addressed as a priority as part of the estate investment planning process. The current backlog maintenance costs across the SCAS estate are: High Risk Cost Significant Risk Cost Moderate Risk Cost Low Risk Cost Total Cost 2,000 30, , , , Summary of changes in the estate The changes in the quality of the estate since the preparation of the original estate strategy in 2007 are summarised in the table below. Facet /12 Physical Condition: % below Category B 43 44* 28 Functional suitability: % below Category B Space Utilisation: % Overcrowded Quality: % below Category B 37 41** 30 Statutory/non statutory standards: % below Category B 43 44*** 23 Energy: % below Category B *Note: 7 properties in 2007 that were acceptable for physical condition were disposed of by 2009 **Note: 8 properties in 2007 that were acceptable for quality were disposed of by 2009 ***Note: 8 properties that were acceptable for statutory requirements were disposed of by 2009 The table indicates that significant progress has been made over the last five years in reducing the amount of poor quality estate. 1 SCAS ERIC returns 2010/11 March 2012 Page 31

32 Having established an overall picture of the estate, the issues facing the Trust with regard its main sites are examined below in terms of Ambulance stations Fleet Maintenance facilities Headquarters/control centres Commercial services Training facilities 2.9 Ambulance Stations The current situation with regard operational ambulance stations is described below Northern Area (Oxfordshire, Buckinghamshire and Berkshire) Stations with issues of poor condition and functionality are: Bletchley Ambulance Station Reading Resource Centre High Wycombe station is in poor condition and overcrowded. In addition Milton Keynes and Wexham Ambulance Stations are considered to be overcrowded. Oxford City is in poor condition Southern Area (Hampshire) Stations with issues of poor condition and functionality are: Gosport Ambulance Station Portsmouth Ambulance Station In addition, these two stations score poorly in terms of space utilisation, quality and energy management. Fareham scores badly for energy and statutory standards. March 2012 Page 32

33 2.10 Headquarters/Control Centres As discussed in section 3.3 the Trust has consolidated its Headquarters and control centre functions since the production of the previous estate strategy in The locations are shown below. Northern House in Bicester is now the main Trust Headquarters. The executive team transferred from Wokingham in It is also the base for the Northern Team. The former Headquarters building at Deanshanger remains vacant and is intended to be remarketed in Wokingham is still in use as an Emergency Operations Centre together with a number of corporate functions. The lease was due to expire in December 2011 but is currently under negotiation with a view to extending it to December The use of the building will be reviewed in Southern House in Otterbourne, provides accommodation for the EOC and South Area. Since July 2011, the three EOCs have been operating as one virtual centre. The common telephony platform, integrated with I/CAD now allows a SCAS call taker in any of the Trust's three EOCs to pick up a patient call from any location in the four counties of Buckinghamshire, Berkshire, Oxfordshire and Hampshire. March 2012 Page 33

34 2.11 Education and Training Facilities Education is provided for all staff throughout the Trust to enable the delivery of a range of courses, recruitment, development, assessment and teaching. Classrooms can be used for commercial purposes and meetings across the Trust. The issues impacting upon the delivery of training currently are: Increased staff numbers (expected to be maintained for at least 12 months) Use of training centres for Graduate Paramedics, Statutory, Mandatory, Updates training, Technicians, ECA, Continued Professional Development, Conflict Management, etc in all Education Centres has been increased and maintained for at least three years Lack of facilities for Driving across Trust. Lack of parking facilities for students, instructors and driving vehicles at current venues Long distances to travel within the Trust to reach Northern, Central & Southern Education Centres. The premises for exclusive Education Purposes are shown in the table below Heyford, Oxford Bracknell, Berks Wexham, Berks Nursling, Hants Reception Area Yes No No No Classrooms Shared 2 Educators Office 1 x2 Small No 1 Student Refreshment area Yes Yes Small No Yes Skills Room 1 No No 2 Small Office 1 2 No 1 Stores Limited Limited Limited Yes Toilets Limited Shared with station Shared with station Shared with station Car Parking 30 permissible but often more Shared with Station 12 Max Very poor Shared with Staff 24 but includes staff parking Student numbers Up to Max 12 Max 24 Max Staff Numbers Not possible 12 Heyford The accommodation at Heyford is a temporary facility and is on a 5 year lease at a former school on the decommissioned USAF base at Upper Heyford (Heyford Park). Plans for the overall redevelopment of the site by the North Oxfordshire consortium were finally approved in March 2011 so a longer term solution is required. Good teaching space to provide 90% of Trust requirements Short Term lease with a question mark over long term availability March 2012 Page 34

35 Nursling Although the facility at Nursling is new it does suffer from capacity constraints: Insufficient students classroom capacity Poor parking Regularly having to hire alternative premises Insufficient office space for all educators based at location Berkshire In summary the issues in Berkshire are: Training facilities spread over multiple sites No one site has sufficient ability to deliver all Education requirements Fleet Maintenance Facilities The SCAS fleet comprises approximately 880 vehicles including emergency ambulances, rapid response cars and motorbikes as well as Patient Transport Service and specialist vehicles. In house workshop support is currently provided from three main workshops at Nursling, Reading (Motorcare) and Oxford City with satellite workshops at Stoke Mandeville and Bletchley. There is also one vehicle commissioning unit (Eastleigh) and one Central Logistics Unit (Southampton). Radio fit out will shortly be moving to Whitchurch. The workshops provide maintenance for both emergency and non emergency vehicles. The Trust has a mixture of leased and owned vehicles. Where vehicles are leased the public sector financial rules mean that if a vehicle is maintained in house or in any public sector workshop the VAT paid on the lease cannot be reclaimed. The Trust recently achieved Van Excellence Accreditation from the Freight Transport Association. The main objective of the previous fleet strategy (2009) was to bring the fleet across all of the operational area up to an acceptable standard. In particular within the Northern area a high percentage of the fleet was overdue the replacement cycle recommendations. The fleet replacement programme was targeted to bring the Northern area in line with elsewhere. Part of the strategy was developing a SCAS wide standard for both vehicles and equipment and this is largely complete. A particular success has been the Make Ready function which has which has seen a reduction in the amount of time that vehicles are not available to respond due to missing/faulty kit. March 2012 Page 35

36 2.13 Commercial Services The Trust s commercial services include Patient Transport Service (PTS) Urgent Care Services (Out of Hours Services) Logistics Services Commercial Training Services Community Equipment Services (Berkshire) Patient Transport Services (PTS) PTS provides transport for non emergency patients requiring transport to, from and between healthcare units with the Trust and in some cases outside it borders. PTS services are subject to market forces with competition from other commercial operators. SCAS currently holds the NHS contracts for Patient Transport in all areas with the exception of Portsmouth Hospitals. The current locations for PTS are: Buckinghamshire PTS services are provided from various ambulance stations including: Bletchley Stoke Mandeville Chalfont St Peter Maids Moreton Amersham High Wycombe Oxfordshire The Oxfordshire service provides services to units throughout the Oxfordshire locality including Oxford Radcliffe Hospitals, Nuffield Orthopaedic Centre NHS Trust, NHS Oxfordshire Primary Care Trust and Oxford Health NHS Foundation Trust (formerly Oxfordshire and Buckinghamshire Mental Health Partnership NHS Trust). The service relies on the work of the voluntary Hospital Car Service, with volunteers taking patients to and from hospital. PTS vehicles are based at: Adderbury Resource Centre Oxford City Resource Centre Kidlington Ambulance Station Didcot Resource Centre Berkshire The current contract with the Royal Berkshire NHS Foundation Trust was renewed in PTS locations in Berkshire are: Newbury Resource Centre Bracknell Resource Centre Reading Resource Centre Transcare (Battle), Reading Wexham Resource Centre In addition, there are also PTS vehicles based at the Royal Berkshire Hospital, Reading, St Mark s Hospital, Maidenhead and Wokingham Hospital, Wokingham. March 2012 Page 36