estates and capital projects six monthly report 9... · · 2014-04-23estates and capital projects...

Estates and Capital projects six monthly report

Produced by:

Chris Harding – Director of Estates & Facilities

Presented by:

Rob Elek – Director of Strategy & Business Development

Board of Directors Meeting

24th April 2014

Action for Board:

For information

For consideration

For decision

ITEM 9

Estates & Facilities biannual report

P a g e 1

Executive Summary 2

Backlog Maintenance 4

Capital works at City Road 8

Satellite Sites 10

Estates & Facilities directorate report 12


P a g e 2

Executive Summary

This report includes an update on the Estates and Facilities directorate, and includes progress

reports for major capital projects, for the six months from October 2013 to April 2014. The

executive summary provides a précis of the important issues for the board, the following sections

include a further level of granularity if required.

The report also includes developments which do not entail direct capital expenditure, but are

estates related in that they involve contractual issues relating to our occupancy at host hospitals.

This report also includes updates on the Estates & Facilities work streams and projects which fall

below the threshold for board approvals as these illustrate the scale of planned developments, and

demonstrate the delivery of the estates and facilities strategy as an enabler to Our Vision of

Excellence across City Road and satellite sites.

The three major capital projects currently in progress are:

City Road backlog maintenance programme;

Ealing Expansion (Modular Building); and

St George's reprovision and expansion.

The backlog maintenance programme has been successfully tendered for 2013/14 and all stages

are now underway. Good progress is being made across the range of projects which includes:

upgrade works to the fire alarm system; fire door and fire compartmentation works; external and

roof works; and lift upgrades / refurbishments. Ingleton Wood LLP have been appointed for a

period of 2 years to deliver the backlog maintenance programme over 2013/14 & 2014/15 This is

based on their performance within our A&E project and track record within healthcare.

The Ealing expansion project is now under construction, with an anticipated completion date in

early July. The project is amber rated due to ground condition risks pending completion of all site

investigations.

The contractual documentation for the St George’s project is nearing completion The next stage

involves a focused detailed design programme to generate a guaranteed maximum price – this

represents the next approval stage for the project. The project is behind the programme within the

approved business case and the revised timescales will be incorporated into St George’s Hospital

Trust’s overall estate strategy.

Other capital projects of note include:

The delivery of a new oxygen storage facility at City Road, this project mitigates business

continuity and health & safety risks;

The creation of a new health information hub in the main entrance corridor at City Road; this

creates a new area for patients to access general information;

The completion of Clinic 1a; this is a new outpatient area designed to pilot virtual clinics

(consultant led clinics with the consultant reviewing clinical decision-making remotely);

The expansion of the paediatric ocular prosthetic department at City Road; and

The addition of medical gas systems at Northwick Park, following agreement by North West

London Hospitals that we may connect to their system; this will enable us to operate on more

complex patients, increasing the services provided and supporting ‘repatriation’.


P a g e 3

The pilot to develop an improved service model for the provision of estates maintenance services

at Northwick Park and St Ann’s has been through a VFM tendering process under a suitable

maintenance framework. This is now in final negotiation ready to issue a 3 year contract to the

successful bidder.

The estates & facilities directorate section includes reports from:

Estates services

Clinical technical services

Security

Sustainability

Telecoms

Front of house – switchboard and reception

Transport services

Interpreting

Domestic services

Catering

Waste management

Departmental mandatory compliance

The key issues for the board to note are:

Sustainability: a programme to achieve compliance with the revised Sustainable Development

Strategy for the Health & Social Care System 2014-2020 has been developed.

Telecoms: the new call management system (Netcall 59R) has been implemented and the

advanced functionality is being piloted on the main switchboard and private patient enquiry line.

Front of house: additional operators have been put in place to improve call answering time

performance, however our current average of 41 seconds (target 80% answered within 15

seconds) and average time on a call of 43 seconds is highlighting both the length of time

required to deal with each call (many are not straightforward) and the volume of calls returned

as unanswered. Further analysis will clarify the switchboard resource requirements and the

implementation of the admin and clerical review will start to improve performance at the clinical

service / user end of the process.

Domestic services: the 2014 Patient Led Assessment of the Care Environment (PLACE) took

place on 24th March and the initial feedback implies that we have improved our good

performance in 2013.

Catering – food hygiene: an external audit of food hygiene standards, systems and processes

took place on 5th December and the report demonstrated that we have significantly improved

our performance in all areas over the past 12 months.

Catering – retail: the Costa outlet has been successfully running for almost 6 months and a

great deal of positive feedback has been received; negative feedback around the size of

signage, lighting levels and general information about catering choices at City Road have all

been resolved satisfactorily – a significant achievement given the rigid branding principles that

Costa usually apply.

Catering – procurement and pricing: the implementation of a new procurement system will

enable the forthcoming catering charging review to be informed by high quality data.

Recommendation

The board is asked to consider the progress made in the delivery of the backlog maintenance

programme and capital projects, and the overall performance of the Estates & Facilities directorate.


P a g e 4

Backlog Maintenance

1.1 FIRE ALARM UPGRADE WORKS

Programme

Milestones

Works commenced on site on 9th December 2013.

Completion by end of March 2014 with final commissioning/de-

commissioning in April 2014.

Progress Negotiation with Powerpoint (the contractor) to achieve an agreed

specification and price. This process has taken some time to

complete.

Works progressing and the main installation was completed by the

end of March 2014, with final programming, commissioning, and

decommissioning of the old fire alarm system in April 2014.

Key Risks Ability of Powerpoint to deliver within the agreed programme.

Presence of asbestos and coordinating that process. This risk

is now much reduced as areas are being cleared as in advance

of the fire alarm works.

Gaining access to all areas being worked on.

Management of Powerpoint’s activities on site.

Coordination/management by Moorfields of out of hours works.

Works to Eye Bank and CSSD – careful detailed planning has

been undertaken.

Planning acoustic testing/commissioning.

Agreement of any change to the fire alarm strategy – Client

side planning meetings now underway.

Cost Summary Budget: forms part of 2013/14 Capital programme of £1,854,516.24

(incl. VAT & fees).

Original Contract Sum Capital £185,433.94 (excl. VAT & Fees).

Client also has an additional allowance for 10% risk/contingency.

Estimated final account is within contract sum & contingency

allowance.

Some additional doors identified requiring inter-facing, but this was

not unexpected and additional cost allowance was originally factored

in to cover this.

Interim Certificate for Payment No 4 now issued.

Overall Project

Status

AMBER, UNTIL COMPLETION OF COMMISSIONING


P a g e 5

1.2 MAIN FIRE DOOR & COMPARTMENTATION WORKS

Programme Milestones

Works commenced on site in January 2014.

Completion by end of March 2014 for the 2013/14 financial year funded works. There is an option to extend the works for 2014/15 funding.

Progress Scope of works agreed with Moorfields and follows recommendations of the Mott MacDonald Fire Compartmentation Survey and Strategy recommendations.

Full tender exercise undertaken and contractor, G&M Building Contractors appointed and are now on site.

Works are currently well advanced on site with the majority of the new ground floor ‘racetrack’ fire doors, fire stopping, and cable containment now installed. The remainder of the work is the installation of a considerable quantity of fire dampers to the ventilation ducts passing through the compartment walls.

Key Risks Tendered scheme has had to be reduced to budget available will still leave certain fire upgrade works that cannot be commissioned until a further budget is made available by Moorfields.

Changes from signed off design will cause both delay and impact on costs.

Change Control must be used and be embedded into the project.

Mott's MacDonald's report information may contain errors,

agreed at Board level this risk is accepted. Pre-tender and

pre-start survey to be undertaken to minimize this risk.

Ability of Contractor to deliver within the agreed programme. Generally access has been relatively easy to obtain.



Cost Summary Budget: forms part of 2013/14 Capital programme of £1,854,516.24 (incl. VAT & fees).

Original Contract Sum Capital £236,741.55 (excl. VAT & Fees). Client also has an additional allowance for 10% risk/contingency.

Estimated final account £ = within contract sum & contingency allowance.


Overall Project Status

GREEN


P a g e 6

1.3 EXTERNAL UPGRADE & BACKLOG WORKS


Works commenced on site on 3rd February 2014.

Completion by end of March 2014 for the 2013/14 financial year funded works subject to lead-in times and weather permitting (as most of the works are external).

Completion date for all works is 12 weeks from 3rd February 2014.

Progress Scope of works agreed with Moorfields and follows recommendations of the Mott MacDonald Backlog Survey and previous Pick Everard specification.

Full tender exercise undertaken and contractor Noble House Services UK Ltd appointed and are now on site.

Works are currently on site with emergency lighting and decoration works well advanced. Removal of redundant plant is underway and the next main phase is the roofing works and replacement of windows.

Key Risks Tendered scheme being reduced to budget available will still leave certain upgrade works that cannot be commissioned until a further budget is made available by Moorfields.



Ability of Contractor to deliver within the agreed programme.


Noisy works causing stoppages and delays.

Risk of smells, etc. impacting on the hospital (especially the roofing works).

Inclement weather (as most of the works are external).


Cost Summary Budget forms part of 2013/14 Capital programme of £1,854,516.24 (incl. VAT & fees).

Original Contract Sum Capital £307,000 (excl. VAT & Fees). Client also has an additional allowance for 10% risk/contingency.

Estimated final account £TBC.

Letter of Intent issued. Order being raised.

Discussion with Finance now held and agreed that Estates can

continue to complete balance of works from April 2014 (using

2014/15 monies) so the works can be run as a single seamless

project.



GREEN


P a g e 7

1.4 LIFT UPGRADE WORKS


Letter of Intent issued on 25th October 2014 to allow Jacksons a suitable lead-in period for the design and off-site manufacture.

Works commenced on site in January 2014.

Completion of the first Lift (Lift No 1) was due by end of March 2014, now estimated completion is 18th April 2014 due to poor performance of Jacksons.

Works to Lift No 3 will then follow on with completion by end of May 2014 within the overall original contract programme.

Progress Tenders were invited and a full report has been prepared and issued by Lerch Bates following detailed tender analysis and tender interviews.

Jackson Lifts were appointed by Moorfields on 25/10/13.

Key Risks Noise during the works resulting in re-programming and therefore time/cost implications.

Contractor having procurement delays.

Presence of asbestos but this was managed, identified, and removed from the Plant Room without impact on the programme.

General performance of Jacksons which has been poor with poor planning evident, and lack of labour. Director level discussions have taken place to try and bring the project back on track and a revised completion date of 18 th April 2014 has been set.

Cost Summary Budget forms part of 2013/14 Capital programme of £1,854,516.24 (incl. VAT & fees).

Original Contract Sum Capital £512,056.00 (excl. VAT & Fees), although authority has only been issued for Lifts 1 & 3. Moorfields/Lerch Bates are currently reviewing whether to proceed with Jacksons for further.

The budget available for the Lifts in the 2013/14 Programme is only for Lift No 2 & 3. Therefore an instruction to proceed has only been given by Moorfields for £206,436.78 (excl. VAT & fees).

Estimated final account TBC but no significant variations have occurred which will have a financial impact on Moorfields.

Tenders were invited and a full report has been prepared and issued by Lerch Bates following detailed tender analysis and tender interviews.

Jackson Lifts were appointed by Moorfields on 25/10/13.



AMBER DUE TO PROJECT DELAYS

The overall programme and scope of all backlog works will be adjusted to ensure that expenditure

remains within the approved affordability envelope allocated by the Capital Planning & Oversight

Group (CPOG). The Estates department has also been addressing significant numbers of the

smaller, discrete backlog maintenance issues through its minor works programme.


P a g e 8

Capital works at City Road

2.1 Medical Gas City Road

This project delivers a new Liquid Oxygen Compound in the goods yard with all associated ground

works. Currently the hospital’s oxygen supply is provided from a bottle supply. This project

mitigates a significant health & safety risk as the oxygen bottles require frequent changing by

porters.

The Tenders were received on 08 April 13 and all three contractors were interviewed and a

recommendation provided to appoint G&M Builders based on the overall tender evaluation.

The project is nearing completion and final commissioning will take place in mid April 2014. An

extension of time was granted due to poor weather.

The Chief Pharmacist has been fully briefed of the project progress and the external Pharmacy

Purity Tester is being appointed.

2.2 Laser Interlocks – Various Locations

The project to fit common laser/door interlock system across the estate is now complete, including

a recent request to add x2 laser lock systems at Croydon to be completed in readiness for the April

opening.

2.3 Health Information Hub

The purpose of this project is to provide patients with an area to access general patient information

via leaflets or browse our information screens.

Construction completed due to be handed over once the following items have been fitted, TV,

patient information screens (Secure), x1 person desk/counter, artwork, and information pod.

The project has experienced some delays as the floor had to be relayed. The anticipated handover

date will be at the end of April 2014.

2.4 Virtual Clinic 1a

The development of virtual clinics is a corporate priority and this new clinical area has been

created from what was “dead space”.

The clinic will be staffed by technicians who will undertake all the required tests with the

ophthalmologist reviewing the test results remotely in a separate session. This will result in an

improved patient experience, potentially reducing the patient journey time by up to 75%.

This clinic will be used by the Glaucoma and Medical Retina services. The project was completed

and handed over on 10th March 2014.


P a g e 9

2.5 EXPANSION OF OCULAR PROSTHETICS RDCEC


Achieve planning permission by 17/01/14. This was achieved early on 16/12/13.

Letter of Intent issued on 19th January 2014 to allow G&M Building

Contractors a suitable lead-in period for the design and off-site

manufacture.

Currently aiming for a start on in March 2014 to allow for lead-in times for modular construction.

Completion by end of May 2014.

Progress Drawing sign-off achieved with users.

Planning Application achieved on 16/12/13.

Scheme was back from tender on 19/12/13. Unfortunately there was a delay in opening the tenders which were opened on 02/01/14.

Contractor appointed and we are currently in the lead-in period for the modular buildings. Detailed working drawings recently received from specialist supplier.

Key Risks Tendering contractors do not meet the required tender specification.



Tender prices may be higher than pre-tender estimate, particularly due to prelims relating to working restrictions, no storage for materials, no parking etc. Lowest tender can be managed to budget (subject to preparation of detailed Tender Report).

Obtaining planning permission – Now achieved so no risk.

Structural capacity of ground floor roof demands upgrading works resulting in time & cost implications. Now assessed and not an issue.

Structural design and work in opening up arch to First Floor, Main Building.

Phasing of the works and working near and in a busy children’s department.

Cost Summary Budget: £336,900 (incl. VAT, Fees, & Equipment).


Estimated final account £TBC.

Tender Report now issued.

Contractor appointed on 19/01/14.

No cost variations to date.


GREEN


P a g e 10

Satellite Sites

3.1 Estates maintenance strategy for satellite sites

The responsibility for estates maintenance for satellite sites, and the quantum of services, varies

from one location to another - ranging from the landlord (host hospital) providing all or no

maintenance, and the City Road estates department directly supporting a number of sites. This

inconsistent approach is confusing for operational staff, and is not an efficient or effective means of

providing such a key service.

A formal tender process for the supply of the planned maintenance services at St Ann’s and

Northwick Park has been successfully completed and is due to commence 1st May 2014, this

contract also includes the flexibility to add our other satellite sites. This has provided a planned

preventative maintenance value with a clear and transparent schedule of rates for technical staff,

(e.g. electricians, plumbers, carpenters etc.) such that any ad hoc emergency maintenance works

required would also be managed through this contract. The contract will report to and be managed

through the Estates & Facilities directorate. It will ensure greater visibility on our performance

through robust key Performance Indicators (KPIs) and more transparent pricing and service

regimes with a full monthly report submitted to Head of Estates and Maintenance for auditing.

Some aspects of maintenance at our satellite sites that are the responsibility of our landlords have

created some concern about quality. The Director of Estates & Facilities has forwarded to relevant

landlord estates departments a list of statutory works for confirmation by the landlord that these

issues have been properly addressed (as required under the landlord and tenants act), and to

ensure that Moorfields has complied with its duty of care to our staff and patients. Where this is

believed to fall below the required statutory standard, or if information is not forthcoming, internal

audit tests have been carried out by Moorfields estates and results shared with the landlord to

action. These are then monitored to compliance completion.

3.2 Moorfields @ Northwick Park

Medical gases

Medical gas systems were removed from the original Northwick Park expansion project prior to

construction. These systems are required to expand the scope of surgical procedures undertaken

in the theatre – a key objective to enable the “repatriation” of further work from City Road and the

development of new local services.

Negotiations with the host hospital have been in progress for some considerable time as our

preferred solution, to connect into the existing site medical gas system, did not appear to be

achievable and the landlord appeared reluctant to give permission for Moorfields to deliver a stand-

alone local system.

The host hospital has very recently agreed that we can connect into the existing system and the

project will now move forward at pace. The project plan is being refreshed and tenders readied for

release, CPOG is to consider funding in April.

Dispensary

The Northwick Park pharmacy dispensary project was successfully handed over on Monday 10

March 2014, all snagging items were completed in March.


P a g e 11

3.3 Moorfields @ St George’s Hospital (SGH)

The board approved the St George’s business case in October 2013 and positive discussions have

continued with SGH around the key clinical requirements (access to main theatre space etc.) and

the finalisation of the development agreement and lease documentation. The original programme

envisaged completion of the documentation in the winter and a 5-month design process ending in

March 2014, leading to the occupation of the new building in January 2016. The delay in the legal

documentation will be reflected in the overall programme and the trust has formally requested that

SGH issue a revised programme.

The legal documentation is expected to be completed in April, with signature in May, this will allow

the project to proceed to the design phase and production of Gross Maximum Price (GMP) which

would be the next approval milestone before construction.

The operational planning for the new building (i.e. how the building will work) needs to complete

within this timescale to ensure that the design process can proceed without any further delays.

3.4 Moorfields @ Ealing Expansion


Achieve planning permission by 22/11/13 – Achieved on 18/11/13.

Authority to proceed from Ealing and instructions issued 30/01/14.

Contractor, G&M Building Contractors, now appointed.

Completion by mid-June and service go-live end June / early July.

Progress Drawing sign-off achieved with users.

Planning permission was granted with only standard conditions.

Scheme was returned from tender on Friday 15th November 2013.

Key Risks Moorfields agreeing lease with Ealing, but this is less of a risk for construction as Moorfields now have the authority to proceed.

Prices were higher than the budget available due to the potential limited life of this site but costs are now with approval limits.

Change Control must be used and be embedded into project.

Obtaining planning permission – mitigated as permission granted

Below ground conditions – Site investigations now instructed.

Lead-in for new modular building.

Provision of electrical supply - advised by Ealing that supplies available – awaiting confirmation as to exact tap-off feed.

Water supply/Legionella given previous outbreaks at Ealing Hospital. Pre-works survey to be undertaken. Ealing recommended sub-contractor to be used. Take supply off existing or new stand-alone hot water supply

Cost Summary Budget: £385,740.00 (incl. VAT, Fees, & Equipment).


Scheme was returned from tender on Friday 15th November

Value engineering has been undertaken to bring the cost of

the scheme down to an affordable level.

No contract variations to date.

No interim payment certificates issued yet.


AMBER, PENDING COMPLETION OF GROUND CONDITION SURVEYS


P a g e 12

Estates & Facilities directorate report

4.1 Estates Services

• The Estates and Maintenance department is to undergo a rebranding exercise to ensure that

all of the site departments are aware of the services we provide, how to request services, our

location, and the contact details of each of the management team.

• The planned Preventative Maintenance (PPM) KPI’s have improved within the past 3 months

from 78% completion on time to an average of 86% The Reactive call completion has improved

but not yet at the same rate as the PPMs.

• The helpdesk has taken on a new member of staff to help support the estates team delivery as

there has been an increase in the workload for the department over the past few months, this

has resulted in the identification of issues with the frontline Computer Maintenance

Management System (CMMS)

• A new bespoke (CMMS) has been developed and designed for future use on the corporate

Estates Management Information System (EMIS). This will encompass the use of PDAs for the

engineers work dockets and have the capacity to monitor all stores and material usage,

reducing the amount of stock holdings. The system will automatically email the clients with the

receipt of the works request and reply when the action has been completed, improving the

communications with all departments. A complete site asset list is being complied so accurate

information can be loaded on to the new system ensuring all statutory tasks are monitored and

recorded.

• The lift maintenance contract has been competitively tendered and Jacksons were appointed

on 2nd September, following tender review and interview, using Lerch Bates as independent lift

specialists. This is the first time this has happened in several years and has returned savings

on a new fully comprehensive contract. The same process will be applied to all the other

statutory maintenance contracts e.g. fire alarms etc.

• All of the specialist contract services we use are to be reviewed, and site processes and

procedures are to be sent to them as a refresher to ensure that they adhere to our safe

systems of work regarding signing in and out, the correct usage of PPM and appropriate

clothing for the tasks being completed.

• There has been a site survey regarding the possibility of a wireless communication system

being installed. This will allow for various new systems to be implemented that otherwise would

not be available such as medical equipment tracking, wireless nurse call and control of all local

heating and cooling plant without having to cable up, saving time and money while also acting

as a test bed for future hospital design.

Lone worker devices can be implemented for out of hours staff and could include mobile panic

alarms if required. We would then be able to introduce hand held PDAs and remote energy

monitoring through the wireless rather than hardwiring.


P a g e 13

4.2 Clinical Technical Services

The structure is now complete with a head of department, administrator and three clinical

engineers all continuing to work towards improving performance and service delivery in

medical equipment management to ensure compliance. All mandatory training and annual

appraisals have been completed for all staff.

During this reporting period the Clinical Technical Service department has delivered the

following:

• Prepared commissioning programme for equipment for the Ghana project which will be

delivered by one of our clinical engineers on site at Korle bu Hospital.

• The planned preventative maintenance (PPM) for medical equipment is complete for 2013-

14. We have now commenced PPMs for 2014-15.

• Maintenance contracts have been re-aligned, reviewed, verified and validated for 2013-14.

All contracts now include Person Identifiable Information (PII) information governance

clauses (if applicable.) We have introduced the inclusion of KPIs in contracts with a value of

10K or more.

• Medical equipment inventory verification for 2013-14 is complete for main site including

operating theatres and all satellites.

• Internal Audit NHSLA quarterly EBME report (excluding theatre data) submitted to Medical

Devices Committee in January 2014. Next quarterly report due April 2014.

• Capital medical equipment plan for 2013-14 has been procured, installed, commissioned

and training delivered.

• Identified significant cost pressure due to out of warranty equipment and recently found

equipment which was not accounted for in our database.

• Actively encouraging departments to complete incident reporting for end user damaged

equipment to collate data.

• A medical equipment purchasing procurement ordering process is now in place which

specifies that head of clinical technical service must sign off on all equipment purchased

irrespective of source of funding. This is to prevent misplacement of equipment and to

ensure that all equipment for the trust is accounted for accurately and in the correct

manner.

• Procured, installed and commissioned all medical equipment for Clinic 1A Glaucoma &

Medical Retina Stable Monitoring Service in a timely manner to ensure service delivery.

• Completed medical equipment procurement for Croydon / Purley and prepared a project

plan for installation and commissioning which has been submitted to the General Manager

and lead clinician. This plan will be implemented week beginning 24 March 2014.

• Completed the project plan for the installation and commissioning of 18 Zeiss HFAs and 11

upgrades. Date of delivery to Moorfields to be confirmed.

• Attended visit to the Ophthalmic Department at Royal Hallamshire Hospital, Sheffield to

view virtual clinics with the objective of implementation at Moorfields.

• Supported schools in STEM programmes to encourage girls to consider engineering in

healthcare as a positive and rewarding career choice.


P a g e 14

4.3 Security

Good progress towards the Self Review Tool (SRT) work plan, and the agreed work plan with

the Security Management Director (SMD), continues.

The following are the key actions underway or completed:

• Satellite visits are on-going, including security visits to “new sites” prior to being operational.

The Security Manager is now part of the “safety walkabout team” along with Risk & Safety

and Clinical Governance, visiting various areas within City Road and satellite sites, meeting

staff and discussing any concerns they have relating to security issues. Several areas /

sites have been visited and resultant recommendations have been actioned.

• A review of CCTV system at City Road is in progress and a business case for replacement

is being drafted.

• The draft CCTV policy has been agreed at the Risk & Safety committee and will be

presented at Management Executive for ratification.

• The Violence and Aggression policy has been agreed at the Risk & Safety Committee and

will be presented at Management Executive for ratification.

• The Prisoner Protocol has been agreed at the Risk & Safety committee and now forms an

appendix to the main Security Policy.

• Aide Memoires have been produced for front line staff dealing with prisoners who are either

escorted to City Road or on license, and this has been forwarded to relevant mangers.

• The lost property protocol has been agreed at the Risk & Safety committee and will be

published on the web site and intranet, as well as being available in hard copy.

• The draft NHS Security Management (NHS Protect) Security Alert Procedure has been

produced in line with NHS Protect SRT guidance 3.3

The Head of Security – local security management specialist (LSMS) is fully engaged with:

• NHS Protect processes and procedures, and has attended NHS Protect quarterly meetings.

All NHS Protect requirements at this time have been met and relevant information and

documents sent.

• Risk & Safety Committee.

• Corporate induction – attending each session to present on security related matters.

• Security issues presentation to ISS staff

• Attended the Centre for the Protection of National Infrastructure (CPNi) course Health

Sector Briefing.


P a g e 15

4.4 Sustainability

The CRC audit has been completed and certification was received on the 2nd July 2013. All of the

Energy and sustainability process are currently under review. For full details see the 2013-2014

sustainability report.

A revised Sustainable Development Strategy for the Health and Care System 2014 – 2020

was released in January 2014. A review of the process has started and the programme to be fully

compliant with the changes is as follows:

Description Action Who When

Sustainable

Development Action

Plan

Review Moorfields’ existing Sustainable Development Action

plan (SDMP) considering all aspects of the revised NHS

strategy

Head of Facilities/Interim

Sustainability Manager 2

nd April

The Good Corporate

Citizen (GCC)

The Good Corporate Citizen (GCC) has been reinstated and

forms part of the new NHS strategy. A full review of this

process is now required and will need to be implemented

within the MEH strategy.



th March

Procurement

engagement

Procurement meetings to be scheduled as they form a large

part of the GCC process


Sustainability

Manager/Procurement leads

26th March

NHS Strategy Route

Maps

Route map review - The Route Map is a framework for action

to help organizations develop a sustainable health system.

The system comprises of models of care, technology, system

governance, use of resources, societal behaviours and

attitudes, Individual behaviours and attitudes

Head of Facilities 2nd

April

Reporting

The Sustainable Development Unit is involved in tracking

national and sub-national progress of the health and care

system's journey towards a more sustainable future. A full

review of the reporting requirement is required and

implemented into the MEH strategy underway

Head of Facilities 12th April

Benchmarking

Site visits and Benchmarking will be completed at Bart’s

hospital as comments have been made with regards to best

practice


Sustainability Manager 26th March

GAP Analysis

A GAP analysis and report will need to be completed

considering all of the above, and our current strategies and

reviewed against the new NHS strategy.



nd April

Presentation and

senior management

approval

Prior to developing plans, a full presentation will be given to

the Strategy and Estates and Facilities director to review and

approve forward process


Sustainability Manager/Rob

Elek/Christopher Harding

April 2014

Management plans Following sign off by senior management a management

plan will be developed and implanted


Sustainability Manager April 2014

Terms of References Review Terms of References to support the revised NHS

strategy


Sustainability Manager April 2014

Stakeholder

Engagement

Implement various meetings to progress with the revised

sustainability strategy TBA May 2014

Staff Engagement Review staff engagement process TBA May 2014

http://www.sdu.nhs.uk/sustainable-health/route-map/1-models-of-care.aspx

http://www.sdu.nhs.uk/sustainable-health/route-map/2-technology.aspx

http://www.sdu.nhs.uk/sustainable-health/route-map/3-governance.aspx

http://www.sdu.nhs.uk/sustainable-health/route-map/3-governance.aspx

http://www.sdu.nhs.uk/sustainable-health/route-map/4-use-of-resources.aspx

http://www.sdu.nhs.uk/sustainable-health/route-map/5-societal-behaviour.aspx

http://www.sdu.nhs.uk/sustainable-health/route-map/5-societal-behaviour.aspx

http://www.sdu.nhs.uk/sustainable-health/route-map/6-individual-attitudes.aspx


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4.5 Telecoms

The head of facilities has now implemented the new system (Netcall 59R) on the main switchboard

and private patient’s enquiry line.

The purpose of 59R is to manage incoming calls, determine the nature of the calls and route them

appropriately. 59R has the capacity to have up to 250 concurrent agents and 50 supervisors. This

means that we now have the capability to be able to have up to 250 call-centres should the Trust

decide to invest in the future.

The reporting suite will allow for detailed analysis on performance that will ultimately assist in future

decision making process within the organisation. Some of the basic reports consist of:

Example report:

Queue summary

Incoming calls

Outbound calls

Call Volumes

Service levels

Queue times

Skills requirements

Working times

Agent summary

Full audit logs

A mini call centre has been implemented within private patients on the main enquiry line. This

allows for improved call routing, intelligent queuing, position in queue and time to answer etc. The

supervisor agent software allows for robust monitoring of agents performance with a suite of

reports that are fully customizable to the individual department. Below is an example of the real

time dashboard that supervisors are able to review.

This is an example live dashboard

that the supervisors have on their

PCs to monitor and control. This

dash board has also been

displayed on a plasma TV within

Private Patients


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4.6 Front of House – Switchboard and Reception

A consultation process has been completed that addressed concerns raised by the Front of House

team relating to the working patterns forming the departmental rota. Two rosters were put to the

team for consideration with an option to create one operating within existing parameters. The

preferred roster as chosen by the department was implemented on Monday 17th February 2014. A

review meeting has been carried out with each member of the department one month post

implementation.

An additional member of staff has been brought in to support switchboard to see the impact this

will have on the current KPI’s. A report will be submitted in due course on the benefits and what will

be required to achieve the 80% of call answered within 15 seconds and 100% of calls answered to

assist within 60 seconds.

Currently the average call answering time is 41 seconds and the average time on a call is 43

seconds which gives an indication of the time required to manage our incoming calls. These

include both incoming calls and those calls “returned” as the required extension was unanswered.

A full report on performance will be submitted to the Estates and Facilities Director in March 2014

4.7 Transport Services

Revised contract management processes have been implemented with the support of the head of

facilities. A transport continuous improvement group has also been implemented engaging with key

clinical staff to support the process. This will allow for better contract management procedures,

reporting and improved trend analysis to support process improvements.

Below is a basic overview of activity and performance for the patient transport contract.

Non-Emergency

Patient Transport

Analysis Aug-13 Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Feb-14

Indicative volume of

journeys 2,828 2,828 2,828 2,828 2,828 2828 2828

Number of patient

transport journeys 3,036 3,252 3,425 3,156 2,567 3246 2853

Service credits

reimbursed to the Trust

for non-compliance of

contracted KPI's £2,906 £3,112 £6,460 £3,011 £2,822 £6,137 £5,645

The second phase of the revised transport booking process, involving the installation of a Simple

Object Access Protocol (SOAP) interface to transfer active patient transport requests from PAS to

Cleric, has not been achieved. It has been evidenced that on average 20 patients per day are not

being booked hospital transport as the correct booking process are not being followed. There is no

identified risk to patient care due to the substitute transport system remaining in operation and

these groups are being manually identified on a daily basis. The failure to follow correct process

has been escalated and further dialogue is ongoing with the groups concerned to achieve a

positive outcome within a minimum time span.


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4.8 Interpreting Services

The outsourced interpreting and translation framework agreement continues to provide a high

quality communication support to our patients with no KPI failures reported, across all sites. It is

noted that the interpreting budget held by Estates, and controlled by clinical users, has been

exceeded by £43K and is forecasted to be approximately £90K overspent.

4.9 Domestic Services

On Wednesday 19th June 2013 the annual Patient Led-Assessment of the Care Environment

(PLACE) took place at Moorfields Eye Hospital, City Road. Results for this assessment are as

follows:

For cleanliness of wards, including bathrooms, furniture, fixtures and fittings, scored 93.69%.

• The national average score was 96%.

• 90% of hospital sites scored more than 80%, of which 144 sites scored 100%.

For condition, appearance and maintenance of sites, including decoration, signage, linen and car-

park access, Moorfields scored 91.92%, which is above the national average score.


• 68% of hospital sites scored more than 80%, of which two sites scored 100%.

For patients’ privacy, dignity and wellbeing, including their changing and waiting facilities,

appropriate separation of single sex facilities, telephone access and appropriate patient clothing,

Moorfields scored 89.33%, which is on par with the national average score.


• 65% of hospital sites scored more than 80%, of which 18 sites scored 100%.

For patients’ food and hydration (including assessment of choice, taste, temperature and

availability over 24 hours, Moorfields scored 100% which is above the national average score.


• 70% of hospital sites scored more than 80%, of which four sites scored 100%.

The 2014 PLACE assessment took place on Monday 24th March. The results will be published in

the next board report but a much improved score has been achieved.

A new reporting suite has been implemented for review by the Infection Control Committee, this

will be reviewed and aligned with the PLACE assessment process over the coming months.

This report allows for detailed breakdown on

cleaning audits per area and can be used to

facilitate all clinical meetings where necessary


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4.10 Catering & Hospitality

Below is summary of the key points within catering over the reporting period.

4.10.1 e-Procurement

An e-Procurement module has been implemented within the catering ordering process – ‘e.p.sys’

is a leading e-Procurement system that promotes buying best practice and is equipped with a wide

range of tools that enhance the ability to buy efficiently. The full supply chain within catering will be

added to this system and the project is due to be completed at the end of April 2014.

This will provide robust data to benchmark costs of all suppliers for all types of ingredients and

supply procured through catering. This will enable the impending catering charge review to be

informed by high quality data.

4.10.2 Food Hygiene Audit

A food hygiene inspection took place on the 5th December 2013. This was undertaken by an external body as requested by the trust. This audit included a physical inspection of the main kitchen, restaurant, ward areas and children’s café. This also included an audit of the Hazard Analysis and Critical Control Point (HACCP) Food Safety Management Programme and documentation systems.

The key messages from this inspection are that all standards, systems and process are of a good standard, and have significantly improved in all areas over the past 12 months. A plan of action was put in place to resolve areas identified as needing attention. All outstanding actions have been completed.

This will be an ongoing process to ensure full compliance within the trust.

4.10.3 Retail

The Costa outlet has been running for almost six months. The project has been deemed a success

and has been fully utilized by patients, visitors and staff. Feedback has been received by patients

and the following issues have been resolved.

Signage too small – There was feedback from patients regarding the size of the font for the

menu boards and food display cabinets. This has now been resolved. The font has been

increased to the maximum size Costa can do. They have also supported this by providing a 5

foot banner that details the coffee prices.

Lighting – There was feedback received regarding the lighting levels. This is due to the spread

of the beams of the LEDs as opposed to the actual lighting levels. Costa has changed the

LEDs and this has resulted in the area being brighter throughout.

Advertising the Restaurant – Feedback has been received from various parties with regards

to advertising the 3rd floor restaurant to all patients and visitors. It was agreed by senior

management that we would not advertise or promote this area as a place to eat for all patients

and visitors. However a leaflet was developed and issued to PALS should any queries be

made with regarding alternative places to eat.


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9,976, 6%

146,098, 91%

5,113, 3% Waste Weights

Landfill

Reused/Recycled

HT incineration with recovery

4.10.4 Food Hygiene Training

It is required by law that any persons handling or preparing food receives food hygiene training.

This process goes beyond the catering team and into the clinical domain. Whilst the handling of

food is very minimal within these areas (opening sandwich packets for less able patients, preparing

tea and coffee and issuing biscuits etc.) the organisation is required to have various systems and

processes in place whereby staff are trained in food hygiene.

It was decided by key stakeholders that this process would be done online by a registered training

provider. This process has been implemented and will continue to be monitored throughout the

year. See below for the compliance report for the relevant areas. Please note this report was run in

February 2014 and various staff have completed their online assessment since this data was

presented.

Satellite sites Private Patients RDCEC Mackellar/Sedgwick

Total staff 12 9 24 43

Completed 9 1 23 26

Registered but not completed 0 1 0 2

Not registered 3 7 1 15

Success criteria 75.0% 11.1% 95.8% 60.5%

Not registered percentage 25.0% 77.8% 4.2% 34.9%

Not completed percentage 0.0% 11.1% 0.0% 4.7%

This process will continue to be monitored until completion. This approach has saved the trust

approximately £10k per annum and eradicated staff needing to go off-site for structured training.

4.10.5 Waste Management

The chart and table shows the total waste generated between July 2013 – December 2013. Also

detailed below is the breakdown of waste by disposal streams. MEH generated 161,187kg of

waste during this period. 146,098kg (91%) was recycled, 5,113kg (3%) was sent to hi-temperature

incineration (with heat recovery) and 9,976kg (6%) was sent direct to landfill.

The LPP and procurement team have tendered the waste streams. The final decision is yet to be

made though this process should be completed within the next quarter.

A waste audit was completed by an external company in line with current legislation. A Waste Audit

plan was competed and all actions have now been resolved.

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