THE NHS ESTATE IN WALES

Transcription

1 THE NHS ESTATE IN WALES Estate Condition and Performance Report 2008/09 WELSH HEALTH ESTATES YSTADAU IECHYD CYMRU

2 THE NHS ESTATE IN WALES Estate Condition and Performance Report 2008/09 WELSH HEALTH ESTATES YSTADAU IECHYD CYMRU

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4 CONTENTS 1 INTRODUCTION Background of report 1.2 Purpose, format and scope of the report 1.3 Comparison with last year s performance 1.4 Report validation Facilities Performance Report 2 EXECUTIVE SUMMARY ESTATE PROFILE Key statistics of the NHS estate in Wales 3.2 The age of the estate 3.3 The essential and non-essential estate 3.4 Expenditure on the NHS estate 4 ESTATE PERFORMANCE Estate Performance General information 4.2 Physical condition 4.3 Statutory and safety compliance 4.4 Functional suitability 4.5 Space utilisation 4.6 Energy performance 5 ENVIRONMENTAL ISSUES Environmental Issues Waste 5.2 Transport 5.3 Water usage 6 APPENDICES Summary Appendix I Appendices II-XI Appendix XII Appendix XIII Trust backlog maintenance costs Summary of Trust information Details of residual and surplus hospital sites Performance indicators and targets

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6 1 INTRODUCTION 1.1 Background of the report The Estate Condition and Performance Report is based on annual estate data returns for the financial year submitted to the on-line Estates and Facilities Performance Management System (EFPMS) by nine NHS Trusts, and Powys Teaching Local Health Board. The system was introduced by the Welsh Assembly Government (Assembly) in April 2002 and is managed by Welsh Health Estates. Since the submission of the data in June 2009, the NHS in Wales has undergone major restructuring. As a result, seven of the NHS Trusts that had submitted data to the EFPMS have been replaced by six Health Boards sitting alongside the long standing Powys Teaching Local Health Board, Velindre NHS Trust and the Welsh Ambulance Services NHS Trust. For this reason, the report makes reference to the new Health Boards, which became operational in October 2009, as they now have the responsibility for achieving the estate national performance targets set by the Assembly. 1.2 Purpose, format and scope of the report The report serves two main functions: It provides the Assembly with high-level data and information on the condition of the health estate in order to monitor, year-on-year, performance trends, inform the strategic planning process and assist in the prioritisation and allocation of resources. It provides Health Boards and NHS Trusts with data and information that enables them to compare their own performance with that of other Health Boards and NHS Trusts, as well as against national trends. It should, therefore, be a driver in the process of improving the performance and efficiency of the health estate The report generally follows the format of previous ones, focusing on the condition and performance of the health estate measured against the following national performance indicators (PI)s: Physical condition Statutory and safety compliance Functional suitability Space utilisation Energy performance Once again the familiar traffic light system has been used to measure Trusts performance against the 2005 and 2008 PI targets set by the Assembly in The use of the traffic light system is fully explained in Section The report also recognises the importance of environmental issues and significant efforts have been made to evaluate the performance of the health estate in respect of waste, transport and water. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 5

7 INTRODUCTION Reference is also made to the Assembly s Sustainable Development Action Plan, the UK Government s Sustainable Development Strategy and any requirements and targets associated with these documents. Whilst the performance indicator for Statutory and safety compliance includes costs associated with fire safety, more comprehensive data on fire safety standards and management is collated annually through the on-line Fire Audit Information System and the Fire and UwFS Incident Reporting System. Separate reports analysing this data are published by WHE The report includes data and information relating to all hospital sites and the remainder of the estate aggregated for the first time into one group. This composite aggregate category represents the total for the five separate categories used previously, which were: Aggregate 1: Aggregate 2: Aggregate 3: Aggregate 4: Aggregate 5: Freehold - Diagnostic & Treatment Centres, Health Centres, Clinics, Ambulatory Diagnostic Centres, One-Stop Centres and Primary Care Units Freehold all other sites Leased and fully serviced by the NHS Trust Leased and fully serviced by the Landlord Leased and part serviced by the NHS Trust/Landlord It should be noted that not all of the aggregate categories are applicable to all Trusts. 1.3 Comparison with last year s performance From April 2008 a number of Trusts merged and, wherever feasible, the data submitted by these individual Trusts for the return has been combined to enable comparisons to be made against this year s return in each case. This applies to the following Trusts: Abertawe Bro Morgannwg University NHS Trust formed from the merger of the former Bro Morgannwg and Swansea NHS Trusts; Cwm Taf NHS Trust, formed from the merger of the former North Glamorgan and Pontypridd & Rhondda NHS Trusts; Hywel Dda NHS Trust, formed from the merger of the former Carmarthenshire, Ceredigion & Mid- Wales and Pembrokeshire & Derwen NHS Trusts; North Wales NHS Trust, formed from the merger of the former Conwy & Denbighshire and North East Wales NHS Trusts Information on the Welsh Ambulance Services NHS Trust (WAST) has been included for the first time. Comparison with last year s performance has not been possible due to the unavailability of data since The scope of the data submitted by the WAST covers all of the facets of estate performance with the exception of energy. This is due to the fact that separate metering, in general, is not currently available where ambulance stations are located on hospital sites. 6 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

8 INTRODUCTION 1.4 Report validation Whilst WHE has not carried out a systematic validation of data submitted by the Trusts, every effort has been made to identify and address anomalies. Responsibility for the accuracy of the data submitted to WHE, however, rests ultimately with the NHS organisations that submitted the data. All the data used in the preparation of the two reports is available electronically from the WHE intranet website Facilities Performance Report This report is complemented by the Facilities Performance Report which focuses on facilities management services included in the EFPMS. These cover telecommunications, car parking, cleaning, catering, laundry & linen, security, portering and postal services. The report is published as a separate, stand-alone document. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 7

9 2 EXECUTIVE SUMMARY 2.1 Context of the report This report addresses the condition and performance of the NHS Estate in Wales for the period It has been compiled by Welsh Health Estates (WHE) and is based on the Estates and Facilities Performance Management System (EFPMS) data submitted by nine NHS Trusts and Powys Teaching Local Health Board. As well as hospital sites, the report includes data on other NHS sites, aggregated on the basis set down in the EFPMS data definitions. The report also includes a limited amount of data aggregated by region thus enabling performance comparisons between the three health regions set up in The effectiveness of the EFPMS is largely dependent upon the reliability and consistency of its data. Whilst the quality of the data submitted this year has improved, the level of improvement nine years after the introduction of the EFPMS remains an issue of concern. The report generally follows the format of previous reports and uses the traffic light performance code in the same way as the report for (the use of the traffic light code is explained fully in Section 4). 2.2 Estate profile The profile of the estate has not changed significantly over the last year, with more than half of it being over 35 years old and almost a quarter over 55 years old. The benefits of implementing the disposal programme of the surplus estate, however, continue to be felt. The disposal programme, managed by WHE, is continuing and the significant benefits, both in terms of reduced surplus land area and backlog maintenance liability will become more apparent in due course. The modernisation of the health estate, therefore, continues to be an important priority for both the Welsh Assembly Government (Assembly) and the NHS. Key to the modernisation process is the development of estate strategies that support service plans, leading to the requirement for new buildings and the refurbishment of old stock. The identification of essential and non-essential buildings, based on whether or not they have a health use exceeding five years, is designed to encourage NHS organisations to dispose of stock with a shortterm future as quickly as possible. Data submitted by the NHS indicates that 163,967m 2 of building area has been identified as non-essential a reduction of 40,119m 2 since last year. The rationalisation process also involves the disposal of non-essential land. According to the data provided, 71ha of land have only a short-term future - a reduction of 30 ha since last year. Early disposal of the non-essential estate is vital if scarce resources are to be directed where they can be used more effectively. This, combined with the current and projected capital made available by the Assembly and the implementation of Designed for Life: Building for Wales - the construction procurement framework based on collaborative working - will play a significant part in revitalising and modernising the estate. 8 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

10 EXECUTIVE SUMMARY 2.3 Estate performance General The NHS is committed to meeting a number of targets based on the following national performance indicators (NPIs): Physical condition Statutory and safety compliance Functional suitability Space utilisation Energy performance The targets relate to the essential estate Physical condition and statutory and safety compliance Over the reporting year, backlog maintenance costs increased by almost 37 million to over 505 million. The increases can be largely attributed to the inclusion of the Welsh Ambulance Services Trust (WAST) data, which added nearly 15 million, together with significant increases with the reported backlog costs for Morriston Hospital, Prince Philip Hospital, Cardiff Royal Infirmary and Ysbyty Gwynedd which, between them, contributed more than 33 million to the overall total. In addition, the overall increase hides the fact that, on a site-by-site basis, excluding the aggregate grouped properties, there have been swings in both directions, with 43 sites showing reductions totalling 23 million and 68 sites showing increases totalling over 63 million. Some of the swings on an individual site basis are likely to reflect difficulties Trusts continue to experience in providing consistent and accurate data in line with the EFPMS definitions of backlog maintenance rather than actual improvement or deterioration in the condition of the estate. It is noted that, using the risk adjusted backlog (RAB) formula introduced for the reporting period, the overall backlog maintenance figure is approximately 258 million. The RAB is now widely regarded as a more appropriate indicator for the overall condition of the estate and, over time, it is anticipated that this method of reporting backlog maintenance will replace the one currently used. The report also points to opportunities for significant reductions in the backlog maintenance liability through the disposal of the residual estate and sites that are either closed or scheduled to close. Their disposal, combined with the implementation of business cases relating to Prince Charles and Morriston Hospitals, Ysbyty Glan Clwyd and Ysbyty Gwynedd would achieve a reduction in excess of 200 million. The cost of complying with statutory and safety requirements, including fire safety, is estimated to be 168 million, of which 124 million relates to the essential estate. This includes almost 20 million associated with the Disability Discrimination Act legislation, which is of on-going concern as the legislation came into full force in October WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 9

11 EXECUTIVE SUMMARY The all-wales average for the Physical condition performance indicator improved from 73.88% in to 75.96% in against the 2008 target for 90% of the estate to be in Estatecode condition B or better. However, the average for the Statutory and safety compliance performance indicator deteriorated from 82.39% in to 81.53% in Functional suitability and space utilisation Data submitted in respect of the Functional suitability performance indicator shows that the all-wales average improved from 79.51% in to 80.06% in , against the 2008 target of 90% of the estate to be in Estatecode condition B or better. As for the Space utilisation performance indicator, the data submitted points to a more significant improvement in the all-wales average for compared with , rising from 83.76% to 88.20% against the 2008 target of 90% of the estate to be in Estatecode condition F Energy performance Weather-corrected net energy consumption fell during the reporting year by 4% and is now 17% below the base year, continuing the downward trend. Seven Trusts reported increases in primary energy consumption resulting in an all-wales increase of 0.76% over the previous year. There are, however, a number of mitigating factors that are apparent from the analysis of this year s Trusts returns, namely CHP output (though now rising, it is still below the maximum available), service demand and increases in heated volume brought about by new developments. With regard to CHP output, the total amount of electricity generated by CHP rose from 4.9% of total electricity requirements last year to 8.86% this year. This was mainly due to the commissioning of new and larger capacity systems during the year. These, along with the resolution of maintenance problems on some sites are expected to deliver further significant increases in CHP output during the reporting period. Rises in energy consumption associated with service demand and increases in heated volume are longterm issues and are likely to increase rather than level out in future. The emphasis, therefore, must continue to be placed on efficiency, by improving the way energy is used. The energy efficiency PI for is 55.07GJ/100m 3, indicating an improvement of 20.4% on the base year and well above the U.K. Government target of a 15% reduction by As with primary energy, there has been an increase in carbon emissions because of the factors described above. Absolute carbon emissions have deteriorated with an increase of 2% on the figure, though still 37% below the base year. It should be noted that the overall reduction since base year has been achieved by the use of green electricity purchase contracts and that this achievement is vulnerable to Trusts reverting to brown electricity in future. The NHS must, therefore, not lessen its drive on energy efficiency and the use of green technologies. A summary of the main findings of this year s returns is given below: The trend in net energy consumption is downward. 10 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

12 EXECUTIVE SUMMARY Absolute carbon emissions have increased from 114,962 to 117,245 tonnes of CO 2, an increase of 2%. The energy efficiency PI is 55.49GJ/100m 3, an improvement of 19.8% over the base year figure of 69.14/100m 3. The amount of CHP-generated electricity has increased from 4.9% to 8.86% of the total electricity requirement and at 66,000GJ, continues to provide a significant amount of the electricity needs. 2.4 Environmental issues Waste Data submitted shows a modest 2% reduction in the overall amount of waste reported, although there has been a corresponding increase of 17% in disposal costs, demonstrating the increasing cost pressures that exist in waste management. Overall, clinical waste has remained almost static. The data shows that 15% of the clinical waste in Wales goes for incineration while the majority, 85%, goes for alternative non-incineration treatment with a cost split of 23% and 77% respectively. The figures indicate that composition of the waste stream is approximately the same as previous years. There are, however, continuing positive signs from the landfill waste and recycling figures, suggesting that NHS Wales is continuing to build on its waste minimisation and recycling performance. There has been a 7% reduction in volume of waste being sent to landfill compared with the previous year s figure (set against continued increasing costs for disposal) and a corresponding modest improvement in recycling performance with an estimated all-wales average of 13%. It is hoped that these encouraging trends will continue Transport Data submitted on transport for was, once again, largely incomplete. The data shows that 60% of Trusts had board-approved Green Transport Plans, as referred to in the EFPMS. It is likely that the inclusion of this data in the EFPMS will be reviewed in future Water usage Water consumption, at 138m 3 per 100m 2, was over 7% lower compared with and the trend with regard to water efficiency continues to improve. There is, however, a great variation in consumption across Trusts, which suggests there is scope for improvement. As the cost of water continues to increase, the benefits of conservation measures and the introduction of additional metering on sites should be fully exploited. 2.5 Key issues arising from the report Significance of the Report As with last year s report, the Estate Condition and Performance Report is significant for three main reasons: WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 11

13 EXECUTIVE SUMMARY The information contained within it is based on data submitted by a reduced number of NHS Trusts following several mergers affecting the Bro Morgannwg, Swansea, North Glamorgan, Pontypridd & Rhondda, Carmarthenshire, Ceredigion & Mid Wales, Pembrokeshire & Derwen, Conwy & Denbighshire and North East Wales NHS Trusts. This had a major impact on the production of the report arising particularly from the wish to provide valid comparisons with data submitted in previous years. For the first time, data submitted to the EFPMS by the Welsh Ambulance Services NHS Trust has been included. Whilst the Trust s estate is significantly different from that of other NHS property holding organisations, it is hoped that the data submitted will provide the basis for year-on-year comparisons of performance within the Trust. This will be the last report to be produced on the basis of data submitted predominantly by NHS Trusts. This is due to the NHS restructuring which, on 1st October 2009, saw the formation of six new Health Boards sitting alongside the long-standing Powys Teaching Health Board, Velindre NHS Trust and the Welsh Ambulance Services NHS Trust. In future, therefore, Estate Condition and Performance reports will be produced around data submitted by these organisations. In the light of these issues it is appropriate to briefly reflect on the performance of the NHS during the reporting period and review its performance since the EFPMS was introduced in Performance in Trust performance against the five national estate key performance indicators provides a mixed picture that includes a few examples of excellent performance where the 90% target set for 2008 has been comfortably exceeded. Typically, the higher levels of performance are associated with Trusts managing a modern property portfolio. Overall, however, the report portrays a less positive picture in which a significant number of Trusts failed to meet the 2008 targets, some by a wide margin, despite the Trust mergers having served to smooth out extremes in some cases. This continues to be particularly the case in respect of the physical condition, functional suitability and space utilisation indicators. Backlog maintenance costs, disappointingly, continue to remain at very high levels and, in contrast to expectations, increased during this last reporting period. It is recognised that this has been partly due to the inclusion of costs submitted, for the first time, by the Welsh Ambulance Services NHS Trust. Both the performance against the national PIs and the high levels of backlog maintenance suggest that, whilst initiatives such as the Major Risk Framework have had a positive impact alongside the ongoing disposal programme, significant improvements in performance and reductions in backlog maintenance costs will be achieved only through the implementation of a radical modernisation programme. In this context, there is an expectation that the current development of new healthcare facilities procured through the Designed for Life: Building for Wales framework will deliver the improvements the NHS requires. On the energy front, whilst there have been increases in net energy consumption, primary energy consumption and absolute carbon emissions, due in part to an increase in heated volume and significant increases in service demand, there are some positive messages: weather-corrected figures demonstrate that there has been a 2% reduction in energy consumption this year, continuing the 12 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

14 EXECUTIVE SUMMARY downward trend since the base year. In addition, performance indicators for energy usage have generally continued to improve, largely as a result of energy conservation measures and benefits from increased CHP use Performance over the eight-year EFPMS reporting period The introduction of the five national performance indicators in 2002 created an expectation that the NHS should achieve the 2005 intermediate and 2008 long-term targets. An analysis of the data submitted during this period shows that, whilst there have been improvements across all of the indicators, none of the 2008 targets, have been met, some by a very wide margin. During the eight-year reporting period, backlog maintenance costs have risen from 431 million to 505 million although, in real terms, backlog costs have fallen by 120 million. The low level of capital investment in the estate during the early years explains, to a degree, the continuing high levels of backlog maintenance. On the positive front, however, there is an expectation that, over the next few years, backlog maintenance costs will see a clear downward trend as new facilities and major upgrading works procured under the Designed for Life: Building for Wales framework replace old and inappropriate facilities. Age profile has been consistently highlighted as a useful indicator of the likely condition of the estate. Over the eight-year period there has been little movement in the overall profile and a slow decline in the proportion of buildings pre-dating 1948 along with a slow increase of those dating from It is expected that the current modernisation programme will have a clear impact on the age profile. The importance of driving forward a vigorous land and property disposal programme, focusing on those elements of the estate in particularly poor physical condition that fail to comply with statutory requirements and present major challenges in delivering modern clinical services, has also been consistently stated. Accordingly, during the EFPMS eight-year reporting period significant progress has been made, resulting in the disposal of 212 hectares of land and 172,000m 2 of building with a disposal value of 88 million. On the energy front, taking into consideration weather-corrected data, and the encouraging 2% decrease on last year s returns for net energy consumption, the trend during the eight-year EFPMS reporting period confirms a steady year-on-year decrease in consumption which is now 17% below the base year. Concerning data on environmental issues dealing with waste, transport and water, during the eightyear reporting period there have been significant changes to the definitions for waste and transport which preclude making direct performance comparisons or the possibility of identifying meaningful trends. For waste, the definitions have improved considerably and work is ongoing to review the transport data to incorporate wider travel considerations in future. It is apparent that, with regards to water, improvement in performance has continued this year with a further significant reduction in consumption. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 13

15 3 ESTATE PROFILE 3.1 Key statistics of the NHS estate in Wales The current portfolio of NHS properties in Wales is diverse, complex and geographically widespread and comprises: A total land area of approximately 750 hectares; Approximately 120 hospitals of varying age, construction, size and function; Over 200 health centres and clinics; Approximately 50 mental health units; Approximately 90 ambulance stations; Over 160 miscellaneous properties in the form of offices, housing, storage and distribution warehouses. Although no hospitals were disposed of during the reporting period, the sale of six smaller health premises was completed. Minffordd Hospital, Bangor is now closed/vacant and Bryn Seiont Hospital, Caernarfon will close during 2009 following the transfer of clinical services to alternative premises. Bronygarth Hospital in Gwynedd was closed and services transferred to Ysbyty Alltwen in April Llwynypia Hospital is expected to be sold on completion of the second Rhondda Hospital late in Abertillery Hospital closed in and its sale is anticipated late in The age of the estate Figure 1 shows the age profile of the NHS estate in Wales and illustrates the changes in profile since the EFPMS was introduced in (%) Pre to to to to to to to Present 2001/ / / / / / / /09 Figure 1: Age profile of the NHS estate in Wales 14 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

16 ESTATE PROFILE Age profile can be a useful indicator of the likely condition of the estate. Figure 1 graphically illustrates the challenges the NHS faces in modernising the health estate in Wales where half of the buildings are over 35 years old, 20% pre-date 1948 and 20% are less than 14 years old. The chart demonstrates that, since the introduction of the EFPMS, there has been a clear reduction in the proportion of buildings pre-dating 1948 along with a small increase of those dating from More significant changes to the profile are expected over the next two years as a number of older hospitals are expected to be replaced with new ones such as Ysbyty Ystrad Fawr in Ystrad Mynach and Ysbyty Aneurin Bevan in Ebbw Vale. Long term, radical changes to the profile will require the implementation of a wider modernisation programme, underpinned by a robust capital investment programme. 3.3 The essential and non-essential estate The WAG requires NHS property holding bodies to develop estate strategies that support service plans. This process can lead to the requirement for new buildings and the rationalisation of old stock. If a building or land has a health use of more than five years it is categorised as essential, and five years or less as non-essential. It is important for the Service that non-essential buildings and land are disposed of as quickly as possible to ensure that resources tied up in maintaining these assets are directed to where they can be used more efficiently. Figures 2 and 3 show the extent of essential and non-essential buildings and land for all NHS Trusts. 350, , , , , ,000 50,000 0 Abertawe Bro Morgannwg Cardiff and Vale Cwm Taf Gwent Hywel Dda GIA (m²) North Wales North West Wales Powys Velindre WAST Essential Non-Essential Figure 2: Essential and non-essential building areas WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 15

17 ESTATE PROFILE Abertawe Bro Morgannwg Cardiff and Vale Cwm Taf Gwent Hywel Dda North Wales Trust Land Area (ha) North West Wales Powys Velindre WAST Essential Non-Essential Figure 3: Essential and non-essential land areas With reference to Figure 3, the essential land area throughout Wales has increased by 37 ha. The inclusion of WAST data has contributed 14 ha to this increase. 3.4 Expenditure on the NHS estate The NHS estate is an extremely important resource which, based on a valuation date of 1 April 2009, the Valuation Office has valued at an existing use value of 2.3 billion. Its annual running cost is estimated at over 300 million and, in addition, capital is required to maintain and modernise it, and to develop new facilities. Figure 4 shows the capital investment in the NHS since and backlog maintenance costs since Also shown is the projected growth in capital expenditure and its predicted effect on the underlying backlog maintenance liability. The figures include capital investment provided by the Private Finance Initiative (PFI). 16 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

18 ESTATE PROFILE Capital investment in the NHS in Wales Millions Financial year Annual net investment Investment required to keep pace with inflation Cumulative shortfall Total backlog maintenance Backlog maintenance at index level Figure 4: Capital investment in the NHS in Wales WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 17

19 4 ESTATE PERFORMANCE 4.1 General information Welsh Health Circular (2002)50 Introduction of an Estates Performance Management System, was issued in April 2002 and provided details of five national PIs and their associated targets. The targets set by the Assembly for 2005 and 2008, shown in Figure 5, relate to the essential estate, that is, the estate that is deemed to have a long-term health use of five years or more. They are based on the performance indicators set out in the Estatecode guidance and cover Physical condition, Statutory and safety compliance, Energy performance, Space utilisation and Functional suitability. Whilst the target dates have passed, they are considered to provide a useful benchmark for use in this report. PERFORMANCE TARGET Physical condition 75% of the estate to be in category B or above 90% of the estate to be in category B or above Statutory and safety compliance 75% of the estate to be in category B or above 90% of the estate to be in category A Functional suitability 75% of the estate to be in category B or above 90% of the estate to be in category B or above Space utilisation 75% of the estate to be in category F 90% of the estate to be in category F Energy performance 15% reduction in primary energy consumption 75% of the estate to be in category B or above 90% of the estate to be in category B or above TARGET DATES COMMENTS 2005 Category B applies to buildings that are sound, operationally safe and exhibit only minor deterioration Category B applies to buildings where action will be needed in the current plan period to comply with relevant guidance and statutory requirements 2008 Category A applies to buildings that comply with all statutory requirements and relevant guidance 2005 Category B applies to buildings that are satisfactory and minor changes are needed Category F applies to buildings that are fully used This is a UK Government primary energy reduction target 2005 Category B applies to buildings with an energy performance of < 65 GJ/100m³ 2008 Figure 5: Table showing national performance indicators and targets The PIs and Trusts' progress in meeting the targets are discussed in more detail later in this report. 18 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

20 ESTATE PERFORMANCE The traffic light compliance code adopted for the report has been used again in this report as a way of visually expressing Trusts progress in meeting the targets set out in Figure 5. Although the target dates have passed, they are considered to provide a useful benchmark. Each PI has again been split into three bands of compliance, colour coded as follows: Failed to meet the 2005 & 2008 targets Met the % target Met the % target All Trusts have been banded according to the above criteria for each of the national PIs The Trusts performance against each of the targets has been estimated from the data submitted and been used to obtain an average figure for each Trust as well as an all-wales figure. 4.2 Physical condition Backlog maintenance Backlog maintenance costs across Wales have increased overall by approximately 37 million, from million reported in to million in It should be noted that the major contributors to the overall increase are the inclusion, for the first time, of the Welsh Ambulance Services Trust (WAST) backlog costs, amounting to almost 15 million, and the large increase in backlog costs reported in respect of Morriston Hospital, amounting to over 17 million. In addition, significant increases reported in respect of Prince Philip Hospital, Cardiff Royal Infirmary and Ysbyty Gwynedd combine to contribute a further 16 million to the overall total for this year The backlog maintenance position for the 10-year period from 1999 is summarised in Figure 6. It is noted that during this period, backlog maintenance costs, in real terms, have fallen by 28 million and Costs ( Millions) / / / / / / / / / /09 Physical Condition Statutory & Safety Total Backlog Maintenance Figure 6: Graph showing trend in backlog maintenance costs WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 19

21 ESTATE PERFORMANCE by 177 million from a peak in It should be noted that energy-upgrading costs are included in the physical condition costs and cannot be identified separately. A breakdown of the individual Trust costs is detailed in Appendices II-XI Further examination of the data shows that, excluding the aggregate grouped properties, backlog maintenance reductions totalling 23 million were reported in respect of 43 sites, no change was reported in respect of 5 sites, and increases totalling 63 million were reported in respect of 68 sites. Where increases in backlog maintenance have been recorded, these are spread across a large number of sites. A detailed breakdown of the backlog maintenance costs by site is included in Appendices II-XI Cost ( millions) / / / / / / / / / / /09 Total Backlog Maintenance Costs Residual Sites - Owned by the NAW, but occupied by the NHS Operational Sites - Trust sites that are fully functional Non-Essential Estate - Trust sites that are surplus or due for closure Figure 7: Trend in backlog maintenance costs illustrating the effect of the residual estate and sites that are closed or due for closure The reported backlog maintenance costs include 91 million associated with sites that have been designated as either non-essential or part of the residual estate or declared surplus. It can be seen from Figure 7 that the implementation of the disposal programme for the residual estate would reduce the overall backlog maintenance costs of the NHS by 61 million. It should be noted that, with effect from 1 October 2009, the residual estate transferred from the Assembly to the WAST, Velindre NHS Trust and the seven new Health Boards. In future, therefore, properties previously referred to as being part of the residual estate will become part of the relevant NHS organisation s non-essential estate. Further details relating to these sites can be found in Appendix XII During the reporting period Abertillery & District and Bron-y-garth Hospitals closed. In future, the disposal of these properties will reduce the backlog maintenance liability of the NHS in Wales by almost 1.4 million. 20 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

22 ESTATE PERFORMANCE The breakdown of the backlog maintenance costs by health region is detailed in Figures 8 and 9. Region Physical Cost to B Stat & Safety Cost to B Fire Safety Cost to B DDA Costs Total Backlog Cost Cost/m² ( ) ( ) ( ) ( ) ( ) ( /m²) Mid & West Wales 111,754,603 19,576,990 7,218,006 9,694, ,549, North Wales 89,265,703 7,040,839 63,971,707 4,480, ,278, South East Wales 136,162,291 61,970,037 8,257,890 4,798, ,390, All-Wales Total 337,182,597 88,587,866 79,447,603 18,973, ,218, Figure 8: Backlog maintenance costs by Health Region Figure 9: Percentage of backlog maintenance by Health Region A risk based methodology for establishing and managing risk was introduced in December 2004 under the cover of WHEN 04/28 - EFPMS data definitions and completion notes , and the EFPMS now includes data fields to enable this information to be collected. Figures 10 and 11 detail the risk assessed backlog costs apportioned by Health Region in the four risk categories set out in the risk based methodology. Region High Risk Cost ( ) Significant Risk Cost ( ) Moderate Risk Cost ( ) Low Risk Cost ( ) Figure 10: Risk assessed backlog maintenance costs by Health Region Risk Adjusted Cost ( ) Mid & West Wales 27,253,180 49,986,774 29,824,890 31,484,755 80,478,070 North Wales 31,410,305 21,295,613 40,162,166 67,410,166 58,025,373 South East Wales 23,552,953 87,817,034 41,182,339 53,837, ,996,645 All-Wales Total 82,216, ,099, ,169, ,732, ,500,088 It can be seen from Figure 10 that the sum of the high and significant risks totals 241 million, which represents 48% of the total risk assessed backlog. The figure has increased by 35 million compared with that reported for The guidance that supports the new methodology recommends that the elements that make up this figure should be given priority and addressed at the earliest possible opportunity. In addition to the four risk-assessed categories there is a weighted methodology for calculating the Risk Adjusted Backlog (RAB). The RAB is considered to provide a more realistic assessment of the overall condition of the estate and, over time, it is anticipated that this method of reporting backlog WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 21

23 ESTATE PERFORMANCE maintenance will replace the one currently used. Using this methodology the reported RAB for is 258,500,088 whereas the corresponding total backlog maintenance figure is 505,218,066. Figure 11 illustrates the breakdown of the total backlog maintenance cost in terms of the four risk assessed categories. Low Risk Backlog Cost 30% High Risk Backlog Cost 16% Moderate Risk Backlog Cost 22% Significant Risk Backlog Cost 32% Figure 11: Percentage of risk assessed backlog maintenance Figure 12 shows the four risk categories of each Trust s total backlog, (as a percentage of total backlog) and reported capital investment in backlog (as a percentage of total backlog). Capital investment in backlog is defined as The amount contained within the Total Capital Investment figure which was invested in the NHS Trusts estate specifically to reduce backlog maintenance costs, inclusive of physical condition, fire safety, and health & safety. It can be seen that eight Trusts appear to have invested sufficient capital to meet the high-risk backlog. The remainder are either awaiting funding associated with outstanding business cases or are continuing to manage the risks. 100% 80% 60% 40% 20% 0% Abertawe Bro Morgannwg Cardiff and Vale Cwm Taf Gwent Healthcare Hywel Dda North Wales North West Wales Powys Teaching LHB Velindre Welsh Ambulance Services High Risk Significant Risk Moderate Risk Low Risk Investment to reduce backlog Figure 12: Risk profile of backlog and investment to reduce backlog 22 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

24 ESTATE PERFORMANCE Figure 13 shows backlog maintenance costs by Trust submitted for the period Detailed analysis of the individual Trust information is included in Appendices II-XI. 120, ,000 80,000 60,000 40,000 20,000 0 Abertawe Bro Morgannwg Cardiff and Vale Cwm Taf Gwent Healthcare Hywel Dda North Wales North West Wales Total Backlog Maintenance Costs ( x 1000) Powys Teaching LHB Velindre Welsh Ambulance Services Figure 13: Comparison of backlog maintenance costs by Trust Physical condition targets Figure 14 shows the percentage of the estate under Physical condition that is in Estatecode condition B or above. The figures for are derived from data submitted by individual Trusts, combined as necessary, to take into account Trust mergers since April This adjustment has enabled performance to be compared with that of It is noted that none of the Trusts have met the 90% target set for The all-wales performance, however, has improved from red to amber, falling still far short of the target required in order to move it into the green band. Trust Physical Condition of Trusts Abertawe Bro Morgannwg Cardiff and Vale Cwm Taf Gwent Healthcare Hywel Dda North Wales North West Wales Powys Teaching LHB Velindre Welsh Ambulance Services All Wales Average Key Met % Target Met % Target Failed to meet 2005 & 2008 Targets Figure 14: Physical condition of Trusts percentage of the estate in condition category B or above WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 23

25 ESTATE PERFORMANCE 4.3 Statutory and safety compliance All NHS Trusts must comply with current Health and Safety Standards and Codes of Practice. Some examples of the main health and safety requirements that Trusts have to comply with include: Electricity at Work Regulations Control of legionella Firecode Control of Substances Hazardous to Health Asbestos Pressure systems Disability Discrimination Act (DDA) The Hazardous Waste Regulations Health and Safety at Work This list is not exhaustive and there are many other statutory requirements that Trusts have to comply with in order to protect the safety of their staff, patients and visitors on their sites The EFPMS does not itemise all health and safety elements and, as a consequence, it is not possible to identify the separate costs for these items. The only health and safety issues that are individually costed are those dealing with fire safety compliance and the DDA The cost of complying with statutory and safety requirements (including fire safety) for all the sites included in the EFPMS is estimated to be 168 million, of which 124 million relates to the essential estate Trusts should have been fully compliant with the DDA by October All 10 Trusts have carried out surveys to identify the extent of the work required to achieve compliance. Costs associated with this work are shown in Figure Abertawe Bro Morgannwg Cardiff & Vale Cwm Taf Gwent Healthcare Hywel Dda North Wales North West Wales Powys Velindre WAST Cost ( /m²) DDA Cost / Occupied Floor Area All Wales Average ( 11.43/m²) Figure 15: Comparison of DDA costs/occupied floor area 24 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

26 ESTATE PERFORMANCE It has been estimated that that the total cost of implementing DDA work is 20 million, which remains the same as the figure reported in Figure 15 indicates that the estimated cost/m 2 for carrying out the required DDA works varies from 0.31/m 2 in Cardiff and Vale NHS Trust to 44.32/m 2 in Hywel Dda NHS Trust. The all-wales average is estimated to be 11.43/m 2 which is a 53p reduction on the average for last year The cost of complying with Firecode across Wales is estimated to be 12 million, which is an increase of 1 million on The estimated cost excludes specific remedial works associated with Ysbyty Glan Clwyd and Prince Charles Hospital, which total approximately 67 million. Statutory and safety compliance targets Figure 16 shows the percentage of the estate under Statutory and safety compliance that is in Estatecode condition B or above. The figures for are derived from data submitted by individual Trusts, combined as necessary, to take into account Trust mergers since April This adjustment has enabled performance to be compared with that of It is noted that the same two Trusts as last year have met the 90% target set for The all-wales performance, however, has deteriorated slightly but remains within the amber band, falling still far short of the target required to move it into the green band. Trust Statutory and safety compliance of Trusts Abertawe Bro Morgannwg Cardiff and Vale Cwm Taf Gwent Healthcare Hywel Dda North Wales North West Wales Powys Teaching LHB Velindre Welsh Ambulance Services All Wales Average Key Met % Target Met % Target Failed to meet 2005 & 2008 Targets Figure 16: Statutory and safety compliance of Trusts In addition to Statutory and safety compliance, the EFPMS collects separate data relating to the level of Fire safety compliance within each Trust, together with an estimate of the costs required to achieve that compliance. These costs are summarised in WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 25

27 ESTATE PERFORMANCE Figure 17 shows the percentage of essential building area considered to be in full fire safety compliance. It can be seen that the all-wales performance has deteriorated slightly but remains within the amber band. However, it falls significantly short of the target required to move it into the green band. Trust Fire safety compliance of Trusts Abertawe Bro Morgannwg Cardiff and Vale Cwm Taf Gwent Healthcare Hywel Dda North Wales North West Wales Powys Teaching LHB Velindre Welsh Ambulance Services All Wales Average Key Met % Target Met % Target Failed to meet 2005 & 2008 Targets Figure 17: Fire safety compliance of Trusts 4.4 Functional suitability Functional suitability is used to determine how effectively a building (or part of a building) supports the delivery of specific Trust services. Key factors, which contribute to these assessments, are: Internal space relationships including walking distances, observation of patients by staff and security; Support facilities such as the adequate provision of toilets and bathrooms, adequate seating and waiting space, and provision for disabled people; Location, including distance to key linked facilities, access to parking areas and access to public transport Figure 18 opposite, shows the percentage of the estate under Functional suitability that is in Estatecode condition B or above. The figures for are derived from data submitted by individual Trusts, combined as necessary, to take into account Trust mergers since April This adjustment has enabled performance to be compared with that of It can be seen that only two Trusts have met the 90% target set for 2008 although five others have reported an improvement in performance. The all-wales performance has improved slightly, though it remains within the amber band, falling still far short of the target required to move it into the green band. 26 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

28 ESTATE PERFORMANCE Trust Functional suitability of Trusts Abertawe Bro Morgannwg Cardiff and Vale Cwm Taf Gwent Healthcare Hywel Dda North Wales North West Wales Powys Teaching LHB Velindre Welsh Ambulance Services All Wales Average Key Met % Target Met % Target Failed to meet 2005 & 2008 Targets Figure 18: Functional suitability of Trusts 4.5 Space utilisation Space utilisation explores how well available space is being used. The objective is to hold no more space than is necessary to satisfy the reasonable demands of the present function and planned requirements Figure 19 shows the percentage of the estate under Space utilisation that is in Estatecode condition F. The figures for are derived from data submitted by individual Trusts, combined as necessary, to take into account Trust mergers since April This adjustment has enabled performance to be compared with that of Trust Space Utilisation of Trust Abertawe Bro Morgannwg Cardiff and Vale Cwm Taf Gwent Healthcare Hywel Dda North Wales North West Wales Powys Teaching LHB Velindre Welsh Ambulance Services All Wales Average Key Met % Target Met % Target Failed to meet 2005 & 2008 Targets Figure 19: Space utilisation of Trusts WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 27

29 ESTATE PERFORMANCE It is noted that five Trusts have met the 90% target set for The all-wales performance has improved although it remains within the amber band. It falls only slightly short of the target required to move it into the green band. 4.6 Energy performance Net energy Net energy consumption for the whole of Wales rose from 2,557,198GJ in to 2,577,784GJ in However, it has been noted from weather-corrected data, that degree days, which is the standard method of weather correction, has increased for the third consecutive winter. Therefore, in order to accurately determine the trend in energy consumption, weather correction has been used. Accordingly, based on weather-corrected figures, consumption decreased from 2,500,000GJ in to 2,400,000GJ in The fall between and was 4% and is now 17% below the base year weather-corrected figure of 2,900,000GJ. Transposing these figures to the graph in Figure 20 shows that, since 1999, there has been a general downward trend in weather-corrected consumption (GJ x millions) Figure 20: Graph showing the trend in net energy consumption in Gigajoules over time Primary energy Figure 21 opposite, shows primary energy consumption data for The figures for are derived from data submitted by individual Trusts, combined as necessary, to take into account Trust mergers since April This adjustment has enabled performance to be compared with that of It can be seen that primary energy consumption in the whole of Wales during was 3,737,597GJ, compared with 3,709,555GJ for This equates to a rise in primary energy consumption of 0.76%. 28 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

30 ESTATE PERFORMANCE Trust PRIMARY (Base Year) PRIMARY PRIMARY Change on Previous Year Change on Base Year (GJ) (GJ) (GJ) (%) (%) ABM 753, , , Cardiff and Vale 811, , , Cwm Taf 324, , , Gwent 554, , , Hywel Dda 371, , , North Wales 461, , , North West Wales 254, , , Powys 102,536 91,021 94, Velindre 22,552 37,637 38, All Wales Total 3,657,029 3,709,555 3,737, Figure 21: Table showing primary energy consumption in Gigajoules Figure 22 shows the trend in primary energy consumption since and Figure 23 overleaf, shows the primary energy trend on a Trust by Trust basis. Figure 22: Chart showing primary energy usage to Primary energy consumption has risen as the percentage of electrical energy in the total amount of energy consumed continues to rise. The returns show that total electrical energy is now approximately 25% of the total bought in energy, emphasising the need for Trusts to focus on electrical savings as part of any energy-saving schemes they may consider. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 29

31 ESTATE PERFORMANCE 900, , , ,000 (GJ) 500, , , , ,000 0 ABM Cardiff and Vale Cwm Taf Gwent Hywel Dda North Wales North West Wales Powys Velindre Figure 23: Chart showing primary energy usage over the assessment period In addition to purchased electricity, a further 66,000GJ of CHP on-site generated electricity was reported for , which was 8.86% of the total electrical consumption. This compares with a figure of 4.9% for the previous reporting year. These figures do not include the output from the installation at Llandough Hospital as this is treated as local energy in the EFPMS. The need to disconnect older CHP installations in order to install new plant at the University Hospital of Wales resulted in a large rise in primary energy consumption on that site in the previous reporting period. The new installation is now operational, resulting in a greater CHP capacity, with extended operating times, thus increasing the percentage of electricity derived. This has helped with the increase in on-site generated electricity reported this year. It should be noted that, as the new installation was only operating at its full capacity for part of the reporting period, further improvements are expected. During this reporting year a number of CHP sites continued to experience severe maintenance problems that dramatically reduced their output. Some of these problems have now been resolved and others are close to resolution. It is therefore expected that another significant increase in output will be reported next year with a consequential reduction in the amount of grid-derived electrical energy. Further analysis on an individual Trust basis can be found in Appendices II-XI It is noted that Trusts are reporting a greater heated volume (12% increase over the base year) resulting from new developments. Similarly, they are reporting increased service demand for high electrical energy consuming clinical services such as diagnostic imaging. Both issues are impacting on energy consumption. It is difficult to quantify the impact with no direct statistical comparison; however, the Government s forthcoming Carbon Reduction Commitment will use increases in revenue costs as evidence of and compensation for increases in service demand. 30 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

32 ESTATE PERFORMANCE The total cost of energy across the NHS in Wales for was 35.3 million compared with 28 million last year, a rise of 26%. Costs of individual bought-in fuels were 27.48/GJ for electricity (compared with 24.16/GJ last year), 8.41/GJ for gas (compared with 5.65/GJ last year) and 12.33/GJ for oil (compared with 10.67/GJ last year). The average overall cost was approximately 13.19/GJ compared with 11.10/GJ last year, an increase of 19%. Last year s report indicated that significant price rises were expected but this year no clear trend can be predicted and it is expected that prices will be volatile. Figure 24 shows the average overall energy cost since , with and without adjustment for inflation. The chart shows that, although there are year-on-year fluctuations that may reduce the cost of energy, there is an increasingly rising trend that is unlikely to change in the long term ( ) COST/GJ COST/GJ INFLATION INFLATION ADJUSTED ADJUSTED Figure 24: Average energy cost Carbon emissions Figure 25 overleaf, shows the amount of carbon dioxide emissions for each Trust over the last two years. It can be seen that in the NHS in Wales produced 117,245 tonnes of CO 2 compared with 114,962 tonnes in , an increase of 2% due mainly to service pressures and increases in heated volume. This highlights the significance of low carbon technologies and the importance of continuing to drive forward CHP, renewable energy and other low carbon technologies to achieve genuine reductions in carbon emissions Notwithstanding this increase, a comparison with the base year figure of 185,000 tonnes of carbon dioxide indicates that a reduction of approximately 37% has been achieved. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 31

33 ESTATE PERFORMANCE Trust CO 2 CO 2 Variation CO 2 (Tonnes) (Tonnes) (%) ABM 23,304 22, Cardiff and Vale 20,929 20, Cwm Taf 13,102 12, Gwent 19,393 19, Hywel Dda 13,101 12, North Wales 14,582 14, North West Wales 8,515 8, Powys 3,705 4, Velindre All Wales 117, , Figure 25: Carbon Dioxide Emissions It should be noted that the above figures take into account the use of zero rated green electricity. If the zero rating factor is not taken into account, the revised emissions figure would be 189,084 tonnes, approximately 2.2% higher than the base year figure. Energy Performance - Targets Energy PIs have been set for new and existing buildings. The targets are 35-55GJ/100m 3 for new buildings and 55-65GJ/100m 3 for existing buildings Figure 26 shows Trusts performance against the energy PI for existing buildings. It is noted that all Trusts fall within the green band having met the target. With a figure of 55.07GJ/100m 3 the all-wales performance has improved since last year and represents a 20.4 % improvement over the base year figure of 69.41GJ/100m 3. This is well above the UK target for the government estate, which is an improvement in energy efficiency of 15% by from a base of Trust Energy performance indicators of Trusts Abertawe Bro Morgannwg Cardiff and Vale Cwm Taf Gwent Healthcare Hywel Dda North Wales North West Wales Powys Teaching LHB Velindre All Wales Average Key < > 67 GJ/100m 3 GJ/100m 3 GJ/100m 3 Figure 26: Energy Performance indicators of Trusts 32 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

34 ESTATE PERFORMANCE A more detailed analysis of individual Trusts performance can be found in Appendices II-XI Figure 27 shows the percentage of the estate under Energy performance that is in Estatecode condition B or above. The figures for are derived from data submitted by individual Trusts, combined as necessary, to take into account Trust mergers since April This adjustment has enabled performance to be compared with that of It can be seen that four Trusts have met the 90% target set for The Welsh Ambulance Service did not submit a return. The all-wales performance has deteriorated and now falls within the red band. Energy performance of Trusts Trust % of estate in category B Abertawe Bro Morgannwg Cardiff and Vale Cwm Taf Gwent Healthcare Hywel Dda North Wales North West Wales Powys Teaching LHB Velindre Welsh Ambulance Services All Wales Average Key Met % Target Met % Target Figure 27: Energy performance of Trusts Failed to meet 2005 & 2008 Targets WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 33

35 5 ENVIRONMENTAL ISSUES 5.1 Waste The total quantity of waste generated by the NHS in Wales in was reported as 18,865 tonnes, compared with 19,106 tonnes in the previous year. However, the cost of disposal of waste in was 5.07 million compared with 4.33 million in the previous year. This headline figure represents a 2% overall reduction in the amount of waste disposed, with a corresponding increase in costs of 17% over the year highlighting the continuing cost pressures including the on-going landfill tax escalator Against this headline picture of reducing overall waste, the headline target from the Healthcare Waste Strategy for Wales was that by 2010 Trusts should reduce their overall waste tonnage by 10% against a baseline. Over the last few years there has been a steady progression of overall reductions following a period of steady increases. Therefore, when compared against the baseline year, NHS Wales total waste production has shown a 3% increase Over recent years there have been many changes in the reporting categories for waste. However, this year, whilst the reporting categories have not been altered, the number and structure of NHS Trusts in Wales has changed due to the merger and re-organisation programme. The changes have been taken into account in some charts showing trends over a number of years. It remains important to note that reported figures and totals do not necessarily represent all waste that is generated, only that which is covered by the EFPMS categories, i.e. waste that goes to landfill, clinical waste disposal facilities or disposal as WEEE Figure 28 shows that the principal waste streams by volume are comprised of approximately 56% landfill waste and 44% clinical waste. This suggests that the landfill stream is showing reductions which will be investigated below Figure 29 shows that the cost of disposal is split into approximately 70% clinical versus 30% landfill waste. This demonstrates that, as in previous years, clinical and hazardous waste still accounts for the majority of the costs, although they make up a smaller (though increasing) fraction of the waste. This, of course, reflects the more complex treatment and disposal requirements of clinical wastes. 7% 27% 17% 56% 37% 56% High Temp Disposal volume Non burn treatment waste volume Landfill waste volume High Temp Disposal cost Non burn treatment waste cost Landfill waste cost Figure 28: Breakdown of waste streams in Figure 29: Breakdown of waste costs in WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

36 Clinical waste The reporting of clinical waste is sub-divided into incinerated (high temperature disposal) waste and alternative (non-incineration) treatment and disposal waste The combined total clinical waste disposed of during is 8,086 tonnes compared with 8,097 tonnes in It should be noted that within this figure there has been an increase of almost 200 tonnes of incineration waste, with a corresponding decrease in the amount of alternative treatment waste. It is also noted that the amount of clinical waste the NHS in Wales has generated and disposed of has remained much the same for the last 3 years The breakdown of how much clinical waste in total has been generated across the Trusts in Wales over the past 5 reporting years is illustrated in Figure 30. Data submitted to the EFPMS reinforces the importance of reducing the amount of clinical waste going to the more expensive incineration route rather than the alternative treatment. Currently, the all-wales average going to incineration is 15% whereas the aim, as expressed by the all-wales contract provider, is 10% or lower. 2,000 1,800 1,600 1,400 1,200 1, ABM Cardiff and Vale Cwm Taf Tonnes Gwent Healthcare Hywel Dda North Wales North West Wales Powys Local Health Board Velindre Figure 30: Clinical waste volumes Across Wales the cost for the disposal of clinical waste in was reported at 3.7 million compared with 3.2 million in This gives an all-wales average disposal cost of 457 per tonne, a significant increase on last year. It is important to note that this is a combined figure including incinerated and non-incinerated clinical wastes although the majority of the cost increase appears to be in the incinerated waste category. The increase is consistent across Wales As stated above, incinerated waste accounts, on average, for 15% of the overall clinical waste volume with a total of 1,247 tonnes generated. Non-incineration alternative treatment accounts for 6,839 tonnes or 85% of clinical waste. The costs of each stream are 847,000 for incineration and 2.85 million for alternative treatment, representing 23% and 77% respectively of the total clinical waste cost. There is, however, some concern over the robustness of some of the cost data submitted. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 35

37 ENVIRONMENTAL ISSUES Landfill waste Landfill waste as a reporting category corresponds approximately with the old category for domestic/commercial waste. NHS Trusts in Wales disposed of 10,525 tonnes of waste to landfill in compared with last year s domestic/commercial waste figure of 11,265 tonnes, a reduction approaching 7% year-on-year. However, the cost of landfill waste disposal increased from 1.22 million in to 1.37 million in The average all-wales disposal cost for landfill waste for was 130 per tonne, a 20% increase on the previous year, with significant local variations across individual Trusts. These raise doubts over the robustness of some of the data submitted In general across Wales, disposal cost increases are attributable to the year-on-year landfill tax escalator imposed by government to act as an incentive to waste minimisation and recycling. Currently, the escalator increases by 8 per tonne per year and will continue to apply until at least 2013, as announced by the Treasury in April Hence, the landfill waste stream will continue to represent the main opportunity for the new Health Boards to reduce their waste, and thereby improve their environmental performance, by initiating recycling and recovery schemes as the cost pressure to reduce waste increases. As an example of good practice, Gwent Healthcare, through the introduction of a major programme of waste segregation and recycling, has reduced its landfill waste by 28%, from 1,432 tonnes in to 1,026 tonnes this year, at a saving of over 61,000. Waste recovery/recycling of waste Data submitted this year shows that all Trusts in Wales report having some waste recovery/recycling schemes in place, which is a further improvement on previous years and a positive trend. The overall picture, however, is still very patchy with figures varying greatly and with many individual hospital sites still reporting zero recycling. These tend to be the smaller community sites which may reflect a lack of human resources to manage recycling initiatives across a large estate or on the inconsistencies in data reporting. However, it is positive to note that all major hospitals are now involved in recycling initiatives in some form The all-wales average recycling figure for domestic waste for was 13%, up 1% on the previous year. A comparison of Trust recycling rates is shown in Figure 31, opposite. It should be noted that the 2010 waste strategy targets for recycling are 30% of packaging and 25% of biodegradable domestic wastes. Data for these individual components are not currently specified within the EFPMS data set but, on examination of the recycling figures reported, with an all-wales rate of only 13%, it appears that the NHS is still falling well short on domestic (of which packaging and biodegradable wastes are a significant component) waste recycling. 36 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

38 ENVIRONMENTAL ISSUES ABM Cardiff & Vale Cwm Taf Gwent (%) Hywel Dda North Wales North West Wales Powys LHB Velindre All Wales Average Figure 31: Waste recycling performance in Waste electrical and electronic equipment (WEEE) The reporting of WEEE is still a relatively new requirement of the WEEE Regulations, which came into force in 2007, stipulating that any waste electrical items must be disposed of through specialist facilities where the waste can be treated correctly. However, due to the wide range of items and equipment which come under the umbrella of WEEE, which may all have differing disposal treatment requirements, and the absence of national arrangements for waste disposal, it is not possible to establish any meaningful trends for the data supplied for and Again for , whilst the situation is improving, there are concerns over the degree of completeness of the data. 5.2 Transport The reporting of transport information remains variable with gaps in much of the required data from several Trusts. A few Trusts failed to submit any of the required data. Due to the continued difficulties experienced by Trusts, the cost of patient travel has been removed from the EFPMS returns In terms of the number of Trusts that have adopted Green Transport Plans, as referred to in the EFPMS, it is noted that 6 of the 10 Trusts reported having a board-approved plan. It is likely that the requirement to submit data covering this environmental information will be reviewed in future Changes brought in by the Assembly in 2008 in connection with parking charges are likely to impact on the data required to be submitted in future by the new Health Boards The reporting of patient, visitor and staff transport mileage continues to be variable with several Trusts being unable to provide data for all three indicators. Therefore, data covering this area of the EFPMS has not been included. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 37

39 ENVIRONMENTAL ISSUES 5.3 Water usage The total water consumption in was just over 2.3 million m 3, 8% lower than the previous year The average cost of water, including sewage and other charges, was 2.48/m 3, representing an increase of almost 11% on the previous year`. Costs varied between 2.74/m 3 and 2.25/m 3. Figure 32 shows Trusts consumption for compared with in relation to floor area, which can be considered as a measure of efficiency. This year s all-wales average is 138m 3 per 100m 2, which is more than 7% lower than last year s figure, showing increased efficiency in water usage m 3 /100m ABM Cardiff & Vale Cwm Taf Gwent Hywel Dda North Wales North West Wales Powys LHB Velindre All Wales A Figure 32: Comparison of metered water consumption 38 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

40 APPENDIX I Trust backlog maintenance costs WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 39

41

42 APPENDIX I Trust backlog maintenance costs Comparison of Trust backlog maintenance costs/occupied floor area WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 41

43

44 APPENDIX II Summary of Trust Information ABERTAWE BRO MORGANNWG UNIVERSITY NHS TRUST WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 43

45

46 APPENDIX II Trust Name: No of Returns: Abertawe Bro Morgannwg University NHS Trust 16 Individual hospital sites Aggregate sites All other non-hospital sites General note The Abertawe Bro Morgannwg University NHS Trust was formed in April 2008 from the merger of the former Bro Morgannwg and Swansea NHS Trusts. Wherever feasible, the data submitted by these individual Trusts for the return has been combined to enable comparisons to be made against this year s return for the Abertawe Bro Morgannwg University NHS Trust. 1.0 Backlog maintenance 1.1 Figure 1 shows that the Trust backlog maintenance costs increased by approximately 44% from 48,930,715 in to 70,451,668 in The largest increase is associated with Morriston Hospital where backlog maintenance costs rose by 17,608,520 to 27,255,728. The Trust has confirmed that this is due to under reporting in previous years. In particular, no account had been taken of deteriorating engineering plant, resulting, for example, in an additional 11 million being included this year relating to the theatre plant alone. Similar reasons have been given to explain an increase of 2,025,080 at Singleton Hospital, highlighting the condition of electrical services along with the need to upgrade emergency lighting and fire alarm systems. The second largest increase was reported against Cefn Coed Hospital where costs rose by 3,633,076 to 6,733,901. Figure 1: Backlog maintenance costs by site WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 45

47 APPENDIX II The most significant single reduction is associated with the aggregate properties where backlog maintenance costs decreased by 2,343,444. Excluding the data submitted for aggregate properties, the backlog maintenance figures associated with hospitals relating to the original Swansea and Bro Morgannwg NHS Trusts increased by 23,473,309 and 390,088 respectively. 1.3 Figure 2 identifies the backlog maintenance costs broken down by risk category. It can be seen that the high and significant risk costs total 45,461,094; this is an increase of 25,413,363 compared with the costs reported by the individual Trusts for Site Name High Risk backlog cost Significant Risk backlog cost Moderate Risk backlog cost Low Risk backlog cost Risk adjusted backlog cost ( ) ( ) ( ) ( ) ( ) Cefn Coed Hospital 665,000 1,600,493 4,189, ,162 2,414,142 Cimla Hospital , ,868 7,158 Fairwood Hospital 5,000 8,000 6, ,189 Garngoch Hospital 40, , ,425 48,658 Gellinudd Hospital ,000 26,478 1,696 Glanrhyd Hospital 0 295, , , ,865 Gorseinon Hospital 42,230 2,623 50, ,780 53,490 Hill House Hospital 78, ,432 58,067 83,261 Llwyneryr Hospital 0 20,000 12,157 16,080 20,475 Maesgwyn Hospital 0 22, ,858 45,250 30,227 Maesteg Community Hospital 0 25, , ,674 48,420 Morriston Hospital 6,129,729 10,958,808 3,950,168 6,217,023 17,384,956 Neath Port Talbot Hospital Princess of Wales Hospital 1,599,500 5,097, ,865 1,017,899 6,739,303 Singleton Hospital 16,296, ,000 2,100, ,608 16,783,644 Tonna Hospital 49,000 76,000 70, , ,329 Aggregate sites 759,040 1,299,298 1,012, ,248 2,124,630 Trust Totals 25,663,872 19,797,222 14,009,211 10,981,363 46,236,443 Figure 2: Backlog maintenance costs by risk category 1.4 Figure 3 opposite, shows the Trust s performance against the key all-wales 2008 targets for the essential estate. It can be seen that the Trust has exceeded the target of 90% in respect of Functional suitability and Space utilisation. 46 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

48 APPENDIX II Target 90% Figure 3: Trust performance against all-wales 2008 targets 1.5 Figures 4-9 overleaf, graphically illustrate the Trust s performance against the key all-wales 2008 targets for the essential estate. The performance indicators for have been re-calculated using the data submitted by the previous individual Trusts. The Trust s performance against last year s re-calculated figures is as follows: Physical condition: improvement from 60% to 68% Statutory and safety compliance: remains the same at 66%. Fire safety: reduction from 94% to 86%. Functional suitability: improvement from 85% to 92%. Space utilisation: improvement from 79% to 97% Energy performance: reduction from 57% to 56% The performance of Abertawe Bro Morgannwg University NHS Trust against that of other Trusts in Wales is graphically represented in Appendix XIII. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 47

49 APPENDIX II Estimated Trust Conditions Physical Condition Statutory & Safety Compliance Fire Safety Compliance C & D 32% C & D 34% C & D 14% A & B 68% A & B 66% A & B 86% Figure 4 Figure 5 Figure 6 Energy Performance Functional Suitability Space Utilisation C & D 44% Unacceptable 8% Unacceptable 3% A & B 56% Acceptable 92% Acceptable 97% Figure 7 Figure 8 Figure Figures 10 and 11 illustrate the amount of essential building area and land the Trust has in its ownership. The essential building and land areas are both 98%. Essential Building Area Essential Land Area Non Essential 2% Non ssential 2% Essential 98% Essential 98% Figure 10 Figure Figure 12 opposite, illustrates the age profile of the Trust. The age profiles of the former Bro Morgannwg and Swansea NHS Trusts have been superimposed onto the figure. It can be seen that approximately 8% of the Trust s estate pre-dates 1948 and approximately 50% is less than 25 years. 48 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

50 APPENDIX II Figure 12: Age profile of the estate 2.0 Energy performance 2.1 In hospitals in the Trust recorded a net energy consumption of 539,589GJ, an increase of 1.2% on last year s figure of 533,200GJ, this figure being the aggregated total for the former Bro Morgannwg and Swansea NHS Trusts. The main reason for the rise is the increased consumption reported at the Trust s three largest hospital sites namely Princess of Wales, Morriston and Singleton. However, the Trust s increase in net consumption is in line with the reported increase in heated volume for the combined Trust. 2.2 Primary energy consumption figures show an increase of 1.8%, from 784,456GJ in to 798,642GJ this year. The latest sets of figures indicate that Trust consumption is 6% above the level of the base year compared with last year s figures of 0.37% below for Bro Morgannwg NHS Trust and 7.06% above for the Swansea NHS Trust. 2.3 In its first full year of operation the CHP installation at the Princess of Wales Hospital has had a significant effect on the site s intake of grid electricity. This has fallen from 33,602GJ in to 25,744GJ in , a reduction of 23%. 2.4 With reference to Figure 13, the overall PI of 61.74GJ/100m 3 remains within the target range of 55-65GJ/100m 3. At 39.90GJ/100m 3, the performance of Neath Port Talbot Hospital is by far the best in the Trust. At 72.59GJ/100m 3, the performance of the Trust s largest site, Morriston Hospital, is considerably above the target. Nonetheless, this figure is significantly better than last year s figure of Further improvements to the energy efficiency at this site would make a considerable difference to the overall Trust performance. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 49

51 APPENDIX II Last year the Bro Morgannwg PI was 51.36GJ/100m 3 whilst the corresponding figure for Swansea was 72.17GJ/100m Morriston Hospital s net energy consumption increased by 3.1% whilst its heated volume increased by 13%, leading to an 8.7% improvement in its PI. Hospital Net Hospital Energy Consumption Change on Previous Year Heated Volume Site PI (GJ) (%) (m 3 ) (GJ/100m 3 ) Cefn Coed Hospital 34, , Cimla Hospital 4, , Fairwood Hospital 1, , Garngoch Hospital 3, , Gellinudd Hospital 1, , Glanrhyd Hospital 27, , Gorseinon Hospital 4, , Hill House Hospital 6, , Llwyneryr Hospital 1, , Maesgwyn Hospital 2, , Maesteg Community Hospital 5, , Morriston Hospital 163, , Neath Port Talbot Hospital ** 51, , Princess of Wales Hospital* , Singleton Hospital 120, , Tonna Hospital 9, , Trust Totals , Figure 13: Individual hospital net energy PIs * Site with CHP installed ** PFI Hospital 3.0 Summary 3.1 Unsurprisingly, the merger of two Trusts, that in had delivered performance figures at opposite ends of the national estate performance indicator spectrum, has had a significant effect on the new Trust s performance figures, with only two of the 2008 national estates key performance indicators targets set by the Welsh Assembly Government in 2002 having been met. 3.2 The high backlog maintenance costs present the new Abertawe Bro Morgannwg University Health Board, which came into operation in October 2009, with significant challenges and suggest that the Board will need to focus its attention on the Princess of Wales, Morriston, Singleton and Cefn Coed Hospital sites. 3.3 The large increase in backlog maintenance costs, attributed mainly to under reporting in previous years, suggests that the new Board will need to strengthen its EFPMS data gathering and input processes. 3.4 Energy performance figures suggest that, whilst the overall Trust PI for fell within the target range, there is scope for significant efficiency improvements at many of its sites, focussing on Morriston and Singleton Hospitals. 50 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

52 APPENDIX III Summary of Trust Information CARDIFF AND VALE NHS TRUST WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 51

53

54 APPENDIX III Trust Name: No of Returns: Cardiff and Vale NHS Trust 9 Individual hospital sites Aggregate sites All other non-hospital sites 1.0 Backlog maintenance 1.1 Figure 1 shows that the Trust backlog maintenance costs decreased by just over 1% from 89,243,135 in to 88,207,713 in The most significant change is associated with the University Hospital of Wales, where a reduction of 4,030,341 was reported. 1.3 The highest backlog maintenance costs are again associated with the Cardiff Royal Infirmary (CRI) and are reported to be 53,942,190 (61% of the Trust s total), an increase of 3,665,190 over the costs reported in Figure 1: Backlog maintenance costs by site 1.4 Figure 2 overleaf, identifies the backlog maintenance costs broken down by risk category. It can be seen that the high and significant risk costs total 70,933,109; this is a reduction of 1,243,220 compared with the figures reported in WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 53

55 APPENDIX III Site Name High Risk backlog cost Significant Risk backlog cost Moderate Risk backlog cost Figure 2: Backlog maintenance costs by risk category Low Risk backlog cost Risk adjusted backlog cost ( ) ( ) ( ) ( ) ( ) Barry Hospital 0 0 5,974 11, Cardiff Royal Infirmary 512,125 53,430, ,942,190 CRI - West Wing 0 1,077, , ,080 1,133,605 Iorwerth Jones Centre Llandough Hospital 590 5,582,772 1,791, ,840 5,699,899 Rookwood Hospital 987, , , ,972 1,401,859 St Davids Hospital University Hospital of Wales 12,087 7,318,538 2,415,651 2,174,983 7,520,007 Whitchurch Hospital 0 742,053 3,954,769 2,563, ,453 Aggregate Sites 16, ,077 1,575,046 1,033, ,303 Trust Totals 1,528,494 69,404,615 10,781,252 6,493,353 71,662, Figure 3 shows the Trust s performance trend between 2001 and 2008 against the key all-wales 2008 targets for the essential estate. It can be seen that the Trust has exceeded the target of 90% in respect of the Fire safety, Energy performance and Space utilisation indicators. Target 90% Figure 3: Trend in Trust performance between against all-wales 2008 targets 1.6 Figures 4-9 opposite, graphically illustrate the Trust s performance against the key all-wales 2008 targets for the essential estate. The Trust s performance against last year s figures is as follows: Physical condition: remains the same at 84% Statutory and safety compliance: reduction from 88% to 87% Fire safety compliance: remains the same at 95% Functional suitability: remains the same at 88% 54 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

56 APPENDIX III Space utilisation: improvement from 91% to 95% Energy performance: improvement from 75% to 96% The performance of Cardiff and Vale NHS Trust against that of other Trusts in Wales is graphically represented in Appendix XIII. 1.7 Figures 10 and 11 illustrate the amount of essential building area and land the Trust has in its ownership. The essential building and land areas are 82% and 100% respectively. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 55

57 APPENDIX III 1.8 Figure 12 illustrates the age profile of the Trust. It can be seen that approximately 28% of the Trust s estate pre-dates 1948 and approximately 22% is less than 25 years old (%) Pre to to to to to to to Present Figure 12: Age profile of the estate 2.0 Energy performance 2.1 In hospitals in the Trust recorded a net energy consumption of 486,922GJ, a reduction of 5.2% on last year s figure of 513,738GJ. 2.2 Primary energy consumption figures show a reduction of 5.08%, from 775,297GJ in to 735,904GJ this year. The latest sets of figures indicate that Trust consumption is 9.36% below the level of the base year. 2.3 The new CHP installation at the University Hospital of Wales had a significant effect on Trust s energy performance during the reporting period, even though the sets were in use for only four months of that period. The installation contributed to the reduction in both net and primary energy but the replacement of green electricity with gas fired self generation caused an increase in reported carbon emission at the site. For the purposes of this report the CHP installation at Llandough Hospital has been treated as local energy. This means a slightly higher net consumption being reported than would otherwise have been the case. 2.4 With reference to Figure 13 the overall PI of 45.06GJ/100m 3 remains below the target range of 55-65GJ/100m 3. It should be noted that the particularly low PI figure for the CRI is due to a considerable reduction in usage. The heated volume, however, remains at the reported level due to the requirement to provide background heating to the unoccupied areas. The site is currently undergoing a major redevelopment. It is noted that Rookwood Hospital is the only site with a PI above the upper limit of the range, suggesting there is scope for significant improvement in performance at this site. 56 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

58 APPENDIX III Figure 13: Individual hospital net energy PIs * Site with CHP installed 3.0 Summary 3.1 The Trust has met and exceeded the targets set by the Welsh Assembly Government in 2002 in respect of three of the national estate performance indicators. The Trust faces a challenge to restore its statutory compliance performance to the levels achieved in previous years. 3.2 The high backlog maintenance figure for the Trust continues to be dominated by the Cardiff Royal Infirmary which, alone, at almost 54 million, represents 61% of the Trust s total. The current modernisation programme for that site will have a huge impact on the Trust s backlog maintenance costs. 3.3 The Trust s investment in new CHP units at the University Hospital of Wales is reflected in an excellent energy performance PI and explains, in part, the significant reduction in the Trust s reduction in net and primary energy consumption. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 57

59

60 APPENDIX IV Summary of Trust Information CWM TAF NHS TRUST WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 59

61

62 APPENDIX IV Trust Name: No of Returns: Cwm Taf NHS Trust 10 Individual hospital sites Aggregate sites All other non-hospital sites General note The Cwm Taf NHS Trust was formed in April 2008 from the merger of the former North Glamorgan and Pontypridd & Rhondda NHS Trusts. Wherever feasible, the data submitted by these individual Trusts for the return has been combined to enable comparisons to be made against this year s return for the Cwm Taf NHS Trust. 1.0 Backlog maintenance 1.1 Figure 1 shows that the Trust backlog maintenance costs increased by just over 3% from 57,865,352 in to 59,671,503 in The largest backlog is associated with Prince Charles Hospital, where the estimated backlog maintenance costs are 32,334,408, which equate to 54% of the Trust s total. This figure is marginally greater than last year s but the hospital is currently subject to significant redevelopment which, on completion, will significantly reduce the backlog at this site. 1.3 Llwynypia Hospital is scheduled to be replaced by the new Ysbyty Cwm Rhondda which is currently being commissioned and due to be opened in This will have the effect of reducing the Trust s backlog by 3,202,484 which will be reflected in the EFPMS return. Dewi Sant Hospital is the only site with a reported reduction ( 36,738) in backlog maintenance. 1.4 It is noted that, for the first time, backlog maintenance costs have been recorded in connection with the Royal Glamorgan Hospital. These total around 870,000, most of which falls into the moderate risk category. Figure 1: Backlog maintenance costs by site WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 61

63 APPENDIX IV 1.5 Figure 2 identifies the backlog maintenance costs broken down by risk category. It can be seen that the high and significant risk costs total 25,736,606; this is an increase of 515,115 compared with the costs reported by the individual Trusts for It is noted that, excluding the data submitted for the aggregate properties, the high and significant risk costs associated with the Trust hospitals located in the former North Glamorgan and Pontypridd & Rhondda NHS Trusts are 23,391,768 and 790,607 respectively. Site Name High Risk backlog cost Significant Risk backlog cost Moderate Risk backlog cost Low Risk backlog cost Risk adjusted backlog cost ( ) ( ) ( ) ( ) ( ) Aberdare General Hospital 3,235, ,926 1,921,853 1,441,390 5,877,606 Dewi Sant Hospital 20,354 3,256 38,213 10,162 26,456 Llwynypia Hospital 380, ,822, ,846 Mountain Ash General 1,959, ,541 1,431,082 1,073,312 3,927,642 Pontypridd & District 35, ,000 25,773 5, ,165 Prince Charles Hospital 9,188,490 5,143,539 10,287,079 7,715,309 15,052,125 Royal Glamorgan Hospital 0 100, ,000 68, ,444 St Tydfil's Hospital 1,857, ,472 1,211,732 3,139,487 2,623,462 Tonteg Hospital 17, , ,729 Ysbyty George Thomas 30, ,475 1,913 18, ,597 Aggregate Sites 1,002, ,195 1,016, ,367 1,732,237 Trust Totals 17,728,202 8,008,404 19,734,640 14,200,261 30,181,309 Figure 2: Backlog maintenance costs by risk category 1.6 Figure 3 shows the Trust s performance against the key all-wales 2008 targets for the essential estate. It can be seen that the Trust has met or exceeded the target of 90% in respect of Energy performance. Target 90% Figure 3: Trust performance against all-wales 2008 targets 62 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

64 APPENDIX IV Estimated Trust Conditions Physical Condition Statutory & Safety Compliance Fire Safety Compliance C & D 29% C & D 20% C & D 31% A & B 71% A & B 80% A & B 69% Figure 4 Figure 5 Figure 6 Energy Performance Functional Suitability Space Utilisation C & D 10% Unacceptable 36% Acceptable 64% Unacceptable 24% A & B 90% Acceptable 76% Figure 7 Figure 8 Figure Figures 4-9 graphically illustrate the Trust s performance against the key all-wales targets for the essential estate. The performance indicators for have been re-calculated using the data submitted by the individual Trusts. The Trust s performance against last year s re-calculated figures is as follows: Physical condition: improvement from 70% to 71% Statutory and safety compliance: unchanged at 80% Fire safety compliance: reduction from 75% to 69% Functional suitability: reduction from 65% to 64% Space utilisation: reduction from 77% to 76% Energy performance: reduction from 94% to 90% The performance of Cwm Taf NHS Trust against that of other Trusts in Wales is graphically represented in Appendix XIII. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 63

65 APPENDIX IV Essential Building Area Essential Land Area Non Essential 6% Non Essential 25% Essential 94% Essential 75% Figure 10 Figure Figures 10 and 11 illustrate the amount of essential building area and land the Trust has in its ownership. The essential building and land areas are 94% and 75% respectively. 1.9 Figure 12 illustrates the age profile for the Trust. The age profiles of the former North Glamorgan and Pontypridd & Rhondda NHS Trusts have been superimposed onto the figure. It can be seen that approximately 20% of the Trust s estate pre-dates 1948 and approximately 48% is less than 25 years old (%) Pre to to to to to to to Present North Glam Pontypridd & Rhondda Cwm Taf Figure 12: Age profile of the estate 2.0 Energy performance 2.1 In hospitals in the Trust recorded a net energy consumption of 248,568GJ, an increase of 2.64% on last year s figure of 242,184GJ, this figure being the aggregated total for the former North Glamorgan and Pontypridd & Rhondda NHS Trusts. The main reason for the rise is the increased consumption reported at the Trust s two largest sites, Prince Charles Hospital and Royal Glamorgan Hospital. Net consumption at these two sites rose by 5.8% and 4.8% respectively. 2.2 Primary energy consumption figures show a reduction of 0.54%, from 354,329GJ in to 352,429GJ this year. This was due to a 7.2% reduction in electricity imported from the grid whilst CHP generated electricity increased by 17%. 64 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

66 APPENDIX IV The latest set of figures indicate that Trust primary energy consumption is more than 8% above the level of the base year compared with last year s figures of 17.51% above for North Glamorgan and 3.16% above for the Pontypridd & Rhondda NHS Trust. 2.3 As mentioned above, CHP output has increased though figures indicate ongoing problems at the Royal Glamorgan Hospital where the CHP electrical output accounts for only 11% of the Trust total with the remaining 89% coming from the smaller installation at Prince Charles Hospital. Figure 13: Individual hospital net energy PIs * Sites with CHP installed 2.4 With reference to Figure 13, the overall PI of 47.02GJ/100m 3 remains below the lower level of the target range of 55-65GJ/100m 3, with none of the sites significantly above the upper level of the range. Last year the North Glamorgan PI was 50.85GJ/100m 3 whilst the corresponding figure for Pontypridd & Rhondda NHS Trust was GJ/100m Whilst the Trust s increase in net consumption was 2.64%, heated volume rose by 8%, indicating improved efficiency. 3.0 Summary 3.1 Unsurprisingly, the merger of two Trusts, that in had delivered performance figures at opposite ends of the national estate performance indicator spectrum, has had a significant effect on the new Trust s performance figures, with only one of the 2008 targets set by the Welsh Assembly Government in 2002 having been met. 3.2 The high backlog maintenance costs present the new Cwm Taf Health Board, which came into operation in October 2009, with significant challenges. It is noted that the current modernisation programme at Prince Charles Hospital will, when completed, significantly reduce the Board s backlog maintenance costs. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 65

67 APPENDIX IV 3.3 The new Board should maximise the benefits gained from the relatively new estate portfolio inherited from the former Pontypridd & Rhondda NHS Trust, making every effort to maintain those parts of the estate in condition B. In this respect it is noted that backlog maintenance costs not far short of 900,000 have, for the first time, been recorded in respect of the Royal Glamorgan Hospital, opened in Energy performance figures indicate progress in terms of efficiency even though net energy consumption has increased. Problems reported last year with the CHP units at the Royal Glamorgan are in the process of being resolved and the benefits are expected to be delivered fully in the reporting year. 66 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

68 APPENDIX V Summary of Trust Information GWENT HEALTHCARE NHS TRUST WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 67

69

70 APPENDIX V Trust Name: No of Returns: Gwent Healthcare NHS Trust 21 Individual hospital sites Aggregate sites All other non-hospital sites 1.0 Backlog maintenance 1.1 Figure 1 shows that the Trust backlog maintenance costs decreased by approximately 3.6% from 57,702,618 in to 55,630,668 in Reductions totalling 2,720,433 have been reported at five sites, the largest being 1,721,340 at Royal Gwent Hospital. 1.3 Increases in backlog maintenance costs have been reported in respect of 16 sites, the largest being 251,236 at Ystrad Mynach Hospital. Figure 1: Backlog maintenance costs by site WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 69

71 APPENDIX V 1.4 Figure 2 identifies the backlog maintenance costs broken down by risk category. It can be seen that Site Name the high and significant risk costs total 13,431,137; this is an increase of 565,190 compared with the costs reported for High Risk backlog cost Significant Risk backlog cost Moderate Risk backlog cost Low Risk backlog cost Figure 2: Backlog maintenance costs by risk category Risk adjusted backlog cost ( ) ( ) ( ) ( ) ( ) Aberbargoed & District 36,645 42,347 13,242 48,664 81,806 Abertillery & District Hospital 133, ,027 63, , ,669 Blaenavon Health Care Unit 13,835 30,772 37, ,630 53,297 Blaina & District Hospital 29,579 14, ,675 Caerphilly District Miners 566, ,053 1,424,941 4,987,295 1,578,638 Chepstow Community 17,024 24, ,414 County Hospital 403, , ,593 2,466,077 1,175,933 Llanfrechfa Grange Hospital 153, , , , ,584 Maindiff Court Hospital 126, , , , ,493 Monnow Vale Health Facility Nevill Hall Hospital 562,353 2,073,711 1,561,470 5,621,293 3,114,915 Oakdale Hospital 55,471 66,796 18,464 66, ,714 Redwood Memorial Hospital 26,004 49,335 5,851 20,918 76,503 Royal Gwent Hospital 898,542 3,249,436 1,979,551 4,157,057 4,557,085 St Cadoc's Hospital 119, , ,945 1,611, ,734 St Woolos Hospital 297, ,328 1,273,466 4,552, ,939 Talygarn & Ty Siriol 18,994 43, ,544 62,512 Tredegar General Hospital 111, ,796 5,488 19, ,172 Ty Sirhowy Unit 35,499 13, ,517 49,248 Ysbytyr Tri Chwm 21,659 25,796 33, ,053 52,797 Ystrad Mynach Hospital 512, ,799 1,682,953 6,016,557 2,558,646 Aggregate Sites 127, , ,893 1,223, ,262 Trust Totals 4,268,489 9,162,648 9,877,166 32,322,369 16,762, Figure 3 opposite, shows the Trust s performance trend between 2001 and 2008 against the key all- Wales 2008 targets for the essential estate. It can be seen that the Trust has exceeded the target of 90% in respect of the Fire safety indicator and that there has been very little change across the indicators in general over the last three years. 70 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

72 APPENDIX V Target 90% Figure 3: Trend in Trust performance between against all-wales 2008 targets 1.6 Figures 4-9 overleaf, graphically illustrate the Trust s performance against the key all-wales 2008 targets for the essential estate. The Trust s performance against last year s figures is as follows: Physical condition: improvement from 75% to 77% Statutory and safety compliance: improvement from 81% to 83% Fire safety: improvement from 92% to 93% Functional suitability: improvement from 72% to 75% Space utilisation: improvement from 73% to 74% Energy performance: improvement from 33% to 58% The performance of Gwent Healthcare NHS Trust against that of other Trusts in Wales is graphically represented in Appendix XIII. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 71

73 APPENDIX V Estimated Trust Conditions Physical Condition Statutory & Safety Compliance Fire Safety Compliance C & D 23% C & D 17% C & D 7% A & B 77% A & B 83% A & B 93% Figure 4 Figure 5 Figure 6 Energy Performance Functional Suitability Space Utilisation C & D 42% Unacceptable 25% Unacceptable 26% A & B 58% Acceptable 75% Acceptable 74% Figure 7 Figure 8 Figure Figures 10 and 11 illustrate the amount of essential building area and land the Trust has in its ownership. It is noted that the essential building and land has increased from 69% and 51% last year to 85% and 74% respectively and this is as direct result of the Trust s re-classification of Llanfrechfa Grange Hospital from non-essential to essential. Essential Building Area Essential Land Area Non Essential 15% Non essential 26% Esential 85% Essential 74% Figure 10 Figure WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

74 APPENDIX V Figure 12: Age profile of the estate 1.8 Figure 12 illustrates the age profile for the Trust. It can be seen that approximately 25% of the estate pre-dates 1948 and approximately 18% is less than 25 years old. The age profile of the estate has changed little over the last few years. However, on completion of the new hospitals currently being constructed in Ebbw Vale and Ystrad Mynach and the subsequent closure of the non-essential estate the age profile will improve dramatically. 2.0 Energy performance 2.1 In hospitals in the Trust recorded a net energy consumption of 404,850GJ compared with 402,142GJ last year, an increase of 0.67%. This equates to a primary energy consumption of 576,644GJ, an increase of 1.48% on last year s figure of 568,260GJ and 4.01% up on the base year consumption. As was the case in last year s report, the energy consumption at the Royal Gwent Hospital and St Woolos Hospital sites has been aggregated to avoid the inaccuracies caused by the method of apportionment of energy used previously. 2.2 With reference to Figure 13, overleaf, the overall PI has improved marginally from 62.15GJ/100m 3 last year to 62.02GJ/100m 3 ; this is within the target range of 55-65GJ/100m 3. The individual hospital PIs suggest that savings can be made by focusing on several poor performing hospitals, particularly at some of the larger sites, such as Nevill Hall Hospital, where net consumption continues to rise, albeit by a small amount, following last year s 14% increase. 2.3 The Trust has invested heavily on Central Energy Fund projects over the course of the last three years, receiving funding to the value of 493,000 during this period. The full benefit of these schemes in terms of carbon, energy and cost savings should be realised in the coming year. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 73

75 APPENDIX V Hospital Net Hospital Energy Consumption Change on Previous Year Heated Volume (m 3 ) Site PI (GJ) (%) (GJ/100m 3 ) Aberbargoed & District 3, , Abertillery & District Hospital 2, , Blaenavon Health Care Unit 1, , Blaina & District Hospital 4, , Caerphilly District Miners 16, , Chepstow Community** 8, , County Hospital 14, , Llanfrechfa Grange Hospital 20, , Maindiff Court Hospital 7, , Monnow Vale Health Facility 3, , Nevill Hall Hospital * 89, , Oakdale Hospital 1, , Redwood Memorial Hospital 2, , Royal Gwent Hospital 174, , St Cadoc's Hospital* 26, , St Woolos Hospital* Talygarn & Ty Siriol 4, , Tredegar General Hospital 5, , Ty Sirhowy Unit , Ysbyty r Tri Chwm 4, , Ystrad Mynach Hospital 12, , Trust Totals 404, , Figure 13: Individual hospital net energy PIs * Site with CHP installed ** PFI Hospital 3.0 Summary 3.1 There has been a marginal improvement against all of the national estate performance indicators with the exception of energy, where a significant uplift has resulted from the reclassification of Llanfrechfa Grange Hospital. However, as with last year, overall Trust performance has fallen significantly short of the 2008 targets set by the Welsh Assembly Government in The Trust performance against the national key performance indicators and the high backlog maintenance costs reported reflect, in part, the age profile of the estate. However, the planned replacement of a number of older hospitals with the two local general hospitals at Ystrad Mynach and Ebbw Vale in the next two years, as part of the Clinical Futures Programme, will have a significant impact on backlog maintenance and Trust performance. 3.3 Whilst Trust energy performance figures fall within the target range, it is evident that there is still scope for improvement at a number of poor performing sites. Significant investment on Central Energy Fund projects over the last three years is expected to reflect in carbon, energy and cost savings in the coming year. 74 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

76 APPENDIX VI Summary of Trust Information HYWEL DDA NHS TRUST WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 75

77

78 APPENDIX VI Trust Name: No of Returns: Hywel Dda NHS Trust 14 Individual hospital sites Aggregate sites All other non-hospital sites General note The Hywel Dda NHS Trust was formed in April 2008 from the merger of the former Carmarthenshire, Ceredigion & Mid-Wales and Pembrokeshire & Derwen NHS Trusts. Wherever feasible, the data submitted by these individual Trusts for the return has been combined to enable comparisons to be made against this year s return for the Hywel Dda NHS Trust. 1.0 Backlog maintenance 1.1 Figure 1 shows that the Trust backlog maintenance costs increased by approximately 14.6% from 55,035,755 in to 63,100,856 in West Wales General Hospital has the largest reported backlog costs for a single site, which now stand at 17,887,764 ( 28%), while Prince Philip Hospital has reported the largest year-on-year increase (144%) from 4,534,332 to 11,082,709. These large increases have been attributed to major building/engineering infrastructure works and the modernisation of HVAC plant. 1.3 Significant backlog maintenance cost increases at the Bronglais Hospital site have been attributed wholly to requirements for fire compartmentalisation. Figure 1: Backlog maintenance costs by site WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 77

79 APPENDIX VI 1.4 Figure 2 identifies the backlog maintenance costs broken down by risk category. It can be seen that Site Name the high and significant risk costs total 29,253,160; this is an increase of 4,730,177 compared with the costs reported by the individual Trusts in It is noted that, excluding the data submitted for the aggregate properties, the high and significant risk costs for the former NHS Trusts are split 15,286,545 in respect of Carmarthenshire NHS Trust, 10,704,760 in respect of Ceredigion & Mid-Wales NHS Trust and 2,758,949 in respect of Pembrokeshire & Derwen NHS Trust. High Risk backlog cost Significant Risk backlog cost Moderate Risk backlog cost Low Risk backlog cost Risk adjusted backlog cost ( ) ( ) ( ) ( ) ( ) Aberaeron Hospital 0 14, ,664 1,552, ,664 Amman Valley Hospital 0 91, , , ,111 Bro Cerwyn & St Brynach ,595 33,101 4,530 Bronglais General Hospital 1,017,828 1,194,226 2,656,555 4,398,316 2,603,991 Cardigan & District Memorial 0 5,423,671 24, ,354 5,506,599 Hafen Derwen (St David's) 0 44, , ,395 58,551 Llandovery Hospital 0 41, , ,363 51,288 Mynydd Mawr Hospital 0 503, , , ,812 Prince Philip Hospital 97,500 5,430,323 1,546,222 4,008,664 5,750,020 South Pembrokeshire 0 145, , , ,722 Tenby Hospital Tregaron Hospital 0 3,054, , ,504 3,181,807 West Wales General 191,480 8,931,094 5,051,688 3,713,502 9,560,833 Withybush General Hospital 0 2,538,999 2,980,432 2,321,728 2,759,922 Aggregate Sites 16, ,906 1,395,424 1,370, ,990 Trust Totals 1,322,808 27,930,352 14,890,379 18,957,317 31,609,840 Figure 2: Backlog maintenance costs by risk category 1.5 Figure 3 shows the Trust s performance against the key all-wales 2008 targets for the essential estate. It can be seen that the Trust has met or exceeded the target of 90% in respect of the Fire safety and Space utilisation indicators. Target 90% Figure 3: Trust performance against all-wales 2008 targets 78 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

80 APPENDIX VI 1.6 Figures 4-9 graphically illustrate the Trust s performance against the key all-wales 2008 targets for the essential estate. The performance indicators for have been re-calculated using the data submitted by the individual Trusts. The Trusts performance against last year s re-calculated figures is as follows: Physical condition: improvement from 82% to 84% Statutory and safety compliance: improvement from 85% to 87% Fire safety: reduction from 93% to 92% Functional suitability: improvement from 85% to 87% Space utilisation: remains at 94% Energy performance: reduction from 86% to 69% The performance of Hywel Dda NHS Trust against that of other Trusts in Wales is graphically represented in Appendix XIII. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 79

81 APPENDIX VI 1.7 Figures 10 and 11 illustrate the amount of essential building area and land the Trust has in its ownership. The essential building and land areas are both 98%. Essential Building Area Essential Land Area Non Essential 2% Non ssential 2% Essential 98% Essential 98% Figure 10 Figure Figure 12 illustrates the age profile for the Trust. The age profiles of the former Carmarthenshire, Ceredigion & Mid-Wales and Pembrokeshire & Derwen NHS Trusts have been superimposed onto the chart. It can be seen that approximately 9% of the Trust s estate pre-dates 1948 and approximately 35% is less than 25 years old (%) Pre to to to to to to to Present Carmarthen (07/08) Ceredigion (07/08) Pembs & Derwen (07/08) Hywel Dda Figure 12: Age profile of the estate 2.0 Energy performance 2.1 In hospitals in the Trust recorded a net energy consumption of 272,252GJ compared with 255,025GJ last year, an increase of 6.75%. This equates to a primary energy consumption of 386,649GJ, an increase of 6.85% on last year s figure of 361,865GJ and 4.03% up on the base year consumption. The figures quoted for last year are the aggregated totals for the former Ceredigion & Mid Wales, Carmarthenshire, and Pembrokeshire and Derwen NHS Trusts. 80 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

82 APPENDIX VI 2.2 With reference to Figure 13, the overall PI has deteriorated slightly from 58.74GJ/100m 3 last year to 60.78GJ/100m 3 ; this is within the target range of 55-65GJ/100m 3. The individual hospital PIs suggest that savings can be made by focusing on several poor performing hospitals, particularly at some of the larger sites. Bronglais and Withybush Hospitals, for example, are both outside the target range. 2.3 The three former Trusts that make up the Hywel Dda NHS Trust invested heavily in Central Energy Fund projects over the course of the last three years, receiving funding to the value of 476,000 during this period. The full benefit of these schemes in terms of carbon, energy and cost savings should be realised in the coming year. Figure 13: Individual hospital energy PIs * Sites with CHP installed 3.0 Summary 3.1 With the exception of energy performance, the merger of the three former Trusts has, in general, not had a dramatic effect on performance figures for the new Trust, which present a mixed picture across the national estate performance indicators for The impact of the new Trust s ageing estate is reflected in the high backlog maintenance costs reported. From October 2009 the new Hywel Dda Health Board will be faced with a significant challenge as it seeks to reduce these costs. The Board will need to focus on a number of its major sites and West Wales General Hospital in particular. 3.3 Energy performance figures demonstrate some deterioration with significant rises in both net and primary energy consumption. Whilst the overall PI is within the target band, improvements can be made by focusing on a number of poor performing sites. The full benefits of the Central Energy Fund schemes in terms of carbon, energy and cost savings should be realised in the coming year. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 81

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84 APPENDIX VII Summary of Trust Information NORTH WALES NHS TRUST WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 83

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86 APPENDIX VII Trust Name: No of Returns: North Wales NHS Trust 25 Individual hospital sites Aggregate sites All other non-hospital sites General note The North Wales NHS Trust was formed in April 2008 from the merger of the former Conwy & Denbighshire and North East Wales NHS Trusts. Wherever feasible, the data submitted by these individual Trusts for the return has been combined to enable comparisons to be made against this year s return for the North Wales NHS Trust. 1.0 Backlog maintenance 1.1 Figure 1 shows that the Trust backlog maintenance costs decreased by approximately 10.5% from 107,693,951 in to 96,388,028 in Site Name Physical Condition Costs S & S Costs Fire Safety Costs DDA Costs Backlog Backlog Maintenance Maintenance Costs Costs 2008/ /08 Variation ( ) ( ) ( ) ( ) ( ) ( ) ( ) Abergele Hospital 3,325, ,755 78, ,735 3,678,512 3,892, ,695 Ablett Unit 240,971 96,270 65,600 96, , ,455-12,614 Bodnant Psychiatric Unit 354,535 31, , , ,688 9,417 Bryn Esket EMI 83,056 31,775 12,500 31, , ,030-4,699 Cedar Court 0 17,173 7,175 17,017 24,348 23, Chirk Community Hospital 6, ,000 31,000-25,000 Coed Celyn Support Unit Colwyn Bay Community 528, , , , ,393-29,265 Deeside Community 35,000 18, ,500 53,000 52, Denbigh Community 421,111 83, , , ,329-27,692 Flint Community Hospital 0 25, ,000 25,000 53,500-28,500 Glan Traeth Day Hospital 107,532 13, , , ,052 2,952 Hafod MHRC 131,456 21, , , ,645 3,741 HM Stanley Hospital 2,319, ,892 10, ,796 2,606,230 2,542,664 63,566 Holywell Community , ,200 Llangollen Community 1,053,247 31, ,500 31,310 1,187,343 1,158,383 28,960 Lluesty Hospital 7,673,500-7,673,500 Mold Community Hospital 5,000 25, ,000 30,000 19,000 11,000 Nant y Glyn Centre 156,458 21, , , ,174-4,445 Penley Hospital Prestatyn Community 97,318 22, , , ,614 2,916 Royal Alexandra Hospital 3,765, , , ,749 4,341,786 4,330,523 11,263 Ruthin Community Hospital 392,279 63, , , ,700-13,717 Ysbyty Glan Clwyd 3,764,668 1,606,417 62,030,000 1,535,149 67,401,085 66,739, ,489 Ysbyty Maelor 11,313,600 1,210, ,000 12,523,600 15,794,000-3,270,400 Aggregate Sites 1,122, , ,600 1,342,450 1,585, ,994 Trust Totals 29,223,147 4,531,981 62,632,900 3,522,718 96,388, ,693,951-11,305,923 Figure 1: Backlog maintenance costs by site WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 85

87 APPENDIX VII 1.2 In March 2008 the new Holywell Community Hospital opened to patients, replacing the original hospital in Holywell and Lluesty Hospital. The closure of these two facilities has resulted in a reduction in Trust backlog maintenance costs of 8,229,700. In addition, 11 other Trust sites reported reductions in backlog maintenance costs, including Ysbyty Maelor, where the figure has reduced by 3,270,400. The Trust has cited investment in a new pharmacy and integration of the imaging facilities and the mental health campus as reasons for the reduction. 1.3 It is noted that 70% of the Trust s backlog maintenance costs are associates with Ysbyty Glan Clwyd, where the figure has risen by 661,489 to 67,401, Figure 2 identifies the backlog maintenance costs broken down by risk category. It can be seen that the high and significant risk costs total 10,276,146; this is 7,827,152 less than the figure reported by the individual Trusts for Site Name High Risk backlog cost Significant Risk backlog cost Moderate Risk backlog cost Low Risk backlog cost Risk adjusted backlog cost ( ) ( ) ( ) ( ) ( ) Abergele Hospital 0 148,976 2,835, , ,319 Ablett Unit 0 68,691 42, ,516 79,829 Bodnant Psychiatric Unit 0 2,279 92, ,789 18,785 Bryn Esket EMI 0 2,158 33,157 92,015 6,418 Cedar Court 0 1,241 7,966 15,141 2,011 Chirk Community Hospital 0 0 6, Coed Celyn Support Unit Colwyn Bay Community 21, , , , ,645 Deeside Community ,000 23,000 1,606 Denbigh Community 0 9,772 57, ,224 41,375 Flint Community Hospital , ,000 Glan Traeth Day Hospital , ,781 5,809 Hafod MHRC 0 1,584 10, ,629 8,161 HM Stanley Hospital 61,944 1,290, , ,828 1,563,907 Holywell Community Llangollen Community 0 2, , ,704 55,182 Lluesty Hospital Mold Community Hospital 0 0 5,000 25,000 1,200 Nant y Glyn Centre 0 1,475 10, ,605 9,470 Penley Hospital Prestatyn Community 0 1,603 10, ,622 6,764 Royal Alexandra Hospital 164, ,273 2,761, , ,415 Ruthin Community Hospital 0 22,908 99, ,012 48,559 Ysbyty Glan Clwyd 203,229 1,821,268 14,448,848 50,927,741 5,201,041 Ysbyty Maelor 1,028,000 4,523,000 3,719,600 3,253,000 5,783,420 Aggregate Sites 0 54, ,667 1,078, ,553 Trust Totals 1,479,722 8,796,424 25,853,432 60,258,448 14,447,719 Figure 2: Backlog maintenance costs by risk category 86 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

88 APPENDIX VII 1.5 Figure 3 shows the Trust s performance against the key all-wales 2008 targets for the essential estate. It can be seen that the Trust has met or exceeded the 90% target in respect of the Statutory & safety compliance and Space utilisation indicators. Target 90% Figure 3: Trust performance against all-wales 2008 targets 1.6 Figures 4-9 overleaf, graphically illustrate the Trust s performance against the key all-wales 2008 targets for the essential estate. The performance indicators for have been re-calculated using the data submitted by the individual Trusts. The Trusts performance against last year s re-calculated figures is as follows: Physical condition: improvement from 85% to 87% Statutory and safety compliance: improvement from 95% to 96% Fire safety: improvement from 81% to 84% Functional suitability: reduction from 75% to 74% Space utilisation: reduction from 91% to 90% Energy performance: reduction from 97% to 59% The performance of North Wales NHS Trust against that of other Trusts in Wales is graphically represented in Appendix XIII. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 87

89 APPENDIX VII Estimated Trust Conditions Physical Condition Statutory & Safety Compliance Fire Safety Compliance C & D 13% C & D 4% C & D 16% A & B 87% A & B 96% A & B 84% Figure 4 Figure 5 Figure 6 Energy Performance Functional Suitability Space Utilisation C & D 41% Unacceptable 26% Unacceptable 10% A & B 59% Acceptable 74% Acceptable 90% Figure 7 Figure 8 Figure Figures 10 and 11 illustrate the amount of essential building area and land the Trust has in its ownership. The essential building and land areas are 95% and 96% respectively. Essential Building Area Essential Land Area Non Essential 5% Non Essential 4% Essential 95% Essential 96% Figure 10 Figure WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

90 APPENDIX VII Figure 12: Age profile of the estate 1.8 Figure 12 illustrates the age profile for the Trust. The age profiles of the former Conwy & Denbighshire and North East Wales NHS Trusts have been superimposed onto the chart. It can be seen that approximately 25% of the Trust s estate pre-dates 1948 and approximately 44% is less than 25 years old. 2.0 Energy performance 2.1 In hospitals in the Trust recorded a net energy consumption of 361,372GJ compared with 329,785GJ last year, an increase of 9.58%. This equates to a primary energy consumption of 506,222GJ, an increase of 6.38% on last year s figure of 475,871GJ and 9.71% up on the base year consumption. These figures refer to the aggregated data for the former North East Wales NHS Trust and the Conwy and Denbigh NHS Trust. 2.2 With reference to Figure 13, overleaf, the overall PI has risen from 56.92GJ/100m 3 last year to 62.27GJ/100m 3, although this is still within the target range of 55-65GJ/100m 3. The individual hospital PIs suggest that savings can be made by focusing on several poor performing hospitals, particularly at two of the larger sites, Ysbyty Glan Clwyd and H M Stanley. 2.3 The two former Trusts invested heavily in Central Energy Fund projects over the course of the last three years, receiving combined funding to the value of 387,000. The full benefit of this investment in terms of carbon, energy and cost savings should be realised in the coming year. 3.0 Summary 3.1 Unsurprisingly, the merger of one of the top performing Trusts with one where performance figures over the years have fallen well short of the targets, has had an impact on the new Trust s performance figures. The Trust has met or exceeded the targets set by the Welsh Assembly Government in 2002 in WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 89

91 APPENDIX VII Hospital Net Hospital Energy Consumption Change on Previous Year Heated Volume Site PI (GJ) (%) (m 3 ) (GJ/100m 3 ) Abergele Hospital 17, , Ablett Unit 4, , Bodnant Psychiatric Unit 2, , Bryn Esket EMI 1, , Cedar Court , Chirk Community Hospital 3, , Coed Celyn Support Unit Colwyn Bay Community Hospital 6, , Deeside Community Hospital 7, , Denbigh Community Hospital 4, , Flint Community Hospital 1, , Glan Traeth Day Hospital , Hafod MHRC , HM Stanley Hospital 17, , Holywell Community Hospital 7,783 N/A 10, Llangollen Community Hospital 1, , Mold Community Hospital 5, , Nant y Glyn Resource Centre , Penley Hospital Prestatyn Community Hospital 1, , Royal Alexandra Hospital 7, , Ruthin Community Hospital 3, , Ysbyty Glan Clwyd* 139, , Ysbyty Maelor 122, , Trust Totals 361, , Figure 13: Individual hospital energy PIs * Sites with CHP installed respect of two of the national estate performance indicators. The new Betsi Cadwaladr Health Board which became operational in October 2009, faces a considerable challenge in achieving all of the 2008 performance targets. 3.2 Whilst the Trust has made significant strides in reducing its overall backlog maintenance burden, this is still dominated by its Ysbyty Glan Clwyd site which alone accounts for 70% of the Trust s total. It is noted that fire safety issues associated with this site are the single biggest factor contributing to the backlog maintenance costs. The Trust, however, has designated these as low risk. 3.3 Energy performance figures demonstrate some deterioration with rises in both net and primary energy consumption, although the overall PI is within the target band. However, further improvements can be made by focusing on a number of poor performing sites. 3.4 The full benefits of the Trust s investment in Central Energy Fund projects over the last three years are expected to be realised in terms of carbon, energy and cost savings in the coming year. 90 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

92 APPENDIX VIII Summary of Trust Information NORTH WEST WALES NHS TRUST WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 91

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94 APPENDIX VIII Trust Name: No of Returns: North West Wales NHS Trust 11 Individual hospital sites Aggregate sites All other non-hospital sites 1.0 Backlog maintenance 1.1 Figure 1 shows that the Trust backlog maintenance costs increased by approximately 14% from 43,055,679 in to 49,158,878 in Increases have been reported in respect of eight sites, the largest, in the sum of 5,665,539 in respect of Ysbyty Gwynedd. Reductions have been reported in respect of four sites, the greatest, in the sum of 33,898, being associated with Ffestiniog Memorial Hospital. 1.2 The 35,622,965 backlog maintenance costs associated with Ysbyty Gwynedd account for approximately 72% of the Trust s total. The main reason given for the increase in backlog maintenance on this site is the risk associated with the electrical infrastructure. It is noted, however, that funding in respect of electrical infrastructure works has been approved and, on completion of the work in 2010, the risk value will be greatly reduced. Figure 1: Backlog maintenance costs by site 1.3 Figure 2 overleaf, identifies the backlog maintenance costs broken down by risk category. It can be seen that the high and significant risk costs total 35,901,946, an increase of 6,741,466 compared with last year s return. Of the 35,901,946 high and significant risk costs, 30,635,687 are associated with Ysbyty Gwynedd. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 93

95 APPENDIX VIII Site Name High Risk backlog cost Significant Risk backlog cost Moderate Risk backlog cost Low Risk backlog cost Risk adjusted backlog cost ( ) ( ) ( ) ( ) ( ) Bron-y-Garth Hospital 7, , ,347 31, ,575 Bryn Beryl Hospital 1,149 23, ,394 87,687 34,945 Bryn-y-Neuadd Hospital 566, , , ,451 1,573,446 Cefni Hospital 29,543 19,130 9,324 5,187 49,077 Dolgellau & Barmouth 9, , ,534 56, ,817 Eryri Hospital 54, , , , ,667 Ffestiniog Memorial Hospital 4,980 53,040 26, ,651 65,347 Llandudno General Hospital 31, , ,299 82, ,309 Tywyn & District War 8,568 63, ,305 41,286 80,005 Ysbyty Gwynedd 27,231,047 3,404, ,186 4,511,093 35,622,966 Ysbyty Penrhos Stanley 2, ,267 45,523 10, ,178 Aggregate Sites 355,401 1,166,216 5,342, ,952 1,728,387 Trust Totals 28,303,723 7,598,223 7,601,192 5,655,743 41,195,719 Figure 2: Backlog maintenance costs by risk category 1.4 Figure 3 shows the Trust s performance trend between 2001 and 2008 against the key all-wales 2008 targets for the essential estate. It can be seen that the Trust exceeded the target of 90% in respect of the Statutory and safety compliance and Energy performance indicators and that there has been little change in the profile over the last five years. Figure 3: Trend in Trust performance between against all-wales 2008 targets 94 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

96 APPENDIX VIII 1.5 Figures 4-9 graphically illustrate the Trust s performance against the key all-wales 2008 targets for the essential estate. Performance against last year s figures is as follows: Physical condition: reduction from 70% to 69% Statutory and safety compliance: unchanged at 92% Fire safety compliance: reduction from 71% to 69% Functional suitability: unchanged at 76% Space utilisation: improvement from 84% to 85% Energy performance: unchanged at 97% The performance of North West Wales NHS Trust against that of other Trusts in Wales is graphically represented in Appendix XIII. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 95

97 APPENDIX VIII 1.6 Figures 10 and 11 illustrate the amount of essential building area and land the Trust has in its ownership. There has been no significant change since last year. Essential Building Area Essential Land Area Non Essential 15% Non Essential 22% Essential 85% Essential 78% Figure 10 Figure Figure 12 illustrates the age profile for the Trust. It can be seen that approximately 21% of the Trust s estate pre-dates 1948 and approximately 21% is less than 25 years old. There has been little change in the profile over the last six years (%) Pre to to to to to to to Present Figure 12: Age profile of the estate 2.0 Energy performance 2.1 In hospitals in the Trust recorded a net energy consumption of 194,958GJ compared with 188,111GJ last year, an increase of 3.64%. This equates to a primary energy consumption of 267,935GJ, an increase of 2.73% on last year s figure of 260,818GJ and 5.28% up on the base year consumption. 96 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

98 APPENDIX VIII Figure 13: Individual hospital energy PIs * Site with CHP installed 2.2 With reference to Figure 13, the overall PI has deteriorated from 54.12GJ/100m 3 last year to 56.13GJ/100m 3, although this is still well within the target range of 55-65GJ/100m 3. The individual hospital PIs suggest that all the larger sites are operating within the target range, so the possibilities for achieving further savings are limited. 2.3 The Trust invested heavily on Central Energy Fund projects over the course of the last three years, receiving combined funding to the value of 210,000 during this period. The full benefit of this investment in terms of carbon, energy and cost savings should be realised in the coming year. 3.0 Summary 3.1 In the Trust met and exceeded the targets set by the Welsh Assembly Government in 2002 in respect of two of the national estate performance indicators and fell considerably short of the targets in respect of the remainder. 3.2 The sharp increase in backlog maintenance costs during largely reflects concerns over the electrical infrastructure at Ysbyty Gwynedd. These are currently being addressed and, on completion of the works in 2010, it is anticipated that the level of risk on this site will fall sharply, reflecting in reduced backlog maintenance costs. Even so, the new Health Board faces considerable challenges in order to reduce the overall backlog costs within the former Trust. 3.3 Energy performance figures demonstrate some deterioration with rises in both net and primary energy consumption. However, the overall PI is good, being well within the target band, and further improvements may prove difficult to achieve. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 97

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100 APPENDIX IX Summary of Trust Information POWYS TEACHING LOCAL HEALTH BOARD WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 99

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102 APPENDIX IX Trust Name: No of Returns: Powys Teaching Local Health Board 10 Individual hospital sites Aggregate sites All other non-hospital sites 1.0 Backlog maintenance 1.1 Figure 1 shows that the LHB backlog maintenance costs decreased by approximately 7% from 5,384,044 in to 4,997,075 in Knighton, Victoria Memorial and Ystradgynlais Community Hospitals reported increases totalling 73,919, whilst all the other sites reported reductions. 1.2 The largest reduction is associated with Brecon War Memorial Hospital, where backlog maintenance decreased by 137,889. The Trust has indicated that the overall reduction is as a result of the implementation of the Brecon reconfiguration work. The largest backlog costs are still associated with Ystradgynlais Hospital which accounts for 1,782,500. This is approximately 45% of the LHB s total. Figure 1: Backlog maintenance costs by site 1.3 Figure 2 overleaf, identifies the backlog maintenance costs broken down by risk category. It can be seen that the high and significant risk costs total 2,525,700. Approximately 62% of the high and significant risk costs are associated with Ystradgynlais Community Hospital, which total 1,558,500. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 101

103 APPENDIX IX Site Name High Risk backlog cost Significant Risk backlog cost Moderate Risk backlog cost Low Risk backlog cost Figure 2: Backlog maintenance costs by risk category Risk adjusted backlog cost ( ) ( ) ( ) ( ) ( ) Brecon War Memorial 2,000 10,000 20,000 5,000 12,625 Broddyfi Community 30, ,000 12,000 12, ,800 Bronllys Hospital 115,000 55, ,000 1,094, ,919 Builth Wells Cottage 26,000 72,000 65,000 15, ,666 Knighton Hospital 2,000 10,200 47,800 35,000 14,270 Llandrindod Wells Hospital 7,500 25,000 24,500 57,000 34,233 Llanidloes & District Hospital 15,500 12,500 30,000 29,000 36,600 Montgomery County 15,000 47,000 40,000 5,000 63,500 Victoria Memorial Hospital 0 15,000 5,000 6,200 15,224 Ystradgynlais Community 8,500 1,550,000 62, ,000 1,564,100 Aggregate Sites 45,000 12, , ,500 66,850 LHB Totals 266,500 2,259, ,300 1,546,075 2,631, Figure 3 shows the LHB s performance trend between 2001 and 2008 against the key all-wales 2008 targets for the essential estate. It can be seen that whilst there has been some slight improvement in performance, the LHB has not met the 90% target against any of the indicators. Target 90% Figure 3: Trend in LHB performance between against all-wales 2008 targets 102 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

104 APPENDIX IX 1.5 Figures 4-9 graphically illustrate the LHB's performance against the key all-wales 2008 targets for the essential estate. The LHB s performance against last year s figures is as follows: Physical condition: improvement from 45% to 53% Statutory and safety compliance: improvement from 79% to 86% Fire safety compliance: improvement from 60% to 74% Functional suitability: improvement from 79% to 80% Space utilisation: improvement from 71% to 75% Energy performance: reduction from 94% to 77% The performance of Powys LHB against that of Trusts in Wales is graphically represented in Appendix XIII. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 103

105 APPENDIX IX 1.6 Figures 10 and 11 illustrate the amount of essential building area and land the LHB has in its ownership. It is noted that 100% of the LHB s building and land area is considered essential. Essential Building Area Essential Land Area Non Essential 0% Non Essential 0% Essential 100% Essential 100% Figure 10 Figure Figure 12 illustrates the age profile for the LHB. It can be seen that approximately 46% of the LHB s estate pre-dates 1948 and approximately 38% is less than 25 year old. It is noted that there has been no significant change in the profile over the last four years (%) Pre to to to to to to to Present Figure 12: Age profile of the estate 104 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

106 APPENDIX IX 2.0 Energy performance 2.1 In hospitals in the LHB recorded a net energy consumption of 74,539GJ compared with 72,265GJ last year, an increase of 3.15%. This equates to a primary energy consumption of 94,196GJ, an increase of 3.49% on last year s figure of 91,021GJ and 8.13% below the base year consumption. 2.2 With reference to Figure 13, the overall PI has deteriorated from 50.86GJ/100m 3 last year to 52.4GJ/100m 3 ; however, this is below the lower limit target range of 55-65GJ/100m 3. The individual hospital PIs suggest that some savings may be made by focusing on several hospitals that have higher PIs. Most sites, however, appear to be extremely efficient. 2.3 The LHB completed all its Central Energy Fund projects during the first year of the programme. Figure 13: Individual hospital energy PIs 3.0 Summary 3.1 The LHB s performance across the key performance indicators is particularly poor despite improvements across five of the indicators since The LHB continues to face a major challenge if it is to achieve the 2008 targets set by the Welsh Assembly Government in The LHB has achieved a reduction in backlog maintenance costs of 26% since the previous reporting year. For further meaningful reductions, the LHB needs to focus on Ystradgynlais Community Hospital, its largest site, which alone accounts for 45% of the LHB s total backlog. 3.3 Energy performance figures demonstrate some deterioration with rises in both net and primary energy consumption. However, whilst the overall PI is good, further improvements may be made by focusing on a number of the poorer performing sites. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 105

107

108 APPENDIX X Summary of Trust Information VELINDRE NHS TRUST WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 107

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110 APPENDIX X Trust Name: No of Returns: Velindre NHS Trust 1 Individual hospital site 1.0 Backlog maintenance 1.1 Figure 1 shows that the Trust backlog maintenance costs decreased by approximately 14% from 3,350,074 in to 2,880,334 in Site Name Physical Condition Costs S & S Costs Fire Safety Costs DDA Costs Backlog Backlog Maintenance Maintenance Costs Costs 2008/ /08 Variation ( ) ( ) ( ) ( ) ( ) ( ) ( ) Velindre Hospital 2,276, ,434 45, ,339 2,880,334 3,350, ,740 Trust Totals 2,276, ,434 45, ,339 2,880,334 3,350, ,740 Figure 1: Backlog maintenance costs by site 1.2 Figure 2 identifies the backlog maintenance costs broken down by risk category. It can be seen that the high and significant risk costs total 1,269,135. In these were estimated to be 1,825,774 which indicates that there has been a reduction of 556,639. Site Name High Risk backlog cost Significant Risk backlog cost Moderate Risk backlog cost Low Risk backlog cost Risk adjusted backlog cost ( ) ( ) ( ) ( ) ( ) Velindre Hospital 27,768 1,241, , ,918 1,390,310 Trust Totals 27,768 1,241, , ,918 1,390,310 Figure 2: Backlog maintenance costs by risk category 1.3 Figure 3, overleaf, shows the Trust s performance trend between 2001 and 2008 against the key all- Wales 2008 targets for the essential estate. It can be seen that the Trust has met or exceeded the 90% target in respect of the Energy performance, Functional suitability and Space utilisation indicators. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 109

111 APPENDIX X Target 90% Figure 3: Trend in Trust performance between against all-wales 2008 targets 1.4 Figures 4-9 graphically illustrate the Trust s performance against the key all-wales targets for the essential estate. The Trust s performance against last year s figures is as follows: Physical condition: improvement from 70% to 79% Statutory and safety compliance: improvement from 80% to 83% Fire safety compliance: improvement from 79% to 83% Functional suitability: improvement from 76% to 90% Space utilisation: improvement from 85% to 93% Energy performance: remains at 100% The performance of Velindre NHS Trust against that of other Trusts in Wales is graphically represented in Appendix XIII. 110 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

112 APPENDIX X 1.5 Figures 10 and 11 illustrate the amount of essential building area and land the Trust has in its ownership. It can be seen that 100% of the Trust s building and land areas at its only hospital site are considered to be essential. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 111

113 APPENDIX X 1.6 Figure 12 illustrates the age profile for the Trust. It can be seen that approximately 48% of the Velindre Hospital site is less that 25 years old (%) Pre to to to to to to to Present Figure 12: Age profile of the estate 2.0 Energy performance 2.1 In the only hospital in the Trust recorded a net energy consumption of 21,942GJ compared with 21,389GJ last year, an increase of 2.59%. This equates to a primary energy consumption of 38,403GJ, an increase of 2.03% on last year s figure of 37,637GJ and 70.29% above the reported base year consumption. 2.2 With reference to Figure 13, the PI for the Velindre Hospital site has improved from 56.86GJ/100m 3 last year to 55.24GJ/100m 3 ; this is just on the lower limit of the target range of 55-65GJ/100m 3. The lower figure indicates improved efficiency for the hospital as its heated volume has risen more than the increase in consumption. 2.3 The Trust completed all its Central Energy Fund projects during the first two years of the programme, completing funded work to a value of 56, WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

114 APPENDIX X Figure 13: Individual hospital energy PIs 3.0 Summary 3.1 The Trust performance has seen significant improvements across the national estate performance indicators since The Trust, however, continues to face a challenge in respect of three of the indicators if it is to achieve the 2008 targets set by the Welsh Assembly Government in The reduction in backlog maintenance costs is to be welcomed. Nonetheless, they continue to present significant challenges for the Trust since they are focused on a single site rather than a diverse property portfolio. 3.3 Energy consumption figures show some deterioration with rises in both net and primary energy consumption. However, the PI has improved as the site s heated volume has increased at a greater rate than energy consumption. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 113

115

116 APPENDIX XI Summary of Trust Information WELSH AMBULANCE SERVICES NHS TRUST WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 115

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118 APPENDIX XI Trust Name: No of Returns: Welsh Ambulance Services NHS Trust Aggregate sites All other non-hospital sites General note This is the first time that data relating to this Trust has been included in an EFPMS Estate Condition and Performance Report. Furthermore, the unavailability of data since 2005 has precluded the possibility of including year-on-year comparisons. 1.0 Backlog maintenance 1.1 Figure 1 shows that the Trust backlog maintenance costs for were reported to be 14,731,343. Figure 1: Backlog maintenance costs by site 1.2 Figure 2 identifies the backlog maintenance costs broken down by risk category. It can be seen that the high and significant risk costs total 6,527,826 which is 44% of the total backlog costs. 1.3 The Trust was successful in securing Major Risk Framework funding to the value of 977,077 in order to carry out essential works to comply with health & safety improvement notices and this work has been completed. Figure 2: Backlog maintenance costs by risk category 1.4 Figure 3 overleaf, shows the Trust s performance against the key all-wales 2008 targets for the essential estate. It can be seen that the Trust exceeded the 90% target in respect of Space utilisation and, with the exception of Fire safety, fell far short of the target in respect of the Physical condition, Statutory and safety compliance and Functional suitability indicators. It is noted that the Trust was unable to submit energy performance figures largely due to the fact that separate metering, in general, is not currently available where ambulance stations are located on hospital sites. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 117

119 APPENDIX XI Target 90% Figure 3: Trust performance against all-wales 2008 targets 1.5 Figures 4-9 opposite, graphically illustrate the Trust s performance against the key all-wales targets for the essential estate. The Trust s performance figures are as follows: Physical condition: 34% Statutory and safety compliance: 20% Fire safety compliance: 85% Functional suitability: 26% Space utilisation: 92% Energy performance: Data incomplete It can be seen from this analysis that, with the exception of Space utilisation, the Trust has not met the 2008 national estate performance targets set by the Welsh Assembly Government in The performance of the Welsh Ambulance Services NHS Trust against that of other Trusts in Wales is graphically represented in Appendix XIII. 118 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

120 APPENDIX XI 1.6 Figures 10 and 11 illustrate the amount of essential building area and land the Trust has in its ownership. It can be seen that 90% of the Trust s building and land areas is considered to be essential. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 119

121 APPENDIX XI (%) Pre to to to to to to to Present Figure 12: Age profile of the estate 1.7 Figure 12 illustrates the age profile for the Trust. It is noted that 12% of the Trust s estate pre-dates 1948 and 28% is less than 25 years old. 2.0 Energy performance 2.1 The Trust was unable to submit data on energy consumption. 3.0 Summary 3.1 Performance across three of the national estates key performance indicators points to the fact that the Trust faces an enormous challenge as it seeks to achieve the 2008 targets set by the Welsh Assembly Government in The high backlog maintenance costs reported suggest that, if these are to be reduced significantly, the Trust needs to take a strategic look at its estate and implement a radical modernisation plan. Whilst this poses considerable challenges, in its favour, the Trust is able to plan for a reduction in backlog maintenance across a very wide property portfolio. 3.3 The Trust was unable to submit robust energy data for its estate, largely due to the fact that separate metering, in general, is not currently available where ambulance stations are located on hospital sites. Typically, in these situations WAST is charged for its energy use on the basis of a service level agreement by the relevant Trust. If Trust-specific energy consumption is to be measured in future, the Trust will need to make arrangements to install meters at all of its sites. 120 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09

122 APPENDIX XII Summary of Trust Information DETAILS OF RESIDUAL AND SURPLUS HOSPITAL SITES WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 121

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124 APPENDIX XII Residual Estate Hospital Physical Cost to 'B' ( ) Statutory & Safety Cost to 'B' ( ) Fire Safety Cost to 'B' ( ) Backlog Maintenance Cost ( ) Date of Closure Abergele Hospital 3,325, ,755 78,625 3,678,512 Cardiff Royal Infirmary 13,939,540 40,002, ,942,190 CRI - West Wing 1,992,090 37,535 53,041 2,082,666 * Llanfrechfa Grange Hospital 919, , ,877 1,227,755 * St Cadoc's Hospital 2,269,727 68,003 10,923 50,258 Sub Total 22,445,636 40,585, ,466 60,981,381 Non-Essential Trust Property Hospital Physical Cost to 'B' ( ) Statutory & Safety Cost to 'B' ( ) Fire Safety Cost to 'B' ( ) Backlog Maintenance Cost ( ) Date of Closure Aberbargoed & District Hospital 66,209 44,418 30, ,898 Abertillery & District Hospital 317, ,154 84, ,395 Dec 2008 Blaina & District Hospital 513 9,682 33,922 44,117 Bodnant Psychiatric Unit 354,535 31, ,105 Bron-y-Garth Hospital 671,875 63,000 15, ,243 April 2009 Caerphilly District Miners Hospital 7,124, , ,379 7,699,409 Cedar Court 0 17,173 7,175 24,348 July 2009 Llwynypia Hospital 2,720, , ,202,484 Spring 2010 Oakdale Hospital 92,322 72,286 42, ,741 Redwood Memorial Hospital 29,256 60,814 12, ,108 Tredegar General Hospital 27, ,401 96, ,146 Ty Sirhowy Unit 2,121 6,833 42,133 51,087 Whitchurch Hospital 6,518, , ,260,430 Ystrad Mynach Hospital 8,414, ,739 65,400 8,974,904 Sub Total 26,340,246 2,852, ,387 29,742,415 Totals 48,785,882 43,438, ,853 90,723,796 * Part of these hospital sites is owned by the Trust. WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 123

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126 APPENDIX XIII Performance Indicators and Targets WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 125

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128 APPENDIX XIII Figure 1: Physical Condition (Categories A & B %) Figure 2: Statutory & Safety Compliance (Categories A & B %) WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 127

129 APPENDIX XIII (%) Abertawe Bro Morgannwg Cardiff and Vale Cwm Taf Gwent Hywel Dda North Wales North West Wales Powys Velindre WAST Fire Safety (Compliance) All Wales Target (2008) Figure 3: Fire Safety Compliance / Trust (%) Abertawe Bro Morgannwg Cardiff and Vale Cwm Taf Gwent Hywel Dda North Wales North West Wales Powys Velindre WAST Functional Suitability (A + B) All Wales Target (2008) Figure 4: Functional Suitability / Trust 128 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2007/08

130 APPENDIX XIII Figure 5: Space Utilisation / Trust Figure 6: Essential Buildings / Trust WELSH HEALTH ESTATES - Estate Condition & Performance Report 2008/09 129

131 APPENDIX XIII (%) Abertawe Bro Morgannwg Cardiff and Vale Cwm Taf Gwent Hywel Dda North Wales North West Wales Powys Velindre WAST Essential Buildings - % All Wales Average Figure 7: Essential Land / Trust (%) Abertawe Bro Morgannwg Cardiff and Vale Cwm Taf Gwent Hywel Dda North Wales North West Wales Powys Velindre WAST Essential Land - % All Wales Average Figure 8: Estatecode Category B Energy Performance 130 WELSH HEALTH ESTATES - Estate Condition & Performance Report 2007/08

132 Copyright Welsh Health Estates 2009 All Rights Reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise without the prior permission of the copyright owner. Designed by Keith James Printed by Icom Works Limited Cover image: Ysbyty Ystrad Fawr. Courtesy of Aneurin Bevan Health Board, BAM Construction Ltd and Nightingale Associates. WELSH HEALTH ESTATES YSTADAU IECHYD CYMRU PO Box 182, Bevan House, Lambourne Crescent, Llanishen Cardiff CF14 5GS PO Box 182, Tŷ Bevan, Cilgant Lambourne, Llanisien Caerdydd CF14 5GS