Our presentation is available here.

Intro slide Transforming the Care we deliver Hambleton, Richmondshire and Whitby CCG Dr George Campbell, Deputy Chair, HRW CCG Sarah Ferguson, Senior Delivery Manager, HRW CCG @HRW_CCG

13th June 2014

Public Engagement

Phase 1 - Vision for Whitby & Surrounding Areas Retendering of Community Services and Out of Hours GP Services • Includes community nursing, specialist nursing, inpatient services, OT and Rehabilitation Services, Minor Injuries Unit, outpatient services and OOH GP services • Contract value is £6-8 million annually • Integrate three separate contracts • 5 year contract (£40 million) • Trigger an asset transfer of the hospital to NHS Property Services • Bidders event on the 3rd July 2014 • Likely route will be competitive dialogue procurement

Major Improvements • • •

• • • • • • •

Develop a frailty assessment service for patients complex comorbidities, dementia and frailty Good rehabilitation and reablement after acute illness or injury and changes to the Day Rehabilitation Service Better clinical input into the inpatient beds and improvements to rehabilitation on wards and in the community to support earlier discharge and provide postdischarge support Access to 24/7 Out of Hours GPs based at Whitby Hospital Maintain local Minor Injuries Unit and integration with OOH Creation of Single Point of Access and 24/7 Community Nursing Choice, control and support towards the end of life Improved access to own care records for them and their health professionals Investing in third sector: sitting/befriending services, community agents and care navigators Additional innovation through collaborative working

Phase 2 - Redeveloping Whitby Hospital Why? •

75% of the current facility is not occupied

•

Privacy and dignity issues

•

No dedicated treatment rooms for integration of Out of Hours and Minor Injury services (off site)

•

Building is beyond its life and not fit for purpose

•

The current site layout does not allow for joint working

The Brief for Community Ventures • Identify options for redevelopment of site, with partners and with NHS • Review existing/alternative uses for the land. • Identify potential revenue and capital opportunities to improve VFM • Prepare a formal set of recommendations for the stakeholders to consider and for CCG governing body/council of members to approve.

Future Service Profile Proposed Schedule of Accommodation

Net

GIA

Inpatient Ward

1031

1482.063

Health and Wellbeing Hub

215.5

309.781

Ambulatory Care Centre

1092.5

1570.469

Total

2339

3362.313

Note: Shared entrance reception/waiting areas not calculated (Additional area to be saved)

Assessment of Long List Options

Do nothing

N/A

Yes

Est. Capital Cost N/A

Remodel buildings on current site New build on current hospital site

N/A

Yes

£6.3m

The cost (value for money), planning constraints and deliverability do not stack up when there are suitable buildings already available on the site which can be utilised. Remodel and refurbish Following a detailed property search no suitable an existing building buildings of the size required and suitability for elsewhere in Whitby that conversion have been identified at this time. is suitable for conversion

No

£9.1m

No

N/A

New build on alternate site in Whitby

No

£9.1m

Option

1 2a and b 3

4

5

Reason

Following discussions with Local Authority planners and a detailed land search no suitable sites of the size and nature required are currently or expected to become available in Whitby at this time.

Taken Forward

Capital Costs are for construction exclude VAT and fees, options 3 and 4 also exclude demolition and remediation and the cost of purchase for a new site

Short Listed Options (Option 2a) Re-model & refurbish health element using the block at the front of the site

Short Listed Option (Option 2b) Re-model & refurbish health element using the 4th floor block on the rear of the current site

Development of Site Commercial Site Development

Development of Site (Preferred Option) Hospital integrated with NYCC Services

Financial Appraisal (Option 2) • Capital Investment - £6.352m • Revenue - £0.9m (circa £800k)

• Capital Receipt - £0.6m - £2.445m

Conclusions •

Local Planning Officers confirms support for a continuing health presence on the site, as well as support for the principle of a mixed use of Extra Care development and general housing for sale.

•

There are feasible options to create a remodelled community hospital on the existing site.

•

Overwhelming message from the engagement period is that people place very significant value on local services and would like to see the new hospital developed on the existing site.

•

Remodelling and refurbishing buildings on the existing site offers the best value for money option going forward to deliver CCG commissioning intentions and the opportunity for integrated services within a timescale and programme that the CCG/NHS can dictate and influence.

•

Progressing the Preferred Option would generate revenue saving to the NHS and would require less capital investment than alternative options.

•

The preferred option offers an immediate solution to LA partners for their strategic service plans assuming appropriate project and commercial arrangements can be agreed.

Recommendations 

Governing Body to approve draft Community Ventures report and agree engagement plan.



Set up a joint commissioning/development project board with NYCC under an Memorandum of Understanding (MOU) with agreed principles and timescales.



Identify the capability and capacity to undertake the project ensuring appropriate resources and skills are available to deliver the next stages.



The principal task of the joint project board will be to develop an interagency plan/business case for the site that realises the vision for a health social care and wellbeing campus.



Alternatively should the partnership be unable to agree a joined up development plan the NHS should continue to pursue a stand-alone remodelled community hospital maximising the opportunities from the surplus land.

Fit 4 the Future – Hambleton & Richmondshire Significant project looking at providing more appropriate care for an aging population, needed because: • Ageing population – 30% increase in over 65s by 2021. • Patients spend too long in acute hospitals. • Community services need to be developed so people can be cared for in their own homes. • Health and social care services need to be more integrated.

Six key areas in the Vision.

Fit 4 the Future – Hambleton & Richmondshire • Currently in the middle of an engagement campaign.

• Good buy-in from health and social care partners. • Conversations with members of the public so far have been generally supportive of the Vision. Some good extra ideas and thoughts. • Will be going out to existing groups over the summer months to further continue the conversation. • Report published in the autumn.

Challenge Fund Update Annie MacLeod Relationship Manager Y&H CSU