Item 13 Strategic Estates Planning Outline Brief for Development of Strategic Estates Plan for Bristol, South Gloucester, North Somerset and Somerset Clinical Commissioning Groups Phase 1: Priorities and Options 1. National Context Commissioners and local providers of health and social care services are working together with Community Health Partnerships (CHP), NHS Property Services (NHSPS) and NHS England (NHSE) to complete strategic estates plans for their areas. The plans will also champion a One Public Estate ethos working with Local Authorities and other locally based public and third sector organisations to maximise where possible whole system efficiency and effectiveness. The strategic estate plans are intended to support the health economy to create a fit for purpose estate at less cost, specifically addressing: changes in demography and population demand; changes in the way that health care services are provided - specifically reflecting plans for integrated health and social care, greater levels of care within communities and new commissioning models; challenges in funding and affordability. Strategic estate planning will assist the NHS to make better use of its estate and ensure that it is aligned with the Five Year Forward View with its vision of more integrated community based services, offering a greater range of diagnostic and treatment services in local hubs. The current NHS estate is in a variable condition. It is not always in the right location to deliver local services to the population and it is often not fully utilised. Commissioners and Providers need to make better use of the existing estate, where major issues include: Void space in long-term core buildings. Bookable space that is not fully utilised. Inappropriate tenants for example, core clinical space is often filled with administration and support services. These services could be relocated, in most cases more cheaply and the space could be used to accommodate integrated clinical services. Space is often not fully utilised for example, a treatment room may be used by one provider for one session a day, three days a week. Lack of joint working across organisations - this can lead to parochial decisions, for example, where new buildings are commissioned close to existing estate, which could have been utilised, potentially negating the need for the new estate. 1.1 Commissioning Led Strategic Estate Plan Properties providing integrated services usually comprise multiple occupants. Transforming primary and community services involves many partners and stakeholders. The only way to ensure an effective system wide approach is to have a robust Strategic Estates Plan that is an integrated part of the commissioning redesign process. 1
This will: Provide an overview of the existing health economy estate and related partners estate Articulate the estates needs that fall-out from the commissioning plans Create deliverable implementation plans to provide fit for purpose estate And will involve: Committing to, and maximising use of the Core Estate Rationalisation and disposal of surplus or unfit estate Improving effective utilisation of the estate Ensuring appropriate utilisation for example, focus on core clinical space delivering integrated clinical services and not admin/support services Using the estate to deliver new models of care, through more integration and a wider range of co-located services Partnering across organisations to achieve maximum system benefits 2. Requirement There is a requirement for a Consultant to develop service driven high level Strategic Estates Plans for Bristol, South Gloucester, North Somerset and Somerset Clinical Commissioning Groups (CCG s), which identifies opportunities for estate efficiencies and investments. This work will be split primarily into three phases. Phase 1: Output - High Level Strategic Estates Plan An initial phase to identify and analyse existing and future commissioning and provider plans, review of existing estate and future estate requirements, gap analysis and identification of potential opportunities for estate efficiencies and investment, including high level estates options. Phase 2a: Output A portfolio of Project Initiation Documents The development of the agreed efficiency and investment opportunities to Project Initiation Document stage. Phase 2b: Output A portfolio of Business Case documents The development of business cases for each of the projects approved at Project Initiation Document stage. For each of the approved business case schemes, it is expected that these will also progress to a further phase Phase 3, Project Implementation. Note - This brief focusses on the delivery of Phase 1 only. A decision regarding the approach to the procurement of all subsequent phases will be made during the delivery of Phase 1. The Consultant is asked to submit a proposal to deliver four separate Phase 1 High level Strategic Estates Plans for Bristol, South Gloucester, North Somerset and Somerset Clinical Commissioning Groups. This phase will comprise a number of activities as set out in the following section. Whilst these are considered to be the key activities and suggested approach to the delivery of Phase 1, should the Consultant wish to propose an alternative and potentially more innovative methodology, CHP are happy to consider this. 2
The Consultant should use formal project management tools in the delivery and reporting of progress to CHP, Bristol, South Gloucester, North Somerset and Somerset Clinical Commissioning Groups and the Primary Care Premises Group. Specifically, the Consultant will be expected to develop and update a project plan, to include key activities, key milestones and critical path and a separate risk, issues and assumptions register. 4. Phase 1 Output: High Level Strategic Estates Plan Phase 1 has been split into four elements: A review of the commissioning intentions existing and likely future service requirements A review of the existing infrastructure A gap analysis Efficiency and investment opportunities for further evaluation/development 4.1 Commissioning Service Review Element The consultant will undertake a review of the strategic priorities and commissioning intentions for each of the CCG s and local Provider organisations, including local acute, community and mental health trusts. This review will include analysis of the following documentation: a. Health and Well Being Board strategies and plans. b. Bristol, South Gloucester, North Somerset and Somerset Clinical Commissioning Groups commissioning plans and strategies. c. Local Provider plans and strategies. d. NHSE local primary care plans and strategies. e. Local Authority plans and strategies at both county and district/town level. This review will also include gathering detailed information on all baseline clinical services e.g. activity and capacity data for existing community and acute providers within the Bristol, South Gloucester, North Somerset and Somerset Clinical Commissioning Groups health economy. This data will include: a. Activity type - community, outpatient, other b. Activity profile - anonymised including care location, number of patient episodes, type of treatment/activity (using standardised schedule of activity types to ensure consistency) and service provider c. GP data practice population and high level activity data It will also be necessary for the Consultant to gather information on, understand and articulate the models of care that are currently in place and future models of care where there is known change agreed or anticipated by each of the CCG s. The Consultant will need to undertake some initial modelling and quantification of activity to determine the future activity and capacity requirements. This will be an iterative process, with the Consultant working closely with each of the CCG s to agree modelling and activity assumptions and outputs. Note - It is recognised that not all of the required data will be available and, in some cases, the data will be of variable quality. NHS data holders, primarily Bristol, South Gloucester, 3
North Somerset and Somerset Clinical Commissioning Groups, Provider organisations and possibly the local Central Support Unit will be expected to share their data to support this project. The Consultant will need to review the quality of this data and identify and escalate to CHP where there are gaps in data or shortfalls in data quality. Workshop to Sign-Off Outputs On completion of this element of Phase 1, the Consultant will run a workshop with the Primary Care Premises Group to present key findings and sign-off the outputs that will be taken forward to develop the high level schedules of accommodation. 4.2 Estates Element 4.2.1 Estates Data Collection. The Department of Health utilises a Strategic Health Asset Planning and Evaluation (SHAPE) webenabled, evidence-based application, which informs and supports the strategic planning of services and physical assets across a whole health economy. In partnership with CHP, the Consultant will be expected to develop a dashboard for each of the CCG areas on the SHAPE database. CHP will issue a standard template to all provider organisations/property owners for completion for each of the properties within the agreed scope. The Consultant will be responsible for reviewing and checking these completed template to ensure that the information is robust in terms of accuracy and currency. The Consultant will also be responsible for ensuring that the quality assured data is uploaded to the SHAPE dashboard in accordance with the project timetable. Note - It is the responsibility of the provider/property owner to provide the estates data within the agreed project plan timeframe. It is likely that data returns will vary in detail and quality and the Consultant should escalate any areas of significant concern to CHP immediately. Key data will include: Site name and NHS Site code if available (links to patient activity) Type (e.g. Community Hospital, GP Practice, Health Centre, etc.) Address (including Town, County, Country and Postcode) Property mapping coordinate (for accuracy on SHAPE) Tenure (e.g. Freehold, Leasehold, etc.) Ownership (e.g. NHS, Third Party) Floor plans showing occupation (where available) Schedule of accommodation (where available) Booking schedule (where available) GIA NIA Build Date Co-located (e.g. Health Centre with GP Practices) Local authority ward Capital, operational and void costs Facet Survey data summary where available GP specific - Main / Branch / co-located with other practices or not 4
GP specific - List Size and weighted list size if available GP specific - Number of patient contacts if available from Providers or Commissioners. 4.2.2 Population Growth/Housing Developments The Consultant will be responsible for gathering information on likely population growth and potential housing developments via the local council and planning authority. The Consultant will be responsible for quality assuring this information and ensuring that it is uploaded to the SHAPE dashboard in accordance with the project timetable. 4.2.3 Space Utilisation/Clinical Adjacencies The Consultant will undertake a high level exercise to establish clinical adjacencies and space utilisation across limited primary and community health facilities in the CCG areas. The cost of any specific site utilisation surveys is not part of this consultancy and will be procured and funded separately on a case by case basis if the need is justified. 4.2.4 Strategic Fit Analysis The Consultant will carry out an analysis of the strategic service fit to the existing estate. Specifically, the consultant will consider if the current estate infrastructure supports effective and efficient service delivery. 4.2.5 Indicative Schedules of Accommodation for Future Operational Demand. The consultant will produce high level schedules of accommodation to deliver future projected models of care and related activity. 4.2.6 Workshop to Sign-Off Outputs On completion of this element of Phase 1, the Consultant will run a workshop with the Primary Care Premises Group to present key findings and sign-off the outputs to enable the Consultant to proceed to the Gap Analysis section. 4.3 Gap Analysis. The Consultant will produce a gap analysis which will set out: Whether the existing estate is suitable/adequate to deliver existing and future primary, community and related services, in terms of condition, access, utilisation, clinical safety and affordability. Whether the existing estate needs to be modified to accommodate existing and future service provision. Where there are gaps in infrastructure supply to deliver existing and future services. 4.4 Identification of Efficiency and Investment Opportunities The Consultant will identify the infrastructure efficiency and investment priorities necessary to support the delivery of safe, effective and affordable existing and future clinical services to the population of the CCG s. This will be further developed at Phase 2. 5
For each of the efficiency and investment priorities, the Consultant will propose high level options for consideration by the Primary Care Premises Group and further development at Phase 2a of the plan. Workshop to Sign-Off Outputs On completion of the final element of Phase 1, the Consultant will run a workshop with the Primary Care Premises Group to present a summary of the key findings and agree the next steps for Phase 2. 5. Governance A Primary Care Premises Group is already in existence that services all four CCG s. Membership includes senior representatives from local health economy and public sector partners. A list of member organisations is attached at Appendix A. The Group will meet on a monthly basis to receive regular presentations and updates from the Consultant on progress against objectives and the project plan. The Group will also receive the Phase 1 final report on behalf of its membership organisations and agree next steps for Phase 2a of the plan. 6. Timeframe for Delivery It is anticipated that Phase 1 should take 3 to 4 months to complete. The Consultant is asked to develop a project plan to show key activities, key milestones, dependencies and timeframe for the delivery of the high level Strategic Estates Plan. 7. Phase 2a and 2b Scope: Detailed Development of Priority Projects Should the outputs of the first phase indicate that the opportunities identified merit further development, the Consultant will be asked to submit a proposal to assist CHP and Bristol, South Gloucester, North Somerset and Somerset Clinical Commissioning Groups with a second phase of work to further develop the efficiency and investment opportunities/priorities/options and progress these to project initiation document stage. The length of time and cost to undertake this work will depend upon the size of the area and the complexity of the opportunities. Proposals for any second phase of work will be agreed with CHP and Bristol, South Gloucester, North Somerset and Somerset Clinical Commissioning Groups following completion of Phase 1. 8. Commercial The Consultant is requested to submit its proposals to deliver Phase 1 of the Strategic Estates Plan xxxxx by 5pm on xxxx 2015. The proposal should cover the following: 6
8.1 Approach: An indicative project plan detailing key activities, milestones and critical path Proposed methodology to deliver Phase 1, including reporting mechanisms Proposed team 8.2 People and Credentials CVs for all proposed team members. These should demonstrate their experience and ability to deliver the services required under this contract. Two detailed experience statements in developing a similar estate strategy for the health sector. The two case studies must include: o A description of the requirements of the client that is recent and relevant to the scope of this requirement; o Explanation of the outcome of the project and how it was delivered, strengths of the approach applied and the role and activities undertaken in providing the service; o Lessons learnt that can be applied to the Employer s project which could enhance the services provided. A selection of up to 10 other health care projects (summaries only) that demonstrate the Consultant s understanding of the current issues facing the health care economy and estates implications. 8.3 Price: A fixed price for delivery Phase 1. This should include estimated days and day rate for each member of the project team. The Phase 1 price should also include a maximum allowance for expenses. Day rates for use in assessing pricing for further work where work is extended into phase 2 of the programme. 7