Queen Margaret Hospital Steam Boiler Replacement

NHS Fife Estates, Facilities and Capital Services Queen Margaret Hospital Steam Boiler Replacement July 2014

1. Introduction In 2011, NHS Fife submitted an application for funding to the Health Facilities Scotland Carbon Reduction Programme for the replacement of steam boilers and associated plant and equipment at Queen Margaret Hospital. This application was on the basis of a supply of energy from the District Heating Network and proposed reductions in energy consumption, CO 2 emissions and energy and carbon cost savings. Since then, technical studies have been undertaken regards the feasibility of connecting the hospital to the District Heating Network and of providing heating and hot water on a stand alone basis. This update paper provides further information concerning the project to replace existing steam boilers and heat exchange equipment at Queen Margaret Hospital. The proposed investment in new plant and equipment at the hospital will also address a number of sustainability issues at the hospital including inefficiencies in existing plant and equipment and ensuring future provision of heating and hot water services. 2. Strategic Context 2.1. Organisational Overview 2.1.i. 2.1.ii. Organisation Profile and Vision NHS Fife provides strategic leadership and direction for all NHS services in Fife. It is accountable to the public and to the Scottish Government for all elements of the NHS system in Fife. It works with partners to improve the health of local people and the services they receive and to ensure the national clinical and service standards are delivered across the NHS system. NHS Fife is working to improve services with the involvement and support of the public, partners in other NHS Boards, Fife Council and voluntary agencies. NHS Fife will continue to inform and consult local people at the earliest possible stage on developments. As a large rural area with varied geography and several centres of population, there are particular challenges to meet the health needs of the people of Fife. The strategic vision has been to develop, with our partners, particularly Fife Council, integrated services accessible in as many localities as possible and, where hospital admission is necessary, to provide high quality facilities that enhance the care experience and improve recovery. Strategic Aims NHS Fife has identified the following strategic aims and goals to move the service forward in line with the vision. Delivery of NHS Fife Local Delivery Plan and the Balanced Scorecard; Develop effective working arrangements with community partners to deliver the Fife Community Plan; Improvement in health and wellbeing, and reduction of inequalities, in line with the five strategic outcomes of the Scottish Government; Pursuing the Scottish Government s modernisation agenda to redesign healthcare services; Ensure that services are continuing to progress towards the achievement of national targets (HEAT targets) and standards; and Delivering sustainable development in line with A Sustainable development Strategy for NHS Scotland - Sustainable Buildings Guide and BREEAM healthcare guidance in respect of new build developments and refurbishment projects. NHS Fife has continued to develop its approach to Performance Management. The Balanced Scorecard is one of the major tools used by NHS Fife to review strategic performance. The Scorecard not only sets out key local priorities but also includes all targets contained within the Local delivery Plan, the Better Health Better Care action plan. A regular reporting framework has been agreed to ensure timely submission of reports to the Scottish Government Health Directorate and a programme of reporting to Fife NHS Board and its standing committees. Page 1

2.1.iii. Current Services NHS Fife has two acute hospitals: Victoria Hospital in Kirkcaldy and Queen Margaret Hospital in Dunfermline. In addition there are eight community hospitals. The Victoria Hospital, Kirkcaldy, is within the locality boundary of Kirkcaldy and Levenmouth CHP, which is served by three community hospitals at Windygates (Cameron Hospital), Buckhaven (Randolph Wemyss Hospital) and Kirkcaldy (Whyteman s Brae Hospital). These community facilities are supported by health centres, clinics and healthcare related facilities across the region to provide an integrated primary care service. The Fife wide responsibility for mental health services also means the CHP has services located at Stratheden Hospital, Cupar, in North East Fife, and at Queen Margaret Hospital, Dunfermline, in West Fife. 2.1.iv. Key Stakeholders Key stakeholders associated with the replacement of steam boilers at Queen Margaret Hospital are: NHS Fife; Fife Council including Planning and Facilities Services; Patient and Carer representative groups; Health Facilities Scotland. 2.2. Existing Business Strategies 2.2.i. 2.2.ii. National Strategies The national strategies and relevant guidance which have influenced the development of local plans are: The Route Map to the 20:20 Vision s aims of quality of care, the health of the population, and value and sustainability are reflected in the named quality ambitions that the healthcare services should be person centred, safe and effective. The 12 priority areas for improvement have been named as primary care, integrated care, unscheduled and emergency care, person centred care, care for multiple and chronic illness, early years, health inequalities, prevention, innovation, efficiency and productivity and workforce; The Five Strategic Outcomes of the Scottish Government (Wealthier and Fairer; Smarter; Healthier; Safer and Stronger; and Greener); Better Health, Better Care (2007) Action Plan; Local Delivery Plan Targets (HEAT) 2013/14; Climate Change (Scotland) Act 2009; Health Facilities Scotland Strategic Energy Efficiency Programme. Local Strategies NHS Fife Property and Asset Management Strategy; Development of a Primary Care Resource Centre, Queen Margaret Hospital (Right for Fife). 2.2.iii. Scottish Government 5 Strategic Objectives There are positive benefits in relation to the five strategic outcomes and relevant national indicators, in particular, the following benefits in relation to the national indicators are identified: Improve public sector efficiency (by reducing system losses through the use of modern and high efficiency technology); Improve the ecological footprint (through the sustainable development of efficient facilities). Page 2

3. Investment Objectives 3.1. Investment Objectives Noting the need for the objectives to relate to the strategies referred to previously in Section 3.2, the following objectives have been established. Objective Heading Reduce CO 2 emissions. Maximise energy reductions. Minimise cost of energy. Reduction in the number of allowances required for the Carbon Reduction Commitment Scheme. Remove requirement for steam raising on site. Reduce backlog maintenance requirements. Contribute to Scottish Government Climate Change targets. Deliver project in a collaborative approach with local partners. Objective Detail NHS Boards are expected to meet HEAT target for the production of CO 2 emissions from the burning of fossil fuels. Target is a 3% reduction per annum. High efficiency plant and equipment will be installed to reduce combustion and system losses. In addition, NHS Boards are expected to meet HEAT target for a reduction in energy consumption. Target is a 1% reduction per annum. Reductions in the consumption of energy should realise a reduction in energy costs dependant upon type of energy supplied. Allowances are purchased on annual basis for every tonne of CO 2 emitted from the consumption of natural gas and electricity. Maximising energy reductions will reduce need for CRC allowances. Reduce resource requirements associated with the need to deliver steam on site. Current figures for backlog maintenance with the Estates Asset Management System highlight a backlog maintenance requirement of 1.398 million for the steam boilers and system plant and equipment. The Climate Change (Scotland) Act 2009 creates a statutory framework for greenhouse gas emissions reductions in Scotland by setting an interim 42 per cent reduction target for 2020 and an 80 per cent reduction target for 2050. Connection to the District Heating Network will provide an opportunity to deliver a joint project that meets the aspirations of the Fife Environmental Partnership. 3.2. Existing Arrangements 3.2.i. Existing Plant and Equipment Heating and hot water are currently provided to the building by three steam boilers serving plant rooms throughout Phases 1 & 2, as well as providing steam to the laundry and kitchen. The total building floor area is 43,270 m 2 with a total heated volume of 146,400m 3. The laundry facilities on site process approximately 164,000 articles of personal laundry per year. At present, three large steam boilers (two B&E and one BIB Cochrane) provide steam & heat to the hospital via heat exchange to low temperature hot water (LTHW). The steam main serves the four main plant rooms, three in Phase 1 and one large one in Phase 2. Each plant room contains two heating calorifiers which in turn serve the LTHW distribution for the given area. Also, each plant room houses two DHW Calorifiers providing DHW to the relevant area. The Phase 2 plant room also contains a number of Air Handling Units for various operating theatres, these incorporate steam humidifier batteries that are currently out of use. In addition to this, the steam main serves three tumble dryers and a calorifier in the personal laundry, and a number of items in the kitchen, whilst there is also a branch off the main to Phase 2 providing background heating to the medical gas store. Page 3

3.2.ii. Deficiencies of Existing Plant and Equipment Low efficiency of Existing Plant - The existing boiler & burner arrangements are ageing and relatively inefficient by modern standards. Reductions in gas consumption could be attained by improving the efficiency of heat raising plant. High losses of existing system - Even with modern, efficient steam plant, more than 40% of gas consumed in a typical hospital boilerhouse is accounted for by losses within the system. It is likely that the hospitals heating needs could be met in a more efficient manner High maintenance costs of existing system - The existing steam boilers require an expensive maintenance regime to be in place, including regular overhauls of the boilers, and an engineer on site at all times. There may be potential for significantly reducing annual maintenance costs. Carbon Emissions - As the existing boilers combust fossil fuel (natural gas), they add over 2,000 tonnes of CO 2 to the atmosphere which is a greenhouse gas. Following an investigation carried out by the Carbon Trust in March 2011, the chart below highlights the distribution of heat from the Queen Margaret Hospital boilerhouse. It shows that 57% of the total heat requirement is associated with losses and means that more than half of the gas being consumed at the site is wasted. Site Gas Consumption System Losses, 33% Phase 1 Heating, 13% Phase 2 Heating, 19% Domestic Hot Water, 1% Combustion Losses, 24% Steam Use, 10% Page 4

4. Business Scope 4.1. Potential Business Scope The potential scope of this project covers elements of work within Fife Council and NHS Fife. These are summarised below. 4.1.i. 4.1.ii. The scope of the District Heating Extension Project is as follows: The laying of buried, pre-insulated heat mains in the road between the existing energy centre at Broomhead in Dunfermline and Queen Margaret Hospital; Interface works at either end - the extension would be connected to the existing network by forming a new secondary heat circuit at the Broomhead energy centre, and to Queen Margaret Hospital 's heating circuits via a heat exchanger in the Queen Margaret Hospital boiler house; Final connections to heating circuits in connected properties - there are a number of buildings along the proposed route (including some Fife Council housing stock) that would be connected to the District Heating Extension; these would require spurs off the main district heating spine to connect to individual properties; and The provision of heat to Queen Margaret Hospital and other properties connected to the District Heating Extension for an assumed minimum period of twenty-five years. The major elements of the project at Queen Margaret Hospital would be as follows: 4.2. Service Requirements 4.2.i. 4.2.ii. General Replacement of existing steam boilers with LTHW dual fuel boilers; Replacement of existing steam to LTHW heat exchangers in main plant rooms with high efficiency plate heat exchangers; Replacement of existing heating batteries in various Air Handling Units throughout Phase 2; Replacement of existing steam laundry and catering equipment to high efficiency gas/electric equipment. The minimum requirement for the Queen Margaret Hospital would be sufficient heating and hot water to meet the needs from whatever source of energy can provide the service. Key Functional Requirements The following table describes the key functional requirements that should be realised from the project: Core Requirements Provision of heating services that meets the needs of Queen Margaret Hospital Provision of hot water services that meets the needs of Queen Margaret Hospital Contribute to NHS Scotland HEAT target regards improving energy efficiency Contribute to NHS Scotland HEAT target regards reducing CO 2 emissions Desirable Requirements Utilisation of low carbon energy as primary heat source Long term supply of low carbon energy to Queen Margaret Hospital Contributes to the Special Duties placed on public bodies within Part IV of the Climate Change (Scotland) Act 2009 Page 5

5. Benefits, Risks, Constraints and Dependencies 5.1. Benefits With regards to the investment objectives in Section 3.1, the following table identifies the relative value of each objective. The benefits criteria associated with each objective have also been assessed using the terms below; Strategic Business Related Operational Management Related Economic Non-cash Releasing Financial Cash Releasing Measurable Defined Targets Qualitative Subjective Assessment Objective Relative Value Criteria Reduce CO 2 emissions. High Operational Financial Maximise energy reductions. High Operational Measurable Minimise cost of energy. Medium/Low Economic Financial Reduction in the number of Medium Economic allowances required for the Carbon Financial Reduction Commitment Scheme. Remove requirement for steam raising on site. Reduce backlog maintenance requirements. Contribute to Scottish Government Climate Change targets. Contribute to Scottish Government Heat Generation Policy. Deliver project in a collaborative approach with local partners. Low High Low Operational Financial Strategic Economic Strategic Measurable Global NHS Fife NHS Fife NHS Fife NHS Fife NHS Fife Beneficiaries Scottish Government Low Strategic Scottish Government Medium Strategic Qualitative NHS Fife/Fife Council 5.2. Risks Key risks associated with the replacement of steam boilers and extension of the District Heating Network is summarised below: 5.2.i. 5.2.ii. 5.2.iii. 5.2.iv. Affordability - There is a risk that sufficient investment will not be available to provide funding for the Project for NHS Fife, or if the District Heating Network provides energy to the hospital, to meet Fife Council s investment criteria. Collaboration - There is a risk that even if sufficient funding is made available to NHS Fife for the Queen Margaret Hospital works, NHS Fife will not commit to the Project. Without the hospital as an anchor load, the Project would not be viable for Fife Council. Resources / Programme - There is a risk that the approvals process within Fife Council and NHS Fife takes longer than forecast, thus delaying the programme and jeopardising the availability of the NHS Carbon Reduction Programme funding to contribute to the cost of the Queen Margaret Hospital works. Low carbon heat availability - There is a risk that the supply of low carbon heat to the District Heating Network is less than forecast, due to there being less landfill gas and/or biogas produced than anticipated. The practical consequence is that unless more lowcost low-carbon heat can be generated, increasing reliance will be placed on using natural gas boilers to meet the overall demand for heat from the network. Using fossil fuel to produce top-up heat is more expensive than using heat recovered from the Page 6

5.2.v. 5.2.vi. 5.3. Constraints 5.3.i. 5.3.ii. landfill and biogas CHP engines, and is also of higher carbon intensity, thus impacting on the Project s operating costs and carbon benefits Costs - There is a risk that the investment required for the Project by Fife Council and NHS Fife exceeds the estimates developed by technical advisers as part of the business case preparation. This could result from construction costs being underestimated or from construction inflation in the event of a delay to the programme. Demand - There is a risk that energy demand from the District Heating Network is greater than forecast, e.g. due to the impact of additional loads connecting (e.g. Tesco). Increasing demand on the network may result in reduced delivery to the hospital and require gas boilers to provide additional heat. Option B Option D1 5.3.iii. Option E1 5.4. Dependencies 5.4.i. 5.4.ii. 5.4.iii. Option B Option D1 Option E1 Detailed technical studies needs to be carried out to determine suitable locations and connections to Queen Margaret Hospital electricity supply, etc. The full benefit of carbon reductions will be realised when delivery of District Heating Network is achieved at Queen Margaret Hospital. Detailed technical studies needs to be carried out to determine suitable locations and connections to Queen Margaret Hospital electricity supply, etc. Capital funding in the region of 3.23 million would need to be secured. Availability of Carbon Reduction Programme funding for the replacement of plant and equipment at Queen Margaret Hospital. Securing additional funding to bridge gap between Carbon Reduction Programme funding and indicative capital costs. Confirmation from Fife Council that delivery of District Heating Network will be undertaken. Long term heat supply agreement being agreed with Fife Council for the delivery of energy from District Heating Network. Capital funding in the region of 3.39 million would need to be secured. Confirmation from Fife Council that delivery of District Heating Network will be undertaken. Long term heat supply agreement being agreed with Fife Council for the delivery of energy from District Heating Network. Page 7

6. Critical Success Factors In consideration of the Investment Objectives in Section 3 and the potential benefits summarised in Section 5, a review of those factors have identified the following limited list of Critical Success Factors deemed to be essential to the project being considered successful. 6.1. Delivery of a low carbon solution that provides a reduction in CO 2 emissions for NHS Fife. 6.2. Reduction of backlog maintenance through the replacement of depreciated assets. 6.3. Removes the requirement to use steam as a primary source of energy at Queen Margaret Hospital. 6.4. The achievement of the project within the available affordability envelope for NHS Fife. 6.5. Reduction of revenue costs throughout the life of the project. 6.6. Provides a long term energy supply to Queen Margaret Hospital. 6.7. Agreement with Fife Council for a long term energy supply 6.8. Compliant with all relevant environmental legislation and guidance. 6.9. Avoids significant disruption to the delivery of clinical services at Queen Margaret Hospital. The hospital will continue to operate as normal during the project works. Page 8

7. List of Options 7.1. General Options that are being considered for the replacement of the steam boilers and the supply of LTHW to Queen Margaret Hospital are as follows: A B C D1 D2 E1 E2 F Options Do Nothing Description Stand alone Gas Fired Combined Heat and Power unit and LTHW boilers at Queen Margaret Hospital Stand alone Biomass and LTHW boilers at Queen Margaret Hospital Extend District Heating Network to Queen Margaret Hospital via direct route and convert steam boilers to LTHW Extend District Heating Network to Queen Margaret Hospital via longer route and convert steam boilers to LTHW Extend District Heating Network to Queen Margaret Hospital via direct route and convert steam boilers to LTHW with additional Combined Heat and Power Unit at Queen Margaret Hospital providing top-up heat to Queen Margaret Hospital only Extend District Heating Network to Queen Margaret Hospital via longer route and convert steam boilers to LTHW with additional Combined Heat and Power Unit at Queen Margaret Hospital providing top-up heat to Queen Margaret Hospital only Stand alone Biomass Combined Heat and Power Unit at Queen Margaret Hospital 7.2. Summary Options D and E are generally associated with the supply of energy via the District Heating Network and as such are Fife Council options. As part of the technical appraisals already undertaken, the preferred option for Fife Council regards the delivery of the District Heating Network to Queen Margaret Hospital is via the direct route to Queen Margaret Hospital which allows options D1 and E1 to be considered. In addition, the technical appraisal discounted option C due to not being economically viable and technical issues with regards delivery issues and locations of storage for biomass fuels while option F was also discounted as not being commercially viable due to the lack of available technology solutions that would provide the performance required at Queen Margaret Hospital. Page 9

8. Conclusion and Recommendation 8.1. General As noted in Section 7, a review of potential options was undertaken by stakeholders and technical advisers to produce the key options that will be taken forward. 8.2. Options to be taken forward The following options have been identified as potential solutions for NHS Fife to provide heating and hot water services at Queen Margaret Hospital. A B D1 E1 Options Do Nothing Description Stand alone Gas Fired Combined Heat and Power unit and LTHW boilers at Queen Margaret Hospital Extend District Heating Network to Queen Margaret Hospital via direct route and convert steam boilers to LTHW Extend District Heating Network to Queen Margaret Hospital via direct route and convert steam boilers to LTHW with additional Combined Heat and Power Unit at Queen Margaret Hospital providing top-up heat to Queen Margaret Hospital only 8.3. Preferred Way Forward All options being considered will provide a reduction in CO 2 emissions, improvements in energy efficiency and remove the requirement for steam to be generated on site at Queen Margaret Hospital. A number of these benefits are summarised in the table below: Objective Option Do Nothing Option B Option D1 Option E1 Reduce CO 2 emissions. No Yes Yes Yes Maximise energy reductions. No Yes Yes Yes Minimise cost of energy. No Yes Yes Yes Reduction in the number of allowances required for the Carbon Reduction Commitment Scheme. Remove requirement for steam raising on site. Reduce backlog maintenance requirements. Contribute to Scottish Government Climate Change targets. Contribute to Scottish Government Heat Generation Policy. Deliver project in a collaborative approach with local partners. No Yes Yes Yes No Yes Yes Yes No Yes Yes Yes No Yes Yes Yes No No Yes Yes No No Yes Yes All of the options being considered to replace the existing steam boilers and associated plant and equipment will deliver energy and carbon reductions, however, only option D1 and E1 will allow connection to the District Heating Network. Queen Margaret Hospital would effectively act as an 'anchor load' for the District Heating Extension Project. The Council and NHS Fife would therefore need to enter into a long-term heat supply agreement in relation to a supply of energy to Queen Margaret Hospital. NHS Fife has been successful with the application for Carbon Reduction Programme funding. A figure of 1.32 million has been awarded but there is a shortfall of approximately 950,000 from the lowest cost option D1, however, the CRP funding is specifically allocated to the replacement Page 10

of steam boilers and associated equipment allowing connection to the District Heating Network. No funding streams are available to NHS Fife at the present time for option B. Representations have been made to Scottish Government for this additional funding and early indications are that this has been successful. The funding allocations for NHS Fife at the present time are therefore as follows; 2014/15 120,000 (Carbon Reduction Programme) 2015/16 1,200,000 (Carbon Reduction Programme) 2016/17 957,000 (Scottish Government) 8.4. Indicative Capital Costs The total Capital costs associated with each of the options are: Option A Do minimum Option B Gas Fired CHP Option D1 DCES Link Option E1 DCES Link & CHP nil 3.2 million 2.3 million 3.4 million It should be noted that the 1.3m of funding from SGHSCD would only be available for Option D1. The other options would not necessarily meet the Carbon reduction requirements to qualify for funding. If Option D1 were to go ahead, an additional 1m would require to be provided. Initial discussions with SGHSCD suggest that this additional funding would be made available in 2016/17. Appendix 9.1 provides a breakdown of the total Capital costs for each of the options. 8.5. Outline of Commercial Case A number of procurement options have been considered for this project including; 8.5.i. Joint procurement between Fife Council and NHS Fife for the District Heating Network and the project works at Queen Margaret Hospital; 8.5.ii. NHS Capital Funding based on traditional procurement (OJEU process) for project works at Queen Margaret Hospital only; 8.5.iii. NHS Capital Funding through Frameworks Scotland 2 ; 8.5.iv. HUB route; 8.5.v. Health Facilities Scotland Carbon Energy Fund. Following a review of these options, it was established that the preferred procurement method to carry out the works at Queen Margaret Hospital would be to use Frameworks Scotland 2. As the works at Queen Margaret Hospital are on the critical path for the project, this route was considered to provide best value for money. 8.6. Outline of Financial Case Appendix 9.2 provides details of the associated annual Revenue costs for each of the options for a selection of years. Whilst Option B is the most favourable to the NHS in financial terms, the requirement to attract 3.2m of additional Capital funding for this stand alone project is unlikely. Similarly the requirement for additional Capital for Option E1 also makes the project unviable. Option D1, whilst not being the best financially, does still return minimum cost savings. The annual saving against the Do Minimum Option for years 1, 5 and 10 are shown below: Year 1 Year 5 Year 10 Option B 0.237m 0.342m 0.483m Option D1 0.011m 0.023m 0.044m Option E1 0.033m 0.047m 0.072m Page 11

Based on the above Capital and Revenue costs, a Net Present Value has been calculated for the options. This shows that from an economic point of the view the preferred option is Option B. Option A Option B Option D1 Option E1 Net Present Value 35.117m 23.951m 33.543m 28.189m Again, whilst Option D1 is not the best from an economic viewpoint, it does still have a lower Net Present Value than the Do Minimum Option. 8.7. Outline of Management Case The delivery of the project will be supported with the allocation of roles and responsibilities based on selected teams at various strategic and project levels: NHS Fife Board; Finance and Resources Committee; Senior Management Team; Project Board; Project Team. It is also anticipated that the following key appointments will take place; Project Owner Director of Estates, Facilities and Capital Services; Project Director to be confirmed; Project Manager External appointment, subject to appointment of Principal Supply Chain Partner under Frameworks Scotland 2 contract; Core Team Internal team appointments to assist with the management and delivery of the project. A number of key project management processes will also be implemented during the planning, design and construction phases of the project, including: Brief Development; Effective Cost Control; Change Control; Risk Management; Progress Monitoring; Regular reporting. 8.8. Indicative Programme A summary of key milestones is provided below: Aug 14 - Approval of business cases by Fife Council and NHS Fife; Oct 14 - Advisers appointed; Nov 14 - Contract notices for Fife Council works and NHS Fife works published; Aug 15 - Main works contractors appointed; Dec 16 - Council works completed; Feb 17 - NHS Fife works completed; Mar 17 - Commencement of heat supply to Queen Margaret Hospital (and other customers). Page 12

9. Appendices 9.1. Indicative costs for the project works associated with Queen Margaret Hospital only are described below: Cost Element Queen Margaret Hospital Heat source Queen Margaret Hospital LTHW conversion works Description Option B Option D1 Option E1 Edina (654 kwth), supply & install 681,326 0 0 Biomass boiler (600 kwth) & fuel feed system, supply & install 0 0 0 ENER-G 770 supply and install 0 0 756,150 Thermal store 35,000 Civil & boiler works to Queen Margaret Hospital facilities 30,000 35,000 Gas supply modifications 30,000 35,000 Plate Heat Exchangers 842,550 842,550 842,550 Boilers 435,420 435,420 435,420 Electrical works (control panels) 36,900 36,900 36,900 New gas pipeline and valves 4,920 4,920 4,920 LTHW circulation twin head pump 46,740 46,740 46,740 Pressurisation unit 14,760 14,760 14,760 Expansion vessels 6,150 6,150 6,150 Water treatment/ softener equipment 61,500 61,500 61,500 Metering 19,680 19,680 19,680 Other items installation costs 55,350 55,350 55,350 Commissioning/ testing of boiler 12,300 12,300 12,300 Flush and clean LTHW pipework 30,750 30,750 30,750 Other commissioning 12,300 12,300 12,300 Controls modifications 123,000 123,000 123,000 New LTHW distribution pipe 63,099 63,099 63,099 Advisory costs Professional services fees (assumed 7.5% of capital value) 188,006 132,406 196,993 Total NHS Fife costs (excl. VAT) 2,694,751 1,897,825 2,823,562 VAT payable 538,950 379,565 564,712 Total NHS Fife costs (incl. VAT) 3,233,701 2,277,391 3,388,274 Page 13

9.2. Indicative revenue costs for the project are described below: Year 1 Year 5 Year 10 Revenue Costs Option A Option B Option D1 Option E1 Option A Option B Option D1 Option E1 Option A Option B Option D1 Option E1 Maintenance 63,550 87,125 10,250 10,250 70,147 96,170 11,314 11,314 85,766 108,807 12,801 12,801 Gas 380,611 423,013 0 0 440,875 489,989 0 0 506,701 563,149 0 0 Electricity 381,260 0 381,260 381,260 485,118 0 485,118 485,118 618,177 0 618,177 618,177 Heat from Council 0 0 368,039 368,039 0 0 426,312 426,312 0 0 489,963 489,963 CRC 58,451 34,732 22,283 246 64,518 38,338 24,596 272 72,997 43,375 27,828 307 Sub Total 883,872 544,870 781,832 759,795 1,060,658 624,497 947,340 923,016 1,283,641 715,331 1,148,769 1,121,248 Depreciation 0 129,347 91,096 91,096 0 129,347 91,096 91,096 0 129,347 91,096 91,096 Total Costs 883,872 674,217 872,928 850,891 1,060,658 753,844 1,038,436 1,014,112 1,283,641 844,678 1,239,865 1,212,344 Electricity Income 0-27,177 0 0 0-34,580 0 0 0-44,064 0 0 Net Costs 883,872 647,040 872,928 850,891 1,060,658 719,264 1,038,436 1,014,112 1,283,641 800,614 1,239,865 1,212,344 Page 14