Annual State of NHSScotland Assets and Facilities Report for 2013

Annex E: Transport and Fleet Management Review

Background

The NHS Scotland Transport and Fleet Management review is progressing well under the direction of the Facilities Shared Services programme board.

The two main overarching elements of the review were initially Fleet Management and Car Leasing, the operational use and utilisation of the vehicles was not considered. However, one of the potential opportunities that emerged from the early analysis of the data was that there was scope for better utilisation of the vehicle fleet and logistics resources. Therefore, a Logistic work-stream has now been included as part of the review.

Initial review findings and potential collaborative opportunities

A number of good examples of collaborative working across the NHSScotland fleet have been identified, which includes:

• The Transport & Travel Planning Group which meets regularly to discuss a wide range of transport and fleet related topics;
• National Procurement contracts for leasing vehicles and Insurance;
• The Logistics operation that supplies goods to all Boards;
• Various pan government contracts;
• NSS and GG&C Boards both manage car leasing schemes for other Boards;
• SAS collaborates with the other emergency services for vehicle maintenance in certain parts of the country; and
• NHS Dumfries & Galloway and Local Authority currently have one Transport Manager to manage both fleets.

However, the potential for greater collaborative working across the fleets is significant, with wide ranging opportunities.

Structure

The organisational structures for delivering Fleet services and the responsibilities of the management both differ considerably across NHS Boards. There are currently upwards of 30 differently managed fleet operations across NHSScotland, which are provided by 16 out of the 22 Boards. This is a significant undertaking when Fleet Management is not a key function for the majority of NHS Boards, and aside from Patient Transport, does not have a direct impact on Patient Care.

The current structure of multiple, small, multi-functional teams has weaknesses;- lack of specialisation, duplication of workload, and lack of consistency across the country; which results in poor utilisation of both staff and vehicle resources. Due to the majority of NHS Board's fleet being small, there is potential to improve efficiency and increase resilience through alternative models of delivery.

Collaborative options for the provision of Fleet Management have been identified and are currently being considered. These include both regional and national models and the potential benefits include improvements in efficiency, effectiveness, economies of scale, and resilience, without compromising operational effectiveness, and ultimately achieving better value for the public purse.

An option appraisal exercise is currently being undertaken to further develop these potential opportunities which should be complete by December 2013.

Transport Strategy & Supporting Policies

Current transport strategies and policies vary widely across the country and there is little evidence of collaboration. An opportunity exists to establish Scotland-wide strategies and supporting policies, which includes;- vehicle acquisition funding, procurement, vehicle replacement criteria, vehicle maintenance, environmental strategy, etc. A more consistent approach will result in the fleet provision being delivered more effectively and efficiently.

Technical Standards and procurement

National Procurement currently has contracts in place for the leasing of cars and commercials, and for vehicle Insurance. However, there is currently no standardisation of vehicle specifications, nor is there any joined up procurement of vehicles. There is, therefore, considerable scope for collaborative working in the standardisation of vehicle specifications across the country and a joined up procurement approach; which will bring many benefits including greater buying power, better utilisation of vehicle assets and reduced operating costs. The intension is to work towards the introduction of a fully joined up approach for the development and procurement of the vehicle fleet across all Boards.

Significant progress has been achieved in the development of national specifications for pool cars and a national tendering exercise is planned for January 2014. It is hoped that all Boards will sign up to this exercise.

Telematics

Telematics is the generic term for the technology used in vehicles to capture essential data about the performance and use of the vehicle. There are currently eleven Boards who have ten different Telematics systems fitted in some 2,000 vehicles.

Telematics has the potential to significantly help Boards improve their utilisation of vehicle and staffing resources and reduce vehicle operating costs. The benefits that Telematics bring are wide ranging and include;- better protection and training for staff, better utilisation of vehicles which will ultimately result in a reduction in the number of vehicles required; reduction in fuel usage (suppliers claim that reductions could be as great as 15%, with a 1% saving for NHSScotland equating to £150k/annum); reduction in the levels of harmful emissions that are emitted; reduced insurance premium and accident damage costs (potentially up to 20%, with a 1% saving for NHSScotland equating to £50k/annum); improvement in vehicle reliability and savings in maintenance costs.

To this end, a review is currently being undertaken to evaluate the different systems that are currently being operated, with the intension of producing a national system specification, where the majority of Boards would migrate onto one standard system and Telematics will be installed in a far greater number of vehicles.

Maintenance of Vehicles

All NHS Boards except the Scottish Ambulance Service (SAS) outsource their vehicle maintenance. The majority of leased vehicles have the maintenance built into their contracts and the work is carried out by a large number of garages across the Country. However, the maintenance of the circa 2,000 owned vehicles differs widely across the country and there are various agreements in place with various service providers.

SAS work very closely with the other Emergency Services in certain parts of the country. A previous review that was carried out in 2004 (Tripartite Review), and which was funded by the Efficient Government Fund, resulted in 10 of the 45 Emergency Services vehicle maintenance workshops being closed and collaborative working being introduced into 8 workshops.

There is scope for better utilisation of SAS workshops for the maintenance of NHSScotland vehicles, in particular, the owned vehicle fleet. Consideration is currently being given to some of the workshops being operated as NHSScotland workshops rather than just for SAS. This has the potential to bring many benefits for the participating Boards, including greater resilience, reduced downtime and be more cost effective.

Car Leasing

Currently, all of the 22 NHS Boards appear to have a different Car Scheme, abate many are similar. These various schemes are managed by 16 of the Boards and the number of Lease cars that are currently provided for staff is circa 6,700.

There are opportunities to standardise the schemes and collaborate on their management. To this end, the car leasing work stream has analysed the various policies that exist across NHSScotland and is considering options for a more joined up and standardised approach. Consideration will also be given to the most cost effective method of funding the schemes and options will include Salary Sacrifice, which may be more cost effective for both the NHS Board and the scheme members.

The potential benefits that this work stream could bring are;- greater levels of fairness across the car user schemes, improvements in efficiency, effectiveness, economies of scale, and resilience, and reduced emissions levels.

Logistics

The logistics element of the review is considering the utilisation of the commercial vehicle fleet, the associated staffing resource, and the Boards interface with the National Distribution Centre.

Current processes, procedures, routes, and functions across Boards are being evaluated in order to ascertain and gain a better understanding of the total cost and potential synergies that exist within the many Logistics operations.

Considerable opportunities exist for a more joined up approach across Scotland, which should result in better utilisation of the vehicle and logistics resources and improve the effectiveness and efficiency of the operations.

Carbon & harmful emission targets

The Scottish Government has set ambitious carbon reduction targets and a number of Boards have now introduced a maximum CO2 emission level for their car leasing schemes. However, there is a lot of scope to reduce emission levels further over the NHSScotland fleet, and there is also potential to introduce more alternatively fuelled vehicles. A national policy will be considered for the reduction in harmful emissions from vehicles, which will include joined up research and development into the utilisation of alternative fuelled and low CO2 emitting vehicles.

Conclusions

The current structure of NHSScotland's fleets, which are generally small and multi-functional, have weaknesses, which is due to lots of small fleets lacking resilience and which cannot be operated as effectively and efficiently as a smaller number of larger fleets. Various collaborative structural models are being considered, which includes regional and national options. An options appraisal paper will be produced for December 2013.

The significant benefits that can be obtained from a more structured national approach, greater utilisation of Telematics, and a national approach to functional areas such as technical specifications and procurement are wide ranging. They include improvements in efficiency, effectiveness, economies of scale, and resilience without compromising operational effectiveness, and ultimately achieving Better value for the public purse.