Table of Contents 04
Introduction 06
Mid Staffordshire NHS Foundation Trust
08
Royal Wolverhampton NHS Trust
10
University Hospitals Coventry & Warwickshire NHS Trust
12
Barnet and Chase Farm Hospitals NHS Trust
13
Dudley Group of Hospitals NHS Foundation Trust
14
South Warwickshire Hospitals NHS Foundation Trust
16
Royal Worcestershire Hospital
18
Warwick Hospital
20
Estate Data
24
Portuguese Institute of Oncology
26
Service Alignment
INTRODUCTION
SHP has 20 years experience in the management of healthcare estate. The management of the healthcare estate
To support this there is a need to ensure
is a critical factor that contributes to the
that healthcare provider organisations
wellbeing of a Nation and it is believed
are aware of their responsibility to:
that the intention of any Government is to develop a healthcare system whose aim
•
Ensure that their land and property
is to improve the health of the population
is used efficiently, effectively and
through the best use of the resources it
strategically to support the strategic
has available.
plans and clinical needs; •
Provide and maintain an appropriate quality of healthcare facilities in the right location, which complement and support the provision of quality healthcare.
•
This can only be achieved if there are clear management guidelines that set out the parameters in which staff are to operate.
4
S T R AT E G I C
HEALTHCARE
P L A N N I N G
SERVICE PLANNING
OLD WORLD
NEW WORLD
INFLUENCES ON ESTATE STRATEGY
ESTATE PERFORMANCE
FINANCIAL PLANNING
Population Nees Access Rates Waiting Times
Centrally led KPIs 6 facet survey focus on physicality of Estate Investment planned in isolation
Captial sourced from discretionary allocations and bidding Whole Trust depreciation and rate of return
GP Commissioning Trust Competition New Care Models PBR unbundling Whole Health Economy changes
Patient Choice Pressure on Estates resources Commissioner led standards Utilisation = Productivity
GP Commissioning Trust Competition New Care Models PBR unbundling Whole Health Economy changes
Strategic flexibilty Care on non acute site Estate consolidation Sub speciality planning Viability doubts Maintaining income
Estate sensitive to capacity Clinical efficiency and bottlennecks Flexibility, generic spaces and multi user spaces
Focus on business development Incentives for more intensive use of Estate Incremental investment rather than ‘big bang’
5
6
Mid Staffordshire NHS Foundation Trust Stafford & Cannock Chase Hospitals The Trust estate consists of two sites, one in Stafford and one in Cannock, with a total land area of 17.99 hectares. The table below summarises the key metrics of the estate;ust does not have any PFI commitments and owns the land and buildings apart from the exceptions noted below. At Stafford Hospital 72% of the current buildings were built between 1975 and 1984 and 22% between 1985 and 1994. Some parts of the estate are not owned by the Trust. At Cannock Chase Hospital the majority (96%) of the building is dated between 1985 and 1994 but parts of the estate are leased out to other parties on tenancy at will or short tenancy agreements. 43% of the space is occupied by MSFT, 37% by third party providers and 20% is not utilised. The Trust has maintained and upgraded, where necessary, the estate as reflected in the capital programme each year however, there was relatively low investment initially which they have tried to rectify in recent years. Strategic Healthcare Planning were commissioned to undertake an estate strategy to determine the future of elements of the estate which were considered to be non-viable. This informed the development of a strategic direction that enabled management decisions to be taken with regards to the future of Cannock Chase Hospital and the manner in which Stafford Hospital shoud be remodeled to improve the efficiency of the clinical models of care as influenced by adjacencies. The survey undertaken identifies 46% of the estate in condition ‘B’. 23% of the site has been identified as condition ‘C’ or below. The survey cost of rectifying backlog maintenance / shortfalls in physical condition for the Stafford site is circa £1.2m. 7
Royal Wolverhampton NHS Trust New Cross Hospital The Royal Wolverhampton Hospitals NHS Trust was established in 1994 and is a major acute Trust providing a comprehensive range of services for the people of Wolverhampton, the wider Black Country, South Staffordshire, North Worcestershire and Shropshire. It gained Cancer Centre status in 1997, was designated as the 4th Regional Heart & Lung Centre during 2004/05 and became one of the first wave Bowel Screening Centres in 2006. The Trust is the largest teaching hospital in the Black Country providing teaching and training to around 130 medical students on rotation from the University of Birmingham Medical School. It also provides training for nurses, midwives and allied health professionals through well established links with the University
8
of Wolverhampton. One of the largest acute providers in the West Midlands the Trust has an operating budget of ÂŁ266 million, 726 beds including 27 intensive care beds and 14 neonatal intensive care cots and employs almost 5000 staff. In 2008/09 the Trust treated more than 670,000 patients at hospital and community sites across the West Midlands.
Strategic Healthcare Planning prepared an Estates Strategy for the future development control of the New Cross Hospital site.
9
University Hospitals Coventry & Warwickshire NHS Trust Redevelopment of Walsgrave Hospital Consortium Builder Architect
Skanska Skanska Nightingale
SHP assisted Walsgrave Hospitals NHS Trust and Coventry Healthcare NHS Trust to seek prioritisation for the development of acute healthcare and mental health acute services to serve the people of Warwickshire.
The Walsgrave Trust is a major acute
The cross-site dislocation of services
facility serving Coventry and the west of
attracted a heavy revenue premium
Warwickshire. Advanced postgraduate
of some £2.5m (net) per annum, and
teaching facilities, and undergraduate
was inefficient in its use of medical
students from Leicester University
and nursing manpower. Key clinical
are also accommodated. Research and
services, such as accident and
Development is undertaken in principal
emergency services and children’s
partnership with Warwick University,
services were split. Training recognition
which is itself seeking to develop a
for the accident and emergency
medical school. The Trust has a number
services had to be withdrawn as a
of regional speciality services and is a
consequence of their physical split.
designated Cancer Centre. The Do Minimum option developed
10
The Trust was based on two sites in
proposed to utilise public capital to
the City of Coventry, with buildings
integrate Accident and Emergency
of varying age and condition. The
services within the city, whilst keeping
majority of even the newer buildings
the amount of capital investment
were in poor condition, as a result of
required to a minimum. It would be
their period and type of construction.
based on a four storey extension to the
Although ongoing attempts have been
main Walsgrave hospital building and
made to address the principle problems
adaptations to the facilities at St Cross
in a programme over a number of years,
hospital in Rugby to provide sufficient
the backlog maintenance requirement
accommodation for all of the services
was estimated to pass £40m within
currently located at the Coventry &
three years.
Warwickshire hospital which could
then be vacated.
transport access.
Although this option would require
The Trust therefore evaluated a number
capital investment of £18.7m, it would
of options, and progressed three to
produce annual revenue savings of
more detailed review. A non- financial
£2.6m. However, even this investment
evaluation indicated that there was
would still leave the Trusts with :
little to choose between the options.
• A major backlog maintenance problem, rising to £40 million over
Implementation of the project would
three years.
significantly redress a number of
• Inflexible accommodation, militating against modern models of care. • Services split across a number of
current areas of health care need. Key elements are: • Integration of accident and emergency services
decaying buildings, with attendant
• Integration of children’s services
manpower and safety problems.
• Re-provision of acute mental
• Inconvenience to patients being treated in Rugby who would previously have been treated in Coventry. • Mental health services located
health services in appropriate accommodation • Facilities to support and promote research and development, education and training.
in inappropriate facilities with significant space wastage against
The proposal was approved by the
current requirements.
Secretary of State for Health and the
• Site access problems in terms of
project implemented.
location of car parking and public 11
Barnet and Chase Farm Hospitals NHS Trust Barnet and Chase Farm Hospitals Barnet and Chase Farm Hospitals NHS Trust came
access to intermediate care beds at Potters Bar
into being on 1 April 1999, following a merger of the
Community Hospital to the north and Finchley
former Chase Farm Hospitals and Wellhouse NHS
Memorial Hospital to the south. Outpatient clinics
Trusts. The Trust currently treats patients from
are also held on both of these sites by various
across Barnet, Enfield, Haringey, East Harrow,
specialties. Additionally, a range of outpatient,
South Hertfordshire, South Essex and Waltham
day case and maternity services are provided at
Forest. General and specialist services are provided
Edgware Community Hospital including a midwife-
at two major acute sites of Barnet Hospital and
led birthing unit and an urgent care centre, this
Chase Farm Hospital. The Trust works closely
site which has also been completely rebuilt and
with four local community hospitals. Patients have
refurbished.
Strategic Healthcare Planning prepared an Estates Strategy for the future development control of the Chase Farm site and consolidated the approach to the PPP development at Barnet.
12
Dudley Group of Hospitals NHS Foundation Trust Russells Hall Hospital Corbett & Guest Hospitals The NHS Plan set out a ten-year strategic and operational framework for the modernisation of the facilities and services within the NHS, to provide a service in line with the needs of the 21st Century. The Plan aims to deliver a more patient focused service, with emphasis on local care in improved facilities, with a planned 100 new hospital schemes to be started by 2001. It set a target of clearing at least one quarter of the backlog maintenance in the NHS and ensuring that 40% by value of the NHS Estate would be less than 15 years old by 2004. The Trust recognised the national drive to improve the estate as part of the Government policy for improving the quality of healthcare delivery. As a result the Trust will measure performance of the estate strategy against the national performance indicators.
13
South Warwickshire Hospitals NHS Foundation Trust Warwick Hospital Warwick is a medium sized District General
old, is dilapidated and has a limited life span. The
Hospital, which houses the Trust’s acute services.
Trust’s Estate Strategy for Warwick is to re-provide
These include 428 day, assessment and inpatient
core services in modern accommodation on the
beds,
south side of Lakin Road, this will allow much of
Accident
diagnostic
Emergency
pathology
department, Inpatient
the dilapidated building stock to be demolished,
theatres, Day Surgery together with an Intensive
provide additional parking and may even allow
Care Unit and Coronary Care Units.
limited amounts of land to be sold and the proceeds
The hospital covers 25 acre and occupies both
used to fund the development of patient services.
north and south sides of Lakin Road. All patient
Patient and Public involvement is both a mandatory
services are located on the south side of Lakin Road,
and vital requirement in the achievement of services
Pathology, Pharmacy, Facilities, Supplies and
that are centred around and focused upon patients.
Finance are situated on the north side of the site.
In opening up opportunities for involvement,
There is inevitably some operational inefficiencies
seeking engagement and welcoming feedback, the
due to this split configuration, the majority of the
Trust will gain an understanding of the needs and
accommodation on the north side is over 60 years
views of its public.
14
and
and
services,
The Trust acknowledges and accepts its duty with regard to patient and public involvement and actively seeks the views and preferences of individual service users, patients, their carers and families as well as members of the general public. The survey undertaken identifies 29% of the Estate in condition ‘B’ or better. These are generally newer buildings such as the Highlands Wing or those that have benefited from recent refurbishment. Around two thirds of the estate is in condition ‘C’ or below. The survey identifies that the following blocks have been assessed as CX/D or DX and therefore require an early strategy to be identified....?
15
Royal Worcestershire Hospital Worcestershire Acute Hospitals NHS Trust Consortium Builder Architect
Catalyst Bovis Lend Lease RTKL
A study was carried out by Strategic Healthcare Planning, as part of an overall Strategic Review being undertaken by Worcestershire Health Authority, to consider the Acute and Community Hospital service requirements for the future, and how services could be located to meet the needs of the population of the County. A sequential analysis was undertaken, considering in turn: • The volume of services that may be required; • A care models assessment; • The options for the location of services and the way in which the physical estate can respond to this need; • The potential financial implications of the various options. A detailed assessment model was used for Acute services that suggested, based on the assumptions made, that the overall bed requirement for the county, including Day Case Beds, was approximately 840. This was a reduction of approximately 225 from the existing level of beds. In order to determine the need for resources in the future SHP took a view on: • The number of people who will need health care • The modes of treating them • The efficiency with which resources are deployed. Forecasting is not a precise science and furthermore, in the case of health care, it is not enough merely to forecast; the actions of the politicians, Trusts, Health Authorities and GPs all influence both demand for health care and the means by which it is delivered. 16
!
!
There are many forces for change in the service, however some of the significant factors that needed to be considered include: •
Changing public expectations
•
Changes in Medical staff training
•
Improvements in medical technology
•
Increase in numbers of elderly in the population
In response to this level of forecast requirement, the Health Authority with assistance from SHP defined 5 options for the disposition of these services across the County. This altered the balance of bed and service provision dependent upon the exact services to be provided by each site. An assessment was made then on how the different options could be achieved in estates terms. With regards to Community Hospital provision, the situation was less clear, as there was no defined strategy or agreed model of care from which to develop such a strategy. The review sets out a range of options and a commentary on the issues that would require consideration. Finally the review provided estimates of the range of savings possible under the various options for both Acute and Community Hospital provision. Following the review the recommendations made were implemented and are now performing as required.
SHP continues to work for the Trust and Consortium to deliver change as required
17
Warwick Hospital Developing Strategic Objectives The local environment for acute services remains an increasingly competitive one; particularly taking into account the potential impact of practice based commissioning, potential new providers of primary care based services, and the other local Acute Trusts. There is no Independent Sector Treatment Centre (ISTC) in the immediate vicinity. The following map shows the existing independent sector providers within the Trust’s catchment area, including the Meridan Hospital on the UHCW site. In order for the Trust to maintain its position, the Trust will need to continue to innovate to provide services in new and different ways in a wide variety of settings whilst at the same time maintaining a competitive edge by continuing to drive up quality and efficiency and wherever possible reduce costs. The Trust provides services within the context of national and local initiatives, meeting the challenging national performance requirements, whilst working with its key commissioners to address local issu
18
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WARD 48
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D 28
WARD 24
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WARD 23
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WC 19
NSV 2.3m2
NSV 2.0m2
WC 17
WARD 16
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6.3m2 V 82 SNR MIDWF/F 83
LABOUR SUITE 3 79 BATH 78 BATH 85 LABOUR SUITE 2 84 LABOUR SUITE 3 79
D/UT 77 CORRIDOR 89 D/UT 85 D/UT 77
WC 72 LABOUR SUITE 4 75 WC 76 ASS W C 67 LABOUR SUITE 1 88
ABN DEL 56 SurgeonsPanel
LABOUR BED 68 Birthing Pool 73 D/UT 92 Birthing Pool 73
LABOUR BED 68
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SH 69 SH 69
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58 57 SH 97 AIRLOCK 95 STAFF CH 99 SH/WC 108
CORRIDOR 105 57
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CORRIDOR 101
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WC 98 ST 103 BASE STAFF 74
AIRLOCK 91 NIGHT STAY 106
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ASSIS WC 93 WC 72 LABOUR SUITE 4 75 WC 76
35 61 STAFF WC
SH SH
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WC LINEN 63 STAFF 62
SH
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34 BED WAIT 34 TRANSFER CORRIDOR 41 CORRIDOR 91
V ST 40
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F STAFF C H 19 SH 20
QT 9.2m2 C WC 11 CLNR 03 CLNR 53 ANAES 46 CLNR 39 EO 32
STAFF ROOM 52 CL/UT 45 THEATRE 43 RECOVERY 42 CORRIDOR 34
ST 37 D/UT 33 CL/UT 31 4 INFANT INC 23
O/UT 48 WC 38 DAY ROOM 14 BEDROOM 13 SECRETARY D6
TWIN BED 12 WC 38
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MIDWF/F MGR D5 STAFF ROOM 52 CL/UT 45 THEATRE 43 D/UT 33
CORRIDOR 34
ST 37
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CORRIDOR 04
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BABY FEED 16 SHR 09 DISP 02
V ST 40
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34 BED WAIT 34 CORRIDOR 41
TRANSFER
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C/UT 66 35 61 STAFF WC WC SH LINEN 63 BLOOD/GAS 31 64 D/UT 65 C/UT 66 C/UT 66 CL/UT 31
BASE 30 BASE 30
SINGLE INC 36 CORRIDOR 22 SINGLE INC 24 SINGLE INC 36 CORRIDOR 22
SISTER 25
SINGLE INC 35 B INFANT 28 STAFF 26 SINGLE INC 35 B INFANT 28
DOC 27 DOC 27
HOSPITAL STREET
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SV 7.5m2 N Rm27
Sv 8.3m2 N ND1
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Clean Utility Room Dirty Utility
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NSV
SV 9.0m2 N
Rm5
Treatment Room
16.2m2 Rm24 NSV
Assisted wc
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Rm6
Shower
11.2m2
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4 BED WARD Rm7
Rm23
Pantry
8.3m2 NSV
Rm8 16.8m2 NSV ND11
34.1m2 NSV
4 BED WARD Rm9
Rm22
Shower/wc Shower/wc
SV 5.9m2 N Rm8A
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Staff Base
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Chapel
60.6m2 C 10.2m2 C
MULTI FAITH ROOM
14.0m2 C
52. Car Park
72.3m2 V
WO/SH 25
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ar/ Semin Area Study sq m 20 C
n
sq
3 Perso Office m sq 18 C
19
C n Office m sq
4 Perso 21
&
C
NSV
MED REC.SECRETARYS
1.4m2
STR.
NSV
T
OFFICE
PHSIO LINEN
ROOM TREATMENT EYE TREATMENT EYEROOM
16.9m2
3.0m2 NSV
5.4m2 NSV
4.8m2 NSV
758 2XGG
HARDW
NSV
35.9m2 V
m
Fem.
5 sq
Dis. . w.c. m sq Cleanm 4 NSV 3 sq NSV
m 7 sq m NSV 2 sq NSV
n 1 Perso Office m 9 sqC
-1 AdminC
C
RO0M COMPUTER
NSV
18.0m2
11.8m2
22.9m2
6.7m2 NSV
CLOAKROOM
26.1m2 M
45.0m2
Store Room
TWIN BED 12
n
m
Male Toilets
4 sq
C
STAIRCASE MAIN STORE
MICROFILM
RECORDS
12.0m2 C
3.6m2 NSV 6.3m2 NSV
9.8m2 NSV
NSV
NSV 1.7m2
NOTES
STORE
D40
3.4m2 NSV
7.0m2 NSV D41
22 NSV 17.4m2
23
To Car Park
WC 11
m
1 Perso Office m 9 sq C
Lobby C m sq
44.8m2 M
METERS
DOWN STAIRS
12.9m2 M
LIFT TROLLEY
5.1m2 V
7.3m2 C
11.4m2
CLEANERS
STAIRS
PHYSIO STAFF
PHYSIOTHERAPY
D39
7.2m2 NSV
D42
D38
D 2 2
Gents Toilet 1
15.1m2 NSV
SHR 09
14
8 sq
V
NSV 2.8m2
STAFF TOILETS
D43
75.3m2 M
D 2 1
BABY FEED 16
n
C
17.6m2
ROOM PLANT
ADMISSIONS MED REC.
MED REC.
ROOM FILING
27.5m2 C
REFERALS G.P. MED REC.
C
NSV
NSV
NSV 5.8m2
NSV
REST ROOM
97.4m2 M
21
Shop
33.6m2 NSV
33.8m2 C
Office
29.9m2 V
7.4m2 V
D 2 3
VP
Mess Room
40
NSV 5.9m2 FD30s
FD30s
D VP 2 4
CORRIDOR 01
m
V 2.9m2
W.C. DISAB.
16.3m2
V 4.8m2
14.2m2 C
20.7m2
79.8m2
17.3m2
COURTYARD
PHYSIOTHERAPY
WORKSHOP
NSV 9.9m2
72.7m2 M
3.4m2 NSV
MASCERATOR
Carpenters
NSV
Managers
FD30s VP
CORRIDOR 101
sq
1 Perso Office m 9 sq C
C
10
bly-
V
40.4m2 C
OLD OPD APPOINTMENTS MED.REC.
24.9m2 C
2.8m2 W.C. V KITCHEN STAFF W.C. 2.9m2
7.3m2 V
OXY. VAC.
17.7m2 NSV
17.0m2 NSV
D44
D37
OFFICE
NSV
FD30s VP
Senior
10.7m2
4.2m2 NSV
41
30.9m2
D 2 6 3
38
WC DISABD 100
n 1 Perso Office m 9 sqC
OXY. VAC.
5.0m2 V
4.4m2 NSV
10.4m2 C
D46
D26
D36
22.3m2 V
8.1m2 NSV
7.9m2 NSV
9.5m2 NSV
10.8m2 V
FD30s VP
Corridor
42
SV 7.0m2 N
P e a gravel
P e a gravel
Gents Toilet
PN
n
V
m e/ Assem sq Coffe 27.5
OXY. VAC. OXY. VAC.
RECOVERY STAGE 1
RECOVERY STAGE 1
RECOVERY STAGE 1
DISABLED TOILET
3.8m2 V
Staff Room
V
V
OXY. VAC.
APPOINTMENTS MED REC.
18.8m2 C
CODING
18.2m2
16.0m2 C
MED.REC.
NEW OPD
7.8m2 V
97.6m2
24.9m2 V
15.7m2 V
D47
2.6m2 NSV
10.2m2 V
43
D2 5
NSV
ST 103
rsLockesq m 17
1 Perso Office m 9 sqC
OR FLO
Plant
2
1
OXY. VAC.
7.9m2 V
16.0m2 V
D45
D34
65.4m2 M
4.5m2 NSV
8.0m2 NSV
10.0m2 V
17.0m2
stub stack
37.8m2 C
FD30s VP
SV 7.3m2 N
37 Meeting Room
D Ladies 2 Toilet 7
20
28.0m2 V
44
Bay
D2 8
Disabled
Beverage
45
Toilet SV 4.0m2 N
NSV
Store Room
Midwifery Led Unit Special Care Baby Unit
57
DCP Option 1 - Phase 3 Warwick Hospital Site
59
DCP Option 1 - Phase 3
ND OU GR
T
V
W.C.
6.6m2 V
DIRTY STORE
2.6m2 V
D27
8.8m2 NSV
10.3m2 NSV
5.6m2 NSV
D48
D33
D35
14.8m2 NSV
9.2m2 NSV
C
Workshop
6.8m2 Technica l Manager
24
V
Maintenance 111.3m2 NSV
36
20.0m2
NSV 26.9m2 Entrance Lobby
OFFICE 102
l Health
LIBRARY
16.6m2 V
Notes Racking
MEDICAL RECORDS
V
16.4m2
ENDOSCOPY
16.0m2
DISINFECTION dirty area
21.7m2
9.8m2 V
dryer
10.6m2 NSV
D28
D 2 0
6.6m2 C
11.5m2 V
11.0m2 V
V
35
D2 9
D3 0
W6
V 3.2m2 3.5m2 V 6.1m2 QT
ationa
Mechanical
V
m not i s roo nt h l a s s e si cess Medica g c k o fa c u e to l a ed d confirm
ENDOSCOPY
RECOVERY STAGE 2
V
wm
D29
1.8m2 NSV
FD30s VP
NSV
DAY/TV ROOM 08
Occup
LIBRARY
V
20.6m2
17.6m2
clean area
Notes Racking
CHANGE/PREP
7.2m2 V
7.7m2 V
STORE/OFFICE
Mechanical
SUB WAIT
6.3m2 V
V
RECEPTION 11.9m2
ADMIN. OFFICE
D22
D49
D25
15.8m2 C
5.6m2 NSV
5.6m2 M
D31
D30
W5
10.8m2
V 1.9m2 838
V 2.4m2 4.7m2 V 15.4m2 V 6.3m2 V
MED.REC. 15.6m2 C
EXIT FIRE
STAIRS REAR
6.2m2 V
CHANGE/PREP
26.8m2
9.5m2 V
FEMALE
D50
10.3m2 M
1.8m2 NSV
34
3.3m2 QT 15.2m2 C
15.4m2 C
7.4m2 V
CHANGE/PREP
MALE
6.7m2 V
D51
D 5
D3 4
19.0m2 C 6
Supervisors Office
Maintenance Manager &
FD30s D3 VP 1
FD30s VP
11
Hotel Services Office 9
10.0m2 C
X R a y Records
172.7m2
89.9m2 V
11.0m2 M
72.4m2 V
10 Hotel Services Manager
6.7m2 C
5
FD30s VP
W7
SV 9.7m2 N
30.6m2 V
D1
D55
D52
3.7m2 NSV D53
7.1m2 C
33
STAFF CH 06
V
D20
20.6m2 M
12
OFFICE W8
9.4m2 V
SERVING KITCHEN
D56
3.3m2 NSV
5.1m2 NSV
D24
8.2m2 NSV
8.9m2 NSV
6.7m2 V
5.7m2 NSV
5.1m2 NSV
1.2m2 V
4.6m2 NSV
49.4m2 NSV
EBME Mechanical 13 Workshop
10.1m2 NSV
Physio Store
G06
5.0m2 V
EBME Workshop
4
32
TEL 07
D2
STORE
D54
D23
2.4m2 2.6m2 V NSV
13.7m2 V
51.1m2 V
15
(vinyl floor)
NSV
CORRIDOR 01
V
STAIRWAY
REAR ACCESS AND
V
DESK
LARGE GYM
D19
12.8m2 M
6.0m2 M
17.2m2 V
5.7m2 NSV
Store
Walkway
General Office
87.9m2 C
135.7m2
P e a gravel
M 61.0m2
AREA
15.4m2
OFFICE
RECEPTION
BOILER ROOM
D17
36.1m2 M
4.8m2 M
7.3m2 M
8.1m2 M
10.4m2 C
10.1m2 V
11.0m2 C
X R a y Records
Theatres
G05 Store
7.9m2 C
G15
7.8m2 C
Mattress Soak Test
14.0m2 NSV
D3 2
W11
DAY/DINING ROOM 51
1
57.6m2
DINING
AREA
OFFICE
LOBBY
DISABLED WC
D57
D63
D 6
11.3m2 C
7
98
10
11
12
13
14
15
16
17
16
Store
NSV 4.0m2 7.2m2 C EBME
Receptio n
W9
37.3m2 NSV
FD30s VP
31
NSV
35.8m2 V
2
WAITING
TREATMENT ROOM
STAFF BASE
PHYSIOTHERAPY
D15
5.6m2 M
SHOWER
D 3
D18
1.6m2 M
up stair under) plant
7
98
10
11
12
13
14
15
16
17
18
6
18
66.5m2 V
19
EBME Manager Office
14
Med Records
G04
7.2m2 V
25.7m2 V
11.8m2 C
G16
X R a y Records
Patio
20.8m2
D3 3
D5
UP
15
5.7m2 V Lift.
WA X TREATMENT ROOM
AIDS WALKING STOREROOM
SMALL GYM
D58
(lift
2111
width
1800 clear
up
20
4.3m2 V
Store
G03
10.3m2 C
Med Records
Gents 17 Toilet
NSV 8.1m2
19 16.9m2 NSV
Meeting
to be
Cashiers Office
replaced
SECRETARY D6
3
3.3m2 V
TOILETS
D59
19
stair
8.6m2 C
21
Risk
G17
V 1.2m2
3.9m2 C
7.2m2 C
40.3m2 C
WC
1
hiers hatc h
VP 30
Plant Room
10.3m2 C
Room
Window
W10Cas
Cashiers Lobby FD30s
CORRIDOR 04
14
NSV
3.3m2 V
8.8m2
D60
20
6
22
G02
Offices I.T. Coding & Notes Storage
W4
W3
W2
2
Corridor
18 4.3m2 NSV
1
Finance to
MILK KITCHEN 08
4
UP
13
5.0m2 V
V
D13
21
4
5
5.0m2 NSV
D14
M 2.2m2 NSV 3.6m2 2.1m2 M
D12
22
18.4m2 C
23
3
23
KITCHEN
G18
6.7m2 V
5.8m2 NSV
V 4.8m2
Pantry
5.93m2 NSV
Entrance
Patio
VISITOR 104
5
20.5m2 NSV
C
25.5m2
L
1.7m2 M 3.2m2 NSV
27.1m2 M
D11
24
2
24
Finance
WC
SECS OFFICE P e a gravel
Proposed
CORRIDOR 105
12
5.6m2 V
5.8m2 V
43.6m2
V
4 3 Bed Ward
PANEL
G CONTRO
D 2
HEATIN
D 9
7.5m2 M
1
8.1m2 V
0.8m2 V 0.8m2 V
1.5m2 V
OFFICE Boiler Room
NSV 2.1m2
13.7m2 C
ROOM PLANT
8.1m2 C
G19
7.2m2 M
25.5m2 M
11.5m2 V
9.5m2 V
4.1m2 NSV
10.7m2 C
Courtyard
13.5m2 C
Corridor Link
107
6
STORE
V
RECORDS X RAY
71.3m2
V
RECORDS X RAY
48.4m2
DINING ROOM
rwp
25.5m2
2 3 Bed Ward
rwp
D10
D 8
77.0m2 M
NSV
NSV
13.7m2
13.8m2
D 7
oor xternal d ary e tion tempor comple ed upon ith remov e dw and r e p l a c II o fp h a s e l interna swing double doors fire
85.3m2 M
D 1
2.9m2 NSV
2
58. Generator House 7.0m2 V
EXAM ROOM R03
ea Wet A r
Assisted Shower/ NSV 6.8m2 WC ea Wet A r
WC
Assisted N S V 6.8m2 Shower/
NSV
NSV
NIGHT STAY 106
11
C
DIABETES CARE
V
4.0m2 C
NSV
KITCHEN
13.0m2
rwp
V
25.5m2
3 3 Bed Ward
12.5m2
59.5m2
04
7
13.0m2
12.3m2
OFFICE
rwp
25.5m2
1 3 Bed Ward
D61
DISP
fr door 1hr ic magnet c/w open hold - door device ned positio t o be lly o n centra r corrido extg. line
NSV
NSV
CORRIDOR 04
10
UP
C
V
WC G64
3.4m2 V
G68
19.4m2 V
6.9m2
STORE 01
9
ELL
LOUNGE
46.4m2
105.0m2
Clean V 7.6m2 Utility
Nurse Station
17.3m2 V
SV 4.8m2 N
SV 2.9m2 N
SV 10.3m2 N
G4
SV 13.7m2 N
2.2m2
3.0m2 NSV
64
8
V
MATW
27.2m2 C
V
Room
8.7m2 C
NSV
KIT MILK 62
E EDIAT INTERM NG LANDI
D5
hour 1/2 g closin self
42.2m2
FOYER
8.1m2 V
V
Beverage Bay
Store
8.5m2
V
4.1m2
Fire Exit
5.8m2 C
27.0m2 V
26m2 V
C.C.U.
TIONS
V 1.7m2
G7
PUVA
7.9m2 V
11.6m2 V
G5
L APPLICA
NSV
8.3m2
V 5.2m2
MALE
WC
5.1m2 C
OFFICE
NSV
SKILLS LAB
61.1m2
CLINICAL
UP
DISABLED
3.1m2 QT
19.4m2 V
rwp
Store
NSV
80.5m2 Q T
23.7m2 C
56.2m2 V
Shower
TOPICA
12.3m2
NSV
Shower/wash
81. Accident Emergency Fracture Clinic FLOOR
CS
3.3m2
22.1m2 Q T
4.8m2 NSV
54.5m2 V
10.1m2 V
SV 62.8m2 N
SV 2.5m2 N
G6
m / W C
NSV 4.7m2
Bathroo
G8
21.0m2 C
2.5m2 NSV
14.8m2
NSV
63
QT
WC
GROUND
rwp
Staff Office
Reception
V
39.4m2 Q T
KITCHEN G59
SV 5.8m2 N
G58
SV 2.4m2 N
NSV 2.7m2
OOM W BAND R
G9
NARRO
SV 7.3m2 N
NSV
4.8m2
DIRTY Y UTILIT
10050E
D6
Room
CLEANER g
NSV
1.5m2 QT
FEMALE
New boiler
5.6m2
6.7m2 QT
19.9m2 NSV
Fire Exit
13.4m2 V
SINGLE G57
12.6m2
DERMATOLOGY
9.3m2 V
6.3m2 V
WC/CHANGE G11
9.0m2 V
SV 7.3m2 N
SECRETARIES G14
18.2m2 C
KITCHEN G13
SISTER G12
10.6m2 C
SISTER G60
10.4m2 C
G1
NSV
NSV
915
Castle Ward
Store
PLANT
l Contro panel
g Existin boiler
V
M
sluice
V
SINGLE G16
12.6m2
38.8m2
NSV
C 14.9m2
73 10.7m2
LAUNDRY /CLR. 4.0m2
C 22.8m2
NURSES STATION
Occupa NSV
SINGLE BED
V 3.5m2
Health 10.7m2
NSV 9.8m2
C 13.0m2 C
LINEN
80. Burkeman Davis MacGregor Ward 53. H.S.D.U. 10.2m2
Dist. board.
2
ENT
WC
10.1m2
Unisex 3.0m2 Staff NSV
Store
Sluice
NSV 4.1m2
NSV
SV 13.4m2 N
SHOWER G17
LINEN G18
NSV
14.8m2
NSV 14.3m2
NSV 5.6m2
KITCHEN
NSV 8.5m2
12.1m2
OFFICE
51 consultants office
5100N
55. General Pathology QT
V
rwp
242.7m2
3.9m2 QT
22.0m2 NSV
8.6m2 V
NSV 4.0m2
8.9m2
WASH
C 5.5m2
C 7.4m2
OFFICE
320
59. Pathology Laboratory
46. Mortuary
74. Woodleigh Beeches
11. Opthalmology Offices.
Victoria Ward (1) Mary Ward (1) 10.0m2
44.6m2 V
25.5m2
Air Vent
NSV
OFFICE
10050E
g
Coronary Care Medical Offices (1) U
10.7m2 V
rwprwp
Ward NEW 3 Bed
rwp rwp
Air Vent
3.8m2 NSV
rwp
Boiler Room
Unisex Disabled NSV WC 3.9m2
10.2m2
NSV
2.6m2 V
SINGLE G56
13.9m2 V
CLNR G20A
SHOWER G20
SV 3.5m2 N
G19
DIRTY G36
10.4 NSV
G46
LINEN G54
2.9m2 V
SHOWER G55
SV 4.1m2 N
24.9m2 V
SHOWER G53
SV 4.3m2 N
SINGLE G52
2.4m2 V
SLUICE G53A
AIR LOCK G21A
SINGLE G21
SV 13.9m2 N
SV 2.9m2 N
DIRTY G37
NSV
6.9m2
15.7m2
17.0m2
W AY OUT 15.6m2
TREATMENT ROOM V
2.5m2 NSV male
3
Male wc Female wc Disabled wc
C 10.6m2 C 6.0m2 C
OFFICE
OFFICE
2.6m2 NSV V
117.6m2
Female Shower/wash
Bay 10 Bed
V 10.5m2
SINGLE BED
OFFICE 2.9m2 NSV
C 6.7m2
NOTES ROOM C 6.7m2
W.C. C 15.0m2
7.8m2
STAFF
NSV 3.9m2
DIRTY
STORE
53 Indicative King's Fund Bed By Others
UP
ea Wet A r
M
NSV
915
11.5m2 V
WC
Assisted N S V 6.8m2 Shower/
V
9.9m2 NSV
SV 6.4m2 N
SH/WC G35
6.5m2
NSV
SV 9.5m2 N
CHANGING G52A
7.1m2 V
12.2m2 V
7.8m2 C
23.3m2 NSV
SV 5.6m2 N
SH/WC G38
NSV & C
47.5m2 V
184.4m2
SH/WC G40
6 BED G22
SV 49.9m2 N
NSV
NSV
25.4m2
5.5m2
12.8m2
6 BED G51
50.0m2 V
4.5m2
SH/WC G39 N S V
SV 4.6m2 N
SV 95.1m2 N
NSV
NSV
915
3.2m2 V
1
21.4m2
7.1m2 NSV
6 BED G50
49.2m2 V
4.4m2
92.6m2 V
SV 4.5m2 N
Linen Store G33
Linen Store G34 V
7.2m2
54.8m2
C 16.0m2
14 75.1m2
915
9.2m2 V
rwp rwp
ENT
10.9m2 NSV
11.6m2 V
34.4m2 NSV 10.6m2 V
Blood Bank
6 BED G49
SV 6.5m2 N
SH/WC G32
SV 6.6m2 N
SH/WC G41
6 BED G20
NSV
2.2m2 NSV
2.2m2 NSV
9.3m2
SV 49.6m2 N
SQUIRE WARD
STAFF G31
STAFF G42
MALINS WARD LINEN G43 0.9m2 V
CLEAN G30 SV 8.3m2 N
48.8m2 V
G29 LINEN
CLEAN G44
SV 8.6m2 N
6 BED G24
SV 50.3m2 N
NSV
4.0m2 V
80.7m2 T
838
7.7m2
CLEAN UTILITYV
STORE
1.8m2 V
rwp rwp
V
4.6m2 V
38.6m2 C
2
22
77 ELEC. 3.8m2
MEDICAL SECS
V 10.3m2
2.9m2 V
25.5m2
Ward NEW 3 Bed
G . W . P.
G . W . P.
G . W . P.
G . W . P.
1.1m2 V
Entrance V Lobby 7.8m2
1.2m2 V
5.1m2 NSV
3.6m2 NSV
G19
SV 4.5m2 N
SH/WC G28
SV 4.4m2 N
SH/WC G45
G48
51.1m2 C
21.7m2 V
SV 5.2m2 N
STORE G27A
4.6m2
V
ROOM TREATMENT G48
BATH G47
SV 10.9m2 N
45.6m2 V
DAY ROOM G27
WC G24
3.8m2 V
SLUICE G24A
SV 6.1m2 N
2.8m2 NSV
5.4m2
SV 6.0mS N
16.0m2 NSV
17
DIRTY UTILITY NSV WC D AY ROOM C
30
ROOM PLANT
46 838
23
DOCTORS OFFICE
V 111.6m2
MALE BEDS
3 lp
54. Purchasing/Stores 10.0m2
3.0m2 V
OFFICE
ROOM STAFF G25
V 1.8m2
tional
21
74 4 5 CLNR
7.3m2
DIS' W C 3.3m2 NSV
3 1 CORRIDOR
Proposed proposedarrangement arrangement
Existing arrangement arrangement existing
16.3m2 C
10 13.4m2 C
45 8.0m2 NSV 2.8m2 NSV
Shwr
5.0m2 NSV
3 2 OFFICE
V
80
4 3 OFFICE 4 4 OFFICE
15.5m2 C 20.5m2 C
2 11.8m2 V
NSV
NSV
14.6m2
7.5m2
1800
3 3 OFFICE
15.5m2 V
STAIRS
15.6m2 C
WC G25A
6.9m2 NSV
width clear
sluice
36 37
A 38
width clear
WC
13 E T R E S T A L P I T O S H G N I S T I E X
T RE E T ITA L S HO SP FFL = 9.772 IN G E X I ST
1 ase k o n Ph in l i n e o fl centre to e wl i n k ine o f n entrel mm c 20966
WC
1 1
41
4 6 OFFICE
4 1 MALE
3 20 42 40
39
9.4m2 C 20.2m2 C 4 7 OFFICE
3 4 OFFICE
12 WC
WC
20.6m2 C 21.8m2 C
17.3m2 C 7.2m2 V 7.5m2 V
72 84
3 8 PLANT
3 7 OFFICE
12.1m2 C 11.8m2 C
4 2 OFFICE 4 0 FEMALE
1 19
16.0m2 C
18 9.7m2 C ROOM 3 6 SEMINAR
3 5 OFFICE
42.8m2 C
20. Doctors Mess
g
37. Facilities
78. Outpatients Fairfax Ward
2
32. Day Surgery Unit 14. Dental Department
S.C.B.U. (1) Beaumont Ward (1) lp
41. Malins Ward Squire Ward Porters/Domestics (1) Clinical Psychology (1) Dietetics (1) 21. Medical measurement
4
Occupants of Parsons Block relocated to vacated accommodation Swan Ward (1) 39. Womens Unit & Colposcopy 79. Chapel e.g. Dugdale ward Secretaries (1) 40. Charlecote Ward Diabetes Care Nurse Changing (1)
g
Telephone 36. exchnage to new building X Ray Recordsetc relocatedNicholas Labour Suite (1) Ward Mai Entrance
18. Telephone Exchange & Security Base
g
Theatre Suite (1) Intensive Care (1) Willoughby Ward (1) g
Finance (1) Oken Ward
31. Day Surgery Unit.
1
5150N
44.
Brooke Suite (1) 12. General Management Medical Records & I.T.
57. Microbiology 42. Dining Room Kitchens & Shop 447.5
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79
84. Hatton Ward
23 Hour Ward (1)
78 50
2 9 STAIRS
16.0m2 NSV
16.44
10. Endoscopy Unit
KEY
!
38. Medical Day Unit
19. Jephson Centre g
81
30. Radiology & Catheter Lab 50. Guy Ward based setting 77. Pharmacy GU services relocated to a communityy 13. Machen Eye Unit
g
22. Cardiac O.P.D. New 2-storey ward block to provide additional capacity with 48 72. Medical Education Block 45. Dugdale Ward 23. Physiotherapy beds Occupational Therapy (1) Ambulatory Cancer Unit 73. Occupational Health
4. John Turner Centre
A g
HOSPITAL BLOCKS.
13.3m2
Ofice/Library
58
23.0m2
C
38.6m2
Special Care Baby Unit
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Estate Data Strategic Issues All healthcare providers have a responsibility for
The SHP guidance on the methodology for analysing
the management of their assets. A well devised
the estate will include standardised cost estimates
estate strategy is an essential element of that
for land, buildings, engineering plant and services,
management. SHP proposes to develop guidance
and external works and on average accounts (with
to hospitals to assist them to develop their Estate
the energy and manpower needed to operate it) for
Strategies.
about 10% of the annual revenue expenditure of a Trust, and 85% of its capital programme.
The Estate Strategy is a long term plan for managing the estate in an optimum way in relation to the
The estate has a critical influence on the key quality
service and business needs of the Organisation and
issues of:
the local health economy. It is required to be able
•
safety
to deliver a modern health service fit for the 21st
•
infection control
century, where buildings and equipment are in the
•
fire precautions
right place, in the right condition, of the right type
•
physical environment (internal and external)
and are able to respond to future service needs. It
•
environmental conditions (energy / emissions /
includes: •
sustainability)
the analysis of the current estate and how it
•
access
performs
•
suitability for function
proposed changes to the estate over the next
•
transportation / car parking
decade
•
aid to healing
•
proposed performance improvements
•
recruitment and retention of staff
•
estate rationalisation plans
•
site master plans
•
a comprehensive estate investment programme
•
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Existing
Proposed
21
The range of benefits to a healthcare provider and
The essence of the healthcare estate is to provide
the wider health economy in having a formal estate
an appropriate environment from which to deliver
strategy are:
a quality healthcare system to all of the population.
•
an assurance that the quality of clinical services
Management of the assets should form part of
provided will be supported by a safe, secure and
an integral process of strategic service planning.
appropriate environment
Developing a realistic service plan will be
a means of ensuring that capital investments
determined by the interaction of service need,
reflect service strategies
asset availability and performance, the constraints
a plan for change in which progress can be
of available finance, and the availability of skilled
measured
healthcare professionals.
• • •
a strategic context in which detailed business cases for all capital
The resources of people, finance, assets and
•
investment can be developed and evaluated
information should be considered in an iterative
•
a means by which the healthcare procurement
way in a strategic service planning exercise.
body can identify capital investment projects
•
which will require formal approval and relate to
The stock of land and property represents a valuable
the Local Development Plan.
resource equally as important as the resources of
a clear strategy to:
finance and manpower. Experience shows that a
•
establish sustainable development and
creative manipulation of the estate in the context
environmental improvements
of service planning can substantially reduce the
•
ensure assets are effectively managed
revenue burden. But it can only be achieved if the
•
ensure
nature of the estate and its future potential are
risks
are
controlled
investment properly targeted •
22
to reduce risk
and
properly understood.
The process of identifying and appraising options as part of strategic service planning produces the framework within which detailed investment proposals can be developed. In summary the following information should be presented: •
the estate that is to be retained;
•
the degree of modification (extension, change of use, reduction) envisaged to your existing estate;
•
the need for additional land and property and the functional units to be provided;
•
the availability for disposal of unwanted existing land and property;
•
the potential for re-use of assets (equipment, plant) currently used in unwanted facilities;
•
the timing for delivery of retained, refurbished, re-usable, extended or newly-created land, property and other assets and the availability for disposal of unwanted assets;
•
the resources to sustain the resultant estate.
23
Portuguese Institute of Oncology
UK
specialist
healthcare
planners
Strategic
Healthcare Planning International Ltd is currently preparing a proposal for presentation to The Portuguese Institute of Oncology to demonstrate the methodology and benefits that can be derived by aligning service aspirations with the estate from which it is to be delivered by the production of an estates strategy. Throughout its history, the Institute has established itself as a multidisciplinary cancer center of reference for the provision of health services in the area of oncology, with extensive activity in the areas of research, education, prevention, diagnosis, treatment, rehabilitation and continuity care, ensuring every patient care to meet their needs, according to the rule: “the patient first.� The Portuguese Institute of Oncology provides its services from 3 different locations, Lisbon, Oporto and Coimbra.
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Service Alignment Operational Issues The first task for the estates professional to understand is the support the estate can give to facilitating the service strategy. This will involve a review of the buildings. Land and property appraisal involves a thorough examination of the land and property with the ultimate aim of calculating what it will cost to maintain the estate at an acceptable standard and where opportunities for adaptation and rationalisation lie. The underlying aim of such an appraisal is to ensure that the estate, as a resource, is aligned with the service objectives, so that you can provide the right facilities in the right place at the right time. Land and property appraisal is the key activity in drawing up a baseline assessment of your land and property. It is the first step in the creation of an estate strategy. Information from land and property appraisal is also essential in drawing up annual minor capital and estate maintenance programmes. Before starting the appraisal process ensure that you are clear about the objectives for carrying out the work. This is important because it will determine the level of detail at which you collect data.
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S T R AT E G I C
HEALTHCARE
P L A N N I N G TTC House Hadley Park, Telford Shropshire, TF1 6QJ T: +44 (0) 1952 677660 F: +44 (0) 1952 605716 info@shp-uk.com www.shp-uk.com