Monklands Replacement/Refurbishment Project. Options Appraisal Pre-Briefing May/June 2018
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1 Monklands Replacement/Refurbishment Project Options Appraisal Pre-Briefing May/June 2018
2 Presenters Graham Johnston Head of Planning
3 Purpose of Session Brief update on MRRP Project General Option Appraisal Principles Description of Options Outline of day 1 & Day 2 Benefits Criteria Weighting & Scoring Financial Appraisal Next steps
4 Background
5 Background (cont.) MRRP consulted through Achieving Excellence Initial Agreement (IA) approved by the Scottish Government in October 2017 Business case process and timescales Regional strategic element Givens: Will have A&E Must serve current UHM emergency catchment
6 Progress since IA approval Building a team Healthcare Planner Lead Advisors Project Director Project Team Process clinically-led: work streams/leads Modelling work done to date Cross-check process Structure MRRP Project Board Project Team Clinical Advisory Group Clinical Support Groups/Work streams
7 MRRP Clinical Specialty Groups Structure Unscheduled Care Complex Services Planned Ambulatory Care Clinical Support Life Sciences and Education Non clinical support Support Lead Graham Simpson Gordon McNeish Gavin Halcrow Sanjiv Chohan Graeme McGibbon Ann Chapman Nicola Ruddy Tracey Dunn Raymond Hamill N/A WGH HM Dr. Mhairi Sinclair John Keaney Dr. Stephan Dalchow Andrew Mitchell Dr. Ken Dagg Brian McGurn Diagnostics Miss Diane Bramley Michelle Thornton N/A N/A BA lead Niall Thomson Iain Buchan Karen Pirrie Theatres Iain Buchan/ Niall Thomson Graham McCorkindale Graham McCorkindale Emergency Dept Renal (Dialysis Unit) Pharmacy Medical Illustration Therapy Assessment CCU Theatres Day Surgery Radiology/ Interventional Radiology Hard/Soft FM Planned Investigations AMRU/ ASAU/ Medical Pathways Frailty Ambulatory Care Level 1-3 beds REACT Medical Day Case Cancer Services Endoscopy Nuclear Medicine Laboratories HR/Workforce Administration and Office Space Admin Lead/Employee Director Inpatients Outpatients Histopathology Microbiology Spiritual Care and Wellbeing Clinical Haematology Infectious Diseases Haematology Mortuary SALUS Medical Physics Respiratory Stroke Maternity Assessment Pre-assessment Endocrinology/ Diabetes Urology Orthodontics Echo/Pulmonary Function ECG
8 Option Appraisal Process Agree options to be scored Consider inclusion of baseline comparative purposes Agree benefits criteria Initial Agreement Agree weighting Agree scoring mechanism Score/rank options Financial evaluation Agree preferred option
9 MRRP - Option Appraisal Scottish Health Council approved process and national guidelines (CEL 4 (2010) and SCIM). A, B, C, D options. Stakeholders Who are the stakeholders? How were the stakeholders identified?
10 Monklands Replacement/Refurbishment Option Appraisal Option A - do minimum
11 Monklands Replacement/Refurbishment Option Appraisal Option B - full refurbishment of current hospital.
12 Monklands Replacement/Refurbishment Option Appraisal Option C - new-build on current hospital site.
13 Monklands Replacement/Refurbishment Option Appraisal Option D - new-build on another site.
14 Option Timescales Indicative Project Programme Activity Option A Option B Option C Option D Outline Business Case Contractor Procurement Full Business Case July 2019 July 2019 July 2019 July 2019 April 2020 April 2020 April 2020 April 2020 October 2020 October 2020 October 2020 October 2020 Construction Ongoing December 2041 December 2029 December 2024 Equipping & Commissioning Ongoing July 2042 July 2030 July 2025 Migration Ongoing February 2043 February 2031 February 2026 Demolition Not applicable Ongoing February 2033 Not applicable
15 Monklands Replacement/Refurbishment Option Appraisal Two formal option appraisal events are scheduled + pre-briefing session Second event will only take place if Option D, new-build on another site, is a high-scoring option.
16 Monklands Replacement/Refurbishment Option Appraisal Day one Clinical model Detail of options Future proofing & Flexibility Pro s and cons Regional context Benefits criteria & Scoring
17 Monklands Replacement/Refurbishment Option Appraisal Day two (if required) Detailed site information: Access Supporting infrastructure Transport/Travel time information Ability to support expansion Pro s & cons Benefits criteria & Scoring
18 Benefits Criteria Person Centredness Improved safety of patient care Improved clinical effectiveness Quality Physical Environment Flexible/Adaptable facilities
19 Person Centredness Assessment Measure Description Proposed Measure Improved access to health and social care Higher engagement of patients in clinical decisions Reduction in delays in transitions between episodes of assessment and care N/A N/A How well does this option deliver the Adjacency of key clinical departments?
20 Improved safety of patient care Assessment Measure Description Proposed Measure Higher patient/carer satisfaction with assessment/treatment Reduction in disruption to clinical activity caused by accommodation and/or environmental factors Presence of noise/vibration/dust Disruption of day to day activity Reduced risk of healthcare acquired infections How well does this option minimise level of disruption? How quickly will this option deliver improvements?
21 Improved Clinical Effectiveness Assessment Measure Description Proposed Measure Reduced number and length of stays in hospital Improved clinical outcomes Providing the opportunity to deliver better clinical outcomes How well does this option deliver the clinical model? More treatments delivered on a day case basis Providing care in the right place at the right time
22 Quality Physical Environment Assessment Measure Description Proposed Measure Adherence to current accommodation standards Improved space utilisation Delivers a modern, clean, therapeutic environment Meets current space standards How well does this option meet recognised Healthcare environmental and space standards?
23 Flexible/adaptable facilities across the healthcare system Assessment Measure Description Proposed Measure Ability to change the use of space from inpatient to outpatient/day care usage Ability to meet current and future demand for health services Is this option designed in a flexible manner? Improved functional suitability Reduction in running costs Ability to respond to changes in clinical practice, user requirements, services changes and developments Is there sufficient expansion space to meet our anticipated requirements (at least 20%)?
24 Benefits Criteria Weighting Scoring/Ranking
25 Financial Evaluation A thorough financial appraisal will then be undertaken including assessment of : Capital costs Land, Construction, Enabling, Parking, Equipment, Furniture Life Cycle costs Maintenance and replacement Recurring Revenue costs Staffing, Rates, Efficiency savings or additional costs Non-Recurring Revenue Double running costs, transition costs, Removal costs, Decant/disposal costs 25 year NPV and EAC assessment
26 Monklands Replacement/Refurbishment Option Appraisal Following the option appraisal event; Production of formal report on process and development of preferred option A period of public engagement, giving all stakeholders the opportunity to have their say on the option appraisal process. A report which will be considered by the Board of NHS Lanarkshire later this year.
27 Questions?
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