Capital Planning Tool

Sharon De Sykes, Principal Estates Advisor

Craig Marriott, Assistant Director of Finance

September 2014

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Background

Overview of System

Extracts from System

National Prioritisation

Capital Planning Tool

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Since 2009……

Benefits of System

Review of Potential Systems

Pilots : D&G, Lanarkshire & Tayside Imported data

Modelled future lifecycles

General reporting and analysis

Investment

Background

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The property condition is assessed using the

Facility Condition Index (FCI) measurement

The output from VFA.facility can automatically

generate an accurate capital plan, for lifecycle

modelling and future capital funding projections

VFA.facility can highlight the areas of capital

investment required to achieve and maintain

Condition ‘B’

Overview of System

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Capital Scenario plans

Detailed Lifecycle Profile

Budget Prioritisation

Benchmarking requests

Reports using NHS ranking protocol

Details of Maintenance Backlog

VFA can generate

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VFA appointed in 2013

Transfer of Data

Lifecycle Models

Board Training

Future Surveys

Programme Since Appointment

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1. What do we own?

3. How much money do we need?

4. What is most important?

2. What is the condition & what

does the condition need to be?

Ensuring Success – VFA.facility

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Facility Condition Index (“FCI”)

‘Current Replacement Cost FCI =

Capital & major maintenance cost to achieve ‘Condition A’

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A standards-based common performance metric:

Measure and compare performance on facility condition using a

Facility Condition Index (“FCI”) for the 4 constituent parts:

A B C D

0% 5% 11% 30% 50% 100% 50% 100%

1. The building envelope;

2. Engineering services;

3. Internal elements;

4. External area.

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Condition Definition Classification FCI

Excellent/as new condition (generally less than 2 years old).

Expected to perform as intended over its expected useful

service life. A ≤ 5%

Satisfactory condition with evidence of only minor deterioration.

Element/Sub-Element is operational and performing as

intended. B 6 - 11%

Poor condition with evidence of major defects.

Elements/Sub-Element remains operational but is currently in

need of major repair or replacement. C 12 – 30%

Unacceptable condition.

Non-operational or about to fail.

Has reached the end of its useful life.

D 31 – 59%

Supplementary rating added to D only to indicate that it is

impossible to improve without replacement. X >60%

NHS Ranking Protocol Ranking Protocol

FCI can be linked to the NHS Ranking Protocol for Physical Condition

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Backlog Maintenance

• Physical Condition

• Statutory Compliance

• Environmental Management

NHS Scotland Property

Appraisal Guidance

• Space Utilisation

• Functional Suitability

• Quality

Standard Functionality of VFA .facility

Future Functionality / Integration with NHS Scotland Property Appraisal

Guidance

The Six Facet Approach

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=

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Maintenance Backlog Detail

MB / Typical Peak Year Requirement List

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Cost Estimating Access to external databases

BCIS, or Own Cost Information

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Modeled system lifecycle data to be added

Based on building use lifecycle models

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Example:

System Detail

View: System level record

BCIS coding

Location

Quantity

Estimated

replacement value

Associated

requirements

Documents

Photos

System Lifecycle Added

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Adjusting Lifecycle based on Observed Conditions

Tailor “normal” data to…

Be contract specific

Reflect maintenance

strategies

Example: System Detail

View:

Tailor “observed”

years remaining

Tailor “% Renew”

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Facility Condition Index is an industry standard

measure used to compare relative building

conditions across regions or portfolios.

Constant insufficient funding

Maintain current condition.

Improve condition

Line represents condition (FCI)

Bars represent funding profile

Replace

Scenario Planning – From tactical to strategic

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Prioritisation of Required Actions

Based on criteria

specified by the user

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Budgeting based on Prioritised Actions

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Bespoke Reporting

Dozens of

standard

reports

Flexible

selection

criteria

Project,

Building,

System level

Custom

reports

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Report distribution

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Web-access

Select from

list

Share

favorites

PDF, HTML,

Excel, CSV

Automated

reporting via

email

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Creation of additional ad-hoc reports

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Drag and

drop

Customize

titles, notes,

instructions

Create

calculation

fields

“Pro” tool

available

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Project Bundling

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VFA FacilityView

Graphically view the Estate

Drill down from Region, Board to Hospital

No additional data entry required

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Governance •Project Board Remit :

Provides overall strategic direction and leadership for the Capital Planning System

•Development Group Remit : Agree and recommend priorities to the Project Board

Testing the lifecycle models Potential future work focusing the Health and Social Care

Integration and the 2020 vision

•User Group Remit Provides a forum for the operational users of the System Can raise and discuss operational issues that require

clarification, change or further development Enables best practice to be shared between Boards

Proposed National Priorities

Triple Aim Quality Ambitions12 Priority Areas

for Improvement

Capital Planning

Tool

Prioritisation

Example

Score (0,1,2,3)NHS Grampians Examples of Projects that may generate a

score

1Person-centred Health and Care Collaborative

implemented

2Information and support to enable people at

home and during times of transition

3 Further increase in safety in Scottish hospitals

4 New broader measure of safety developed (SPSI)

5

Maternity, mental health and primary care

components of the Scottish Patient Safety

Programme implemented with measureable

improvements

6 Implementation of new GP contract

7 2020 Vision for expanded primary care

8 New models of ‘place-based’ primary care

9 Out of hospital care action plan

10 Sustainable performance on 4-hour A&E waits

11 Increase flow through the system

12 New Bill

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Preparatory work with NHS Boards, local

authorities, third and independent sector and

the building of effective Integrated Health and

Social Care Partnerships

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Key pressure points in the entire patient

pathway for most common multiple illnesses

will be identified and actions agreed

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Through more detailed analysis of existing

data, people will be identified as ‘at risk’ and

anticipatory plans will be agreed

Early Years 16

The world’s first national multi-agency quality

improvement programme will be implemented

across partner organisations

Child development programme, leasing new accommodation

to provide services for Children in their communities.

17 New focus on most deprived areas

18‘Deep-end’ GP practices approach rolled out

more widely across relevant areas

19 Early detection of cancer

20 New restrictions on tobacco advertising

21 2020 Vision for NHSScotland workforce

22Detailed action plan agreed to deliver 2020

Workforce Vision

23A new fund to provide pump-priming for

innovative approaches in healthcare

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A new procurement portal will be

established to encourage working with

SMEs and third sector

Efficiency and

Productivity25 Recommendations to increase shared services

IT solution - introduction of Hospital Electronic Prescribing

and Medicine Administration System (HEPMA)

Development of the "one stop" ambulatory care process,

Implementing the Electronic Patient Record system and

introducing the Clinical Guidance Intranet (CGI) for Clinicians,

and health care workers.

Provision of new primary care premises in Grampians more

deprived areas such a the new dental unit in Fraserburgh and

new GP premises in Woodside, Aberdeen.

Provision of new diagnostic and radiography services in the

acute and community setting and increased MRI Capacity

25 Key Deliverables for 2013/14

Person-centredPerson-centred

Care0

0

He

alt

h I

mp

rov

em

en

t

Quality of

Care

Health of the

Population

Prevention

Effective

Unscheduled

and Emergency

Care

Integrated Care

Care for

Multiple

and Chronic

Illnesses

Health

Inequalities

Introduction of "Smarter offices" to improve the working

environment and efficiency of our staff and the provision of

quality affordable accommodation to health care workers.

Innovative solutions for Healthcare provision have already

been introduced to NHSG such as local community owned

Maud Resource Centre, the new Crimmond Health and

Community Centre provided by a local benefactor.

Workforce

Innovation

IT solutions - IT for community based Staff, Patient Portal,

"No Delays" and improved Quality of Physical Environment

Improving Statutory Standards Compliance, Improving SCART

scores and Reduction in Backlog Maintenance

Implementation of Primary Care Premises 10 year Plan

New Build Emergency Care Centre and increased use of Tele-

medicine centre for unscheduled care.

Introduction of Health and Social Care agenda, partnership

working projects such as Health Village, Maud Resource

Centre, Whinhill and Maggies Centre.

Value and

Sustainability

Safe Safe Care

Primary Care

Person-centred

Safe

Effective Quality

of Care

Health of the

Population

Value and

Sustainability

Eff

icie

ncy

HEAT TARGETS

Acc

ess

Tre

atm

en

t

0

0

0

Proposed National Prioritisation Criteria

• Person Centred • Safe • Effective Quality of Care • Health of Population • Value and Sustainability

Pairwise Ranking

Profile of Scoring

Workshop Questions

1. What are your views on the weightings of the national priorities proposed?

2. How will you use this tool as part of your local prioritisation for formula capital investment?

3. What issues do you need to consider when implementing this approach?

Allow 25 mins discussion and 15mins for all tables to feedback.