Asset Management Group MINUTE of MEETING of the NHS Highland Asset Management Group Board room John Dewar Building Assynt House Beechwood Park Inverness IV2 3BW Tel: 01463 717123 Fax: 01463 235189 Textphone users can contact us via Typetalk: Tel 0800 959598 www.nhshighland@.scot.nh s.uk Tuesday 21st July 2015 Present: Nick Kenton, Director of Finance & Chair (NK) Carol Marlin, Monitoring Accountant - (CM) Quentin Cox Consultant Orthopaedic Surgeon & ACF rep (QC) David Whyte, Interim Section Head, Medical Physics - (DW) Ian Scott, Clinical Lead - (IS) Linda Kirkland, Director of Quality Improvement & Interim Director of Operations Office - (LK) - VC Neil Stewart, Head of Procurement - (NS) Alex Javed, Service Manager, Labs & Radiology - (AJ) In Attendance: Kate Leishman, PA to Head of Estates (minute) (KL) Heather Cameron, Senior Project Manager Estates (HC) Iain Ross, Head of ehealth Infrastructure Services (IR) David Ross, Head of Estates Argyll & Bute (DR) Jan Baird, Director of Adult Care (JB) Gill McVicar, Director of Operations North & West (GM) -VC Welcome/Introductions: Nick Kenton welcomed the group & apologies were noted on behalf of; Alasdair Lawton, Michael Hall, Christina West, Bill Reid, Bruce Merchant, Deborah Jones, Eric Green, David Alston & George Morrison. 1. MINUTE OF THE MEETING HELD ON TUESDAY 23 rd JUNE 2015 The minutes were approved as an accurate record. 2. MATTERS ARISING 2:1 Lomond House CM had a scope of works & cost breakdown, the majority of the works are revenue costs as this is for refurbishment work it would only come under capital if it could be proven that the work had added value to the property. George Morrison was awaiting a surveyor s report which will project the value of the building after the work has been completed. 1
NK asked if there was to be a capital cost where this would come from & asked if there was a possibility that it could come from Estates budget. CM advised that she had not spoken to Eric Green about this but there is certainly no contingency for this in the Estates budget, HC confirmed this. Action: Approved & if any Capital cost will look to see if any available budget otherwise will have to default to Revenue. 2:2 QC raised concerns with the replacement of image intensifiers at Raigmore, in that in the paper & minute it was stated that newer models support procedures currently only carried out in Radiology, if newer ones were in place these could be used in endoscopy. QC s concern is usage levels & he wouldn t want to be in a position where cancellation of procedures happened due to the intensifiers being used in another area. This was noted by both AJ & DW & will be passed on to the relevant people. 2:3 A&B Mental Health Project NK explained that the stage 1 submission from Hubco is over the affordability cap, this was considered at the Project Board. There is also a potential plan b, which is to utilise space at the PFT hospital. So firstly the project board have written to Hubco to say the submission is rejected & this will hopefully facilitate a sit down meeting with them to go over the submission & get this under the affordability cap. This will cause delays in the project & means that we have had to come out of the Inverurie Hubco bundle & another bundle will have to be found, Badenoch & Strathspey & Skye Lochalsh & South West Ross projects being the most obvious. The existing facility is no longer fit for purpose & any remaining patient services will need to be relocated in the interim so as not to compromise patient care in any way. AMG previously authorised work to be carried out on Succoth Ward to facilitate moving of these patient services and it is anticipated that all patients will be moved from the existing facility by November 2015. 3. MONITORING REPORTS CM stated there was not much to report as it is still early in the financial year, there is still a deficit so actively seeking savings & ask that all keep CM updated on all spends/savings. NK clarified the deficit is the minus contingency of 157k on the report & there is also a risk that there will be a shortfall in disposals income of just over 300k. Overall there is therefore a risk of overspend and the position will be managed very closely. Percentage of budget spent at month 3 is 16%. QC asked why there was only a small amount of staff costs on the report as in previous years these had been considerably more. NK explained this was due to a different configuration following the retirement of 2 members of staff. CM also explained that Estates officers are able to charge their time directly to capital on Maximo rather than having specific staff costs. 4. CAPITAL REPORTS Due to access issues & a proposed change of format no Capital Reports were presented to the meeting. Action: New reports for next meeting. 2
5. INITIAL AGREEMENT FOR SKYE, LOCHALSH & SOUTH WEST ROSS RE- DESIGN AMG is asked to: Approve the Initial Agreement for the redesign of services in Skye, Lochalsh & South West Ross including building a new community hospital & resource centre Hub in Broadford & developing a Spoke facility in Portree. Agree that, subject to any amendments the Initial Agreement can now be submitted to NHS Highland Board for their approval on 11 th August & subject to their approval & any amendments onward to the Capital Investment Group for their consideration on 22 nd September 2015. GM reiterated that there would be no change in facilities until the new building is completed. Workshops are still ongoing & steering groups have been formed to address any issues the public have specifically concerns of those living in the north of the island. NK stated the projected capital costs need revised to take account of timescales as they appear to be based on current costs but construction inflation is much higher than 'normal' inflation so this will have a significant increase by 2018/19. QC bed modelling - highlight that the current beds are not used to capacity otherwise it could look like beds are closing to save money. Staff levels should also be looked at closely particularly at night. Also be clear on the geographical scope of the modelling i.e. that it includes Wester Ross and any intention to relive pressure at Raigmore. NK the cover paper read as re-design in Skye only there is a need to highlight in the cover paper that the project covers Lochalsh & South West Ross as well as Skye - illustrates that Broadford is more central. NK was also concerned about the Cabinet Secretary s list of requirements (p45) GM & HC gave assurances that these requirements will be met & are currently being addressed & worked on. NK also asked for clarity on how the decision about the spoke services will be made. QC p5 of cover paper seemed to conflict with later financial section. It needs to be clear that savings from reduced running costs are to be re-invested in community services. QC had a query over X-Ray provision in Portree he felt that he'd read somewhere in previous papers that it was a problem that patients had to travel for X-ray to Broadford yet this is what we're proposing in future. It needs to be clear on the minor injuries/a&e at Portree and that the proposals are not a downgrade. NK asked about the specific impact on staff; GM explained more detailed plans will go into the OBC/FBC. GM current staff will be given the option of working at the new site or in community; current & new vacancies will be temporary posts as it s difficult to foresee what will happen in 3 years. NK queried the adequacy of project resource (and specifically if GM was comfortable with continuing as Project Director as well as Director of Operations). GM & HC this will depend on bundling to an extent, if bundled we might expect an overall bundle project director. This will be reviewed & discussed at the next project meeting, for noting the Estates project team will have an admin support member of staff shortly. 3
NK questioned the timetable as the IA states the OBC is due in November 2016 which is quite far ahead. GM advised that this had recently been reviewed & they had been asked to bundle the projects together by Christmas. Badenoch & Strathspey is also to be reviewed. Action: Approved to go to the board. 6. UPDATE ON EHEALTH CAPITAL ALLOCATION 2015/16 The ehealth Department was allocated 1,300K capital funding for 2015/16. A further 85K of capital funding was made available to support the Detect Cancer Early programme giving a total ehealth allocation for 2015/16 of 1,385K. This capital was to be used to support the service by funding ehealth priorities across NHS Highland. Along with the Detect Cancer Early programme there are 5 other schemes, Renal Replacement, Laboratory Replacement, Digital Ward, Patient Management System (PMS) & Keeping the Lights On. QC asked about the PMS work that has already been undertaken & the increased costs due to more work than anticipated. IR The previous work was phase 1 of the implementation of PMS they are now moving into phase 2 which is the clinical aspect of PMS & this had always been planned but was delayed due to the issues of phase 1. They are in discussions with the company around the difficulties & issues of phase 1, there will be no monetary refund from the company but NHSH have got a significant amount of additional support. Lessons learnt by NHS Highland have been passed on to other areas & they have benefited from this. NK commented that whilst most of the proposed spend seemed to be a no-brainer he still felt that it lacked a strategic context and a clarity regarding the decision-making process. IR advised that this will be the last year AMG will see this kind of paper as going forward there will be a wider ehealth strategy & linked to the capital allocation. Action: Noted. 7. REQUEST FOR NEW OFFICE SPACE IN CFHS NHS Highland s new Technology Enabled Care Service is now partnering with Prof Angus Watson s research & development team & HIE to deliver a new Digital Health Hub, based at the Centre for Health Science. The service is supported by the Chief Executive, Chief Operating Officer & the Director of Adult Care. This service, as well as deploying Telehealth at scale within the Highland community will bring all of NHS Highland s digital health initiatives into one entity that will avoid silo working & duplication across the organisation & have a strong academic evaluation base that will promote, guide & encourage innovation both within the community and our organisation. This co-location within the Centre for Health Science is vital part of the strategy to provide a collaborative, innovative space that will be NHS Highland s new front door to Digital Health engaging academics, clinicians, SME s and the Highland community. This is a new converged service which will initially accommodate 11 staff, 7 of which are new, externally appointed staff, the majority due to start on the 27 th July 2015. There is no alternative accommodation within NHS Highland/Council. 4
The one year lease requested is to be funded by the NHSH TEC Service which in turn, is funded centrally by the Scottish Government. This however, is a three year programme, with additional funding due each year until 2018 and it is expected that the lease would be renewed on a yearly basis to 2018 as funding is confirmed. No core NHSH funding is to be used for accommodation purposes. The one year lease is 9,657.74 from 27 th July 2015 to the 27th July 2016. Renewal will be via joint HIE/TEC funding in subsequent years. QC asked if this had come to AMG due to being a property issue even if it came under Revenue costs, NK confirmed this to be the case as AMG deal with property & Capital. NK pointed out the lateness of the request & stated that this should have been submitted the AMG much further in advance due to audit purposes, JB expressed her apologies for this. CM advised that Barbara Milne (BM) in finance is the person who deals with leases so she would advise that JB got in touch with BM to ensure no potential issues had been missed. CM also advised that non recoverable VAT is payable from HIE & she wasn t sure if this had been included in the costs JB will check this & speak to BM. Action: Approved in principle. 8. A.O.C.B. HC - Update on timescales for Outline Business Case, we ll need to do one joint case for Badenoch & Strathspey & Skye, Lochalsh & South West Ross we will attempt to meet the earlier B&S timescales which means completing Outline Business Case at the end of August 2016. If this can be brought forward we ll try to do that however the timescales for Badenoch & Strathspey were informed through discussion with hubco so we wouldn t want to set an unrealistic target. NK - this highlights the need to move patients out of the old mental health unit at Lochgilphead as this is likely to be included in the bundle & this would mean a delay to that project. There being no other business the meeting was closed. Date of Next Meeting Tuesday 18 th August 2015 2pm Venue: Board room John Dewar Building Agenda items & papers must be submitted by 12 noon on Monday 10 th August 2015. 5
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