Present: Alasdair Lawton, Non Executive Director and Chair

HIGHLAND NHS BOARD

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MINUTE of MEETING of the
NHS Board Asset Management Group
Ante Room, Assynt House, Inverness / Tuesday 17th December 2013,
2pm

Present: Alasdair Lawton, Non Executive Director and Chair

John Crossley, Section Head, Medical Physics

Bruce Merchant, Public Representative

Carol Marlin, Monitoring Accountant

Ian Scott, Clinical Director, South & Mid

Brenda Dunthorne, Head of Finance, Raigmore

Ray Stewart, Staff Side Representative

Bill Reid, Head of eHealth

Eric Green, Head of Estates

Neil Stewart, Head of Procurement

David Matheson, Procurement

Alex Javed, Service Manager

Mary Morton, Head of Community Pharmaceutical Services

(representing Area Clinical Forum)

Elaine Wilkinson, Non-Executive (by VC)

Derek Leslie, Director of Operations, A B (by VC)

Michael Hall, Clinical Director, A B (by VC)

In Attendance: Kirsteen Stewart, Estates Support Manager (minutes)

WELCOME/INTRODUCTIONS

Alasdair Lawton welcomed everyone to the meeting.

Apologies for absence were received on behalf of Nick Kenton and Bob Summers, with Iain Rudd being replaced by Mary Morton as Area Clinical Forum representative.

1. MINUTE OF THE MEETING HELD ON 14th NOVEMBER 2013

The minutes of 14th November 2013 were approved, after the following amendments were made:

Item 13, paragraph 2 should say ‘build’ not ‘bill’.

A.O.C.B. Obstetrics Scanning Machines, paragraph 2, wording amended to “There are a number of staff off sick with suspected RSI in the Ultrasound dept. It is possible that the weight of the existing probes and an increased number of screenings may be a contributory factor”.

2. MATTERS ARISING

Pharmacy Isolator Project

Two isolators have been approved through the Detecting Cancer Early Capital monies and two additional isolators to deal with the TPN requirements where funding is sought specifically by Capital.

Action: Carol Marlin to identify if there are any more funds available within the DCE Capital budget - this is still not agreed and to be carried forward.

Further matters will be picked up on the Agenda.

3. MONITORING REPORTS

Carol Marlin explained that the reports show that there is over-commitment to unallocated funds, but this was expected, and there are 3 disposals listed at the bottom of the reports, which are still to happen.

Ray Stewart raised the Islay generator scheme with budget of £74k and asked for an update on whether an agreement had been reached on the Council paying a third of this cost. Eric Green advised that negotiations were still ongoing, however, could not provide any guarantee, but added that NHS Highland will require to replace the generator regardless of whether or not the Council agreed to pick up any of the cost.

Eric Green advised that the Biomass was now on site at Raigmore, and that this would result in significant expenditure.

Carol Marlin advised that Deirdre Brindle, Capital Accountant, has set up a pre-meeting to this meeting for managers.

4. 2020 CAPITAL VISION

Eric Green advised the group that a meeting with ARUP was organised for 08/01/14 with the plan being to set up a programme for engagement with NHS Highland. Eric Green will provide further detail to the group on how this will be approached at the next meeting, in January ’14.

Action:

Eric Green to provide feedback from meeting with ARUP at next AMG meeting on 14.01.14.

5. CATERING EQUIPMENT

Eric Green advised the group that there was a National Audit of Catering across NHS Scotland, undertaken by Health Facilities Scotland, on which we have now received feedback. Significant issues have been highlighted relating to trolleys. Some of the Community Hospitals were highlighted as higher risk than Raigmore, although problems at Raigmore were also identified. Eric Green added that investment in the region of £300k-£350k would be required, across 3 years, to replace all trolleys, and that there has been no allocated budget over past 3 years to replace catering equipment. To add to this, significant defects on catering equipment across NHS Highland were also reported. Eric Green suggested that this be done next year, or if money still available at the end of this year, purchasing catering trolleys may be a useful way of dealing with slippage, and if this was to be the case, some preparation work could be done now.

Alasdair Lawton asked whether there was a frameworks contract but Neil Stewart advised that this was not something which had been utilised in Grampian. If there was some sort of agreement this may make things easier. Eric Green agreed to provide a full list and plan for the next meeting.

Ray Stewart added that any decisions should not be driven purely by cost, but by quality as well.

Elaine Wilkinson asked whether the investment in trolleys would be right across NHS Highland, and this was confirmed by Eric Green.

Actions:

Eric Green to provide a full list of catering equipment, and plan, for next AMG meeting, on 14.01.14.

6. CAPITAL NETWORK MEETING

Eric Green attended this meeting, along with others from across NHS Scotland who were involved in delivering Capital projects, and shared a number of discussion points with the group, as follows: -

-  Work done on Reference Design – Health Centre in Glasgow; which is the most efficiently designed Health Centre in Scotland, and metrics have been set up on which to judge other builds. As part of this design a standard design for consulting rooms, which could be used by various disciplines, was identified, and competition at design phase of build was also introduced, which drove down costs as a result of Architects having to enter into competition to come up with best design for the building.

-  Capital spending will be restricted for next 3 years, up to 2016/17.

-  Asset Management Strategy is the tool which the Scottish Government will use to divide up additional funding as it becomes available.

-  Update on HUB projects; Aberdeen Health Village is now complete.

-  Identify any forward pipeline projects to be included under HUB; as much information to be included in the Asset Management Strategy; the more information, the better the planning.

-  Energy Projects – no further Capital allocations for the next 3 years. However, the Westminister Government is keen to push the use of the Greenbank, which the NHS is currently excluded from using, though a change to this rule is being looked into.

-  Eric Green also advised that Health Facilities Scotland will be running energy audits, and NHS Highland will be taking part. However, NHS Highland has done most big energy projects, so our scope for this will be relatively small.

Elaine Wilkinson raised the issue of Integration in Argyll & Bute, and whether there had been any discussion in the 3 year plan about how this should be dealt with? Eric Green advised that each relevant organisation e.g. The Highland Council, will have a forward plan, though he could not answer specifically for Argyll & Bute. Derek Leslie advised that for the past 5/6 years they have worked with the Council on property sharing, though there was still some uncertainty around what model it’s going to be in A & B, there would not be a huge amount of investment expected.

7. SFT WORK ON PROPERTY RATIONALISATION

Eric Green discussed a project, which Scottish Futures Trust are leading on, called Smarter Offices, which centres around the efficient use of office accommodation and is being piloted in Edinburgh at the moment, with view to making efficiency savings and taking advantage of agile working policies.

Pilots in Edinburgh have managed to achieve a ratio of 8:12 for desks:members of staff. It has been decided that NHS Highland should follow this example, with Scottish Futures Trust offering support to every Board, and Eric Green further advised that the PAMS for 2014 must include a proposal on office accommodation rationalisation. Eric Green proposed a paper to Executive then Senior Management Team and will keep the group updated.

Alasdair Lawton suggested that, initially, it was a Change Management and Business Process Management issue, then becomes an Asset Management issue at the end.

Elaine Wilkinson suggested that such work would fit with the Highland Quality Approach, 5 S’s, etc, and pointed out the need to be careful that this work does not conflict with work which is already ongoing.

Ray Stewart suggested that there is a need to be careful that there are not unintended consequences for the Asset Management Group, of more people working at home; there will be a need to provide infrastructure, which will come at a cost.

Eric Green informed the group that The Highland Council have made steps to work to this standard and proposed that NHS Highland work in partnership with them.

Carol Marlin also highlighted that the Council differentiates between fixed desk staff and mobile staff, and the ratio is applied to the mobile staff.

8. OBSTETRICS SCANNING MACHINES

Brenda Dunthorne advised the group that the Service Manager had yet to obtain an Occupational Health view on the lighter probes, and whether they will have a significant benefit to this issue.

John Crossly explained usage and how the problem may be to do with wrist action rather than weight, so some sort of support may be beneficial, though accepted that the professional input from Occupational Health was required, and still to come.

Brenda Dunthorne has contacted the Service Manager on several occasions to obtain an Occupational Health view and will continue with this.

Actions: Brenda Dunthorne to continue to chase Occupational Health for professional input on this issue.

9. ARGYLL & BUTE INTEGRATED EQUIPMENT STORE

Derek Leslie discussed the proposal, which is for 2014/15, to spend £42k and save £50k Capital, which is then converted into Revenue, which will help the Board’s position. Ray Stewart asked how old the second hand machines were, and how long the machines are likely to last for? Derek Leslie advised the group that he will obtain and share all the relevant information.

Actions: The group agreed to approve in principle, subject to answers to Ray Stewart’s points, and subject to approval for the Capital to Revenue virement next year.

10. A.O.C.B

10.1 Cardiac Output Monitor, ITU

£12k to replace.

Has scored 48 on the scoring system and services will stop if not replaced.

This request was approved.

10.2 Bladder Scanner, OPD

£10k to replace.

Has scored 48 on the scoring system and services will stop if not replaced.

This request was approved.

Actions: Carol Marlin asked John Crossley to forward details of both of the above requests to Deirdre Brindle.

10.3 Item 9 on Agenda

Carol Marlin went back to Item 9 on Agenda and advised that the LDP was due on 14th February 2014, however, the Capital Plan and Surplus Asset Plan was due by 17th January 2014. The Capital Plan should be ready for approval at January meeting and there is a need to make sure that the Capital Plan ties in with the PAMS.

10.4 ECRP at Raigmore – Endoscopy Procedure

Eric Green explained that there was a paper (not from Asset Management Group) resulting in significant internal debate on the issue of an endoscopy procedure. The procedure is currently done in the X-ray Department, however, it makes more sense for it to be done in the new Endoscopy Procedure Room.

The business case is being worked on at present, as it initially identified this as a significant additional cost, however, Eric Green advised that the construction process is currently ahead of pace and that, if the extra piece of X-ray equipment was to be housed in the Endoscopy area, in order to make the process safer, and reduce number of required staff, it would be easier to do work to accommodate this now, during construction work, rather than retrospectively. Total construction cost for required room in Endoscopy is £48k, however, we could spend £10k now, and undertake the most disruptive elements of construction, which is to lead-line the wall, and then, if we decide to go with business case, the rest can be done at later date without too much disruption. Proposal is that £10k is spent now, as a way of future proofing, or £28k if done restrospectively. Overall project cost is £4m. Alasdair Lawton asked if this has been agreed from the Clinical side and Eric Green confirmed that it was a Clinical priority (both Endoscopy and X-ray).

Eric Green advised that increased power supply is in place, and electrical infrastructure has been checked, so capacity is there. Alasdair Lawton voiced concern that we may be spending money which we may not need to spend. Brenda Dunthorne advised that one of the reasons that a business case hasn’t come forward is because other rooms have been looked at for suitability, however, running out of options.

Brenda Dunthorne further advised that Ron Coggins, Clinical Director, has expressed that there is Clinical Risk for where procedure is currently being carried out.

Eric Green stressed that there is a time pressure, as the plasterboard is going on the wall in 2 weeks time, in order to ensure that project completes on time, so Eric Green urged that a decision is required today, one way or the other.

The group agreed to proceed with option of lead-lining walls.

The meeting closed at 15.00 hours.

11. DATE OF NEXT MEETING

14th January 2013, 2pm, Ante Room, Assynt House

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