SUMMARY REPORT. Meeting: Title: Authors: Accountable Directors: Meeting Date: 28 March 2019 Agenda Item: Enclosure Number: 15

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1 SUMMARY REPORT Meeting Date: 28 March 2019 Agenda Item: Enclosure Number: 15 Meeting: Title: Authors: Accountable Directors: Other meetings presented to or previously agreed at: Trust Board Estates and Facilities Update Report Robert Graves, Director of Estates and Facilities Sarah Lloyd, Associate Director of Finance Date Key Points/Recommendation Committee Reviewed from that Committee Resource & 25 February Performance 2019 Purpose of the report To provide the Board with an update on key facilities and estates matters, as reported to, and reviewed by, the Resources and Performance Committee. Strategic goals this report relates to: To deliver high quality care To support people to live independently at home To deliver integrated care Consider for Action Approval Assurance Information To develop sustainable community services Summary of key points in report The purpose of this report is to advise and report to the Board on key estates matters. The paper reports on the following: Estates Compliance Water Management Estates Operational NHS Property Services (NHSPS) Estate Optimisation Capital Works Asset Management Drawings and Data Model Hospital Key Recommendations The Board is asked to: Receive the progress report about the compliance work completed to date and the ongoing programmes. Accept that estates compliance reporting is continuing to improve. 1 Accountable Director: Sarah Lloyd, Associate Director of Finance Trust Board Meeting: 28 March 2019

2 Support the day to day activities of the estate management function and the focus on efficiency. Consider the progress being made in respect of estate optimisation and that this will need to align with STP aspirations for the future Is this report relevant to compliance with any key standards? YES OR NO CQC Yes State specific standard or BAF risk Requirement to ensure buildings support safe, high quality care IG Governance Toolkit No Board Assurance Framework No Impacts and Implications? YES or NO If yes, what impact or implication Patient safety & experience Yes To ensure buildings are safe to occupy. Financial (revenue & capital) Remedy of statutory and regulatory noncompliance will have financial implications. Yes OD/Workforce No Not directly as a result of this report Legal Yes Creation of new / improved relationships with landlords. 2 Accountable Director: Sarah Lloyd, Associate Director of Finance Trust Board Meeting: 28 March 2019

3 Title Estates Update 1. Introduction 1.1 The purpose of this report is to advise and report to the Board on key estates matters. The paper reports on the following: Estates Compliance Water Management Estates Operational NHS Property Services (NHSPS) Estate Optimisation Capital Works Asset Management Drawings and Data Model Hospital 2. Compliance The Trust s liability for compliance (statutory and mandatory testing systems) is dependent on a number of factors: and proof of safe 1. Owner occupier full liability. 2. Wholly leased and occupied building full liability unless clearly defined as a lower responsibility within the occupation (lease) terms. 3. Shared lease and occupancy subject to terms and conditions of occupation part liability/serviced office/clinical space low levels of liability generally limited to nonbuilding fabric and systems. a. Trust Responsibility The current compliance report dashboard as of 19 th March 2019 is given in Appendix A. This shows the number of buildings/assets, risk rating and forward action plan by reporting element. The dashboard shows generally all items are green RAG rated. b. Non-Trust Responsibility Properties Where landlord details and compliance responsibilities were known, a schedule of responsibilities has been collated for non-freehold property. Landlord letters went out to 32 landlords. MPFT are currently preparing chaser letters where no response has been received and letters to additional new landlords whose details have now been supplied. 3. Water Management A full Facilities and Estates Infection Prevention and Control (IPC) r eport including water safety is provided to the IPC Committee meeting and Water Safety Group. The policy, governance and in-patient ward water quality items from the IPC report are given below. 1

4 a. Water Safety Policy MPFT are updating their policy and this update, modified for the SCHT governance, could be adopted rather than have extensive modifications to the existing SCHT policy. The policy in the future needs to be the guiding principles with defined responsibilities as the procedures are now covered in the adopted Water Safety Plan. The MPFT policy is programmed for May SCHT will benefit from the extensive rewriting of the MPFT policy which will also meet the needs of SCHT and the production of a shorter, more pertinent and useful document. b. Whitchurch Hospital Legionella in water system Domestic Hot and Cold Water In discussion with the local Water Safety Group, sampling is limited to the small number of remaining positive areas. The on-going sampling last took place on 13 th February; positive areas include treatment room, multi-purpose room in OPD and Rehab ward 2 shower all of which have higher positive pre-flush results which have largely cleared post flush indicating a use/flushing issue. The other positive reading was for the buffer vessel for the hot water system which has since been pasteurised. Replaceable filters are installed at outlets. The filters are being changed in accordance with manufacturer s instructions. A capital bid for 2019/20 is being developed for the remaining remedial actions including the replacement of taps as agreed with IPC. c. Ludlow Water Issues General water quality A Water Quality Meeting took place at Ludlow on 10 th January, to discuss on-going water quality issues, water remedial works and the action tracker. Proportional continuous dosing is still being considered. At the meeting it was confirmed MITIE have now removed all flexi hoses, they are cleaning and disinfecting shower hoses, and removing the diverters for fixed head showers so there will only be one outlet available at each shower. NHS PS is arranging another Water Quality Meeting. Interim results from samples taken on 4 th March show 12 outlets with positive results across the site. Final results are due before the end of March All legionella positives identified are of a species type. Remedial works are scheduled for Friday 22 nd March and through the weekend. The works are generally in the plant room areas and basements. Once complete another full system disinfection will take place. NHS PS are managing the scheme providing temporary hand wash basins, hot water, bottled water etc. They have also linked in with all occupants. Another intrusive water risk assessment is to be arranged on completion of these works with another water user group meeting to be held in late April. Date to be agreed. NHS PS is working through the action tracker for the remedial works highlighted. The minor works elements are on-going but will involve some disruption and weekend working for some work. The NHS PS remedial action plan works began at the end of October. The works are managed by NHS PS/MITIE. SCHT have agreed sample locations following remedial works. The works have involved a survey which has identified further remedial actions and quotes 2

5 have been provided to SCHT for consideration. SCHT s Head of IPC is in discussion as some of the quotations are not relating to SCHT areas. On advice from Martin Rooney the NHS PS Authorised Engineer (AE) Water; points of use filters have been removed from wash hand basins to increase the poor flow through the system but remain on showers. The filters are changed on a PPM schedule by MITIE. Risk assessments have been carried out to permit the removal of filters in areas occupied by SCHT and SaTH. Flushing continues by SCHT domestics and all little used outlets are also being flushed by MITIE on behalf of NHS PS. Following the interim results shared early February by NHS PS flushing continues twice daily on Stretton and Dinham Wards side rooms, all the link toilets and the MIU. Maternity is being flushed by SCHT Domestic staff in the morning and SaTH staff later in the day. NHS PS is looking to carry out a major capital refurbishment of the hot water generation on site. A draft scheme has been issued to tenants for comment. MPFT will respond by the deadline of the end of March SCHT have requested that on site laundries are disconnected from water services, as laundry services will be provided off-site under new service supply arrangements. d. Bridgnorth The last sample results were from 6 th February 2019 indicated there were positive outlets. The full site Thermostatic Mixing Valve servicing has taken place over the last month. There are some remedial items which MPFT will be supplying quotations to remedy by the end of March Point of use filters have been fitted to control the risk in localised areas where there have been positive samples and are on a planned maintenance schedule to be changed in accordance with manufacturer s instructions. Daily flushing and cleaning is being undertaken by the SCHT domestic staff. e. Bishops Castle The last sampling report dated 13 th February 2019 indicated a positive outlet with a very minor reading. This outlet has been thoroughly cleaned and disinfected and will be sampled again this Month (March 2019) A point of use filters remains on the single outlet that had a positive sample. f. Water Audit and Governance The governance process associated with water safety is being reviewed together with the AE s report and recommendations by SCHT with MPFT working in partnership. SCHT s Responsible Person for water has been formally appointed and is the Trust s Head of IPC. The AE audit took place on 9 th /10 th October An action plan has been developed which is being reviewed as part of the Water Safety Group. It is has been recommended that key staff have some legionella awareness training e.g. domestic supervisors and site managers. Training has been booked for key staff for 1 st April The next SCHT Water Safety Group is on 30 th April 2019 following the IPC committee. 3

6 4. Estates Operational a. Bishops Castle - The generator has recently been repaired but consideration should be given to replacing this item and this will be reviewed through the Capital and Estates Group. b. Bridgnorth Operating Theatre A full audit has been carried out by the Authorising Engineer on 26 th November Remedial items were identified which included works to the Surgeons Panel and the noise level in the theatre. The panel has been repaired and a scheme for attenuation of the noise is being prepared. A decontamination audit has also been carried out and a meeting was held with SCHT IPC, theatre staff and MPFT estates on 23 rd January The results of the audit showed some remedial items around procedures and training requirements for SCHT staff that will be addressed. c. The MPFT/SCHT contract is being revised and updated based on use of the block contract to provide a more detailed specification and define the services provided in greater clarity. The existing contract is a transactional maintenance contract with an additional clause for associated services paid on an hourly rate or for capital services as a percentage of contract value. The new contract needs to both define and support the successful partnership working and support the STP and efficiency agenda. d. Oswestry HC - The next Building User Group meeting is planned for 4 th April On-going remedial works continue. The triage capital scheme works are now complete. The standard of cleaning remains under review and this is continuing to be discussed with NHS PS. e. Monkmoor campus MPFT are supporting negotiations with the landlord regarding maintenance liabilities and compliance. 5. NHS Property Services (NHSPS) Hard & Soft Facilities support The last monthly operational meeting with NHS PS took place on 1 st March NHS PS stated that they were looking at a more flexible approach to property use with respect to their tenants. They were also developing a Property Dashboard of information and a follow on meeting was to be arranged with MPFT to explore how we could work better together in the future. A new web site for NHSPS has been developed and went live on 1 st March. NHSPS are now planning both the long term larger capital investment opportunities and requirements as well as minor new works on sites and it is hoped users of their service will see a marked improvement. A new Facilities and Estates software system (a CAFM system) is being rolled out across the country. The first phase will be launched in quarter 1 of the 2019/20 financial year beginning in the north west. The roll out will proceed when teething problems have been sorted out. NHSPS advised they are still working to SFG20 standards and not the HTM version. MPFT asked that NHSPS advise where this results in any sub-standards to HTMS and any risks in Healthcare premises emanating from this. The next meeting is booked for Friday 3 rd May

7 6. Estate Strategy and Optimisation 6.1 Strategic Projects The Trust s Estates Optimisation Group is considering projects which will support delivery of the Estates Strategy, focusing on: increasing space utilisation and bookable space; colocation of services; and working with partners across the STP to make best use of accommodation, all where appropriate. 6.2 Estate Optimisation overview and lease work. The Estates Optimisation Group continues to develop local estates plans that are strategically aligned to the Neighbourhood ambition for co-ordinated and co-located services. It is recognised that the estate requirements may change over time to remain aligned to future models of care provision. Until this is better defined estates optimisation and capital investment will focus on the estate elements which we are confident will support service delivery in the medium term.. SCHT estates optimisation is now being driven by the Right Estate, Right Service surgeries and excellent work and ideas have been generated, including but not exclusively: 1. Telford estate Overview, rationalisation and improvement of the estate. This is being done in liaison with the CCG and a number of meetings and a workshop have already been completed. 2. Reviewing lease arrangements and occupancy at Hortonwood, Telford. 3. Review of dental estate requirements include including consideration of both children s services and obese patient care. The review will consider lifting standards to achieve HTM This review will take into account any changes to dental service specifications arising from changes to NHS England s commissioning intentions. An initial meeting has been held with the dental leads for SCHT to identify accommodation requirements going forward, with site visits planned to enable a site option appraisal to be delivered. 4. Whitchurch Community Hospital - The occupation of West Midlands Police at Whitchurch Hospital is progressing. 7. Estates Capital Works MPFT are currently supporting the capital programme for the estates elements for the 2018/19 financial year based on risk and other criteria including IPC, fire safety, backlog maintenance statutory and mandatory, service development, patient experience, transformation/cip, IM&T and security. 8. Asset Management System (Facilities and Estates) The asset management system (MiCAD), hosted by MPFT continues to provide statutory building maintenance data of the built environment for SCHT. A concise compliancy report uses this data to provide assurances/exceptions in the form of the attached Appendix A. In order for the MiCAD system to be fully operational it is required that accurate drawings need to be in place. This also accords with the needs of the Carter Metrics and NHS Improvements Model Hospital agenda. 5

8 MiCAD is a strategic asset management tool and also supports data returns such as ERIC which is also an additional service supplied to the block contract. 9. Drawings and Data To fully maximise the potential of the asset management system (MiCAD) it is necessary to have AutoCAD drawings of all the SCHT buildings. Investment into accurate drawings will assist in making reductions in the estate and should eventually be self-funding. The continuing implementation of NHS England s Model Hospital which uses some of the metrics from the ERIC returns and the likely rollout of Carter metrics beyond acute hospitals is likely to require the investment in drawn records of the estate. There is a lack of accurate drawings for Trust sites and buildings and the Trust s Benefits Realisation Group will be asked to consider funding to progress such work, which has numerous benefits. Sites will be prioritised appropriately following agreement of this work. Additional investigation will be undertaken to identify all sources of digital drawings while parallel recommendations will be made about investment in drawings. 10. Model Hospital - ERIC Model Hospital information is now available which includes the 2017/18 ERIC data submission. The overall Facilities and Estates position is good with costs at the median level. Access is to be given to MPFT to allow further analysis of the data by MPFT to identify possible opportunities. 11. Recommendations The Board is asked to: Receive the progress report about the compliance work completed to date and the on-going programmes. Accept that estates compliance reporting is continuing to improve. Support the day to day activities of the estate management function and the focus on efficiency. Consider the progress being made in respect of estate optimisation and that this will need to align with STP aspirations for the future 6

9 Appendix A Compliance Dashboard 7

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