Scarborough and Ryedale CCG Interim Strategic Estates Plan ... · Scarborough and Ryedale, with a registered population of approximately 118,000 ... Silver Birches (Office in a Care

Scarborough and Ryedale CCG

Interim Strategic Estates Plan –

December 2015

2

Document Control

Interim SEP agreed by:

Name Title Date

S Brown Scarborough & Ryedale CCG Associate Director of Corporate Affairs

DD/MM/2015

T Britcliffe NHS PS Strategic Estates Advisor DD/MM/2015

Version control:

Issue Ref. Version

Date Status / Summary of changes Amended By

3

Notes to Strategic Estates Plan

• This document has been produced by NHS PS in conjunction with the Scarborough and

Ryedale CCG, NHS England and other NHS and local authority stakeholders

• A number of the property opportunities contained within the review are at outline

proposal stage only and are subject to further public engagement

• The costs and benefits set out in the document are indicative, and are subject to further

planning and viability testing

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Contents Executive Summary

1. Scope

2. CCG key drivers and challenges

3. Estate overview

4. Key themes emerging from the review

5. Property strategy forward view

6. Summary of property opportunities

7. Investment considerations

8. Financial Analysis

9. Work Plan

10. Recommendations

Back-up slides:

• Annexe A – Lease ends and breaks

• Annexe B – Planned growth & impact on the Primary Care estate and potential

developer contributions

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Executive Summary Scarborough and Ryedale CCG Estate

Strategy (2015 -2020)

This paper provides a summary of the CCG local

estate strategy review process and the proposals

to support the NHS 5 year forward view:

1. Scope overview: The review covers the health estate in Scarborough

This plan is critical to the delivery of the Care Closer to

Home and Primary Care Strategy

2. The CCG drivers and challenges: To review and adapt the way in which health and social

care services are commissioned and delivered to meet the

challenges of an aging population and relatively high levels

deprivation in the locality

3. Property overview:

Community Estate 2.5k sqm and costs of £245k p/a

GP Estate 12.4k sqm and costs of £1.8m p/a

Scarborough Hospital comprises 35k sqm and has costs of

£14.7m

Mental Health estate of 5.4k sqm

4. Key themes emerging from the review: Developing integrated services around a community hub model

of care to enable patients to be cared for as close to home as

possible

Reducing the need for patients to attend and/or be admitted to

secondary care by providing suitable alternative services in

primary or community settings

5. Property opportunities and savings: Implement the Hub and Spoke model in central Scarborough for

primary care which could be linked to PCTF

Potential savings in the community estate of £189k p/a

CCG to co-ordinate PCTF bids for the GP estate

6. Investment requirements The key investment would be the central Scarborough hub

Others will depend on the detail of and successful

implementation PCTF bids in the GP estate

7. Recommendations The strategy and opportunities are endorsed by the CCG and

NHS Property Services

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1. Scope Overview • This strategy reviewed the CCG clinical strategy and health property in the CCG’s area – a

summary of the key themes is included at section 4 of this report

• The review was undertaken during June to December 2015 and incorporated representatives

from the CCG, Council and local GPs

• SRCCG is comprised of 16 practices occupying 23 properties across the areas of

Scarborough and Ryedale, with a registered population of approximately 118,000

• Acute services are provided by York Teaching Hospitals FT from Scarborough Hospital and

Mental Health services are provided by Tees, Esk and Wear Valleys NHS Foundation Trust

from 5 properties in Scarborough

• The community healthcare estate in the area is owned or leased by NHS Property Services

and the annual running costs of this estate is c. £250k (2015/16)

• NHS PS estate is small and nearly all leasehold

• Dialogue with other NHS stakeholders and the Council has taken place in the development of

this strategy and will continue as the opportunities are developed

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2. CCG Key Drivers and Challenges The overarching vision for the CCG is improving the health and wellbeing of its

communities

• The CCG’s long term intention is to fundamentally change the way health and

social care services are delivered for the population of Scarborough and Ryedale

Relative deprivation and an elderly population with high health usage

• The CCG has a relatively elderly population with 21.9% of its population aged

over 65

• Over 50% of the CCG population lives in the most deprived population quintile of

North Yorkshire

• The demographic profile of the CCG provides it with the combined challenge of an

elderly population with high health resource usage; and significant areas of

deprivation with associated poor health outcomes. As such this is a challenge

unlike any other in North Yorkshire

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3a. The NHS PS Estate Overview

Health Centre

Nursing / Care Home

Hospitals

Offices

Land without buildings

Other / Unknown

7 Holdings / 2.5k sq m NIA

6 Holdings

2.1 k sq. m NIA

Top 5 properties (by size - NIA)

0 Holdings

0 Holdings 1 Holding

0.45 k sq. m NIA

0 Holdings 0 Holdings

• Northway Clinic (HC) F/H 798sq. m

• Town Hall (CCG HQ) L/H 456sq. m

• 3-4 York Place (HC) L/H 427sq. m

• Eastfield Dental Surgery L/H 126sq. m

• The Street L/H 107sq. m

Total Cost of Estate

Based on 15/16 costs: £245k

Property Running

cost £ p/a

Running

cost £

p/sqm

p/a

1. Northway Clinic £99k £124

2. Scarborough Town Hall £63k £139

3. 3-4 York Place £53k £123

4. Trafalgar Medical Practice

(vacant) £25k £38

Total c £ 240K (98% of total cost)

Top 4 buildings by cost

The community healthcare estate in the area is owned or leased by NHS Property Services

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3a. The NHS PS Estate Overview

NIA 3.5 k sq m (8 Holdings) Lease End + Break Profile (NIA sq m)

(32 holdings)

(25) (2)

• Over 69% of the estate is leasehold. This offers future opportunities to release property running costs

if local consolidation is possible

• A full list of lease ends and breaks to 2020 is included in the back-up slides at Annexe A

• The key opportunities in the next 5 years are summarised below:

Leasehold Opportunities (5 Years)

Silver Birches (Office in a Care Home) Lease has expired £1.3k annual running cost

Scarborough Town Hall (CCG HQ) Lease End May 2016 £63k annual running cost

3-4 York Place (HC) Lease End February 2020 £252k annual running cost

The Street (HC) NHS will not take this lease as tenants

moving out in September

Rent will be paid till September 2016

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3. The Estate Overview Estate Map

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3b. GP Estate Overview

(32 holdings)

(25) (2)

• There are 23 general practice properties in the Scarborough and Ryedale CCG area

• The general practice estate is a significant resource totalling almost 17.k sq. m and about 70% is

owner occupied. Full details of the GP estate can be found in annexe C

• The rental baseline (2013) was £1.5m. Total expenditure on GP premises is £1.8m p/a

• A number of premises may require review due to compliance considerations (based on 2008 survey

results), given the age of the surveys, new surveys would be a priority for the CCG

The Survey Codes can be found in Annexe D

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3c Acute Services - Scarborough Hospital

• The acute services are provided from Scarborough Hospital which was

originally built in 1936

• It has an Accident and Emergency department and provides acute

medical and surgical services, including trauma and intensive care

services to the local population and visitors to the North East Yorkshire

Coast.

• Recent developments include a new Women’s Unit and Midwifery-Led

Unit, new Radiology Department, Gastroenterology Department,

refurbishment of A&E and Maple Ward, a new surgical ward

• The hospital has a GIA of 35k sqm and sits on almost 10ha of land in

central Scarborough

• The current running costs for the hospital are £14.7m (2014/15)

• Currently the hospital has 15% of its space un-utilised

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3d Mental Health Services Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV) deliver mental health services in the

CCG area from 5 properties in Scarborough with a total floor area of 5.4k sqm. Four of which they

own:

• Cross Lane Hospital is main acute site which has a floor area of 4k sqm and has two in patient

wards with a total of 46 beds. There was significant investment of £3.5m between 2011-13 in

this facility

• Ellis centre has a floor area of 529sqm and provides services for addictive behaviour as well

as the base for the Early Intervention Team

• Lake House (aka Manor Court) has a floor area of 566sqm and is the CAMHS (child and

adolescent mental health service) base for the area

• Eastfield Clinic has a floor area is 346sqm and provides the learning difficulties service

and space (TBC) that they lease at:

• Trafalgar House to provide IAPT services (Improving Access to Psychological Therapies)

Capital Plans

TEWV through their Estates & Facilities Management Framework Sept 2014 – Mar 2017 doesn’t

identify any the requirement to address any sub-standard estate in the CCG.

Future Strategy

Further review of Children's and Young Persons facilities at Scarborough 2015/16

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4. Key Themes Emerging from the Review 1. Immediate Priorities:

• Developing integrated services around a community hub model of care to enable patients to be cared for as

close to home as possible

• Using innovative solutions to link primary, secondary and community services and social care to encourage

patient centred services

• Reducing the need for patients to attend and/or be admitted to secondary care by providing suitable alternative

services in primary or community settings

2. Healthcare Planning and Challenges:

• An elderly population and planned population growth

• Substance misuse and mental health a problem

• A transient population due to seasonal variations linked to the tourism economy

• Inequalities in life expectancy between Scarborough and other parts of Yorkshire

• Over 50% of the CCG population lives in the most deprived population quintile of North Yorkshire

• A combined challenge of an elderly population with high health resource usage; and significant areas of

deprivation with associated poor health outcomes

• The isolated nature of the geography of the area and poor public and road transport

3. Service Model Developments /Changes:

• The CCG have full delegated authority for Primary Care. There are currently 15 practices delivering Primary

Care services from 23 sites

• In 5 years the model of care will be less focused on hospital care and more focused on supporting patients to

live healthy, active lives in the community supported by responsive services tailored to meet individual needs

• The community hub model will provide medical, mental health, social, therapy and nursing integrated care

aimed at keeping patients in their own homes and minimising the need for acute admission to secondary care

4. Financial considerations:

• Making better use of estate and facilities

• Only using hospital services where no other option is appropriate: Developing the community hub

• The future implications of the running costs of Scarborough Hospital

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4. Key Themes Emerging from the Review 5. Existing strategies and plans:

• CCG Strategic Plan 2014-2019

• Hub model to wrap around the district hospital run by York Teaching Hospital Foundation Trust

• Ambition for Health strategy for Scarborough services

• A new primary care strategy is being developed and the estates plan will be a big part of the delivery of this

6. Future Housing Growth :

Scarborough Borough Council consulted upon on its draft New Local Plan in May 2014. When adopted it will

guide development up to 2030. The Ryedale District Council Local Plan Strategy (to 2027) was adopted in

September 2013. The site allocations document is in preparation and will make up the statutory development plan

along with the Helmsley Plan.

Scarborough:

• Total population – 108,800 (Draft Local Plan May 2014; 2011 Census)

• Total housing requirement – 7720 dwellings including the following (indicative) spatial concentrations:

Site HA 13: South of Cayton Strategic Growth Area (2500 dwellings or 5075 patients);

Site Allocations:

Site HA 6 Land to east of Lancaster Park, Scalby (900 dwelling or 1827 patients)

Site HA 9 Land to north of Middle Deepdale, Eastfield (500 dwellings or 1015 patients)

Site HA 8 Land to west of Middle Deepdale, Eastfield (100 dwellings or 203 patients)

Site HA 7 Land to north west of Middle Deepdale, Eastfield (600 dwellings or 1380 patients)

NHS PS have assisted the CCG in considering the impacts of this planned growth on primary care and a table

showing the impacts and potential developer contributions to mitigate this can be found in Annex B.

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4. Key Themes Emerging from the Review Ryedale:

• Total population – 51,700 (Local Plan Strategy 2013; 2011 Census)

Total housing requirement – 200 units per annum, in order to deliver at least 3,000 homes over the period 2012-

2027 in the following (indicative) spatial concentrations:

• Malton and Norton 1500 (50%)

• Pickering 750 (25%)

• Kirkbymoorside 300 (10%)

• Helmsley 150 (5%)

• Service Villages 300 (10%)

7. Key site requirements:

Hub model for the town of Scarborough is the key property requirement in the next 5 years

• Implement the Hub and Spoke model in central Scarborough

• This project is still at the inception stage and could involve 6 existing practices (all private or owner occupied)

• However which practices are in or out of scope is still to be agreed

• There is the potential for a new build (location to be determined) to support this

Wider GP Estate

• Opportunities to bid for PCIF in the new bidding round in February 2016

• This estates plan provides a strong evidence base to make the case for new investment in some of the existing

practices in Scarborough

• The CCG to work with individual practices to explore co-location opportunities in the GP estate to meet clinical

intentions

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4. Key Themes Emerging from the Review

7. Key site requirements continued:

CCG HQ at the Town Hall (456sqm NIA)(NHS PS Leasehold)

• NHS PS to work with the CCG to consider options on their future requirement and whether they want to remain

at this property (lease end May 2016). If following the strategic review and options appraisal they would like to

remain, then consider re-gear options to extract value from the lease

NHS Clinical Estate

Northway Clinic (freehold)

• Currently in a poor condition

• NHS PS will work with the tenants on options for their future requirements and this could include a disposal of

this building

• There is an option of the community services delivered from this property being included in the scope of the

Scarborough hub model and any potential new build (options paper needed)

Silver Birches (Leasehold)

• This a lease for a number of rooms in a care home (55sqm NIA) where community services are delivered from

• The lease has expired

• NHS PS will work with the tenants Harrogate and District Foundation Trust (HDFT) on options for their future

requirements and this could include a lease exit or potential lease re-gear options

Trafalgar Medical Practice (Leasehold)

• This is a disposal that is progressing (642sqm NIA) with the tenants HDFT having already moved to The Street,

however they will vacate the Street in mid 2016 and move into Council property. It has been agreed that NHS

PS will therefore no take a lease on the Street but will pay rent to landlord till September 2016

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5. Property Strategy Forward View As-is Position To-be Position

Small NHS PS estate Northway Clinic is in a poor condition Void space at Trafalgar House

Town Hall is the only property which is the CCG HQ

456sqm and running costs of £64.5k p.a. The lease end is may 2016

Implementing a hub model in central Scarborough the main estates priority

Scope to be confirmed but could include up to 6 GPs and community services and disposal of Northway Clinic

Opportunities to invest in the GP estate through PCTF

Explore co-location opportunities in the GP estate Disposal of Trafalgar Medical centre to remove void

Opportunity to determine the CCGs requirements

and renew the lease

Running costs: Savings of 76% of current costs (£188.5k p/a) This doesn’t take account of new provision needed

Estate footprint by March 2020:

- Removal of void - Potential disposal of Northway Clinic - GP estate and its running costs will be subject

to what estates form the hub model takes and other PCTF bids

Clinical Estate

Admin Estate

Estate Metrics

Running costs: NHS PS Community Estate £245k p/a GP Estate £1.8m p/a Scarborough Hospital £14.7p/a

Estate footprint: The NHS PS estate comprises: 1.5k sqm Clinical space over 7 properties 0.45 sqm of Admin estate over 1 property GP Estate comprises: 12k sqm over 23 properties Scarborough Hospital comprises 35k sqm Mental Health Estate of 5.4ksqm

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Summary of financial benefits:

Cautionary note

• If the above savings are achieved it will result in a 50% cost reduction based on current costs, however this

does not take into consideration the running costs of new provision that Scarborough would need to implement

the hub model for primary care. It also does not consider the costs for investment needed

Summary of non-financial benefits:

• Reconfiguration of the estate to better meet the commissioners needs

• Removal of void space

6. Summary of Property Opportunities

* This will depend on the options taken by the tenants and CCG

Ref.

Opportunity Area

15/16

16/17

17/18

18/19

19/20

Totals

One-off

capital

receipts

One-off

maintenance

Savings

6.1 • Disposal opportunities 0 0 0 0 99 99 780 TBC

6.2 • Improved utilisation and sublet

savings / maintenance avoidance 0 0 0 0 0 0 0 TBC

6.3

• Leasehold opportunities –

-Exits 25 1.3* 0 0 0 26.3 780 TBC

- Lease regearing 0 TBA* 0 0 0 0 0 TBC

Totals 25 1.3 0 0 99 125.3 780

Running cost savings by Financial Year (£k)

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Investment considerations:

Implementation of the hub model for central Scarborough

• The CCG is at an early stage with these proposals. The scope of the project and NHS

PS support is to be agreed

• It is envisaged that a detailed options paper will be developed with other key

stakeholders such as local GPs, NHS England, other health providers and

Scarborough Borough Council

• Feasibility work will need to be carried out and will focus on project affordability and key

risks

• The options will consider the suitability of existing buildings (NHS PS and privately

owned), co-location and disposal opportunities, investment in existing portfolio (NHS PS

and private) as well as bespoke new build to meet identified gaps or where feasibility

suggests this is the best option

Wider GP Estate

• GPs in the area will work with the CCG to bid against the PCTF which is a £1bn four

year investment programme into infrastructure in general practice. This funding will be

specifically targeted at increasing capacity in primary care

• This will enable better access to general practice and its associated community

services, improving services for the frail and elderly and hence reducing unnecessary

demands on urgent care services, as well as building the foundations for more

integrated care to be delivered in community settings

7. Investment Considerations

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• Indicative profile of running costs savings and estimated cost to

achieve:

• Cost savings profile based on full year benefit from the year of the

event, with cumulative benefit

• Disposal proceeds shown in year of receipt

• Non-discounted and illustrative only to show high-level viability


Target Financial Year 15/16 16/17 17/18 18/19 19/20 5 Year

Total

- 15/16 savings 25 25 25 25 25 125

- 16/17 savings 1.3 1.3 1.3 1.3 5.2

- 17/18 savings 0 0 0 0

- 18/19 savings 0 0 0

- 19/20 savings 99 99

A - Total 5 Year Running Cost Savings £k 25 26.3 26.3 26.3 125.3 229.2

Maintenance Savings £k 0 0 0 0 0 0

Disposal Proceeds £k 0 0 0 0 780 780

B - Total One Off Benefits 0 0 0 0 780 780

C- TOTAL FINANCIAL BENEFITS (A +B) 25 26.3 26.3 26.3 905.3 1009.2

D - TOTAL COST TO ACHIEVE £k Unknown as re-provision will be needed

NET BENEFIT £k (C – D) (undiscounted) Unknown as re-provision will be needed

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A feasibility study for the proposed is required to produce indicative financial

analysis for:

• cost savings

• potential disposals

• the costs of the necessary extensions to existing facilities

• or the costs for the potential for new builds if the options papers identify this

The development of options papers and business cases for the 5 locality hubs

would take the form of the following next steps:

1. Develop a detailed requirements brief

2. Commission consultants to prepare options appraisal

3. Considering funding opportunities

4. Consider all financial and non–financial benefits of the hub solution


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9. Work Plan • NHS PS is working with the CCG to deliver the strategy

• Timeline of work programmes

CCG

approve

the draft

SEP

2017/18 Q3 2015/16 Q4 2015/16 16/17 2018/19

Options Paper

is completed

and feasibility

and business

case testing

begins

Commence

Options

Paper for the

town centre

hub

Business case and

feasibility work

completed and a

decision is made on

the hub

Potential

disposal of

Northway

Clinic

Delivery of the

hub begins Dispose of

Trafalgar

Medical

centre

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10. Recommendations

1. Implementing priority

healthcare changes The review covers the health estate in

Scarborough

This plan is critical to the delivery of

the Care Closer to Home and Primary

Care Strategy

2. Cost reduction opportunities The review has identified costs

savings of £125k p/a or 50% p/a

These costs savings are predicated

on new provision replacing them

This cost reduction will allow the CCG

to plan for the implementation of the

central hub for Scarborough town

centre

3. Dealing with void space The proposals will remove all void

space in the estate.

4. Improving estate utilisation The CCG will consider co-location

opportunities with individual

practices

The utilisation of the estate will

continue to be monitored and

reviewed and any significant

changes will be addressed by the

CCG and NHS PS in line with this

strategy

5. GP Estate This strategy provides a detailed

baseline of the GP estate and

identifies confirmed investment

This information can be used for

new bids for PCIF funding

6. Work Plan The plan at section 9 outlines a

number of key projects that will

need to be progressed to realise

the savings

These projects need to be

worked through utilising NHS PS

Asset Management, Capital and

Facilities teams

NHS PS and the CCG will work

together to drive forward the

opportunities and optimise the

benefits.

Scarborough and Ryedale CCG Estate Strategy (2015-20)

Recommendations for CCG approval

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Back-up Slides

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Annexe A – NHS PS Lease ends and breaks pipeline

Property name Main Use Lease Expiry

Date

Lease Break

Date Comment

Silver Birches

Health Centre

24/05/2015

n/a

Potential lease exit

Scarborough Town Hall Offices 31/05/2016 n/a Potential lease exit or lease

re-gear

3-4 York Place Health Centre 09/02/2020 n/a

Trafalgar Medical Practice GP 10/09/2025 In the disposal process

The Street Health Centre No info No info

Eastfield Dental Surgery Health Centre No info No info

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Annexe B – Planned growth & impact on the Primary Care

estate and potential developer contributions

Planning Reference LocationNumber of

houses/dwellingsPractice impacted Branch

Population

based on 2.03

per household

(A)

Number of GPs

per 1,500

population (A)

Sq m per GP @

300sq.m. per GP

GIA (A)

£ per Sq m per

GP @ £1563

sq.m. (A)

HA29 East Ayton 40 West Ayton West Ayton 81.2 0.05 16.24 25,383

HA30 East Ayton 100 West Ayton West Ayton 203 0.14 40.60 63,458

HA31 West Ayton 70 West Ayton West Ayton 142.1 0.09 28.42 44,420

HA28 Seamer 60 West Ayton Seamer 121.8 0.08 24.36 38,075

HA08 Middle Deepdale 100 Eastfield Eastfield 203 0.14 40.60 63,458



HA14 Osgodby 90 Eastfield Eastfield 182.7 0.12 36.54 57,112

HA10 Eastfield 10 Eastfield Eastfield 20.3 0.01 4.06 6,346

HA11 Cayton 40 Eastfield Eastfield 81.2 0.05 16.24 25,383

HA12 Cayton 80 Eastfield Eastfield 162.4 0.11 32.48 50,766

HA13 South Cayton 2500 Eastfield Eastfield 5075 3.38 1015.00 1,586,445

HA24 Filey 30 Filey Filey 60.9 0.04 12.18 19,037



HA25 Hunmanby 60 Hunmanby Hunmanby 121.8 0.08 24.36 38,075



HA1 Springhill 40 Falsgrave Falsgrave 81.2 0.05 16.24 25,383

HA2 Westwood 50 Falsgrave Falsgrave 101.5 0.07 20.30 31,729

HA32 Burniston 60 Scarborough Medical Group Cloughton/Danes Dyke 121.8 0.08 24.36 38,075



HA6 Scalby 900 Scarborough Medical Group Danes Dyke 1827 1.22 365.40 571,120

HA5 Newby 60 Scarborough Medical Group Danes Dyke 121.8 0.08 24.36 38,075

HA4 Newby 100 Scarborough Medical Group Danes Dyke 203 0.14 40.60 63,458

HA3 Prospect Mount 30 Prospect Road Prospect Road 60.9 0.04 12.18 19,037

10/01893/RM Filey 300 Filey Filey 609 0.41 121.80 190,373

09/00717/OL Scalby 515 Scarborough Medical Group Danes Dyke 1045.45 0.70 209.09 326,808

14/01141/OL Gristhorpe 45 Filey Filey 91.35 0.06 18.27 28,556

11/01914/OL Eastfield 1350 Eastfield Eastfield 2740.5 1.83 548.10 856,680

Totals 7980 16199.4 10.80 5,063,932

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Annexe C – 6 Facet Survey Codes

Documents

Scarborough and Ryedale CCG Interim Strategic Estates Plan ... · Scarborough and Ryedale, with a registered population of approximately 118,000 ... Silver Birches (Office in a Care