NHSScotland assets and facilities 2015: annual report

Annex G: Facilities Shared Services Review

Background

The Facilities Review and Shared Services Programme Board was established in 2014 to manage the portfolio of projects identified by the Strategic Facilities Group. The current delivery of operational support services which were seen as having the greatest potential to deliver improvements in the quality of services and create efficiencies are as follows:

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

Capital Planning

The capital planning review is focussed on addressing the risks associated with the potential shortfall in experienced technical staff with the necessary skill set to deliver the pipeline of capital projects in Scotland over the next 5 - 10 years. Its aim in responding to this issue is to create a critical mass of highly skilled staff that will have clear career progression opportunities to work across all healthcare sites and scales.

A fully inclusive appraisal of options for addressing this issue has been completed and a preferred option identified based on a geographical model of service delivery. Working with the Stakeholders, consultants have refined the outcomes from the appraisal of options exercise events to refine the data and develop the potential model of service which will deliver a more efficient capital planning and construction project management service. Stakeholders from Scottish Government, Health Facilities Scotland and the Health Boards have been working together to take the agreed principles and create a practical operational structure with clear lines of accountability and responsibility which will deliver the NHSScotland capital programme more efficiently with costs being avoided and projects delivered on time to the quality and costs agreed.

Operational Management of PPP/ PFI Contract

A Business Case has been developed and approved to establish a Specialist Support Team to assist Boards with the operational and commercial management of PPP/ PFI contracts to ensure that Boards receive the appropriate service in relation to quality and quantum. The Specialist Support Team will be hosted in Health Facilities Scotland and is tasked with delivering significant revenue benefit and quality improvements.

The Specialist Support Team will continue to influence the future standard forms of contract for revenue funded Hub Schemes and NPD Pipeline Projects in the light of operational experience.

The strategic direction and work plan for the activity of the Specialist Support Team is set by the PPP Joint Board which draws its membership from the Scottish Government, Health Facilities Scotland, Scottish Futures Trust and Health Boards.

The PFI/ PPP Advisory Group is a very active forum for help, advice and collaboration. It has matured as a group and ensures, where ever possible, that there is an effective exchange of intelligence and consistent approach to contractors. The development of the informed client role by sharing experience and cooperation between Boards with common PFI providers has proved to be extremely effective.

SFT Colleagues also continue to bring lessons learned from their In-depth Reviews and these are proving to be very helpful, bring an increased level of commercial acumen to the interface with our commercial PPP/ PFI partners.

This shared services project is complete with the following products flowing from this work identified as:

• The acquisition of funds to develop the Specialist Support Team.
• The establishment of the PPP/ PFI Advisory Group.
• The creation of governance structures to support the operational management of these commercial contracts.

The developed service has returned to "Business as Usual" and the management and monitoring of the activity associated with the management support for PPP/ PFI contracts will be undertaken by Health Facilities Scotland.

Decontamination of reuseable medical devices

The initial work of the project identified the lack of communication between Boards when considering investment in their Central Decontamination Units. This combined with overprovision of services/facilities in some Board areas and the need for investment in others highlighted the need to develop a national strategy for the provision and operation of Central Decontamination Units. Proposals detailing the future strategy for Central Decontamination Units will be developed.

The gathering of data relating to the likely capital investment will allow more effective allocation of capital.

Transport and Fleet Management

The business case to develop a national support structure with regional and local management was approved by Scottish Government.

Funding for the implementation of the National Support Team and a single fleet and transport management system (including telematic units for vehicles) is likely to make the phased introduction of a consistent specification and management system for vehicles to be operational in early 2016. A conservative estimate of the annual savings to be delivered by the project is £2m. This will be returned to the Health Boards which accrue those savings.

A pilot of the regional model of transport management is being carried out in the East Central Hub area (Fife, Tayside and Forth Valley). This is proving to be a successful small test of change and will be rolled out to the other regions in due course.

Logistics

A detailed review has been carried out of all delivery routes in Scotland. A project will be undertaken to examine opportunities to reduce the number of miles covered by NHSScotland vehicles by more efficiently using the fleet and avoiding duplication of tasks. The objective being to reduce the total cost and carbon footprint of the NHS in Scotland.

Car Leasing

Agreement has been reached on the adoption of core principles which should be adopted by Health Boards when negotiating car lease policies with staff.

There will be a single management structure which will manage the lease car arrangements for all Health Boards on a "Once for Scotland's NHS" basis.

Waste

All outcomes from the work streams were considered by the Facilities Review and Shared Services Programme Board before being passed to the Waste Management Steering Group of Health Facilities Scotland.

This specialist waste management group will ensure a national approach to the disposal of WEEE, paper and cardboard, furniture, reverse logistics and administrative processes. Changes to the administrative process are predicted to reduce costs by, in the region of, £400k.

The work of this has now been passed back to the Waste Management Steering Group. The deliverables will be monitored through the Strategic Facilities Group, hosted by Health Facilities Scotland.