1

LONDON CAPITAL COMMITTEE

PAPER TITLE: Estates and Technology Transformation Fund [ETTF] report: May 2017

PAPER AUTHOR: Jill Webb, Head of Primary Care, NHS England (London)

CLEARANCE: Liz Wise, Director of Primary Care Commissioning, NHS England (London)

DATE OF MEETING: 25th May 2017

PURPOSE OF PAPER: To

• endorse the removal of 4 schemes from the ETTF Pipeline

• advise on the financial position and forecast for ETTF funded schemes as at

31st March 2017; subject to audit

• seek approval to the release of £184,487 from 2017/18 ETTF

• update LCC on the status of the ETTF Pipeline for 2017/18 to 2019/20

• seek conditional approval to the draft ETTF Pipeline of schemes; noting that

work is still ongoing to bring this within LCC approved tolerances

• advise on high level risks to the programmes and mitigations to these risks

EXECUTIVE SUMMARY London region’s ETTF allocations for the years 2016/17, 2017/18, 2018/19 and 2019/20 have been confirmed

at £17.3m, £26.1m, £26.2m and £28.0m respectively.

A total of 62 schemes have been supported in principle to progress to the next stage; although one of these has

subsequently been withdrawn and is being progressed via the London Improvement Grant Fund. 49 schemes

have had next stage funding approved to date.

The forecast out turn for 2016/17 is £27.9m, an under spend of £2.4m against received allocations and funding

available.

Total funding available for 2017/18 is £38.4m; including the 2016/17 accrual.

Approvals totalling £184,487 are requested this month and it is noted that a number of schemes are being

presented outside of this paper.

An ETTF Pipeline review has been undertaken and work continues with the CCGs and STP leads to bring this

in line with LCC approval limits confirmed last in April 2017. Notwithstanding this ongoing work London region

has confirmed to the national team that it expects to fully utilise its ETTF control total in 2017/18.

High level risks and mitigations have been reviewed and updated.

INTRODUCTION ETTF funding at national and regional levels has been confirmed for the 4 years 2016/17 to 2019/20. The

funding confirmed for the London region is £17.3m, £26.1m, £26.2m and £28.0m respectively.

PROGRAMME UPDATE Current Position – ETTF 2016/17 The progression of bid numbers is set out in the following table, which represents the final position for 2016/17:

2

Application 1st Stage

Assessment

2nd Stage Assessment (Pipeline)*

Removed from

Pipeline*

Remaining on

Pipeline

Supported to Progress

“Live”

Schemes

With Approvals

to Date

New Building

111 102 99 99 18 18 15

Improvement 146 110 107 19 88 18 17 13

Technology 100 92 78 78 26 26 21

357 304 284 19 265 62 61 49

* The pipeline is subject to regular review and, as a part of this, schemes may be removed if it is no longer appropriate that they remain on it (e.g. if alternative funding is identified). A scheme will only be removed if such action is approved by the sponsoring CCG. The above removals include the 4 schemes identified below.

As part of the ongoing review of the ETTF Pipeline, several schemes have been identified to be removed from

it. The outstanding confirmations have now been received from Redbridge and Havering CCGs that 4 schemes,

duplicated on both the ETTF Pipeline and the London IG Programme, should be removed from the ETTF Pipeline

to be progressed under the London IG Fund; Enfield CCG has requested that their scheme (21104 – Eagle

House Surgery) be retained on the ETTF Pipeline, which means it will be removed from the London IG

Programme.

This is consistent with the national policy that schemes can only appear once in a region’s capital programme.

The schemes to be removed from the Pipeline are:

Reference Scheme Name CCG STP

21605 Maylands Healthcare NHS HARINGEY CCG NEL

21607 Lynwood Medical Centre NHS HARINGEY CCG NEL

22513 Glebelands Practice NHS REDBRIDGE CCG NEL

22515 The Drive Surgery NHS REDBRIDGE CCG NEL

FINANCIAL POSITION 2016/17 Overall Funding for London region’s ETTF expenditure in 2016/17 is available from 3 sources:

• 2015/16 accrual @ £6.474m. NB this figure has been adjusted from that previously notified (£7.245m)

to ensure agreement with NHS England London region’s financial ledger

• B/fwd funds – for commitments b/fwd from 2015/16 @ £6.327m. NB this figure has been updated to

reflect an additional allocation of £0.206m only notified to the PMO in May

• 2016/17 ETTF programme @ £17.300m

The outturn positions against these sources are shown in the table below and are subject to audit:

Revenue

Grant Acquisition Grant Acquisition Revenue Total Funding Variance

£000 £000 £000 £000 £000 £000 £000 £000 £000

2015/16 Accruals

- Approved Schemes 5,282 117 178 5,282 117 178 5,576 6,474 898-

Total 2015/16 Accruals 5,282 117 178 5,282 117 178 5,576 6,474 898-

B/Fwd Funds

- Approved Schemes 7,345 - 1,467 7,345 - 1,467 8,812 6,533 2,280

- Schemes Yet to be Approved - - - - -

Total B/Fwd Funds 7,345 - 1,467 7,345 - 1,467 8,812 6,533 2,280

ETTF 2016/17

- Approved Schemes 176 3,497 9,003 176 3,497 9,003 12,676 14,674 1,998-

- Scemes Yet to be Approved 216 - 600 216 - 600 816 2,626 1,810-

- Risk Adjustment -

Total ETTF 2016/17 393 3,497 9,603 393 3,497 9,603 13,492 17,300 3,808-

Grand Total 13,020 3,614 11,247 13,020 3,614 11,247 27,881 30,306 2,426-

Capital

Year to Date (M12)

Capital

Forecast Outturn

The gross expenditure forecast is £27.9. This is an under spend of £2.4m.

3

2015/16 Schemes Forecast expenditure on 2015/16 schemes is £14.4m; being £1.4m more than the associated funding. The position represents an increase of £1.9m compared with last month; which is due to:

• Revision of the 2015/16 accrual as noted above - £0.8m

• Increased forecast cost for (primarily) feasibility studies not invoiced in 2015/16 - £0.7m

• PHGH Doctors – inclusion of scheme cost in revised forecast - £0.4m 2016/17 Schemes Forecast expenditure on 2016/17 schemes is £13.5m; being £3.8m (or 22%) less than the available funding. The forecast represents no change from the draft position set out in the April report. 12 schemes supported to progress failed to satisfy the due diligence requirements in 2016/17; although five of

these are not due to start until 2017/18 and so were not expected to make a submission in 2016/17. Of the

remaining seven schemes:

• Two are cohort 1 schemes, which have not made sufficient progress and will revert to their original

Pipeline position

• Five are cohort 2 schemes, which will now be progressed in 2017/18

Details of the schemes with approvals in 2016/17 are attached at Appendix A1 whilst details of those schemes

that failed to satisfy the due diligence requirements in 2016/17 are attached at Appendix A2.

FINANCIAL POSITION 2017/18 Overall Funding for London region’s ETTF expenditure in 2017/18 is available from 2 sources:

• 2016/17 accrual @ £12.316m (subject to audit) and

• 2017/18 ETTF programme @ £26.060m

In common with previous years a detailed financial forecast has not been produced for month 1; although London

region is forecasting full utilisation of available resources.

Virtual Approvals since 19th April 2017 - £0

There have been no virtual approvals since the last report.

Supplementary Approvals - £87,273 Schemes in this category have been previously approved but are seeking now further approval for unforeseen,

or additional, costs.

The costs have been subject to due diligence process and are recommended for approval subject to any specific

conditions noted in Appendix B.

New Scheme Approvals - £97,214 Schemes in this category have received no previous approval.

The costs have been subject to due diligence process and are recommended for approval subject to any specific

conditions noted in Appendix B.

Details of the approvals requested, totalling £184,487 are attached at Appendix B.

4

It is noted that the following schemes are currently expected to be discussed by the LCPG prior to LCC on 25th

May 2017:

• 10237 – Clapham Park Group: Brief statement of approval being requested (what and values being

requested analysed by year)

• 20501 – Bromley Health and Wellbeing Centre – PID

• 21902 – Archway Primary Care Hub

• 23013 – London Health and Care Information Exchange: re-submission of proposals, including re-

profiling of spend, based on feedback from April Pipeline and LCC meetings

• 22312 - South West London Interoperability - resubmission

ETTF PIPELINE REVIEW The first review of London region’s Pipeline took place on 27th April 2017. The review was led by NHS England

with attendance from STPs, CCGs, PAU, the PMOs and London LMC representatives.

LCC approved the principles to be applied to the review in April 2017 (see Appendix C for reference) and the

Draft Pipeline being proposed in this paper was compiled in line with those principles. LCC also confirmed that

it would support an overall ETTF Pipeline over commitment of 40% with a maximum 70% over commitment in

2017/18 and 2019/20.

The draft Pipeline currently over commits the overall funding by 37%; which is within the limit approved by LCC.

However, in-year over commitments for 2017/18 and 2018/19 are 98% and 76% respectively; which exceed the

limits approved. The draft Pipeline includes 5 new schemes (of the 18 reviewed for support subject to resources

available), which can now be supported to progress subject to the ongoing work set out below. Detail of the

draft ETTF Pipeline is included at Appendix D.

All regions were required to confirm their forecast resource utilisation to the national team by 3rd May 2017.

London region confirmed that it is forecasting full utilisation and set out its response in a slide deck, which is

attached as Appendix E.

As noted, in-year commitments currently exceed the approvals given by LCC and work is now underway to

identify how the programme can be brought within the approved limits with STP estates and technology leads

undertaking a further critical review of ETTF scheme funding requirements to include consideration of:

• Remove requirement (alternative funding)

• Reduce requirements (co-funding)

• The potential of limiting to level of original bid

• Removal of scheme “creep”

• Interface of technology schemes in relation to interoperability in recognition of the significant financial

cost of these schemes to the ETTF programme and

• Further review of phasing to bring 2017/18 programme within LCC approved limit

The timeframe for completion of this work is end-May and the results will be set out in the June report to LCC.

Until this work is complete, the ETTF team is not proposing to recommend to LCC that the 5 new schemes

referred to above should be formally advised that their schemes are supported to progress.

Linked to this work London region has recently highlighted with the national team an apparent unintended

consequence of the rule that no capital scheme can appear on more than one pipeline. Currently if a scheme

is on a pipeline it is unable to apply for funding from alternative sources unless it is formally removed from that

pipeline. This position restricts actions against the first two bullet points above and the national team have been

asked to clarify the application of the rule where there is legitimate argument for a scheme to receive alternative

funding or be co-funded.

5

Additionally, regular formalised progress reporting is being implemented, consistent with the operating

procedures approved by LCC in April, to ensure that substantial progress is made on all schemes supported to

progress. The reports will facilitate:

• Early identification and mitigation of problems and

• Early identification of opportunities

LCC is asked to support in principle the following concepts/ measures, subject to STP feedback, to

evidence substantial progress:

• Submission of initial report with realistic timeframes / financial profiles supporting and reconciling with

the final ETTF Pipeline to be agreed in June

• Appointment of professional support teams as appropriate

• Submission of required business case/ PID

• Purchase of equipment where appropriate (and submission of any required evidence)

These measures to be applied to schemes as applicable; e.g. bullet point 1 will apply to all schemes whilst bullet

point 2 will only apply to those schemes that have received approval to appoint advisors.

Should a scheme not make substantial progress as measured above, the CCG should either:

• Submit a new plan showing revised phasing for the scheme or

• Remove the scheme from the ETTF Pipeline where delivery is no longer possible for whatever reason

Reporting will be via STP estates and technology leads to ensure their ownership of schemes and the first

checkpoint for these reports will be July 2017. Whilst frequency of reporting, subject to fit with any national

requirements, will generally be quarterly schemes showing variation from their approved timetable/ financial

profile will be required to submit further monthly reports detailing how the scheme will be brought back on track

or confirming new timetable/ financial profiles.

ETTF PROGRAMME RISKS The national ETTF team review ETTF programme risks identified within the four regions’ monthly reports as part

of their reporting to the NHS England ETTF Programme Board. London region has identified the following

updated risks:

• Value of ETTF allocations: These have now been confirmed to 31st March 2020. The impact of the

fourth-year allocation has now been initially assessed (in London region’s ETTF Pipeline mid-year review

meeting on 27th April 2017) and allows only a further 5 schemes to be supported to progress. London

region will continue to work with CCGs, STPs and the national team to identify opportunities that may

allow additional schemes to advance.

• Commitment to current PMO supplier: The contract with the current supplier ended on 31st March 2017.

CEG considered London region’s business case for a 2-year extension on 5th April 2017 but failed to

approve it, requiring additional information to be provided. Because of this full approval (including DH

sign off) is not now likely before end-June 2017. The PMO supplier has indicated that they are willing to

continue to provide support at risk but require London region to underwrite their costs for work undertaken

from 1st April 2017 should the business case ultimately not be approved. As both South England and

London region are in the same position, the national ETTF team has undertaken to test whether funding

can be released to honour monthly payments in the meantime, in recognition of the importance of the

role of the ETTF PMO to regions and scheme sponsors – this confirmation is required by end-May to

ensure continuing PMO support.

• VAT: National procurement advice confirms that VAT is payable on PMO support costs, which has been

disputed by London (and other) regions. Pending further work on this London region has accepted the

VAT risk to retain PMO support at its current level and the current provider is committed to support

London region to mitigate this.

6

• Revised Premises Directions: Regions have been advised that these will now not be published before

June 2017. This continuing delay in the issue/ implementation of the new rules may impact on the

number/ type of projects being progressed in 2017/18

• Transfer of allocations to NHS property companies: It had been understood that NHSPS/ CHP would be

able to receive allocations in 2016/17 and utilise these to complete schemes in their properties

completing in 2017/18. As noted above this has not been possible and so this risk has crystallised in

2016/17. National determination is now required to ensure that this position is not repeated in 2017/18.

• Revenue neutrality of resources transferred to NHS property companies: Whilst it has been confirmed

that revenue allocations transferred to NHSPS/ CHP will not attract capital charges talks are ongoing at

a national level regarding the level of any management fee that may be payable.

• Capacity of NHS property companies: A lack of capacity in NHSPS/ CHP may slow the delivery of priority

schemes. Correspondence has been received from the Chief Executive of NHSPS confirming her

commitment to working with NHS England to avoid this.

RECOMMENDATIONS AND ACTION LCC is asked to

1) Note progress made with the approval/ implementation of schemes in London region’s ETTF

Pipeline

2) Endorse the removal of 4 schemes from the ETTF Pipeline.

3) Note the current financial position and forecast

4) Approve the release of funding of £184,487 recommended in this report

5) Note work undertaken to date to identify the ETTF Pipeline for 2017/18 to 2019/20

6) Note the draft ETTF Pipeline of schemes; subject to ongoing work to bring this within LCC

approved tolerances

7) Support in principle, subject to STP feedback, the measures outlined to provide assurance that

schemes are making substantial progress; and the subsequent actions should this not be the

case

8) Note the current programme risks and mitigations

Jill Webb

17th May 2017

7

APPENDIX A1 – CUMULATIVE 2016/17 ETTF SCHEME APPROVALS (MAY 2017)

20104 Barking Riverside Developement N NHS BARKING AND DAGENHAM CCG 346,560 346,560

12/16 LCC Report

Phasing amended to all

in 16/17

20301 Bexley Group Practice N NHS BEXLEY GROUP 820,064 176,334 643,730 01/17 LCC Report

20302

Infrastructure to support virtual

consultations, communication, remote

access and virtual training

T NHS BEXLEY CCG 194,970 194,970 VA (12/16)

20304 Erith Health Centre additional capacity I NHS BEXLEY CCG 20,280 20,280 TBC TBC TBC VA (01/17)

20401Central Middlesex Hospital Hub+ Primary

Care FacilityI NHS BRENT CCG 104,388 104,388 TBC TBC TBC 01/17 Separate Paper

20408NWL Digital Bid 1: Digital Workforce and

InnovationT NHS BRENT CCG 6,645,933 460,355 3,456,723 2,728,855 01/17 Separate Paper

20410NWL Digital Bid 3: Integrated Care

StandardsT NHS BRENT CCG 351,780 351,780 VA (12/16)

20411 NWL Digital Bid 4: Video Conferencing T NHS BRENT CCG 772,365 77,911 641,800 52,654 VA (12/16)

20501 Bromley Health and Wellbeing Centre N NHS BROMLEY CCG 102,418 102,418 TBC TBC TBC VA (03/17)

20502

Information Technology Programme

enabling the development of Integrated

Care Networks in Bromley.

T NHS BROMLEY CCG 762,353 541,241 221,112 VA (12/16)

20801 Springfield Health Centre Interim N NHS CITY AND HACKNEY CCG 707,440 707,440 12/16 Separate Paper

20802 Tollgate Lodge Interim I NHS CITY AND HACKNEY CCG 126,480 126,480 12/16 Separate Paper

20901 Croydon - GP Systems Migration T NHS CROYDON CCG 455,351 455,351 01/17 Separate Paper

21201Gallions Reach Health Centre

RefurbishmentI NHS GREENWICH CCG 323,170 323,170 03/17 LCC Report

21203 Population Health Management T NHS GREENWICH CCG 720,000 720,000 02/17 Separate Paper

21207 Patient Access to Records T NHS GREENWICH CCG 185,000 185,000 02/17 Separate Paper

21401 Tottenham Hale Welbourne Centre N NHS HARINGEY CCG 60,140 60,140 TBC TBC TBC 12/16 LCC Report

21402 Hawes & Curtis Green Lanes N NHS HARINGEY CCG 60,140 60,140 TBC TBC TBC 12/16 LCC Report

21403 Iceland Building Wood Green N NHS HARINGEY CCG 60,140 60,140 TBC TBC TBC 12/16 LCC Report

21404 Digital Integrated Shared Record T NHS HARINGEY CCG 240,000 240,000 01/17 Separate Paper

21601 St George’s Development N NHS HAVERING CCG 142,884 142,884 12/16 LCC Report

21701 Yiewsley Family Practice I NHS HILLINGDON CCG 36,426 36,426

21703Heathrow Medical Centre - deferred 15/16

schemeI NHS HILLINGDON CCG 216,234 216,234 03/17 LCC Report

21801 Chiswick Health Centre I NHS HOUNSLOW CCG 44,860 44,860 TBC TBC TBC 01/17 Separate Paper

21901Andover Medical Centre Extension

SchemeI NHS ISLINGTON CCG 130,500 130,500 TBC TBC TBC VA (01/17)

21902 Archway Primary Care Hub N NHS ISLINGTON CCG 37,800 37,800 TBC TBC TBC 12/16 LCC Report

22001 Regents Wing N NHS KINGSTON CCG 37,000 37,000 TBC TBC TBC 12/16 Separate Paper

22004Chambers and practices’ telephony -

VOIPT NHS KINGSTON CCG 166,442 166,442

VA (02/17)

With SS - sign-off o/s

22101 Gracefield Gardens Scheme 1 I NHS LAMBETH CCG 85,800 85,800 TBC TBC TBC 02/17 LCC Report

22201Lewisham CCG: Integrated Primary Care

Hub (N2)N NHS LEWISHAM CCG 43,116 43,116 TBC TBC TBC VA (03/17)

22202Population Health System to support

integrated care (Connect Care)T NHS LEWISHAM CCG 560,000 560,000 VA (02/17)

22314 Kinesis - South West London T NHS MERTON CCG 883,200 439,200 444,000VA (03/17)

P Baumann 21/3/17

22315Deployment of iPlato SMS application -

South West LondonT NHS MERTON CCG 898,270 898,270

VA (03/17)

Approved by P

Baumann

22316Digital document sharing via cloud

solution - South West LondonT NHS MERTON CCG 164,436 164,436

VA (03/17)

Approved by P

Baumann

22404Froud Development - Fees Only to

Continue designN NHS NEWHAM CCG 228,960 129,350 99,610 12/16 LCC Report

22406 Telephony and Video Conferencing T NHS NEWHAM CCG 657,240 393,607 263,633 01/17 Separate Paper

22414 Royal Wharf N NHS NEWHAM CCG 142,140 142,140 TBC TBC TBC 12/16 LCC Report

22505 Loxford Polyclinic Optimisation I NHS REDBRIDGE CCG 648,270 516,270 132,000 12/16 LCC Report

22601 North Road Surgery relocation N NHS RICHMOND CCG 18,600 18,600 TBC TBC TBC 12/16 LCC Report

22703

Dulwich Health Centre - project

management, furniture and equipment and

transition costs

N NHS SOUTHWARK CCG 392,310 310,890 81,420 12/16 LCC Report

22705 Local Care Record Development T NHS SOUTHWARK CCG 1,410,000 508,000 902,000VA (02/17)

PB sign-off o/s

22710 Peckham GP Premises rationalisation I NHS SOUTHWARK CCG 194,483 138,653 55,830 TBC TBC VA (01/17)

22716SEL Wide Tech Bid – Local Care Record

/ Connect Care Interoperability (Priority 1)T NHS SOUTHWARK CCG 1,460,000 243,000 1,217,000 VA (02/17)

22801Robin Hood Lane Health Centre

DevelopmentI NHS SUTTON CCG 41,100 41,100 TBC TBC TBC 12/16 LCC Report

23013The London Health & Care Information

ExchangeT NHS WALTHAM FOREST CCG 2,551,750 2,551,750 12/16 Separate Paper

23015 Data sharing and HIE T NHS WALTHAM FOREST CCG 969,999 47,098 922,901

VA (03/17)

To be approved by P

Baumann

23024Primary Care Online Services – Linked

BidT NHS WALTHAM FOREST CCG 1,900,000 1,900,000 11/16 Separate Paper

23101Queen Marys Hospital (Roehampton) and

Mayfield/Westmoor reconfigurationI NHS WANDSWORTH CCG 44,000 44,000 12/16 Separate Paper

23103Remote access to GP system using

EMIS Anywhere and EMIS MobileT NHS WANDSWORTH CCG 277,783 277,783 01/17 Separate Paper

27,442,575 14,674,307 9,986,759 2,781,509 0

2017/18 2018/19 2019/20 Approval Route2016/17Scheme

Ref.Title

New

Imp

Tech

CCG

Current Grant

Value

Approved

£

8

APPENDIX A2 – 2016/17 ETTF SCHEMES SUPPORTED TO PROGRESS BUT FAILING TO MEET DUE DILIGENCE REQUIREMENTS IN 2016/17

20203Colindale and West Hendon Stage 2

(Grahame Park Health Centre)N NHS BARNET CCG 0

20303Expansion of capacity at Lakeside Health

CentreI NHS BEXLEY CCG 0

20902Croydon - East Croydon GP Network

TransformationI NHS CROYDON CCG 0

20903Croydon - New Addington / Selsdon GP

Network TransformationI NHS CROYDON CCG 82,500

21101 Seven Day Working in General Practice T NHS ENFIELD CCG 0

21102 Meridian Water Regeneration Scheme N NHS ENFIELD CCG 85,000

22005 EMIS T NHS KINGSTON CCG 0

22301 Colliers Wood N NHS MERTON CCG 0

22303 Patrick Doody I NHS MERTON CCG 200,000

22312SWL Interoperability Solution - South

West LondonT NHS WANDSWORTH CCG 1,461,823

22313Patient e-consultation and MDT video

conferencing - South West LondonT NHS WANDSWORTH CCG 1,337,440

22807 Integrated Digital Care Record T NHS SUTTON CCG 0

3,166,763

Scheme

Ref.Title

New

ImpCCG

2016/17

ForecastComments

2017/18 scheme

2017/18 scheme

Fees for Business Case development - nothing received

2017/18 scheme

This cohort 1 scheme will now revert to its former priority position on the Pipeline

NHSPS scheme to be advanced in 2017/18

2017/18 scheme

To be brought forward in 2017/18 - not capable of approval in 2016/17

To be brought forward in 2017/18 - not capable of approval in 2016/17

Fees for Business Case development - nothing received

2017/18 scheme

This cohort 1 scheme will now revert to its former priority position on the Pipeline

9

APPENDIX B – SCHEMES REQUESTING APPROVAL (MAY 2017)

SUPPLEMENTARY APPROVALS REQUESTED

Design &

Engineering

@ 12%

Project

Manageme

nt @ 1%

Legals SDLT

Abated

Annual

Rent

Increase

Abatement

Length

Annual

Rent Was

Abatement

Ends

10809 G83052 GP Direct MHS Bexley CCG

Additional Costs

The practice has requested funding in conneciton to the extension of their

existing telephone system as a result fo their approved ETTF scheme.

2,077 1,371 - - - - 1,371 n/a n/a n/a 1718 ETTF

22710 n/a Peckham GPs rationalisation NHS Southwark CCG

Additional Fees

NHS PS development fees in connection to the finalising and agreeing the

extension of the lease and landlord consent, in connection to this approved

7,800 7,800 - - - - 7,800 n/a n/a n/a 1718 ETTF

20801 n/a Springfield Health Centre InterimNHS City & Hackney

CCG

Project Development Fees

This scheme received approval from Paul Baunman last year as a transfer

to NHS PS. However, the scheme has stalled and NHS PS now requires

development fees (i.e. non-recurrent revenue) to progress this scheme.

78,102 78,102 - - - - 78,102 n/a n/a n/a 1719 ETTF

** DO NOT USE - INSERT NEW ROW ABOVE **

Total: - - - - - -

Total ETTF Commitment

NEW APPROVALS REQUESTED

Design &

Engineering

@ 12%

Project

Manageme

nt @ 1%

Legals SDLT

Abated

Annual

Rent

Increase

Abatement

Length

Annual

Rent Was

Abatement

Ends

20303 n/a Lakeside Health Centre NHS Bexley CCGProject Development Fees

CHP/LIFTCO development fees to progress this supported ETTF scheme.85,800 85,800 - - - - 85,800 n/a n/a n/a 1718 ETTF

10828 G84002 Dysart Surgery NHS BROMLEY CCG

Abortive Fees

This was an original PCIF scheme that progressed due diligence

information, with the exception of the planning (which was subsequently

not approved by the council). The CCG subsequently submitted a ETTF

bid, which has been approved to progress, therefore, the is scheme is no

longer required.

11,414 11,414 - - - - 11,414 n/a n/a n/a 1718 ETTF

** DO NOT USE - INSERT NEW ROW ABOVE **

Total: - - - - - -

Total ETTF Commitment

Total ETTF Approvals Now Requested 184,487

Potential Fees (£)

Total ETTF

Portal

ID

Practice

Code

Practice Name / Scheme NameCCG

Grant

Required (£)

Portal

ID

Practice

Code

Practice Name / Scheme NameCCG

Description

Description

Supplement

ary Cost (£)

Revenue Impact Anticipated

Source of

Funds

Revenue Impact

Approval Conditions/ Comments

87,273

Approval Conditions/ Comments

Anticipated

Source of

Funds

97,214

Total ETTF

Works/

Fees Cost

(£)

Grant

Required (£)

Potential Fees (£)

10

APPENDIX C – ETTF PIPELINE REVIEW PRINCIPLES TO BE APPLIED

The following principles will be applied during the review as approved by LCC in April 2017:

• Current supported schemes will be reviewed and re-validated by CCGs/ STPs to confirm the most current

forecast expenditure figures are incorporated into the Tracker. Where a scheme was supported in

2016/17 as a cohort 1 scheme, but has not yet made sufficient progress with due diligence, it will revert

to its original pipeline position.

• The three current supported schemes that were explicitly excluded from submission to the ETTF pipeline,

as they preceded its introduction, will be included as ETTF funding commitments (see further detail

below)

• In addition to the current supported schemes the next 18 schemes on the ETTF pipeline will be reviewed

for inclusion as schemes that could be supported to progress subject to the level of over commitment

supported (see below)

• Assumptions regarding alternative funding will be re-validated using the best available information.

Where it remains the case that alternative funding is identified, schemes will not be supported for

progression via ETTF, and scheme sponsors will be requested to formally remove these schemes from

the ETTF pipeline.

• CCGs/ STPs will be required to advise their best current estimates of expenditure, and it’s phasing, for

scheme implementation and apply a RAG rating to this assessment based on a matrix supplied for that

purpose to ensure consistent interpretation.

• The ETTF PMO will consolidate all returns into a single ETTF pipeline and Tracker. It is [almost]

inevitable that this consolidation will confirm a programme that is not affordable at either an aggregate

level or on a year by year basis.

In April 2017 LCC:

• confirmed support for an aggregate ETTF programme over commitment of 40% at 31st March 2018

• confirmed support for maximum in-year over commitments of 70% for the years 2017/18 and 2018/19

• noted the national stated expectation that additional funding will become available to support certain over

spend on 2017/18 ETTF schemes later in the year, as a result of slippage from wider GPFV programmes

Pre-ETTF Soft Commitment Schemes A number of schemes were considered to be well developed at the end of last year and most of these have been resolved in the current year 3 schemes remain outstanding at 31st March 2017. These schemes are supported by their host CCGs and explicitly excluded from submission to the ETTF pipeline.

• 10237 – Clapham Park Group

Fees expenditure only included in forecast. Should this scheme be supported funding will be required in

2017/18; which is estimated to be £1.5m

• 11851 – Honeypot Lane

Fees expenditure only included in forecast. Should this scheme be supported funding will be required in

2017/18; which is estimated to be £0.5m.

• 11368 – Enderley Road

Fees expenditure only included in forecast. Should this scheme be supported funding will be required in

2017/18; which is estimated to be £0.1m

In April 2017 LCC noted:

• the position of these former soft commitment schemes and potential impact that they will have on funds

available in 2017/18

11

• that the national ETTF team has confirmed that it expects there will be potential for additional funds to

be released in 2017/18, in addition to those already announced, and it would support these schemes

being funded against this.

12

APPENDIX D – DRAFT PIPELINE AT 27TH APRIL 2017

40,283,685 11,341,508 26,060,000 34,065,443 6,342,650 52,260,000 16,104,848 2,138,298 80,260,000 90,453,976 19,822,456 110,276,432

CHP/ NHSPS/

Trust

REVISED PHASING (STP/ CCG)

ID Title Year CCG IT or Build RankRAG

Rating2017/18

Capital Revenue

2018/19

Capital Revenue

2019/20

Capital Revenue

Total

Capital Revenue Total

Cumulative Totals 2017/18

£ %

Cumulative Totals to 2018/19

£ %

Cumulative Totals to 2019/20

£ % 10237 Clapham Park Group 1516 NHS LAMBETH CCG MIG N/A 1,471,312 1,471,312 6% 1,471,312 3% 1,471,312 2% 1,471,312 1,471,312 A

11368 Enderley Road 1516 NHS HARROW CCG MIG N/A 130,000 1,601,312 6% 1,601,312 3% 1,601,312 2% 130,000 130,000 A

11851 Honeypot Lane 1516 NHS HARROW CCG MIG N/A 500,000 2,101,312 8% 2,101,312 4% 2,101,312 3% 500,000 500,000 A

22505 Loxford Polyclinic Optimisation 1617 NHS REDBRIDGE CCG MIG 1 132,000 2,233,312 9% 2,233,312 4% 2,233,312 3% 132,000 132,000 G

21404 Digital Integrated Shared Record 1617 NHS HARINGEY CCG Tech 3 6,000,000 8,233,312 32% 3,160,000 11,393,312 22% 11,393,312 14% 9,160,000 9,160,000 R

22202Population Health System to support

integrated care (Connect Care)1617 NHS LEWISHAM CCG Tech 3 8,233,312 32% 11,393,312 22% 11,393,312 14% G

22314 Kinesis - South West London 1617 NHS WANDSWORTH CCG Tech 3 444,000 8,677,312 33% 11,837,312 23% 11,837,312 15% 444,000 444,000 G

23013The London Health & Care Information

Exchange1617 NHS WALTHAM FOREST CCG Tech 3 6,130,000 14,807,312 57% 17,967,312 34% 17,967,312 22% 6,130,000 6,130,000 R

20408NWL Digital Bid 1: Digital Workforce and

Innovation1617 NHS BRENT CCG Tech 9 3,456,723 18,264,035 70% 2,728,855 24,152,890 46% 24,152,890 30% 6,185,578 6,185,578 G

21601 St George’s Development 1617 NHS HAVERING CCG New Build 9 18,264,035 70% 24,152,890 46% 24,152,890 30% G

22601 North Road Surgery relocation 1617 NHS RICHMOND CCG New Build 9 685,400 18,949,435 73% 24,838,290 48% 24,838,290 31% 685,400 685,400 G

22801Robin Hood Lane Health Centre

Development1617 NHS SUTTON CCG MIG 13 433,079 19,382,514 74% 1,421,730 26,693,099 51% 4,025,191 30,718,290 38% 5,880,000 5,880,000 G

20401Central Middlesex Hospital Hub+ Primary

Care Facility1617 NHS BRENT CCG MIG 15 1,795,612 21,178,126 81% 28,488,711 55% 32,513,902 41% 1,795,612 1,795,612 G

22001 Regents Wing 1617 NHS KINGSTON CCG New Build 16 434,490 21,612,616 83% 3,300,000 32,223,201 62% 36,248,392 45% 3,734,490 3,734,490 G

22404Froud Development - Fees Only to

Continue design1617 NHS NEWHAM CCG New Build 16 99,610 21,712,226 83% 32,322,811 62% 36,348,002 45% 99,610 99,610 G

22414 Royal Wharf 1617 NHS NEWHAM CCG New Build 21 1,961,613 23,673,839 91% 34,284,424 66% 38,309,615 48% 1,961,613 1,961,613 G

22315Deployment of iPlato SMS application -

South West London1617 NHS WANDSWORTH CCG Tech 22 G

20301Relocation and Consolidation of Bexley

Group Practice - Welling (G83028)1617 NHS BEXLEY CCG New Build 25 702,652 236,534 24,613,025 94% 35,223,610 67% 39,248,801 49% 702,652 236,534 939,186 G

23101Queen Marys Hospital (Roehampton) and

Mayfield/Westmoor reconfiguration1617 NHS WANDSWORTH CCG MIG 25 1,456,000 26,069,025 100% 36,679,610 70% 40,704,801 51% 1,456,000 1,456,000 R

21201Gallions Reach Health Centre

Refurbishment1617 NHS GREENWICH CCG MIG NHSPS 28 1,218,558 653,170 27,940,753 107% 4,617,720 43,169,058 83% 219,103 47,413,352 59% 6,055,381 653,170 6,708,551 G

21401 Tottenham Hale Welbourne Centre 1617 NHS HARINGEY CCG New Build 28 50,000 27,990,753 107% 3,000,000 140,000 46,359,058 89% 35,000 230,000 50,868,352 63% 3,035,000 420,000 3,455,000 G

20501 Bromley Health and Wellbeing Centre 1617 NHS BROMLEY CCG New Build 30 268,000 187,000 28,445,753 109% 1,466,000 48,280,058 92% 1,760,000 54,549,352 68% 3,494,000 187,000 3,681,000 A

22101 Gracefield Gardens Scheme 1 1617 NHS LAMBETH CCG MIG 30 1,110,428 29,556,181 113% 370,143 49,760,629 95% 56,029,923 70% 1,480,571 1,480,571 G

21403 Iceland Building Wood Green 1617 NHS HARINGEY CCG New Build 33 50,000 29,606,181 114% 2,000,000 140,000 51,950,629 99% 2,681,000 230,000 61,130,923 76% 4,681,000 420,000 5,101,000 G

21901Andover Medical Centre Extension

Scheme1617 NHS ISLINGTON CCG MIG 34 249,362 130,500 29,986,043 115% 498,724 52,829,215 101% 249,362 62,258,871 78% 997,448 130,500 1,127,948 A

22316Digital document sharing via cloud

solution - South West London1617 NHS WANDSWORTH CCG Tech 34 G

20304 Erith Health Centre additional capacity 1617 NHS BEXLEY CCG MIG NHSPS 37 224,936 30,210,979 116% 53,054,151 102% 62,483,807 78% 224,936 224,936 G

20104 Barking Riverside Developement 1617 NHS BARKING AND DAGENHAM CCG New Build 38 30,210,979 116% 100,000 53,154,151 102% 62,583,807 78% 100,000 100,000 G

20411 NWL Digital Bid 4: Video Conferencing 1617 NHS BRENT CCG Tech 39 641,800 30,852,779 118% 52,654 53,848,605 103% 63,278,261 79% 694,454 694,454 G

20502

Information Technology Programme

enabling the development of Integrated

Care Networks in Bromley.

1617 NHS BROMLEY CCG Tech 39 270,000 220,000 31,342,779 120% 144,000 54,482,605 104% 144,000 64,056,261 80% 270,000 508,000 778,000 G

21203 Population Health Management 1617 NHS GREENWICH CCG Tech 39 720,000 32,062,779 123% 55,202,605 106% 64,776,261 81% 720,000 720,000 G

21207 Patient Access to Records 1617 NHS GREENWICH CCG Tech 39 185,000 32,247,779 124% 55,387,605 106% 64,961,261 81% 185,000 185,000 G

22705 Local Care Record Development 1617 NHS SOUTHWARK CCG Tech 39 35,000 667,000 32,949,779 126% 210,000 56,299,605 108% 65,873,261 82% 35,000 877,000 912,000 G

22716SEL Wide Tech Bid – Local Care Record /

Connect Care Interoperability (Priority 1)1617 NHS SOUTHWARK CCG Tech 39 1,217,000 34,166,779 131% 57,516,605 110% 67,090,261 84% 1,217,000 1,217,000 G

22201Lewisham CCG: Integrated Primary Care

Hub (N2)1617 NHS LEWISHAM CCG New Build 47 20,000 34,186,779 131% 592,000 58,128,605 111% 67,702,261 84% 592,000 20,000 612,000 G

22703

Dulwich Health Centre - project

management, furniture and equipment

and transition costs

1617 NHS SOUTHWARK CCG New Build 50 161,750 34,348,529 132% 116,000 58,406,355 112% 390,192 783,100 69,153,303 86% 390,192 1,060,850 1,451,042 G

20302

Infrastructure to support virtual

consultations, communication, remote

access and virtual training

1617 NHS BEXLEY CCG Tech 51 194,968 34,543,497 133% 58,601,323 112% 69,348,271 86% 194,968 194,968 G

21402 Hawes & Curtis Green Lanes 1617 NHS HARINGEY CCG New Build 52 50,000 34,593,497 133% 2,000,000 140,000 60,791,323 116% 220,000 230,000 71,988,271 90% 2,220,000 420,000 2,640,000 G

20410NWL Digital Bid 3: Integrated Care

Standards1617 NHS BRENT CCG Tech 53 G

21801 Chiswick Health Centre 1617 NHS HOUNSLOW CCG MIG 53 934,140 35,527,637 136% 61,725,463 118% 72,922,411 91% 934,140 934,140 A

23015 Data sharing and the HIE 1617 NHS WALTHAM FOREST CCG Tech 53 220,489 702,412 36,450,538 140% 180,000 62,828,364 120% 74,025,312 92% 220,489 882,412 1,102,901 R

21902 Archway Primary Care Hub 1617 NHS ISLINGTON CCG New Build 58 43,198 36,493,736 140% 810,000 43,198 63,724,760 122% 810,000 43,198 75,774,906 94% 1,620,000 129,594 1,749,594 G

23103Remote access to GP system using EMIS

Anywhere and EMIS Mobile1617 NHS WANDSWORTH CCG Tech 59 G

22710 Peckham GP Premises rationalisation 1617 NHS SOUTHWARK CCG MIG 65 736,094 55,830 37,285,660 143% 64,516,684 123% 76,566,830 95% 736,094 55,830 791,924 G

22004 Chambers and practices’ telephony - VOIP 1617 NHS KINGSTON CCG Tech 69 G

20901 Croydon - GP Systems Migration 1617 NHS CROYDON CCG Tech 78 G

23024 Primary Care Online Services – Linked Bid 1617 NHS WALTHAM FOREST CCG Tech 82 G

20801 Springfield Health Centre Interim 1617 NHS CITY AND HACKNEY CCG New Build 98 657,000 73,440 38,016,100 146% 65,247,124 125% 77,297,270 96% 657,000 73,440 730,440 G

20802 Tollgate Lodge Interim 1617 NHS CITY AND HACKNEY CCG MIG 102 102,000 24,480 38,142,580 146% 65,373,604 125% 77,423,750 96% 102,000 24,480 126,480 G

21701 Yiewsley Family Practice 1617 NHS HILLINGDON CCG MIG 122 444,809 38,587,389 148% 65,818,413 126% 77,868,559 97% 444,809 444,809 G

13

40,283,685 11,341,508 26,060,000 34,065,443 6,342,650 52,260,000 16,104,848 2,138,298 80,260,000 90,453,976 19,822,456 110,276,432

CHP/ NHSPS/

Trust

REVISED PHASING (STP/ CCG)

ID Title Year CCG IT or Build RankRAG

Rating2017/18

Capital Revenue

2018/19

Capital Revenue

2019/20

Capital Revenue

Total

Capital Revenue Total

Cumulative Totals 2017/18

£ %

Cumulative Totals to 2018/19

£ %

Cumulative Totals to 2019/20

£ % 21703

Heathrow Medical Centre - deferred 15/16

scheme1617 NHS HILLINGDON CCG MIG 139 G

22406 Telephony and Video Conferencing 1617 NHS NEWHAM CCG Tech 140 263,633 38,851,022 149% 66,082,046 126% 78,132,192 97% 263,633 263,633 G

22303 Patrick Doody 1617 NHS MERTON CCG MIG 2 67,000 38,918,022 149% 67,000 66,216,046 127% 66,000 78,332,192 98% 200,000 200,000 G

22312SWL Interoperability Solution - South West

London1617 NHS WANDSWORTH CCG Tech Trust 3 2,066,985 40,985,007 157% 605,053 68,888,084 132% 81,004,230 101% 2,672,038 2,672,038 R

22807 Integrated Digital Care Record 1617 NHS SUTTON CCG Tech 12 5,554,000 46,539,007 179% 74,442,084 142% 86,558,230 108% 5,554,000 5,554,000 R

22301 Colliers Wood 1617 NHS MERTON CCG New Build 16 170,000 507,000 47,216,007 181% 412,000 75,531,084 145% 412,000 88,059,230 110% 170,000 1,331,000 1,501,000 A

21102 Meridian Water Regeneration Scheme 1617 NHS ENFIELD CCG New Build 16 215,000 47,431,007 182% 1,118,800 76,864,884 147% 89,393,030 111% 1,333,800 1,333,800 A

22313Patient e-consultation and MDT video

conferencing - South West London1617 NHS WANDSWORTH CCG Tech 20 1,337,440 48,768,447 187% 157,175 78,359,499 150% 90,887,645 113% 1,494,615 1,494,615 R

20203Colindale and West Hendon Stage 2

(Grahame Park Health Centre)1617 NHS BARNET CCG New Build 39 48,768,447 187% 950,000 79,309,499 152% 91,837,645 114% 950,000 950,000 G

20902Croydon - East Croydon GP Network

Transformation1617 NHS CROYDON CCG MIG 47 650,000 120,000 49,538,447 190% 1,381,600 81,461,099 156% 93,989,245 117% 2,031,600 120,000 2,151,600 A

20303Expansion of capacity at Lakeside Health

Centre1617 NHS BEXLEY CCG MIG 49 346,812 36,000 49,921,259 192% 169,574 82,013,485 157% 94,541,631 118% 516,386 36,000 552,386 G

20903Croydon - New Addington / Selsdon GP

Network Transformation1617 NHS CROYDON CCG MIG 57 50,000 49,971,259 192% 600,000 150,000 82,813,485 158% 685,000 96,026,631 120% 1,285,000 200,000 1,485,000 A

23201 Violet Melchett Centre 1718 NHS WEST LONDON CCG MIG 22 417,510 50,388,769 193% 1,800,000 85,030,995 163% 2,200,000 100,444,141 125% 4,417,510 4,417,510 R

20805Optimisation and Engagement in GP

Demand Management1617 NHS CITY AND HACKNEY CCG Tech 39 600,000 50,988,769 196% 1,000,000 86,630,995 166% 102,044,141 127% 1,600,000 1,600,000 R

20413 NWL Digital Bid 6: Care Home Pilot 1718 NHS BRENT CCG Tech 61 241,424 51,230,193 197% 110,867 86,983,286 166% 102,396,432 128% 352,291 352,291 R

22402Custom House Surgery (F84047)

Replacement Build1718 NHS NEWHAM CCG New Build 61 100,000 51,330,193 197% 230,000 87,313,286 167% 1,650,000 104,376,432 130% 1,650,000 330,000 1,980,000 R

22304 Central Medical 1718 NHS MERTON CCG MIG 61 295,000 51,625,193 198% 4,425,000 92,033,286 176% 1,180,000 110,276,432 137% 5,900,000 5,900,000 R

Schemes with 2016/17 Approvals

2016/17 supported schemes without Approvals in 2016/17

New schemes b/fwd

14

APPENDIX E – LONDON REGION SUBMISSION TO NATIONAL TEAM 3RD MAY 2017

15

16

17