APPENDIX VOLUME Outline Business Case · 2018-09-28 · Business Case – Hutted Wards Replacement...

APPENDIX VOLUME

Outline Business Case

for delivery of the

Hutted Wards Replacement

(Estates Strategy Phase 3)

within

Wye Valley NHS Trust

Business Case – Hutted Wards Replacement (Estates Strategy Phase 3)

List of Appendices Number Title

Approvals

1.1 Trust approval – Trust Board minutes [TO FOLLOW]

Strategic Case

2.1 Trust Estate Strategy

2.2 Development Control Plan September 2018 Update

2.3 Model Hospital Report

2.4 County Hospital Site Constraints

Economic Case

3.1 Shortlisted Options OB Cost Forms

3.2 DCF Outputs

Commercial Case

4.1 Furniture, Equipment and IM&T Strategy

4.2 Preferred Option Design 1:200

4.3 Schedule of Accommodation & Derogations Schedule

4.4 MEP Service Strategy

4.5 BREEAM Design Stage Report

4.6 LA Planning Officer meeting note

Finance Case

5.1 Loan Financing Option

5.2 SOCI Impact

Management Case

6.1 Project Execution Plan (PEP) v0.6

6.2 Detailed Project Programme

6.3 Project Risk Register

6.4 Trust Corporate Estates & Facilities Risks

6.5 Benefits Realisation Plan

Clinical Quality Case

7.1 Quality Impact Assessment


Appendix 1.1

Trust Board Minutes

[To Follow]


Appendix 2.1

Trust Estate Strategy

Estates Strategy 2015 – 2020 v1.5 200115

Page 1 of 9

Estates and Facilities Strategy 2015-20 1. Background and Introduction

Wye Valley NHS Trust (the Trust) formed in 2011 and this Estates Strategy encompasses the vision for the future of the Estate and Facilities which are utilised by Trust services. The Strategy has been developed in parallel with other strategic plans to consider options for the future. Professional advisors have supported the Trust’ staff to engage with clinical services to ensure the Strategy is fit for purpose.

2. What is an Estates Strategy?

An Estates Strategy is recognised as best practise within the Health Service and has been created using applicable guidance1. The Strategy is meant as a high level document to support the direction of travel for the Trust’s Estates and Facilities. The Strategy does not detail specific solutions for individual service needs but provides a consistent framework from which plans can be developed. These plans will follow applicable guidance and where necessary be set out in Strategic Outline Case (SOC) form before proceeding.

Strategic DirectionService Strategies

Estates StrategyMasterplan

Data and policies

Strategic DirectionService Strategies

Estates StrategyMasterplan

Data and policies

1 NHS Estates (2005) Developing an Estate Strategy


Page 2 of 9

2.1 Aims and Objectives

The aims and objectives of the Strategy are:

Improve patient experience and quality (e.g. dementia friendly)

To provide a safe, fit for purpose and therapeutic environment to deliver healthcare

To support the clinical/service strategy and business requirements of WVT

Increase efficiency – better utilisation, lower overheads

Provide flexible solutions for future changes in function & capacity

Re-provide where buildings are unsustainable for modern healthcare

Reduce carbon footprint and become more sustainable

2.2 Key Principles

Use space better

Sharing of offices supported by flexible design & technology (including Electronic Patient Records, Telehealth etc.)

Improve booking/access systems

Invest in mobile working

Utilising existing buildings (occupied and vacant)

Be more efficient

Better energy performance

Use less space – intensify on key sites

Reduce leased accommodation

Improve information (e.g. Service Line Management)

2.3 Clinical Strategy/Direction

There are some very specific underlying issues which need to be addressed in the Estate to support the clinical services strategy including:

a) Increased capacity for inpatients and outpatients


Page 3 of 9

b) Improved flow of patients through clinical pathways

c) Improved privacy and dignity

d) Increased flexibility of the environment to be able to provide more and a wider range of elective procedures and treatments

3. Where are we now?

3.1 Key facts

• The Trust occupies 60 buildings and less than 7% that are under 10 years old

• The buildings are on 45 sites with 39% within the City of Hereford

• The Trust owns 30% of these buildings

• The Trust’s income in 2013/14 was £173,500,000

• Occupancy costs:

o Capital Charges/Depreciation £3,366,000

o Rent and rates £1,003,826

o Maintenance £/m2 30.56 (Median compared to peers)

o Energy & utilities £/m2 25.64 (Median compared to peers)

• Occupancy cost per area £/m2 290.55 (Median compared to peers)

• Equipment Value £3,427,000

• Land value £5,990,000

• Building value £66,474,355

• Gross Internal Area 42,685m2

• Physical backlog £19,094,727

• High and significant risk backlog £12,476,814

• High and significant Backlog per occupied floor area £/m2 223.89

Note the above is three times the upper quartile compared to peers (upper 71.29)

• Total capital investment per occupied floor area £/m2 25.50

Note the above is 50% less than the lower quartile compared to peers (lower 51.57)


Page 4 of 9

3.2 The Trust invests on average 7 times less (under 15%) than its peers in the Estate and has 4 times as much critical backlog (essential works required like replacement of Canadian Huts). The underlying issue here is that the Trust’s depreciation barely covers replacement of minor equipment let alone capital investment in existing facilities.

3.3 In terms of service provision, often referred to as Hard and Soft Facilities Management (Hard FM and Soft FM), the following summarises the current position:

• Most services at the County Hospital are provided through a PFI Contract.

• Hard FM is generally provided by Trust staff on other sites and these services are also provided to third parties (e.g. mental health provider and commissioners).

• Soft FM facilities are contracted to a third party on other sites that also provide this to other health services to offer best value.

3.4 NHS Premises Assurance Model (PAM)

NHS PAM is not currently mandatory. It is a self-assessment against a number of questions. This is an NHS tool developed from an Office of Government Commerce methodology. Current self-assessment is shown in the chart below. This shows that over the last 12 months there has been some improvement in the lowest scoring domain (Organisational Governance). Patient Experience, Safety and Organisational Governance domains should all now be targeting the ‘Good’ assessment level. This indicates that the Trust is broadly covering the key Estates and Facilities functions to an adequate level currently. 3.5 Estates and Facilities Risks Key risks which need to be addressed by the Strategy include:

• Loss of capacity or harm caused by critical failure of the Canadian Huts (wards and support accommodation).

• Business continuity from lack of resilience in systems (e.g. medical gases). • Increased revenue costs due to poor quality of owned estate due to increased

maintenance, high energy costs and poor efficiency.


Page 5 of 9

4. Where do we want to be?

This is summarised here by description in qualitative and quantitative measures.

4.1 Qualitative measures of improvements to be made include2:

i. Supporting the Trust Vision to improve the health and wellbeing of the people we serve in Herefordshire and the surrounding areas.

ii. Supporting the Trust Mission to provide a quality of care we would want for ourselves, our families and friends.

iii. To help provide ‘Right care, right place, right time…every time.’ iv. To embody the Trust Values by:

• People First - Creating positive working, living and healing environments • Passion for excellence - Supporting clinical development and best in class

design • Personal responsibility - Providing supporting environments and choice that

promote privacy, dignity and independence • Pride in our team - Inclusive planning and development processes to support

the workforce in delivering services • Promoting thriving communities - Sustainable spaces that support future

development opportunities

v. Supporting the Trust Primary Objectives

2 The items in bold are Trust published vision and values.


Page 6 of 9

• To enjoy a reputation for and be able to demonstrate exceptional quality, safety and customer service – through high performance and excellent assurance processes.

• To achieve sufficient financial prosperity to enable services to be sustained and developed – by offering demonstrable value for money and investing to reduce overheads

vi. Supporting Service Delivery Objectives:

• To deliver community focused and integrated health care services – by investing in mobile and flexible working solutions.

• To deliver a clinically sustainable portfolio of secondary care services – by offering flexible environments.

• To extend the range and, where appropriate, the volume of health care services we offer – by showing how capacity and changes of use in facilities can be delivered cost effectively over a log period

vii. To ensure that we deploy our estate and assets efficiently and effectively to provide care in a first class environment.

4.2 Quantitative measure of improvements to be made include:

i. NHS Premises Assurance Model (PAM) the Trust targets a minimum of ‘good’ standard across all domains within three years.

ii. Patient Led Assessments of the Care Environment (PLACE) the Trust targets being better than peer average across all domains;

o Cleanliness

o Food and Hydration

o Privacy, Dignity and Wellbeing

o Condition, Appearance and Maintenance

iii. To continue delivering top quartile value for money in Estate efficiency as demonstrated in national Estates Return Information Collection (ERIC) data.

iv. To support reducing the Trust’s Carbon Footprint by 26% from 20073 levels by 2020 and then by 80% by 2050.

3 Baseline year identified by NHS Sustainable Development Unit


Page 7 of 9

5. How do we get there?

5.1 A summary of key elements of the strategy is shown in the table below:

5.2 The key to delivering aims and objectives of the strategy is through:

• Capital Investment in key assets

• Robust programme and project management

• Alignment with other strategies (e.g. IT, Dementia and Health and Safety)

• Partnership working

5.3 The options developed to date have been set against emerging service strategies and all preferred options will be contingent upon these strategies being fully supported over time.

5.4 A development control plan showing options for long term changes to be made to improve or amend services and use of the estate will be developed for all inpatient sites. A preliminary development control plan for the County Hospital site is


Page 8 of 9

shown at Appendix A showing how development might be phased to suit a number of preferred options for different clinical and support functions.

5.5 A Workforce Development Plan for Estates and Facilities will be agreed in year 1.

5.6 Ensure BREAAM (Building Research Establishment Environmental Assessment Method) for Health is utilised for all necessary developments to ensure the highest standards of sustainability are being implemented.

5.7 Description of how Strategy will meet key aims and objectives

Aim/Objective Strategic Response

To support the clinical/service strategy and business requirements of WVT

Robust Programme Management including stakeholder engagement

To provide a safe, fit for purpose and therapeutic environment to deliver healthcare

Utilising NHS Premises Assurance Matrix to show continuous improvement, Clear briefing for designers

Increase efficiency Better space utilisation, lower overheads, less sites

Provide flexible solutions for future changes in function & capacity

To increase capacity and flexibility of the environment to support growth and changes in practice (e.g. 7 day working)

Improve patient experience and quality Continuous improvement on PLACE

Re-provide where buildings are unsustainable for modern healthcare

Replacement of Canadian Huts

Reduce carbon footprint and become more sustainable

Investment in energy reduction and use of BREAAM assessments


Page 9 of 9

6. Next Steps

6.1 Due to the urgent nature of some of the needs including those items listed below a capital bid is being made for 2015/16 to progress these works:

i. Additional bed capacity

ii. Preparation for replacement of podiatric theatre from Belmont Abbey where a lease expires

iii. Improvements to patient flow and compliance of Emergency Department.

iv. Replacement of outpatient activity currently housed in rented unit (‘Arkwright Suite’)

v. Site infrastructure to enable safe delivery of strategy including medical gases, telephony, storage etc.

6.2 In parallel with a short term bid for capital in 2015/16 a Strategic Outline Case (SOC), Outline Business Case (OBC) and Full Business Case (FBC) will be developed in year 1 to demonstrate:

i. Preferred options for replacement of hutted wards and support accommodation.

ii. Additional improvements required in capacity and patient flow specifically including inpatients, outpatients, daycase, endoscopy, ITU, women and children’s services.

iii. Consideration of Combined Heat and Power (CHP) at County Hospital.

iv. Preferred options for support accommodation including residential units.

v. Financial appraisal of each option to assess capital and revenue affordability.

vi. Procurement and funding options to support the required developments along with feasibility/deliverability plans including any potential disposals.

Phase 1Phase 1Phase 1Phase 1

1. Urgent Beds – Mortuary Car Park

2. Multi deck temporary car park – Gwyndra Downs

3. Arkwright Exit – Fred Bulmer

4. Midwifery Led Unit – 2ndFloor PFI

5. A&E localised internal remodelling

6. Medical Records Phase 1 Relocation - Pathology

7. Additional Storage


1. Spires relocation - Ground floor main entrance

2. Refurbishment for Administration – Lionel Green

3. Podiatric and Ambulatory Theatres

– Hutted Wards (Diabetes & Medical Records)

4. Urgent Care Centre & Helipad – Front of A&E

5. Combine Heat & Power (CHP)

6. Medical Records Phase 2 Relocation - Pathology


1. Wards & Clinical Building (10 Bed ITU)

– Hutted Wards (Administration)

2. Extend/complete perimeter service road

3. Multi Storey Car Park – Main car park


1. Endoscopy relocation – Existing ITU

2. Day Case Reorganisation

Phase 5 - Potential Further DevelopmentPhase 5 - Potential Further DevelopmentPhase 5 - Potential Further DevelopmentPhase 5 - Potential Further Development

1. Eign Brook redevelopment

2. Orchard site development (limited by planning constraints)

3. Hutted Ward Site (Monnow & Leadon)

4. Car park site redevelopment opposite A&E

5. Operating Theatre

6. Staff Accommodation (Longfield House)

7. Offices site redevelopment (Finance offices)

8. Pathology site redevelopment

Endoscopy relocation –

Existing ITU

Urgent Beds –

Mortuary Car Park

Multi Storey Car Park –

Main car park

Urgent Care Centre

& Helipad – Front of A&E

Medical Records Phase 1

Relocation - Pathology

Spires relocation -

Ground floor main entrance

Refurbishment for Administration

– Lionel Green

Podiatric and Ambulatory Theatres –

Hutted Wards (Diabetes & Medical Records)

Wards & Clinical Building (10 Bed ITU) –

Hutted Wards (Administration)

Arkwright Exit –

Fred Bulmer

Midwifery Led Unit –

2ndFloor PFIMulti deck temporary

car park – Gwyndra Downs

A&E localised internal

remodelling

Combine Heat &

Power (CHP)

Day Case

Reorganisation

Future Development Zone –

Hutted Wards (Monnow & Leadon)Future Development

Zone - Eign Brook

Future Development Zone -

Orchard site (limited by planning constraints)

Additional

Storage

2

1

1

1

1

5

5

1 2 21 2

1

2

3

5

4

4

inspiredenvironments

Init NotesRev Date

Status

Drawing No. Revision

Drawing Title

Scale Date

Project Title

Sheet Drawn Checked

Chkd

A1

London - 7 Birchin Lane, London, EC3V 3BW

Bristol - Rivergate House, Bristol, BS1 6LS

Plymouth - East Quay House, Plymouth, PL4 0HN

RIBA Chartered Practice

Project No.

Drawing Reference

Drawing Originator

Client

020 7160 6000

0117 923 2535

01752 261 282

www.aww-uk.com

1 : 100

D

3227

Wye Valley Trust

Development Control PlanEstates Strategy

Estates Strategy

FEASIBILITY

TF 19/12/2014

001

A 19/12/14 TF

B 07/01/15 TF

C 16/01/15 TF Adjustments as per GV sketch16/01/15

D 20/01/15 TF Multi Storey Car Park to Ph3

NOT TO SCALE

Operating

Theatre5

Future Development Zone -

Car park5

Future Development

Zone - Offices5

7

Future Development Zone

Staff accommodation5

Extend/complete

Perimeter service road3

Future Development Zone - Pathology

(EPR complete & health records

storage no longer required)5

Medical Records Phase 2

Relocation - Pathology2

3

APPENDIX A - DEVELOPMENT CONTROL PLAN - HEREFORD COUNTY HOSPITAL


Appendix 2.2

Development Control Plan

September 2018 Update


Appendix 2.3

Model Hospital Report

Wye Valley NHS TrustEstates & Facilities

Alan Dawson

30 August 2018

https://[email protected]

Generated by Alan Dawson ([email protected]) on 30 August 2018 09:32 from Production (build 2.1.0) Page 1 of 6

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mailto:[email protected]

Cost Efficiency Period TrustActual

PeerMedian

Benchm arkValue

Info Variation Trend

Estates & Facilities Cost (£ per m2)2016/17 £539 - £308 Click for national variation

Hard FM Cost (£ per m2) 2016/17 £73 - £75 Click for national variation No trendline available

So ft FM Cost (£ per m2) 2016/17 £148 - £127 Click for national variation No trendline available

Estates & Facilities Cost (£ per W AU )2016/17 £668 - £395 Click for national variation

Hard Facilities Man agemen t (FM) Cost (£ perW AU ) 2016/17 £90 - £90 Click for national variation

So ft Facilities Man agemen t (FM) Cost (£ perW AU ) 2016/17 £183 - £156 Click for national variation

Estates & Property Main ten an ce (£ per m2)2016/17 £29 - £29 Click for national variation No trendline available

G rou n ds an d garden s main ten an ce (£ per m2)-

NOTAVAILABLE - -

Clean in g Cost (£ per m2)2016/17 £46 - £38 Click for national variation

Food Cost (£ per Meal)2016/17 £4.26 - £3.35 Click for national variation

Lau n dry & Lin en Cost (£ per Item)2016/17 £0.30 - £0.33 Click for national variation

En ergy Cost (£ per U n it)2016/17 £0.050 - £0.040 Click for national variation

W ater & Sew age Cost (£ per m2)2016/17 £3.91 - £3.67 Click for national variation

Porterin g (£ per m2)2016/17 £23 - £19 Click for national variation

To ta l W aste Cost (£ per Ton n e)2016/17 £270 - £225 Click for national variation No trendline available

Lan d fill Cost (£ per ton n e) 2016/17 £122 - £153 Click for national variation No trendline available

In cin eration Cost (£ per ton n e) 2016/17 £387 - £424 Click for national variation No trendline available

Recyclin g Cost (£ per ton n e) 2016/17 £230 - £92 Click for national variation No trendline available

O th er Recovery Cost (£ per ton n e) 2016/17 £218 - £193 Click for national variation No trendline available

Estates & Facilities, Trust Level



Productivity Period TrustActual

PeerMedian

Benchm arkValue


Amou n t o f Non -Clin ica l Space (%)2016/17 32.4% - 33.9% Click for national variation

Amou n t o f empty space2016/17 0.5% - 0.4% Click for national variation

Amou n t o f u n der-u tilised space2016/17 0.0% - 0.6% Click for national variation

O ccu p ied F loo r Area (1,000m2 per W AU )2016/17 1.24 - 1.23 Click for national variation

Clean in g Produ ctivity (m2 per W TE)2016/17 726 - 680 Click for national variation

Food Service Produ ctivity (Meals per bed day)2016/17 4.45 - 2.80 Click for national variation

Lau n dry & Lin en Produ ctivity (Items per W AU )2016/17 65.5 - 37.0 Click for national variation

En ergy Produ ctivity (U n its per m2)2016/17 515 - 457 Click for national variation

W aste Produ ctivity (Kg per W AU )2016/17 22 - 20 Click for national variation No trendline available

Quality & Safety Period TrustActual

PeerMedian

Benchm arkValue


Critica l In frastru ctu re R isk (£ per m2)2016/17 £270 - £64 Click for national variation

To ta l Critica l In frastru ctu re R isk2016/17 £15.28m - £3.93m Click for national variation

To ta l B ack log Main ten an ce (£ per m2)2016/17 £280 - £156 Click for national variation

Clean lin ess - Patien t Led Assessmen t Sco re2016/17 92.3% - 99.2% Click for national variation

Food - Patien t Led Assessmen t Sco re2016/17 81.8% - 90.5% Click for national variation

Privacy, D ign ity & W ellbein g - Patien t LedAssessmen t Sco re 2016/17 74.6% - 83.1% Click for national variation

Con d ition , Appearan ce & Main ten an ce -Patien t Led Assessmen t Sco re 2016/17 86.2% - 94.3% Click for national variation

Demen tia En viron men t - Patien t LedAssessmen t Sco re 2016/17 65.0% - 77.6% Click for national variation

Disab ility - Patien t Led Assessmen t Sco re2016/17 69.5% - 82.8% Click for national variation



Using peer list: My Peers



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Appendix 2.4

County Hospital Site Constraints

SUPPORT

BUILDING

MAIN HOSPITAL BUILDING

MONITORING

OFFICE

GWYNDRA DOWNS

JOHNSONS

HOSPITAL

AGE CARE/

REHABILITATION

PATHOLOGY

MORTUARY

ITU

THEATRES

5,6 & 7

FINANCE

LIONEL GREEN

WASTE

TRANSFER

POST GRAD

MED CENTRE

LONGFIELD

HOUSE

MAIN

ENTRANCE

A&E

24 HOUR

ENTRANCE

DIABETIC

UNIT

M.R.U.

M

O

N

N

O

W

W

A

R

D

L

E

A

D

O

N

W

A

R

D

O

F

F

I

C

E

S

O

F

F

I

C

E

S

H

E

A

L

T

H

R

E

C

O

R

D

S

A

N

A

E

S

T

H

E

T

I

C

D

E

P

T

292 m2

84 m2

367 m2

1375 m2

571 m2

81 m2

2432 m2

CORRIDOR

328 m2

373 m2

163 m2

41 m2

555 m2

375 m2

173 m2

350 m2

214 m2

378 m2

160 m2

333 m2

89 m2

80 m2

335 m2

897 m2

438 m2

941 m2

182 m2

762 m2

355 m2

783 m2

912 m2

9408 m2

390 m2

S.R.U.

457 m2

GILWERN

ASSESSMENT

UNIT

THEATRE

10

140 m2

72 m2

STORE

WEIGH

BRIDGE

560 m2

Drawing No

Project

Drawing Title

Scale :

Original Drawing Size :

Rev

As constructed

For construction

For tender

For comment

AppdRev

Drawn:

Chkd:

Appd:

Date:

Design:

Revision details Chkd Date

Preliminary

STATUS

Mercia Support Building

County Hospital

Stonebow Road

Hereford

HR1 2BN

Tel : 01432 364408

Fax : 01432 266120

HEREFORD COUNTY HOSPITAL

HCH-SP-001

A2

SITE PLAN

WARNING

This drawing may not be to correct, this

includes dimensional information and

room designation therefore please check

as necessary for your purposes

DBH

1:1000 AT A2



SITE PLAN

H

A

SODEXO CONTRACT

01.12

DBH

B

ONGOING UPDATES

10.06.15

DBH

C

ADDITIONAL CAR PARKING

SPACES ADDED

16.09.15

DBH MW

DADDITIONAL CAR PARKING

SPACES No's REVISED

17.09.15

DBH MW

E SITE UPDATED

16.03.16

DBH

F VANGUARD UNIT REMOVED

06.04.16

DBH

G SERVICE YARD STORE ADDED

13.04.16

DBH

H TEMPORARY BUILDINGS ADDED

16.11.16

DBH

gvaughan

Polygonal Line

gvaughan

Polygon

gvaughan

Polygon

gvaughan

Text Box

Public Sewer

gvaughan

Text Box

Welsh Water Existing Easement

gvaughan

Line

gvaughan

Text Box

Welsh Water Easement required for future development

gvaughan

Polygonal Line

gvaughan

Text Box

Access Required

gvaughan

Line

gvaughan

Polygonal Line

gvaughan

Text Box

Blue light route avoiding air ambulance

gvaughan

Line

gvaughan

Text Box

Fire Road

gvaughan

Line

gvaughan

Polygon

gvaughan

Text Box

No ability to link new development directly to main Hospital

gvaughan

Line

gvaughan

Text Box

Operational Railway

gvaughan

Line

gvaughan

Text Box

Railtrack Access

gvaughan

Line

gvaughan

Text Box

2gether Mental Health Unit Access

gvaughan

Line

gvaughan

Text Box

Constraints to be considered for new developments Rev1

gvaughan

Line

gvaughan

Text Box

Network (public) 225mm Gas main

gvaughan

Line

gvaughan

Line

gvaughan

Text Box

Created by WVT Estates Aug 2018

gvaughan

Polygon

gvaughan

Oval

gvaughan

Text Box

Air Ambulance Flight path to be considered

gvaughan

Line


Appendix 3.1

Shortlisted Options OB Cost Forms

Cost Management

Program, Cost, Consultancy

Version 2.03

New Ward Scheme


Hereford County Hospital OB Forms

04 September 2018

Hereford County Hospital OB Forms

Version 2.03

04 September 2018

New Ward Scheme


Cost Management

Program, Cost, Consultancy

DOCUMENT ISSUE SHEET

Document Version File Path Issue Date Parties Sent To Prepared By Checked By Verified By

2.03 \\UKOXF1DC001\EUProjectVol\UKOXF1-

PCC\Projects\New folder\Hereford\09 - Estimates

04-Sep-18 Sharyn Hewett Nigel Riga Richard Tunstall

Document History Version File Path Issue Date Parties Sent To Prepared By Checked By Reviewed By



draft Sharyn Hewett draft draft



23-Aug-18 Sharyn Hewett draft draft



21-Aug-18 Sharyn Hewett Nigel Riga draft



21-Sep-17 Matt Collett Colin Henderson Mike Irmiger







This document has been prepared by AECOM Limited (“AECOM”) for sole use of our client (the “Client”) in accordance with generally accepted consultancy principles, the budget for fees and the terms of reference agreed between AECOM and the Client. Any

information provided by third parties and referred to herein has not been checked or verified by AECOM, unless otherwise expressly stated in the document. No third party may rely upon this document without the prior and express written agreement of AECOM.

Hereford County Hospital OB

Forms

WVT


Forms

WVT / Kier / IBI / WSP


Forms



Forms



Forms

WVT


Forms

WVT


Forms

draft

i

Document: Hereford County Hospital OB Forms Version: 2.03 Date:

Project: New Ward Scheme Client: Wye Valley NHS Trust

CONTENTS

1.00 Introduction

2.00 Overview

3.00 Key Risks

4.00 Approach

5.00 Basis of Estimate

6.00 Methodology

7.00 Exclusions

8.00 Information Base

OB FORMS

Appendix 1

Option 1 - 2 x 24 Bed Ward (2 floors)

Option 1 Form OB1

Option 1 Form OB2

Option 1 Form OB3

Option 1 Form OB4

Option 1 On-Costs

Appendix 2


Option 4 Form OB1

Option 4 Form OB2

Option 4 Form OB3

Option 4 Form OB4

Option 4 On-Costs

04 September 2018

ii

Document: Hereford County Hospital OB Forms Version: 2.03 Date: 04 September 2018


EXECUTIVE SUMMARY

1.00 Introduction

2.00

The Shortlisted Options Scheme Cost

- 2,737 m2 £15,404,035

- Option 4 - 3 x 24 Bed Ward (3 floors) 3,802 m2 £21,009,477

3.00

-

-

-

4.00

5.00

5.01

5.02

5.03

5.04

5.05

5.06

-

- Option 4 - 3 x 24 Bed Ward (3 floors)

5.07 Non-Works Cost:

- Asbestos Refurbishment Survey

- CCTV Drainage Survey

- Archaeology Survey and Report

- Archaeological Recording of exposed deposits/features

- Ecological Protected Species Survey

- Archaeological Watching Brief

- Tree Surgery / Tree Netting

- Cherry tree and nesting bird survey

- Flood Risk Assessment

- Acoustic Survey

- Air Quality Survey

- Ground investigation

- Underground Services Survey

- Structural Integrity Testing

- Services infrastructure and capacity investigation

- 3D Cloud Point Survey

- IBI Group (Planning Consultant)

- Planning Application

- Building Control

5.08

5.09

5.10

ApproachCost advice is set at an indicative level appropriate to an Outline Case.

The approach has been to appraise the options with emphasis placed on true discrimination between the options but ensuring the 'bottom line' is sufficiently realistic for financial

planning. The approach adopted for assessment of the cost of each of the OB Form cost headings has been generally consistent across all sites and options as follows. Site or option

specific considerations are captured within the OB Forms and supporting build-up sheets.

Basis of Estimate

Specific allowances have been made for defined elements of work.

This element includes the demolition of the existing hutted wards in two phases; Phase 1 (Hutted Wards & Diabetes) which has already begun, instructed under Compensation Event

ref. CE017. Phase 2 (Monnow & Leadon) is planned to be demolished after the completion of the replacement wards.

On-costs:

Departmental Costs:

Departmental Costs are based on AECOM's Cost Estimate V5.01 dated 25th June 2018 priced at BCIS PUBSEC index level 250 and rebaselined at index level 258 (BCIS update 3rd

August 2018).

Sub-total:

Is the total of items 1 and 2. The costs are set at BCIS PUBSEC index level 250 and rebaselined at index level 254 (updated August 2018), the current NHS reporting level.

Works Cost:

Allowances relate to all design disciplines, and include for Trust internal costs incurred in connection with the project, as well as legal fees, although the latter are limited to those

incurred in connection with the building contract and PFI contract variations.

A location adjustment for Herefordshire is incorporated into the OB forms.

Provisional Location Adjustment:

This figure represents the total Works Cost at the given base date and project location. It is the figure used for deriving the Works Cost/m² for the scheme/option.

Optimism Bias:

Optimism Bias for Option 4 has an allowance of 2.1% and assumptions are provided under the Optimism Bias Mitigation Factor Calculation heading.

Fees:

To cost heads 4 to 7 (excluding Land Costs - 7(b)). This is the minimum provision that we would expect all sites and options have an allowance based on a 5% addition to see at OB

Stage for Option 1. An allowance of 7.5% is provided for Option 4 due to the requirement for redesign of the additional floor.

Planning Contingency:

The fee allowances included in OB4 covers specific elements of fees in connection with Option 1 & 4 as follows:

Equipment:

New equipment has been allowed for where a new or expanded service is being provided, otherwise it is assumed that most equipment will be transferred from existing facilities.


For IM&T, we have included notional allowances. These vary depending on whether existing servers, etc., and equipment is assumed to be re-used.

Have been assessed and summarised for each option. Typical items include:

Optimism Bias for Option 1 was reduced to Nil following instruction from the Trust and agreement that the design was of acceptable level to proceed to GMP and not likely to have

further risk of change.

Inflation used is based on PUBSEC index level 258 for 3Q2019. There is a risk that the construction programme may run over 2 years in which case it may increase to a forecast

index level of 264 1Q2020. Any increase in inflation will impact on the cost forecast.

Key RisksThere are a number of key risks to affordability which we have set out below:


AECOM have been requested to update the current Outline Business Case ('OBC') Version 1.01 dated 21st September 2017 in which Option 1, 2 x 24 Bed Ward (2 floor) was the

preferred option and has been developed up to Stage 4 design with Planning Application granted. Wye Valley Hospital NHS Trust ('the Trust') is in a position to consider an alternative

Option 4, 3 x 24 Bed Ward (3 floor) Scheme which will provide a total capacity of 72 beds for acute inpatient care.

AECOM are commissioned to provide construction related capital and recurrent cost advice in support of the OBC submission for the Trust. This revision of the report is updated to

reflect the latest PUBSEC inflation indices published by BCIS in August 2018.

These OBC forms confirm the following accommodation and outturn costs of Option 1 and Option 4 for the Projects at the Hereford County Hospital site.

Overview

Area

Programme slippage - the PSCP's Outline Indicative Programme for 3x24 Bed dated 6th August 2018 assumes a start on site 1Q2019. There is a risk that Works may only

commence in 2Q2019 following funding approval. Any slippage in the programme will impact on the cost forecast, and may affect the ability to commence works on subsequent

phases of the redevelopment plan.

PSCP Stand-down - there is an risk related to the stand-down of the PSCP for the period between Jan 2019 - May 2019. Works during this time may include design reviews,

programme & logistics, DTMs, site surveys, procurement etc which will impact on the cost forecast.

4



5.11

Date Index Status DoH Base Date 173 Inflation

1Q2016 213 Firm Current Index Level 250 3Q2018

2Q2016 223 Firm Inflation Baseline 258 3Q2019 3.20%3Q2016 224 Firm Potential Inflation risk 264 1Q2020 5.60%4Q2016 225 Firm

1Q2017 237 Firm

2Q2017 248 Firm

3Q2017 251 Revised

4Q2017 251 Provisional



3Q2018 250 Forecast

4Q2018 252 Forecast

1Q2019 254 Forecast

2Q2019 256 Forecast

3Q2019 258 Forecast

4Q2019 261 Forecast

1Q2020 264 Forecast

2Q2020 266 Forecast

5.12

5.13

5.14

6.00-

-

-

-

-

-

-

-

7.00- Fees beyond those listed in Section 5. Trust to confirm their required fee allowance including any third party or legal fees.

- Non-works costs (including decanting and temporary accommodation costs) - Trust to fund separately.

- Group 2 and 3 Equipment purchased by the Trust over the allowances listed in Section 6.

- VAT including VAT recovery on Works costs (over and above those noted on summary). Trust to liaise with BDO to verify VAT recovery assumptions.

- Capital allowances or other incentives/grants.

- Local Authority charges, costs of planning approval, road closures, statutory contributions (e.g. CIL, S106, S278 etc.).

- Client finance costs and insurances.

- Monitoring of adjacent buildings.

- Archaeological survey or excavation costs (over and above initial investigations only).

- Any necessary off-site reinforcement of services infrastructure.

- Survey and investigation costs not specifically listed in this report.

- Site infrastructure and diversions - other than those listed.

Extract BCIS PUBSEC Tender Price Index of Public Sector Building Non-Housing #904 Updated

03-Aug-2018.

Exclusions

An indicative cashflow forecast analysis has been included. It should be noted, however, that this analysis is based on limited information at this time, and requires further assessment

and validation as the phasing/programme strategy is developed.

Cashflow:

VAT:

VAT has been allowed at 20% of total cost excluding Fees where it is assumed that VAT is recoverable.

As described above, costs are set at BCIS PUBSEC index reporting level 250. Where a development programme has been established, future inflation has been assessed by

reference to the published BCIS PUBSEC Tender Price Index (August 2018). These are summarised below:

Inflation allowance:

Methodology

Risk Management:

Refer to the Introduction page for details of overall methodology and approach.

Fees are based on actual Fees to date applied via PSCP Valuation and estimates to develop up to Stage 3.

Allowances have been made for demolition of hutted wards.

The measurements contained within this report shall not be relied upon for any other purpose other than the formulation of the estimate itself.

Infrastructure is assumed in a good state of repair and available for local connection.

This estimate has been compiled assuming procured through P21+ multi-project route at framework rates with works packages procured through tendered completion.

Backlog maintenance is excluded from these costs and has been provided separately by the Trusts.

It is assumed that all options allow sufficiently for the accommodation required.

While overarching risk registers have been prepared to support the OBC, the allowance for the Planning Contingency is notional allowance, albeit set at an appropriate level for this

stage of a project.

5


Design Information Details / Drawing number Company Rev. Date Received

8.01.01 Telephone Discussions

WYE Valley NHS

Trust - 20/06/2018

8.01.02 Emails

-WYE Valley NHS

Trust - 21/11/2017

Kier - 17/05/2018

Kier - 17/05/2018

Kier - 22/05/2018

IBI Fee Drawdown Schedule dated 02/05/2018 IBI - 22/05/2018

WYE Valley NHS

Trust - 07/06/2018

WSP Fee Schedule dated 30/04/2018 WSP - 21/05/2018

WSP Fee Schedule dated 21/05/2018 WSP - 21/05/2018

8.01.03 Design Queries

WSP Design Query sheet no. 1 - Foundations & steelwork WSP - 02/05/2018

WSP Design Query sheet no. 2 - Access Road WSP - 02/05/2018

Architectural

8.01.04 Architectural plans

Option 1 - 24 Bed Ward Ground Floor Layout AR-AW-01-PL-200-001 IBI H 19/04/2018

Option 1 - 24 Bed Ward First Floor Layout AR-AW-01-PL-200-002 IBI J 19/04/2018

Option 1 - 24 Bed Ward Roof Layout AR-AW-RF-PL-200-007 IBI G 19/04/2018

General Arrangement Layout - Roof Top Plant Level AR-AW-RF-PL-250-003 IBI A 20/04/2018

General Arrangement Layout - Roof AR-WB-RF-PL-250-004 IBI B 20/04/2018

Site Location Plan AR-AW-00-PL-100-013 IBI C 15/02/2018

Logistics Plan - Site Areas 5114/LOG/001 - 009 Kier Draft 1 09/02/2018

Existing Site Plan AR-AW-WS-PL-100-018 IBI A 14/02/2018

Proposed Site Landscape Plan AR-AW-WS-PL-100-010 IBI B 07/02/2018

Existing Site Plan- Whole Hospital AR-AW-WS-PL-100-015 IBI B 15/02/2018

Proposed Site Plan- Whole Hospital AR-AW-WS-PL-100-016 IBI B 31/01/2018

External image 1 AR-WS-ML-VS-200-001 IBI A 15/02/2018

External image 2 AR-WS-ML-VS-200-002 IBI A 15/02/2018

8.01.05 Architectural Elevations

Proposed Elevations AR-WB-ML-EL-200-001 IBI C 29/01/2018

8.01.06 Architectural Sections and Details

Site Massing Section- Existing Link Setting Out AR-AW-ML-SK-100-001 IBI A 15/02/2018

Site Massing Section- Existing Link Setting Out AR-AW-ML-SK-100-002 IBI A 15/02/2018

WVT update of Trust Internal Fees to Date and cashflow forecast to

complete.

Email received Graham Vaughan dated

07/06/2018 at 11:01

Contractor market testing - cladding rateEmail received Duncan Gendall dated

22/05/2018 at 11:03

Contractor market testing - masonry rateEmail received Duncan Gendall dated

22/05/2018 at 11:03

Email received Peter Burke dated 15/05/2018

at 15:47

Email received Graham Stewart on

21/05/2018 at 14:28

Email received Graham Stewart on

21/05/2018 at 14:28

The basis for the OBC forms is AECOM's Cost Estimate priced at PUBSEC 270 and issued on the 25th June 2018. A list of the documents used as the basis for the estimate can be seen

below:

WVT request to exclude Lionel Green from Forecast Outturn Cost -

accounted for in previous Trust Budgets.

Telephone discussion with Graham Vaughan

on 20/06/2018

Business Case Fee Status dated 21/11/2017 - funds for Revised SOC

£391k paid elsewhere

Contractor Stage 3 Fee Summary and CE017 combined Cashflow CE017 Enabling Works

Page 6


Structural

8.01.07 Structural

Composite Concrete Metal Deck Upper Floor Level Layout SK004 WSP - 20/09/2017

Composite deck details SK005 WSP - 20/09/2017

Structural Level 00 General Arrangement HCH-WSP-00-00-DR-200101 WSP 02 20/04/2018

Structural Level 01 General Arrangement HCH-WSP-00-01-DR-S-200101 WSP 02 20/04/2018

Structural Level 02 General Arrangement HCH-WSP-00-02-DR-200101 WSP 02 20/04/2018

Structural Upper Roof Plan General Arrangement HCH-WSP-00-RF-DR-S-200101 WSP 02 20/04/2018

External Plant Compound HCH-WSP-DDN-S-002 WSP 02 03/05/2018

8.01.08 Civils

Proposed Drainage Layout Option 1 SK009-1 WSP - 20/09/2017

External Works Layout HCH-WSP-00-XX-DR-C-950101 WSP P01 08/05/2018

External Works Sections and Details HCH-WSP-00-XX-DR-C-950801 WSP P01 08/05/2018

Mechanical, Electrical and Public Health

8.01.09 MEP

WSP Services Strategy Report dated 170707 WSP 07/07/2017

WSP 17/08/2017

WSP Acoustic Technical Note WSP

Option 4 Roof Layout AR-AW-RF-PL-200-009 IBI - 04/09/2017

Option 4 Second iteration sketch - WSP Comments AR-AW-XX-SK-200-051 WSP - 04/09/2017

Option 4 Second iteration sketch - WSP Comments AR-AW-XX-SK-200-052 WSP - 04/09/2017

Existing Overhead Line, Underground Cable Survey ELEC-006Western Power

Distribution- 23/04/2018

Reflected Ceiling Plan - Ground Floor AR-AW-00-PL-332-001 IBI A 18/04/2018

Reflected Ceiling Plan - First Floor AR-AW-01-PL-332-002 IBI A 18/04/2018

Reflected Ceiling Plan - Roof Top Plan Level AR-AW-RF-PL-332-003 IBI - 18/04/2018

Ground Floor Security and Access Control Strategy AR-AW-00-PL-322-001 IBI - 23/04/2018

First Floor Security and Access Control Strategy AR-AW-00-PL-322-002 IBI - 23/04/2018

Second Floor Security and Access Control Strategy AR-AW-00-PL-322-003 IBI A 23/04/2018

Ground Floor Security and Access Control Strategy AR-AW-00-PL-322-001 IBI - 30/04/2018

First Floor Security and Access Control Strategy AR-AW-00-PL-322-002 IBI - 30/04/2018

8.01.10 MEP - Enabling Works

Mechanical Services Equipment Schedules 1184-WSP-AW-XX-SH-M-500001 WSP 13/04/2018

Electrical Services - Enabling Works Distribution Schematic 1184-WSP-AW-ZZ-DR-E-620901 WSP 01 17/04/2018

Mechanical Services - Enabling Works Heating Schematic 1184-WSP-AW-ZZ-DR-M-560902 WSP 01 17/04/2018

Electrical Services - Enabling Works Power Sheet 1 of 2 1184-WSP-AW-00-DR-E-620201 WSP 01 17/04/2018

Electrical Services - Enabling Works Power Sheet 2 of 2 1184-WSP-AW-XX-DR-E-620202 WSP 01 17/04/2018

Demolition and Enabling Works dated 16th April 2018 1184-WSP-AW-XX-SP-MEP-500101 WSP 01 17/04/2018

8.01.11 Fire

50346A / AR-IBI-SP-M61 IBI - 13/04/2018

AR-WB-ML-DT-572-001 IBI - 20/04/2018

AR-WB-ML-DT-572-002 IBI - 20/04/2018

Service Penetrations Through Fire Rated Floors AR-WB-ML-DT-572-003 IBI - 20/04/2018

NBS Specification Section: P12 Fire stopping systems 50346A / AR-IBI-SP-P12 IBI - 13/04/2018

Demolition of Hutted Admin Accommodation - Building Services Report

NBS Specification Section: M61 Intumescent coatings for fire protection of

steelwork

Service Penetrations Through Fire Rated Walls - Metal Stud Partitions

Service Penetrations Through Fire Rated Walls - Masonry Partitions

Page 7




2 x 24 Bed Ward (2 floors) Detailed Build up

04 September 2018

OPTION 1:

OUTLINE BUSINESS CASE COST FORM OB1 / Option 1

Trust/Provider Unit: Wye Valley NHS Trust

Scheme: 2 x 24 Bed Ward (2 floors)

Phase: N/A

CAPITAL COSTS SUMMARY

Cost Exc.VAT VAT VAT Recovery Cost Incl.VAT

£ £ £ £

1 Departmental Costs (from Form OB2) 8,180,477 1,636,095 -187,994 9,628,578

2 On-Costs ( from Form OB3)

( 26% of Departmental Cost) 2,161,901 432,380 -49,682 2,544,599

3 Works Cost Total (1+2) at 250 PUBSEC FP/VOP

(Tender Price Index Level 10,342,378 2,068,476 -237,676 12,173,177

1975 = 100 Level)

4 Provisional location adjustment (if applicable)

94 Herefordshire -620,543 -124,109 28,521 -716,130

5 Sub Total (3+4) 9,721,835 1,944,367 -209,155 11,457,047

6 Fees (d)

(15.73% of of sub total) 1,626,622 325,324 -325,324 1,626,622

7 Non-Works Costs (from Form OB4) (a) OTHER 222,374 44,475 0 266,849

(b) LAND SALES 0 excl 0 0

8 Equipment Cost (from Form OB2)

( 9% of Departmental Cost) 754,000 150,800 0 904,800

9 Planning Contingency (5% of 5+6+7(b)+8) 616,242 123,248 0 739,490

10 TOTAL (for approval purposes - excl. Op Bias) (5+6+7+8+9) 12,941,073 2,588,215 -534,480 14,994,808

11 Residual Optimism Bias 0.00% 0 0 0 0

12 TOTAL (for approval purposes - incl. Op Bias)) (10+11) 12,941,073 2,588,215 -534,480 14,994,808

13 Inflation Adjustments (2Q19 start on site) 258 414,114 82,823 -87,709 409,228

14 FORECAST OUTTURN BUSINESS CASE TOTAL (12+13) 13,355,187 2,671,037 -622,189 15,404,035

NOTES: The Fees at line 6 exclude OBC&FBC Fees separately funded

Proposed Start on Site: 2Q2019

Proposed Completion Date: 1Q2021

Cash Flow :

Year EFLOther

GovernmentPrivate

£

1 17/18 0 0 0 - 0

2 18/19 2,449 0 0 - 2,449

3 19/20 7,885 0 0 - 7,885

4 20/21 5,070 0 0 - 5,070

15,404 15,404

Form completed by: AECOM

Telephone No: (01235) 858400

Address: Avalon House, Marcham Road, Abingdon, Oxon OX14 1TZ

Date:

Authorised by: ..............................................

PROJECT DIRECTOR

04 September 2018

Source

(-6% of Works Cost)




Phase: N/A

CAPITAL COSTS: DEPARTMENTAL COSTS AND EQUIPMENT COSTS

Function Units/

Space

Requirements

Area m2 N/A/C Cost

Allowance

Equipment

Cost

£ £

1 N/A inc On-costs -

2 HBN 04-01 Adult in-patient facilities Ward Space 1,181 N 3,908,223 214,021

3

Circulation /

Communication /

Plant Space

1,556 4,272,254 281,979

4 Equipment 2,737 - inc above

5 2,737 N/A - 258,000

Equipment

Departmental Costs and Equipment Costs carried forward to OB1 2,737 8,180,477 754,000

Generally office equipment based on capped allowance, assuming proportion tranfered from existing facility to

supplement allowance.

Functional Content

Demolition of Existing Hutted Wards

Circulation, Communication and Plant

Space

IM&T




Phase: N/A

CAPITAL COSTS: ON-COSTS

Estimated

Cost (exc.

VAT)

Percentage of

Departmental Cost

%

1. Communications £

a. Space incl

b. Lifts 260,035 260,035

2. "External" Building Works

a. Drainage 136,899

b. Roads, paths, parking 140,106

c. Site layout, walls, fencing, gates 79,128

d. Builders work for engineering

services outside buildings 30,212 386,345

3. "External" Engineering Works

a. Steam, condensate, heating, hot

water and gas supply mains incl

b. Cold water mains and storage incl

c. Electricity mains, sub-stations,

stand-by generating plant incl

d. Calorifiers and associated plant incl

e. Miscellaneous services 32,548 32,548

4. Auxiliary Buildings 43,138 43,138

5. Other on-costs and abnormals

a. Building incl

b. Engineering 980,972

c. Demolition of Hutted Offices 458,863 1,439,836

Total on-costs to Summary OB1

2,161,901 26.43%


Telephone No: (01235) 858400


Date: 04-Sep-18




Phase: N/A

CAPITAL COSTS: FEES AND NON-WORKS COSTS

£Percentage of

Works Cost

%

1. Fees (including "in-house" resource costs)

a. Architects 363,963

b. Structural Engineers 105,721

c. Mechanical Engineers 228,675

d. Electrical Engineers inc above

e. Quantity Surveyors 90,980

f. Project Management/Employers Agent 166,000

g. Project Sponsorship

h. Legal Fees 11,500

i. NEC Supervisor inc PM

j. Others (specify)

- Sundry Fees

- Contingency 72,348

- Planning Consultant 16,000

- Fire Engineering 10,202

- Acoustics Consultant 28,114 15.73%

- Business Case Writer 70,724

- BREEAM Assessor 42,921

- Transport/Highways Consultant 10,000

- Ecology Consultant 7,054

- External Commisioning Manager 15,000

- External Design Review Consultant 15,000

- Mercia & Sodexo CN2279 120,150

- LifeCycle Costing 10,000

- Finance / VAT Advisor 20,000

- Principal Supply Chain Partner (PSCP) 150,794

k. In house Trust costs 50,000

L. PFI Administration & Change Control 21,476

Total Fees to Summary OB1 1,626,622 15.73%

£

2. Non-Works Costs

a. Land and property sales - fees -

b. Land purchase costs and associated legal fees -

c. Statutory and Local Authority charges Included above

d. Building Regulations and Planning Fees 24,482

e. Other (specify)

- Surveys 182,699

- Section 106 Agreement no allowance

- Section 278 works no allowance

- Artwork -

- Other 15,193

Non-Works Costs to Summary OB1 222,374


Telephone No: (01235) 858400


Date: 04-Sep-18




04 September 2018

OPTION 4:

3 x 24 Bed Ward (3 floors) Detailed Build up




Phase: N/A

CAPITAL COSTS SUMMARY

Cost Exc.VAT VAT VAT Recovery Cost Incl.VAT

£ £ £ £

1 Departmental Costs (from Form OB2) 11,273,208 2,254,642 -154,037 13,373,812

2 On-Costs ( from Form OB3)

( 19% of Departmental Cost) 2,137,390 427,478 -33,455 2,531,412

3 Works Cost Total (1+2) at 250 PUBSEC FP/VOP

(Tender Price Index Level 13,410,598 2,682,120 -187,493 15,905,225

1975 = 100 Level)

4 Provisional location adjustment (if applicable)

94 Herefordshire -804,636 -160,927 11,250 -954,313

5 Sub Total (3+4) 12,605,962 2,521,192 -176,243 14,950,911

6 Fees (d)

(14.74% of of sub total) 1,976,479 395,296 -395,296 1,976,479

7 Non-Works Costs (from Form OB4) (a) OTHER 423,874 84,775 0 508,649

(b) LAND SALES 0 excl 0 0

8 Equipment Cost (from Form OB2)

( 8% of Departmental Cost) 886,000 177,200 0 1,063,200

9 Planning Contingency (7.5% of 5+6+7(b)+8) 1,191,924 238,385 0 1,430,308

10 TOTAL (for approval purposes - excl. Op Bias) (5+6+7+8+9) 17,084,239 3,416,848 -571,539 19,929,547

11 Residual Optimism Bias 2% 357,061 71,412 0 428,473

12 TOTAL (for approval purposes - incl. Op Bias)) (10+11) 17,441,299 3,488,260 -571,539 20,358,020

13 Inflation Adjustments (2Q19 start on site) 258 558,122 111,624 -18,289 651,457

14 FORECAST OUTTURN BUSINESS CASE TOTAL (12+13) 17,999,421 3,599,884 -589,828 21,009,477

NOTES: The Fees at line 6 exclude OBC&FBC Fees separately funded

Proposed Start on Site: 2Q2019

Proposed Completion Date: 1Q2021

Cash Flow :

Year EFLOther

GovernmentPrivate

£

1 17/18 - - - - -

2 18/19 2,449,481 - - - 2,449,481

3 19/20 7,478,043 - - - 7,478,043

4 20/21 7,466,902 - - - 7,466,902

5 21/22 3,615,051 - - - 3,615,051

21,009,477 21,009,477


Telephone No: (01235) 858400


Date:

Authorised by: ..............................................

PROJECT DIRECTOR

Source

04 September 2018

(-6% of Works Cost)




Phase: N/A

CAPITAL COSTS: DEPARTMENTAL COSTS AND EQUIPMENT COSTS

Function Units/

Space

Requirements

Area m2 N/A/C Cost

Allowance

Equipment

Cost

£ £

1 N/A inc On-costs -

2 HBN 04-01 Adult in-patient facilities Ward Space 1,744 N 5,771,329 268,802

3

Circulation /

Communication /

Plant Space

2,058 5,501,879 317,198

4 Equipment 3,802 - inc above

5 3,802 N/A - 300,000

Equipment

Departmental Costs and Equipment Costs carried forward to OB1 3,802 11,273,208 886,000

Functional Content

Demolition of Existing Hutted Wards

Circulation, Communication and Plant

Space

IM&T

Generally office equipment based on capped allowance, assuming proportion tranfered from existing facility to

supplement allowance.




Phase: N/A

CAPITAL COSTS: ON-COSTS

Estimated

Cost (exc.

VAT)

Percentage of

Departmental Cost

%

1. Communications £

a. Space incl

b. Lifts 283,386 283,386

2. "External" Building Works

a. Drainage 136,899

b. Roads, paths, parking 299,681

c. Site layout, walls, fencing, gates 79,128

d. Builders work for engineering -

services outside buildings 14,898 530,605

3. "External" Engineering Works

a. Steam, condensate, heating, hot

water and gas supply mains incl

b. Cold water mains and storage incl

c. Electricity mains, sub-stations,

stand-by generating plant incl

d. Calorifiers and associated plant incl

e. Miscellaneous services incl -

4. Auxiliary Buildings 43,138 43,138

5. Other on-costs and abnormals

a. Building incl

b. Engineering 821,398

c. Demolition of Hutted Offices 458,863 1,280,261

Total on-costs to Summary OB1

2,137,390 26.13%


Telephone No: (01235) 858400


Date: 04-Sep-18




Phase: N/A

CAPITAL COSTS: FEES AND NON-WORKS COSTS

£Percentage of

Works Cost

%

1. Fees (including "in-house" resource costs)

a. Architects 284,149

b. Structural Engineers 63,485

c. Mechanical Engineers 130,634

d. Electrical Engineers inc above

e. Quantity Surveyors 162,420

f. Project Management/Employers Agent 286,363

g. Project Sponsorship

h. Legal Fees 11,500

i. NEC Supervisor inc PM above

j. Others (specify)

- Sundry Fees

- Contingency 111,669

- Planning Consultant 16,000

- Fire Engineering 16,702

- Acoustics Consultant 32,079 14.74%

- Business Case Writer 6,706

- BREEAM Assessor 50,578

- Transport/Highways Consultant 10,000

- Ecology Consultant 7,054

- External Commisioning Manager 15,000

- External Design Review Consultant 15,000

- Mercia and Sodexo CN2279 120,150

- LifeCycle Costing 10,000

- Finance / VAT Advisor 25,000

- Principal Supply Chain Partner (PSCP) 428,513

k. In house Trust costs 152,000

L. PFI Administration & Change Control 21,476

Total Fees to Summary OB1 1,976,479 14.74%

£

2. Non-Works Costs

a. Land and property sales - fees -

b. Land purchase costs and associated legal fees -

c. Statutory and Local Authority charges Included above

d. Building Regulations and Planning Fees 83,483

e. Other (specify)

- Surveys 192,699

- Section 106 Agreement no allowance

- Section 278 works no allowance

- Artwork -

- Other 147,692

Non-Works Costs to Summary OB1 423,874


Telephone No: (01235) 858400



Project: New Ward Scheme Client: Wye Valley NHS Trust Scheme: Option 4

Optimism Bias Allowance Calculation

Optimism Bias - Upper Bound Calculation for Build

Lowest % Upper Bound 13% Actual % Upper Bound for this project 19.0%

Mid % 40% Mitigation for this project % 11%

Upper % 80%

Actual % Upper Bound for this project 19.0% Actual % for this project 2.1%

Build complexity Scope of scheme

Choose 1 category X Choose 1 category X

Length of Build < 2 years X 0.50% 0.50% Facilities Management Hard FM only or no FM X 0.00% 0.00%

2 to 4 years 2.00% 0 Hard and soft FM 2.00% 0

Over 4 years 5.00% 0

Choose 1 category

Choose 1 category Equipment Group 1 & 2 only 0.50% 0

Number of phases 1 or 2 Phases X 0.50% 0.50% Major Medical equipment 1.50% 0

3 or 4 Phases 2.00% 0 All equipment included X 5.00% 5.00%

More than 4 Phases 5.00% 0

Choose 1 category

Choose 1 Category IT No IT implications X 0.00% 0.00%

Single site* X 2.00% 2.00% Infrastructure 1.50% 0

2 Site 2.00% 0 Infrastructure & systems 5.00% 0

More than 2 site 5.00% 0

* Single site means new build is on same site as existing facilities Choose more than 1 category if applicable

External Stakeholders 1 or 2 local NHS organisations X 1.00% 1.00%

Location 3 or more NHS organisations 4.00% 0

Universities/Private/Voluntary sector/Local

government 8.00% 0

Choose 1 Category

New site - Green field New build 3% 0 Service changes - relates to service delivery e.g NSF's

New site - Brown Field New Build 8% 0

Existing site New Build X 5% 5.00% Choose 1 category

or Stable environment, i.e. no change to service X 5% 5.00%

Existing site Less than 15% refurb 6% 0 Identified changes not quantified 10% 0

Existing site 15% - 50% refurb 10% 0 Longer time frame service changes 20% 0

Existing site Over 50% refurb 16% 0

8.00% Gateway

Choose 1 category

Place only X in each of the sections RPA Score Low X 0% 0.00%

Medium 2% 0

High 5% 0

11.00%

04 September 2018

Number of sites involved (i.e. before

and after change)


Project: New Ward Scheme Client: Wye Valley NHS Trust Scheme: Option 4

Optimism Bias Mitigation Factor Calculation

Optimism Bias Mitigation Factor Calculation

Contributory Factor to Upper Bound % Factor Contributes % Factor Contributes

after mitigation

Design complexity 4 0

Design Team capabilities 3 0.5

Client capability and capacity (NB do not double

count with design team capabilities)

6 1

Robustness of Output Specification 25 3

Agreement to output specification by stakeholders 5 1

New service or traditional 3 0

Local community consent 3 1

Stable policy environment 20 0

Likely competition in the market for the project 2 0

TOTAL 100 11.0

Other Regulatory 4 0

Progress with Planning Approval 4 1.5

Explanation for rate of mitigation

A new planning application is planned to be submitted during August 2018, which will result in 1 week to

register the application, followed by a 12 week planning period.

Non required

Whilst the design is of high quality this type and size of project and design has been undertaken before.

The design is not considerably complex, however, it is within the live operating environment of the

existing hospital. There is an element of hospital personelle that needed to be decant and have taken

occupancy elsewhere whitin the hospital site as well as rehousing the Emis Office and redeveloping the

Diabetes Office.

The standard P21+ NEC 3 Contract (Scheme for Multiple Projects) is currently in use for Stages 2 and 3

and unlikely to be changed for Stage 4.

Depth of surveying of site/ground information 3 0.5

Detail of design 4 1

Surveys have already been carried out when developing Option 1, 2 x 24 Bed Ward (2 floors). There

may be minimal requirements for additional surveys to be carried out for Option 4, 3 x 24 Bed Ward (3

floors).

RIBA Stage 4 design has been carried out for the 2 x 24 Bed Ward (2 floors) scheme but not yet sign-off.

The PSCP has been requested by Wye Valley NHS Trust ('the Trust') to commence design for the 3 x 24

Bed (3 floor) scheme.

Innovative project/design (i.e. has this type of

project/design been undertaken before)

3 0

Likely variations from Standard Contract 2 0

Involvement of Stakeholders, including Public and

Patient Involvement

5 1

Contractors’ capabilities (excluding design team

covered above)

2 0.5

Contractor Involvement 2 0

The Design Team engaged is IBI Group, who are a competent and specialist healthcare design team

appointed since inception of the Redevelopment Scheme in 2015 and therefore very familiar with this

project.

The PSCP contracted is Kier Group, who have also been engaged since inception in 2015 and have

substantial healthcare experience and familiar with this project.

The PSCP has been contracted to develop the Redevelopment Scheme for Stages 2, 3 and currently

working towards a GMP and Stage 4.

The Trust is the client's team in place with construction and in-house experience. The PFI Stakeholders

Mercia and Sodexo are also onboard and engaged with monthly progress meetings. The Trust will carry

out the NEC Project Manager and Supervisor. External advisors (legal, planning, etc) are appointed.

The development of RIBA Stage 4 information for all design disciplines is now underway for the 3 x 24

Bed Ward (3 floors/total 72 beds). This is a development of the 2 x 24 Bed Ward (2 floors) proposal with

the Trust confirming that the additional floor for the 72 bed scheme shall replicate the floor below

excluding Seminar, Interview and Staff Rest Rooms. The 1:200 layout drawings for the 2 x 24 bed

scheme where signed off by the Trust on 06/09/17 subject to Fire Officer comments and the 1:50 layout

drawings and associated C-Sheets were issued for final sign off on 15/08/18.

Planning approval for the 2 x 24 bed scheme has been granted.

The project is procured through the P21+ Framework and PSCP (Kier Group) have been appointed on a

NEC3 Contract (Sheme for Multiple Projects) executed on 14th July 2015.

Involvement of the following Stakeholders have been managed up to date; Trust Executive Team, Senior

Management Team, Clinical and Nursing Teams, Infection Prevention, Trust Fire Safety Manager, Trust

H&S Team, Patient Engagement Forum, Open Public Meeting, Letters and Newsletters to adjoining

neighbours, a stand at the Annual Public Meeting July 2018, Ward Councillor, L.A. Planners,

presentations to WVT Staff, Commissioners and Strategic Transformation Plan stakeholders (Accepted

as local STP bid).

Plans, Schedule of Accommodation, functional arrangement and adjacencies agreed/signed off by the

Operational Team and Project Board, including PFI partners. Schedule of derogations approved by

Director of Nursing (also DIPC) and Medical Director.

Traditional service

Full support has been expressed by members of the public, city and county and adjoining county wide,

during visits to public displays. There were no objections to the planning application for a 2 x 24 bed ward

block submitted on 23rd February 2018 and approved on 17th May 2018. A Planner has commented

that during a door to door visit of neighbours the only comments were based on ‘is it enough beds?’.

General support by Ward Councillor, Hereford City Council, Herefordshire Council, STP.

About AECOM AECOM (NYSE: ACM) is built to deliver a better world. We design, build, finance and operate infrastructure assets for governments, businesses and organizations in more than 150 countries. As a fully integrated firm, we connect knowledge and experience across our global network of experts to help clients solve their most complex challenges. From high-performance buildings and infrastructure, to resilient communities and environments, to stable and secure nations, our work is transformative, differentiated and vital. A Fortune 500 firm, AECOM companies had revenue of approximately US$19 billion during the 12 months ended June 30, 2015. See how we deliver what others can only imagine at aecom.com and @AECOM.

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Appendix 3.2

DCF Outputs

Net Present Values

Discounted at 3.5% Y1-30, 3.0% Y31-60

(Excluding VAT, inflation, depreciation and financing charges)

18/19 19/20 20/21 21/22 22/23

£000's TOTAL Y0 Y1 Y2 Y3 Y4 Y5 Y6 Y7 Y8 Y9 Y10 Y11 Y12 Y13 Y14 Y15 Y16 Y17 Y18 Y19 Y20 Y21 Y22 Y23 Y24 Y25 Y26 Y27 Y28 Y29 Y30 Y31 Y32 Y33

Option no.Discount Factor Undiscounted 1.000 0.966 0.934 0.902 0.871 0.842 0.814 0.786 0.759 0.734 0.709 0.685 0.662 0.639 0.618 0.597 0.577 0.557 0.538 0.520 0.503 0.486 0.469 0.453 0.438 0.423 0.409 0.395 0.382 0.369 0.356 0.346 0.336 0.326

1 Option 1 - 48 beds on 2 floors

Capital outlay (exc inflation and VAT) (12,941) (1,902) (6,433) (4,606)

Staffing cost increase (29,734) (212) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509)

Operational cost increase (19,920) (142) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341)

Lifecycle costs (from AECOM) (4,837) 0 0 0 0 (14) (14) (14) (10) (7) (15) (51) (70) (87) (76) (42) (89) (126) (166) (100) (77) (53) (146) (107) (132) (125) (131) (86) (73) (63) (49) (63)

Lifecycle savings from hutted wards 0

Utility cost (4,381) (31) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75)

Utilitiy cost of current hutted wards 1,110 8 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19

Total Cashflow (70,704) (1,902) (6,433) (4,984) (906) (906) (906) (906) (920) (920) (920) (916) (913) (921) (957) (976) (993) (982) (948) (995) (1,032) (1,072) (1,006) (983) (959) (1,052) (1,013) (1,038) (1,031) (1,037) (992) (979) (969) (955) (969)

PV (1,902) (6,215) (4,652) (817) (790) (763) (737) (723) (699) (675) (649) (625) (610) (612) (603) (593) (566) (528) (536) (537) (539) (488) (461) (435) (461) (429) (424) (407) (396) (366) (349) (335) (321) (316)

Net Present Value (35,640)

Annual Equivalent Cost (1,351)4 Option 4 - 72 beds on 3 floors

Capital outlay (exc inflation and VAT) (17,442) (1,902) (6,092) (6,083) (3,365)

Staffing cost increase (29,734) (212) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509)

Operational cost increase (25,411) (181) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435)

Lifecycle costs (from AECOM) (6,496) 0 0 0 0 (18) (18) (18) (14) (9) (21) (68) (94) (117) (102) (56) (120) (169) (223) (134) (104) (71) (197) (144) (177) (168) (176) (116) (98) (84) (65) (84)


Utility cost (6,601) (47) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113)

Utilitiy cost of current hutted wards 1,110 8 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19

Total Cashflow (84,575) (1,902) (6,092) (6,516) (4,403) (1,038) (1,038) (1,038) (1,056) (1,056) (1,056) (1,052) (1,047) (1,059) (1,106) (1,132) (1,155) (1,140) (1,094) (1,158) (1,207) (1,261) (1,172) (1,142) (1,109) (1,235) (1,182) (1,215) (1,206) (1,214) (1,154) (1,136) (1,122) (1,103) (1,122)

PV (1,902) (5,886) (6,082) (3,971) (905) (874) (844) (830) (802) (775) (746) (717) (701) (707) (699) (689) (657) (610) (623) (628) (634) (569) (536) (503) (541) (500) (497) (476) (463) (426) (405) (388) (370) (366)


Annual Equivalent Cost (1,646)

0 Do minimum/ baseline


Hired ward unit (249,591) (5,289) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286)

Total Cashflow (249,591) 0 0 0 (5,289) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286)

PV 0 0 0 (4,770) (3,735) (3,609) (3,487) (3,369) (3,255) (3,145) (3,038) (2,936) (2,836) (2,740) (2,648) (2,558) (2,472) (2,388) (2,307) (2,229) (2,154) (2,081) (2,011) (1,943) (1,877) (1,814) (1,752) (1,693) (1,636) (1,580) (1,527) (1,483) (1,439) (1,397)


Annual Equivalent Cost (3,849)

Net Present Values

Discounted at 3.5% Y1-30, 3.0% Y31-60

(Excluding VAT, inflation, depreciation and financing charges)

£000's

Discount Factor

Option 1 - 48 beds on 2 floors

Capital outlay (exc inflation and VAT)

Staffing cost increase

Operational cost increase

Lifecycle costs (from AECOM)

Lifecycle savings from hutted wards

Utility cost

Utilitiy cost of current hutted wards

Total Cashflow

PV

Net Present Value

Annual Equivalent CostOption 4 - 72 beds on 3 floors

Capital outlay (exc inflation and VAT)

Staffing cost increase

Operational cost increase

Lifecycle costs (from AECOM)


Utility cost

Utilitiy cost of current hutted wards

Total Cashflow

PV

Net Present Value

Annual Equivalent Cost

Do minimum/ baseline


Hired ward unit

Total Cashflow

PV

Net Present Value

Annual Equivalent Cost

Y34 Y35 Y36 Y37 Y38 Y39 Y40 Y41 Y42 Y43 Y44 Y45 Y46 Y47 Y48 Y49 Y50 Y51 Y52 Y53 Y54 Y55 Y56 Y57 Y58 Y59 Y60

0.317 0.307 0.298 0.290 0.281 0.273 0.265 0.257 0.250 0.243 0.236 0.229 0.222 0.216 0.209 0.203 0.197 0.192 0.186 0.181 0.175 0.170 0.165 0.160 0.156 0.151 0.147 26.375

(509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509)

(341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341) (341)

(87) (85) (126) (262) (291) (140) (93) (76) (106) (120) (119) (90) (156) (50) (16) (58) (153) (145) (114) (76) (55) (93) (133) (64) (48) (55) (40)

(75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75) (75)

19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19

(993) (991) (1,032) (1,168) (1,197) (1,046) (999) (982) (1,012) (1,026) (1,025) (996) (1,062) (956) (922) (964) (1,059) (1,051) (1,020) (982) (961) (999) (1,039) (970) (954) (961) (946)

(314) (305) (308) (338) (337) (286) (265) (253) (253) (249) (241) (228) (236) (206) (193) (196) (209) (201) (190) (177) (168) (170) (172) (156) (149) (145) (139)

(509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509) (509)

(435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435) (435)

(117) (114) (169) (352) (392) (188) (125) (103) (142) (161) (160) (120) (210) (67) (21) (77) (206) (195) (153) (102) (74) (125) (179) (86) (65) (74) (54)

(113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113) (113)

19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19

(1,155) (1,152) (1,207) (1,390) (1,430) (1,226) (1,163) (1,141) (1,180) (1,199) (1,198) (1,158) (1,248) (1,105) (1,059) (1,115) (1,244) (1,233) (1,191) (1,140) (1,112) (1,163) (1,217) (1,124) (1,103) (1,112) (1,092)

(366) (354) (360) (403) (402) (335) (308) (294) (295) (291) (282) (265) (277) (238) (222) (227) (245) (236) (221) (206) (195) (198) (201) (180) (172) (168) (160)

(4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286)

(4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286) (4,286)

(1,357) (1,317) (1,279) (1,242) (1,205) (1,170) (1,136) (1,103) (1,071) (1,040) (1,010) (980) (952) (924) (897) (871) (845) (821) (797) (774) (751) (729) (708) (687) (667) (648) (629)

Total

(EAC

Assumptions

Options appraisal

1. Common to all appraisals

i) Costs are exclusive of VAT, inflation, depreciation and financing costs

ii) Lifecycle costs represent the incremental change from the current baseline

* Option 0 - do nothing

i) Terminal failure of wards from21/22 resulting in need to hire 38 bedded ward

ii) 3 months of lost income in the first year whilst the hired units are established

iii) Soft FM and staffing remain the same as just transferring to the hired unit

Yr 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Option GIFA Total

Option 1 (2 x 24 Bed Wards) 2,737 £5,090,820 £0 £0 £0 £0 £13,527 £13,527 £13,527 £10,054 £6,741 £15,273 £50,619 £69,561 £86,878 £76,172 £41,702 £88,933 £125,778 £165,851 £99,548 £77,350 £52,798 £146,317 £107,128 £131,828 £124,824 £131,024 £86,181 £72,650 £62,645 £48,632 £62,532

VAT @ 20% £1,018,164 £0 £0 £0 £0 £2,705 £2,705 £2,705 £2,011 £1,348 £3,055 £10,124 £13,912 £17,376 £15,234 £8,340 £17,787 £25,156 £33,170 £19,910 £15,470 £10,560 £29,263 £21,426 £26,366 £24,965 £26,205 £17,236 £14,530 £12,529 £9,726 £12,506

Total £6,108,984 £0 £0 £0 £0 £16,232 £16,232 £16,232 £12,064 £8,089 £18,328 £60,742 £83,474 £104,254 £91,407 £50,042 £106,719 £150,933 £199,021 £119,457 £92,820 £63,357 £175,581 £128,553 £158,194 £149,789 £157,228 £103,417 £87,180 £75,174 £58,359 £75,038

Yr 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Option GIFA Total

Option 4 - (3 x 24 Bed Wards) 3,802 £6,843,600 £0 £0 £0 £0 £18,184 £18,184 £18,184 £13,515 £9,062 £20,532 £68,047 £93,511 £116,791 £102,399 £56,060 £119,552 £169,083 £222,954 £133,822 £103,982 £70,976 £196,695 £144,012 £177,217 £167,801 £176,135 £115,853 £97,663 £84,214 £65,376 £84,061

VAT @ 20% £1,368,720 £0 £0 £0 £0 £3,637 £3,637 £3,637 £2,703 £1,812 £4,106 £13,609 £18,702 £23,358 £20,480 £11,212 £23,910 £33,817 £44,591 £26,764 £20,796 £14,195 £39,339 £28,802 £35,443 £33,560 £35,227 £23,171 £19,533 £16,843 £13,075 £16,812

Total £8,212,320 £0 £0 £0 £0 £21,821 £21,821 £21,821 £16,218 £10,874 £24,638 £81,656 £112,214 £140,149 £122,878 £67,272 £143,463 £202,900 £267,544 £160,587 £124,778 £85,171 £236,034 £172,815 £212,660 £201,362 £211,362 £139,024 £117,196 £101,057 £78,452 £100,874

Notes

1. All costs are base date Q3 2018 and net of Inflation

Option

Option 1 (2 x 24 Bed Wards)

Option

Option 4 - (3 x 24 Bed Wards)

Notes

1. All costs are base date Q3 2018 and net of Inflation

32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60

£87,305 £84,890 £125,512 £262,019 £291,304 £139,644 £92,681 £76,258 £105,953 £119,902 £119,091 £89,636 £156,175 £49,579 £15,924 £57,523 £153,091 £145,112 £113,766 £75,886 £55,179 £92,664 £133,230 £63,731 £48,342 £54,929 £40,347 £127,629 £131,921

£17,461 £16,978 £25,102 £52,404 £58,261 £27,929 £18,536 £15,252 £21,191 £23,980 £23,818 £17,927 £31,235 £9,916 £3,185 £11,505 £30,618 £29,022 £22,753 £15,177 £11,036 £18,533 £26,646 £12,746 £9,668 £10,986 £8,069 £25,526 £26,384

£104,766 £101,867 £150,615 £314,423 £349,564 £167,572 £111,217 £91,510 £127,143 £143,882 £142,909 £107,563 £187,410 £59,495 £19,109 £69,028 £183,709 £174,134 £136,520 £91,063 £66,215 £111,197 £159,876 £76,478 £58,011 £65,915 £48,416 £153,155 £158,305

32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60

£117,364 £114,117 £168,726 £352,233 £391,600 £187,723 £124,591 £102,514 £142,432 £161,184 £160,094 £120,498 £209,947 £66,650 £21,407 £77,328 £205,800 £195,074 £152,936 £102,013 £74,177 £124,568 £179,102 £85,674 £64,987 £73,841 £54,238 £171,572 £177,342

£23,473 £22,823 £33,745 £70,447 £78,320 £37,545 £24,918 £20,503 £28,486 £32,237 £32,019 £24,100 £41,989 £13,330 £4,281 £15,466 £41,160 £39,015 £30,587 £20,403 £14,835 £24,914 £35,820 £17,135 £12,997 £14,768 £10,848 £34,314 £35,468

£140,837 £136,941 £202,472 £422,679 £469,920 £225,268 £149,509 £123,017 £170,919 £193,421 £192,113 £144,597 £251,936 £79,980 £25,688 £92,794 £246,960 £234,089 £183,524 £122,416 £89,013 £149,482 £214,922 £102,809 £77,984 £88,609 £65,086 £205,886 £212,810


Appendix 4.1

Trust Furniture, Equipment & IM&T Strategy

Drafted by GV/ Draft 2 Reflecting DW Comments

Estate Strategy Phase 3

Replacement Wards

Furniture, Equipment and IM&T Strategy (Version 1)

Introduction and Context

Furniture and Equipment is required for the new wards replacing Monnow and

Leadon.

This strategy recognises the requirement for:

• Furniture, Fixtures and Equipment required for an inpatient ward.

• IT equipment (processors, screens and printers) on a like for like basis.

Therefore, with the exception of ‘Pullprint’ it is planned to transfer all

existing IT equipment through the services of Hoople exceptions being any

equipment being replaced by the rolling IT replacement programme.

• Efficient use of space and safe, flexible and ergonomic workplaces.

• Cost benefit analysis of replacement compared to transfer.

Effective strategic management of F, F & E encompasses many facets

including:

• Management and operational responsibilities

• Acquisition

• Maintenance

• Standardisation

• Training

• Safety and risk management

• Record keeping and inventory management

• Lifecycle/Replacement Programme

• Disposal

The Equipment Strategy sets out the key principles and framework which will be

critical to fitting out Phase 3 efficiently with flexibility and provides a platform for

continued asset management.

Typically, the benefit of selecting appropriate sized, shaped and coloured items is

crucial to the efficient use of space and creation of a clinically efficient, effective

ergonomic and safe environment.


IM&T

• Network infrastructure will be delivered to the standard of performance,

capacity and resilience necessary to support the Trust’s IM&T strategy

including EPR.

• Network wiring closets/hub rooms will be located so that a distance of no

more than 90-metres shall exist to any point in the building.

• Cableways and wiring closets shall be no more than 50% utilised to allow for

future expansion and upgrades.

• Consideration shall be given to the capacity of existing services on the site,

such as server storage.

• New active network equipment shall be provided to avoid the need to

decommission existing areas to free-up equipment.

• Telephone handsets, faxes and numbers will be transferred and augmented by

recycled stock where possible.

• IT equipment, telephones and Faxes will be surveyed as part of an operational

commissioning plan. Items that are defined as not suitable for transfer will be

replaced.

• Computer equipment to be Transferred will be prepared for moving by Hoople

(Trusts IT Provider), transported by appropriately qualified contractors and

then re-assembled and re-connected by Hoople. Hoople to be given adequate

notice of moves. Where risks assessments demonstrate double running is

required so as not to compromise clinical practice/patient safety additional

equipment will be provided for the short period of decant.

• Additional Computer equipment will be provided either new through the IT

procurement and commissioning process or recycled in a controlled process if

available.

• Wireless enabled equipment will be supported by a new Access Point

installation.

• Shared document centres such as Pullprint will be included in line with the

Trusts centralised printing initiative.

• Wherever possible, IM&T infrastructure will be specified to cover likely

future as well as known immediate requirements – future-proofing.


• The existing ICT server room in Fred Bulmer is to be retained and maintained

as a going concern. Additional server room capacity for resilience will be

leased off-site (e.g. from Herefordshire Council at Plough Lane)

Procurement

• NHS procurement practice will be managed by the trusts procurement for

Group 2 and 3 items (Fixed by contractor and lose items respectively)

• Procurement of Group 1 items (Supply and fixed by the contractor) by P21+

contractor utilising NHS frameworks where possible and economically

beneficial.

• Continual monitoring of forecast costs will be carried out and reported to the

Programme Board.

Specification and Product Selection

• Specifications and product selection will carried out by a team representing

Lead Users, Procurement, IM&T, Design, H&S, Estates and Infection

Prevention as may be necessary. Selection will consider national guidance,

local preferences, future flexibility and foreseeable changes in

technology/processes.

• Existing FF&E will be surveyed and items of acceptable condition and

suitable for the safe and efficient use of the new facility will be identified,

recorded, labelled and transferred.

• All will be aligned to an operational commissioning programme including:

Delivery Date, Delivery Address, Accepting, Checking, Technical

Commissioning/Setting up and Assembly.

Delivery

Delivery requirements will be planned and notified to suppliers at the earliest possible

time during procurement.

Acceptance, Testing and Assembly

Accepting, checking, technical commissioning/setting up and assembly will be carried

out by various parties including, Contractor, Trust, Hoople and Sodexo. Each parties

responsibility and liability will be established to ensure all risks are identified,

managed and mitigated. New electrical equipment will be checked visually for


damage and reported as required and transferred equipment will be PAT tested in new

location.

Lifecycle

Active components and serviceable equipment will be scheduled and the relevant

parties notified of the items for which they will be responsible. Maintenance of IT

and active components will be via the IT provider and or lease companies as per the

Trusts contracts. Reactive repairs to furniture will be through the Sodexo Helpdesk.

Cleaning

All FF&E will be cleaned prior to the area becoming operational.

Disposal and Waste Management

• The disposal of redundant items will be via:

• Dispersal sales/Agent managed by Estates.

• Recycling

• Breaking for spares

• Transferred as waste

All IT equipment will be disposed of by Hoople including removal of all data etc.

Replacement Wards (3 x 24 Beds) DRAFT EQUIPMENT LIST for costing

Ref on Drawings Room Trust Ref Supplier Transfer

QTY on

Plan

QTY to

Order Comments

ART001

ART, wall mounted artwork. Trust 0 26 26

BED013

BED Kings Fund; variable height; two-way tilt; adjustable backrest; bedstripper; on castors Trust 38 69 31

BED BARI

Bariatric Bed variable height; two-way tilt; adjustable backrest; bedstripper; on castors Trust 0 3 3

BED ALARM

Bed fall alarm Trust 0 30 30

BIN900

BIN; waste paper Trust 0 15 15

BOA006

BOARD; marker; whiteboard; dry-wipe; with pen holder; wall mounted; 1200H1800W Trust 0 3 3

BOA013

BOARD; display/notice; wall mounted; 900H 1200W Trust 0 9 9

BOA017

BOARD; display/notice; magnetic; wall mounted; 1200H 1200W Trust 0 3 3

BOA022

BOARD; display/notice; magnetic; wall mounted; 900H 600W Trust 0 5 5

BOA034

BOARD; marker; whiteboard; dry-wipe; with pen holder; wall mounted; 600H 900W Trust 0 2 2

BOA037

BOARD; marker; whiteboard; dry-wipe; with pen holder; wall mounted; 900H 1200W Trust 0 8 8

BOO005

BOOKCASE; 2 shelves; open; 1230H 800W 310D Trust 0 6 6

BRA003

BRACKET; holder; suction unit; wall mounted Trust 0 84 84

BRA015

BRACKET; flat panel monitor; height adjustable; wall mounted Trust 0 9 9

CAB025

CABINET; filing; 4 drawer; 1320H 465W 620D Trust 0 4 4

CAB047

CABINET; urine test; lockable; wall mounted; 550H 600W 300D Trust 0 3 3

CAB062

CABINET; drugs; self dispensing medication; lockable; wall mounted; 515H 410W 155D Isol lobby Trust 0 3 3

CAB064

CABINET; metal; controlled drugs; 1 door; lockable; with warning light; wall mounted; 550H 600W 300D Clean Util Trust 0 3 3

CABINET; metal; drugs; 1 door; wall mounted; 800H 500W 300D Clean Util Trust 0 3 3

CABINET; metal; drugs; 1 door; wall mounted; 900H 500W 300D Clean Util Trust 0 6 6

CABINET; metal; drugs; 1 door; floor standing on plinth; 900H 1000W 550D Clean Util Trust 0 3 3

CHA301

CHAIR; swivel; height adjustable; high back; with arms; wipeable; 5 star base; on castors Trust 0 36 36

CHA304

CHAIR; swivel; height adjustable; medium back; wipeable; 5 star base; on glides Trust 0 3 3

CHA307 AlarmedCHAIR; easy; high back; with open arms; upholstered; wipeable With Fall alarm Trust 0 36 36

Draft 2

CHA307

CHAIR; easy; high back; with open arms; upholstered; wipeable Trust 13 33 20

CHA307-A

CHAIR; easy; high back; with open arms; upholstered; wipeable (Dementia) Trust 0 3 3

CHA317

CHAIR; upright; upholstered; stacking; wipeable Trust 0 118 118

CHA383

CHAIR; stacking; polypropylene; with back and seat pads; wipeable. Trust 0 27 27

CLO001

CLOCK battery; wall mounted Staff areas Trust 0 15 15

CLO904

CLOCK, Day/ Night, (dementia design), Dementia Bedrooms Trust 0 36 36

COM031

COMPUTER CPU Trust 16 33 17

COM033

COMPUTER KEYBOARD Trust 6 30 24

COM049

COMPUTER MONITOR; 17; TFT; digital flat panel display; high-resolution screens; desk top 22" ONLY £106.00 Trust 6 30 24

COUCH; examination/treatment; (3 section); variable height; retractable wheels; with paper roll holder Trust 0 3 3

CUP907

Key Cupboard; 50 Keys Trust 0 3 3

CUR900

CURTAIN; weighted shower 2 sets to be provided 0 36 36

Fabric CurtainsWindows: 26No. Windows 2 sets = 52 windows to be provided with labels Various Trust 0 3 3Observation Panels: 32 No pairs or singles 2 sets = 64 to be provided with labels Bedrooms Trust 0 3 3Cubicle Track (Sets) 32 No. L Shapes 2 sets to be provided 2 sets to be provided with labels Multi Beds Trust 0 3 3Room Divider (Sets) 2no 2 sets to be provided with labels Treatment Trust 0 3 3

DES026

DESK UNIT; cantilever; cable management; adjustable legs; modesty panel; 1400W 700D Trust 0 6 6

DIS002

DISPENSER; cooler; drinking water; (fountain); (capacity 63.3 l/hr); floor standing Trust 0 3 3

DIS004

DISPENSER; disposable bedpans; wall mounted Trust 0 6 6

DIS012

DISPENSER; disposable cup; wall mounted Trust 0 3 3

DIS016

DISPENSER; paper sheet (for couch/trolley); wall mounted Trust 0 3 3

DIS026

DISPENSER; Medical hand sanitizer; lever action; wall mounted Trust 0 43 43

DIS027

DISPENSER; Medical hand moisturiser; lever action; wall mounted Trust 0 12 12

DIS028

Hand Sanitizer, Mobile Trust 30 72 42

DIS064-A

DISPENSER; wipes; Wall mounted Trust 0 65 65

DIS438

DISPENSER; disposable gloves set of 3 and disposable apron; wall mounted Trust 0 38 38

DRA056

DRAWER UNIT; 2 drawer; lockable; on castors; 600H 410W 600D Trust 0 6 6

ECS015

ENTERTAINMENT/COMMUNICATION SYSTEM; bedside; adjustable arm. HOSPEDIA System. Trust 0 1 1

EVA900

Fire Evacuation Blanket Trust 0 72 72

HOL020

HOLDER; sharps box; up to 7 litre capacity; rail/trolley hang or wall mounted; 170H 125W 100D Trust 0 3 3

HOL021

CLIPBOARD HOLDER, A4 size, with A4 clipboard with pen attachment, wall mounted Trust 0 9 9

HOL022

BED FILE HOLDER, polycarbonate, wall mounted. Trust 0 72 72

HOL023

SUGGESTION BOX, polycarbonate, wall mounted. Trust 0 3 3

HOL901

Sharps Bin, Counter top Trust 0 3 3

LOC004

LOCKER; bedside; as specified by Pharmacy and current WVT style Trust 0 72 72

LOC012

LOCKER; wall mounted; 340H 300W 300D Trust 0 3 3

LOC019

LOCKER; 6 compartments; 1800H 300W 450D Trust 0 21 21

OUT900

Oxygen flow meter Trust 38 84 46

OUT901

Air flow meter Trust 38 84 46

OUT902

Suction connection valve; tube and bottle Trust 38 84 46

OVE013

OVEN; microwave; heavy duty; 1600watt; capacity 26 litre; 370H 465W 560D Trust 2 3 1

PPE901

Bodily Fluids Spill Kit Trust 0 3 3

PRI010

PRINTER multifunction; network; floor standing Trust 3 3

PRO026

PROJECTOR; multi-media; ceiling mounted Trust 0 1 1

RAC062

RACK; gas cylinder; holds 2 cylinders 670 long with diameter 180-270mm; wall mounted; 1000H 550W 350D Trust 0 3 3

RAC409

RACK; metal; 1 bay; 4 shelves; 1980H 1200W 450D Trust 0 18 18

RAC416

RACK, metal, 1 bay, 4 shelves, 1980H 900W 300D Trust 0 3 3

RAC440

RACK; leaflet; wall mounted; 915H 250W 105D Trust 0 3 3

RAC901

RACK, metal, 1 bay, 4 shelves, 1980H 700W 300D Trust 0 5 5

REF059REFRIGERATOR; medical (drug/vaccine); capacity 160 litre; external temperature gauge; automatic defrost; lockable;

underbench; 850H 550W 620D Trust 0 3 3REF Large Drugs

REFRIGERATOR; medical (drug/vaccine); capacity 285 litre; external temperature gauge; automatic defrost; lockable;

underbench; 1430H 600W 620D Trust 1 6 5

SHE127

SHELF BOOK UNIT; 5 shelves; single sided; open; freestanding; 2000H 800W 250D Trust 0 4 4

SIG901

Sign ’Danger very hot water’ Trust 0 3 3

SMT002TROLLEY; modular storage; single open frame; including handle and worktop; with up to 5 sets of runners for 600 facing

inserts; 850H 730W 450D Treat'room Trust 0 3 3

STA142

STAND; infusion; twin hook; breaks; mobile Trust 0 3 3

STO006

STOOL; surgeon/anaesthetist; height adjustable; includes anti-static seat pads Trust 0 3 3

STO008

STOOL; kick; retractable castors Store Trust 0 3 3

STO023

STOOL; laboratory; complete with footring Clean Util Trust 0 3 3

TAB028

TABLE; circular; 710H 900mm dia. Multi Beds Trust 0 12 12

TAB053

TABLE; occasional; square; 415H 610W 610D Staff rest Trust 0 2 2

TAB073

TABLE; overbed; cantilevered Trust 20 72 52

TAB900

Table; meeting 1500W 800D Trust 0 3 3

TEL903

TELEPHONE; wall mounted Trust 0 3 3

TEL CORDLESS

Cordless telephone with 1 handset Trust 0 6 6

TEL DESK

Desk telephone Trust 4 30 26

TOA003

TOASTER; automatic; electric; 2 slices; model 60 slices per hour; 1.25kW loading Trust 0 3 3

TRO025

TROLLEY cleaners; double bucket; mop wringers; unit including wide mop; 1250H 350W 104L Cleaner Trust 2 3 1

TRO068

TROLLEY; cleaners; mop bucket; 3 shelves tray and waste sack holder; 980H 1170W 550D Cleaner Trust 2 4 2

TRO070

TROLLEY; for single cylinder; type F or G; 1155H 510W 105D Trust 2 3 1

TRO131

TROLLEY; dressing/instrument; stainless steel; buffered; 870H 450W 450D Treat'room Trust 0 3 3

TRO133

TROLLEY; dressing/instrument; stainless steel; buffered; 870H 750W 450D Treat'room Trust 0 3 3

TRO181

TROLLEY; general purpose; 3 tier; buffered; 950H 890W 590D Pantry Trust 0 3 3

TRO183

TROLLEY; general purpose; 2 stainless steel shelves; 940H 970W 540D Cleaner Trust 0 3 3

TRO235

TROLLEY; contaminated linen; single ring; stainless steel Trust 0 3 3

TRO252

TROLLEY; medical records/case notes; 2 x tier; 975H 900W 380D Trust 2 9 7

TRO310

TROLLEY; emergency/resuscitation; complete with defibrillator; 955H 825W 575D Trust 2 6 4

TRO397

TROLLEY; accommodates complete computer equipment; height adjustable 720-870mm and paper shelf; 870H 620W 840D Large 4 beds Trust 0 3 3

TRO900

TROLLEY, drugs dispensing, lockable. Trust 2 9 7

TRO910

Linen cage 1800H 800W 800D Trust 0 3 3

TVM003

TELEVISION monitor; colour; flat panel; large; wall mounted Trust 6 9 3

Grand Total 268 1787 1519


Appendix 4.2

Preferred Option Designs

Extent of Hospital Street to Existing

Ward EntranceStaff Only

G-23Single Bed(DementiaFriendly)

G-22En Suite

(DementiaFriendly)

G-21Single Bed ACC

G-20En Suite ACC

G-43FT

G-18En Suite

G-19Single Bed (With

Hoist)

G-17En Suite

G-16Single Bed

G-24Single Bed (with

hoist)

G-25En Suite

G-26Staff Base

G-41Dirty Utility

G-13En Suite

G-12Single Bed

G-15MH

G-14RT

G-274 Bed Bay

G-114 Bed Bay

G-66Staff & MDT

Base

G-28En Suite

G-29Assisted En Suite

G-30Treatment Room

G-59IPS G-42

Clean Utility

G-10Pantry G-08

En Suite

G-07En Suite

G-09Linen Store

G-31Large 4 Bed Bay

G-55LV A

G-49LV B

G-064 Bed Bay

G-48General Store

G-61LC

G-60Staff Cloaks

G-57Riser

G-46Medical Gas

Manifold

G-33Disp Hold

G-38Cleaner

G-35Staff WC

G-39Clinicians Office

G-05Clinicians Office

G-04En Suite

G-03Single Bed (With

Hoist)

G-37Acc WC

G-36Wait/ FT

G-02Isolation Bed

G-34Isolation Lobby

G-01En Suite

G-63RiserG-32

Reception

G-54Stair 2

G-50Hospital Street

G-50Hospital Street

G-51Stair 1 (Lev. G

Landing)

G-53Lift 2

G-52Lift 1

G-47C W Tank/Pump

E-01Sprinkler Tank &

Pump Set

E-02LOX Tanks

E-03Generator

E-04Fuel Storage

Notes:

PAS 1192 Status Code

Drawing Title

Project

Date Created

Drawing Number Revision

Job Number

Purpose

North Sign / Key Plan

The following external model files are included within this drawing:

Client

www.ibigroup.com

IntelligenceBuildingsInfrastructure

100mm0mm

▪ This drawing is copyright.▪ Do not scale dimensions from this drawing.▪ This drawing is to be read in conjunction with all other relevant drawings.▪ All discrepancies on this drawing are to be reported to the architect.▪ Do not modify any element of this drawing.▪ Use drawing only for purpose(s) issued.

Scale@A1

1 : 100

General Arrangement PlanGround Floor

50346A 17/08/2018

Hereford County Hospital - Replacement WardsDevelopment

S2

Wye Valley NHS Trust /Kier Construction

Issued for Information

AR-WB-00-PL-250-104

Rev Date Revision Notes Drawn Review

0 1m 5m3m

Scale: 1:100

N

Drawing superseeds AR-WB-00-PL-250-101, whichwas previously submitted to planning on the 21/02/18as part of application P180679/F.

1-01En Suite

1-02Single Bed

1-03Single Bed (With

Hoist)

1-04En Suite

1-05Clean Utility

1-064 Bed Bay

1-07En Suite

1-08En Suite

1-10Pantry

1-09Linen Store

1-114 Bed Bay

1-12Single Bed

1-13En Suite

1-14RT

1-15MH

1-16Single Bed

1-17En Suite


Hoist)1-18

En Suite1-20

En Suite ACC

1-21Single Bed ACC

1-22En Suite

(DementiaFriendly)

1-23Single Bed(DementiaFriendly)


Hoist)

1-25En Suite 1-26

Staff Base

1-274 Bed Bay

1-28En Suite

1-29Assisted En Suite

1-30Treatment Room

1-31Large 4 Bed Bay

1-32Staff Rest

1-33Staff Cloaks

1-34Disp Hold

1-36MDT

1-37Staff WC

1-38Wait/ FT

1-39Acc WC

1-40Cleaner

1-41Clinicians Office


1-43Dirty Utility

1-44General Store

1-46LV B

1-47Corridor 2

1-48Corridor 1

1-49FT

1-50Riser

1-51LV A

1-53Hospital Street

1-55Lift 1

1-56Lift 2

1-60Mech Riser

1-58IPS

1-59Riser

Ward EntranceStaff Only

1-66Store

1-64Reception

1-62LC

1-63Riser

1-69Seminar Room

1-53Hospital Street

1-52Hospital Street

1-65Stair 2

1-54Hospital Street

(Lift Lobby)

1-57Stair 1 (Lev. 1

Landing)

1-67Circulation Lobby

1-68Interview Room

Notes:


Drawing Title

Project

Date Created


Job Number

Purpose



Client

www.ibigroup.com


100mm0mm


Scale@A1

1 : 100

General Arrangement PlanFirst Floor

50346A 17/08/18


S2



AR-WB-01-PL-250-105


0 1m 5m3m

Scale: 1:100

N

Drawing superseeds AR-WB-00-PL-250-102, whichwas previously submitted to planning on the 21/02/18as part of application P180679/F.

2-64Reception

2-53Hospital Street


2-65Stair 2

2-37Staff WC2-34

Disp Hold

2-40Cleaner

2-26Staff Base

2-44General Store

2-62LC

2-33Staff Cloaks

2-30Treatment Room

2-47Corridor 2

2-31Large 4 Bed Bay

2-29Assisted En Suite

2-50Riser

2-58Riser

2-28En Suite

2-274 Bed Bay

2-14RT

2-15MH

2-25En Suite


Hoist)

2-23Single Bed(DementiaFriendly)

2-22En Suite

(DementiaFriendly)

2-21Single Bed ACC

2-49FT

2-20En Suite ACC

2-18En Suite

2-19Single Bed (with

hoist)

2-17En Suite

2-16Single Bed

2-48Corridor 1

2-12Single Bed2-13

En Suite

2-43Dirty Utility

2-36MDT

2-05Clean Utility

2-51LVA

2-46LVB

2-60Mech Riser

2-114 Bed Bay

2-39Acc WC

2-10Pantry

2-08En Suite

2-09Linen Store 2-07

En Suite

2-064 Bed Bay

2-41Clinicians Office 2-04

En Suite


Hoist)

2-02Single Bed

2-38Wait/ FT

2-01En Suite

2-66Store

2-63Riser

2-54Hospital Street

(Lift Lobby)

2-57Stair 1 (Lev. 2

Landing)

2-59Riser

2-55Lift 1

2-56Lift 2

2-52Hospital Street

Notes:


Drawing Title

Project

Date Created


Job Number

Purpose



Client

www.ibigroup.com


100mm0mm


Scale@A1

1 : 100

General Arrangement PlanSecond Floor

50346A 17/08/18


S2



AR-WB-02-PL-250-106


0 1m 5m3m

Scale: 1:100

N

02-07IT HubRoom

02-06UPS Room

02-05LV SwitchRoom A

02-03Bolier Plant

02-02Boiler &

HWS PlantRoom

02-01RF Plant

Room

02-08RF PlantLobby 1

02-09Lift Lobby

02-10RF PlantLobby 2

02-11Stair 2 (L2)

02-12Medical Air

Plant

RF-01Lift

Notes:


Drawing Title

Project

Date Created


Job Number

Purpose



Client

www.ibigroup.com


100mm0mm


Scale@A1

1 : 100

General Arrangement PlanThird Floor

50346A 17/08/18


S2



AR-WB-03-PL-250-107


0 1m 5m3m

Scale: 1:100

N


Appendix 4.3

Schedules of Accommodation & Derogations Schedule

Rev: 03 (29/08/2018)

Revised to suit GMP2 (additional ward floor) requirements.

Activity Space Source Space m² Qty Total m2 Designed

Size m²

Remarks Rev

Clinical Spaces

Single Bedroom Existing PFI 11.0 7.0 77.0 82.2 1no. To be an isolation room

Single Bedroom: disbaled use Existing PFI 12.0 1.0 12.0 12.0

Shower room: en-suite Existing PFI 4.0 7.0 28.0 28.3 1no. Slightly larger due to internal planning/layout

Shower room: en-suite: disabled use Existing PFI 6.0 1.0 6.0 5.8

Multi-bed room: 4 beds HBN 04-01 64.0 1.0 64.0 60.0 min PFI allowance for larger ward

Multi-bed room: 4 beds Existing PFI 40.0 3.0 120.0 124.5

Shower room: assisted: in-patient Existing PFI 7.0 4.0 28.0 27.0

WC: semi ambulant: in-patient HBN 04-01 2.0 0.0 0.0 Omitted as existing PFI

Bathroom: assisted HBN 04-01 15.0 0.0 0.0 Omitted as existing PFI

Isolation Lobby HBN 04-01 0.0 0.0 0.0 7.4

Support Facilities

Office/meeting room:10 places (incl. 2 workstations) HBN 04-01 16.0 1.0 16.0 Omitted as existing PFI

Touchdown base HBN 04-01 2.0 12.0 24.0 Omitted as existing PFI

Clinician's office Existing PFI 8.0 1.0 8.0 10.0 Added as existing PFI

Clinician's office Existing PFI 9.0 1.0 9.0 9.0 Added as existing PFI

Staff base Existing PFI 10.0 1.0 10.0 7.7 Added as existing PFI

Staff base Existing PFI 10.0 1.0 10.0 0.0

Staff base Trust brief 8.0 1.0 8.0 20.6 Central with MDT Space

MDT Space Trust brief 0.0 1.0 0.0 0.0 Added to central space with staff bases. Trust request 31.08.17

Treatment Room: double side couch access HBN 04-01 16.0 1.0 16.0 15.8

Interview Room: 4 place (incl. 1 wheelchair place) HBN 04-01 8.0 0.0 0.0 Omitted as existing PFI

Breakout space: patients Existing PFI 6.0 0.0 0.0 Omitted as existing PFI

Ward pantry Existing PFI 6.0 1.0 6.0 10.3

Parking bay for resuscitation equipment Existing PFI 1.0 1.0 1.0 1.7

Parking bay food trolley HBN 04-01 2.0 1.0 2.0 1.6 Second space for FT in waiting area

Parking bay for mobile hoist HBN 04-01 2.0 1.0 2.0 2.2

Ward storage allowance HBN 04-01 0.75 24.0 18.0 Omitted as existing PFI

Medicine store/preparation area HBN 04-01 8.0 0.0 0.0 Clean utility as alternative - omitted as existing PFI

Linen store Existing PFI 4.00 1.0 4.0 2.9 Added as existing PFI

General store Existing PFI 8.50 1.0 8.5 18.0 Added as existing PFI

Dirty utility room for bedpan processing Existing PFI 9.0 1.0 9.0 13.2 Number reduced as existing PFI (HBN 04-01: 1 per 12 beds)

Cleaners' room Existing PFI 10.0 1.0 10.0 7.7

Staff Spaces

Locker bay: 12 small lockers HBN 04-01 1.5 4.0 6.0 Omitted as existing PFI

Staff cloaks Existing PFI 5.0 1.0 5.0 5.6 Added as existing PFI

WC: ambulant HBN 04-01 2.0 1.0 2.0 Omitted as existing PFI

WC: ambulant Existing PFI 3.0 1.0 3.0 2.4 Added as existing PFI

Staff rest and mini kitchen HBN 04-01 1.8 6.0 10.8 Omitted as existing PFI

Seminar room: 24 place (including 1 wheelchair) HBN 04-01 32.0 0.4 12.8 0.0 omitted as User/WVT comments on First Floor only

Communal changing area HBN 04-01 1.4 36.0 50.4 Omitted as existing PFI

Store cupboard 0.0 Omitted

Essential Complimentary Accommodation

Reception HBN 04-01 5.5 1.0 5.5 7.0 Added back in.

Waiting area HBN 04-01 1.7 2.0 3.4 45.8 Trust brief - 1 per 2 wards. Space includes circulation, FT.

WC: semi-ambulant (Staff) HBN 04-01 2.5 0.0 0.0 0.0 Trust brief - 1 per 2 wards (inc change)

WC: independent wheelchair HBN 04-01 4.5 1.0 4.5 5.0 Trust brief - 1 per 2 wards (HBN04-01: 1 per 48 beds)

Additional Clinical Space

Clean supply room allowance HBN 04-01 8.0 0.0 0.0 Clean utility as alternative

Local Cleaners Room Trust brief 2.0 1.0 2.0 1.8 Added by trust 31.08.17

Disposal hold allowance HBN 04-01 6.0 1.0 6.0 10.1 0.25m2 per bed

Optional Accommodation

Nappy Change HBN 04-01 5.0 0.0 0.0 Omitted as existing PFI

Vending machine HBN 04-01 3.0 0.0 0.0 Omitted as existing PFI

Lobby to isolation room HBN 04-01 5.0 0.0 0.0 Omitted as existing PFI

Isolation room HBN 04-01 19.0 0.0 0.0 Omitted as existing PFI

Clean Utility HBN 04-01 16.0 0.0 0.0 Omitted as existing PFI

Clean Utility Existing PFI 10.0 2.0 20.0 16.9 Added as existing PFI

Shower room: assisted HBN 04-01 8.0 0.0 0.0 Omitted as existing PFI

Sitting room: 7 place inc 1 wheelchair HBN 04-01 12.0 0.0 0.0 Omitted as existing PFI

Regeneration Kitchen HBN 04-01 0.0 0.0 0.0

Distribution cupboard Existing PFI 2.5 1.0 2.5 0.0 Added as existing PFI see engineering space allowance

IT hub room Assumed 12.0 1.0 12.0 0.0 Moved to roof. 03

Net Internal area (NIA) 642.4 562.5

Circulation allowance HBN 04-01 25.0% 160.6 203.5 corridor areas

Communication allowance HBN 04-01 0.0% 0.0 0.0 Omited rev1

Engineering space allowanceOmited rev1-WSP to confirm as 12/07/17 discussions see MEP Plant Schedule

48 bed 70011184 Rev 01 dated 11/07/17

Medical Gas Manifold 8.8

Cold water tanks / pumps 62.9

Riser 2.5

IPS 4.5 to larger 4 bed ward increased as latest M&Ecomments

LV Switchroom A 3.6 omitted now in roof plantroom as latest M&Ecomments

LV Switchroom B 3.6

Isolation Room Riser 3.0 Added further to WSP comments

Internal area (GIA) 803.0 854.9

Communication space outside wards

Fire escape stairs Designed 18.0 2.0 36.0 76.7 Both stairs incl. lifts. 03

Hospital street link to existing hospital Designed 150.0 1.0 150.0 163.1 03

Riser to hospital street Designed 3.8 03

Internal area Including Hospital Street 989.0 1098.6 03

Partition allowance 57.7 03

As drawn GIFA Ground Floor (inc allowance for hospital Street) (m2) 1156.3

Notes:

Job ref: 50346

Job Title: Hereford County Hospital

AR-IBI-RP-040 Schedule of accommodation 1 24 Bed Ward 33% single rooms

24 BED WARD - LEVEL 00 - GROUND FLOOR

Rev: 03 (29/08/2018)



Size m²

Remarks Rev

Clinical Spaces

Single Bedroom Existing PFI 11.0 7.0 77.0 82.6

Single Bedroom: disbaled use Existing PFI 12.0 1.0 12.0 12.0

Shower room: en-suite Existing PFI 4.0 7.0 28.0 27.3

Shower room: en-suite: disabled use Existing PFI 5.5 1.0 5.5 5.7

Multi-bed room: 4 beds HBN 04-01 64.0 1.0 64.0 60.0 min PFI allowance for larger ward

Multi-bed room: 4 beds Existing PFI 40.0 3.0 120.0 124.5

Shower room: assisted: in-patient Existing PFI 7.0 4.0 28.0 26.8

Isolation Lobby HBN 04-01 0.0 0.0 0.0 No Isolation room at first floor

WC: semi ambulant: in-patient HBN 04-01 2.0 0.0 0.0 Omitted as existing PFI

Bathroom: assisted HBN 04-01 15.0 0.0 0.0 Omitted as existing PFI

Support Facilities

Office/meeting room:10 places (incl. 2 workstations) HBN 04-01 16.0 1.0 16.0 Omitted as existing PFI

Touchdown base HBN 04-01 2.0 12.0 24.0 Omitted as existing PFI

Clinicians office Existing PFI 8.0 1.0 8.0 9.0 Added as existing PFI

Clinicians office Existing PFI 9.0 1.0 9.0 9.3 Added as existing PFI

Staff base Existing PFI 10.0 1.0 10.0 7.7 Added as existing PFI

Staff base Trust brief 8.0 1.0 8.0 0.0

Staff base Trust brief 8.0 1.0 8.0 20.6 Central with MDT Space

MDT Space Trust brief 0.0 1.0 0.0 0.0 Added to central space with staff bases. Trust request 31.08.17

Treatment Room: double side couch access HBN 04-01 16.0 1.0 16.0 15.8

Interview Room: 4 place (incl. 1 wheelchair place) HBN 04-01 8.0 0.0 0.0 7.3 Only first floor

Breakout space: patients Existing PFI 6.0 0.0 0.0 Omitted as existing PFI

Ward pantry Existing PFI 6.0 1.0 6.0 10.2

Parking bay for resuscitation equipment Existing PFI 1.0 1.0 1.0 1.9

Parking bay food trolley HBN 04-01 2.0 1.0 2.0 1.6 1no. FT included within waiting area

Parking bay for mobile hoist HBN 04-01 2.0 1.0 2.0 1.9

Ward storage allowance HBN 04-01 0.75 24.0 18.0 Omitted as existing PFI

Medicine store/preparation area HBN 04-01 8.0 0.0 0.0 Clean utility as alternative - omitted as existing PFI

Linen store Existing PFI 4.00 1.0 4.0 2.9 Added as existing PFI

General store Existing PFI 8.50 1.0 8.5 15.8 Added as existing PFI addit storage as User comments

Dirty utility room for bedpan processing Existing PFI 9.0 1.0 9.0 13.2 Number reduced as existing PFI (HBN 04-01: 1 per 12 beds)

Cleaners' room Existing PFI 10.0 1.0 10.0 5.5

Staff Spaces

Locker bay: 12 small lockers HBN 04-01 1.5 4.0 6.0 Omitted as existing PFI

Staff cloaks Existing PFI 5.0 1.0 5.0 5.6 Added as existing PFI

WC: ambulant HBN 04-01 2.0 1.0 2.0 Omitted as existing PFI

WC: ambulant Existing PFI 3.0 1.0 3.0 3.0 Added as existing PFI

Staff rest and mini kitchen HBN 04-01 1.8 6.0 10.8 14.8 Only on first floor

Seminar room/multi-purpose space HBN 04-01 32.0 0.4 12.8 14.3 Reduced further to trust comments.

Communal changing area HBN 04-01 1.4 36.0 50.4 Omitted as existing PFI

Store cupboard 4.5


Reception HBN 04-01 5.5 1.0 5.5 6.9

Waiting area HBN 04-01 1.7 2.0 3.4 48.9 Wait / FT

WC: semi-ambulant HBN 04-01 2.5 0.0 0.0 0.0 Trust brief - 1 per 2 wards

WC: independent wheelchair HBN 04-01 4.5 1.0 4.5 5.0 Trust brief - 1 per 2 wards (HBN04-01: 1 per 48 beds)


Clean supply room allowance HBN 04-01 8.0 0.0 0.0 Clean utility as alternative

Local Cleaners Room Trust brief 2.0 1.0 2.0 1.8 Added by trust 31.08.17

Disposal hold allowance HBN 04-01 6.0 1.0 6.0 10.3 0.25m2 per bed


Nappy Change HBN 04-01 5.0 0.0 0.0 Omitted as existing PFI

Vending machine HBN 04-01 3.0 0.0 0.0 Omitted as existing PFI

Lobby to isolation room HBN 04-01 5.0 0.0 0.0 Omitted as existing PFI

Isolation room HBN 04-01 19.0 0.0 0.0 Omitted as existing PFI

Clean Utility HBN 04-01 16.0 0.0 0.0 Omitted as existing PFI

Clean Utility Existing PFI 10.0 2.0 20.0 16.8 Added as existing PFI

Shower room: assisted HBN 04-01 8.0 0.0 0.0 Omitted as existing PFI

Sitting room: 7 place inc 1 wheelchair HBN 04-01 12.0 0.0 0.0 Omitted as existing PFI

Regeneration Kitchen HBN 04-01 0.0 0.0 0.0

Distribution cupboard Existing PFI 2.5 1.0 2.5 0.0 Added as existing PFI see engineering space allowance

IT hub room Assumed 12.0 1.0 12.0 0.0 Moved to roof 03

Net Internal area (NIA) 639.9 593.5

Circulation allowance HBN 04-01 25.0% 160.0 208.0 corridor areas

Communication allowance HBN 04-01 0.0% 0.0 0.0 Omited rev1


48 bed 70011184 Rev 01 dated 11/07/17

IT Hub 0.0

mechanical riser 10.1 2no. Back to back as latest M&Ecomments

Riser 2.5

IPS 4.5 to larger 4 bed ward increased as latest M&Ecomments

elec riser A 3.6

elec riser B 3.6

Isolation Room Riser 3.6

Gross Internal area (GIA) 799.9 829.4


Fire escape stairs Designed 18.0 2.0 36.0 79.7 Both stairs incl. lifts 03

Hospital street Designed 150.0 1.0 150.0 107.3 03



Partition Allowance 68.4 03

As drawn GIFA First Floor (inc allowance for hospital Street) (m2) 1088.6

Notes:

Job ref: 50346



24 BED WARD - LEVEL 01 - FIRST FLOOR

Rev: 03 (29/08/2018)



Size m²

Remarks Rev

Clinical Spaces

Single Bedroom Existing PFI 11.0 7.0 77.0 82.6 03

Single Bedroom: Disabled use Existing PFI 12.0 1.0 12.0 12.0 03

Shower room: en-suite Existing PFI 4.0 7.0 28.0 27.3 03

Shower room: en-suite: disabled use Existing PFI 5.5 1.0 5.5 5.7 03

Multi-bed room: 4 beds HBN 04-01 64.0 1.0 64.0 60.0 min PFI allowance for larger ward 03

Multi-bed room: 4 beds Existing PFI 40.0 3.0 120.0 124.5 03

Shower room: assisted: in-patient Existing PFI 7.0 4.0 28.0 26.8 03

Isolation Lobby HBN 04-01 0.0 0.0 0.0 No Isolation room at second floor 03

WC: semi ambulant: in-patient HBN 04-01 2.0 0.0 0.0 Omitted as existing PFI 03

Bathroom: assisted HBN 04-01 15.0 0.0 0.0 Omitted as existing PFI 03

Support Facilities

Office/meeting room:10 places (incl. 2 workstations) HBN 04-01 16.0 1.0 16.0 Omitted as existing PFI 03

Touchdown base HBN 04-01 2.0 12.0 24.0 Omitted as existing PFI 03

Clinicians office Existing PFI 8.0 1.0 8.0 9.0 Added as existing PFI 03

Clinicians office Existing PFI 9.0 1.0 9.0 9.3 Added as existing PFI 03

Staff base Existing PFI 10.0 1.0 10.0 7.7 Added as existing PFI 03

Staff base Trust brief 8.0 1.0 8.0 0.0 03

Staff base Trust brief 8.0 1.0 8.0 20.6 Central with MDT Space 03

MDT Space Trust brief 0.0 1.0 0.0 0.0 Added to central space with staff bases. Trust request 31.08.17 03

Treatment Room: double side couch access HBN 04-01 16.0 1.0 16.0 15.8 03

Interview Room: 4 place (incl. 1 wheelchair place) HBN 04-01 8.0 0.0 0.0 Only first floor 03

Breakout space: patients Existing PFI 6.0 0.0 0.0 Omitted as existing PFI 03

Ward pantry Existing PFI 6.0 1.0 6.0 10.2 03

Parking bay for resuscitation equipment Existing PFI 1.0 1.0 1.0 1.9 03

Parking bay food trolley HBN 04-01 2.0 1.0 2.0 1.6 1no. FT included within waiting area 03

Parking bay for mobile hoist HBN 04-01 2.0 1.0 2.0 1.9 03

Ward storage allowance HBN 04-01 0.75 24.0 18.0 Omitted as existing PFI 03

Medicine store/preparation area HBN 04-01 8.0 0.0 0.0 Clean utility as alternative - omitted as existing PFI 03

Linen store Existing PFI 4.00 1.0 4.0 2.9 Added as existing PFI 03

General store Existing PFI 8.50 1.0 8.5 15.8 Added as existing PFI addit storage as User comments 03

Dirty utility room for bedpan processing Existing PFI 9.0 1.0 9.0 13.2 Number reduced as existing PFI (HBN 04-01: 1 per 12 beds) 03

Cleaners' room Existing PFI 10.0 1.0 10.0 5.5 03

Staff Spaces

Locker bay: 12 small lockers HBN 04-01 1.5 4.0 6.0 Omitted as existing PFI 03

Staff cloaks Existing PFI 5.0 1.0 5.0 5.6 Added as existing PFI 03

WC: ambulant HBN 04-01 2.0 1.0 2.0 Omitted as existing PFI 03

WC: ambulant Existing PFI 3.0 1.0 3.0 3.0 Added as existing PFI 03

Staff rest and mini kitchen HBN 04-01 1.8 6.0 10.8 Only on first floor 03

Seminar room/multi-purpose space HBN 04-01 32.0 0.4 12.8 Only on first floor 03

Communal changing area HBN 04-01 1.4 36.0 50.4 Omitted as existing PFI 03

Store cupboard 4.5 03


Reception HBN 04-01 5.5 1.0 5.5 6.9 03

Waiting area HBN 04-01 1.7 2.0 3.4 48.9 Wait / FT 03

WC: semi-ambulant HBN 04-01 2.5 0.0 0.0 0.0 Trust brief - 1 per 2 wards 03

WC: independent wheelchair HBN 04-01 4.5 1.0 4.5 5.0 Trust brief - 1 per 2 wards (HBN04-01: 1 per 48 beds) 03


Clean supply room allowance HBN 04-01 8.0 0.0 0.0 Clean utility as alternative 03

Local Cleaners Room Trust brief 2.0 1.0 2.0 1.8 Added by trust 31.08.17 03

Disposal hold allowance HBN 04-01 6.0 1.0 6.0 10.3 0.25m2 per bed 03


Nappy Change HBN 04-01 5.0 0.0 0.0 Omitted as existing PFI 03

Vending machine HBN 04-01 3.0 0.0 0.0 Omitted as existing PFI 03

Lobby to isolation room HBN 04-01 5.0 0.0 0.0 Omitted as existing PFI 03

Isolation room HBN 04-01 19.0 0.0 0.0 Omitted as existing PFI 03

Clean Utility HBN 04-01 16.0 0.0 0.0 Omitted as existing PFI 03

Clean Utility Existing PFI 10.0 2.0 20.0 16.8 Added as existing PFI 03

Shower room: assisted HBN 04-01 8.0 0.0 0.0 Omitted as existing PFI 03

Sitting room: 7 place inc 1 wheelchair HBN 04-01 12.0 0.0 0.0 Omitted as existing PFI 03

Regeneration Kitchen HBN 04-01 0.0 0.0 0.0 03

Distribution cupboard Existing PFI 2.5 1.0 2.5 0.0 Added as existing PFI see engineering space allowance 03

IT hub room Assumed 12.0 1.0 12.0 0.0 As latest M&E comments - moved to roof 03

03

Net Internal area (NIA) 639.9 557.1 03

Circulation allowance HBN 04-01 25.0% 160.0 208.0 corridor areas 03

Communication allowance HBN 04-01 0.0% 0.0 0.0 Omited rev1 03


48 bed 70011184 Rev 01 dated 11/07/1703

IT Hub 0.0 03

mechanical riser 10.1 2no. Back to back as latest M&Ecomments 03

Riser 2.5 03

IPS 4.5 to larger 4 bed ward increased as latest M&Ecomments 03

elec riser A 3.6 03

elec riser B 3.6 03

Isolation Room Riser 3.6 03

Gross Internal area (GIA) 799.9 793.0 03


Fire escape stairs Designed 18.0 2.0 36.0 79.7 Both stairs incl. lifts. 03

Hospital street Designed 150.0 1.0 150.0 107.3 03




As drawn GIFA Second Floor (inc allowance for hospital Street) (m2) 1038.7 03

Notes:

Job ref: 50346



24 BED WARD - LEVEL 02 - SECOND FLOOR

Rev: 03 (29/08/2018)



Size m²

Remarks Rev

Engineering Plant at roof level

Fire escape stair / lift 36.1 03

Main Plant Room 379.6 03

Hot Water Service Room 37.8 03

Boiler Room 8.1 03

LV Switch Room B Omitted 03

LV Switch Room A 13.4 03

UPS Room 15.2 03

Medical Air Plant 24.3 Room added. 03

Circulation 82.5 Room added. 03

Net Internal Area 597.0 03


As drawn GIFA Roof (m2) 622.0 03

Notes:

Job ref: 50346



24 BED WARD - LEVEL 03 - ROOF

IBI GROUP

105 -106 Creative Quarter

Cardiff CF10 1AF UK

tel +44 (0) 29 2044 8900

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Health

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Derogations and Assumptions Schedule : Proposed Additional Wards comparison HBN Comparison

Project Information

50346 Hereford County Hospital Version 1.1 28th November 2017

Trust Updated 24th August

2018 to reflect Staff Rest Room included in SOA

Item Document

Source Document Title Rev/Year Clause Description Response / Comment/ Mitigation Added to

register Status

HBN 00-09 Infection Control in the Built Environment

2013 2.24 Sketch plans (1:200 scale designs) 2.25 At this stage, 1:200 scale outline departmental layout drawings showing rooms outlined within departments will be available and discussions held with the design team. The IPC team needs to assess whether the facility is designed to support the prevention and control of infection. Examples include: • confirming operational procedures;

• establishing baseline and future staffing profiles;

• establishing baseline and future revenue budgets;

• establishing equipment requirements;

• strategy for equipping;

• procurement and selection of furnishings and equipment;

• missing rooms/facilities;

• appropriate placing and accessibility of hand-hygiene

facilities;

• single-bed rooms suitable for patient isolation and special

ventilated isolation rooms;

• ventilation and air-conditioning systems including the level of

filtration where specialised ventilation is required;

• water supply, heating and plumbing;

Storage, utility rooms, changing rooms

Plans discussed with infection control, clinical

handwash required near ward entrance.

Included in design brief.

Location of cleaners room to be agreed.

Sizes of bed spaces are based on existing wards in the main hospital. The management and performance of those wards has demonstrated that they are suitable and acceptable. A larger 4 Bedded room is provided on each ward to enable further flexibility for specific patient/equipment needs.

Closed

Accepted

Accepted

HBN 00-09 Chapter 3: Designing a healthcare facility: items to consider

Examples of design principles Provide sufficient space for activities to take place and to avoid cross-contamination between adjacent bed spaces

Bed spaces not designed to HBN guidance. As prescribed by the Trust bed spaces to be designed to meet existing PFI. Note: Sizes of bed spaces are based on existing wards in the main hospital. The management and performance of those wards has demonstrated that they are suitable and acceptable. A larger 4 Bedded room is provided on each ward to enable further flexibility for specific patient/equipment needs.

Accepted

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Cardiff CF10 1AF UK

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Sizing/space 3.5 The provision of sufficient space in clinical areas, particularly for each bed space, is one of the most important considerations in the planning and design of in-patient accommodation. A risk-based approach should be taken to ensure that the environment is appropriate for carrying out clinical activities and undertaking manual handling operations while maintaining a good standard of infection control.

Bed spaces not designed to HBN guidance. As prescribed by the Trust bed spaces to be designed to meet existing PFI. Note: Over and above the existing facility there are 2 significant advances: 1. A larger 4 Bedded room is provided on each ward

to enable further flexibility for specific patient/equipment needs.

2. A treatment room is incorporated to enable some clinical activity to be carried away from the bedspace.

Accepted

HBN 04-01 In patient Care: Adult in-patient facilities

2013 edition

3.1 The size of single-bed rooms has increased from 21 m2 to 23.5 m2 as a result of the review of DCAGs,1 which added 2.5 m2 to each bed space

As prescribed by the Trust single bed rooms are to be designed to meet existing PFI standards.

The size of the PFI single bed room is 11m² and en-suite 4m² which was current in 1997.

Current HBN recommended sizes are 19 m² for room

and 4.5m² for en-suite = total 23.5m²

PFI rooms + en suite = 15m²

Rooms are 8.5 m² less than HBN

recommendations. Note: The existing single bedrooms have proven to be successful in performance. With fixed overbed hoists in some rooms the rooms offer a safe and functional environment. The inclusion of a treatment room on each ward will prevent the need to carry out certain procedures in the bedroom.

Accepted

3.2 The size of multi-bed rooms has increased from 60 m² to 72.5 m² as a result of: (a). the 2001 review of DCAGs, which added 2.5 m² to each bed space (b) the impact of the Disability Discrimination Act, which requires that sanitary facilities should be provided for independent users and those requiring assistance from staff. As a result the assisted shower room, which now includes a WC as well as a shower and wash-hand basin, has increased in area from 4.5 m2 to 6.5 m2.This has increased the overall dimensions of the Multi-bed room.

As prescribed by the Trust 3 of the 4,4 bed rooms are to be designed to meet existing PFI standards.

The size of the multi bed rooms in the PFI average at around 40m² and en-suite 7m². This current HBN recommended room size is 64m² including approx. 3 m² for clinical support area with an assisted shower room with WC of 6.5m².

The PFI multi bed room + en-suite is 47m². Rooms are 23.5m² less than HBN recommendations.

Note: Sizes of bed spaces are based on existing wards in the main hospital. The management and performance of those wards has demonstrated that they are suitable and acceptable. A larger 4 Bedded room is provided on each ward to enable further flexibility for specific patient/equipment needs. Over and above the existing facility there are 2 significant advances: 1. A larger 4 Bedded room is provided on each ward to enable further flexibility for specific patient/equipment needs. 2. A treatment room is incorporated to enable some clinical activity to be carried away from the bedspace.

Accepted

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Key Features of a desirable environment

4.18- Studies …have shown that the following features are necessary to provide a desirable in-patient environment

(a) Sufficient space for clinical activity at the bedside etc.

Bed spaces considerably smaller than HBN guidance. As prescribed by the Trust bed spaces to be designed to meet existing PFI. Note: Refer to 3.2 above.

Accepted

Space Requirements 4.24 The provision of sufficient space in clinical areas, particularly for each bed space, is one of the most important considerations in the planning and design of in-patient accommodation. Ergonomic studies have established that most activities carried out at the bedside can be accommodated within the dimensions 3600 mm (width) × 3700 mm (depth). This represents the clear bed space and does not include space for fixed storage, preparation and worktops

Bed spaces considerably smaller than HBN

guidance. As prescribed by the Trust bed spaces to be designed to meet existing PFI. Note: The use of existing ward layouts has demonstrated that the proposed sizes are suitable. It is planned to locate all fixtures and fittings in the same locations as existing. It is planned that the 4 bedded rooms will have a slightly longer wall at the bedhead to ensure that the the bedspaces are not less than existing. Also refer to 3.2 above.

4.28-9 For greatest flexibility of use, all sanitary facilities in in-patient areas should be accessible and manageable by people with physical or sensory disabilities with or without assistance The Department of Health commissioned research into the size and layout of en-suite shower rooms to single-bed rooms to identify a space-efficient design that would, as far as possible, meet the needs of the majority of patients

Single bedroom en-suites have not been

designed to HBN guidance. As prescribed by the Trust they are designed to meet existing PFI. Note: The existing ensuites have performed well and are acceptable. There are larger ensuites in the 4 Bedded rooms that offer greater assistance and independent use for disabled patients.

Accepted

Moving and Handling Patients 4.56 Patient moving/handling tasks are associated with the greatest proportion of musculoskeletal disorders in the health services (see ‘Moving and handling in health and social care’, HSE). One way of avoiding such injury is to move patients by use of a hoist, which requires sufficient space around the bed for staff to perform these tasks.

Further guidance given on space requirements in

section 4.24 above.

Note: Mobile hoists can be used in all rooms,

however, they are not suitable for all patients in all

situations, therefore, some 4 bedded rooms and

single rooms will be fitted with fixed overbed hoists.

The Trust have a ‘Safe Moving and Handling Policy’ that

Guidelines for managing Bariatric patients.

Accepted

& Policy

in place.

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Spaces: Bed and sanitary facilities 5.10 Multi-bed room sanitary facilities.

It is convenient to provide an assisted shower room (with WC, shower and wash-hand basin) and a separate semi-ambulant WC (with hand-rinse basin), both en-suite to the bed area. Thus one person showering does not prevent others from using the WC.

No separate WC provided. Designed to meet existing

PFI as prescribed by the Trust

Note: The existing facility has proven to be

acceptable and adequate.

Accepted

5.13 In addition to en-suite facilities, an assisted bathroom or shower room is required, although this may be shared with other wards.

No assisted bathroom provided on ward. Omitted by the Trust not provided as existing PFI. Note: Previous bathrooms within the existing wards have been decommissioned and converted due to the lack of use and the potential for compromising privacy and dignity in a ward serving both Male and Female. A bathroom is available within the hospital to accommodate any special requirements.

Accepted

5.36 The medicine store/preparation room is required for the storage and preparation of all the medicines to be used on the ward. This will include controlled drugs, medicines requiring refrigeration, and consumables such as syringes and needles. Rechargeable syringe drivers and infusers may be stored here. See ‘Medicine store/preparation room’ in Health Building Note 00-03 – ‘Clinical and clinical support spaces’.

According to HBN 1no. at 8m2 to be provided to each ward. Omitted by the Trust, Note: The Clean Utility will be used for this requirement as per existing procedures and practice.

Accepted

5.37 A dirty utility room with bedpan processing is required. One dirty utility room should serve no more than 15 beds. See ‘Dirty utility room for bedpan processing’ in Health Building Note 00- 03– ‘Clinical and clinical support spaces’.

HBN advises for this size ward 2no. dirty utility rooms at 12m2. Only 1no. dirty utility provided (13m2) as prescribed by the Trust. Note: The dirty utility planned will serve 24 beds per ward whereas four of the wards in the main hospital wards have more beds served by 1 dirty utility of less size in an acceptable manner.

Accepted

5.48 Facilities are required for staff changing, clothes storage, showers and sanitary facilities. These facilities may be shared between several wards. Estimates of the amount of changing space and locker provision should take into account the numbers of full-time and part-time staff, including trainees and students. See ‘Changing area: staff ’,‘Changing room: semi-ambulant’, ‘Shower room: ambulant’ and ‘Uniform exchange area in Health Building Note 00-02 – ‘Sanitary spaces’.

No staff change provided, but staff cloak room provided to each ward as prescribed by the Trust to meet existing PFI. Note; Staff change facilities including Male and

female showers etc are provided for all staff in the main hospital.

Accepted

Accepted by: Wye Valley NHS Trust Dept. Medical Director and Director of Nursing.


Appendix 4.4

MEP Service Strategy

Appendix 4.4

Foreword

Replacement Ward Project, Hereford County Hospital

Engineering Services Strategy

Surveys of the existing Services Infrastructure, Distribution and Capacity have been carried out to inform the design and the PFI Company as to whether the existing supplies can sustain the proposed development.

A detailed MEP Services strategy has been developed for a previous proposal of a block accommodating 48 beds (2 x 24 bed wards). That strategy (Appendix 3.4) together with the output of the surveys provide adequate information for the engineering services design of a 72 bed (3 x 24 bed wards) to be carried out.

The significant aspects that provide reassurance about this approach are:

Electricity - Main Supply - MRU Substation has a capacity of 1000kva and a current demand of 100kva. New block requires approx. 320kva leaving a residual capacity in excess of 500kva. Backup – Existing site generators are close to capacity and load shedding is in place. Therefore, the new block will be provided with its own generator set to provide 100% essential supply.

Heating and Hot Water – A new connection from the Mains network will supply a new boiler facility dedicated to the new block.

Water – Site infrastructure has capacity to supply the new block.

Medical Gases – All provided locally within new development including backup.

Pneumatic tube, Fire Alarm, Staff Attack, Data, Telephony – Linked into or reporting to existing main systems.

Fire Fighting – Hydrants are available at appropriate locations.

It is to be noted that throughout the detail design the strategy is being reviewed and to date

the following items have been identified and allowed for in costings. The strategy will be

updated or an addendum agreed.

1. The mechanical ventilation strategy states a total of three air handling units, this may change to include two additional air handling units.

2. The isolation suite strategy includes for a run around coil, but this is not allowable so has been excluded.

3. The comfort cooling strategy includes for ducted fan coil units using chilled water or direct expansion refrigerant. This is not required and overheating is managed through the mechanical ventilation.

4. ZigZag transformer not in current design. In lieu of this an allowance for a suitable isolation transformer at the UPS output is included.

V1.0 by G Vaughan

MEP SERVICES STRATEGY HEREFORD HOSPITAL:

NEW WARDS

Revision 3 70011184

17TH OCTOBER 2017

Type of document (version) (Confidential) Project no: 70011184 Date: 16th October 2017

1 Capital Quarter, Tyndall Street, Cardiff

CF10 4BZ

Tel: 02920 769200

www.wsp.com

MEP SERVICES STRATEGY

HEREFORD HOSPITAL:

NEW WARDS

Q U A L I T Y M A N A G E M E N T

ISSUE/REVISION FIRST ISSUE REVISION 1 REVISION 2 REVISION 3

Remarks Preferred scheme developed

Preferred scheme developed

Client comments incorporated

Date July 2017 September 2017 October 2017 17th October 2017

Prepared by Biva Paul

Matthew Hubbard

Biva Paul

Matthew Hubbard

Biva Paul

Matthew Hubbard

Biva Paul

Matthew Hubbard

Signature

Checked by Graham Stewart

Damian Isaac

Graham Stewart

Damian Isaac

Graham Stewart

Damian Isaac

Damian Isaac

Signature

Authorised by Graham Stewart Graham Stewart Graham Stewart Damian Isaac

Signature

Project number 70011184 70011184 70011184 70011184

Report number

File reference Reports Reports Reports Reports

ii

MEP Services Strategy Document WSP Wye Valley Trust Project No 70011184 September 2017

TABLE OF CONTENTS 1 INTRODUCTION ...........................................................................1

2 DEMOLITION WORKS .................................................................2

3 MECHANICAL AND ELECTRICAL SERVICES ...........................2

3.1 MECHANICAL ENGINEERING SERVICES ...................................................... 2

HEATING ............................................................................................................ 2

GENERAL HEATING STRATEGY ...................................................................................3

HEAT EMITTERS ............................................................................................................3

VENTILATION .................................................................................................... 3

NATURAL VENTILATION ................................................................................................3

MECHANICAL VENTILATION .........................................................................................3

COMFORT COOLING ........................................................................................ 6

AUTOMATIC CONTROLS/BMS ......................................................................... 6

WATER SERVICES ............................................................................................ 6

OVERVIEW ......................................................................................................................6

MAINS COLD WATER SYSTEM .....................................................................................6

BOOSTED COLD WATER SYSTEM ...............................................................................6

HOT WATER SYSTEM ....................................................................................................7

ABOVE GROUND SANITARY DRAINAGE ..................................................... 10

MATERIALS ................................................................................................................... 10

INSULATION ................................................................................................................. 11

ABOVE GROUND RAINWATER DRAINAGE .................................................. 11

PIPED MEDICAL GASES ................................................................................. 11

PNEUMATIC TUBE SYSTEM .......................................................................... 13

3.2 ELECTRICAL ENGINEERING SERVICES ..................................................... 14

INCOMING ELECTRICITY ............................................................................... 14

STANDBY GENERATION ................................................................................ 14

LV DISTRIBUTION ........................................................................................... 15

MECHANICAL CONTROL CENTRES ............................................................. 15

PHOTOVOLTAICS ........................................................................................... 15

EXTERNAL SERVICES .................................................................................... 16

MEDICAL LOCATION GROUPS ...................................................................... 16

EARTHING AND BONDING SYSTEMS .......................................................... 17

UNINTERRUPTIBLE POWER SUPPLIES, ISOLATED POWER SUPPLIES AND SPECIALIST MEDICAL EQUIPMENT ..................................................... 17

TERTIARY POWER SUPPLIES FOR ANCILLARY SYSTEMS ....................... 18

CONTAINMENT................................................................................................ 18

SMALL POWER................................................................................................ 18

UPS / IPS SOCKETS ....................................................................................... 19

GENERAL LIGHTING ....................................................................................... 19

EMERGENCY LIGHTING ................................................................................. 23

iii

Services Strategy Document WSP Wye Valley Trust Project No 70011184 July 2017

EXTERNAL LIGHTING ..................................................................................... 24

PUBLIC ADDRESS SYSTEM ........................................................................... 24

SECURITY AND CCTV SYSTEMS .................................................................. 25

ACCESS CONTROL SYSTEMS ...................................................................... 25

INTRUDER ALARM .......................................................................................... 25

FIRE DETECTION AND ALARM ...................................................................... 25

NURSE CALL / DISABLED ALARMS SYSTEM ............................................... 26

STAFF ATTACK SYSTEM ............................................................................... 26

DISABLED REFUGE SYSTEM ........................................................................ 27

BED HEAD SERVICES .................................................................................... 27

INDUCTION LOOP SYSTEM ........................................................................... 27

AUDIO / VIDEO DISTRIBUTION ...................................................................... 27

LIGHTNING PROTECTION .............................................................................. 27

IT SYSTEMS ..................................................................................................... 27

LIFT INSTALLATION ........................................................................................ 27

1

MEP Services Strategy Document WSP Wye Valley Trust Project No 70011184 October 2017

1 INTRODUCTION

Wye Valley NHS Trust are proposing to increase the number of patient beds within the Hereford County Hospital following the demolition of the existing Hutted Accommodation. Three options were initially considered. The trust have now identified the following option as the preferred scheme:

1. New build 48 bed ward comprising two floors of accommodation.

Enhanced beds are to be included on the ground and first floors and will consist of 2 No. 4 bed wards. There will also be an Isolation room on the ground floor.

This report sets out how mechanical and electrical servicing of the building could be achieved. This includes alterations to any existing mechanical and electrical services that maybe affected by the proposal. It also details the installation of mechanical and electrical services for the room types proposed based on the architect’s drawings. Where appropriate options and key risks and next steps are listed.

A survey of the Mechanical and Electrical Services was carried out by representatives of WSP on 17th May 2017 to establish the extent and condition of the existing major plant and services serving the existing Hutted Accommodation. The surveys were limited to a visual examination of the plant rooms and distribution services where they are observable, no tests were undertaken and no plant was opened up for internal examination.

The high level design proposals detailed in this report are in accordance with the requirements of current British Standards, Building Regulations, CIBSE Guidance, Health Technical Memoranda (HTM), Hospital Building Notes (HBN), any other relevant NHS guidance. The report will highlight HTM compliant design proposals which may not be required or deemed feasible by the Trust and therefore a schedule of derogations from the HTM/HBNs will need to be agreed and recorded.

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2 DEMOLITION WORKS

Please refer to the separate demolition of Hutted Accommodation building services report which has been updated to reflect requirements for the New Wards scheme.

3 MECHANICAL AND ELECTRICAL SERVICES

3.1 MECHANICAL ENGINEERING SERVICES

HEATING

GENERAL GENERATION STRATEGY There are potentially two options for generating heat for the space heating and domestic hot water either via the existing site wide steam infrastructure or via a new natural gas main from the existing site wide gas infrastructure. (Following a further review of the existing steam system information available, the option of utilising natural gas will be proposed.) This will minimise the potential design risk due to the limited record information available on the existing installed steam plant design and the heating strategy going forward will be based on this heat generation option. There is an existing low pressure gas main installed beneath Union Walk, parallel to the south west boundary of the hospital building and directly adjacent to the proposed site. There is also one just inside the site. The client will need to submit a capacity enquiry to National Grid to determine whether the existing 180/125mm diameter PE main can supply the required demand for the proposed New Wards. The New Wards development will either require a new metered gas supply which will need to be provided locally to the building by National Grid or connected to an existing meter with available capacity. There is currently an existing redundant meter adjacent to the Heath Records Office. Current information on this meter confirmed this as a redundant meter with a capped 50mm diameter outgoing pipe and rated a maximum flow of 25m3/h at 21 to 23mbar. Use of the existing meter would be subject to the outcome of a capacity enquiry submitted to National Grid. New stand-alone gas fired condensing boilers will be installed as the heat source for the low temperature hot water (LTHW) heating. The boiler plant will be located in suitably sized plant room at roof level of the New Ward building. The flue from the boiler plant will discharge vertically through the building roof or via an external wall. The heating requirement will be provided utilising 2 No. boilers sized to provide 66% of the peak heating demand. The boiler selection shall be based NOx emission levels at normal operating conditions to achieve BREEAM credit Pol 02 (NOx emissions). The heating plant will have control panel mounted onto the boilers for control and boiler status purposes. The following control operation shall be provided as a minimum:

• On/off

• High limit protection

• Low water protection

• Volt free common alarm and boiler run indication

• Manual override

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The heating plant controls shall be interfaced to a local MCC panel located within the plant room. The MCC panel shall have an integrated power compartment (separate to the controls compartment) which provide power supply to the boilers and associated pumps.

HEATING STRATEGY

The heating system shall have a primary and secondary circuits to provide hydraulic separation from the heat source. The pumped constant temperature (CT) primary circuit will be connected to a low loss header and a number of pumped secondary variable temperature (VT) circuits. The number of VT circuits will be dependent on the zoning of rooms to be heated. The VT circuits will serve the room heat emitters and the CT circuits will serve the heating coils within the AHU and hot water plate heat exchangers. Primary and secondary twin pump sets will be located within the plant room locally to the boiler to circulate the LTHW within each circuit. A pressurisation unit and expansion vessel will be installed locally to the boilers to maintain the pressure and allow for expansion within the sealed system. The pipework and accessories will be insulated. The secondary VT heating circuit to the New Wards will provide heating to heat emitters strategically located within each room to provide optimum thermal comfort.

HEAT EMITTERS

The proposed heat emitters will be low temperature hot water ceiling mounted radiant panels. The smaller toilet and circulation areas will be provided with wall mounted Low Surface Temperature type radiators. There will be locally mounted controls in each space to provide local occupancy control.

VENTILATION

NATURAL VENTILATION

In line with the recommendations from all relevant HTNs and HBN documents, individual spaces should be naturally ventilated wherever possible. Natural ventilation will be considered as a ventilation strategy for the New Wards once further information on layouts, room size, façade, internal finishes and window size have been provided to enable a more detailed acoustic analysis to be carried out. Due to the acoustic criteria detailed in HTM and following an acoustic site survey natural ventilation is not proposed as an option for the New Ward development at this time as acoustic suitability is very marginal.

MECHANICAL VENTILATION

There will be 3 No. AHUs, each AHU will provide ventilation for the following areas:

• Main ward areas

• Enhanced wards and associated rooms

• Isolation room The Enhanced wards will accommodate high risk patients and will require a specialised ventilation system in line with HTM 03-01. This will be a dedicated ventilation system separate from the main New Ward ventilation system. The Isolation Room will require dedicated ventilation system separate from the main New Ward ventilation system. The Isolation lobby will be positively pressurised with fresh air which will transfer into the isolation room via high level pressure stabilisers. The pressure stabilisers will be located above the door into the isolation room. Fresh air will not be supplied directly into the isolation room. The air from the isolation room will be extracted from the isolation room via the

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adjacent ensuite which will be negatively pressurised. The plant will be located within the roof plant room and consist of a separate supply AHU and extract fan with a run around coil within supply and extract ducts. The ventilation rate will be in line with HBN 04-01 supplement 1 and will allow for door leakage between the lobby and corridor. A full fresh air handling unit system (AHU) with supply and extract fans will be provided to meet the ventilation requirements of the rooms proposed in accordance with HTMs, Building Regulations and CIBSE Guidance. The AHU will be located on the roof in a roof top plantroom or externally to the side within a suitably sized plant room/enclosure. Extract ventilation will be provided in sanitary facilities, dirty utilities, cleaner’s rooms, WCs and shower rooms which will all be negatively pressurised. WC extract rate will be in accordance with Building Regulations, Approved Document F. The WC extract will be provided with a separate dedicated ‘dirty’ extract system.

The air change rates detailed in the Appendix will be used as the basis of the ventilation design, otherwise a minimum of 10 litres per second per person will be provided. Refer to the Appendix for the proposed ventilation rates for the various room types detailed in the Schedule of Accommodation. The Treatment rooms on each floor will have clinical procedures carried out them and in accordance with HTMs will be provided with 10ACH ventilation. Due to the high air change rate required and the large area, the quantity of treatment rooms will have an impact on the duct and AHU sizes.

The rooms will either be maintained negatively, positively pressurised or balanced, depending on the function of the room and in accordance with HTM 03-01. Make-up air into negatively pressurised rooms will be from adjacent rooms via door undercuts, door or wall transfer grilles without compromising the fire strategy or privacy requirements. The corridor will be positively pressurised and supplied with sufficient make up air to satisfy the negatively pressurised rooms. Overall, the department should be positively pressurised, however the overall extract air returning to the AHU will not be reduced significantly to ensure the heat recovered from the returning extract air is maximised. This will reduce the heating coil load required to temper the incoming fresh air. The AHU will contain the following sections in line with HTM:-

- Fresh air intake - Motorised isolation/smoke damper - Frost coil - Pre-filter – panel filter - Energy recovery device - Fans - Heating coil - Final bag filter - Manual isolation/Volume control damper - Attenuators

An energy recovery device will be provided with the AHU to comply with HTM 03-01. A cooling coil are not expected to be required to temper the supply air during the summer months due to the ‘coolth’ energy recovered from the room air via the energy recovery device. This will be tested as part of the overheating analysis at the next stage. The plant room will be sized to ensure an AHU with an energy recovery device can be accommodated with adequate access on one side for cleaning and general maintenance, in line with HTM 03-01. All filters should be provided with a means of visually checking the differential pressure across them. Direct-reading dial-type gauges marked with clean and dirty sectors are preferred. Differential-pressure transducers should be provided to remotely monitor and alarm on excessive filter pressure drop. The primary pre-filter will be the panel type, G4 grade (G3 is required in line with HTMs as a minimum). This will be positioned on the inlet side of the supply fan, downstream of the frost coil. The secondary filter, will be a bag filter, F7 grade. This will be fitted on the

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positive-pressure side of the fan. The filter grades proposed will satisfy the filter grade requirements of all the room types as stated in HTM 03-01. The Enhanced wards AHU will have dirty-filter indication lights at the point of use in line with HTMs. Motorised low leakage shut off dampers will be provided behind the intake and discharge of each supply and extract. All control valves will be fail safe and close in the event of power or air flow failure except for the frost coil which will remain open to protect the AHU in line with HTM 03-01. A manually operated isolating damper will be provided between the AHU and the ductwork distribution. This will allow the AHU to be isolated when it is being cleaned. A humidifier section will not be provided with the AHU based on the room types detailed in the Schedule of Accommodation and in line with HTM. Humidifiers are expensive in terms of plant running costs and maintenance. It will therefore only be included within or remotely from the AHU, if specifically required. The access and maintenance provided for the AHUs will be fully compliant with HTM 03-01. The AHU will be located in plantroom sized to ensure adequate access is provided for cleaning and maintenance in line with HTM requirements. The AHU will be greater than 1m wide and would ideally have access on both sides or have large access doors to enable ‘full and safe entry for maintenance personnel’. Access doors will be provided for all regulating dampers, motorised smoke fire dampers, filters, both sides of coils, fans and motors, in line with HTM 03-01 and BESA DW144. Additionally observation ports will be provided with suitable lighting to heating coils and filters. Areas around the AHU should be tanked to prevent water penetration in adjacent areas. Any combustion plant will be located in a separate fire compartment to the AHU. The fresh air will be introduced via a low-velocity insulated ductwork system and will be tempered and filtered by the AHU before being distributed via high-level outlets. The extract ductwork will be insulated to ensure maximum heat is recovered at the AHU. The fresh air from the AHU will be supplied into the room via diffuser to provide adequate air distribution into the wards utilising the Coanda affect and to minimise any excessive air movement and consequently discomfort to patients. The diffuser and grille locations will be strategically located in the ceiling to ensure uniform air distribution within the space and without causing discomfort to patients. The supply and extract grilles and diffusers will be fitted with opposed blade dampers for final balancing at each outlet in line with HTM 03-01. Each intake and discharge point should be fitted with corrosion-resistant weatherproof louvres or cowls to protect the system from driving rain and be sized on a maximum face velocity of 2m/s. The louvres will either be cleaned via access doors in the plenum or externally. The duct connection to the louvre will be self-draining or tanked. The intakes and exhausts will be 10m apart and over 20m from sources of pollution in line with BREEAM. Attenuators will be provided within the ductwork emanating from the AHU, on the atmospheric and room side. Cross talk attenuators and additional acoustic lagging will be provided in ductwork if required in line with acoustic requirements and in accordance with the HTMs.

Fire dampers and/or smoke and fire actuated dampers will be provided at the locations required by HTM 05-02 and the fire strategy. An access hatch will be provided adjacent to each fire smoke damper so that its correct operation can be directly observed. The final detail for any fire related ventilation design will be informed by the Fire Engineering Consultant and local Fire Officer and will be in accordance with HTM 05-02. Actuated fire smoke dampers will be activated via the local automatic fire detection and alarm system and open on reset. A remote indicator will be provided on the casing of the damper to indicate status. The smoke dampers will be connected to a central panel to allow for testing and to indicate status. Monitoring and control will be via a hazard management system, which will be only viewable by Wye Valley NHS Trust.

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COMFORT COOLING

Thermal modelling will be carried out at the next stage and will indicate the patient areas which temperature exceeds 28ºC in summertime conditions for more than 50 hours of the year in line with HTM 03-01. Ducted FCUs with chilled water or direct expansion (DX) coil will be provided in rooms where cooling and ventilation is required. Split DX system will be provided for the IT hub rooms. Resilience will be provided to each main IT server rooms with an N+1 arrangement or as required by the Trust. A dedicated outdoor heat rejection plant area will be provided adjacent the roof plantroom. The cooling will be generated via air cooled chillers and associated pumps. A cooling coil will only be required within the AHU to temper the incoming fresh air during peak summer months if the energy recovery device cannot provide the required supply air temperature to maintain comfortable room temperatures in line with HTM-03 recommended design temperatures. Local room temperature will be indicated on a supervisory control panel at the staff base and repeated on the provided by the site wide BMS in line with HTM requirements.

AUTOMATIC CONTROLS/BMS

All systems will be connected to the BMS and have automatic control and monitoring (including meters) to match the existing site BMS strategy. Details of this strategy are to be determined.

WATER SERVICES

OVERVIEW

The New Ward building will be provided with a metered mains cold water supply (MCWS) from the existing site infrastructure and will be distributed underground to serve the water services plantroom.

A boosted cold water system (BCWS) will be distributed from the water services plantroom via a bulk cold water storage tank and booster set to serve all wards and medical areas.

A domestic hot water system (DHWS) c/w pumped secondary return will be distributed from the boiler room via 2no packaged plate heat exchanger and buffer vessels to serve all wards and medical areas.

MAINS COLD WATER SYSTEM

A mains cold water system will be provided to serve the following areas, but not limited to:

� Water Services Plantroom

� Drinking Fountains

BOOSTED COLD WATER SYSTEM

A boosted cold water system will be provided to serve the following areas, but not limited to:

� Multi-Bed Bays

� Patient & Clinical Support Areas

7


� Single Bedrooms

� Staff Spaces

� Cleaners Rooms

� Refuse Stores

� Mechanical Plantroom

� Ancillary Areas

� Isolation Room

� Enhanced wards

HOT WATER SYSTEM

A hot water system will be provided to serve the following areas, but not limited to:

� Multi-Bed Bays


� Single Bedrooms

� Staff Spaces

� Cleaners Rooms

� Ancillary Areas

� Isolation Room

� Enhanced wards

COLD WATER STORAGE TANKS

The cold water storage tank will be a GRP sectional tank, with type AG air gap and internal division and will provide Category 3 protection to the mains cold water supply in accordance with the Water Regulations Guide.

Each tank will be provided with an electronic tank management system as per the Keroflo Tanktronic.

DOMESTIC COLD WATER BOOSTER SETS

The packaged cold water booster sets will include high efficiency inverter driven pumps, complete with control panel, expansion vessel and a heavy gauge galvanised steel base plate.

PACKAGED PLATE HEAT EXCHANGER

A domestic hot water system (DHWS) complete with pumped secondary return will be distributed from the boiler room via 2no packaged plate heat exchanger and buffer vessels rated at 66% each.

The PHE will be supplied with a cold water connection from the boosted cold water system. The PHE will be connected to the low temperature hot water system, complete with a typical 3 port valve arrangement.

8


A pumped secondary return system will be provided to ensure correct temperatures of hot water at the outlets.

All terminal fittings will be individually temperature controlled by TMV3 thermostatic mixing valves to a safe temperature of 43°C, as manufactured by Honeywell or equal and approved.

Domestic hot water service return regulating valves will be thermostatic balancing valves as per the Alwa- Kombi- 4 as manufactured by Honeywell or equal and approved.

MECHANICAL PLANTROOMS & WASHDOWN BIB TAPS

Individual localised packaged break tank and booster sets will be provided via the BCWS to supply any mechanical plantroom and washdown bib taps. The packaged break tank and booster sets are required to provide a category 5 protection to the landlords BCWS and will be located at high level within the rooms.

Where hose union bib taps are installed within landlord’s areas these will be a suitable vandal protected bib tap as per the Arrow Valves HUTBT range or equal and approved.

PARTICULATE FILTRATION

The New Wards will have a fully automatic and backwashing filtration system in order to protect the proposed system from particulate solids and debris build-up. Filtration will be as manufactured by Hydrotec (UK) Ltd and their HydroFIL range or equal and approved.

The unit will comprise; gun-metal housing complete with fully programmable, timer facilitated solenoid purge valve and automated backwash facility allowing independent self-cleansing of internal elements thus extending life expectancy of disposable cartridges / elements.

ELECTRO-MAGNETIC PHYSICAL WATER CONDITIONING

The Contractor will supply and install a WRAS approved Electro-Magnetic Physical Water Conditioning device as manufactured by Hydrotec (UK) Ltd and their HydroMAG range or equal and approved.

PIPEWORK & FITTINGS

All internal water services pipework and fittings will be carried out using a copper tube system with press-fit type fittings in accordance with EN 1057 as per the Mapress Copper press system by Geberit.

Exposed pipework and fittings will be carried out using a stainless steel tube system as per the Mapress Copper press system by Geberit.

All below ground water services pipework and fittings will be blue MDPE protecta-line (barrier pipe), as manufactured by GPS pipe system (Glynwed). A site investigation/contamination report is required to confirm if barrier pipework is required.

VALVES

A fast acting safety valve will be provided after the booster set to protect the downstream pipework systems from excess pressure. The safety valve will operate at a maximum pressure of 16 bar and be adjustable between 1 - 12 bar as per the Honeywell SV300-100A 50A type equal or approved. Drainage will be provided within the plantroom to collect the discharge from the valve.

9


The safety pressure relief valves will be installed in combination with vacuum air breaker/auto air vent valves (surge arrestors / SAAVs) located at the top of the riser service pipes.

All sanitary appliances will be fitted with a combined servicing and automatic flow limiting valve to automatically limit the flow of hot and cold water in accordance with the BS8558, Approved Document Part G or BREEAM requirements, whichever is the more stringent.

Isolation valves will be fitted in any of the following situations:

a) A manual full bore valve will be fitted to the connection to any appliance or plant/equipment.

b) A manual valve will be fitted in the lateral pipework to each floor to which water is supplied.

c) A manual valve will be fitted in the pipework to each self-contained area into which water

is supplied.

d) A manual valve will be fitted in the pipework on the inlet to any riser.

e) A manual valve will be fitted in the lateral pipework immediately downstream of any connection with the riser.

A BREEAM compliant electrically operated solenoid shut off valve will be installed on the cold water supply pipe serving the each common toilet area which will be activated by PIR sensors located in the ceiling near each entrance. The solenoid valves will be commissioned to shut off the water supply to the toilet block when no motion is detected for a preset period of time.

Any such valves will be clearly identifiable and will be readily accessible and easy to operate, preferably at a convenient height from floor or platform level.

All pipework, fittings, plant and equipment, associated with the water services installation will be WRAS approved.

All water services pipework routing through unheated areas and roof level areas will be insulated and trace heated to prevent freezing. All other water services pipework will be insulated for condensation/heat loss purposes. The hot water insulation material and thickness will be coordinated with the Part L model and its criteria to ensure compliance where necessary.

CONTROL REQUIREMENTS

The following items of plant/equipment will be connected to the BMS.

� Incoming Water Temperature Sensors

� Cold Water Storage Tank Temperatures

� Cold Water Storage Tank Levels (high and low)

� Tank Management System

� Automatic Filtration Units

� Packaged Cold Water Booster Sets

� Cat 5 Packaged Break Tank and Booster Sets

� Pipework Trace Heating System

� Water Meters

10


� Packaged Plate Heat Exchangers

� Hot Water Circulation Pump

� PHE Cold Feed Temperature Sensors

� Flow and Return Temperature Sensors

ABOVE GROUND SANITARY DRAINAGE

The New Ward building will be provided with an above ground foul drainage system that conveys foul water into the below ground drainage systems by gravity without causing a nuisance or danger to health arising from leakage or blockage. This will wherever possible discharge directly into the below ground drainage infrastructure without the need for pumping.

A foul drainage system will be provided with coverage generally to the following areas:

� Multi-Bed Bays


� Single Bedrooms

� Staff Spaces

� Cleaners Rooms

� Refuse Stores

� Mechanical Plantroom

� Ancillary Areas

MATERIALS

There are 2 options that will be considered further at the next design stage for all main internal vertical and horizontal foul drainage pipework and fittings 75mm:

• either lightweight cast iron

• uPVC; note uPVC will require additional acoustic treatment in noise sensitive areas.

All waste pipes and fittings 50mm dia and below will be carried out using an MuPVC solvent welded system as manufactured by Polypipe Terrain or equal and approved.

Any temperature/pressure relief and pumped drainage pipework will be carried out using a copper tube system with press-fit type fittings in accordance with EN 1057 as per the Mapress Copper press system by Geberit.

Rubber lined steel brackets will be used on all pipework to reduce any structure borne noise.

All AAVs will be as per the Maxi-Vent range as manufactured by Studor. Ensure that all air admittance valves that are to be used have a current British Board of Agrément Certificate (BBA). Locate air admittance valves to allow full access for maintenance and replacement.

Ensure all traps have seal depths and diameters in accordance with BS EN 12056, and that they bear the British Standard Kite Mark. Ensure that they are fitted with a universal compression outlet, e.g. as indicated below:

Bottle traps are acceptable for use on WHBs only. Ensure that they are of the re-sealing type, and that the re-sealing insert is removable.

11


The architect will identify any traps to appliances that are required to be chrome plated.

INSULATION

Where pipelines pass through areas sensitive to noise, the Contractor will fully insulate to comply with the requirements of the Building Regulations Document E. This will include pipework offsets at high level also.

As a minimum the insulation will comprise 25mm unfaced mineral wool, securely located on the pipe by the use of chicken wire or similar – Detail to be confirmed and specified by the acoustic specialist to ensure it complies with the requirements of the Building Regulations Document E.

ABOVE GROUND RAINWATER DRAINAGE

The New Ward building will be provided with an above ground gravity rainwater drainage systems that conveys surface water into the below ground drainage systems without causing a nuisance or danger to health arising from leakage or blockage.

IBI are responsible for the overall roof drainage strategy and design, however WSP will assist with rainwater calculations and downpipe locations.

PIPED MEDICAL GASES

The following medical gasses will be required based on the room types detailed in the Schedule of Accommodation for the New Ward options and in line with HTM 02-01:

• Oxygen

• Compressed air (4 bar)

• Vacuum

The medical gas requirements are based on the following room types detailed in Table 11 of HTM 02-01:

• Single and multiple bedrooms (in-patient accommodation) - oxygen, MA4 and Vacuum

• Treatment rooms (in-patient accommodation) - oxygen, MA4 and Vacuum

• Enhanced bedrooms - oxygen, MA4 and Vacuum

• Isolation Room - oxygen, MA4 and Vacuum with dedicated AVSU

It should be noted the treatment room requirements for medical gases will vary depending on the room usage which will be determined at the next stage.

Area Valve Service Units (AVSU) and aesthetic gas scavenging (AGS) terminal units will be provided where required.

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OXYGEN

The existing site oxygen supply is from a central simplex vacuum insulated evaporator (VIE) plant located at the east end of the site adjacent to the Waste Transfer Yard and has good road access for BOC when re-filling. In accordance with HTM 02-01, this forms the “primary supply” of oxygen to the site.

Adjacent to the VIE, in a separate manifold room is the standby automatic oxygen manifold comprising 2 x 5J cylinders. In accordance with HTM 02-01, this forms the “secondary supply” of oxygen to the site.

A common 54mm dia oxygen main extends from the primary and secondary supplies to the Tower basement plant room where it splits into two separate supplies. These being

• A 35mm dia supply to Theatres 5, 6 & 7, MRU, Monow & Leadon Wards

• A 42mm dia supply to the Main building including ITU, Theatres 1, 2, 3, 4 and the delivery theatre.

There is the facility to provide the connection of the “reserve supply – third source” of oxygen in accordance with HTM 02-01 to each of these branches in the form of a centralised automatic manifold system (similar to the secondary supply) but none has been provided. It is understood that the “reserve” supplies are provided by local oxygen bottles connected to a Nist pipework connection in the oxygen service pipework to each department.

The oxygen provisions incorporate the primary, secondary and reserve supply sources and is therefore fully compliant with HTM 02-01 section 2 Table 1.

The oxygen VIE is the property of the BOC Group and is approximately 39 years old. Over the years, therapeutic uses of medical oxygen are likely to have increased the demand over and above the original design intent. Sodexo have reported that the process vaporiser and pipework is prone to ‘icing’ and this can be an indicator of a plant that is being worked very hard i.e. the demand flow is in excess of the design flow. It is unlikely the existing VIE will have sufficient spare capacity to supply the New Wards options.

The oxygen pipe supply system requires the following to ensure continuity and resilience, in line with HTM 02-01:

• Duplicate components (primary and secondary supply)

• Provision of a third supply

• Provision of alarm systems

• Connection to the emergency power supply

There are 3 options that will be considered further at the next design stage:

• The existing VIE plant capacity (primary supply), the standby automatic oxygen manifold capacity (secondary supply) and infrastructure to be upgraded to supply the existing hospital and the proposed New Ward.

• A new liquid oxygen cylinder manifold to be sized to supply the New Ward building only. A primary and secondary supply will be provided and located in separate external plant areas to provide resilience in line with HTM-02. The final location for the primary and secondary plant areas to be reviewed and finalised at the next design stage.

• A new compressed gas cylinder manifold to be sized to supply the New Ward building only. A primary and secondary supply will be provided and located in separate external

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plant areas to provide resilience in line with HTM-02. The final location for the primary and secondary plant areas to be reviewed and finalised at the next design stage.

A new manifold room will be provided within the New Ward building as detailed on the architectural layouts. The room will be designed to accommodate the third supply of oxygen manifolds and for cylinder storage and will include a separating wall. The third supply may not be required for the New Ward due to the size of the building; this will be reviewed at the next design stage.

COMPRESSED AIR

The existing compressed air supply (4 bar) for the site is provided from two locations the Pharmacy plant and an external plant room adjacent theatre 7. The compressed air provisions within the Pharmacy plant room supplies the main building including ITU, Theatres 1, 2, 3, 4, delivery and dental departments. The compressed air provisions within the external plant room, adjacent to theatre 7, supplies theatres 5, 6 & 7 only.

The existing triplex compressed air plant located in the Pharmacy plant room (at roof void level in the nucleus templates) appears to have sufficient spare capacity to supply the proposed New Ward (acting as both “primary and secondary supply). A detailed analysis will be required when the building is being designed to confirm this. The distribution routes for any new medical air pipework from this plant room, to the new buildings will require careful consideration.

Connecting to the existing compressed air system will have associated risks as the condition, the route and the actual available capacity of the existing system are unknowns. A new compressed air plant has therefore been proposed and would be located within the roof plantroom and distribute to serve ground and first floor.

VACUUM

The existing medical vacuum provisions for the site are provided from the Pharmacy plant room and the Tower Plant room. The vacuum provisions within the Pharmacy plant room supplies the main building including ITU, Theatres 1, 2, 3, 4, delivery and dental departments.

The existing triplex vacuum plant, also located in the Pharmacy plant room, appears to have sufficient spare capacity to supply the proposed New Ward (acting as both “primary and secondary supply) however a detailed analysis of peak demand will be required. The distribution routes for any new vacuum pipework from this plant room to the various options for the New Wards location will require careful consideration.

It has been noted from a previous survey, that the ambient temperatures in the pharmacy plant room should be monitored and additional ventilation should potentially be provided to ensure the full operational life of the plant is achieved as the room temperature is likely to be in excess of the maximum figure stated by the plant manufacturer.

Connecting to the existing vacuum system will have associated risks as the condition, the route and the actual available capacity of the existing system are unknowns. A new vacuum plant has therefore been proposed and would be located within the roof plantroom and distribute to serve ground and first floor.

PNEUMATIC TUBE SYSTEM

A new pneumatic tube system is to be provided for the new wards linked into the existing site wide system. New stations are to be provided within each Clean Utility.

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3.2 ELECTRICAL ENGINEERING SERVICES

INCOMING ELECTRICITY

To service the electrical requirements of the new facility two new Low Voltage (LV) electrical supplies will be provided from the relocated Hutted Ward switchgear and from the Macmillan Renton Unit (MRU) substation via underground submains cables respectively. The cables will terminate into two new switchboards. The existing Hutted Ward switchroom 2 currently supplies the Hutted buildings, Diabetic building and the New Poor Law building. The switchroom is situated in the footprint of the proposed New Ward Block and will therefore be replaced as part of the demolition of the Hutted Wards. Refer to the separate demolition document for full details. The existing MRU transformer currently services the existing MRU building and is rated at 1000kVA. At the time of the survey the transformer had a maximum demand of approximately 100kVA. There is sufficient electrical capacity within the transformer to supply the electrical demands of the New Ward Blocks and there is spare ways within the switchpanel to service the new development. To maximise the resilience the routes from each source shall be diverse as far as reasonably practical. An initial electrical load assessment has been carried out and has determined a circa 270kVA is required to serve the new facility. The load has been sized to accommodate for 25% space capacity for future modifications/alterations.

OPTION AREA (M²) *1

LOAD (W/M²) *2

TOTAL LOAD (KW)

P.F KVA SPARE %

TOTAL LOAD (KVA)

ANTICIPATED SWITCHROOM

2 LOAD

ANTICIPATED MRU LOAD

MRU GENERATOR

RATING (KVA)

2 x 24 Bed Ward

2926 70 204.82 0.95 215.6 25 269.5 94.325 175.175 300.00

Note

*1 Area sizes to be finalised in conjunction with the Architect.

*2 Loads based on BSRIA Rules of Thumb Guidance

STANDBY GENERATION

To ensure electrical services within the building remain operational during a failure of the DNO supply essential services set shall be provided in accordance with HTM 06. There is an existing generator connected upstream of the existing Hutted Ward switchgear. Discussion with members of Sodexo have indicated that the existing generator is at capacity. As a result a drop out contactor will be installed to the new switchgear to ensure the load on the generator does not increase and as such provide a non-essential supply. To provide an essential supply to the New Ward Block a new standby generator will be connected to the new switchboard provided from the MRU building. The level of autonomy for the generator system will be determined during the next stage.

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The Generator shall be sized to provide the essential services of the building in the event of a power failure. Initial calculations have indicated that the generator will be sized at 300kVA to account for a 60% load step. This is dependent on the option taken and will need to be verified during the next stage.

LV DISTRIBUTION

Supplied from the MRU switchboard and the relocated Hutted Ward switchgear will be two new sub distribution MCCB panel boards located within dedicated electrical rooms. Emanating from the existing LV switchboards, multicore XLPE/SWA/LSF sub mains cables shall be installed to final circuit distribution boards, mechanical control panels and fixed loads including Fire Alarm Panels (Enhanced fire rated cabling) located throughout the building. Refer to the electrical schematic for details of the proposed distribution. The final circuit distribution boards will generally enable lighting and power loads to be metered and logged separately in accordance with Building Regulations Part L. The split metering of lighting and power will be achieved through the use of separate lighting & power distribution boards, each separately metered and split metered lighting and power distribution boards. The final distribution boards will be provided to incorporate 25% future spare capacity in terms of load capacity and space for additional breakers. Final circuit protective devices will be Miniature Circuit Breakers (MCB’s) or residual-current circuit breaker with overload protection (RCBO) in accordance with BS7671 and the HTM’s. In all patient areas and clinical support areas, as far as practically possible, the lighting and small power circuits will be interleaved to provide a minimum of two lighting and two small power circuits to ensure local circuit failure or maintenance operations will not entail complete loss of lighting or power to the area. The design will ensure that the lighting or small power in the same area is not connected to differing phases even when final circuits originate from alternate distribution boards. SP&N MCB distribution boards supplied via a UPS / IPS system arrangement will be provided for the enhanced bedrooms. An IT electrical system is to be used for final circuits supplying medical electrical equipment intended for life support systems, surgical applications and electrical equipment used in the patient environment. Where a medical IT electrical system is used, additional protection by means of an RCD will not be used. In Medical Location Group 1 and 2 where RCDs are required only type A or type B will be used.

MECHANICAL CONTROL CENTRES

A new Mechanical Control Centre will be installed within the plantroom to service the mechanical requirements of the wards.

PHOTOVOLTAICS

A complete Photovoltaic system will be designed, manufactured, installed, set to work and commissioned by a Micro generation Certification Scheme (MCS) registered specialist. The system shall comply with relevant regulations and standards, in particular with G77/1, G83 and G59/1, BS EN 61194 and BS 7671.

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An array of panels will be installed at roof level. The panels will be connected to an inverter unit including a G59 relay to allow synchronisation with the mains supply, which will be connected to the main LV switchpanel.

EXTERNAL SERVICES

A series of underground ducts shall be installed for the power, lighting, comms and ancillary services.

MEDICAL LOCATION GROUPS

An initial medical location assessment has been undertaken utilising the requirements of IEC 60364-7-710, BS7671, Guidance Note 7 and HTM 06-01.

The Clinical Risk Categories are fundamental issues that have a major impact on the electrical infrastructure. It is essential that the proposals are reviewed by Clinical members of staff and formally agreed between all parties.

Medical Locations are definitions as follows:

Group 0: Medical location where no applied parts are intended to be used and where discontinuity (failure) of the supply cannot cause danger to life

Group 1A: Medical location where discontinuity of the electrical supply does not represent a threat to the safety of the patient and applied parts are intended to be used externally or invasively to any part of the body except where group 2. A tertiary power supply (UPS) is not required.

Group 1B: Medical location where discontinuity of the electrical supply does not represent a threat to the safety of the patient and applied parts are intended to be used externally or invasively to any part of the body except where group 2. A tertiary power supply (UPS) is required.

Group 2: Medical location where applied parts are intended to be used, where discontinuity (failure) of the supply can cause danger to life, in applications such as intracardiac procedures or vital treatments and operations. A tertiary power supply (UPS) is required.

The risk assessment has determined the following:

Area/space Medical Location Group

Enhanced Bedrooms 2

Bedrooms/Wards 1A

Corridors 0

Examination / Treatment rooms 1A

Offices 0

En Suite / WC's 0

Clean Utility 0

Dirty Utility 0

Staff Base 0

Reception 0

Waiting 0

Stores 0

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Plant Areas 0

EARTHING AND BONDING SYSTEMS

An earthing and bonding system will be provided in accordance with HTM’s, HBN’s, BS7671 and BS7430. The earthing will provide sufficiently low impedance to facilitate satisfactory protection and operation of protective devices under fault conditions. The earthing system will retain system voltages within reasonable limits under fault conditions (such as lightning, switching surges or inadvertent contact with higher voltage systems), and ensure that the insulation breakdown voltages are not exceeded. An earth bar will be provided adjacent to the new LV switchpanel. All main connections will be provided with test links. All extraneous conductive metalwork will be bonded to the earth bars including but not limited to the following:

• Earth Bonding Bars

• Lightning Protection System

• Building structure

• Incoming Electrical services

• Incoming Mechanical Services

• Photovoltaic Panels

• Lift guide rails

• Mechanical services

• Ceiling grid

• Raised floor support

• Cladding Areas assessed as Medical Locations Group 1 or 2 will be provided with dedicated Earth Reference Bars (ERB) in a lockable enclosure. Within these rooms supplementary Equipotential Bonding between all exposed conductive surfaces will be provided to satisfy the requirements of BS7671. A supplementary Equipotential Earth Bonding (SEEB) Plug and Socket will also be installed within the rooms.

UNINTERRUPTIBLE POWER SUPPLIES, ISOLATED POWER SUPPLIES AND SPECIALIST MEDICAL EQUIPMENT

Uninterruptible power supplies (UPS), isolated power supplies (IPS) and Medical Equipment (ME) will be provided in accordance with HTM’s, HBN’s, BS7671 and IET Guidance Note 7. A UPS / IPS system arrangement will be provided for the Enhanced bedrooms. The UPS units shall be provided within their own dedicated room and will be provided with 60 minute battery autonomy. The units shall be sized to cover 100% of the UPS load. The UPS shall be provided in an ‘N + N’ arrangement to provide redundancy. The UPS will be sized to provide power to socket outlets within the Enhanced bedrooms. Specific medical equipment UPS are assumed to be provided locally by the manufacturer. Each UPS will be provided with an external bypass panel for maintenance.

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All IPS units will be SP&N installed locally to the area it is serving within a lockable cupboard. A Delta ZigZag (Dzn0 – vector group) transformer shall also be installed within the UPS room to generate a phase shift and provide a fixed neutral local to the UPS to prevent the UPS from becoming a generator with a floating (electronically generated) Neutral as recommended in HTM06 01.

TERTIARY POWER SUPPLIES FOR ANCILLARY SYSTEMS

Fire alarm panels, security panels and the nurse call system will be provided with integral tertiary power supplies. Additional UPS units will be provided via locally based load specific units to keep essential equipment operational as required by the Trust. These units shall be provided by the Trust as a Group 3 item.

CONTAINMENT

An interlinked network of cable containment shall be installed throughout the building to allow the effective distribution and support of all electrical services. Typically, distribution of cables will be carried out using cable containment systems installed within the corridors with sub-branches to serve individual rooms/spaces. The containment will include for 25% future spare capacity. Typically the containment will be as follows: Typically the containment shall be as follows:

• Galvanised ladder rack and tray for LV sub main distribution cables o Dedicated containment to be provided for the A / B distribution systems.

• Galvanized ladder rack and tray for UPS/IPS LV sub main distribution cables

• Galvanised trunking and conduit for the lighting and small power final sub circuits from distribution boards

• Galvanized trunking and conduit for small power final sub circuits from IPS units.

• Galvanised trunking and conduit for emergency lighting connected to the Static Inverter.

• Galvanised basket for IT fibre and structured cabling

• Segregated galvanised basket and conduit for fire alarm and extra low voltage services including (lighting control, CCTV, access control, intruder alarm and nurse call cabling).

• Horizontal Medical services trunking within bedded areas Dedicated containment will be provided for medical location group 2 areas. The containment shall carry wiring exclusively to the use of equipment and fittings in that location. White multi-compartment UPVC Horizontal Dado trunking shall generally be provided in offices areas and Consulting rooms. All containment will be equipotentially bonded in accordance with BS7671.

SMALL POWER

A new small power installation will be provided to satisfy the requirements of the end user. The installation will be provided in accordance with the HTM’s, HBN’s BS7671, and IET Guidance Note 7. The general purpose power systems generally comprise the assortment of socket outlets, isolating switches and fused connection units etc. The small power system will be either:

• Wired in LSF single core cables, laid in trunking and/or drawn through conduits.

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• Wired in multi core armoured cables, on cable tray / ladder. All accessories shall be in accordance with Part M and shall be of the same finish and manufacturer whether they are installed flush mounted, within wall mounted multi compartment dado or bedhead system. Accessories in plantrooms, risers and ceiling voids shall be metal clad and fixed over a matching surface mounting back box. In all other locations the installation shall be concealed within the building finishes. All dado trunking will be UPVC in construction with inherent segregator for the data wiring section of the trunking. Trunking and accessories in all clinical rooms shall have certified inherent anti-micro bacterial properties to reduce the risk of transmission of infection. IP66 socket outlets will be utilised in any wet area or external locations. Single socket outlets will be provided throughout the building to provide power for cleaners/maintenance. The outlets will be located so as accessible from each area. Fused connection units and isolators will also be provided for ancillary services and miscellaneous plant as required. Shaver socket outlets shall be installed in all en-suite rooms. All socket outlets shall have outboard rockers. Socket outlets served via an ‘essential’ supply will have red rocker switches.

UPS / IPS SOCKETS

All UPS sockets shall be unswitched red socket outlets to clearly distinguish between general socket outlets.

All IPS sockets shall be unswitched blue socket outlets to clearly distinguish between general socket outlets.

All medical socket outlets shall be unswitched red or blue socket outlets with engraved white lettering stating ‘Medical Equipment Only’ connected to the UPS/IPS system.

GENERAL LIGHTING

New artificial illumination shall be installed to provide an optimum working environment whilst ensuring that a well illuminated and safe working environment is provided. The installation shall be functional for clinical use, yet emphasis shall be given to provide an aesthetically scheme. The internal lighting design shall be provided to satisfy the relevant mandatory, legislative and regulatory requirements, British Standards, Codes of Practice and Best Practice professional guidance publications including but not limited to:

• BREEAM Assessment Criteria

• Building Regulations

• CIBSE/SLL Lighting Guides (in particular LG2 & LG7)

• Code for Interior Lighting (CIBSE/SLL)

• HTM 06

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New artificial lighting shall be installed throughout by low energy luminaires typically via LED luminaires via a combination of recessed, suspended and surface mounted luminaires. The design and selection of the lighting system shall offer a calm and welcoming environment with good quality colour rendering (4000k lamp colour temperature). A fully addressable DALI lighting control system shall be provided to control and operate the lighting. This will allow the ability to control individual luminaires and detectors, configure and re-configure groups and create interactive groups of luminaires. This will also allow complete lighting management and reporting, along with integration into other elements of a building management system. Accessories shall be in the form of 20amp rated grid assembly switches. The finish of the accessories shall be provided to suit the particular location they are installed in such as Plantrooms, Staff and Patient areas and wet rooms. All accessories will be in accordance with Part M. Accessories in all clinical and treatment rooms shall have certified inherent anti-microbacterial properties to reduce the risk of transmission of infection. Suitably IP rated accessories shall be utilised in any wet area or external locations. Lighting controls will be installed to aid in the conservation of energy whilst ensuring that a flexible and convenient method of lighting control is present. As a minimum, the lighting controls will meet the requirements detailed within Part L of the Building Regulations and BREEAM. Where sufficient natural daylight is present, a photocell override will be provided, which will dim or switch off the artificial lighting. Daylight linked dimming shall not be awarded within the multi ward areas due to the complexity of the space (curtains etc) Reception The lighting installation within the reception area will generally comprise of recessed modular LED luminaires to provide the general lighting requirements and additional feature downlighters to accentuate the space. Control of the lighting will be via a manual switch. Waiting Area Lighting within the waiting area shall be by means of circular recessed LED luminaires. Control of the lighting will be via a manual switch. Nurse Base The lighting installation within the nurse base areas will generally comprise of recessed modular LED luminaires to provide the general lighting requirements and additional feature downlighters to accentuate the space. Control of the lighting will be via dimmable manual switching and automatic control to provide absence detection that shall operate independently from the circulation space. General Circulation Lighting within the clinical circulation areas will be via recessed linear LED luminaires positioned asymmetrically to one side and via recessed downlighters. Control of the lighting will be Automatic. The controls will provide a reduced level of illuminance at night.

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Clinical Circulation Areas Lighting within the clinical circulation areas will be via recessed linear LED luminaires positioned asymmetrically to one side to minimise glare to patients being transported on trolleys/beds. Control of the lighting will be Automatic. The controls will provide a reduced level of illuminance at night. Offices Offices shall generally comprise of recessed modular LED luminaires. The luminaires shall satisfy the requirements of CIBSE Guide LG7. Control of the lighting will be via manual switching and automatic control to provide absence detection. Multi Bed Wards The lighting installation within the multi bed wards will generally comprise of multiple recessed LED downlighters with technical louvres to limit glare to the patient and a wall mounted LED luminaire at the bedhead that consists of separately controlled uplighter and downlighter sections. The lighting system shall provide multiple lighting scenes within the bedroom including General nursing care, patient rest, Reading, Observation and Night Light. Control of the lighting will be via manual switching at the entrance and a handset at the bed for patient control. ‘Nightlight’ functionality will be provided by a switch located at the bedroom entrance. When the switch is operated the ceiling mounted luminaire will illuminate at a lower level of its full output to allow the nurse to safely move around the ward whilst not compromising the sleeping environment. Single Bed Wards The lighting installation within the single bed wards will generally comprise of recessed LED downlighters with technical louvres to limit glare to the patient and a wall mounted LED luminaire at the bedhead that consists of separately controlled uplighter and downlighter sections. The lighting system shall provide multiple lighting scenes within the bedroom including General nursing care, patient rest, Reading, Observation and Night Light. Control of the lighting will be via manual switching at the entrance and a handset at the bed for patient control. ‘Nightlight’ functionality will be provided by a switch located at the bedroom entrance. When the switch is operated the ceiling mounted luminaire will illuminate at a lower level of its full output to allow the nurse to safely move around the ward whilst not compromising the sleeping environment.

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Typical Lighting arrangement within Single Bed Ward

Enhanced Bed Wards The lighting installation within the Enhanced Bed wards will generally comprise of recessed LED downlighters with technical louvres to limit glare to the patient and a recessed multi-function ‘clean’ LED luminaire. The lighting system shall provide multiple lighting scenes within the bedroom including General nursing care, watchlight, patient rest, clinical care and examination. Control of the lighting will be via a manual switch. The general circulation lighting within the space will be controlled via a manual switch at the entrance. The four lighting scenes will be controlled manually at the bed head. WC Areas WC areas will be provided with recessed circular LED luminaires. Control of the lighting will be automatic. Shower Areas / Ensuite Shower and Ensuite areas will be provided with suitably IP rated recessed circular LED luminaires. Control of the lighting will be automatic. Plant In these areas batten type linear LED luminaires shall be provided with suitable ingress and mechanical protection. The lighting shall be fully co-ordinated with the plant.

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Control of the lighting shall be via a bank of manual switching. Examination lamps Examination lamps will be provided to satisfy the requirements of the end user. Exact details are to be established during the next design stage. Illumination / colour rendition levels The levels of maintained illumination / minimum colour rendition in accordance with CIBSE Guidance shall be;

Area/space Illumination level (lux) Minimum Colour Rendition

Bedrooms/Wards

General Circulation Space 100 at floor Ra80

Patient Activity/Reading 300 at bedhead 1.0m AFFL

Ra80

General Nursing Care 300 at bed Ra80

Nightlight 5 lux at 0.85m, 0.5 max at bedhead

Ra80

Watchlight 15-20 at bedhead Ra80

Examination (to be provided using mobile examination lamp)

1000 at bed Ra90

Corridors

Daytime 200 at floor Ra80

Night-time 50 at floor Ra80

Examination / Treatment rooms

General 500 at WP Ra80

Local Examination 1000 at bench Ra90

Offices

General 300 at desk Ra80

En Suite / WC's 200 at floor Ra80

Clean Utility 150 at WP Ra80

Dirty Utility 200 at WP Ra80

Staff Base

Daytime 300 at desk Ra80

Night-time 30-200 at desk Ra80

Reception 500 at desk Ra80

Waiting 200 at floor Ra80

Stores 100 at floor Ra80

Plant Areas 300 at Floor Ra80

EMERGENCY LIGHTING

An emergency lighting facility shall be provided in accordance with the relevant HTM, HBN’s, LG2, BS 5266, BS7671 and Building Regulations. To provide sufficient illumination in the event of a power failure strategically selected luminaires within the building shall have integral battery pack and invertor arrangement capable of providing illuminance in emergency conditions for a minimum period of 3 hours.

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These ‘maintained’ luminaires shall also be supplemented by dedicated non-maintained emergency luminaires. These fittings shall be located as prescribed in the appropriate standards and to suit building control requirements including the direction of the “running man”. All emergency and escape luminaires shall be connected to an automated centralised test system. The emergency lighting central testing system shall provide continuous monitoring of all emergency luminaires for lamp, battery and control gear faults, together with a programmable test regime to fully meet legislation requirements and provide documented history. The automatic testing facility shall be undertaken using PC based software.

Emergency lighting within the Enhanced bedrooms shall be provided via an Emergency Lighting static inverter. The static inverter shall be connected to strategically selected luminaires and provide 100% light output of said luminaires in the event of mains failure.

The static inverter shall be installed within the electrical cupboard within the area. The static inverter shall be capable of providing illuminance in emergency conditions for a minimum period of 3 hours and shall be sized to include 25% capacity for future expansion. All supply cables from the static inverters will be run on dedicated containment and the supply cables will be the enhanced fire rated type. Emergency lighting shall also be provided within external areas where occupants have to travel to reach a place of safety.

EXTERNAL LIGHTING

External lighting complying with CIBSE Code for External Lighting and The Institution of Lighting Engineers will be provided. The lighting shall provide safe movement around the site, freedom of access and security during the hours of darkness. The external lighting will minimise, as far as practicable, light pollution into particular hospital areas (e.g. sleeping accommodation), any adjoining development areas and to the environment in general in accordance with ILE Guidance Note on Obtrusive Light whilst ensuring that the level of light is adequate for CCTV usage. External lighting will be provided to the entrance areas, building façade and external walkways/paths. The external lighting shall be via column mounted LED luminaires, wall mounted LED luminaires and in ground LED bollard luminaires. The LED lamp source colour temperature and type will be selected to soften the lighting effect and minimise glare and reflected light from the building facades. Controls of the external lighting will be via a contactor, photocell and digital time clock arrangement split into zones and linked to the BMS system. The photocell will be externally mounted. The external lighting will be provided with a manual over ride facility. A series of underground cable ducts linked by cable draw pits shall be provided linking luminaires and their origin of the supply.

PUBLIC ADDRESS SYSTEM

There is no provision for a Public Address system.

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SECURITY AND CCTV SYSTEMS

New IP CCTV cameras will be installed and fully integrated into the existing side wide CCTV system. Final details of the system shall be developed during the next stage.

ACCESS CONTROL SYSTEMS

New Access Control will be provided to regulate access to authorised staff or personnel to certain areas. The system will be installed and fully integrated into the existing side wide Access Control. The system will comprise of contact-less card readers, door release buttons, electro-magnetic locking devices, green emergency door release break glass units, appropriate door controllers and remote door expanders as necessary. All controllers shall be linked to the fire alarm system via suitable interface units and in the event of a fire alarm activation all doors shall fail open. All accessories shall be in full compliance with the disability discrimination act.

INTRUDER ALARM

Due to the 24hour nature of the building there is no provision for an intruder alarm system.

FIRE DETECTION AND ALARM

A new fully analogue addressable fire alarm and detection alarm system complying with current British Standards BS 5839 and HTM 05-03 will be installed. The new system will be fully interfaced with the existing system. It should be noted that the existing Siemens system is currently at full capacity however is due to be upgraded prior to the proposed Ward Block works. In accordance with HTM 05-03 the installation shall be designed to ‘L1’ standard, with combined detector and sounder loops utilised and principles of phased evacuation to be used. The new fire alarm and detection system will comprise of a fire alarm analogue addressable panel, fully functional repeater/indicator analogue addressable panels, automatic high performance point detectors, manual call points, audible and visual alarms, aspirating smoke detection systems and associated ancillary equipment. The system will also be linked to the BEMS system for monitoring. A new fire damper control system will also be installed. The cables for the fire detection and alarm systems will be in red sheathed enhanced fire resisting cable in accordance with the requirements of BS 5839-1. Where required by risk assessment, detectors will be installed within ceiling void spaces. In areas where occurrence of false alarm is likely to happen combined smoke/heat/carbon monoxide detectors will be provided.

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NURSE CALL / DISABLED ALARMS SYSTEM

A combined nurse call and disabled alarm system will be provided in accordance with BS8300, HTM 08-03 and Building Regulations Approved Document Part M. The system will be designed, installed and commissioned by a specialist supplier. The system will operate on a follow the light basis. Activation of a call unit shall illuminate strategically placed lights to indicate the most direct route for staff, to the waiting patient. As a minimum the system shall accommodate the following call types:

• Patient

• Emergency

• WC The system shall, however be capable of accommodating user-defined calls, with tone levels and flash rates individually programmed to meet specific site requirements. The system shall have the functionality for calls to be escalated depending on their seriousness. (I.e. Emergency call escalates over WC call) System devices will include:

• Nurse call panels

• Push button - patient / staff call,

• Ceiling pull cord - patient / staff call

• Push button - staff emergency call with reset and integral reassurance lamp

• Ceiling pull cord - staff emergency call

• Bedhead unit consisting of: o Nurse call handset o Push button - staff emergency call with reset and integral reassurance lamp o Reset unit and integral reassurance lamp

• Reset unit with repeat lamp

• Underdesk panic button

• Overdoor/ceiling led indicator unit

• Overdoor/ceiling indicator unit with sounder

• Overdoor/ceiling sounder

• Ancillary equipment A Nurse Call Panel shall be installed in each Nurse Base station to give full details of calls on the system. The system shall have an integral battery back-up facility providing a minimum autonomy of 3hours. The system shall be a stand-alone system not linked to any other nurse call systems.

There is no provision for a Staff Paging system.

Connection of drug cupboards and fridges to the system shall be detailed in the next stage.

STAFF ATTACK SYSTEM

There is no provision for a staff attack system

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DISABLED REFUGE SYSTEM

The provision of a disabled refuge system shall be developed during the next stage.

BED HEAD SERVICES

At all bed locations a vertical medical services trunking system shall be provided. The unit shall contain the following provision:-

• Bedhead power

• Data outlets

• Nurse Call including patient handset

• Bracket for patient handset

• Light switches to meet lighting philosophy.

• Medical Gas Outlets Separate compartments will be provided for each of the following services:-

• LV Power

• Data & ELV Services

• Piped Services The trunking systems shall have no sharp edges or dust traps.

INDUCTION LOOP SYSTEM

The provision of an Induction loop systems shall be developed during the next stage.

AUDIO / VIDEO DISTRIBUTION

The provision of an Audio / Video system shall be developed during the next stage.

LIGHTNING PROTECTION

A lightning protection system shall be installed to the new buildings in accordance with the recommendations of BS62305 to offer optimum protection of the building, the buildings integral equipment, staff and the public against the effects of a lightning strike.

IT SYSTEMS

An integrated structured cabling system is to be installed throughout the area to serve the voice and data installation requirements of the new building. New IT Cabinets shall be provided within the dedicated IT Room. The new data system shall be connected to the existing system. A WiFi installation will be installed to supplement the hard wired system.

LIFT INSTALLATION

New Motor Room Less (MRL), HTM compliant lift(s) will be installed within the area. The lift(s) will be heavy duty designed to withstand the anticipated foot traffic.

28


A lift traffic analysis will need to be carried out at the next stage to determine the full requirements.

29

MEP Services Strategy Document WSP Wye Valley Trust Project No 70011184 September 2017


Appendix 4.5

BREEAM Design Stage Report

Kings Orchard1 Queen StreetBristolBS2 0HQTel: +44 117 930 2000wsp.com

WSP UK Limited | Registered address: WSP House, 70 Chancery Lane, London WC2A 1AFRegistered in England and Wales No. 01383511

Kier Construction LtdCentral House, Sabre Close,Quedgeley,Gloucester,GL2 4NZ

Hereford Wards BREEAM 70011184

21 August 2018

Dear Sir,

Hereford Wards BREEAM Assessment Letter of Comfort

We are writing to confirm that WSP (in our capacity as licensed BREEAM assessors) are undertaking theBREEAM assessment for the above project.

To date the project has been assessed as a two storey, 48 bed scheme. An option is currently proposed foran additional floor, of the same functional use, taking the total bed number to 72.

We write to confirm the inclusion of an additional floor does not require a separate BREEAM assessment,and can be assessed under the current registered assessment (BREEAM-0069-1956). Furthermore, theBREEAM design stage strategy remains unchanged, with the same credits targeted and consideredachievable in consultation with the project team, as per the 48-bed scheme. Therefore, subject to the designteam providing the necessary evidence to comply with credit requirements, we have confidence in the projectachieving an Excellent rating.

It must be noted the BRE Global Ltd certification audit process will independently review a sample ofevidence WSP, as licenced BREEAM Assessors, submit for third party certification. The BREEAM rating forthe development cannot be guaranteed until this assurance process is complete.

Yours sincerely

Harry HazellBREEAM Consultant

BREEAM 0069-1956AUGUST 2018 CONFIDENTIAL


HEREFORD WARDS72 Bed BREEAM Design Stage Report


HEREFORD WARDS72 Bed BREEAM Design Stage Report

ACTION REPORT (VERSION 1) CONFIDENTIAL

PROJECT NO. 70011184OUR REF. NO. BREEAM 0069-1956

DATE: AUGUST 2018

WSPWSP House70 Chancery LaneLondonWC2A 1AFPhone: +44 20 7314 5000Fax: +44 20 7314 5111WSP.com

HEREFORD WARDS WSPProject No.: 70011184 | Our Ref No.: BREEAM 0069-1956 August 2018Wye Valley NHS Trust

QUALITY CONTROL

Issue/revision First issue Revision 1 Revision 2 Revision 3

RemarksDesign Stage:BREEAM NewConstruction 2014

Date 21st August 2018

Prepared by Harry Hazell

Signature

Checked by Rachel Cakebread

Signature

Authorised by Rachel Cakebread

Signature

Project number 70011184

Report number 70011184 - 01

File referenceBREEAM 0069-1956

WSP HEREFORD WARDSAugust 2018 Project No.: 70011184 | Our Ref No.: BREEAM 0069-1956


PRODUCTION TEAM

Wye Valley NHS TrustClient

IBI GroupArchitect

KierContractor

WSPMEP Engineer

BREEAM Assessor

BREEAM AP

Structural Engineer

HEREFORD WARDS WSPProject No.: 70011184 | Our Ref No.: BREEAM 0069-1956 August 2018Wye Valley NHS Trust Page 1 of 12

CONTENTS

1 EXECUTIVE SUMMARY 2

1.1 CONTEXT 21.2 SCORING 3

2 PROJECT BACKGROUND 5

3 INTRODUCTION 5

3.1 REPORT PURPOSE 5

4 ASSESSMENT STRATEGY 6

4.1 AGREED BREEAM PROGRAMME: 6

5 ROLES AND RESPONSIBILITIES 7

6 BACKGROUND TO BREEAM 7

6.1 BREEAM SCORING AND RATING 76.2 BREEAM CATEGORY WEIGHTINGS 86.3 MANDATORY REQUIREMENTS 96.4 REQUIREMENTS WITH SPECIFIC ACTION TIMINGS 10

7 REPORT FORMAT 11

8 DISCLAIMER 11

9 COPYRIGHT 11

APPENDICESAppendix A- BREEAM Design Stage Tracker

WSP HEREFORD WARDSAugust 2018 Project No.: 70011184 | Our Ref No.: BREEAM 0069-1956Page 2 of 12 Wye Valley NHS Trust

1 EXECUTIVE SUMMARY

1.1 CONTEXTWSP has been appointed in its capacity as Licensed BREEAM Assessors by the Wye Valley NHS Trust toprovide consultancy advice and undertake a BREEAM assessment of the healthcare development known asHereford Wards.

The project team has recently proposed to add an additional floor, taking the total bed number to 72. Thepurpose of this report is to support the business case for this design, by demonstrating the project team’sability to reach a BREEAM Excellent rating with the current design. Note, due to updated design informationbeing required, the majority of credits previously marked as achieved (for the 48-bed option) have to berevisited, resulting in the reduction of the achieved score. The targeted score for the assessment howeverremains unchanged between the 48 and 72 bed options.

The project under assessment comprises:

Project Name Hereford Wards

Location Hereford

Main Use Function Healthcare

BREEAM AssessmentScheme BREEAM Non-Domestic New Construction 2014

Assessment type Fully Fitted: Healthcare

Approximate NIA (m2) TBC

Current Stage RIBA Stage 4

Target Rating/ Reason Excellent

Stage of Assessment Design Stage

The purpose of this report is to demonstrate:

¡ The agreed route to BREEAM certification for the project.¡ The credits/ performance requirements which the team agreed to target and implement.¡ The current status of the building in terms of BREEAM performance.¡ The actions required by the project team to satisfy BREEAM evidential requirements.


1.2 SCORINGBased on discussions and agreements with the Design Team and client, the following scoring scenarios arepredicted:

Scoring Scenario BREEAM Score(Cumulative)*

Indicative BREEAMRating

BREEAM NON-DOMESTICNEW CONSTRUCTION2014

Achieved 30.75% Pass

Targeted 74.25% Excellent

Potential 76.21% Excellent

*Score as produced by BRE’s BREEAM scoring tool

Graphical representation of the credits associated with each environmental section

0%

20%

40%

60%

80%

100%

Man Hea Ene Tra Wat Mat Wst Le Pol Inn

BREEAM Section Scoring

Achieved Targeted Potential Not achievable


Graphical representation of progress to a targeted score of 75% (e.g. BREEAM Excellent of 70% plus 5%buffer)

Targeted Scoring ScenarioThis is based on the items agreed as being targeted by the design team. Upon the presentation of suitabledocumentary evidence to the Assessor, the corresponding achievement will be confirmed.

We recommend that at least 5% is targeted above the required rating, i.e.60% for Very Good or 75% for‘Excellent’. This is to safeguard for missed credits during completion of the design and construction of theasset.

Additional Scoring ScenarioFurther to those items noted as targeted, the following additional credits were identified, which upon furtherinvestigation from the design team or updates to the design could result in an additional (higher) score andrating.

Potential Credits

Item Additional% score Brief action/Summary Production Team

Owner

Mat 03 –Responsiblesourcing ofmaterials

0.96%

Detailed materials information (building elementmaterial makeup, volume and supplier) requiredto establish if additional credits can be targeted.This information is required for both buildingfabric and mechanical and electrical equipment.

ArchitectM&E

Le 04 – Increase inEcological Value 1.00%

Credit can be achieved if significant softlandscaping is adopted. Requires evaluation bythe WSP appointed ecologist.

Ecologist

For full details please refer to the main assessment tracker table in Appendix A.

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Targeted Score

Achieved Targeted Potential Not achievable


2 PROJECT BACKGROUNDWSP has been commissioned to carry out a BREEAM (Building Research Establishment's EnvironmentalAssessment Method) assessment services for the proposed new Hereford Wards development.

The Hereford Wards project consists of a new build ward building, now consisting of three floors (previouslyassessed on a scheme with two) situated on the Hereford County Hospitals current operational site.

The development is being developed to a fully fitted state and assessed under the BREEAM New Construction2014 Healthcare scheme.

At this stage the client is aiming to target a BREEAM ‘Excellent’ rating.

This report identifies the design stage actions of the BREEAM assessment and includes a proposed strategyfor an ‘Excellent’ certification. The BREEAM Assessor and BREEAM AP have proposed a schedule forprogressing the Design Stage Assessment, to be further agreed with the Design team.

3 INTRODUCTION

3.1 REPORT PURPOSEThe report builds upon the initial strategy developed during a Pre-Assessment workshop held on the 14th July2017, RIBA Stage 2 review workshop held on the 31st January 2018, and the Design Stage Assessmentworkshop held on the 24th April 2018.

The project has recently proposed to add an additional floor, taking the total bed number to 72. The purpose ofthis report is to support the business case, by demonstrating the project team’s ability to reach a BREEAMExcellent rating with the current design. Note, due to updated design information being required the majority ofcredits previously marked as achieved (for the 48-bed option) have to be revisited, resulting in the reduction ofthe achieved score. The targeted score for the assessment however remains unchanged between the 48 and72 bed options.

The purpose of this report is to:

¡ demonstrate the strategy (targeted BREEAM credits and overall score) agreed with the project team toachieve a BREEAM ‘Excellent’ rating.

¡ provide a record of the early design considerations of the team.¡ outline the current assessment status.¡ provide detailed actions to be addressed by the project team to satisfy the assessment evidential

requirements.

To summarise these outcomes, this report includes the following:

¡ an appraisal of the development proposals against the BREEAM criteria;¡ identification of the mandatory credits which are essential to be included within the development to

achieve the desired rating;¡ consideration of additional credits which could be targeted, subject to additional consideration,

investigation and possibly additional costs.¡ actions to be addressed by the project team, and the responsible party for each.

This report has been prepared by qualified BREEAM Assessors at WSP who are licensed by the BRE toundertake assessments using the BREEAM Non-Domestic New Construction 2014 Scheme.

In order to demonstrate compliance with the targeted credits as part of the formal design stage andconstruction stage BREEAM assessments documentary evidence demonstrating performance is required tobe presented by the project team. It is therefore important for all project team members to ensure thatcommitments made at this early stage are carried through the design process and are implemented through toconstruction. Cost implications of the assumptions made in this report have not been evaluated as part of thisstudy.


The assessment requirements for achieving a BREEAM certificate can be challenging if overlooked during thedesign evolution process. The team can access the full scheme document (technical manual), which is freelyavailable, at:

http://www.breeam.com/BREEAMUK2014SchemeDocument/

4 ASSESSMENT STRATEGYThe stages of a BREEAM assessment require as a minimum a Construction Stage assessment in order toreceive a final BREEAM certificate. It is strongly recommended that a three stage assessment process isundertaken to maximise the efficiency of achieving the required rating.

¡ Pre-Assessment¡ Design Stage Assessment¡ Construction Stage Assessment

This report represents the design stage (RIBA stage 4 revisit) of the BREEAM Assessment whereby the teamhave identified and agreed a set of BREEAM performance measures to ensure the overall achievement of therequired BREEAM rating is met.

4.1 AGREED BREEAM PROGRAMME:The BREEAM Programme agreed to date is shown below:

Item Ideal RIBA Stage Timing OwnershipPre-Assessment/ StrategyReporting

RIBA Stage 2 Stage 1- 14th Jul 2017 (completed)

Assessor

Design Team Meetings withan AP present

Appointment must bedemonstrated bycompletion RIBA Stage11 x meeting at each keystage

Each RIBA Stage.Stage 1- 14th Jul 2017Stage 2- 31st Jan 2018Stage 3- 24th Apr 2018Stage 4- TBC

Assessor/ AP

Design Stage AssessmentKick-off Meeting

RIBA Stage 3/4 24th Apr 2018(completed)

Assessor/ DesignTeam

Design Stage Action andGuidance report

RIBA Stage 3/4 24th Apr 2018(completed)

Assessor

Design Team – Productionof Information

RIBA Stage 3/4 Deadline TBC Design Team

Design Stage Assessment –Recommendation forCertification

RIBA Stage 4 TBC Assessor

Design Stage (InterimCertification)6-8weeks for QA response

Following RIBA Stage 4 TBC BRE


5 ROLES AND RESPONSIBILITIESThe BREEAM Assessor and BREEAM Accredited Professional (AP) must act in accordance with their“BREEAM License Agreement” with BRE Global Ltd; the owner, managing body and certification authority forall BREEAM schemes.

The design/ construction team will be required to demonstrate “achievement” of the various BREEAMperformance requirements through the presentation of documentary evidence as listed by BRE and conveyedby the Licensed Assessor. This audit material often requires specific responses/ reporting to demonstratecompliance.

During the early stages of assessment, ownership for the various actions and dates for submission will beagreed, which if not met may require a variation to our agreed scope of works.

In accordance with the BREEAM License the Assessor/BREEAM AP must maintain a position of non-conflictof interest. This means that whilst they can provide guidance to the various design/ construction teammembers, they cannot be responsible for the delivery of any part of the required audit trail.

Note: It is acceptable that the Assessor/ AP is part of the same organisation as a member or members of thedesign team who are responsible for information production).

6 BACKGROUND TO BREEAMBREEAM is a market-focused tool aimed at encouraging significant improvements in the performance ofbuildings through quantification of a building’s full life environmental impacts.

The BREEAM score provides a means of recognising a projects sustainability benefits and so benchmarking itagainst other buildings. Key benefits of using the methodology include:

¡ Maximising opportunities to enhance the building’s performance during the planning, design andconstruction phases of new build, refurbishment and fit out projects.

¡ Specifying environmental requirements during procurement and management of all types ofdevelopments.

¡ Use of an independently verifiable measurement tool for forming part of Environmental ManagementSystems.

¡ Providing an independently verifiable sustainability label for marketing and promotional purposes.

6.1 BREEAM SCORING AND RATINGBREEAM ratings are divided into six levels as shown in Table 1. The associated percentage score is achievedbased on meeting the requirements of a number of credits that correspond to meet or exceed the ratingbenchmarks.

Table 1 – BREEAM rating benchmarks

BREEAM Rating Percentage Required

UNCLASSIFIED >30%

PASS 30%

GOOD 45%

VERY GOOD 55%

EXCELLENT 70%

OUTSTANDING 85%


6.2 BREEAM CATEGORY WEIGHTINGSThe categories within BREEAM are weighted according to relative importance within the country ofassessment through a weighting system derived by BRE Global as shown in Table 2. Within each categorythere are a different number of credits, therefore, individual credits carry specific percentage weightings, as apercentage of the overall total.

The number of credits available is based on the scoping of appropriate assessment criteria for the projecttype, location and functions. WSP’s assessment tracker (found in Appendix A) shows the percentagecontribution of each targeted credit to highlight that a credit in one section may not carry the same contributionto the score as a credit in another, due to the category weightings.

BREEAM incorporates a mechanism whereby schemes achieving exemplar performance in a particular areaor demonstrating innovation can achieve an additional 1% for each credit up to a maximum of 10. Theinnovation section is shown at the end of the main assessment table.

Table 2 - Section Weightings

Category Section Weighting

Management 12.0%

Health & Wellbeing 15.0%

Energy 15.0%

Transport 9.0%

Water 7.0%

Materials 13.5%

Waste 8.5%

Land Use & Ecology 10.0%

Pollution 10.0%

Innovation N/A


6.3 MANDATORY REQUIREMENTSTo achieve a BREEAM rating, the minimum percentage score (associated with credits achieved) must be metplus mandatory standards for specific requirements applicable to that rating level must be complied with.These are shown in Table 3.

Table 3 - Mandatory Credits

CreditRef

Credit BREEAM Rating/ Minimum Number of Credits

Pass Good Very Good Excellent Outstanding

Man03

ResponsibleConstructionPractices

- - - One Credit(CCS)

Two Credits(CCS)

Man04

Commissioning andhandover

- - - Criterion 10(Buildinguser guide)

Criterion 10(Buildinguser guide)

Man05

Aftercare (N/A forShell and Core)

One credit(Seasonalcommissioning

One credit(Seasonalcommissioning

Ene01

Reduction of Energyuse and carbonemissions

- - - Five credits Eight credits

Ene02

Energy Monitoring(first credit)

- - One Credit(First credit)

One Credit(First credit)

One Credit(First credit)

Wat01

Water Consumption - One Credit One Credit One Credit Two Credits

Wat02

Water Monitoring - Criterion 1only (mainswater meter)

Criterion 1only(mains watermeter)



Mat03

ResponsibleSourcing of materials

Criterion 1only(LegalTimber)





Wst01

Construction WasteManagement

- - - - One Credit

Wst03

Operational Waste - - - One Credit One Credit

Le 03 Minimising Impact onexisting site ecology

- - One credit One credit One credit


6.4 REQUIREMENTS WITH SPECIFIC ACTION TIMINGSWhen targeting some credits, the requirements can include delivery of work ahead of completion of a specificproject stage (RIBA Stage) to ensure opportunities for positive sustainability outcomes are not missed by theproject team. These are shown in Table 4.

Table 4 – Timing of assessment (key credits)

CreditRef

Credit Plan of work

Preparation andbrief (1)

Concept design(2)

Developeddesign (3)

Technical design(4)

Construction andhandover (5/6)

Man 01 Stakeholderconsultation

Consultation Feedbackprovided

Man 01 Sustainability champion(design)

Appointment(BREEAM AP)

Sustainabilitytarget agreed

Man 02 Life cycle cost andservice life planning

Elemental lifecycle cost (LCC)

Component levelLCC appraisal

Man 03 Sustainability champion(construction)

Appointment andmonitoring

Hea 03 Laboratory safecontainment

Objective riskassessment

Ene 04 Passive design analysis Passive designanalysis andthermal model

Ene 04 Low or zero carbontechnologies

LZC appraisal

Ene 05 Energy Efficient ColdStorage

Cold StorageStrategy

Tra 05 Travel Plan Travel Plan

Mat 03 SustainableProcurement Plan

ProcurementPolicy

Mat 06 Materials efficiency Whole teamengagement

Whole teamengagement




Wst 05 Structural and fabricresilience

Climate changeadaptationstrategy

Wst 06 Functional adaptability Adaptabilitystudy

Adaptationmeasuresadopted

LE 02 Ecological protection Constructecologicalprotection aheadof sitepreparation

Le 04 Ecologist's report andrecommendations

Appointment(SQE)

Ecology reportwithenhancements

LE 05 Long term impact onbiodiversity

Local expertise(valuable habitat)

Appointment(SQE)


7 REPORT FORMATThe tracker in Appendix A shows the BREEAM Non-Domestic New Construction 2014 criteria against whichthe building is being assessed. The credits available for each issue are shown along with a calculated overallpercentage score and rating. The scoring has also been undertaken on the BREEAM Non-Domestic NewConstruction 2014 assessment scheme tool.

This allows for simple analysis of the effect of achieving more or removing any given credit. A summary of theactions has been shown, however the full requirements for the BREEAM assessment can be viewed within theassessment manual or can be provided upon request.

The table provides high level discussion of performance requirements and agreements. During the next stageof formal assessment, explicit ownership, actions and timing for production will be shown based on agreementwith the team.

8 DISCLAIMERWSP has undertaken the following BREEAM Non-Domestic New Construction 2014 report, with input andagreement from the Design Team. All information provided has been accepted in good faith as being accurateand representative of the proposed scheme at the time of review.

The credits and credit requirements are based on the BREEAM Non-Domestic New Construction 2014methodology.

The assessor (for him/herself and as an agent for his/her staff) shall not be held liable whether in Contract orin Tort or otherwise for any loss or damage sustained as a result of using or relying on the informationcontained in this report or the final certificate from BRE that it is based on.

9 COPYRIGHTThe BREEAM name and logo are registered trademarks of the Building Research Establishment Ltd.Copyright exists on BREEAM and it may not be used or reproduced in any form or for any purpose withoutprior written consent of BRE.


APPENDIX A – BREEAM DESIGN STAGE TRACKER

Hereford Wards - Design Stage Action and GuidanceBREEAM 2014 New Construction: Healthcare

30.75% 74.25% 76.21%

Pass Excellent Excellent

Exce

llent

Achieved Targeted Potential

Management

One credit –Stakeholderconsultation(project delivery)

1-3

- Prior to completion of RIBA Stage 2, the project delivery stakeholders have met toidentify and define their roles, responsibilities and contributions for each of the keyphases of project delivery.

- In defining the roles and responsibilities for each key phase of the project, the followingmust be considered:a .End user requirementsb. Aims of the design and design strategyc. Particular installation and construction requirements/limitationsd. Occupiers budget and technical expertise in maintaining any proposed systemse. Maintainability and adaptability of the proposalsf. Requirements for the production of project and end user documentationg. Requirements for commissioning, training and aftercare support.

- The project team demonstrate how the project delivery stakeholder contributions andthe outcomes of the consultation process have influenced or changed the Initial ProjectBrief, including if appropriate, the Project Execution Plan, Communication Strategy, andthe Concept Design.

1 0.57% 1 1NHS trust have provided a completed letter and supporting evidencedemonstrating compliance with all consultation criteria.Credit Achieved.

No Further Action Required RIBA Stage 2

All project teammembers

(Project Manager /Client responsible for

the deliverables)

Stakeholderconsultation (thirdparty) 4-7

- Prior to completion of RIBA Stage 2, all relevant third party stakeholders have beenconsulted by the design team and this covers the minimum consultation content.

- The project must demonstrate how the stakeholder contributions and outcomes of theconsultation exercise have influenced or changed the Initial Project Brief and ConceptDesign.

- Prior to completion of the RIBA Stage 4, consultation feedback has been given to, andreceived by, all relevant parties.

- The consultation exercise used a method carried out by an independent party.

1 0.57% 1 1

NHS trust have provided a completed letter and supporting evidencedemonstrating compliance with all criteria.NHS trust have provided the project DQI report demonstrating a third partyindependent consultation method.Credit Achieved.


Project Manager /Client /

Public RelationsTeam

SustainabilityChampion (design) 8-10

- A Sustainability Champion has been appointed to facilitate the setting andachievement of BREEAM performance target for the project. The design stageSustainability Champion is appointed to perform this role during RIBA Stage 1.

- The defined BREEAM performance target has been formally agreed between theclient and design/project team no later than RIBA Stage 2.

- To achieve this credit at the interim design stage assessment, the agreed BREEAMperformance target must be demonstrably achieved by the project design, demonstratedvia the BREEAM design stage assessment report.

1 0.57% 1 1

WSP have been appointed as BREEAM AP, therefore this credit can betargeted.Please note the achievement of this credit is dependant on achieving thetargeted Excellent rating.Credit Achieved (subject to achieving an excellent rating).

No Further Action Required RIBA Stage 1Client

BREEAM AP

SustainabilityChampion(monitoringprogress)

11-12

- The third credit is achieved.

- A Sustainability Champion is appointed to monitor progress against the agreedBREEAM performance target throughout the design process and formally reportprogress to the client and design team. The Sustainability Champion must attend keyproject/design team meetings during the Concept Design, Developed Design andTechnical Design stages.

1 0.57% 1 1

WSP have been appointed as BREEAM AP, therefore this credit can betargeted.Please note the achievement of this credit is dependant on achieving thetargeted Excellent rating.Credit Achieved (subject to achieving an excellent rating).

No Further Action Required RIBA Stage 4Client

BREEAM AP

Criterion MaxAvailableBREEAM Criteria Responsibility at

Design Stage

Man 01

Proj

ectB

riefa

ndD

esig

n

Ref

MandatoryRequirements% Worth (in

total foreach

question)

CommentaryIndicative

timeframe forConsideration

Sub-TitleTitle Evidence to be provided:

Design Stage Scoring

Cumulative scores

BREEAM Design Stage Action Report1 of 16

Exce

llent



Design StageRef


total foreach

question)





Elemental life cyclecost (LCC) 1-3

- An elemental life cycle cost (LCC) analysis has been carried out, at RIBA Stage 2together with any design option appraisals in line with 'Standardised method of life cyclecosting for construction procurement' PD 156865:2008.

- The LCC analysis shows: an outline LCC plan for the project based on the building'sbasic structure and envelope, appraising a range of options and based on multiple cashflow scenarios e.g. 20, 30, 50+ years;

- The fabric and servicing strategy for the project outlining services component and fit-out options (if applicable) over a 15-year period, in the form of an 'elemental LCC Plan'.

2 1.14% 2 2

Stage 2 elemental life cycle cost report received in which also demonstrateshow this has influenced design and specification.2 Credits Achieved. No Further Action Required RIBA Stage 2

Component levelLCC Plan 4-5

A component level LCC plan has been developed by the end of RIBA Stage 4 in linewith PD 156865:2008 and includes the following component types (where present):a. Envelope, e.g. cladding, windows, and/or roofingb. Services, e.g. heat source cooling source, and/or controlsc. Finishes, e.g. walls, floors and/or ceilingsd. External spaces, e.g. alternative hard landscaping, boundary protection.

1 0.57% 1AECOM advised the component level stage 4 LCC plan will be producedcovering all floors.Credit Targeted.

1) A copy of the compliant Component level LCC planwith supporting documentation of analysis of alternativeoptions and the benefits of the chosen option;

2) Design drawings / specification of the inclusion ofthe recommended options identified by the LCC reports.

3) A copy of the maintenance strategy or a formalcommitment to produce one in compliance with therequirements and be informed by the LCC.

Capital costreporting 6

Report the capital cost for the building in pounds per square metre (£k/m2), via theBREEAM Assessment Scoring and Reporting tool, Assessment Issue Scoring tab,Management section.

1 0.57% 1

Letter received from the Trust noting the capital cost of the project.Updated capital cost letter required for 72 bed scheme.Credit Targeted. 1) Updated capital cost in £ per m2.

Site timber 1

Pre-requisite

All temporary site timber and timber based products used on the project is 'Legallyharvested and traded timber', e.g. is FSC or PEFC certified

- YES YES Kier advised all timber used on site will be legally harvested and traded.Commitment letter received from Kier. RIBA Stage 4

Environmentalmanagement 2-3

- The principal contractor operates an environmental management system (EMS)covering their main operations such as ISO 14001.

- The principal contractor implements best practice pollution prevention policies andprocedures on-site in accordance with Pollution Prevention Guidelines, Working atconstruction and demolition-sites: PPG6

1 0.57% 1 1

Kier have ISO14001 therefore credit is achievable.Note, the ISO 14001 certification must be maintained through to projectcompletion.Commitment letter received from Kier.Credit Achieved.

RIBA Stage 4

SustainabilityChampion(construction)

4-6

- A Sustainability Champion is appointed to monitor the project to ensure ongoingcompliance with the relevant sustainability performance/process criteria, and thereforeBREEAM target, during the Construction, Handover and Close Out stages. TheSustainability Champion will monitor site activities with sufficient frequency to ensurethat risks of non-compliance are minimised. They will report on progress at relevantproject team meetings.

- The defined BREEAM performance target forms a requirement of the principalcontractor's contract.

1 0.57% 1Kier confirmed a sustainability champion will be appointed.Awaiting formal confirmation WSP have been appointed to deliver this role.Credit Targeted.

RIBA Stage 4

Considerateconstruction 7

Using the Considerate Constructors Scheme (CCS) the principal contractor mustachieve scheme certification and a CCS score as follows:1. One credit: a CCS score between 25 and 342. Two credits: a CCS score between 35 and 39

2 1.14%

One

Cre

dit(

CC

S)

2 2

Kier confirmed a CCS score of 35 to 39 can be committed to, in line withrequirements of 2 credits.Commitment letter received from Kier.2 Credits Achieved.

RIBA Stage 4

Monitoring ofconstruction-siteimpacts

8

Energy consumption - Monitor and record data on principal constructor's and subcontractors' energyconsumption in kWh (and where relevant, litres of fuel used) as a result of the use ofconstruction plant, equipment (mobile and fixed) and site accommodation. - Report the total carbon dioxide emissions (total kgCO2/project value) from theconstruction process

Water consumption - Monitor and record data on principal constructor's and subcontractors' potable waterconsumption (m3) arising from the use of construction plant, equipment (mobile andfixed) and site accommodation. - Report the total water use (m3/project value) from the construction process

1 0.57% 1 1

Data monitoring and collation was advised by Kier to be incorporated within siteactivities.Commitment letter received from Kier.Credit Achieved

RIBA Stage 4

9-17

Transport of construction materials and waste - Monitor and record data on transport movements and impacts resulting from deliveryof the majority of construction materials to site and construction waste. - Using the collated data, report separately for materials and waste, the total fuelconsumption (litres) and total carbon dioxide emissions (kgCO2 eq), plus total distancetravelled (km).

1 0.57% 1 1

Data monitoring and collation in regards to tranport of materials and waste toand from site was advised by Kier to be incorporated into site activities.Commitment letter received from Kier.Credit Achieved.

RIBA Stage 4

Man 02

Res

pons

ible

cons

truc

tion

prac

tices

Man 03

Life

cycl

eco

stan

dse

rvic

elif

epl

anni

ng

1) A formal letter of commitment or contractualrequirements document confirming the appointment ofa construction stage sustainability champion.

Cost Consultant/Client

ClientProject manager

Principal Contractor

RIBA Stage 4


Exce

llent



Design StageRef


total foreach

question)





Commissioningand testingschedule andresponsibilities

1-4

- A schedule of commissioning and testing that identifies and includes a suitabletimescale for commissioning and re-commissioning of all complex and non-complexbuilding services and control systems and testing and inspecting building fabric.

- All commissioning activities are carried out in accordance with current BuildingRegulations, BSRIA and CIBSE guidelines and/or other appropriate standards, whereapplicable.

1 0.57% 1 1

WSP MEP team confirmed commissioning requirements can be achieved.Commitment letter provided by Kier confirming requirements will be met inrelation to commissioning.Credit Achieved.


Project Manager

Principal Contractor(Commissioning

Monitor)

Commissioningbuilding services 5-6

Buildings with complex building services and systems, a specialist commissioningmanager is appointed during the design stage with responsibility for:a. Undertaking design reviews and giving advice on suitability for ease ofcommissioning.b. Providing commissioning management input to construction programming and duringinstallation stages.c. Management of commissioning, performance testing and handover/post-handoverstages.

Where there are simple building services, this role can be carried out by an appropriateproject team member provided they are not involved in the general installation works forthe building services system

1 0.57% 1 1

NHS Trust confirmed a specialist commissioning manager will be appointedand requirements will be met.Commitment letter provided by Kier confirming requirements will be met inrelation to commissioning, and the appointment of a specialist commissioningmanager.Credit Achieved.

No Further Action Required RIBA Stage 4Specialist

CommissioningManager

Testing andinspecting buildingfabric

7-9

- The commissioning and testing schedule and responsibilities credit is achieved.

- The integrity of the building fabric, including continuity of insulation, avoidance ofthermal bridging and air leakage paths is quality assured through completion of postconstruction testing and inspection. Dependent on building type or construction, this canbe demonstrated through the completion of a thermographic survey as well as anairtightness test and inspection.

- Any defects identified in the thermographic survey or the airtightness testing reportsare rectified prior to building handover and close out. Any remedial work must meet therequired performance characteristics for the building/element.

1 0.57% 0 0 0 Kier confirmed this is a credit not usually achieved therefore not targeted.Credit Not Sought. No Further Action Required RIBA Stage 4

Suitably QualifiedThermographer

Handover 10-11 - A Building User Guide (BUG) is developed prior to handover for distribution to thebuilding occupiers and premises managers. 1 0.57%

Crit

erio

n10

(Bui

ldin

gU

serG

uide

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1 1

Project team advised a BREEAM compliant building user guide will beproduced.Commitment letter received from Kier.Credit Achieved.

No Further Action Required RIBA Stage 4Principal Contractor(with support from

design team)

Aftercare support 1-2

- There will be operational infrastructure and resources in place to provide aftercaresupport to the building occupier(s), which includes various criteria (available on request)

- There will be operational infrastructure and resources in place to co-ordinate thecollection and monitoring of energy and water consumption data for a minimum of 12months, once the building is occupied.

1 0.57% 1 1

NHS trust confirmed these requirements will be met and delivered.Commitment letter provided by Kier confirming aftercare requirements will bemet.Credit Achieved.

No Further Action Required

Client

Project Manager


Seasonalcommissioning 3

Seasonal commissioning activities must be completed over a minimum 12-month periodby a Specialist Commissioning Manager, once the building becomes substantiallyoccupied.

1 0.57%

One

Cre

dit(

Seas

onal

Com

mis

sion

ing)

1 1

Project team advised a specialist commissioning manager will be appointedand requirements met.Note this credit is mandatory for the achievement of an Excellent rating.Commitment letter provided by Kier confirming seasonal commissioningrequirements will be met.Credit Achieved.


Client

Project Manager


Post occupancyevaluation 4-5

- The client or building occupier makes a commitment to carry out a post-occupancyevaluation (POE) exercise one year after initial building occupation by an independentthird party.

- The client or building occupier makes a commitment to carry out the appropriatedissemination of information on the building’s post-occupancy performance.

1 0.57% 1 1

NHS trust advised a BREEAM compliant post occupancy evaluation will takeplace.Commitment letter provided by the Trust committing to undertake POE.Credit Achieved.


Client /Building Occupier

Independent ThirdParty

Com

mis

sion

ing

and

hand

over

Man 04

Afte

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Man 05 RIBA Stage 4


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Health & Wellbeing

Glare control 1-2

- The potential for disabling glare has been designed out of all relevant building areasusing a glare control strategy, either through building form and layout and/or buildingdesign measures.

- The glare control strategy avoids increasing lighting energy consumption

1 0.79% 0 0 0

Project team confirmed that no blinds are to be fitted in the ward rooms,therefore this credit is unachievable as glare control is required in all occupiedspaces.Credit Not Sought.

No Further Action Required RIBA Stage 4 Architect

Daylighting 3

All occupied areas have an average daylight factor of 2% in 80% of the spaceOccupied patient areas and consulting rooms of 3% in 80% of the spaceAND either item a or b and c below are achieved:

a. A uniformity ratio of at least 0.3 or a minimum point daylight factor of at least 0.3 timesthe relevant average daylight factor valueb. At least 80% of the room has a view of sky from desk or table top heightc. The room depth criterion d/w +d/HW < 2/(1-RB) is satisfied

2 1.58% 0 0 0WSP MEP team advised daylighting calculations have been undertaken andthe development does not meet BREEAM requirements.Credit not sought

No Further Action Required RIBA Stage 4Architect

Daylighting specialist

View out 4-6

- 95% of the floor area in relevant building areas is within 7m of a wall which has awindow or permanent opening that provides an adequate view out.- For bedrooms, all relevant positions must be within 5m of a wall which has a window orpermanent opening that provides an adequate view out.

- The window/opening must be ≥ 20% of the surrounding wall area.

2 1.58% 0 0 0 Due to occupied spaces with no view out, this credit is not achievable.Credit Not Sought. No Further Action Required RIBA Stage 4 Architect

Internal andexternal lightinglevels, zoning andcontrol

7-13

Internal lightingAll fluorescent and compact fluorescent lamps are fitted with high frequency ballasts.Internal lighting in all relevant areas of the building is designed to provide an illuminance(lux) level appropriate to the tasks undertaken, accounting for building userconcentration and comfort levels. This can be demonstrated through a lighting designstrategy that provides illuminance levels in accordance with the SLL Code for Lighting2012 and any other relevant industry standard.For areas where computer screens are used, the design complies with CIBSE LightingGuide 72 sections 3.3, 4.6, 4.7, 4.8 and 4.9External lightingAll external lighting is specified in accordance with BS 5489-1:2013 Lighting of roads andpublic amenity areas and BS EN 12464-2:2014 Light and lighting - Lighting of workplaces - Part 2: Outdoor work places.Zoning and ControlsInternal lighting is zoned to allow for occupant control in accordance with the criteriabelow for relevant areas present within the building: a. In office areas, zones of no more than four workplaces b. Workstations adjacent to windows/atria and other building areas separately zonedand controlled c. Seminar and lecture rooms: zoned for presentation and audience areas d. Library spaces: separate zoning of stacks, reading and counter areas e. Teaching space or demonstration area f. Whiteboard or display screen g. Auditoria: zoning of seating areas, circulation space and lectern area h. Dining, restaurant, café areas: separate zoning of servery and seating/dining areas i. Retail: separate zoning of display and counter areas j. Bar areas: separate zoning of bar and seating areas k. Wards or bedded areas: zoned lighting control for individual bed spaces and controlfor staff over groups of bed spaces l. Treatment areas, dayrooms, waiting areas: zoning of seating and activity areas andcirculation space with controls accessible to staff.

1 0.79% 1

WSP MEP team confirmed internal and external lighting will meet requirements,and internal lighting zoning and control will also meet BREEAM requirements.Updated drawings and specification to be provided demonstrating compliance.Credit Targeted.

1) Specification confirming compliance with the relevantCIBSE, BS and zoning requirements.

2) Marked up drawings confirming the zoning andcontrol of internal and external lighting.

RIBA Stage 4 M&E (lighting)Engineers

Visu

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1An indoor air quality plan has been produced, with the objective of facilitating a processthat leads to design, specification and installation decisions and actions that minimiseindoor air pollution during occupation of the building.

1 0.79% 1 1

Air quality plan received from the WSP air quality team.Credit achieved, with the air quality team due to confirm no amendments arerequired in the air quality plan to account for additional floor.Credit Achieved.

No Further Action Required RIBA Stage 4 M&E Engineers

2-5

- Provide fresh air into the building in accordance with the criteria of the relevantstandard for ventilation.

- Design ventilation pathways to minimise the build-up of air pollutants in the building, asfollows:i. The building’s air intakes and exhausts are over 10m apart and intakes are over 20mfrom sources of external pollution. ORii. The location of the building's air intakes and exhausts, in relation to each other andexternal sources of pollution, is designed in accordance with BS EN 13779:2007 AnnexA2.

- Where present, HVAC systems must incorporate suitable filtration to minimise externalair pollution, as defined in BS EN 13779:2007

- Areas of the building subject to large and unpredictable or variable occupancy patternshave carbon dioxide or air quality sensors

1 0.79% 1

Air quality plan received from the WSP air quality team which demonstrates theventilation criteria have been met through design and specification.Updated MEP specifications for the extra floor are required to demonstrateinformation within the air quality plan is representative of the design.Credit Targeted.

1) Design drawings demonstrating the ventilationpathway distances are to be achieved, or specificationconfirming these are designed in accordance with BS EN13779:2007 Annex A2

2) Where applicable, specification confirming thatbuilding areas subject to large and unpredictable orvariable occupancy patterns have carbon dioxide or airquality sensors

RIBA Stage 4 M&E Engineers

6-7

Volatile organic compound (VOC) emission levels (products) - All decorative paints and varnishes specified meet the criteria in the BREEAM manual

- At least five of the seven remaining product categories listed in the BREEAM manualmeet the testing requirements and emission levels criteria for volatile organic compound(VOC) emissions.

1 0.79% 1 1 No Further Action Required RIBA Stage 4

Architect

Indoor Air QualityTesting Specialist

8-12

Volatile organic compound (VOC) emission levels (post construction) - The formaldehyde concentration level is measured post construction (but pre-occupancy) and is found to be less than or equal to 100µg/averaged over 30 minutes.

- The total volatile organic compound (TVOC) concentration level is measured postconstruction (but pre-occupancy) and found to be less than 300µg/over 8 hours.

- The testing and measurement of the pollutants are in accordance with the relevantstandards confirmed in the BREEAM manual.

1 0.79% 1 1 No Further Action Required RIBA Stage 4 Contractor/ VOC Tester

Adaptability -Potential fornatural ventilation

13-14

- Occupied spaces of the building are designed to be capable of providing fresh airentirely via a natural ventilation strategy. The following are methods deemed to satisfythis criterion dependent upon the complexity of the proposed system:

i. Room depths are designed in accordance with CIBSE AM10 (section 2.4) to ensureeffectiveness of any natural ventilation system. The openable window area in eachoccupied space is equivalent to 5% of the gross internal floor area of that room/floorplate.ORii. The design demonstrates that the natural ventilation strategy provides adequate crossflow of air to maintain the required thermal comfort conditions and ventilation rates. Thisis demonstrated using ventilation design tool types recommended by CIBSE AM10.

1 0.79% 0 0 0

WSP MEP team confirmed several of the occupied spaces may not haveadequate natural ventilation due to room layout.

Credit Not Sought.

No Further Action Required RIBA Stage 3Architect /

M&E Engineers

Minimisingsources of airpollution

Indo

orA

irQ

ualit

y

Hea 02

Kier and IBI advised the requirements in regards to products and testing can bemet.WSP Assessor advised Trust to ensure furniture used does not impact testingresults, as it is not covered under the BREEAM scope in regards to productcategories.Indoor air quality plan has been received which demonstrates compliance withVOC product requirements and a commitment for testing.Two Credits Achieved.


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Thermal modelling 1-4

- Thermal modelling has been carried out using software in accordance with CIBSEAM11.

- The software used to carry out the simulation at the detailed design stage provides fulldynamic thermal analysis.

- The modelling demonstrates that summer and winter operative temperature ranges inoccupied spaces are in accordance with the criteria set out in CIBSE Guide AEnvironmental design, Table 1.5; or other appropriate industry standard (where this setsa higher or more appropriate requirement/level for the building type).

- The building is designed to limit the risk of overheating, in accordance with theadaptive comfort methodology outlined in CIBSE TM52: The limits of thermal comfort:avoiding overheating in European buildings.

- The PMV (predicted mean vote) and PPD (predicted percentage of dissatisfied)indices based on the above modelling are reported.

1 0.79% 1

WSP sustainability team have provided thermal modelling report whichdemonstrates compliance.Updated report required due to addition of extra floor.Credit Targeted.

1) Updated thermal modelling report. RIBA Stage 4 M&E Engineers

Adaptability - for aprojected climatechange scenario

5-8

- The first credit is achieved.

- The thermal modelling demonstrates that the relevant requirements set out above areachieved for a projected climate change environment.

- Where thermal comfort criteria are not met for the projected climate changeenvironment, the project team demonstrates how the building has been adapted, ordesigned to be easily adapted in future using passive design solutions in order tosubsequently meet the requirements.

- For air conditioned buildings, the PMV and PPD indices based on the above modellingare reported.

1 0.79% 0 0 0 WSP sustainability team have advised this credit is not achievable.Credit Not Sought. No Further Action Required RIBA Stage 4 M&E Engineers

Thermal zoningand controls 9-11

- The first credit is achieved.

- The thermal modelling analysis has informed the temperature control strategy for thebuilding and its users.

- The strategy for proposed heating/cooling system(s) demonstrates that it hasaddressed the BREEAM criteria listed in the guidance manual.

1 0.79% 1

WSP MEP team confirmed the thermal modelling will influence control andzoning strategy. Specifications to be provided confirming compliance withthermal zoning and control requirements.Credit Targeted.

1) MEP specifications confirming thermal controlstrategy. RIBA Stage 4 M&E Engineers

Hea 05

Aco

ustic

Perf

orm

ance

1-3

The building meets the appropriate acoustic performance standards and testingrequirements defined in the checklists and tables section which defines criteria for theacoustic principles of the indoor ambient noise criteria, reverberation and soundinsulation.

3 2.37% 3

WSP acousticians appointed and advised the requirements can be met viaappropriate design. Updated acoustic design report to be provided whichconfirms compliance with ambient, reverberation and sound insulationrequirements including the new floor.3 Credits Targeted.

1) Updated acoustic design report demonstratingcompliance with Indoor Ambient Noise, Sound Insulation,and Reverberation criteria.

RIBA Stage 4 Acoustician

Hea 04

Ther

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Safe access 1-10

Where external site areas form part of the assessed development the following apply:

- Dedicated cycle paths from the site entrance(s) to any cycle storage provided, withoutthe need to deviate from the cycle path. - Footpaths on-site provide direct access from the site entrance(s) to the buildingentrance(s) - Where provided, drop-off areas are designed off/adjoining to the access road andprovide direct access to pedestrian footpaths - Dedicated pedestrian crossings are provided where pedestrian routes cross vehicleaccess routes, and traffic calming measures are in place to slow traffic down at thesecrossing points.- The lighting for access roads, pedestrian routes and cycle lanes is compliant i.e. inaccordance with BS 5489-1:20131 Lighting of roads and public amenity areas.

Where vehicle delivery access and drop-off areas form part of the development, thefollowing apply: - Delivery areas are not directly accessed through general parking areas and do notcross or share pedestrian and cyclist routes. - There is a dedicated parking/waiting area for goods vehicles with appropriateseparation from the manoeuvring area and staff and visitor car parking. - Parking and turning areas are designed for simple manoeuvring according to the typeof delivery- There is a dedicated space for the storage of refuse skips and pallets away from thedelivery vehicle manoeuvring area and staff/visitor car parking

1 0.79% 0 0 0

The NHS Trust confirmed via email this credit is not sought due to particularlysignificant investment and co-ordination required with future developments thatare only at the strategy status stage.Credit Not Sought.


Security of site &building 11-13

- A suitably qualified security specialist (SQSS) conducts an evidence-based SecurityNeeds Assessment (SNA) during or prior to RIBA Stage 2.

- The SQSS develops a set of recommendations or solutions during or prior to RIBAStage 2.

- The recommendations or solutions proposed by the SQSS are implemented. Anydeviation from those recommendations or solutions will need to be justified, documentedand agreed in advance with a suitably qualified security specialist.

1 0.79% 1

NHS Trust have provided a security report from Tristan Morgan, along withsome confirmation it was reviewed by an ALO.Tristan to provide qualifications of the ALO and detail the involvement inreviewing the report.Credit Targeted.

1) Confirmation of ALO involvement and evidencedemonstrating they are suitably qualified.

Energy

Ene 01 1

Up to twelve credits where evidence provided demonstrates an improvement in theenergy efficiency of the building’s fabric and services and therefore achieves lowerbuilding operational related CO2 emissions. This is based upon the Energy PerformanceRatio for New Constructions.

12 7.83%

Five

Cre

dits

5

5 credits are required as a mandatory requirement to achieve an Excellentrating.Project Part L compliance report provided, which results in a credit score of 5.Updated Parl L compliance report to be provided accounting for additional floor.5 Credits Targeted.

1) As-designed BRUKL Input (.inp) and Output (pdf)report. RIBA Stage 4 M&E Engineers

Ener

gyM

onito

ring

Sub-metering ofmajor energyconsuming

systems

1-4

- Energy metering systems are installed that enable at least 90% of the estimatedannual energy consumption of each fuel to be assigned to the various end-usecategories of energy consuming systems.

- The energy consuming systems in buildings with a total useful floor area greater than1,000m2. are metered using an appropriate energy monitoring and management system(e.g. BMS)

- The end energy consuming uses are identifiable to the building users, for examplethrough labelling or data outputs.

1 0.65%

One

Cre

dit(

Firs

tCre

dit)

1

Metering is mandatory and therefore targeted. WSP MEP team to provideupdated drawings and specifications confirming provision of compliantmetering.Credit Targeted.


Sub-metering ofhigh energy load

and tenancy areas5

An accessible energy monitoring and management system is provided, covering asignificant majority of the energy supply to tenanted areas or, in the case of singleoccupancy buildings, relevant function areas or departments within the building/unit.

Catering must also be metered separated if included.

1 0.65% 1WSP MEP team to provide updated drawings and specifications confirmingprovision of compliant metering.Credit Targeted.


Ene 03 1-3

The building has been designed to operate without the need for external lighting(including building, signs and at entrances).

OR

Where the building does have external lighting: - The average initial luminous efficacy of the external light fittings within the constructionzone is not less than 60 luminaire lumens per circuit Watt. - All external light fittings are automatically controlled for prevention of operation duringdaylight hours and presence detection in areas of intermittent pedestrian traffic.

1 0.65% 1WSP MEP team to provide updated drawings and specifications confirmingexternal lighting requirements will be met.Credit Targeted.

1) Specification confirming compliance with the relevantenergy efficient lighting and lighting control criteria.

2) Drawings showing the extent of the external lightingand the type of fittings.

RIBA Stage 4 M&E (lighting)Engineers

RIBA Stage 2

Client

Architect

Suitably qualifiedsecurity specialist

(SQSS)

Client

Ene 02

Red

uctio

nof

CO

2

Emis

sion

sEx

tern

alLi

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1) Specification / metering schematic / drawingsconfirming metering of relevant systems.

2) Written confirmation of the systems that have beenmetered using a pulsed output meter, including: a. Space Heating b. Domestic Hot Water c. Humidification d. Cooling e. Fans (major) f. Lighting g. Small Power (lighting and small power can be on thesame sub-meter where supplies are taken at eachfloor/department). h. Other major energy-consuming items whereappropriate

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Passive design 1-3

Passive design analysis

- The first credit within issue Hea 04 Thermal comfort has been achieved todemonstrate the building design can deliver appropriate thermal comfort levels inoccupied spaces.

- The project team carries out an analysis of the proposed building design/developmentto influence decisions made during RIBA Stage 2 and identify opportunities for theimplementation of passive design solutions that reduce demands for energy consumingbuilding services.

- The building uses passive design measures to reduce the total heating, cooling,mechanical ventilation and lighting loads and energy consumption in line with thefindings of the passive design analysis and the analysis demonstrates a meaningfulreduction in the total energy demand as a result.

1 0.65% 1

Passive Design Analysis report received, which contains all BREEAM requiredcontent, and demonstrates a meaningful reduction of 6.7% has been achievedvia passive design measures.Updated report required to account for additional floor.Credit Targeted.

1) Updated passive design analysis report. RIBA Stage 2 M&E Engineers

Free cooling 4-6

Free cooling

- The passive design analysis credit is achieved.

- The passive design analysis carried out under the second criterion above includes ananalysis of free cooling and identifies opportunities for the implementation of free coolingsolutions.

The building uses ANY of the free cooling strategies listed in the BREEAM manual toreduce the cooling energy demand, i.e. it does not use active cooling.

1 0.65% 0 0 0 WSP MEP team advised this credit is not achievable.Credit not sought. No Further Action Required RIBA Stage 2 M&E Engineers

Low and zerocarbontechnologies

7-8

Low zero carbon feasibility study

- A feasibility study has been carried out by the completion of the RIBA Stage 2 by anenergy specialist to establish the most appropriate recognised local (on-site or near-site)low or zero carbon (LZC) energy source for the building.

- A local LZC technology/technologies has/have been specified for thebuilding/development in line with the recommendations of this feasibility study and thismethod of supply results in a meaningful reduction in regulated carbon dioxide (CO2)emissions e.g. 5% reduction in CO2.

1 0.65% 1

Low Zero Carbon study received, which meets BREEAM content requirementsand demonstrates a 19.2% reduction in CO2 emissions as a result of inclusionof LZC technologies.Updated report required to account for additional floor.Credit Targeted.

1) Updated low zero carbon feasibility study. RIBA Stage 2M&E Engineers (Energy

Specialist)

Energyconsumption 1

- An analysis of the transportation demand and usage patterns for the building has beencarried out to determine the optimum number and size of lifts, escalators and/or movingwalks.

- The energy consumption has been calculated in accordance with BS EN ISO 25745Energy performance of lifts, escalators and moving walks, Part 2 : Energy calculationand classification for lifts (elevators) and/or Part 3 - Energy calculation and classificationfor escalators and moving walks, for at least two types of lift.

- The use of regenerative drives should be considered. - The transportation system with the lowest energy consumption is specified.

1 0.65% 1 RIBA Stage 3

Energy efficientfeatures 2-6

For each lift, three energy efficient features are specified: - The lifts operate in a standby condition during off-peak periods. - The lift car lighting and display lighting provides an average lamp efficacy of > 55 lamplumens/circuit Watt. - The lift uses a drive controller capable of variable speed, variable-voltage, andvariable-frequency (VVVF) control of the drive motor.

Where the use of regenerative drives is demonstrated to save energy, they arespecified.


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Ene 04

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Ene 06

Vertical transport report received, however updated version required to accountfor additional floor.Kier to ensure energy efficiency features are specified and energy calculationsare provided for the systems chosen.Credits Targeted.

1) Updated vertical transport report.

2) Confirmation lift system and energy efficient featuresoutlined in the VT report will be implemented.

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Ene 08 1-3

Where functions/equipment responsible for the significant majority of unregulated energyconsumption are energy efficient, based on the criteria below:Category AThe following equipment has been awarded an Energy Star rating OR has beenprocured in accordance with the Government Buying Standards:1. Office equipment2. Other small powered equipment3. Supplementary electric heatingCategory FDomestic scale appliances have the following ratings (or better) under the EU EnergyEfficiency Labelling Scheme, where provided:1. Fridges, fridge-freezers: A+ rating2. Washing machines: A++ rating3. Dishwashers: A+ rating4. Washer-dryers and tumble dryers: A rating.Category GThe procurement of large-scale equipment (where present) and sets of electricalequipment (where numbering more than 50) has been informed and selected by lifecycle costing analysis for at least two options in accordance with HTM07-02,Part B,Chapter 14

2 1.30% 2 2

Project team advised the requirements can be met, and only categories A, Fand G are applicable to this development.NHS trust confirmed government buying standard can be met, and fridges andhealthcare requirements can be complied with.Letter received from the trust committing to providing estimated contribution tounregulated energy demand during the construction stage assessment, andalso confirming small power, catering and healthcare equipment will beprocured in line with the credit requirements.Credits Achieved.

No Further Action Required RIBA Stage 4 M&E EngineersClient

Transport

Accessibility Index 1-2 Up to five credits are awarded on a sliding scale based on the assessed buildings’accessibility to the public transport network 5 4.50% 3 3

Transport calculations have been performed based on the site plan, whichdemonstrate an Accessibility Index of 10.18.3 Credits Achieved.

No Further Action Required RIBA Stage 4 Transport Consultant

Tra 02 1-2

One credit where evidence provided demonstrates that the building is located within500m of four of the following accessible local amenities:- Grocery shop or food outlet- Postal facility- Cash machine- Outdoor open space- Recreation/leisure facility- Over the counter services associated with a Pharmacy

1 0.90% 1 1

Local amenity information has been collated by the BREEAM assessor, whichdemonstrates required number of amenities are present nearby to thedevelopment.Credit Achieved.

No Further Action Required RIBA Stage 4 Transport Consultant

Tra 03

Cyc

listF

acili

ties

Cycle Spaces 1-3

One credit where evidence provided demonstrates that covered, secure and well-litcycle storage facilities and changing facilities are provided for all building users.

The number of cyclist storage spaces which needs to be provided is: 1 cycle space per10 staff

Where the accessibility index for Tra 01 achieves more or equal to 3 credits, thisquantity of cycle spaces can be halved.

Two credits where, in addition to the above, two of the following facilities are provided insufficient quantity as per the BREEAM manual:- Showers: 1 for every 10 cycle spaces- Changing Facilities: e.g. bench seat and/or hooks- Lockers: adequately sized with equal number of lockers to cycle spaces- Drying space: adequately sized

2 1.80% 2

NHS Trust advised that building cycle storage provision can be designed tomeet requirements.NHS Trust advised that no facilities are to be provided in this new building,therefore a site wide assessment in regards to cycle storage will be adopted.

Trust have provided site wide staff and bed numbers (2397 staff and 308 bed).Based on this 56 cycle spaces are required, 56 lockers and 6 showers.Trust have provided site plans demonstrating locations of and number ofcompliant cycle storage and facilities (showers and lockers). Trust have alsoprovided datasheets for the existing cycle spaces, which are compliant.

Trust to provide updated site wide building user number and bed number forrecalculation of required spaces and facilities.Credits Targeted.

1) Updated site wide building user and bed number.

2) Evidence demonstrating site wide cyclist facilityprovision in accordance with BREEAM requirements(minimum number and type).

RIBA Stage 2

Architect

M&E Engineers(Lighting)

Client

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Tra 04

Max

imum

carp

arki

ngca

paci

ty

1

One credit is available for incorporating a maximum number of car parking spaces peroccupant (or nominal occupant). This is ratio is determined by the accessibility indexunder Tra 01.

For an accessibility index of <41 credit = 1 car park space per 3 building users.2 credits = 1 car park space per 4 building users.

Foranaccessibilityindexof≥4 - <81 credit = 1 car park space per 4 building users.2 credits = 1 car park space per 5 building users.

For an accessibility index of ≥81 credit = 1 car park space per 5 building users.2 credits = 1 car park space per 6 building users.

1 0.90% 1

NHS srust have provided site plan showing the number of car parking spacessite wide.

Updated occupancy information required accounting for additional beds andstaff of the additional floor.Credit Targeted.

1) Updated site wide building user and bed number. RIBA Stage 2

Transport Consultant

Architect

Landscape Architect

Tra 05 1-4

One credit where evidence is provided to demonstrate that a travel plan, based on atransport survey, has been developed and tailored to the specific needs of the buildingusers.

The plan must have been developed as part of the feasibility and design stages.

1 0.90% 1 1

NHS trust have provided a copy of the site specific travel plan, travel surveyand completed letter demonstrating all criteria have been complied with andplan will be implemented post construction.Credit Achieved.


Transport Consultant

Client /Building Occupier

Water

Wat 01

Wat

erC

onsu

mpt

ion

1-6

Up to five credits where evidence provided demonstrates that the specification includestaps, urinals, WCs and showers that consume less potable water in use than standardspecifications for the same type of fittings. Credits are awarded based on the followingimprovement over the notional baseline:- One credit - 12.5% improvement- Two credits - 25% improvement- Three credits - 40% improvement- Four credits - 50% improvement- Five credits - 55% improvement

The calculations is based upon the following sanitary fittings:a) WCsb) Urinalsc) Tapsd) Showerse) Bathsf) Dishwashersg) Washing machineh) Kitchen pre-rinse nozzles

5 3.89%

One

Cre

dit

3 3

IBI Group have provided the sanitary ware specification/schedule with allclinical equipment highlighted to allow exclusion. The only equipment forassessment is a WC and hand wash basin tap.Based on a WC (dual flush 4.5/3 litres) and basin tap (3.9lpm) performance, 3credits have been achieved.Assuming same equipment will be used for additional floor, which the architectis due to confirm.3 Credits Achieved

1) Specification / sanitary schedule confirming numberof fittings and water efficiency figures for the following:

a) WCsb) Urinalsc) Tapsd) Showerse) Bathsf) Kitchen tap (restaurant)g) Commercial dishwasherh) Commercial washing machinesi) Waste disposal unit

2) Manufacturer datasheet confirming the waterefficiency figures in the specification can be delivered.

RIBA Stage 4 Architect

Wat 02 1-4

One credit where evidence provided demonstrates that a water meter with a pulsedoutput will be installed on the mains supply to each building/unit.

The water consuming plant or areas consuming 10% or more of the building's water useneed to be fitted with a pulsed sub meter or have water monitoring equipment integral tothe plant or area.

1 0.78%

Crit

erio

n1

only

1WSP MEP to provide updated drawings and specifications demonstrating watermetering.Credit Targeted.

1) Specification confirming the provision of a watermeter and its connection to BMS.

2) Design plan confirming location of water meter andBMS display.

3) Written confirmation whether water consuming plantor areas consume 10% or more of the building's wateruse.


Leak detectionsystem 1

One credit where evidence provided demonstrates that a leak detection system isspecified or installed on the building's water supply. This should meet the following:a. Audible when activated;b. Activated when a continuous flow of water passes through the water meter at a flowrate above a pre-set minimum for a pre-set period of time;c. Able to identify different leakage rates, e.g. continuous, high and/or low level leaks,over set time periods;d. Programmable to suit the owner/occupiers’ requirements; ande. Where applicable, designed to avoid false alarms caused by normal operation of largewater consuming plant such as chillers.


Flow controldevice 2

One credit where flow control devices that regulate the supply of water to each WCarea/facility according to demand are installed.E.g. presence detector & time controller 1 0.78% 1 RIBA Stage 4

Wat

erm

onito

ring

Maj

orle

akde

tect

ion

&pr

even

tion

Wat 03

Trav

elpl

an

1) Specification confirming the inclusion of the leakdetection system and its capabilities as listed in theBREEAM Criteria column.

2) Specification confirming the inclusion of flow controldevices.

3) Design plan / schematic confirming location ofsolenoid valves and PIRs to WC areas.

M&E EngineersWSP MEP to provide updated drawings and specifications demonstratingcompliant leak detection and flow control devices will be installed.Credit Targeted.


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Wat 04

Wat

eref

ficie

nteq

uipm

ent

1-2

One credit where the design team has identified all unregulated water demands thatcould be realistically mitigated or reduced.

The systems or processes have been identified to reduce the unregulated waterdemand, and demonstrate, through either good practice design or specification, ameaningful reduction in the total water demand of the building.

1 0.78% 1 1Letter received from Landscape Architect advises all planting will rely solely onprecipitation and be contextually appropriate species.Credit Achieved.

No Further Action Required RIBA Stage 4 Landscape Architect

Materials

Mat 01

Life

cycl

eim

pact

s

1-3

Up to five credits are available, determined by the Green Guide to Specification ratings,third-party Environmental Product Declaration (EPD) and Life cycle Green House Gasemissions for the major building elements.

Covering:- External Walls- Windows- Roof- Upper Floor Slabs- Floor finishes/coverings

6 5.79% 6

IBI have provided completed materials table outlining the material elements ofthe building and the green guide ratings for each.An uplift in score has also been achieved through the use of Forbo safetyflooring, which holds an environmental production declaration certification.

IBI to provide updated table accounting for additional floor.6 Credits Targeted.

1) Updated BREEAM Mat01 table. RIBA Stage 4 Architect

Mat 02

Har

dla

ndsc

apin

gan

dbo

unda

rypr

otec

tion

1One credit where evidence provided demonstrates that at least 80% of the combinedarea of external hard landscaping and boundary protection specifications achieve an Aor A+ rating, as defined by the Green Guide to Specification.

1 0.96% 1Materials template table issued to IBI for completion of Green Guidespecifications .Credit Targeted.

1) Drawings/specification confirming material build up,area and locations of elements.

2) Completed Mat 2 template table confirming thefollowingfor each material specification:a. area (m²)b. green guide element numberc. green guide rating.

RIBA Stage 4Architect

Landscape Architect

1Pre requisiteAll timber and timber based products used on the project is 'Legally harvested andtraded timber'

-

Crit

erio

n1

only Yes Yes Kier confirmed all timber will be legally sourced.

2

One credit where the principal contractor sources materials for the project in accordancewith a sustainable procurement plan that includes the following:1. Risks and opportunities are identified against a broad range of social, environmentaland economic issues. BS 8902:20092. Aims, objectives and targets to guide sustainable procurement activities.3. The strategic assessment of sustainably sourced materials available locally andnationally.4. Procedures are in place to check and verify that the sustainable procurement plan isbeing implemented/adhered to on individual projects.

1 0.96% 1 1 Kier have provided a copy of their sustainable procurement plan.Credit Achieved.

3

Up to 3 credits are available where evidence provided demonstrates that 80% of theassessed materials in the majority of building elements are responsibly sourced.Includes building services insulation.

Credits are awarded based on the following % points achieved:- 3 credits - 54% of available points achieved- 2 credits - 36%- 1 credit - 18%

Any material type, other than ceiling and internal partitions/internal walls, whichclearly accounts for less than 1m³ per 1000 m² of gross internal floor area, can beexcluded from assessment.

3 2.89% 1

Project team agreed to mark 1 credit as potential. The team also committed tocompleting the necessary information table to allow assessment of responsiblesourcing of material %.Mat 3 template table issued to the WSP MEP to populate with materialspecification for building services, and IBI to populate fabric specification.1 Potential Credit

Mat 04

Insu

latio

n

Embodied Impact 1-2

Any new insulation specified for use within the external walls, ground floor, roof andbuilding services must be assessed.

One credit where the thermal insulation products used in the building is the same as orgreater than 2.5. All materials would need to be A+ or A rated to achieve an index of 2.5.

1 0.96% 1

IBI Group and WSP MEP team confirmed the insulation specified will meetrequirements.Mat 4 template table issued to the WSP MEP to populate with materialspecification for building services., and IBI to populate fabric specification.WSP MEP have returned completed template table, however to ensurecompliance will write a clause into specifications stating all insulation will be A+rated. Clause to be sent to assessor when available.Credit Targeted.

1) Drawings/specification confirming material build upof insulation elements.

2) Completed fabric Mat 4 template table confirming thefollowing for each material specification:a. area (m²)b. thickness (mm)c. thermal conductivity (W/m.k)d. green guide rating

RIBA Stage 4

Architect /Principal Contractor

M&E Engineers

Principal ContractorArchitect

1) Drawings/specification confirming material build upof elements.

2) Completed Mat 3 template table confirming thefollowing:- Breakdown of element- Supplier details and certification type (e.g. ISO14001)- Volume of material

3) Specification confirming that all timber will be sourcedin accordance with the UK Government's TimberProcurement Policy.

RIBA Stage 4Mat 03

Res

pons

ible

sour

cing

ofm

ater

ials


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Mat 05 1-2

Protecting vulnerable parts of the building from damage.The building incorporates suitable durability and protection measures or designedfeatures/solutions to prevent damage to vulnerable parts of the internal and externalbuilding and landscaping elements.

Protecting exposed parts of the building from material degradationThe relevant building elements incorporate appropriate design and specificationmeasures to limit material degradation due to environmental factors

1 0.96% 1

IBI group have provided evidence outlining the durability measures specified,along with how environmental degradation has been mitigated.IBI to confirm evidence previously received is unchanged, and it representativeof the project with an additional floor.Credit Targeted.

1) Confirmation information provided is representative ofthe project with an additional floor. RIBA Stage 3 Architect

Mat 06 1-2

Opportunities have been identified, and appropriate measures investigated andimplemented, to optimise the use of materials in building design, procurement,construction, maintenance and end of life.

The above is carried out by the design/construction team in consultation with therelevant parties at each of the following RIBA stages:a. Preparation and Briefb. Concept Designc. Developed Designd. Technical Designe. Construction.

1 0.96% 0 0 0

Project team advised this credit is not achievable, due to no materials efficiencyreporting undertaken for RIBA stage 1 or 2.Credit Not Sought. No Further Action Required RIBA Stage 1

All project teammembers

WasteUp to three credits are available where evidence provided demonstrates that the amountof non-hazardous construction (excluding demolition and excavation) waste (m³/100m²or tonnes 100m²) generated on site by the development is the same as or better thangood or best practice levels. This should be shown in a BREEAM compliant Site WasteManagement Plan.

One credit for <13.3 m³/11.1 per 100m² (gross internal floor area)

Note: where existing structures are to be demolished prior to development, a pre-demolition audit should be produced.

1 1.06% 1 1

Two credits for <7.5m³/6.5 tonnes per 100m² 1 1.06% 1 1

Three credits for < 3.4m³/3.2 tonnes per 100m² 1 1.06% 0 0 0

Waste divertedfrom Landfill 4-5

One further credit where evidence provided demonstrates that 80% by volume or 90%by tonnage non-hazardous construction and demolition waste generated by thedevelopment will be diverted from landfill and reused or recycled.

1 1.06% 1 1

Wst 02

Rec

ycle

dag

greg

ates

Recycledaggregates 1-3

One credit where The total amount of recycled or secondary aggregate specified isgreater than 25% (by weight or volume) of the total high grade aggregate specified forthe development.

The % of recycled/secondary aggregates in each high-grade aggregate application, mustmeet the following:

- Structural frame - 15%- Bitumen or hydraulically bound base, binder and surface courses for paved areas androads - 30%- Building foundations - 20%- Concrete road surfaces - 15%- Pipe bedding - 100%- Granular fill and capping - 100%

1 1.06% 0 0 0Recycled aggregates in quantities required for credit achievement were advisedto be unachievable.Credit Not Sought.

No Further Action Required RIBA Stage 4 Structural Engineer

Wst 03 1-2

One credit where a central, dedicated space is provided for the storage of the building’srecyclable waste streams. This space must be: - Clearly labelled - Accessible to building occupants or facilities operators - Of a capacity appropriate to the building type, size, and predicted volumes of wastethat will arise

Where high and consistent volume of operational waste streams are likely, the followingfacilities should be provided:- static waste compactor or baler- vessels for composting suitable organic waste or storing for collection- where organic waste is to be stored/composted on site, a water outlet should beprovided.

The specified/installed operational waste facilities are compliant with the relevant NHSguidelines for that part of the UK

1 1.06%

One

Cre

dit

1Trust have passed requirements onto Sondeco (FM team) to confirm wastestrategy meets requirements.Credit Targeted.

1) Design plan confirming location and area (m²) ofstorage area.

2) Written confirmation that the space is adequatelysized for the anticipated volume of waste and the wastecollection arrangement, is clearly labelled for recycling,within easy reach of the building (<20m away from anentrance) and in a location with good vehicular access.

Where large volumes of either packaging or food wasteis expected, static waste compactor(s) or baler(s); andcomposting facilities should be provided, along with awater outlet for cleaning and hygiene purposes.


1-3

Ope

ratio

nalW

aste

Mat

eria

leffi

cien

cyD

esig

ning

ford

urab

ility

and

resi

lienc

e

Con

stru

ctio

nSi

teW

aste

Man

agem

ent

Wst 01

Non-HazardousConstructionWaste

RIBA Stage 4No Further Action Required

Kier confirmed 2 credits are achievable in regards to resource efficiency.Kier confirmed demolition is to take place, and a pre-demolition audit will takeplace.Enabling works contractor has confirmed the requirements in relation to a predemolition audit and diversion from landfill can be met. Waste information fromenabling works to passed onto Kier for inclusion in the projects site wastemanagement plan.Commitment letter received from Kier confirming credit requirements arecommitted to.3 Credits Achieved.


Demolition Contractor(If different to the

above)


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Wst 05

Ada

ptat

ion

tocl

imat

ech

ange

Structural andfabric resilience 1

Conduct a climate change adaptation strategy appraisal for structural and fabricresilience by the end of RIBA Stage 2, in accordance with the following approach:

Carry out a systematic (structural and fabric resilience specific) risk assessment toidentify and evaluate the impact on the building over its projected life cycle fromexpected extreme weather conditions arising from climate change and, where feasible,mitigate against these impacts.

The assessment should cover the following stages:i.Hazard identificationii.Hazard assessmentiii.Risk estimationiv.Risk evaluationv.Risk management.

1 1.06% 1 1

WSP MEP have provided the adaption to climate change study completed inRIBA stage 2.Credit Achieved. No Further Action Required RIBA Stage 2

Structural EngineersMEP

Architect

Wst 06 1-2

- A building-specific functional adaptation strategy study has been undertaken by theclient and design team by RIBA Stage 2, which includes recommendations for measuresto be incorporated to facilitate future adaptation.

- Functional adaptation measures have been implemented (RIBA Stage 4) inaccordance with the functional adaptation strategy recommendations, where practicaland cost effective.

1 1.06% 1

A copy of the functional adaptability study for the project has been received,which covers the required content.

MEP and Architect to provided updated evidence demonstrating measuresproposed in the functional adaptability study have been incorporated into newdesign with additional floor.

Credit Targeted.

1) A copy of the Functional adaptation strategyappraisal report to identify and make recommendationsfor measures to be incorporated to facilitate futureadaptation.

2) Evidence to demonstrate how the findings of theFunctional adaptation strategy appraisal report haveinfluenced the design and particular measures have beenimplemented (e.g. implementation report, drawings orspecification documents)

RIBA Stage 2

Client

Architect

M&E Engineers

Structural Engineers

Cost Consultant

Land Use & Ecology

Re-use of Land 1One credit where evidence provided demonstrates that the majority (75%) of thefootprint of the proposed development falls within the boundary of previously developedland.

1 1.00% 1Project team confirmed the site is previously developed therefore this credit isavailable.Credit Targeted.

1) Drawings which shows the site and its land use priorto development overlaid with a site boundary for the newworks. This should confirm the footprint areas associatewith both states.


ContaminatedLand 2-3

One credit where a specialist's site investigation, risk assessment and appraisaldemonstrate that the land used for the new development has, prior to development,been defined as significantly contaminated and where adequate remedial steps havebeen taken to decontaminate the site prior to construction.

1 1.00% 0 0 0It has been confirmed that no contamination has been found on the site. Creditno longer targeted.Credit Not Sought.

No Further Action Required RIBA Stage 2 Contaminated LandConsultant

Ecological value ofsite 1 One credit is awarded where evidence provided demonstrates that the construction

zone is defined as land of low ecological value. 1 1.00% 1 1WSP ecologist has provided ecological report and bat survey results confirmingthe site is of low ecological value.Credit Achieved.

Suitably QualifiedEcologist

Protection ofecological features 2-3

All existing features of ecological value within and surrounding the construction zone andsite boundary area are adequately protected from damage during clearance, sitepreparation and construction activities in line with BS42020: 2013 prior to anypreliminary site construction or preparation works

1 1.00% 0 0 0The landscape architect advised a mature tree is due for removal as part of thesite works, therefore this credit is not achievable.Credit Not Achievable.


1 One credit where evidence provided demonstrates that the change in the site’s existingecological value, as a result of development, is negative but minimal . 1 1.00%

One

Cre

dit

1

1) Suitably Qualified Ecologist’s report highlightinginformation required in accordance with the GN13guidance note relating ecologist’s report to BREEAM.The GN13 template can be provided on request.

RIBA Stage 2

2 Two credits where evidence provided demonstrates that there is no negative change inthe site’s existing ecological value as a result of development. 1 1.00% 1

2) Pre and post development site plans to be providedto the BREEAM assessor and also the ecologist to allowthem to undertake calculation.

RIBA Stage 2

LE01

Min

imis

ing

impa

cton

exis

ting

site

ecol

ogy

LE03

Func

tiona

lada

ptab

ility

Site

Sele

ctio

nEc

olog

ical

valu

eof

site

and

prot

ectio

nof

ecol

ogic

alfe

atur

es

Ecologist confirmed loss of ecological value is unlikely due to the low ecologicalvalue of the site.To achieve two credits a species change between pre and post site of zero isrequired.Awaiting completion of BRE calculator tool by WSP ecologists once site surveywork is complete.2 Credits Targeted.

LE02




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Ecologist's reportandrecommendations

1-3

One credit where the design team (or client) has appointed a suitably qualified ecologistto advise and report on enhancing and protecting the ecological value of the site; andimplemented the professional’s recommendations for general enhancement andprotection of site ecology.

1 1.00% 1 1 No Further Action Required RIBA Stage 1Suitably Qualified

Ecologist(WSP)

Increase inEcological value 4-6 A second credit where, in addition to the above, there is a positive increase in the

ecological value of the site of six plant species or greater 1 1.00% 12) Pre and post development site plans to be providedto the BREEAM assessor and also the ecologist to allowthem to undertake calculation.

RIBA Stage 1

One credit where the client has committed to achieving the mandatory requirementslisted and at least two of the additional requirements. 1 1.00% 1 RIBA Stage 4

A second credit where the client has committed to achieving the mandatoryrequirements and at least four of the additional requirements. 1 1.00% 1 RIBA Stage 4

Pollution

Three credits where the building does not require the use of refrigerants within its plant /systems.

Pre-requisite: All systems (with electric compressors) must comply with therequirements of BS EN 378:20081 (parts 2 and 3) and where refrigeration systemscontaining ammonia are installed, the Institute of Refrigeration Ammonia RefrigerationSystems Code of Practice.

One credit where systems using the refrigerants have Direct Effect Life Cycle CO2equivalent emissions (DELC CO2e) of 1000kgCO2e/kW cooling capacity.


Two credits where systems using refrigerants have DELC CO2e of 100kgCO2e/kWcooling capacity. OR where the air-conditioning or refrigeration systems use refrigerantswith a GWP of less than 10.

1 0.77% 0 0 0 RIBA Stage 3

Refrigerant LeakDetection andContainment

6-7

One credit where systems using refrigerants are contained in moderately air tightenclosure and an automated permanent refrigerant leak detection system covering highrisk parts of the plant or where a refrigerant leakage/charge loss detection system isspecified. AND automatic shutdown and pump down of refrigerant occurs on thedetection of a leak / charge loss.

1 0.77% 1 No Further Action Required RIBA Stage 3 M&E Engineers

Up to Three Credits where the dry NOx emissions (at 0% excess O2) ≤100 mg/kWh(space heating) 1 0.77% 1

≤70 mg/kWh (space heating) 1 0.77% 1

≤40 mg/kWh (space heating) 1 0.77% 1

1-3

1-5

1-2

The proposed development has proposed multiple hermetic systems that userefrigerants.WSP MEP have confirmed all systems are below 6kg charge, providingevidence to support this, therefore the leak detection credit has been achievedby default .

Updated pol01 calculators and product datasheets to be provided by the MEPteam, along with confirmation of compliance with the pre-requisite.

2 Credits Targeted.

WSP MEP team to provide confirmation of the boilers chosen, and a datasheetconfirming emissions of below 40Mg/kWh.

3 Credits Targeted.

Long

term

impa

cton

biod

iver

sity

Direct Effect LifeCycle CO2EquivalentEmissions

Impa

ctof

refr

iger

ants

Pol 01

Pol 02

NO

xem

issi

ons

from

heat

ing

sour

ce 1) Specification confirming heating, cooling and hotwater systems.

2) Manufacturer's datasheet confirming:a. dry NOx emission rate (at 0% excess O2)b. heat and electrical outputs of all systems


1) Written confirmation and manufacturer datasheetof the relevant refrigeration type confirming refrigerantcharge (kg) and system information, if applicable:a. Refrigerant Recovery Efficiency factor (%)b. Annual Leakage Rate (units: % refrigerant charge)c. Annual Purge Release factor (% Refrigerant charge)d. Annual Service Release (% Refrigerant charge)e. Probability factor for catastrophic failure (% refrigerantcharge loss/year)f. Global Warming Potential of refrigerantg. Cooling capacity (kW)

M&E Engineers

LE05

LE04

Enha

ncin

gSi

teEc

olog

y



WSP ecologist has provided ecological report and bat survey results confirmingthe site is of low ecological value and a list of the recommended protection andenhancement measures.Letter received from Kier confirming implementation of all ecologistsrecommendations.

Due to limited planting, a species increase of 6 species was deemed unlikelytherefore only one credit to be targeted in this section.Awaiting completion of BRE calculator tool by WSP ecologists once site surveywork is complete.1 Credit Achieved, 1 Potential Credit.

WSP ecologist confirmed the credit requirements can be met, and Kierconfirmed a biodiversity champion will be appointed to cover the additionalitems.WSP ecologist advised they have been appointed to provide a 5 year habitatand landscape plan.Commitment letter for contractor items received from Kier, confirming acommitment that 3 additional measures for improvement of long termbiodiversity will be carried out by the contractor.Ecologist to provide updated report and gn13 template upon completion of batsurveys, which will confirm compliance with relevant legislation, commitment toproduce a 5 year management plan, and which additional measures areappropriate to the site.Credits Targeted.

1) Suitably Qualified Ecologist’s report highlightinginformation required in accordance with the GN13guidance note relating ecologist’s report to BREEAM.The GN13 template can be provided on request.

2) Written confirmation from the Contractor of theadditional on site measures that will be undertaken tomitigate the impacts to biodiversity.



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Flood Risk 1-3 Two credits where the development is situated in a low flood risk zone, as confirmed bya site specific Flood Risk Assessment. 2 1.54% 2 2

Previous scheme flood risk assessment has been provided (produced in 2015),along with a site plan from Mark Bundy demonstrating this project falls withinflood zone 1.2 Credits Achieved.

No Further Action Required RIBA Stage 2 Drainage Consultant

- Pre-requisite - an appropriate consultant is appointed to carry out and demonstrate thecriteria.

One credit where drainage measures ensure the peak rate of run-off from the site to thewatercourses is no greater post development than the pre-development site, inaccordance with the 1 year and 100 year return period events. Calculations shouldinclude an allowance for climate change.

Maintenance agreements for the ownership, operation and maintenance of all SuDS arein place.

1 0.77% 1

Previous site (Lionel Green) approach to drainage has been used to determineachievable credits on this site.Template provided by drainage team confirm compliance, however ownershipof SUDS maintenance is required.Maintenance schedule received, Trust to confirm ownership.Credit Targeted.

One credit where flooding of property will not occur in the event of local drainage systemfailure AND

Drainage measures are specified to ensure the post development run-off volume is nogreater than the prior to the site’s development for the 100-year 6-hour event, includingan allowance for climate change

Where there is any additional predicted flow this is prevented from leaving the site byinfiltration or other SUDS techniques. OR where this is not possible (this must bejustified), the post peak rate of run-off must be reduced to a limiting discharge.

1 0.77% 0 0 0

Gn15 template provided by drainage engineer confirms this credit in relation tovolume run off is not achievable.Credit Not Sought.

Minimising watercourse pollution 15-22

There is no discharge from the site for rainfall up to 5mm

In areas with a low risk source of watercourse pollution, pollution prevention treatment isprovided, using appropriate SuDS techniques.

Oil / petrol separators should be specified in high risk areas: vehicle manoeuvring areas,car parks, waste disposal facilities, delivery and storage facilities or plant areas.

All water pollution prevention systems are designed and installed in accordance withPPG 3 and/or SuDS manual

A comprehensive and up to date drainage plan of the site will be made available for thebuilding/site occupiers.

1 0.77% 0 0 0

Gn15 template provided by drainage engineer confirms this credit in relation tovolume run off is not achievable.Credit Not Sought.

Pol 04 1-6

One credit where evidence provided demonstrates that the external lighting design is incompliance with the guidance in the ILP Guidance notes for the reduction of obtrusivelight, 2011. All external lighting (except safety and security) should be automaticallyswitched off between 23:00 and 7:00 hours.

Safety and security lighting levels should be lowered between these hours to meet thecriteria in table 2 of the ILP notes.

illuminated advertisements, where specified, must be designed in compliance with ILETechnical Report 5 – The Brightness of Illuminated Advertisements

1 0.77% 1WSP MEP team to provide updated drawings and specifications demonstratingcompliance with external lighting requirements.Credit Targeted.

1) Specification confirming compliance with the ILPGuidance notes for the reduction of obtrusive light, 2011and inclusion of controls to automatically switch offlighting between 23:00 and 07:00 hours.

RIBA Stage 4M&E (Lighting)

Engineer

4-14Pol 03

Red

uctio

nof

Nig

htTi

me

Ligh

tPo

llutio

n

Surf

ace

wat

erru

nof

f

Surface water runoff

1) Drainage consultant's report/ calculations/specification confirming:a.Type and storage volume (l) of the drainage measuresb. Total area of hard surfaces (m2)c. Peak/Volume flow rates (l/s) pre and post developmentfor the return period events and discharge ratesd. Additional allowance for climate change designed in tothe systeme. Impact on the building of flooding from local drainagesystem failuref. specification of SuDS and pollution measures for highrisk areas as applicable.

RIBA Stage 2 Drainage Consultant


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Pol 05 1-5

Where there are no noise-sensitive areas or buildings within 800m radius of theassessed site.OR

Where the building does have noise-sensitive areas or buildings within 800m radius ofthe site: - A noise impact assessment in compliance with BS 7445 is carried out - The noise impact assessment must be carried out by a suitably qualified acousticconsultant - The noise level is a difference no greater than +5dB during the day (07:00 to 23:00)and +3dB at night (23:00 to 07:00) compared to the background noise level. - Where the noise is greater than the levels described measures have been installed toattenuate the noise at its source to a level where it will comply.

1 0.77% 1

WSP Acoustics have been appointed and have carried out the appropriate on-site measurement. They confirmed suitable attenuation of noise is possiblewith the current design to achieve the requirements.

Updated acoustic design report to be provided.Credit Targeted.

1) Acoustician's report confirming:a. Distance to noise sensitive buildings from theproposedsources of noise in the new development.b. Baseline noise investigations (compliant with BS7445:1991) and plant noise values that the backgroundnoise levels will not be exceeded and the proximity of anynoise sensitive receptors in the vicinity.c. Recommendations for noise attenuation measures.

2) Written confirmation that any recommendationsmade by the Acoustician will be implemented into thedesign to ensure the final building is compliant with therelevant standards

RIBA Stage 4 Acoustician

Innovation

Man 03 A CCS score of 40 or above is achieved, with at least 7 in each section 1 1.00% 0 0 0Kier advised a score of 40+ cannot be committed to, so not targeted in thedesign stage assessment.Credit Not Sought

No Further Actions Required. As above -

Man 05

There will be operational infrastructure and resources in place to co-ordinate thefollowing activities at quarterly intervals for the first three years of building occupation:a.Collection of occupant satisfaction, energy consumption and water consumption data.b.Analysis of the data to check the building is performing as expected and make anynecessary adjustments to systems controls or to inform building user behaviours.c.Setting targets for reducing water and energy consumption and monitor progresstowards these.d.Feedback any ‘lessons learned’ to the design team and developer for use in futureprojects.e.Provision of the actual annual building energy, water consumption and occupantsatisfaction data to BRE.

1 1.00% 1 1Commitment letter provided by the Trust committing to undertake exemplarylevel aftercare support for the first three years of occupation.Credit Achieved.

No Further Action Required As above -

Hea 01 - Occupied areas have an average daylight factor of 3% in 80% of the space - A minimum point daylight factor of 1.2% OR 2.1% for spaces with glazed roofs, suchas atria

1 1.00% 0 0 0 No Further Actions Required. As above -

Hea 02

One credit - All seven remaining product categories listed in the BREEAM table meet the testingrequirements and emission levels criteria for Volatile Organic Compound (VOC)emissions.


Ene 01

Up to four credits - Zero regulated carbon - The building achieves an EPRNC≥ 0.9 and zero net regulated CO2 emissions. - An equivalent percentage of the buildings modelled ‘regulated’ operational energyconsumption is generated by carbon neutral on-site or near-site sources and used to


Wat 01 As per Wat 1, one exemplary credit can be achieved where there is a 65% reduction inwater consumption over the notional building. 1 1.00% 0 0 0 No Further Actions Required. As above -

Mat 01

Route 1: Using the Green Guide to Specification (elemental approach) - one credit - The building achieves at least two points in addition to the total points required toachieve maximum credits under the standard BREEAM criteria 2 2.00% 0 0 0 No Further Actions Required. As above -

Mat 03 Where, in addition to the standard BREEAM requirements, 70% of the availableresponsible sourcing points have been achieved. 1 1.00% 0 0 0 No Further Actions Required. As above -

Wst 01

Where non-hazardous construction waste generated by the building’s developmentmeets or exceeds the resource efficiency benchmark required to achieve three credits(as outlined in the guidance). 1 1.00% 0 0 0 No Further Actions Required. As above -

Wst 02

Where 35% (by weight or volume) of the total high-grade aggregates specified in thedevelopment are recycled and/or secondary. The percentage of high-grade aggregatethat is recycled and/or secondary, must meet the following levels:- Structural frame - 30%


Wst 05

Achievement of the Structural and fabric resilience criterion in this issue and thefollowing criteria points or credits:

Hea 04 Thermal comfort

1 1.00% 0 0 0

1 0 0 0 N/A - -Additional Innovation credit - requiring application to BRE.

Noi

seA

ttenu

atio

n

Responsible ConstructionPractices

Recycled aggregates

Adaptation to climatechange

Responsible Sourcing ofMaterials

Construction Site WasteManagement

Materials Specification

Water Consumption

Reduction of energy useand carbon emissions

Indoor Air Quality

Visual Comfort -Daylighting

Aftercare

-No Further Actions Required. As above


WSP House70 Chancery LaneLondonWC2A 1AF

wsp.com


Appendix 4.6

Planning Meeting Note

Appendix 4.5

Replacement Ward Project, Hereford County Hospital

File note of a meeting with the Planning Dept., Herefordshire Council, 17th July 2018

The meeting was held at Herefordshire Council, Plough Lane, Hereford.

Present:

Kelly Gibbons, Principal Planning Officer, Herefordshire Council.

Christian Homersley, Head of Estates, Wye Valley NHS Trust

Graham Vaughan, Capital Programme Manager, Wye Valley NHS Trust.

CH and GV provided an overview of the requirement to provide additional adult acute beds at the County Hospital in line with the Strategic Transformation Plan. KG was able to relate to that and it reflected opinions expressed to the planning dept during the consultation process that led to the approval of a 48 bedded ward building in May 2018.

The proposed location, adding a floor onto the building previously approved, was accepted as the most logical, operational and future proofing location. This reflected the constraints on the site and the need for the wards to be linked to the main hospital. This does not conflict with any planning guidance and in the light of general attitudes of all those previously consulted is likely to be granted consent subject to the architectural treatment and technical aspects being appropriate.

KG indicated support for the principles of the proposal for an additional 24-bed ward as a vertical extension of that approved in May 2018 as per the preferred option. The main comments were:

• A 3rd storey would not significantly impact on neighbours beyond that previously

approved as the building is set back from the boundary providing space for a service

road and landscaping between the building and the boundary.

• There were no formal objections to the previous planning application that was

approved.

• Informal comments from neighbours to the planning officer, regarding the previous

application, during the planning consultation period were ‘are there enough beds?’

• The detail design of any option proposed will reflect the window treatment/design as

the approved building to avoid unreasonable overlooking and provide some patient

privacy without curtains being drawn.

• The Local Authority understand the restrictions of the site and do not consider that

additional car parking is required as part of any planning application, even with an

increase in the bed base. This is a local site matter for the Trust to Manage.

• Conditions are likely to be the same as those on the previous approval but where

appropriate they may reflect any applications to discharge said conditions.

It was agreed that the trust would submit an application to vertically extend the building

approved 17th May 2017 ref 180679.

Post meeting note: Subsequent discussions concluded that there would be no requirement

for a formal Pre-app application or formal meeting prior to the submission of the planning

application.

V1.0 by G Vaughan


Appendix 5.1

Loan Financing Option

Appendix 5.1

Loan financing option

5.1.1 Introduction The financial case is constructed on the basis that the capital outlay is financed through

PDC. This is due to the Trust not being able to afford to meet loan repayments without

increasing future borrowing requirements.

Due to the scarce nature of PDC in the NHS, the Trust has modelled the impact that capital

loan financing for this investment would have.

5.1.2 Impact on the SOCI The table below shows the impact on the SOCI of the preferred option including loan interest

rather than the PDC dividends in the financial case:

From 21/22 onwards, the cost of loan interest would be £0.3m per annum more than the

PDC dividend charge. This is due to PDC dividends decreasing drastically once the building

is impaired whereas the loan interest remains on the outstanding balance of the full loan

(over 25 years).

The loan interest would reduce slightly each year as the outstanding balance reduces.

The interest rate is based on 2.58% per the Public Works Loan Board (PWLB) Equal

Instalments of Principle (EIP) rates.

18/19 19/20 20/21 21/22 22/23 23/24Total to

23/24

£'000 £'000 £'000 £'000 £'000 £'000 £'000

Revenue costs

Pay costs 0 0 (289) (700) (707) (714) (2,410)

Pay savings 0 0 77 186 188 190 640

Non Pay 0 0 (220) (540) (551) (562) (1,873)

EBITDA 0 0 (432) (1,054) (1,070) (1,087) (3,643)

Loan interest 0 (112) (305) (496) (526) (504) (1,942)

Net revenue cash position 0 (112) (737) (1,549) (1,596) (1,591) (5,585)

Depreciaiton 0 0 (50) (199) (199) (199) (648)

Impairment 0 0 (12,369) 0 0 0 (12,369)

Incremental Impact on retained surplus/ (deficit) 0 (112) (13,156) (1,749) (1,795) (1,790) (18,602)

Performance adjustments:

Adjust back Impairment 0 0 12,369 0 0 0 12,369

Incremental impact on I&E surplus/ (deficit) 0 (112) (787) (1,749) (1,795) (1,790) (6,233)

Cost avoidance Monnow and Leadon replacement 5,629 4,658 4,756 15,043

Incremental impact on 'do nothing' I&E surplus/ (deficit) 0 (112) (787) 3,881 2,863 2,965 8,810

Activity

5.1.3 Impact on cashflow

The cashflow would deteriorate further if loan financing was provided. The annual repayment

when the loan is fully drawn would be £0.84m over a 25 year period.

5.1.4 Impact on Balance Sheet

The Trust’s balance sheet would also deteriorate further with the introduction of an increase

in loan liabilities per above.

5.1.5 Conclusion Loan financing is not affordable for the Trust without borrowing further in order to repay the

capital loan principal and interest; therefore PDC financing will be requested.

18/19 19/20 20/21 21/22 22/23 23/24

£'000 £'000 £'000 £'000 £'000 £'000

Capital costs (2,448) (7,479) (7,468) (3,614) 0 0

Revenue costs 0 (112) (737) (1,549) (1,596) (1,591)

Principle loan repayments 0 0 0 (420) (840) (840)

Capital loan received 2,448 7,479 7,468 3,614 0 0

Incremental impact on Cash Flow 0 (112) (737) (1,969) (2,436) (2,431)

Cumulative impact on Cash Flow 0 (112) (849) (2,818) (5,255) (7,686)

Cashflow

18/19 19/20 20/21 21/22 22/23 23/24

£'000 £'000 £'000 £'000 £'000 £'000Balance Sheet

Property plant and equipment 2,448

(5,255)

9,927

(7,686)

(17,395) (20,589) (19,748) (18,908)Loan liabilities (2,448) (9,927)

4,976 8,391 8,191 7,992

Cash and cash equivalents 0 (112) (849) (2,818)


Appendix 5.2

SOCI Impact

Appendix 5.2

Impact to SOCI if bed capacity is not increased in 2018/19

5.1.1 Introduction The financial case is based upon the Trust increasing bed capacity on the acute site by 24 in

2018/19 and the revenue costs associated with the increase already being part of the Trust’s

recurrent financial position by 2020.

The Trust is only able to secure this additional capacity before the replacement ward building

is complete if it is successful in bidding for additional capital in 2018/19. If the Trust is unable

to secure that additional funding, then the revenue impact of those 24 beds will need to be

included in this investment case.

The Trust is planning to complete a FBC, once GMP is reached, in early 2019. If the Trust

has not been able to secure capital to increase capacity by then the FBC will be altered to

incorporate this.

5.1.2 Impact on the SOCI The table below shows the impact on the SOCI of the Trust is not able to increase capacity

by 24 beds before the completion of this three story building:

From 21/22 onwards, the EBITDA would deteriorate from the Trust’s current planned base

but there would be higher revenue savings, when compared to the do nothing option. The do

nothing option for these 24 beds are based upon having to continue to run with high usage

of escalation areas, resulting in RTT deteriorations, increased reliance upon agency staff,

etc.

18/19 19/20 20/21 21/22 22/23 23/24Total to

23/24

£'000 £'000 £'000 £'000 £'000 £'000 £'000

Revenue costs

Pay costs 0 0 (1,202) (2,913) (2,942) (2,971) (10,028)

Pay savings 0 0 0 0 0 0

Non Pay (550) (1,348) (1,377) (1,405) (4,680)

EBITDA 0 0 (1,752) (4,261) (4,319) (4,377) (14,708)

PDC dividends (42) (211) (240) (180) (192) (141) (1,006)

Net revenue cash position (42) (211) (1,992) (4,441) (4,510) (4,518) (15,714)

Depreciaiton (50) (199) (199) (199) (648)

Impairment (12,369) (12,369)

Incremental Impact on retained surplus/ (deficit) (42) (211) (14,411) (4,640) (4,710) (4,717) (28,731)

Performance adjustments:

Adjust back Impairment 12,369 12,369

Incremental impact on adjusted I&E surplus/ (deficit) (42) (211) (2,042) (4,640) (4,710) (4,717) (16,362)

Cost avoidance Monnow and Leadon replacement 5,629 4,658 4,756 15,043

Cost avoidance 24 beds anticipated for winter 2018 2,150 5,211 5,263 5,315 17,938

Total cost avoidance 0 0 2,150 10,840 9,921 10,071 32,981

Incremental impact on 'do nothing' I&E surplus/ (deficit) (42) (211) 108 6,200 5,211 5,354 16,619

Activity


Appendix 6.1

Project Execution Plan (PEP)

Project Reference: WVT EF 0001

Project Title: Programme Execution Plan for the Developments at Hereford County Hospital

Project Executive: Jon Barnes (Chief Operational Officer)

Client Department: Trust Executive Management Team

Draft PEP

Version 0.6

Author: Christian Homersley

Head of Estates, Facilities and Capital Planning

Tel: 01432 354005

[email protected]

Date: October 2017

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Document History

Document Owner The owner of this document is: Christian Homersley

Document Location This document is only valid on the day it was printed and the electronic version is located:

‘J:\Planning & Development\20 Estates Strategy\Est Strat Ph1 OBC Sept 14 on’ Document Status The current status for this document is current issue Revision History Date of next revision: GMP

Version number

Revision date Previous revision

date

Summary of changes

Changes marked

0.1 March 15 0.2 May 2015 General update to

apply programme management, new roles/structures, inclusion of communications plan

N/A

0.4 June 2015 Minor comments from Programme Board including TOR changes.

N/A

0.5 June 2015 Update to structure chart & TOR.

N/A

0.6 October 2017 General updates with current scope of project

Reviewers This document requires review by the following

Name Signature Responsibility Date of issue

Version

Jon Barnes COO 12/10/17 0.6 Howard Oddy Director of

Finance & Information

12/10/17 0.6

Christian Homersley

Head of Estates, Facilities and Capital Planning

12/10/17 0.6

Approvals This document requires approvals to be signed off and filed in

project files Name Signature Responsibility Date of

issue Version

Programme Board

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Table of Contents DOCUMENT INFORMATION .................................................................................... 2

STATUS .................................................................................................................. 2 VERSION HISTORY .................................................................................................. 2 OWNER .................................................................................................................. 2 DOCUMENT LOCATION ............................................................................................. 2 DISTRIBUTION ......................................................................................................... 2

1. INTRODUCTION ................................................................................................... 7 BACKGROUND ......................................................................................................... 7 OBJECTIVES OF PROGRAMME .................................................................................. 8 AUTHORITY FOR THE PROGRAMME ........................................................................... 8

2. PROJECT DEFINITION ........................................................................................ 8 KEY DELIVERABLES ................................................................................................. 8 CONSTRAINTS ......................................................................................................... 9 ASSUMPTIONS......................................................................................................... 9 EXCLUSIONS ........................................................................................................... 9 INTERFACES ........................................................................................................... 9 EXTERNAL DEPENDENCIES .................................................................................... 10 TOLERANCE .......................................................................................................... 10 BENEFITS ............................................................................................................. 10 COSTS ................................................................................................................ 101

3. APPROACH/PROCESS/EXECUTION AND PLAN ............................................. 11 APPROACH ........................................................................................................... 11 INITIAL PROGRAMME PLAN/MILESTONES ................................................................. 11

4. CONTINGENCY PLANS ..................................................................................... 11 5. ORGANISATION STRUCTURE .......................................................................... 11

SRO .................................................................................................................... 11 PROJECT DIRECTOR .............................................................................................. 11 PROGRAMME MANAGER ......................................................................................... 11 PROJECT MANAGER ............................................................................................... 11 PROGRAMME BOARD .............................................................................................. 12 PROJECT TEAM ...................................................................................................... 12 USER GROUPS ....................................................................................................... 12 OBC DELIVERY TEAM .............................................................................................. 12 PROJECT FILING STRUCTURE ................................................................................. 12

6. COMMUNICATION AND STAKEHOLDERS ...................................................... 12 7. REPORTING CYCLE .......................................................................................... 12

PROGRAMME INITIATION ........................................................................................ 12 REPORTING PERIODS ............................................................................................ 12 DECISION POINTS .................................................................................................. 12 EXCEPTION REPORTING ........................................................................................ 12 PROJECT ISSUES .................................................................................................. 13 END PROJECT NOTIFICATION ................................................................................. 13

8. RISK ASSESSMENT .......................................................................................... 13 9. QUALITY ............................................................................................................ 13 APENDICES

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APPENDIX 1 – PROJECT ROLES AND RESPONSIBILITIES ............................... 13 APPENDIX 2 – COMMUNICATIONS PLAN ........................................................... 18 APPENDIX 3 – PROJECT STRUCTURE................................................................ 30 APPENDIX 4 – TERMS OF REFERENCE (DESIGN TEAMS) ................................ 31 APPENDIX 5 – TERMS OF REFERENCE (DELIVERY TEAMS) ............................ 33 APPENDIX 6 – TERMS OF REFERENCE (USER GROUPS) ................................. 35 APPENDIX 7 – TERMS OF REFERENCE (PROGRAMME BOARD) ..................... 38

Glossary of Terms

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The following table presents a glossary of specific terms used in this Project Execution Plan that may be important with regard to precise definitions of the content of the document.

Term Acronym Definition Programme Execution Plan

PEP The Programme Execution Plan (PEP) is effectively the "contract" for the project (between the Project manager and the Programme board.)

Electronic Patient Record EPR An electronic representation of relevant patient specific clinical information that should be readily available at the time of treatment

Clinical Commissioning Group

CCG Hereford’s Clinical Commissioning Group who are the principal commissioners of WVT services

Outline Business Case OBC Identify the preferred option as a precursor to initiating procurement

Office of Government Commerce

OGC The independent body of the Treasury responsible for efficiency and best practice

Development Control Plan DCP Single drawing to illustrate how a site might be developed over a long period

Full Business Case FBC Where a single stage approval is agreed, the FBC will demonstrate the affordability of the programme and seeks authority to sign the proposed deal that has been negotiated with the chosen supplier

Trust Development Authority

TDA The TDA is a Special Health Authority of the Department of Health and exists to Trusts that remain directly accountable to the NHS

Public Dividend Capital PDC Public dividend capital represents the Department of Health's equity interest in defined public assets across the NHS.

Private Finance Initiative PFI A funding and operational model for the NHS Estate and facilities.

Wye Valley Trust WVT Wye Valley NHS Trust, Hereford.

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Purpose The purpose of this PEP is to define the programme, to form the basis for its management and the assessment of overall success.

This PEP has two primary uses:

• To ensure that the Programme has a sound plan to proceed and achieve milestones and objectives

• To act as a base document, against which the Programme Board and Project Manager can assess progress, risks, issues, change and ongoing viability questions

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1. Introduction

1.1 Background In 1998 one of the Trust founder organisations (Hereford Hospitals NHS Trust) signed a business case for the development of the County Hospital under a PFI deal which has been operational since 2002 and expires in 2029. The business case only dealt with part of the Hospital site and this case now demonstrates the need for significant investment in the remainder of the site to address the requirements 16 years on. In conjunction with this the Trust acquired a number of other sites within the first year of becoming the substantive provider of community services in Herefordshire when Wye Valley NHS Trust was formed in April 2011. This investment therefore looks at the new opportunities that the Estates portfolio now presents.

There are a number of urgent issues which need to be addressed by investment including over £11 million of critical backlog maintenance and underlying shortfalls in capacity for critical services. The case therefore focuses on:

• Replacing the hutted wards and support accommodation • Extending inpatient capacity • Co-locating ambulatory/day surgery facilities onto one site • Enabling future developments and flexibility

The current estimated capital cost is in the region of £15m for replacement of the hutted wards.

Affordability requires analysis of revenue cost and to what extent this can be offset by income. Key considerations are:

• Hutted wards and offices have fully depreciated but new assets will have depreciation overheads

• Potential to reduce rent at other sites • Increased operating and facilities cost from additional wards • Increased income from additional activity and better elective performance

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1.2 Objectives of Programme The objectives of the programme are as follows:

To produce an Outline Business case to support the implementation of the Estates Strategy.

To implement phase 1 of the Estates Strategy including bidding for capital in 2015/16.

The overall objectives of the Estates Strategy are:

• Improve patient experience and quality (including dementia friendly)

• To provide a safe, fit for purpose and therapeutic environment to deliver

healthcare

• To support the clinical/service strategy and business requirements of WVT

• Increase efficiency – better utilization of facilities, lower overheads

• Provide flexible solutions for future changes in function & capacity

• Re-provide where buildings are unsustainable for modern healthcare

• To co-locate common clinical functions wherever possible

• Reduce carbon footprint and become more sustainable

1.3 Authority for the Programme This programme has been authorised by the Trust Executive Management Team (Minutes Jan 13th 2015) and the Trust Board (January 2015).

2. Project Definition

2.1 Key Deliverables The key deliverables for the programme will be:

Trust Board Approve Estates Strategy, SOC and 2015/16 Capital Plan Jan 2015

TDA/ITFF Approve SOC and Capital Bid Mar 2015

Outline Business Case Approved (Trust Board) Oct 2015

Business Case for Additional Inpatient Capacity Feb 2015

Additional inpatient capacity (urgent) Dec 2015

Additional inpatient capacity (permanent) May 2020

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2.2 Constraints

The constraints on this project are as follows:

• Financial; the project is constrained by current spending limits within the public sector.

• Time; the project is constrained by the timeframe set in the objectives.

• Environmental : The site is developed and land locked

• To ensure the project at a local level is successful this is dependent on full participation and engagement across the range of stakeholders

• Resource constraints/peoples time in a consistent period performance/bed pressures.

• There is limited project support available within estates and operations and depending on how elements will be procured additional management resource may be required.

2.3 Assumptions (Unknowns or estimates related to the project including events, timings, outcomes etc)

The project is predicated on the following assumptions:

• NHSI Support

• ITFF or other funding made available

• CCG will be engaged and supportive

• Full engagement and positive participation by stakeholders to develop the project.

• Stakeholders will be required to develop and ensure effective communications, feedback, and engagement with their wider clinical and operational management group.

2.4 Exclusions Areas that are excluded from this project are:

• Minor capital works not included with the SOC

• Changes to the community Estate not referred to in the Estates Strategy or SOC unless they are required to facilitate the changes within scope.

• There will be no funding available for project delivery beyond the project funding

• It will not be possible to include all of the capital projects identified as this will make the size and costing of the project to large to successfully complete within the timeframe

2.5 Interfaces The other projects and pieces of work that interface with this project are:

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• Annual Capital Programme

• Implementation of Electronic Patient Record

• Service Transformation Programme

2.6 External Dependencies The project is externally dependant on the following:

• NHSI

• ITFF

• CCG

2.7 Tolerance The tolerances for the Programme are difficult to define at this stage. However it is expected that any material change to time, cost or quality will be escalated. For the purposes of defining materiality any variance over 5% will be reported and may require approval.

2.8 Benefits The project will provide the following benefits:

• protect the current and increase bed capacity to improve and reduce bed occupancy rates

• Facilitate operations to Improve care pathways, discharge and patients flow

• To facilitate the medical review model • To co-locate HDU beds with critical care facilities • To improve mental health assessment facilities for adults and children • To reduce the overbooking of outpatient clinics • To improve the management of medical records to ensure timely and

appropriate access • To replace temporary facilities with appropriate permanent facilities • To ensure the ability to clean and maintain clinical areas is optimised • To ensure facilities improve infection control • To create a flexible site development control plan for The County Hospital

• To replace the ‘Canadian huts’ as soon as possible

• To reduce the number of complaints from patients about the environment

• To ensure all facilities are compliant to a minimum standard

A benefits realisation plan with further details will be developed during the OBC

phase.

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2.9 Costs The initial costs for this project are

Area Cost

SOC £225k

OBC £390k

FBC TBC

Capital works £14.52m

3. Approach/Process/Execution and Plan

3.1 Approach As the programme is in effect a series of linked projects it is recommended that the Office of Government Commerce ‘Managing Successful Programmes’ methodology is used.

3.2 Initial Programme Plan/Milestones Milestones in the programme are:

Trust Board Approve Estates Strategy, SOC and 2015/16 Capital Plan Jan 2015

TDA/ITFF Approve SOC and Capital Bid Mar 2015

First additional bed capacity in place Nov 2015

Estates Strategy Programme Board Business Case approval Sep 2017

Trust Board approval Oct 2017NHSI / ITFF approval – Business Case & capital bid Dec 2017 Proceed with detailed design Jan 2018 Enabling works - GMP agreed & start April 2018 Main construction – GMP agreed & start June 2018 New inpatient capacity operational May 2020 Demolish Monnow & Leadon huts July 2020 Phase 3 projects complete Aug 2020

4. Contingency Plans These will be required for individual projects and are identified in the risk register.

5. Organisation Structure The Structure is summarised at Appendix 3.

5.1 SRO The Senior Responsible Owner for the project is Chief Operating Officer.

5.2 Project Director The Project Director is the Head of Estates, Facilities and Capital Planning.

5.3 Programme Manager The Programme Manager for the projects is Capital Programme Manager

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5.4 Project Manager This is to be confirmed for each project.

5.5 Programme Board The Terms of Reference for the Programme Board are attached in appendix 7.

5.4 Project Team Each project, once approved, will have its own Project Team reporting into the Programme Board and terms of reference for each will be ratified by that Board. As a minimum the Programme Board will receive an exception report from each project once per month.

5.5 User Groups Terms of reference for the User Groups are attached in appendix 6.

5.6 OBC Delivery Team Terms of reference are attached in appendix 5.

5.6 Project Filing Structure The electronic project files will be kept on J:\Planning & Development\20 Estates Strategy\Est Strat Ph1 OBC Sept 14 on\PEPJan 2015

The paper project files will be kept Estates and Facilities Eign Brook Complex, The County Hospital

6. Communication, Engagement and Stakeholders The Communications and Engagement plan is attached at Appendix 2.

7. Reporting Cycle

7.1 Programme Initiation The programme will formally start when the SRO and Project Director have approved this project document.

7.2 Reporting Periods The SRO and Board will meet Monthly.

Project Teams to meet as require but provide monthly exception report. The exception report will track any change to the baseline plan as described in the Strategic Outline Case.

7.3 Decision Points The following sets out the points when key decisions must be taken:

• All stages of business case approvals

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• Changes to strategy

• Changes to individual projects or plans over and above defined limits (e.g.

delegated budgets or agreed milestones).

• For each Phase a Board level decision for scope to be confirmed

7.4 Exception Reporting Exception reporting will be carried out by the Project Manager as required to the SRO and the Programme Board.

7.5 Project Issues Project issues may be raised by anyone with an interest in the project at any time.

The Programme Manager will manage the issue log.

7.6 End Project Notification The Programme will be formally closed by the SRO when the benefits are presented to the Trust Executive Board and accepted

8. Risk Assessment The risks relevant to Project are contained in the initial risk log at Appendix C.

9. Quality This programme will meet the following quality standards

Note: Quality Criteria When assessing the fitness for purpose of the PID, the following criteria should be considered

• Does the document accurately reflect the project? • Is the project viable, achievable and in line with

strategy? • Is the Organization Structure complete, with agreed

appointees and job descriptions for all roles? • Are the reporting lines, lines of authority and

direction lines clear and workable? • Is the proposed project approach realistic and

achievable?? • Are the timescales consistent with the business

objectives? • Does the order of activities within the plan reflect the

list of prioritized requirements? • Does the plan reflect the need to address areas of

risk at appropriate times? • Are all affected classes of users identified in the

plan?

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• Is the proposed user effort consistent with the needs of both the existing business processes and the development?

• Will the necessary effort (from all personnel) be available when required?

Appendix 1 - Project Roles and Responsibilities


Programme Board

1.1 The Programme Board is accountable for the success of the projects and has responsibility and authority within the remit set by corporate management. The main responsibilities of the Project Board are:

(a) Review and approve the Project Initiation Document;

(b) Agree with the Project Manager their responsibility and objectives;

(c) Agree project and stage tolerances;

(d) Specify external constraints on the project such as quality assurance;

(e) Appoint individuals to project assurance roles; and

(f) Authorise commitment of project resources.

1.2 As the project progresses:

(a) Guide project ensuring it remains within specified constraints;

(b) Authorise the start of each stage, or recommend termination of the project;

(c) Review and approve plans;

(d) Management of risks identified at plan approval stages;

(e) Approval of changes; and

(f) Ensure compliance with corporate directives.

1.3 At the end of the project:

(a) Assure that all products have been delivered;

(b) Assure all acceptance criteria have been met;

(c) Approve End Project Report;

(d) Authorise Project Closure;

(e) Approve Project Evaluation Review; and

(f) Approve Post Implementation Review.

1.4 The Programme Board is made up of:


(a) Executive - who provides project guidance and assesses the project continuously from a business, financial and senior management point of view. The prime responsibility is to ensure that the project achieves the expected benefits and that it is completed within the approved cost and timescales. Specific tasks for the Executive are:

(i) Ensure that tolerances are set for the project and the stages of the project;

(ii) Authorise expenditure;

(iii) Approve End Project Report;

(iv) Brief corporate management on progress;

(v) Chair Project Board meetings;

(vi) Senior Responsible Owner;

(vii) Responsible for the overall business assurance of the project although some functions may be delegated;

(viii) Recommend action to corporate management if project tolerance is exceeded (e.g. terminate, allow more time, allocate more resources);

(ix) Agree Project Closure; and

(x) Arrange Post Implementation Review.

(b) Senior User - who represents the interests of all user departments affected by the project and monitors the project’s progress against the requirements of user management. This role may be delegated to more than one person but for the sake of effectiveness should not be split between too many people. Specific tasks for the Senior User are:

(i) Ensure desired outcome is specified and remains consistent;

(ii) Ensure User resources are available when required;

(iii) Approve product descriptions;

(iv) Relay User opinions;

(v) Relay User requirements;

(vi) Brief User management in the project;

(vii) Assess the impact of potential changes to the Users; and


(viii) Undertake User assurance responsibilities (e.g. approve on behalf of the users the Acceptance Criteria).

(c) Senior Supplier - who represents the interests of the development and operations organisations at Project Board level and monitors project progress against the requirements of technical management, Specific tasks for the Senior Supplier are:

(i) Agree objectives for technical activities;

(ii) Assure desired outcome from the Supplier perspective;

(iii) Assign technical resources needed by the project;

(iv) Approve Product Descriptions;

(v) Relay Supplier opinions;

(vi) Resolve Supplier requirements;

(vii) Brief non-technical management on technical aspects of the project;

(viii) Assess the impact of potential changes to the supplier; and

(ix) Undertake Supplier assurance responsibilities.

Programme Manager

1.5 The Programme Manager has the authority to run the project on a day-to-day basis on behalf of the Project Board within the constraints decided by the Board. The main responsibilities of the Project Manager are:

(a) To deliver agreed products to required specification and quality within budget and according to plan;

(b) Direct and motivate the project team;

(c) Project manage and plan all stages of the project;

(d) Agree delegation and project assurance roles;

(e) Prepare project, stage and exception plans and agree with the Project Board;

(f) Manage business and project risks (includes contingency planning);

(g) Produce the PID;

(h) Liaise with members of associated projects or programmes;

(i) Monitor progress, expenditure, resources, initiation of corrective action;


(j) Keep Project Board informed of deviations in plans and associated action (i.e. Change Control);

(k) Preparation of Highlight Reports for the Project Board;

(l) Liaise with Project Board to assure the direction and integrity of the project;

(m) Establish technical and quality strategy with appropriate members of the Project Board;

(n) Prepare End Project Report;

(o) Identify and obtain support and advice necessary for the management, planning and control of the project;

(p) Responsibility for project administration.

Project Assurance (OBC Delivery Team)

1.6 Project Assurance has responsibility for independent monitoring of all aspects of the project’s performance and products. Specific responsibilities of Project Assurance are:

(a) To maintain liaison throughout the project between the Supplier and the Customer;

(b) To assure that User needs and expectations are being met or managed;

(c) To assure that risks are being controlled;

(d) To keep the project in line with departmental and NICS strategies and policies;

(e) To monitor project expenditure versus benefits;

(f) To inform the project of any changes caused by external events; and

(g) To ensure adherence to quality assurance standards.

Team Manager/Team Leader

1.7 Specific responsibilities of the Team Manager/Leader are:

(a) Set work plans for the Project Team in conjunction with the Project Manager;

(b) Plan and allocate work within the team;

(c) Progress the tasks on the plan;


(d) Monitor team progress and costs, and initiate any necessary corrective action;

(e) Report progress to the Project Manager;

(f) Communicate any problems or slippage regarding Project tasks;

(g) Communicate any concerns or project issues to the Project Manager;

(h) Liaise with any appointed assurance roles;

(i) Attend Checkpoint meetings;

(j) Monitor technical progress against plans and inform the Project Manager of any major deviations;

Team Responsibilities

1.8 Specific responsibilities of the Project Team are:

(a) Agree work plans with the Team Manager;

(b) Complete work plans in accordance with agreed timescales; and

(c) Communicate any problems, concerns or issues to the Team Manager.

1.9 To ensure:

(a) Progress meetings

(b) independent reviews

(c) Design reviews

Appendix 2 – Communications Plan

Estates Strategy Outline Communications Plan

Release/Status LIVE

Version 4

Date October 2017

Prime Authors John Burnett

(Edited Christian Homersley)

Document title Estates Strategy outline communications plan


1. Introduction Wye Valley NHS Trust operates out of 60 buildings scattered across Herefordshire.

Forty five of these sites are within Hereford city with the County Hospital being the main building out of which the Trust operates.

The hospital, built through the Private Finance Initiative process, was opened in 2002. The PFI contract runs until 2029.

The Trust’s Estates Strategy is a high level document which supports the direction of travel for the management and development of the buildings and land it operates out of.

The Trust owns about third of these buildings.

In recent years there have been a number of calls for the County Hospital to be expanded to cope with the increasing number of people the Trust is caring for - for example, the number of hospital admissions between March 2014 and April 2015 is 16 per cent higher than for the same period 12 months previous.

The Trust is reporting one of the highest bed occupancy rates (around 95 per cent), which is above the national target, and was criticised by the Care Quality Commission in 2014 for its handling of patients through the emergency Department

As a result, work has begun to consider expansion options at the County Hospital site. The Trust began developing its Estates Strategy in 2014 to support this process.

2. Background

WVT was formed in 2011. Its estates and facilities strategy covers the period 2015 to 2020.

Some of the key aims of the strategy are:

• To improve patient experience and quality of care

• To provide a fit for purpose and safe environment for patients

• To support the clinical/service strategy and business requirements of WVT

• Provide flexible solutions for changes to functions and capacity

• Re-provide where buildings are unsustainable for modern healthcare

The strategy tackles a number of specific underlying issues which need to be addressed (some of these were picked up by the Care Quality Commission when it inspected the Trust and put it into special measures in October 2015).

These include:

• Lack of capacity (for inpatients and outpatients)


• Flow of patients while in our care

• Privacy and dignity of patients

• Lack of flexibility to provide more and a wider range of elective procedures and treatments

A number of urgent issues also exist in relation to a backlog of critical maintenance (which will cost in the region of £11 million to put right). The Estates Strategy will:

• Replace the aging hutted wards

• Extend inpatient capacity

• Co-locate ambulatory/day surgery facilities onto one site

• Enable future development and create flexibility

3. The Estates Strategy The Estates Strategy is split into five phases. The total cost for all of the phases stands at between £40 and £50 million.

The solutions and sequencing has changed during the Outline Business Case stage however the phases included in the Strategy indicated the following likely activities:

Phase 1: o Create a 16-bed unit on the mortuary car park o Reprovide car park on the Gwyndra Downs car park o Arkwright exit – Fred Bulmer building o Remodeling of the current Emergency Department to create

greater capacity o First phase of remodeling of medical records to pathology o Create additional storage space at the County Hospital site o Enabling works Phase 2: o Second phase of moving medical records and offices to enable hut

demolition Phase 3: o Create new wards into area currently occupied by hutted wards o Demolish Monnow and Leadon Wards Phase 4: o Consider other developments including:

Endoscopy ITU Day case Orchard site development (subject to planning constraints)


o Develop site currently occupied by Monnow and Leadon hutted wards

o Review operating theatres o Review staff accommodation – Longfield House o Lionel Green as potential location for support accomodation

Many of these will require work-arounds for staff and are likely to cause varying degrees of inconvenience to both staff members and patients and their families.

Individual work projects are likely to require varying amounts of internal and external communication support.

4. Outline communications plan

While there is a general awareness that the County Hospital needs extra capacity, the public in Herefordshire will not have a great understanding of what this means in practice.

Many local people will have based their knowledge on what they have seen, heard and read in the local and national media.

So to the public, it will mean very much “business as normal,” however, there will be good news stories to tell when we hit certain milestones and changes take place, but essentially they will continue to visit the hospital, or be visited by members of Trust staff and receive the treatment that they expect.

Changes to the Trust’s estate cannot come about without affecting members of the Trust’s staff - we need to ensure they will support the changes.

Staff will therefore be key to ensuring inevitable disruption and changes are managed and implemented smoothly and efficiently.

It is vital therefore that staff members are kept informed of progress with timely and accurate information. This will vary from one project to another within the Estates Strategy.

Our many stakeholders, partners and service providers have a vested interest in the Trust and we need to engage with them in a meaningful way to ensure they are on side, on message and able to become ambassadors for the changes the Estates Strategy will bring about at the County Hospital site.

And there are a number or organisations to which the Trust is accountable, both as a commissioned service provider and as an NHS body. These will have to be communicated to and with to ensure they understand the plans, the rationale for them and how we are progressing.

This communications plan lists the key audiences the Trust needs to communicate and engage with along with the channels which can be used.

It also references key messages which should be incorporated in all communication. It is difficult to suggest a timetable at this point in time - this can be added once more information regarding milestones is known.

3. Communications aims and objectives


A managed programme of communications will ensure that coherent and accurate information is distributed in a planned and timely manner.

This will help to ensure that:

• Staff at Wye Valley NHS Trust are fully briefed with regular information about progress throughout the term of the Estates Strategy

• Health and social care partners across Herefordshire and further afield are kept informed of progress

• Those who provide services to the Trust which will be impacted by the work will know in advance and be able to prepare for any changes – influencing them where necessary

• Commissioners of services understand the Estates Strategy, know how to influence it and are kept informed of progress

• Those bodies that monitor/scrutinise WVT are kept abreast of progress with timely updates

• The public understand the rationale for the Estates Strategy, know how to become involved where appropriate and are generally kept informed of progress

• The media understands the process and is actively involved as a partner with the Trust to ensure key messages and information about progress are communicated to the wider public

The premise will be that all information given is accurate and timely and that there are no surprises for the Trust and its partners in the local media.

4. Key messages/topline brief

• Doing nothing is not an option

• Any changes will be sustainable and flexible for future changes in demand, technology, medical treatments etc.

• Patients will be at the heart of any changes we make

• That the proposals are subject to the planning process and the Trust securing funding

• The Programme Board will seek to minimum disruption to day-to-day service provision during any proposed works

• Privacy & dignity and patient flow is to be improved

5. Stakeholders/audiences


The Trust has a responsibility to communicate with a number of distinct audiences.

Our key stakeholders/audiences, along with their level of influence and level of impact are identified here:


Broad communications channels for these stakeholders are illustrated below:

Stakeholder Communication channels Trust exec team Individual meetings Patients Meet as required Trust board Individual meetings Sodexo Meet as required Mercia Meet as required SUMs Programme board Clinical directors Project team Commissioners (CCG and across border)

Programme board

TDA Meet as required Herefordshire Council – planners Meet as required Air ambulance Meet as required Staff (general) Keep informed through established

channels Tenants Regular updates Volunteers Regular updates User groups Regular updates Public Regular updates Healthwatch Meet as required Councilors (parish/county) Regular updates Transport providers Regular updates Ambulance service Regular updates Service providers – gas, electricity, water Meet as required Infection prevention Project team PALS Regular updates Diagnostics Project team Pathology Project team Pharmacy Project team MPs Meet as required Primecare Keep informed 2gether Keep informed Trust members Regular updates


6. Communication channels in detail

We will use a range of communication channels to ensure information is broadcast clearly and fashioned in a manner which is accessible and timely. Some will receive regular communications; others will receive information on an ad hoc basis to communicate a specific event or milestone.

Where possible existing communication channels will be used to support this programme of work.

The Trust’s communication team will liaise closely with Kier’s communication team to ensure timely and accurate information is sent out to audiences as required.

Channels include:

Internal Channel Notes Trust Talk Weekly bulletin issued to all staff via email and available

on our intranet. Around 80 copies are also posted to all Departments via internal mail.

Team Brief Delivered by the CX to around 40 key managers on the first Thursday of each month. All managers expected to cascade to their staff so all WVT staff receive it within two weeks

Routine clinical/medical meetings

Use these already planned meetings as channels to give updates etc

Screensavers These will contain the most up to date information and can be used to celebrate milestones

Intranet Can be used to hold background papers/updates for staff

Global emails These can be used on a an ad-hoc basis to reinforce key messages, celebrate success, announce milestones etc

Meetings Meetings of various groups involved in the delivery of the Estates Strategy will involve an exchange of relevant material for these groups

External

Channel Notes WVT website Pages to be developed

These pages will include background information explaining the rationale for the Estates Strategy as well as general information about progress throughout the project and the benefits to patients the building work will bring

Press releases To be used to celebrate milestones within the strategy Briefings These can take place in a ad hoc fashion when it is felt a

particular audience group needs to be informed of a particular issue/general progress throughout the strategy

Posters Will be used when required around the County Hospital site to advise patients/staff/visitors of disruption/progress etc


Meetings These will be arranged as and when they are required Project team meetings

Exchange of operation information as part of the agenda for these meetings

Regular updates These can be updates which are emailed to communication leads at various organisations for cascade throughout their organisation, or to specific people within their organisation – for example, a Team Brief update for the Trust could be shared with the coms lead at Herefordshire Council for use in their communication with their staff members

Meet as required Meetings between key Trust staff and other organisations can be arranged on an ad-hoc basis to inform and update on progress

7. Communications challenges and risks

Most people will form their view on what they read/see/hear through the media.

With many differing experiences of care at the Trust, patients will form differing views.

Communications risks Mitigation General view that this should have happened a long time ago

Clear communication that this is not about the past, but about the improvements that the changes will bring for future generations

View that this is the fault of the original PFI contract

Acknowledgement that the original PFI contract met the needs at the time, but that changes to demographics had changed the needs the hospital was here to meet

Worried patients who feel the hospital is not providing safe high quality care until these extensions are built

Reassurance that the hospital provides safe and caring treatment to its patients – reference to performance information/reviews/PLACE survey/patient surveys/FFT results

Staff fed up of inconvenience caused by work/workmen as the strategy will run for several years

Openness and honesty in all communications with staff. Scanning horizon regularly to pre-empt disruption with clear communications prior to it happening.

Need to demonstrate long-term benefits the short-term inconvenience will bring.

Concentrate on bigger picture.

Media picking up complaints from patients due to inconvenience/disturbance caused by works

Openness and honesty in all communications with journalists. Need to demonstrate long-term benefits the short-term inconvenience will bring. Illustrate mitigation and be up front – advise of disruptions before it begins.


Concentrate on bigger picture.

8. Next steps

We need to:

• Identify key messages

• Include timeline highlighting key milestones into this communications plan

• Based on this timeline, draw up a rolling 90-day communications plan which includes the key events during the next three months. This will be reviewed on a monthly basis to ensure communications surrounding key events is planned and will effectively become the coms action plan for the project

Appendix 3 – Project Structure

DRAFT 5 |Project Structure Estates Strategy Phase 1: Outline Business Case

Proposed membership of Programme Board: Project Sponsor – Chief Operating Officer Director of Finance Project Manager (Estates) Head of Estates, Facilities and Capital Planning Service Unit Manager – Elective Care Service Unit Manager – Care Closer to Home and Urgent Care Service Unit Manager – Integrated Family Health Services Director of Nursing Medical Director Head of Strategy CCG representative Senior Supplier (Kier Representative) Independent Cost Advisor Healthcare Planner

Proposed membership of OBC Delivery Team: Project Manager (Estates) Project Manager (Operations) Capital Accountant Head of Estates Cost Consultant – AECOM P21+: Kier Health Team Leader

IBI Lead Designers SWEETT Business Case Writer

Proposed membership of User Groups (Acting as Project Teams): • Service Unit Managers • Lead Clinician(s) • Head of Nursing • Lead Nurse • Infection Prevention • Service Unit/ Revenue Accountant • Health and Safety Note: Patient Rep groups to be identified and Rep linked into appropriate User Group.

Membership will be adjusted where required.

• Fire Safety Manager • Estates Project Manager & Health

Care Planner • Project Manager (Operations) • Sodexo • Mercia Healthcare • Design Team

Programme Board

OBC Delivery Team

Trust Executive Management

Design Team Meeting

User Group Support Services/

Corporate

User Group Breast & Retinal

User Group Urgent Care/ Walk-in Centre/ A&E/Helipad

User Group Critical

Care

User Group Endoscopy

User Group Day Surgical

Services/ Ambulatory Care

User Group New Wards

User Group Community

User Group Repeatable

Rooms

Appendix 4 – Terms of Reference (Design Team)

WYE VALLEY NHS TRUST Estate Strategy OBC – DESIGN TEAM MEETINGS TERMS OF REFERENCE V1.1

1. Purpose The purpose of the Design Team Meeting (DTM) is to co-ordinate all design disciplines, plan, scrutinise and monitor impact on individual projects and the overall OBC. Provide assurance that costs, benefits, functionality and programme are being monitored and issues escalated. To achieve this it will receive briefings from the Design Manager and design development documents from the Architects. 2. Membership

• P21+ Design Manager • Architects • Design Engineers • Structural Engineer* • Specialist Designers* • Project Manager • Cost Consultant • Trust Healthcare Planner • Sodexo • Mercia Healthcare

3. Attendance Specialist suppliers will be invited to attend as required. Trust Estates and PFI contract staff will be invited as appropriate.

Each discipline above will be represented by the same User Group attendees. 4. Chair The Design Manager will chair and arrange the recording of action notes. Deputy chair will be the Project Manager. 5. Secretary Design Manager will provide these services. 6. Quorum This meeting will not have any voting rights or decision making that requires a quorum. The chair will be assess whether any decisions required can be finalised at the meeting or agree an appropriate means of reaching a subsequent conclusion in a timely manner. 7. Frequency of Meetings

Appendix 4 – Terms of Reference (Design Team)

The DTM shall meet at a frequency appropriate for the design requirements at any particular time based on every 2 weeks. Design development and co-ordination between meetings will be managed by the Design Manager and Lead Architect.

8. Notice of Meetings Unless otherwise agreed, notice of each meeting confirming the venue, time and date together with an agenda of items to be discussed and supporting documents, shall be forwarded to each member of the DTM and any other person required to attend, no later than 2 calendar days before the date of the meeting. It is accepted that in certain situations information will be tabled but that is to be minimised as can reasonably be expected. 9. Minutes of Meeting Action notes and specific minutes (formal notes as and when required) will be issued to all members within 5 working days after the meeting. 10. Duties The duties of the DTM are:

Develop a coordinated design to satisfy the requirements of the User Groups and the overall Estate Strategy.

Manage the design to satisfy the time programme. Monitor the impact of the design on cost and time programme. Monitor the impact of the design on the operational services. Record deviations from plan. Seek approvals for deviations and/or assumptions. Seek approvals for derogations against any guidance

The discharging of these core duties will require:

The development and implementation of a risk monitoring tool to feed into the Programme Board Risk Register.

The preparation and updating of programmes and cost models. Escalation of issues requiring authorisation and/or direction from the

Trust.

11. Reporting Responsibilities The action notes of DTM shall be reported to the next meeting. 12. Review These Terms of Reference will be reviewed at 1:500 sign off or sooner if required and recommendations made to the Programme Board for approval. 13. Approval Date of Approval: Approving Body:

Appendix 5 – Terms of Reference (Delivery Team)

WYE VALLEY NHS TRUST Estate Strategy OBC – DELIVERY TEAM MEETINGS TERMS OF REFERENCE V1.2

1. Purpose

The purpose of the OBC Delivery Team (ODT) is to plan, scrutinise and monitor the inputs and outputs required to deliver an approved Outline Business Case. The Team will provide assurance that relevant processes and guidance are followed.

The Team will provide assurance to the Programme Board in relation to the following specific items:

• Programme • Cost – Revenue and Capital • Affordability • Benefits management

2. Membership

• Senior Finance Lead • Project/Programme Manager • Project Director/Head of Estates, Facilities and Capital Planning • Cost consultant • Design team lead • Business case writer • Head of Strategy • Mercia Healthcare Limited

3. Attendance Other mangers and design team members will be asked to attend and suppliers/ contractors will attend as required/requested.

Deputies will be allowed provided that they have full authority to act. The ODT can co-opt members as required.

4. Chair The Project Director will chair the meeting. Programme Manager will be the Deputy Chair. 5. Secretary Estates and Facilities will provide secretarial support. 6. Quorum For the meeting to be quorate the following will need to be present: • Chair or Deputy • 50% of eligible members Other members may identify deputies to represent them.

Appendix 5 – Terms of Reference (Delivery Team)

7. Frequency of Meetings The ODT shall ordinarily meet fortnightly and not less than monthly.

8. Notice of Meetings Unless otherwise agreed, notice of each meeting confirming the venue, time and date together with an agenda of items to be discussed and supporting papers, shall be forwarded to each member of the ODT and any other person required to attend, no later than 3 calendar days before the date of the meeting. 9. Minutes of Meeting Draft minutes of the meeting shall be circulated within 7 days to all Members of the ODT and once agreed to all Members of the Leadership Team. 10. Duties The duties of the ODT are:

Develop the Trust’s long term estate strategy/capital plan and ensure that this is aligned with service requirements in the Integrated Business Plan and Long Term Financial Model

Develop and manage the programme for delivering the OBC/FBC and works

Recommend the business case in line with guidance. Coordinate the management and delivery of projects within the

Programme Update and manage the cost plan

The discharging of these core duties will require:

The development and implementation of a risk register and programme. The creation and updating of the draft business cases. The preparation of reports to update and seek approval from Programme

Board.

11. Reporting Responsibilities The minutes of ODT shall be reported to the next meeting. 12. Review These Terms of Reference will be reviewed annually or sooner if required and recommendations made to Programme Board for approval. 13. Approval

Date of Approval: 28th May 2015 Approving Body: Programme Board

Appendix 6 – Terms of Reference (Clinical User Groups)

WYE VALLEY NHS TRUST Estate Strategy OBC – CLINICAL USER GROUP MEETINGS TERMS OF REFERENCE V1.1

1. Purpose The purpose of the Clinical User Group (CUG) is to develop and agree a justifiable design to support the production of the outline business case (OBC). The design should be able to withstand scrutiny and ensure that individual projects are co-ordinate to support the whole estates strategy. The group should also provide assurance that costs, benefits, functionality and programme are being monitored and issues escalated. To achieve this it will receive briefings from the Healthcare Planner and drawings from the Architects. 2. Membership

• Clinical lead for Nursing And Medicine • A Head of Nursing • Infection Prevention • Capital Programme Manager • P21+ Design Manager • Architects • Design Engineers • Project Manager • Trust Healthcare Planner • Sodexo • Mercia Healthcare • Informatics • Fire Safety Manager • Health And Safety Manager • Key stakeholders depending on the specialty

3. Attendance Specialist support will be invited to attend or advise as required

Each discipline above will be consistently represented 4. Chair The Healthcare Planner or Capital Programme Manager will chair and arrange the recording of action notes. Deputy chair will be the Architect 5. Secretary Healthcare Planner or Capital Programme Manager will provide these services. 6. Quorum


This meeting will not have any voting rights or decision making that requires a quorum. The chair will assess whether any decisions required can be finalised at the meeting or agree an appropriate means of reaching a subsequent conclusion in a timely manner. 7. Frequency of Meetings The CUG shall meet at a frequency appropriate for the design requirements at any particular time initially weekly and then as required. Design development and co-ordination between meetings will be managed by the Healthcare Planner or Capital Programme Manager and the Architect.

Meetings are anticipated to run until February 2015

Notice of Meetings Unless otherwise agreed, notice of each meeting confirming the venue, time and date together with an agenda of items to be discussed and supporting documents, shall be forwarded to each member of the CUG and any other person required to attend, no later than 2 calendar days before the date of the meeting. It is accepted that in certain situations information will be tabled but that is to be minimised as can reasonably be expected. 8. Minutes of Meeting Action notes and specific minutes (formal notes as and when required) will be issued to all members within 5 working days after the meeting. 9. Duties The duties of the CUG are:

Develop a coordinated design to satisfy the requirements of the service and the overall Estate Strategy.

Manage the design to satisfy the time programme. Elevate the impact of the design on the operational services. Record deviations from plan. Attend meetings or send the fully briefed representative Complete all actions in a timely manner Communicate with the service unit team Coordinate responses as required by the user group Provide reports to the monthly programme board

The discharging of these core duties will require the group:

To adopt a shared contributory and learning approach to its work require:

Escalation of issues requiring authorisation and/or direction from the Trust.

10. Reporting Responsibilities


The action notes of CUG will be circulated to the user group membership and made available to the programme board as required 11. Review These Terms of Reference will be reviewed at 1:50 sign off or sooner if required and recommendations made to the programme board for approval 13. Approval Date of Approval: Approving Body:

Appendix 7 – Terms of Reference (Programme Board)

WYE VALLEY NHS TRUST Estate Strategy OBC – PROGRAMME BOARD MEETINGS TERMS OF REFERENCE V1.5 1. Purpose

The purpose of the Estates Strategy Phase 1 (OBC) Programme Board will be primarily to achieve the following objectives:

• Oversee the development of preferred options for the Estate Strategy • To deliver an Outline Business Case (OBC) • To make clear recommendations to the Trust Executive Management Team

and Trust Board

2. Attendees Membership

Core membership (including in voting where decisions require): Project Sponsor – Chief Operating Officer Director of Finance Project Manager (Estates) Head of Estates, Facilities and Capital Planning Service Unit Manager – Elective Care Service Unit Manager – Care Closer to Home and Urgent Care Service Unit Manager – Integrated Family Health Services Director of Nursing Medical Director Head of Strategy In attendance (not included in voting but sent all papers and advising Programme Board on decisions where appropriate) CCG representative Lead from design team/Senior Supplier (Kier Representative) Independent Cost Advisor Healthcare Planner

3. Attendance All core members expected to attend or ensure appropriate representation. Others may be asked to attend as necessary to provide assurance, feedback or communications

4. Secretary The secretary will ensure action notes are taken and circulated to the meeting and agenda items are collated as necessary. Members will receive minutes and agenda no later than 5 working days prior to meeting.

Appendix 7 – Terms of Reference (Programme Board)

5. Quorum In order to make any decisions 50% of the core membership must be in attendance with at least two Executive Directors.

6. Frequency of Meetings

Approximately every 3-4 weeks.

7. Notice of Meetings

Meetings will be set up 3 months in advance and notice given by the Chair or nominated deputy.

8. Minutes of Meetings

No formal minutes will be issued but key actions logged and any matters requiring escalation or of significance noted to provide a record. The meeting will ratify these notes on an ongoing basis and the actions reported through to Trust Executive Management.

9. Duties relating to Estates Strategy Phase 1 (OBC) Project a) Monitor the performance of the required workstreams/project teams

including deliverables/recommendations from service areas and any additional sub-group (e.g. OBC Document Team).

b) Agree the format and content of the OBC. c) To ensure route for approval of OBC both internally and externally is clear

and articulated in the document. d) To prioritise the programme for investment e) To review and recommend options for programme/sequencing of works. f) To deliver a development control plan for the County Hospital Site. g) To oversee Project risk register. h) Ensure appropriate consultation is carried out within the time frame

available. i) Ensure the business case, as far as possible, addresses the whole impact

of the proposals on the Trust including clinical, financial, reputational etc. j) To ensure that all delivery options are considered including those relating

to raising investment funds and procurement. k) Consider the relative benefits of a parallel process accelerating the

delivery of additional inpatient capacity. l) To ensure the objectives and benefits to be realised are clearly articulated

in the case for change and are clearly assessed for the preferred option/s.

10. Reporting Responsibilities The meeting will report into Trust Executive Management.

11. Review The terms of reference will be reviewed annually unless required sooner.


Appendix 6.2

Detailed Project Programme

Hereford Hospital Phase 3 For Wye Valley NHS Trust

View - SummaryPhase 3: Outline Indicative Programme - 3 x 24 Bed Option

Programme No. 5114-05 Revision Comment:

Revision Date:24/08/2018

On:06/08/2018

Revision No:P2

Page:1 of 1

Drawn By:MPS

Kier ConstructionCentral

UniqueTask ID Activity Start

Duration(Working

Days)Finish

2019 20202018 2021Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep

2 16 30 13 27 10 24 8 22 5 19 3 17 31 14 28 11 25 11 25 8 22 6 20 3 17 1 15 29 12 26 9 23 7 21 4 18 2 16 30 13 27 10 24 9 23 6 20 4 18 1 15 29 13 27 10 24 7 21 5 19 2 16 30 14 28 11 25 8 22 8 22 5 19 3 17 31 14 28 12 26 9 23 6 202 6 10 14 18 22 26 30 34 38 42 46 50 54 58 62 66 70 74 78 82 86 90 94 98 102 106 110 114 118 122 126 130 134 138 142 146 150 154 158 162 166-1

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KEY DATES / CLIENT MATTERSPM/011 issued - Design & procurement services to produced a GMP for 3x24 bedreplacement wards schemeCE/029 Authorised by client

Client consideration period - GMP for 3x24 bed replacement wards scheme

Instruction issued to proceed with construction of 3x24 bed replacement wards scheme

Sectional completion - Enabling Works - Offices & Health Records

Start on site - Replacement ward blockSectional Completion - Replacement ward blockClinical commissioning, staff training & decant undertaken (from Leadon & Monnowwards to Replacement ward block) (by client)Access date - Leadon & Monnow wards (Vacant possession)

Start on site - Demolition - Leadon & Monnow wards

Sectional Completion - Demolition - Leadon & Monnow wards

Completion date - Project completion - Phase 3

PRE-CONSTRUCTION WORKSFee Proposal - 3x24 BedCE/029 Fee proposal developed - For design and costing of 3x24 bed replacementwards schemeFee proposal issued - For design and costing of 3x24 bed replacement wards scheme

Design Development - 3x24 BedDesign for planning application producedDesign for market testing producedDesign for market testing issued

Town Planning - 3x24 BedPlanning application submitted

Planning application consideration period

Planning permission granted

Pre-start planning conditions discharged

Pricing - Replacement Ward Block & Demo 23x24 BedBoQ produced

Market testing undertaken

GMP established & adjudicated

GMP submitted

Mobilisation - 3x24 Bed

Early On Site Work Package & Materials Procurement - 3x24 BedCONSTRUCTION WORKSEnabling Works - Offices & Health Records Demolition (Demo 1)Replacement Ward Block (RWB) - 3x24 BedFinal Demolition, Link Corridor & Service Road (Demo 2)

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30/08/21

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19/10/1824/08/1819/10/1819/10/1825/01/1924/08/18

23/11/18

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25/01/19

14/12/1802/11/18

30/11/18

14/12/18

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24/05/19

24/07/1927/08/2114/12/1827/11/2027/08/21

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PC3S-6

PC3S-7

PC3S-8

PC3S-9

PC3S-10

PC3S-11

PC3S-12

PC3S-13

PC3S-14

PC3S-15

PC3S-16

PC3S-17

PC3S-18

+ +PC3S-19

+ +PC3S-21

C3S-1

+ +C3S-2

+ +C3S-4

+ +C3S-15

UniqueTask ID Activity Start

Duration(Working

Days)Finish

2 6 10 14 18 22 26 30 34 38 42 46 50 54 58 62 66 70 74 78 82 86 90 94 98 102 106 110 114 118 122 126 130 134 138 142 146 150 154 158 162 166-12 16 30 13 27 10 24 8 22 5 19 3 17 31 14 28 11 25 11 25 8 22 6 20 3 17 1 15 29 12 26 9 23 7 21 4 18 2 16 30 13 27 10 24 9 23 6 20 4 18 1 15 29 13 27 10 24 7 21 5 19 2 16 30 14 28 11 25 8 22 8 22 5 19 3 17 31 14 28 12 26 9 23 6 20

Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep2019 20202018 2021

StageKey Dates Approvals By Others Pre-construction Stage Pricing Design Stage Town Planning Mobilisation Procurement Stage Build Stage Demolition Main Construction


Appendix 6.3

Project Risk Register

ProCure21 Joint Risk Register V4

Project Title:

P21+ Scheme

ID:

Date Register First Created: 29/08/2018 Revision Number: 1

Control Buttons:

Ref No:

Risk

Category Risk Description

Probability

(1-5)

Impact (1-

5)

Risk Rating (1-

25)

Action Plan

Completed?

Time /

Cost Impact Mitigation

Probability

(1-5)

Impact (1-

5)

Risk Rating (1-

25)

1 Unable to progress due to insufficient funding available. 3 5 15 N T&C

NHSI have been kept in the loop throughout process.

2 5 10

2 OBC document not approved internally and/or externally.3 5 15 N T&C

Regular presentation and Programme Board and ongoing dialogue with

NTDA. Consideration of WVT Board engagement. 2 4 8

3Reducing available spare capacity within the system (Elec, gas, water,

drainage)5 4 20 Y T&C

*******************Only power and water will connect to PFI

infrastructure. Gas and drainage is to city main. Sodexo to confirm it

is within allowable levels. 2 2 4

4 Stakeholder may have contradictory aspirations 3 4 12 Y T&C Agree 1:50 layouts during stage 3 2 4 8

5 Non-compliance with new legislation. Room areas 4 4 16 Y T&C

Ensure ongoing dialogue through development of 1:50s during GMP

period. 2 4 8

6Utility and existing services capacity insufficient to supply new build

elements of the project. 4 4 16 Y T&CEarly engagement of Utility companies.

3 4 12

7

Site wide Infrastructure, including generators, capacity insufficient to

supply new build and refurbishments (inc Elec, gas, water, storm

drainage, foul drainage, medical gases). Also suitability for Earthing

Requirements, medical locations. 4 4 16 Y T&C

********************Applies to water and power only. Engagement with

Sodexo as soon as possible. Surveys instructed where existing data is

not held.3 4 12

8Cost/programme/income implications of site phasing and logistics not

adequately defined or agreed with Stakeholders. 4 4 16 Y T&C

Ongoing discussion to be progressed with Kier, Trust and Sodexo re.

implications of project delivery. 2 3 6

9Inability of other stakeholders to deliver to programme causes delay to

the works

3 4 12 Y T&C

Monitor whether Project teams are likely to become

feasible/functional. Delivery team and Estates deal with key

stakeholders in liaison with Divisional Managers (DUM). Ensure impact

of information gathered on other depts. is compatible with Clinical

Strategy. 3 3 9

10 Failure to realise the expected contributions, (VAT)5 3 15 N T&C

VAT advice sort by Trust and continually updated in line with P21+

HMRC requirements. 2 3 6

11

Design, workmanship defects and poor structural/fabric condition of

existing buildings - link corridor & diabetes unit results in additional

programme and cost impact when works commence. 4 3 12 Y T&C

Full survey suit of existing buildings impacted by the development to

be undertaken during GMP period.3 3 9

12 Obtaining Planning Consent and discharge of associated conditions 3 3 9 N T&C Continuous dialogue with LPA. 2 3 6

13

Planning - New requirement for Pre-application Service may mean that

the planning submission may have more onerous requirements in terms

of content and cost. 4 4 16 Y T&C

Continuous dialogue with LPA re. scheme proposals leading up to Pre-

application Meeting3 5 15

14

Building position and requirement to maintain access to fire access

road could have an impact on proximity of the building to the site

boundary adjacent the footpath and residential property. 4 4 16 N T&C

Kier to review construction zone requirements and develop access

strategy with Trust.3 4 12

15Construction Inflation calculations may be inadequate to reflect actual

cost

4 3 12 N T&C

Early engagement with likely subcontractors on key packages to

determine the current market rates and any known inflationary

factors. PSCP and Trust to input. - Ultimately Kier will be proving a

GMP and therefore inflation risk will be taken by Kier. 3 3 9

16

Maintaining service roads, clinical services specifically with respect to

shutdowns, isolations and drainage.

Risk associated with stoppages due to noise, dust, vibration cause. 4 3 12 N T&C

Establish programme/sequence as soon as possible. Kier have held

meetings with Trust and Sodexo - Sodexo to determine and confirm

methodology for service shutdowns and terminations3 3 9

17 Customer / Patient perception whilst works are carried out. 4 3 12 N T&C Lots of communication. Construction planning/controls. 3 3 9

18Project is delayed due changes in the organisational form to the Trust

due to external factors 3 4 12 N T&CStay in touch with NHSI

3 3 9

RISK REGISTER

Replacement Wards GMP2 Risk Champion: P Burke

Prior to Mitigation Post Mitigation

Hereford County Hospital - Replacement Wards

21/09/2017 Date Updated: Updated by: Kier & WVT

High Risks Medium Risks Low Risks

Reset

Closed RisksActive Risks

Action Date Approaching

Overdue Risk

PSCP Risks NHS Client Risks Joint RisksInsert Row

Joint R Register 290818 Rev1 1 Risk Register


19Delay or Increased Cost due to Mercia not engaging or agreeing

consent

3 4 12 N T&C

Engage with Mercia Health care early in any process. Agree a draft

programme and sequence. Monitor Contractual attitudes. Review

procurement of works via PFI or WVT and set up legal as early as

possible. 2 4 8

20Discovery of unknown contamination (hydrocarbon, asbestos, arsenic

etc) as works proceed, and subsequent management. 4 4 16 N T&C

Undertake full testing suits of development impacted area during GMP

to assist in the compilation of design solutions and mitigation

strategy. 2 4 8

21 Cutting existing unknown services serving other parts of the hospital.4 4 16 N T&C

Kier, Trust, Sodexo and WSP MEP to work through practical

logistics/strategy. Probability must reduce tp 2 prior to commence 3 4 12

22Higher running costs due to lack of input of Trust & Mercia supply

chain (e.g. hard and soft FM) 3 3 9 N T&CSodexo and Mercia to produce FM strategy for current design.

1 3 3

23Operational Procedures and Policies not up to date and reflected in

the design. 3 3 9 N T&CDesign has incorporated discussions to date.

1 3 3

24Failure to integrate Trust's IT Provider (Hoople) requirements into the

scheme. 3 3 9 N T&C

**********Meeting taken place with Trust IT Director. Scope to be

produced to check interfaces with MEP Hoople and IT dept engaged 2 3 6

25 Project is delayed due to changes on clinical strategy 3 3 9 N T&C Agree 1:50 layouts during stage 3 3 3 9

26Failure to quantify FF&E requirement into the design Inc. wayfinding

(cost and space provision). 3 3 9 N T&C

Trust to establish Legacy FF&E and what can be transferred. Kier to

develop loaded 1:50's, Room Data Sheets and wayfinding proposals. 2 3 6

27

Lack of accurate survey information exists ( conflicting topo survey

/CAD record information) assumptions have been made about the

boundary positions etc 3 3 9 Y T&C

Surveys complete

1 1 1

28Discovery of unknown asbestos /similar as works proceed, and

subsequent management. 2 5 10 N T&CWatching brief during demolition works to be maintained

2 5 10

29Works around known existing live services and works to divert existing

live services serving affecting other parts of the hospital 5 4 20 N T&C

WSP survey has identified these services and the project requirements

associated with these are recorded in the hutted wards demolition

report. Contract to identify when disruptive works can be undertaken 3 4 12

30 Lack of record information (MEP)5 3 15 Y T&C

WSP survey has identified services which can be identified and the

project requirements associated with these are recorded in the hutted

wards demolition report and MEP report. Intrusive survey as part of 3 2 6

31 Additional requests from Planners, following planning approval 3 4 12 N T&C Ongoing dialogue with LPA 2 3 6

32 Known condition of existing plant; inability to connect new services.3 3 9 Y T&C

WSP survey existing plant, assessed plant and viability of connection -

use of package plant room 2 2 4

33Removal and disposal of existing redundant 'old' plant, identified in

Works Information 5 1 5 Y T&C

Existing plant to be appropriately isolated and examined before

removal to establish any potential hazard 5 1 5

34Potential for unknown hazardous materials in existing structure and

services 4 2 8 N T&Con-going monitoring during works

3 2 6

35 Existing unknown services within ceiling voids discovered5 1 5 N T&C

The services to be surveyed once the ceilings are removed

throughout the refurbished areas to determine any potential hazards. 2 1 2

36Existing services / buildings are required to be removed / demolished

prior to the new build element. 5 5 25 Y T&CWorks to be appropriately phased.

1 1 1

37Areas of the hospital will remain in use which may impact negatively

in terms of logistics during construction. 4 4 16 Y T&CLiaise with Trust to arrange access, phasing interface etc

2 4 8



38 Potential for existing buildings to support bat roosts3 5 15 Y T&C

Internal inspection of lofts to be carried out before any substantial

demolition work, followed by dusk dawn surveys May-Sept 2018 (visits

to be spaced 2 weeks apart and no of required visits TBC after internal 2 5 10

39 Existing buildings/trees support nesting birds5 3 15 Y T&C

Demolition to be Sept-Feb (outside of BB season) OR ecological

supervision/check on morning of demolition. Tree and shrubs

removed. 2 3 6

40 Ground Investigation - failure to take account of surveys 3 3 9 Y T&C Ground Investigation complete, implications incorporated in GMP 2 2 4

41

New Drainage routes via the existing runs through the Canadian Huts.

The Trust have noted that this route is continually being block and is

not recommended. 4 5 20 Y T&C

WSP concluding drainage following receipt of CCTV information.

2 2 4

42Building Control requiring additional works following Plan Approval

stage(consequential improvements) 3 3 9 Y CEngage with AI during stage 3

1 1 1

43Continuing development of design after the OBC submission and start

of FBC due to time lag. 3 3 9 Y T&CContinue to monitor - car parking reprovision example

3 3 9

44 Trust/Mercia decant works not completed in time to commence works.5 3 15 N T&C

Meeting to discuss5 3 15

45Insufficient cost and time allowance for Trust staff training and

familiarisation on completion. 2 3 6 N T&CSoft Landing to be developed

2 2 4

46Costs and delays in achieving Fire compliance - with existing building

and at junction/interface with existing3 2 6 Y T&C

Consultation with Trust Fire Officer taken place. Compliancy with

Building Regs agreed as the strategy.

Fire Officer to sign off Fire Strategy drawings. 2 2 4

47 Planners requesting enhanced BREEAM status to extension.2 3 6 N T&C

Liaise with LPA and confirm anticipated BREEAM requirement for the

scheme - obtain draft conditions asap 2 2 4

48Site investigations and surveys not carried out in sufficient time for

construction period design and works to progress. 2 3 6 Y T&CSurveys complete

1 2 2

49 Impact of loss of permanent car parking spaces.4 4 16 N T&C

Spaces have been identified as being lost due to the build. WSP to

review relocation. 3 4 12

50Demolition of existing office and medical record huts (Unknown

Service Diversion, Asbestos Removal and Demolition) 5 5 25 Y T&CUnable to mitigate due to limited services and asbestos information.

5 5 25

51 Finding items of archaeological interest delays the works4 4 16 Y T&C

SDesk top survey carried out as well as watching brief during ground

investigations. Strategy as agreed with LPA 3 4 12

52Failure of the Trust to obtain BREEAM Credits (Lift, Travel Plan,

Security, Waste Management) 4 4 16 Y T&CTrust credits have been assigned on the BREEAM Tracker.

3 3 9

53 Damage to existing known infrastructure4 4 16 N T&C

Kier programme, logistics and method statements to be detailed.

Delap survey to be undertaken prior to works commencing 2 4 8

54 Change to Building Regulations before construction 3 3 9 N T&C Building Control Approved Inspector consulted. 1 3 3

55

Replacement filters to existing plant equipment on the Hospital site

during and after the construction works due to increase dust

generation. 4 4 16 N T&C

Kier to install mitigation measure to site activities but risk can not be

fully mitigated.2 3 6

56 Site Security during construction 2 4 8 N T&C Use existing security and site compound set up 1 3 3

57There may be insufficient funds to deliver the full Clinical

Requirement 3 4 12 N T&Con going dialogue during phase 3 design

3 3 9

58Archaeological watching brief to meet Planning requirements discovers

matters of interest which delays the works 3 4 12 N T&Csee item 51

3 3 9

59 Contamination found in the temporary site compound (orchard site).

4 3 12 N

Should orchard area be used for parking further investigation maybe

required - current proposal is to overlay with mat to provide parking

for main scheme post enabling works 2 3 6

60 Subcontractor becoming insolvent after orders placed. 3 4 12 N T&C Robust view taken on subcontractor selection for GMP. 2 4 8

61Costs of discharging conditions of Planning Consent may be greater

than allowance provided for 3 4 12 N T&C

Undertake review of conditions on receipt and revise cost plan

accordingly 3 4 12

62 Planning Condition discharge approvals may be delayed 3 4 12 N T&C Review approvals and monitor with tracker 3 3 9

63Changes to Legislation/Standards, (DDA, Building Regs, HTMs, Fire

Regs, CDM, BREEAM etc) 3 4 12 N T&CReview legislation changes during DTM

1 4 4

64 May not conduct Equipment Planning effectively 3 4 12 N T&C All party liaison 3 4 12

65The PSCP Programme may not be aligned with the Trusts

requirements 3 4 12 N T&CAll party liaison

3 3 9

66

Works Information may not be adequate or accurate, (PSCP

Appointment Stage - review and ownership of existing Works

Information) 3 5 15 N T&C

Agree WI

3 4 12

67PSCP may fail to estimate an appropriate level of Design Contingency

against the GMP 3 5 15 N T&CAgree design contingency - risk item with client

3 4 12

68 Local objection may influence Planning Permissions 2 4 8 N T&C No objections raised to planning at date of this revised register 1 4 4

69 Variations to P21 Contract may not be approved or agreed 3 5 15 N T&C EWN and CE's to be agreed as variations arise 2 2 4

70 May fail to engage with Infection Control during Design 3 5 15 N T&C All party liaison 1 3 3

71 May fail to engage with Infection Control during Construction 3 5 15 N T&C All party liaison 3 3 9



72May fail to maintain Patient Security during Construction, Decanting

etc. 3 5 15 N T&CAll party liaison

3 3 9

73Proposed materials may not be available at GMP rates

3 4 12 N T&C

Robust view and market test of materials to be undertaken in good

time 2 3 6

74

Trusts may fail to include allowances for Compensation Events,

(Changes to Works Information, failure to meet Approval Periods etc.)

3 5 15 N T&C

Use of P21+ contract document suite CE register. Ensure contigency

allowance is adequate3 4 12

75 May forecast final costs inaccurately 3 5 15 N T&C see item 74 3 2 6

76 May fail to get access to the whole site when planned 4 5 20 N T&C All parties to agree logistics and access 4 4 16

77

May encounter unforeseen events, (Site contamination,

archaeological, extreme weather, environmental, Utility pipes/cables,

other unexpected previous construction etc.) 3 4 12 N T&C

Consider if eventualities arise and act in accordance with contract

documentation3 4 12

78Lead-in periods may be inaccurate

3 4 12 N T&C

Establish early procurement schedule and identify lead periods in

conjunction with programme 1 4 4

79 May be unable to acquire people resources when required 3 4 12 N T&C Identify resources as required in conjunction with programme 2 4 8

80 The utilities (Cadent) may provide sub-standard service 4 5 20 N T&C commence early consultation with utility companies 4 5 20

81Directly employed sub-contractors may fail to adhere to the

Programme. 3 4 12 N T&CUndertake regular Subcontract programme reviews

2 3 6

82Both parties may fail to adopt or maintain a collaborative working

relationship. 3 5 15 N T&CWork together as NEC ethos

1 3 3

83

Underground service duct running alongside and between new hospital

and site has been confirmed as weak/poor structure - vehicles

prohibited from trafficking now defining site logistics for replacement

ward phase 5 5 25 N T&C

Scope of work for rectification/replacement to be confirmed and

implemented prior to construction of replacement wards

4 4 16

84Current cost plan insufficient for new carriageway construction as HCH-

WSP-EC-C-0005 4 5 20 N T&C

Review WSP scheme and adjust/make comparison with current cost

plan 3 2 6

85NHSI requirement for BREEAM excellent may impact on affordability of

scheme 5 3 15 N T&CRegular BREEAM workshops to assess implications

5 2 10

86Incorporation of WVT requirement for sprinklers may impact of

affordability of scheme 5 3 15 N T&C

Ensure requirement is considered and incorporated in affordability

model 4 3 12

87Project requirement for ward specific med gas infrastructure and

associated external works/buildings may impact on affordability 5 3 15 N T&C

Ensure requirement is considered and incorporated in affordability

model 4 3 12

88 WSPInability to agree oxygen plant layout and access with BOC. BOC may

not engage 2 4 8 Y T&CBOC engaged and have been asked to comment

2 3 6

89 WSPCadent may not allow to build over gas main and may have special

build over requirements 4 5 20 Y T&CCadent have been engaged and asked to comment

3 4 12

90 WSP Not able to establish capacity f existing calorifiers in Leadon/Monnow5 4 20 Y T&C

Recommended that no more than 1 bath per hour is allowed (although

more may be possible) 3 4 12

91 WSP Not able to agree welsh water connection detail for drain 3 5 15 Y T&C Welsh Water are engaged and have been asked to comment 3 4 12

92 WSPNot able to gain commentary from Authorised Engineer/Authorised

Person 3 4 12 Y T&C

Engage with Aiuthorised Engineer and issue WSP MEP Design

Information for review. 3 4 12

93 WSPInability to gain BREEAM credits that are Employer responsibility to

achieve required rating 3 4 12 Y T&CCredits have been assigned to all parties in BREEAM tracker

2 3 6

94 WSPEnabling. Adapting existing electrical installation, possibility existing

equipment can fail electrical testing. 3 4 12 Y T&CNo mitigation, but if failures occur upgrades will be required. Cost risk

3 4 12

95 WSPEnabling. Spare capacity of Mortuary Fire Alarm Panel to be confirmed

for enabling.

3 4 12 Y T&C

To be checked with fire alarm provider by M&E subcontractor. If

insufficient spare capacity to re-feed the Diabetes unit is available. A

new standalone Fire Alarm System maybe required within the Diabetes

Unit with interface signal to main hospital. 3 4 12

96 WSP

Enabling. Unknown status of the LTHW heating

balancing/commissioning. Delay to completing works. Ward down

time. 4 5 20 Y T&C

Pumps selected mid curve to aid commissioning flexibility

3 4 12

97 WSP

Enabling. Unknown condition of existing LTHW heating network being

connected to within Leadon. Delay to completing works. Ward down

time 4 5 20 Y T&C

Plate heat exchanger included in package to protect new heating

plant should the LTHW system be contaminated. 3 4 12

98 WSPUnknown condition of steam main and service duct. Disconnections

could cause hospital down time. 2 4 8 Y T&CSurvey prior. M&E subcontractor RAMS

2 3 6

99 WSP

Diversion of existing pneumatic branch to diabetic unit takes a

significant period of time affecting the use of the system for diabetics

unit. 4 4 16 Y T&C

Ensure new below ground services can installed to the new building

before attempting switch-overby including accessible new below

ground duct interface with the existing below ground duct. 2 3 6

100 WSPNoise from new building plant (excl. packaged plant)

4 3 12 Y T&C

Acoustic report has considered noise emissions and mitigation

measures. These are to be implemented in scheme. 1 3 3

101CCTV - Isolate of additional CCTV cameras as required to demolition

areas. Maximum 2No. Days included. 3 3 9 Y T&CPre enabling scope determined after appointment of contractor

3 2 6



102Door Access - Isolate additional Access control doors as required to

demolition areas. Maximum 2No. Days included. 3 3 9 Y T&CPre enabling scope determined after appointment of contractor

3 2 6

103Intruder Alarm - Isolate any intruder alarm detectors as required to

demolition areas. Maximum 1No. Day included. 3 3 9 Y T&CPre enabling scope determined after appointment of contractor

3 2 6

104 Additional pipe freezes should existing valves not fully isolate services.4 4 16 Y T&C

Pre enabling scope determined after appointment of contractor3 2 6

105Add baby change unit to diabetes unit ref MEP comments GV 20th April

2017 5 1 5 Y T&CPre enabling scope determined after appointment of contractor

3 1 3

106 Fire alarm amendments required by Employer

5 4 20 Y T&C

Input from specialist and associated cost expected w/c 23/4 - detail

received Siemens ref 10391_AC_Hereford Panel dated 02/05/2018 -

MEP within Enabling Phase up-dated 3 4 12

107Disconnection and reinstatement of power source to Newgate

entrance/exit barriers by Employer 3 3 9 Y T&CEstablish most cost effective solution

3 3 9

108Ductwork from corridor end to PFI duct work - condition of duct

covering unsuitable 3 3 9 Y T&CConfirm route and usability of existing duct for part of the length

3 3 9

109Concrete plinth to house boiler package plant 3 2 6 Y T&C

Obtain details from specialist - consider siting and sequencing

regarding drainage works 2 2 4

110 Paving slabs to Monnow perimeter to house mechanical pipework 3 2 6 Y T&C Obtain quotation form trade contractor 1 1 1

111Remove and reinstate ceilings to diabetes and link to facilitae LV sub-

mains 3 2 6 Y T&CEstablish scope and work out of operating hours

2 2 4

112 Cleaners room & disposal hold requirements 3 3 9 Y T&C Scope to be confirmed and design info up-dated 3 3 9

113 Amendments to trust requirements to new wards 1 3 3 Y T&C Trust to review design and provide feedback to team 1 3 3

114 Localised hot water heater for cylinical provision required 4 2 8 Y T&C WSP to confirm location and availibility 3 1 3

115Existing services and contaminated ground found below existing

buildings, which have not been subject to survey 4 4 16 Y T&CSurvey and investigation post demolition

3 3 9

116Potential increased scope to diabetes wall junction with existing

Canadian hut to be demolished 4 3 12 Y T&CIdentify during works and provide solution

3 2 6

117Requirement to work in conjunction with Sodexo if encoutering

confined space 4 2 8 Y T&CLiase with Sodexo

3 1 3

118Employer unable to provide access to undertake work at required

programme time 4 2 8 Y T&CMitigate change as necessary

3 2 6

119Fire alarm containment requirements following Siemens quote as RR

106 4 2 8 Y T&CDefine containment and ductwork requirement

3 2 6

120 Fire watch requirement during fire alarm panel down time by 4 1 4 Y T&C Appoint fire watch 3 1 3

121potential damage to party walls and third party property caused by the

works’ 4 4 16 Y T&CTrust to employ Building Surveyor to acrryout 'condition survey'

3 2 6

123Soft landscaping yet to be priced 4 1 4 Y T&C

Confirm soft landscaping scope3 1 3

124 Manhole CL reductions in entrance road 4 1 4 Y T&C Confrim detail 3 1 3

125 OH3 compliant sprinkler required 4 3 12 Y T&C Confrim detail 3 2 6

126 XL sprinklers heads to comply with life safety req. 4 1 4 Y T&C Confrim detail 3 2 6

127Excavated materal following WAC test is classified as Non hazardous or

contaminated - costed as inert in GMP 4 1 4 Y T&CConfrim detail

3 1 3

128 All STATS provision & associated BWIC by Employer 5 2 10 Y T&C Confrim detail 3 1 3

129 B regs approval plan check report yet to be received 5 2 10 Y T&C LA now engaged and undertaking check 3 1 3

130 Planning approval for revisions to approved design drawings 5 2 10 Y T&C LA engaged. 3 1 3

131 LA rates charged on welfare set-up 3 1 3 Y T&C Confrim detail 3 1 3

132 Uncertainty of existing structure to link during demo 2 phase. 5 2 10 Y T&C Confrim detail 3 1 3

133 Design construction detailing leads to increase in costs 4 3 12 Y T&C Assess and mitigate throughout the process/build 3 2 6

134M&E Design - Scope not clear (WSP - v- Sub contractor) 3 5 15 Y T&C

Awaiting WSP for full scope of services2 2 4

135 M&E Subcontractor - lowest bid used; costs increase 0 Y T&C 0

136 Kier allowance made in M&E pricing insufficient 0 Y T&C 0

137

defects caused or contributed to by and/or conditions, risks,

contingencies or circumstances relating to any building or structure

existing on the Site at the first access date 3 2 6 Y T&C condition survey of existing buildings before work commences 3 1 3

138Stand down period between GMP 2 Submission and commencement of

Construction Phase works 4 2 8 Y T&C

Submit funding application as soon as possible, plan for refreshing

tenders/costings, make allowance for inflation. 3 1 3

139BREXIT - Availability of labour and imported material; increase in

labour and imported material costs 3 3 9 N/A T&C

Monitor impact on supply chain availability,consider impact on product

selection, monitor industry advice inc RICS/RIBA statements 3 2 6



Appendix 6.4

Trust Corporate Estates & Facilities Risks

Estates Risk Register - Updated 06/07/2018ID

Pri

nci

pal

ob

ject

ives

Div

isio

n

Loca

tio

n

Ris

k Ty

pe

Mo

nit

ori

ng

Co

mm

itte

e

Op

ened

Title Description

Co

nse

qu

ence

(in

itia

l)

Like

liho

od

(in

itia

l)

Controls in place

Co

nse

qu

ence

(cu

rren

t)

Like

liho

od

(cu

rren

t)

Ris

k le

vel (

curr

ent)

Gaps in control Assurance Gaps in assurance Action Summary Notes

Targ

et r

atin

g

Dat

e o

f La

st r

evie

w

Risk Owner

412

De

ve

lop

fir

st cla

ss fa

cili

tie

s a

nd

te

ch

no

log

y to

su

pp

ort

th

e c

are

we

pro

vid

e

Co

rpo

rate

Hu

tte

d W

ard

s

Envi

ron

men

tal I

mp

act

Stra

tegi

c

10

/11

/20

14

Risk of Critical Failure in

Hutted Ward Environment

There is a risk of harm to staff and patients and the continued ability to provide inpatient care due to

the age and condition of the hutted wards.

This could lead to:

1) Reduced bed capacity for service provision / patient care

2) Patient harm

3) Patient claims - Financial

4) Staff harm

5) Staff claims - Financial and workforce

6) Cancellation of elective surgery

7) Loss of service provision related income

8) Breaches in national targets, 4hr wait, 18weeks, 2WW etc.

9) Increased costs if further building failures occur

10) Increased numbers complaints

11) Deteriorating Trust reputation

Context

The hutted wards were designed and built in 1943 with an intended life span of 10 to 15 years.

They are now 73 years old and are continuing to be used for patient care. However, they are long

past their intended useable life span and are no longer adequate. A recent failure of the fabric of

one area resulted in the temporary partial loss of beds on Monnow Ward. This resulted in an

increased number of complaints, the cancellation of elective surgery and the uncertainty around a

total loss of surgical capacity on Monnow and the increased workloads and pressures on existing

CA

TA

ST

LIK

EL

Y

1. Estates Strategy including

Estates Governance Processes,

Capital Programme

2. SOC was agreed by Trust Board

in January 2015

3. Agreement of future ward plan -

outline Business Case agreed at

Finance and Performance

Committee in October and

submitted to NHSi, SOC re-

approved by Trust Board in

December and submitted to the

NHSI

4.Additional roof protection installed

in 2015

CA

TA

ST

PO

SS

15

1. No alternative decant

space.

2. No emergency decant plan

internally or externally with

commissioners/agencies

1. Condition Survey every year.

2. Monthly inspections of building fabrics

None Identified. 1. Programe board oversight including

Decant project, Lead C Homersley 31/3/18

13/06/2018 - CH Update condition survey

completed April 18, enabling works order raised

May 18, emergency capital bid has been made.

Planning permission granted for 2 story option May

18.

5

29

/06

/20

18

Ch

rist

ian

Ho

mm

ersl

ey

726

To

im

pro

ve

th

e q

ua

lity a

nd

sa

fety

of ca

re to

ou

r p

atie

nts

, th

eir

ca

rers

, th

eir

fa

mily

an

d o

ur

sta

ff.

Esta

tes

& F

acili

ties

Co

un

ty H

osp

ital

Hea

lth

& S

afet

y

Hea

lth

& S

afet

y

18

/01

/20

18

Lack of EBME personnel There is a risk of harm to staff and patients, due to insufficient EBME staff to carry out the required

regular maintenance on Medical Devices at all WVT sites.

MO

D

LIK

EL

Y

1.Prioritisation of critical areas

first.

2. Areas are planned so non

compliances are known.

3. Reactives in areas without PPM

undertaken are prioritised.

4. Workfore Bank Band 5 and

Permenant Band 2 Porter in post

5. Specialist sub contractor onsite

11th June for 2 weeks, this will be

reviewed following this period and

re-assessed for need.

MO

D

LIK

EL

Y

12

The current controls do not

increase compliance

1. Estates and Engineering Manager and

EBME manager meet monthly to review KPI's

2. EBME KPI's monitored to H&S Committee

Recruit a Band 4/5 Post M.Jones Lead Target 30/09/2018 13/06/2018 - M.Jones update review of staffing

and business case for changes with tragetory

action plan completed, Band 6 has been split into

Band 2 and Band 4/5. Band 2 is in post. Band 4/5

to go to advert, Band 5 Bank to remain until

recruited.

5

29/06/2018 Martin Jones

735

To

en

joy a

re

pu

tatio

n fo

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nd

be

ab

le to

de

mo

nstr

ate

exce

ptio

na

l

qu

alit

y, sa

fety

an

d c

usto

me

r se

rvic

e

Esta

tes

& F

acili

ties

Co

un

ty H

osp

ital

Bu

sin

ess

Co

nti

nu

ity

Hea

lth

& S

afet

y

03

/07

/20

18

ABB Breakers are now

obsolete and have

reached lifecycle

expiration.

Context

WVTs County Hospital has ABB breakers installed and in the event of a fault they may not

disconnect the electrical supply.

Source/Cause/Event

There is a risk with power staying on in a fault condition could cause irreparable damage to

secondary boards which supply

Consequence/Impact

The consequences for this could include the loss of functional facilities for an extended period of

time until the boards could be replaced.

MA

JO

R

PO

SSNo current control methods are

possible.

MA

JOR

PO

SS 12

None Work has been tendered and supplier

identified but no programme of works

or timeline available.

Sodexo have Vertiv on site 30/06/2018 to prepare

replacement programe. - Sodexo AP

Sodexo to advise the trust of timescales and impact on

clinical functions needed to carry out the replacements -

July 2018 - Sodexo AP

03/07/2018 - risk assessment written 09/04/2018,

added to risk register today.

4 29/06/2018 Martin Jones

737

To

en

joy a

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n fo

r a

nd

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ab

le to

de

mo

nstr

ate

exce

ptio

na

l

qu

alit

y, sa

fety

an

d c

usto

me

r se

rvic

e

Esta

tes

& F

acili

ties

Co

un

ty H

osp

ital

Bu

sin

ess

Co

nti

nu

ity

Hea

lth

& S

afet

y

04

/07

/20

17

ITU Switchgear &

Shutdown

Context

ITU switchgear is lifecycle expired, Trust risk assessment had advised for replacement not to go

ahead due to impact of replacement.

Source/Cause/Event

Following a recent permit to work, Sodexo have identified deterioration with the switchgear

beyond the original risk assessment which now needs to be reviewed.

Consequence/Impact

In the event of a failure of the switchgear ITU, Longfield House, Trust HQ, NEC will have no power

until the units can be replaced.

MA

JO

R

PO

SS

Switching is minimsed to reduce

wear on switchgear

Annual Visiual Inspection on PPM

MA

JOR

PO

SS 12

None Sodexo have been monitoring the issues over

the last 4 years of the issue being raised and

have highlighted at this point the deteriorate

quality

Frequency of Switching events is monitored via

the Electrical Safety Group.

None Sodexo to provide timeline for lifecycle replacement of

switchgear, this is to include alternative arrangement for

feeding of power. This is potentnally from MRU

switchgear. Lead Sodexo 30 August 2018




585

Imp

rove

th

e q

ual

ity

and

saf

ety

of

care

to

ou

r p

atie

nts

, th

eir

care

rs

and

fam

ilies

Co

rpo

rate

Tru

stw

ide

Hea

lth

& S

afet

y

Hea

lth

& S

afet

y

21

/04

/20

16

Potential for serious self-

harm caused by ligature

hazards in the clinical

environment

Context

The nature of the acute physical healthcare environment is such that there are likely to be

numerous ligature hazards throughout the environment. It is therefore important to recognise the

risk to those who may be vulnerable and take steps to manage.

Source/Cause/Event

There is a risk that someone attempts suicide or self-harm. This could be by use of a ligature point

(e.g. coat hook) and/or other ligature hazard (e.g. cable, cord etc). There is also a risk of accidental

strangulation particularly by children on loose cords (e.g. from blinds) - this has been the subject of

a safety alert.

Consequence/Impact

The risk could lead to death or serious physical injury.

CA

TAST

PO

SS

1. Patient specific clinical risk

assessment.

2. Mental Health liaison Team

involvement with vulnerable MH

patients

3. Amendments to ED room with

reduced ligature environment

(following previous risk assessment

and actions).

4. Replacement of high risk blinds.

5. Ligature cutters available on

wards.

6. Ligature Assessment Policy In

Place.

CA

TAST

UN

LIK

ELY

10

Staff awareness/training. Monitoring Incident trends through Clinical

Quality Committee

3. Staff awareness program following implementation of

Policy. Lead Head of Estates, date TBC

5

29

/06

/20

18

Christian Hommersley

723

Imp

rove

th

e q

ual

ity

and

saf

ety

of

care

to

ou

r p

atie

nts

, th

eir

care

rs a

nd

fam

ilies

Co

rpo

rate

Co

un

ty H

osp

ital

Hea

lth

& S

afet

y

Fire

Saf

ety

28

/04

/20

17

Risk of avoidable

harm/fatality due to

insufficient water

pressure for fire fighting

Context

The water pressures required for delivering and managing an active fire are not sufficient should a

major fire take place.

Source/Cause/Event

There is a risk that the water pressures of the fire main are below recommended levels.

Consequence/Impact

In the event of a major fire incident this could increase the risk of severe damage or injury.

CA

TA

ST

PO

SS

1. Active management of fire

detection and fire alarms

2. Collaborative working with

HWFRS sharing information to

provide external mitigating actions

3. Staff training for early detection

of fires

4. Programme of works being

undertaken by Mercia Healthcare.

CA

TA

ST

UN

LIK

ELY

10

HWFRS inspection reported to Health & Safety

Committee

Monitoring incidents through Clinical Quality

Committee

Pressure unable to be monitored

currently, will be completed once

programme of works completed.

1. Fire main is being replaced by Sodexo work

commenced and expected completion 23/07/2018

5

29

/06

/20

18

Martin Jones

736

To

en

joy a

re

pu

tatio

n fo

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nd

be

ab

le to

de

mo

nstr

ate

exce

ptio

na

l q

ua

lity, sa

fety

an

d

cu

sto

me

r se

rvic

e

Esta

tes

& F

acili

ties

Co

un

ty H

osp

ital

Bu

sin

ess

Co

nti

nu

ity

Hea

lth

& S

afet

y

04

/07

/20

17

Underground Service Duct Context

Structural issues with the Duct have been highlighted by Sodexo

Source/Cause/Event

There is a risk that if the duct was to fail due to heavy traffic on the Fire Road then services would

be lost (Steam, Water, Electric)

Consequence/Impact

There would be a loss of power to ITU, Longfield House, Finance, Trust HQ, NEC, Theatre 5,6,7,

Hutted Wards and potentially if a mains trip occured - Pathology, Mortuary, Gilwern, Fred Building,

Johnson's Hospital, Monitoring Office, Gwyndra Downs, Stonebow unit.

There would be a loss of Heating / Hot Water to Hutted Wards, Fred Bulmer Building, Pathology,

Mortuary, ITU

There would be a loss of Water to Hutted Wards, Diabetic, Fred Bulmer Building , Pathology

Mortuary, ITU, Lionel Green

CA

TA

ST

PO

SS

Car Parking is being managed by

CPPlus to try to ensure no parking.

Barriers are in place to stop traffic.

CA

TAST

UN

LIK

ELY

10

Car Parking are not able to

fully enforce no parking in

this area and are only a

detterant.

Monitored as part of the Hutted Ward Building

project.

1. Sodexo are investigating removal of services from

within the duct to alternative means Lead - Sodexo

November 2018

Mercia Healthcare have appointed a designer to

facilitate the works.




248

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nd

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mo

nstr

ate

exce

ptio

na

l q

ua

lity, sa

fety

an

d c

usto

me

r se

rvic

e

Co

rpo

rate

Tru

st w

ide

Rep

uta

tio

nal

Stra

tegi

c

22

/02

/20

12

Reputation risk as a result

of car park charges

Context

The car parking contract for Wye Valley NHS Trust sites (County hospital and community hospital's)

is held by a third party and prices are set, therefore the Trust cannot guarantee prices without

subsidising cost.

Source/Cause/Even t

There is a risk that WVT do not manage or have control relating to public charges for parking at Wye

Valley Hospital premises, and lack of available staff onsite parking facility.

Consequence/Impact

The consequence could lead to reputational damage.

MO

D

LIK

EL

Y

1.Frequent communications review

of media

2.Briefing information for staff

Future options appraisals with all

providers

3.Allocation of permits

4.Concesssions

MO

D

PO

SS

9

None Identified. 1. Monitoring via patient volunteer group

2. Monitoring patient feedback through PALS

and complaints

None 1. Proposal from Mercia to hold price for 3 years Lead C

Homersley, target date Complete - NEED DATE

AGREED PRICE HOLD

2. Estates Strategy work looking to include parking

2018/2019 Lead C Homersley, target date 31/3/2019

30/03/2018 - Can this be reduced and closed or is

this an accepted risk?

3

02

/11

/20

17

Tristan Morgan

249

To e

njo

y a

rep

uta

tio

n f

or

and

be

able

to

dem

on

stra

te

exce

pti

on

al q

ual

ity,

saf

ety

and

cu

sto

mer

ser

vice

Co

rpo

rate

Lio

nel

Gre

en

Hea

lth

& S

afet

y

Hea

lth

& S

afet

y

21

/09

/20

15

Risk of prosecution or

enforcement action due to

statutory failure of

asbestos management

Context

Asbestos is present in an unused building on site at County Hospital premises.

Source/Cause/Event

There is a risk of action against the trust following exposure to ACM in Lionel Green building.

Consequence/Impact

The impact of exposure could result in harm, reputational damage and/or financial claim.

MA

JO

R

PO

SS

Locked down of Lionel Green

building

Access control monitored

Exterior signage

Permits to work in building issued

Removal of asbestos

MA

JO

R

UN

LIK

ELY

8

Unclear what areas asbestos

was removed

Air tests in/around Lionel Green

Health & Safety Committee monitoring

Confidence in contractor who

undertook initial removal work.

Remainder of Asbestos to be removed when

authority/finance given. Lead C Homersley target date

31/03/2019

Work has been put on hold in year 2018 and will

be completed as part of Lionel Green

Refirbishment.

4

29

/06

/20

18

Christian

Hommersley

250

To

de

live

r a

clin

ica

lly s

usta

ina

ble

po

rtfo

lio o

f se

co

nd

ary

ca

re

se

rvic

es

Co

rpo

rate

Tru

stw

ide

Hea

lth

& S

afet

y

Hea

lth

& S

afet

y

22

/02

/20

12

Non-compliance with

HTM design requirements

when utilising medical

gases

Context

There is a limited back up system in place for the supply of medical gases on all WVT premises.

Source/Cause/Event

There is a risk that all WVT sites utilising medical gases, have poor back up facilities that are

unlikely to comply with new Heath Technical Memorandum design requirements.

Consequence/Impact

This could impact on the safe provision of care to patients

MA

JO

R

PO

SS

1. Cylinder Gases Available

2. Ambulances to divert patients to

other hospitals if required

3. Business continuity plans

4. Alternative cylinder suppler

identified to BOC which is Air

Liquide

MA

JO

R

UN

LIK

ELY

8

Lack of oversight of availability

and or distribution of

cylinders.

Medical Gases Committee oversight. Non compliant with HTM/best practise.

HTM requires 3 sources of supply of

medical gases in locations to provide

continuity of supply.

1. Awaiting funding for Estates Strategy before

prioritisation of resilience - Lead Christian Homersley -

18/19 Financial year.

2. Full technical risk assessment required Lead M.Jones

BOC has been appointed. 31 July 2018.

3. Emergency contingency plans, M Jones to update into

Policy and Procedure. Target date 30/11/18

4

29

/06

/20

18

Martin Jones

574

Dev

elo

p f

irst

cla

ss f

acili

ties

an

d

tech

no

logy

to

su

pp

ort

th

e ca

re w

e

pro

vid

e

Me

dic

al D

ivis

ion

Ga

ol S

tre

et -

DA

C

Co

mp

lian

ce w

ith

sta

nd

ard

s

Med

ical

Div

isio

n

10

/03

/20

16

Gaol Street Clinic non-

compliance with the

Equalities Act 2010

(replacing Disability

Discrimination Act 1995).

There is a risk that the due to non-compliance with the Equalities Act 2010, patients could feel

discriminated against due to WVT non-compliance.

This could lead to;

1. Complaints

2. Negative publicity & damage to Trust reputation

3. Inspections

4. Fines

5. Improvement orders

Context

Multiple community based services operate out of Gaol Street. The current Gaol Street premises &

current configuration do not meet the requirements laid out within the Equalities Act 2010 (replacing

Disability Discrimination Act 1995).

MIN

OR

LIK

EL

Y

1. Staff are aware of environment

shortfalls & manage as best they

can in the current premises in order

to meet patient needs.

MIN

OR

LIK

EL

Y

8

None Identified. Work included in Backlog 18/19 register and

approved at Capital Meeting for

commencement.

None 1. Schedule of works to be agreed with all services &

service leads within Gaol Street. L.Phillips leading.

30/09/2018

2. Works to be completed (subject to agreement &

available funding). L.Phillips leading. Target date

subject to funding - Funding agreed, plan in place for

work to be completed by 31/3/2019

29/06/2018 - Works due to be completed by

31/3/19, following this environment to reassesed to

ensure compliant with Equalities Act 2010.

2

29

/06

/20

19

Martin Jones

639

Imp

rove

th

e q

ual

ity

and

saf

ety

of

care

to o

ur

pat

ien

ts, t

hei

r ca

rers

an

d f

amili

es

Co

rpo

rate

Wo

rks D

ep

art

me

nt (B

elm

on

t)

Co

mp

lian

ce w

ith

sta

nd

ard

s

Hea

lth

& S

afet

y

02

/12

/20

16

Non-compliance with

guidance on testing

regime/ periods for fixed

electrical testing.

Context

Non-compliance with guidance on testing regime/periods for fixed electrical testing.

Source/Cause/Event

There is a risk of shock and/or enforcement action as a result of non-compliance with guidance on

testing regime/ periods for fixed electrical testing.

Consequence/Impact

The consequence could lead to reputational damage and harm to public/staff.

MA

JO

R

PO

SS

Regular PAT Testing

Competent Persons undertaking

work (contractor with 17th Edition)

Certificates from works on system

PPM on systems including

emergency lighting.

MA

JO

R

UN

LIK

ELY

8

No electrical safety low

voltage operating procedure

No formal 5 yearly compliance

certificates

Authorising Engineer has now been

appointment and audit to commence.

1. AE to carry out audit and provide a report with action

plan. Lead Paul Stephens 31/08/2018

2. Action plan by authorising engineer (AE) to be

monitored through electrical safety group which will feed

into H&S, Lead Paul Stephens 30/08/2019

4

05

/04

/20

18

Mar

tin

Jo

nes

725

To

en

joy a

re

pu

tatio

n fo

r a

nd

be

ab

le to

de

mo

nstr

ate

exce

ptio

na

l q

ua

lity, sa

fety

an

d c

usto

me

r se

rvic

e

Esta

tes

& F

acili

ties

Co

un

ty H

osp

ital

Bu

sin

ess

Co

nti

nu

ity

Hea

lth

& S

afet

y

04

/07

/20

17

Risk of backup power

supply failing

Context

WVT does not have adequate backup processes in place for supply of electricity to County Hospital

Source/Cause/Event

There is a risk that there will be interruptions to the power supply in the event of mains failure.

Consequence/Impact

The consequences for this could include the loss of functional facilities for a period of time. This is

compounded an intermittent fault with the G59 showing underspeed following a manual generator

run, this requires a panel reset to clear the fault.

MA

JO

R

PO

SS

G59 Fault - Sodexo AP are carrying

out checks on the Panel to ensure

they are fault free on their weekly

generator runs.

MA

JOR

UN

LIK

ELY

8

There is only 1 backup

system.

Not all areas are covered by

backup systems UPS etc.

Recent PPM has identified key

areas of remedial work.

Authorised persons and AE reports.

Monitoring through electrical safety group.

Sodexo AP has provided 2 years of

maintenance records to Trust.

1. G59 intermittent fault with "underspeed" indicator on

attenuator needs to be replaced and panel upgraded to

include fault link to BMS / Audible Alarm - Sodexo to

advise on Lifecycle replacement and timescales 30th

August 2018


738

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joy a

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n fo

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nd

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mo

nstr

ate

exce

ptio

na

l q

ua

lity, sa

fety

an

d c

usto

me

r se

rvic

e

Esta

tes

& F

acili

ties

Co

un

ty H

osp

ital

Bu

sin

ess

Co

nti

nu

ity

Hea

lth

& S

afet

y

04

/07

/20

17

Longfield House ABC/DEF

Main Switchgear

Context

Following recent Permit to Work for longfield house mains housing, the main incoming switch to

both ABC and DEF blocks was not able to be operated as the unit has assumed welded contacts.

Source/Cause/Event

Unit cannot be isolated in the event of planned or emergency works.

Consequence/Impact

In the event of a emergency the unit cannot be isolated located and futher damage may be caused

to the equipment and or plant.

MO

DE

RA

TE

PO

SS

Sodexo has made permenant

signage for the doors to identify

switching arrangements to ensure

safety of residents, staff and

equipment.

MO

DER

ATE

UN

LIK

ELY

6

None Sodexo PTW system in place, controlled by

Sodexo AP

None Sodexo to provide cost appraisal to allow replacements

to be included into backlog maintenance. To be provided

by 30th of July 2018 to allow Trust to review.





Appendix 6.5

Benefits Realisation Plan

Supports

Estate

Strategy

Objectives

Supports

Project

Objectives

1Improve patient experience and quality (including dementia friendly)

1Provide acute inpatient capacity in the right amount and right places to align with STP proposals

All 1Acute inpatient capacity that aligns with H&W STP acute proposals

1

2To provide a safe, fit for purpose and therapeutic environment to deliver healthcare

2Improve the quality of inpatient accommodation and support the model of care

1,2,3,4 2Sustained improvement in patient experience and satisfaction

2,3

3To support the clinical/service strategy and business requirements of WVT

3Improve the inpatient experience for patients, visitors & carers

1,2 3 Optimal utilisation of inpatient beds 1,4,5

4Increase efficiency – better utilisation, lower overheads

4Support the Trust’s provision of elective care & reduce outlying patients

1,2,3,4,5 4Inpatient healthcare in modern setting with less variation in provision across the Trust

2,6

5Provide flexible solutions for future changes in function & capacity

5Enable resilience in the provision for higher dependency patients

1,2,3,4,5 5Facilities that support service efficiency and contribute to the Trust's sustainability

4,5,6,8

6Re-provide where buildings are unsustainable for modern healthcare

6Ensure all inpatient and staff accommodation facilities are compliant to a minimum standard

All 6Facilities for improved medical, clinical and support staff morale, recruitment and retention

2,6

7Reduce carbon footprint and become more sustainable.

7Replace the Canadian Huts as soon as possible

All 7Improved estate performance - risk, condition, suitabiliity & sustainability

7,8

8

Improve the performance of the estate and maintain flexibility for the Trust’s site development control plan for The County Hospital

2,3,5,6,7 8Enables a flexible masterplan; creates and safeguards site for future development

8

WVT Estates Strategy Objectives Phase 3 Project Objectives Phase 3 Project Benefits

Benefits Realisation Plan Appendix

Wye Valley Trust - HCH Wards Replacement Benefits Realisa�on Plan v2 13Sep17

No. Project Objective Benefit Measure Data & Baseline Frequency & Duration Owner

1 1.1 Number of inpatient beds Number of funded acute inpatient beds

Baseline - Month minus 12

Quarterly time series - Month 3 to Month

15

AD - Strategy &

Planning1.2 Inpatient occupancy rates Inpatient beds utilisation / occupancy rate



15

AD - Strategy &

Planning1.3 Time to admit from ED to relevant

wards

Number of patients spending >4 hours from decision to admit to

admission

Number of patients spending >12 hours from decision to admit to

admission

Baseline - Month minus 12, Monnow / Leadon wards


15/18

AD - Strategy &

Planning / online

2 Improve the quality of inpatient

accommodation and support the model of

care (Estate Strategy Objectives 1,2,3,4)

Inpatient healthcare in modern setting

with less variation in provision across

the Trust

2.1 Out-turn design in line with Schedule

of Accommodation & design principles

Confirm that As-built facility is in line with signed-off SoA

Baseline - N/A

Review as part of post-project evaluation

/ Design In Use study

Trust PM

2.2 No inpatient accommodation

provided in Nightingale wards

Confirm accommodation in new facility

Baseline - N/A



Trust PM

2.3 Mixed sex breaches Number of mixed sex breaches


Based on Trust frequency of analysis -

Monthly / quarterly (depending on Trust

frequency of analysis) - Month minus 6

to Month 15/18

3 Improve the inpatient experience for

patients, visitors & carers (Estate Strategy

Objectives 1,2)

Sustained improvement in patient

experience and satisfaction

3.1 FFT take-up rates FFT completion rates time series for Trust, Monnow & Leadon

wards


Monthly time series - Month minus 12 to

Month 15/18

AD - Strategy &

Planning / online data

3.2 FFT Inpatient scores FFT inpatient scores time series for Trust, Monnow & Leadon

wards



Month 15/18

AD - Strategy &


3.3 Patient satisfaction Need more information regarding the frequency and content of

surveys conducted by Trust


At least one pre-operational and one

post-project survey focused on

accommodation issues

Trust PM / Service

Lead

3.4 Complaints Complaints / comments arising from Monnow / Leadon wards





to Month 15/18

AD - Strategy &

Planning / Service

Lead

3.5 NHS Choices comments & ratings Comments arising from Monnow / Leadon or generic inpatient

wards



monthly / quarterly, starting in Month

minus 12 to Month 15/18

AD - Strategy &

Planning

4 Support the Trust’s provision of elective care

& reduce outlying patients (Estate Strategy

Objectives 1,2,3,4,5)

Efficient services that support Trust's

financial sustainability

4.1 Elective cancellations Number / percentage of elective cancellations attributed to lack

of inpatient beds


Quarterly time series - Month minus 6 to

Month 15/18

AD - Strategy &

Planning / Service

Lead4.2 RTT rates for elective inpatient

procedures

RTT numbers / rates for elective inpatient procedures


Quarterly time series - Month minus 6

toMonth 15/18

AD - Strategy &

Planning / Service

Lead4.3 Elective inpatient admissions Number / percentage Elective inpatient admissions

Baseline- Month minus 6

Quarterly time series - Month minus 6

toMonth 15/18

AD - Strategy &

Planning / Service

Lead4.4 Outlying medical or surgical patients Number / percentage of outlying medical or surgical patients


Quarterly time series - Month minus 6 to

Month 15/18

AD - Strategy &

Planning / Service

Lead

5 Enable resilience in the provision for higher

dependency patients (Estate Strategy

Objectives 1,2,3,4,5)

Excellence in patient care

ITU / higher dependency resilience

5.1 Provision of beds in new wards

facility with services uplifted to enable

care for Level 1 higher acuity patients

Number of higher acuity beds as-built compared to signed-off

design



Trust PM

6 6.1 Statutory issues of asbestos,

legionella etc are resolved in the

relevant buildings

As-built design in line with signed-off plans Review as part of post-project evaluation


Trust PM

6.2 Staff FFT scores FFT completion rates time series for Trust



Month 18

AD - Strategy &


6.3 Staff satisfaction surveys FFT staff scores for Trust



Month 15/18

AD - Strategy &


6.4 Staff engagement NHS Staff Survey relevant variables, including engagement scores

Baseline - 2017 survey

Annual survey, covering results for years

2017 - 2020

AD - Strategy &


6.5 Staff retention Turnover rates by staff type & grade for relevant wards





toMonth 15/18

AD - Strategy &

Planning / Service

Lead

6.6 Model Hospital operational metrics TBC TBC AD - Strategy &

Planning

7 7.1 Trust Board approval of Phase 3

Business Case by October 2017

Minutes from Trust Board meeting October 2017 n/a Trust PM

7.2 Date wards operational Project programme and operational date Review as part of post-project evaluation


Trust PM

8 8.1 Relevant project areas meet

category A on six-facet review

Trust ERIC returns for Trust and six-facet information on

condition, suitability and sufficiency by building

Baseline - ERIC return & backlog 2017

Annual returns 2017 - 2021 Trust PM / Head of

Estates

8.2 Total amount of backlog

maintenance, critical infrastructure risk

& risk-adjusted backlog

Trust ERIC / Model Hospital returns for Trust and six-facet

information on backlog maintenance by building

Critical Infrastructure Risk (£ per m2)

Total Critical Infrastructure Risk (£ per m2)

Total Backlog Maintenance (£ per m2)

Baseline - ERIC / Model Hospital return & backlog 2017

Annual returns 2017 - 2021 Trust PM / Head of

Estates

8.3 BREEAM certified as VG or Excellent Final BREEAM certificate

Baseline - n/a

Review as part of Post-project evaluation Trust PM

8.4 Performance against Model Hospital

estates-related metrics

Energy Productivity (Units per m2)

Condition, Appearance & Maintenance - Patient Led Assessment

Score

Baseline - 2017

Annual returns 2017 - 2021 Head of Estates

Improve the performance of the estate and

maintain flexibility for the Trust’s site

development control plan for The County

Hospital (Estate Strategy Objectives

2,3,5,6,7)

Replace the Canadian Huts as soon as

possible (Estate Strategy Objectives

1,2,3,4,5,6,7)

Ensure all inpatient and staff

accommodation facilities are compliant to a

minimum standard (Estate Strategy

Objectives 1,2,3,4,5,6,7)

Provide acute inpatient capacity in the right

amount and right places to align with STP

proposals (Estate Strategy Objectives

1,2,3,4,5,6,7)

Unlocks areas of the site for essential

improvements in healthcare provision

Enables a flexible masterplan

Acute inpatient capacity aligns with

H&W STP acute proposals

Efficient services that support the Trust's


Optimal utilisation of inpatient beds

Fit for purpose accommodation

Improved estate condition, suitability

and sustainability

More economically sustainable estate

Future estate developments

safeguarded

Efficient facilities that support Trust's


Improved medical, clinical and support

staff morale, recruitment and retention

Page 2


Appendix 7.1

Quality Impact Assessment

QIA

Consequence Likelihood Score Mitigation actions controls Residual

Score

Escalate to

SU / Trust

risk register?

Quality indicators Threshold (i.e.

Current

achievement)

Rationale for

threshold

chosen

Trigger for

escalation

Actions to be

taken upon

breaching

trigger level

Responsible

person

Adverse Incidents Worse than Escalate D Mowbray

Complaints Worse than Escalate D Mowbray

Environmental audit Worse than Escalate D Mowbray

Patient satisfaction – monthly Worse than Escalate D Mowbray

Adverse Incidents Worse than Escalate D Mowbray

LOS Worse than Escalate D Mowbray

Patient Safety Thermometer Worse than Escalate D Mowbray

Bed occupancy Worse than Escalate D Mowbray

Patient satisfaction – monthly Worse than Escalate E Allen

Adverse Incidents Worse than Escalate E Allen

Complaints Worse than Escalate E Allen

Patient Safety Thermometer Worse than Escalate E Allen

Turnover rate Worse than Escalate E Allen

Sickness and absence levels Worse than Escalate E Allen

E Allen

E Allen

Adverse Incidents Worse than Escalate C Homersley

Complaints Worse than Escalate C Homersley

C Homersley

C Homersley

Waiting times general No Escalate V Lewis

V Lewis

V Lewis

V Lewis

15 Average Residual Score 6 Quality Indicators

Adverse Incidents

Bed occupancy

Complaints

EDD

Environmental audit

LOS

Mandatory training

Patient Safety Thermometer

Date Patient satisfaction – monthly

Readmission rates

Sickness and absence levels

Turnover rate

Waiting times general

Comments

Comments -

Medical

Director/Director of

Nursing

Signed - Director of NursingL. Flanagan

Date27-Sep-17

Signed - Medical Director Date

12On register

Average Risk Score

Signed - Clinician/PractitionerA. Dawson

Date20-Sep-17

Targets /

Performance

Lack of flexible inpatient capacity results in theatre cancellation and significant numbers of medical outliers 3 5 15

Ward replacement will improve bed flexibility and increase capacity by ten beds. This is an improvement but not likely to be enough to fully mitigate the risk.

Ward replacement would improve the environment so that it was as good or better than the PFI build. 4

On register

Staff Experience

Anecdotal evidence that current environment inhibits recruitment to clinical roles

3 4 12Modern clinical environment would attract clinicians to work in it

Inequalities

Patients cared for in the hutted wards have a considerably worse care environment than other patients in the County Hospital 3 5 15

Ward replacement would incorporate patient feedback and provide a modern healthcare environment 4

On register

4On register

Patient Experience

Poor patient experience in outdated environment dating from the second world war. 4 4 16

Ward replacement would provide a new building and

mitigate risk 5On register

Clinical Effectiveness

Poor environment for patient care

5 3 15Improved clinical environment, no worse than the main PFI building. Building to incorporate a new model of surgical care. 5

Patient Safety

Critical failure of inpatient environment imminent

5 3 15

On register

Project (From Index Sheet) Hutted Ward Replacement

Clinician/Practitioner Completing QIA Alan Dawson

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