Annual State of NHSScotland Assets and Facilities Report for 2013

Annex F: Facilities Shared Services Review

Background

The Facilities Shared Services Programme, established in 2011/12 is examining opportunities to develop strategic partnerships between Health Boards and, where appropriate other public sector organisations.

The areas of activity being examined are:

• Capital Planning/Project Management and Hard Facilities Management.
• Operational Management of PPP/PFI Contracts
• Decontamination of Medical Devices
• Transport.
• Waste Management.

Governance and Engagement

The full engagement and support of Health Boards and staff engaged in the delivery of the services being reviewed is essential to the success of this programme. Structures have been put in place to ensure that all those involved in the departments which are being reviewed are fully involved in the process of examining the current service and where appropriate developing options to improve the quality and efficiency of those services.

In an effort to avoid duplication and utilise the existing groups and structures service engagement is primarily sought through the professional and technical advisory structures of Health Facilities Scotland's Strategic Facilities Group. Staff representatives are identified through the Scottish Partnership Forum and the wider constituency of staff organisation representatives working in the departments which are being reviewed.

Work Streams

To enable an accurate, or as accurate a baseline as possible to be established a significant data collection exercise has been undertaken. This allows the scope of the exercise to be agreed and the cost and quality improvements which are delivered as a result of changes made to be quantified.

The five work streams which form the programme are:

• Capital and Hard Facilities Management.
• Operational Management of PPP Contracts
• Sterile Services
• Transport
• Waste Management

Capital Planning and Hard Facilities Management

This work has been divided into its specialist areas of capital project management and the operational estates management of facilities which exist.

Capital Planning

A detailed examination of the Local Delivery Plans and the projected demand for capital planning and project management skills is being undertaken. Examples of good practice are being identified and shared. Options will be developed which will consider different method of service delivery based on local, regional or national structural models.

Good Practice

Staff from the capital Physical Planning Department in Grampian Health Board are supporting the delivery of some aspects of the NHS Highland capital programme.

Hard Facilities Management

Areas of productive opportunity were examined and a recommendation report will be considered by the Facilities Shared Services Programme Board.

Operational Management of PPP Contracts

A national advisory group has been established to facilitate the exchange of knowledge and expertise in the area of contract management. This has proved to be a useful forum allowing information on existing practice to be discussed and issues identified and resolved. The nature of the contracts which exist has developed since the inception of the Private Finance Initiative. In order to ensure best value is being achieved Health Facilities Scotland, working closely with the Scottish Futures Trust, are supporting the Shared Services Programme by examining in detail the existing contracts and how they are managed. This work is focusing particularly in the areas of procurement, energy and energy management and insurance.

A number of contracts are approaching a review period, this is an opportunity to debate and renegotiate aspects of the contract. Effective discussion within the service based on a sound data base will ensure negotiations are fully informed.

Good Practice

Effective negotiations with the PPP provider resulted in revenue savings of £495, 000 on the Royal Infirmary of Edinburgh contract. The approach taken to achieve these savings will be shared with all contract managers and where appropriate to the contract the approach will be adopted.

Sterile Services

This work stream falls logically into 3 areas:

• Endoscopy Decontamination
• Local Decontamination
• Central Decontamination (mainly theatre instruments)

Endoscopy Decontamination

This activity generally takes place close to the department which undertake the procedure. The practice within these was recently reviewed and a programme of capital investment to upgrade decontamination facilities is underway. There is effective sharing of information through the Health Facilities Scotland advisory structure. The processes will be examined to establish if the sharing of services or the enhancement of the current service can be achieved.

Local Decontamination

This is the decontamination of surgical instruments used in the primary care setting, predominately dental and podiatry. There has been considerable investment in the facilities provided to deliver local decontamination. These services will vary, mainly based on the geography of the area being served and the availability of compliant facilities. Some podiatry service have move to single use instruments as a more cost effective solution. A data collection exercise will be undertaken to establish the current level and type of provision.

Central Decontamination

Health Boards currently support theatre activity by providing decontamination services across NHSScotland.

The data collected as part of the development of the contingency plan needs to be refined to allow it to be used as a strategic planning tool. This information will be gathered and used to identify any spare capacity in the physical assets used to provide this service. Options will then be developed to assess the suitability of this capacity to support clinical services.

Good Practice

The gathering of data relating to activity and capacity has enabled a national contingency plan to be developed.

Transport

A close examination of the delivery of logistics, transport and fleet management together with the provision of vehicles to allow staff to undertake their clinical and non-clinical activities (including the use of pool, lease and hire vehicles) will be required.

A significant data collection exercise and pilot studies in the areas of logistics and telematics are being undertaken.

The review will include the services which are being delivered to maximise the quality, efficiency and effectiveness of these services while also considering the most appropriate structure to manage them.

Waste

Zero Waste Scotland has worked closely with Health Facilities Scotland to scope the issues associated with the implementation of the Waste Scotland Regulation 2011.

The Waste Management Steering Group has identified 5 areas which have the potential to deliver efficiencies, possibly using a shared service model. They are:

• Food Waste
• Furniture
• WEEE
• Reverse Logistics
• Administrative processes

Recommendations on these areas of activity will be made during 2012/13.

Process

All outcomes from the work streams will be considered by the Facilities Shared Services Programme Board before being passed to the Efficiency Portfolio Board for approval.