Oxford University Hospitals NHS Trust
Expansion of Newborn Facilities
Full Business Case (FBC)
VERSION HISTORY
Version Date Issued
1.0
March 12
1.1
1.2
25 March 2012
20 March 12
25 March 12
Brief Summary of Change
First Draft Version for
Divisional Executive approval
Minor typos
Minor revisions
Page 1 of 43
Owners Name
Tony McDonald/Lynda Atkins
Tony McDonald/Lynda Atkins
Tony McDonald/Lynda Atkins
Contents
1. Executive summary
2. Strategic case
3. Economic case
4. Commercial case
5. Financial case
6. Management case
Appendices
A
Neonatal Network Activity Model
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
Network Request for Capacity Expansion
Neonatal Network Support for OBC
Specialist Commissioner Support for OBC
Risk Register
Revenue Costs Model
Floor plan of existing Unit (Option 1)
1:50 and RDS Option 2
FBC forms Option 2
Floor plan of Option 3
Outline Project Programme
Gateway Risk Assessment
Benefits Realisation Plan
Equality Impact Assessment
Staffing Plan
Derogations List
GMP Details
Internal Decant Plan
Post Project Evaluation
Grant of Full Planning Permission
AEDET Evaluation
Trust Board FBC approval, once granted
25 March 2012
Page 2 of 43
1. Executive Summary
1.1 Introduction
This FBC seeks approval to invest £3.079m in an extension to the Newborn Intensive Care
Unit at the John Radcliffe Hospital. This will provide 16 cot spaces suitable for use as
either Newborn Intensive Care (NICU) or High Dependency (HDU) care. Six cot spaces
(equivalent to 7 cots’ of activity at current occupancy levels) will be lost in the
construction of the extension, and 2 additional cot spaces could be created in space on the
Unit which is currently unused, so there will be an overall increase of 12 cots once the
Unit has reached its maximum capacity. The Trust plans to open 4 additional cots in the
first instance, gradually extending cot numbers, at the rate of 2 every 6 months to a
maximum of 53 overall, as demand and staffing allow.
1.2 Strategic case
1.2.1 The strategic context
The Oxford University Hospitals NHS Trust (OUH) is one of the largest acute teaching
hospital trusts in the UK. It has a national and international reputation for the excellence
of its services and its role in teaching and research. On 1st November 2011 the Oxford
Radcliffe Hospitals NHS Trust merged with the Nuffield Orthopaedic Centre NHS Trust
to become the Oxford University Hospitals NHS Trust (OUH).
The Newborn Unit is the only designated Neonatal Intensive Care Unit for Oxfordshire,
Berkshire and Buckinghamshire. It currently provides low dependency special care (SC),
high dependency care (HDU) and intensive care (ICU), in a service comprising 41 cots, 20
HDU/ICU and 21 SC. The theoretical capacity of the unit is 40 cots but demand is such
that the activity level equates to 41 cots at present, with an additional cot included in
nursery space when it cannot be avoided.
The unit serves the population within the areas covered by the northern half of South
Central Strategic Health Authority. Care is shared with five other neonatal units in the
area. As the designated NICU, the OUH Newborn Unit offers complex medical intensive
care together with neonatal surgery, neonatal cardiology and neonatal neurosurgery.
These services could not exist in their current forms at the OUH without the
comprehensive support offered by the newborn intensive care unit.
Since the OBC was approved, arrangements have been made for the equivalent of
2-cots of ICU activity to transfer from the Royal Berkshire Hospital in advance of
the activity flows outlined in the OBC. This activity has been separately funded
by commissioners, and has been excluded from the calculations in this FBC
regarding June 2012 to March 2013.
1.2.2 The case for change
25 March 2012
Page 3 of 43
Changes in Clinical Practice
Changes in clinical practice result from a range of factors, but key among these are
increasing rates of premature and multiple births resulting from improvements in the
availability of IVF (both in the UK and overseas) and improving survival rates for
particularly premature babies. Both premature and multiple-birth babies are much more
likely to require some form of special, high dependency or intensive care.
Growth trajectories have been independently modelled by Solutions for Public Health
(SPH) on behalf of the South Central Neonatal Network. These show both the most likely
predicted growth and possible low or high growth alternatives and all are shown at
Appendix A.
National and Regional Guidance
Department of Health guidance in November 2009 has led commissioners to review the
provision of neonatal services within the north half of the South Central region (‘South
Central North’). The review, by Specialist Commissioners and the SHA Board of
Commissioners (including PCT Chief Executives from Berkshire, Oxfordshire and
Buckinghamshire) examined options for centralising intensive care. They concluded that
their preferred option was to continue with a single NICU and therefore, in September
2010, they wrote to the Chief Executive of the ORH to ask for NICU capacity to be
increased – see Appendix B. Subsequently, both the South Central Neonatal Network and
Specialist Commissioners have confirmed that the preferred option in this FBC meets their
requirements. This is shown at Appendices C and D respectively.
1.3 Economic case
1.3.1 The long list
The long listed options for extending the Newborn Intensive Care Unit are:
Option
Shortlisting Decision
A
Do Nothing
Shortlist as baseline for comparison –
Option 1
B
Do Minimum – Redevelop
existing space
Do not shortlist as will not increase
available cots, despite disruption
C
Use space vacated by other
services in the JRII building
Do not shortlist, as it would be too far
from the Delivery Suite
D
Extend Children’s Hospital
Do not shortlist, as it would be too far
from the Delivery Suite
E
Use space vacated by other
Do not shortlist, as no space to be
25 March 2012
Page 4 of 43
Option
Shortlisting Decision
services in the Women’s
Centre building
vacated
F
Extend existing
accommodation to provide
a completely new neonatal
area with 60 cots. Preferred
Option from SOC.
Shortlist - Option 3
G
Extend existing
accommodation to provide
a new neonatal area,
continuing to use existing
space, total of 53 cots
Shortlist - Option 2
H
Build a new Women’s
Centre, including neonatal
facilities and a Delivery
Suite, adjacent to the
Children’s Hospital
Do not shortlist, as insufficient funds
would be available so clearly
impracticable
1.3.2 The short list
The following short list of options emerged:
Option 1 – do nothing: A floor plan of the existing unit is at Appendix G.
Option 2 –
extend existing accommodation to provide a maximum of 53 cots, 16 of
them in new facilities. Detailed 1:50 plans of Option 2 are at Appendix H.
This option provides:
Scope:
provides enough cots to meet predicted Network demand, including
all babies of less than 27 weeks gestation and repatriated babies from
outside the Network, and allow for limited further expansion of
activity
Solution:
16-cot extension to rear of current NNU which will allow a gradual
expansion of activity as follows:
Cot Types
ICU/HD
U
25 March 2012
2011
Activity
baseline
11/9
March
2013
Sept
2013
March
2014
Sept
2014
March
2015
15/9
17/9
19/9
20/10
20/10
Page 5 of 43
SCBU/
rooming
in
Total
21
21
21
21
21
23
41
45
47
49
51
53
The 8-cot bay configuration is the most efficient, so 2 bays will deliver
16 new cots. Six cot spaces (equivalent to 7 cots’ of activity at current
occupancy levels) will be lost in the construction of the extension, and
2 additional cot spaces could be created in space on the Unit which is
currently unused, so there will be an overall increase of 12 cots once
the Unit has reached its maximum capacity.
Opening the cots in a phased programme will allow a viable staffing
plan to be developed and implemented, to ensure that staff are
available when they are needed. If demand does not increase at the
predicted rate, then the rate at which cots are opened can be slowed
or stopped. The Neonatal Network Transport service is managed by
the OUH Trust, and will enable a degree of control over the rate at
which activity is transferred to the new Unit.
The proposal also includes the introduction of an Electronic Patient
Record (EPR) system throughout the ICU/HDU/LDU area. This will
allow much more efficient use of medical staff and thus reduce
ongoing revenue costs.
The new cots will be on the first floor of a 2-floor extension, on the
same level as the existing Neonatal area, with new plant to serve the
new area on the ground floor.
Service delivery:
current service model to be used in new facilities with cots used at
recommended occupancy rates as shown in the network Activity
Model at Appendix A.
Implementation:
construction from Q1 12/13 to Q4 12/13, occupation Q4 12/13
Funding:
Following approval of the OBC, a final GMP for the project has
been received, with a total build cost of £3.453m including VAT. A
further £32k will be spent on equipment during the construction of
the extension. The Trust was allocated £2.8m of capital for this
project by South of England SHA, which was used during 2011/12
to fund equipment and some site preparation works. Previous
plans for a charitable appeal for equipment costs have
consequently been revoked.
This option will produce an overall annual surplus rising to £231k
25 March 2012
Page 6 of 43
with all cots open
Option 3 – extend existing accommodation to provide a maximum of 62 cots, all in new
facilities, and a dedicated operating theatre. A floor plan of Option 3 is at Appendix J.
This option provides:
Scope:
provides enough cots to meet predicted Network demand and
assumes some activity transferred in from beyond Network (unmet
demand from other network areas)
Solution:
62-cot extension to side of current NNU, existing space reconfigured
for use by non-clinical service elements (offices, storage, parent
accommodation) and a dedicated operating theatre
Service delivery:
current service model to be used in new facilities
Implementation:
construction from Q2 12/13 to Q2 14/15, occupation Q3 14/15
Funding:
capital cost of £27.43m, supported by charitable funding of £1.82m for
equipment. The campaign will only launch upon approval of the
FBC by the SHA, OUH Trust Board and OUH Charitable Funds
Section 11 Trustees.
Overall annual revenue loss of £2.37m. The
increased capital charges on this development and the higher staffing
costs are the principal reason for the annual loss which would be
made.
1.3.3 Key findings
On the basis of the details set out above, the only way in which the Trust can meet the
project objectives and Commissioner requirements is to implement Option 2. Option 1
will not provide the capacity required by commissioners or the Network, while Option 3
is unaffordable in capital terms. Option 2 is, therefore, the preferred option.
1.4 Commercial case
1.4.1 Procurement strategy
25 March 2012
Page 7 of 43
This project consists of the provision of a 16-cot extension to the Newborn Intensive Care
Unit under a P21+ contract. The ProCure21+ National Framework is a framework
agreement with six Principal Supply Chain Partners (PSCPs) selected via an OJEU Tender
process for certain types of capital investment construction schemes in England. The Trust
is able to select a Supply Chain for this project without having to go through a separate
OJEU procurement exercise.
This project has been combined with two other, smaller projects (the Kadoorie Centre and
the Wolfson Centre) within the Trust to form an overall package of work. The PSCP for
the project is Willmott Dixon.
1.4.2 Required services
The required services are the construction of an extended neonatal facility, consisting of 16
cot spaces. The planned extension is shown at 1:50 scale at Appendix H. The drawings
have been signed off by all key stakeholders, including Infection Control and the key
users. Some derogations from the DH Estates guidance issued in June 2011 have been
agreed.
1.4.3 Potential for risk transfer and potential payment mechanisms
The general principle is that risks should be passed to ‘the party best able to manage
them’, subject to value for money. Under the P21+ process, risks are allocated
accordingly, with an emphasis on the joint management of risk and a mutual process of
risk reduction. In particular, the establishment of a Guaranteed Maximum Price (GMP)
for the project means that the risks borne by the trust are understood, minimised and
manageable.
The Trust intends to make payments in relation to the proposed development in line with
standard P21+ project terms. As the contract is for the construction of the extension, and
does not include operation of the new facilities, payments will be complete once the
facilities are satisfactorily in place.
1.5 Financial case
1.5.1 Financial expenditure
Summary of financial appraisal:
ICU cots
HDU cots
Do Nothing
Current
SCBU cots
25 March 2012
11
9
21
41
16 Cot Expansion
16 Cot Expansion
Option 2 2013/14
Option 2 - final
ICU cots
16 ICU cots
20
HDU cots
9 HDU cots
11
SCBU
cots
21 SCBU cots
22
46
53
Page 8 of 43
staff costs
non-pay costs
subtotal direct costs
7,024,372
1,131,756
8,156,128
7,776,099
1,456,360
9,232,459
9,501,075
1,774,325
11,275,400
678,666
1,012,741
1,351,185
Indirect costs
capital charge and
depreciation
corp overheads
HGH costs
Total Revenue
Costs
82,534
1,325,219
1,910,039
530,848
1,427,077
1,910,039
530,848
1,427,077
1,910,039
12,152,586
14,113,163
16,494,548
total Income
12,359,655
14,363,255
16,725,255
207,069
250,091
230,706
Surplus/(Deficit)
1.5.2 Overall affordability and balance sheet treatment
The project will be affordable for the Trust. This will be the case from initial opening with
4 additional cots, and the affordability will improve as further cots open over time. The
Revenue Costs Model at Appendix F sets out the revenue consequences of the project in
detail.
For the FBC, all costs have been identified on an ‘actual’ basis, rather than ratios being
applied to existing costs. A detailed staffing plan ensures that pay costs (the major
change to revenue) are precise. The application of the ‘pessimistic’ principle has been
applied in assuming that new staff will be paid the average of existing staff on the
relevant grade, rather than assuming all new staff will be appointed at the bottom of a
scale. This allows for the recruitment of experienced staff from other units, should they
wish to apply.
Network and Commissioner support is shown at Appendices C and D.
SHA approval for this project is required because the capital expenditure, although from
Trust resources, is beyond the limit delegated to the Trust under current rules.
1.6 Management Case
1.6.1 Project Management Arrangements
The project will be managed in accordance with the principles of PRINCE 2 methodology.
A Project Group has been established which is chaired by Tony McDonald, Divisional
General Manager, Children's & Women's Division, and Project Director, meets monthly
and reports in to the Children’s and Women’s Divisional Executive as Project Board. A
25 March 2012
Page 9 of 43
detailed project structure has also been set up for the combined P21+ project of which this
is part.
1.6.2 Benefits Realisation and Risk Management
Benefits realisation will follow the same management process as change management,
with a plan in place for the FBC which will be implemented by the Unit team under the
overall supervision of the Children’s and Women’s Divisional Executive. The Benefits
Realisation Plan is at Appendix M. A copy of the project risk register is attached at
Appendix E. This details who is responsible for the management of risks and the required
counter measures, as required. The majority of risks have already been mitigated to some
extent or completely, in accordance with the P21+ process.
1.6.3 Post project Evaluation Arrangements
The project will be evaluated in the first few months after commissioning to evaluate the
design and construction process, and then 2 years after opening to evaluate the changes to
patient flows and clinical care.
The impacts/risks associated with the project have been scored against the risk potential
assessment (RPA) for projects. The RPA score is 24, indicating that the project is relatively
low risk. The report is attached at Appendix L.
1.7 Recommendation
It is recommended that this project is approved by the Trust Management Executive for
submission to the Trust Board.
Signed:…………………………………………………………..…..
Date:………………………………………………………….
Senior Responsible Owner
Project Team
25 March 2012
Page 10 of 43
2. The Strategic Case
2.0 Introduction
This Full Business Case (FBC) is for the extension of Newborn facilities at the John
Radcliffe site of the Oxford University Hospitals NHS Trust.
This FBC builds on the Outline Business Case (OBC) for the project which was
approved by South of England SHA in February 2012. Details from the OBC have been
updated and key changes are indicated in bold type in text boxes.
Structure and content of the document
This FBC has been prepared using the agreed standards and format for business cases, as
set out in the Capital Investment Manual and subsequent DH/HMT guidance. The
format is the Five Case Model, which comprises the following key components:
•
•
•
•
•
the strategic case section. This sets out the strategic context and the case for change,
together with the supporting investment objectives for the scheme
the economic case section. This demonstrates that the organisation has selected the
choice for investment which best meets the existing and future needs of the service and
optimises value for money (VFM)
the commercial case section. This outlines the content and structure of the proposed
project
the financial case section. This confirms funding arrangements and affordability and
explains any impact on the balance sheet of the organisation
the management case section. This demonstrates that the scheme is achievable and can
be delivered successfully to cost, time and quality.
The purpose of this section is to explain and revisit how the scope of the proposed project
or scheme fits within the existing business strategies of the organisation and provides a
compelling case for change, in terms of existing and future operational needs.
Part A: The strategic context
2.1 Organisational overview
The Trust
The Oxford University Hospitals NHS Trust (OUH) is one of the largest acute teaching
hospital trusts in the UK. It has a national and international reputation for the excellence
of its services and its role in teaching and research.
25 March 2012
Page 11 of 43
The Trust, which is currently based on four sites, provides general hospital services for the
local population in Oxfordshire and neighbouring counties and many specialist services
on a regional and national basis. The Trust was formed from the merger of the Oxford
Radcliffe Hospitals NHS Trust with the Nuffield Orthopaedic Centre (NOC) NHS Trust
on 1st November 2011 to form the Oxford University Hospitals NHS Trust.
The Trust sits within the NHS South of England Strategic Health Authority. Its main
commissioners
are
Oxfordshire,
Buckinghamshire,
Berkshire,
Wiltshire,
Northamptonshire and Gloucestershire PCTs as well as Specialist Commissioners.
The OUH provides general hospital services for children on the John Radcliffe and the
Horton General Hospital sites. The Churchill site is a centre for cancer and renal services
and other specialities, while the NOC provides orthopaedic and rehabilitation services.
The Children’s Hospital, opened in January 2007 on the John Radcliffe site, has allowed
the Trust to concentrate all of its children’s services in Oxford in one place and is a major
advance in the treatment of children in Oxfordshire and the Thames Valley.
Neonatal Services at the JR
The Newborn Unit, opened in 1972, is located in the Women’s Centre on the John
Radcliffe site, and is the only designated Neonatal Intensive Care Unit for Oxfordshire,
Berkshire and Buckinghamshire. It currently provides low dependency special care (SC),
high dependency care (HDU) and intensive care (ICU), in a service comprising 41 cots, 20
HDU/ICU and 21 SC.
The service philosophy envisages that services will be as integrated as possible, sharing
clinical and non-clinical support accommodation where appropriate. The environment
should reflect the babies’ needs for privacy and peace, and also enable their rehabilitation.
The unit serves the population within the areas covered by the northern half of the then
South Central Strategic Health Authority. Care is shared with five other neonatal units in
the area. As the designated NICU, the OUH Neonatal Unit offers complex medical
intensive care together with neonatal surgery, neonatal cardiology and neonatal
neurosurgery. The neonatal surgery, paediatric cardiology and paediatric neurosurgery
services could not exist in their current forms at the OUH without the comprehensive
support offered by the unit.
A significant number of babies are transferred to Oxford (many in utero) for immediate
surgery and/or intensive care, following delivery. This involves supporting referrals to
the specialist obstetrics service (prenatal diagnosis/fetomaternal medicine), leading to
close involvement in the work of the cardiac and other paediatric specialists, who take on
the long term care of these babies. Approximately 60% of South Central North’s
ICU/HDU activity takes place in the newborn unit at the John Radcliffe. In addition to
intensive care services, the unit also provides special care for the local catchment area.
The unit is adjacent to the Delivery Suite within the Women’s Centre.
25 March 2012
Page 12 of 43
Patients seen in the unit ‘out of area’ are referred back to their local services once the baby
is deemed well enough (care level meets HDU or SC criteria), ensuring that appropriate
care is given at all times, as close as practicable to the patient’s home.
Interim Development
On 27th August 2009 the then Trust Executive Board agreed an interim plan for the
Neonatal Unit, to address the most pressing overcrowding and infection risk issues facing
the service. This interim plan has been implemented, and is working effectively. While
the interim plan has addressed the worst problems which the unit faced previously, it has
not provided enough capacity for current and future projected demand.
SOC and OBC Approval
In September 2009, the Trust Board approved a Strategic Outline Case (SOC) for the
expansion of the Neonatal Unit. The plans set out in that SOC were developed into an
Outline Business Case (OBC). The preferred option identified in the SOC was retained
and reconsidered in the OBC. The OBC, which identified an alternative preferred option,
was approved by the Trust Board on 1st December 2011 and subsequently by NHS South
of England on 13 February 2012.
Confirmation of Trust Board approval for this FBC, once granted, will be included at
Appendix V, prior to the case being formally passed to South of England SHA for final
approval.
2.2 Business strategies
The Trust currently has six strategic goals that were generated through a strategic review
involving patient and public groups, staff and colleagues in other organisations:
SO1
To provide high quality general acute healthcare services to the population of
Oxfordshire
SO2
To provide high quality specialist services to the population of Oxfordshire and
beyond
SO3
To be a patient-centred organisation providing high quality and compassionate
care – “delivering compassionate excellence”
SO4
To be a partner in a strengthened academic health sciences system with local
academic, health and social care partners
SO5
To meet the challenges of the current economic climate and the changes in the
25 March 2012
Page 13 of 43
NHS and become a resilient, flexible and successful Foundation Trust
SO6
To achieve the integration of the ORH and the NOC during 2011/2012, realising
the benefits as set out in the business case
This project is a key part of the realisation of goal SO2.
2.3. Other Organisational Strategies
There are no other organisational strategies directly affecting the Neonatal services which
are the subject of this case.
Part B: The case for change
2.4 Investment objectives
To preserve and develop the services offered by the Neonatal Unit within the Women’s
Centre in order to:
1. Meet the commissioning requirements of South Central Specialist Commissioners.
2. Fulfil caseload needs for neonatal medical, surgical, cardiological and neurosurgical
patients within South Central North, through providing the right capacity for planned
activity, including all babies of less than 27 weeks gestation and repatriated babies
from outside the Network.
3. Improve health outcomes (e.g. by minimising infections and therefore interventions).
4. Avoid the need for the transfer of mothers, many with high risk pregnancies, out of the
JR to other hospitals due to a lack of capacity. In particular, avoid separating mothers
and babies.
5. Improve privacy and dignity and provide an improved environment for babies and
their families.
6. Become the hospital of choice within the Region for high risk pregnancies, able to
support mother and baby at all levels (obstetrics, fetal maternal, Perinatal, medical
(including cardiology and surgical) on one site, in line with DH publication Maternity
Matters (2007).
2.5 Existing arrangements
The existing arrangements are as follows: the Trust provides low dependency special care
(SC), high dependency care (HDU) and intensive care (ICU), in a service comprising 41
cots, 20 HDU/ICU and 21 SC. The theoretical capacity of the unit is 40 cots but demand
is such that the activity level equates to 41 cots at present, with an additional cot included
in nursery space when it cannot be avoided.
25 March 2012
Page 14 of 43
There are 8 Low Dependency cots at the Horton General Hospital, but these are run
separately from the Neonatal Unit, providing a service for residents in the Banbury area.
Babies requiring intensive or high dependency care from the Banbury area will be
transferred to Oxford until ready to return to Low Dependency.
Since the OBC was approved, arrangements have been made for the equivalent of 2cots of ICU activity to transfer from the Royal Berkshire Hospital in advance of the
activity flows outlined in the OBC. This activity has been separately funded by
commissioners, and has been excluded from the calculations in this FBC regarding June
2012 to March 2013.
Table 1: Existing Activity and Income
ICU cots
HDU cots
SCBU cots
Do Nothing
Current
m2
staff costs
non-pay costs
subtotal direct costs
Indirect costs
capital charge and
depreciation
corp overheads
11
9
21
41
1086
7,060,400
1,131,756
8,192,156
681,589
82,534
1,331,062
Total Revenue Costs
12,197,380
total Income
12,359,655
Surplus/(Deficit)
162,275
Activity and income in the OBC were based on 2010/11 full year activity at 2011/12
prices. This used the downside for both elements, presenting a very conservative
position. This has been carried forward in the FBC to provide a like-for-like
comparison, but the impact of increased activity which took place in 2011/12 has also
been modelled. This is shown in detail later in this FBC and in Appendix F.
25 March 2012
Page 15 of 43
Delays to the completion of the GMP process mean that the project has been delayed.
Start on site will now be in June 2012 (subject to FBC approval) rather than March 2012
and the first 4 planned new cots will open in March 2013.
2.6 Business needs
Demographic Changes
The UK population is growing, but the impact of this will be felt most in older age groups,
which will not affect maternity and thus neonatal services. Office for National Statistics
(ONS) projections do, however, show a slight increase in the total female population of
child bearing age over the next 25 years.
Changes in Clinical Practice
Changes in clinical practice result from a range of factors, but key among these are
increasing rates of premature and multiple births resulting from improvements in the
availability of IVF (both in the UK and overseas) and improving survival rates for
particularly premature babies. Both premature and multiple-birth babies are much more
likely to require some form of special, high dependency or intensive care.
There are several reasons for the increase in demand for neonatal intensive care. The birth
rate nationally and locally has increased every year since 2001. In addition, the trend in
low birth weight babies is increasing in the UK as in all developed countries. The reasons
are not exactly understood, but are due in part to an increase in births to older mothers, to
a large increase in babies born by assisted conception and to increased complexity and
success of medical intensive care.
As this can be difficult to predict, 3 growth trajectories have been independently modelled
by the Solutions for Public Health on behalf of the South Central Neonatal Network.
These show both the most likely predicted growth and possible low or high growth
alternatives and all are shown at Appendix A. This is a further development of the
activity model which was referenced in the OBC for this project. It confirms that the
capacity provided by the preferred option in this FBC will meet the needs of the Network.
National and Regional Guidance
Department of Health guidance in November 2009 has led commissioners to review the
provision of neonatal services within the northern half of the South Central region (‘South
Central North’). The review, by Specialist Commissioners and the SHA Board of
Commissioners (including PCT Chief Executives from Berkshire, Oxfordshire and
Buckinghamshire) examined options for centralising intensive care. They concluded that
their preferred option was to continue with a single NICU and therefore, in September
2010, they wrote to the Chief Executive of the ORH to ask for NICU capacity to be
25 March 2012
Page 16 of 43
increased – see Appendix B. Subsequently, both the South Central Neonatal Network and
Specialist Commissioners have confirmed that the preferred option in the OBC meets their
requirements. This is shown at Appendices C and D respectively.
In June 2011, DH issued ‘Neonatal units: Planning and design manual’. This set out
guidance on the standards to be applied in planning and designing new neonatal
facilities. The guidance was reviewed and, where appropriate was incorporated in the
plans set out in this case. This is covered in detail below.
This FBC is consistent with the Joint Strategic Needs Assessment for Oxfordshire aim of
‘improving children and young people's life chances’.
Local Issues
Demand:
The demand for neonatal intensive care services at the JR has increased significantly over
the last 10 years. Despite a significant increase in the Trust’s intensive care provision in
the last 3 years, demand for its neonatal services continues to exceed capacity and the
Network objective of meeting 95% of demand within the Network has not been met.
Figure A shows how demand has risen since 2005, with the exception of 2008 when
significant infection problems led to a reduction in the capacity of the Unit for some
months.
Figure A: Demand for NICU and HDU cots at the JR
Critical Care Activity
6000
ITU/HDU beddays
5000
4000
3000
2000
1000
0
2004 2005 2006 2007 2008 2009 2010 2011
Figure B below shows predicted demand for cots will increase if current demand trends
continue.
25 March 2012
Page 17 of 43
Figure B: Demand for NICU and HDU cots at the JR extrapolated
Critical Care Activity
8000
ITU/HDU beddays
7000
6000
5000
4000
3000
2000
1000
0
2004
2006
2008
2010
2012
2014
The demand for NICU and HDU cots at the JR in 2011/12 was 6,108 bed-days of activity
(based on M11 figures) which is consistent with the extrapolation at Figure B.
Within the Trust, demand for neonatal cots has out-grown the space available. The lack of
capacity has led to mothers and babies from within the Trust’s catchment area being
turned away. During 2010/11, data gathered by the Neonatal Networks showed that 142
babies from the South Central North area (in which the John Radcliffe Hospital is the
major provider of intensive care capacity) could not be cared for within the Network. A
further 153 requests for cots were received from outside the Network. This confirms that
there is a significant under provision of capacity within the Network.
2.7 Potential business scope and key service requirements
The South Central Neonatal Network commissioned Solutions for Public Health (SPH) to
develop an activity model which predicts the capacity required for the network. A copy
of the model is at Appendix A. The model identifies the number of cots needed by levels
of care, with predictions for ICU, HDU and Low Dependency. In practice, cots equipped
for ICU and HDU are best set up and equipped for ICU levels of care, as recommended in
the June 2011 DH guidance, as the requirements are very similar and it is much more costeffective and flexible to ensure the ICU level of need is met. The Trust has, therefore,
assessed ICU and HDU cot numbers separately but planned for new cots to be set up to
the same standard for both to allow maximum flexibility.
The model makes a prediction of activity up to 2021, with specific predictions for 5 and 10
years hence. This shows that at:
25 March 2012
Page 18 of 43
•
Low levels of growth, an eventual maximum of 48 cots (16 NICU, 10 HDU and 22
Low Dependency)
•
Medium levels of growth, an eventual maximum of 52 cots (17 NICU, 11 HDU and
24 Low Dependency)
•
High levels of growth, an eventual maximum of 54 cots (18 NICU, 12 HDU and 24
Low Dependency)
These predictions have been taken as the basis for the capacity to be developed and
reflected in this business case. The low growth requirement becomes the minimum
potential business scope, the medium level of growth along with capacity to meet some
external demand is the intermediate scope and the high level of growth is based on both
an assumption of attracting activity from outside the Network because of unmet need in
other areas or continued growth beyond a 5-year period gives the maximum scope. The
maximum business scope represents the long-term need for the area, and includes
provision for an operating theatre so that babies do not need to be transported across the
hospital site from the Newborn Intensive Care Unit to paediatric theatres for surgical
procedures.
Table 2: Business Scope and Key Service Requirements
Potential Business
Scope
Key Service
Requirements
Minimum
Provide sufficient
cots for network
needs at low level of
growth (48 cots)
Intermediate
Provide sufficient
cots for network
needs at medium
levels of growth (52
cots) to allow for
future needs and/or
transfers in from
outside network
Maximum
Provide sufficient
cots for network
needs, and assume a
proportion of unmet
need outside the
network will be
transferred in (62
cots) plus dedicated
operating theatre
At least 48 cots,
At least 52 cots,
At least 62 cots,
allowing a minimum allowing a minimum allowing a minimum
of 26 ICU/HDU cots of 28 ICU/HDU cots of 38 ICU/HDU
cots. Operating
theatre
The number of new cots to be provided is determined not simply by the overall numbers
of cots needed, but also by the implications of building an extension to the current unit. If
cot spaces are lost in order to allow the construction of the extension, they will need to be
replaced to maintain overall numbers.
2.8 Main benefits criteria
This section describes the main outcomes and benefits associated with the implementation
of the potential scope in relation to business needs.
25 March 2012
Page 19 of 43
Satisfying the potential scope for this investment will deliver the following high-level
strategic and operational benefits. The benefits have been assessed by a cross-section of
stakeholders, including clinicians, administration staff and parents.
By investment
objectives the benefits identified are as follows:
Table 3: Investment objectives and benefits
Investment Objectives
1. Meet Commissioning
Requirements
2. Fulfil caseload needs
3. Improve health
outcomes
4. Avoid transfers
5. Improve privacy and
dignity
6. Hospital of choice
Main benefits criteria
Cash releasing: repatriate activity currently
outside network (saving to commissioners as
costs are higher in London where most out –ofNetwork babies are cared for)
Qualitative: meet national quality standards:
centralise intensive care for local babies.
Accommodate all babies of less than 27 weeks
gestation.
Cash releasing: repatriate activity currently
outside network (saving to commissioners)
Non- cash releasing: allow increased activity in
other specialties, generate additional income for
the NNU
Qualitative: provide appropriate facilities for
babies needing specialist care
Non- cash releasing: maintain or further reduce
incidence of HAI, and thus reduced lengths of
stay
Qualitative: potential reduction in long-term
morbidity and mortality
Non- cash releasing: reduced risk of unit closures
as new area will have separate, new plant
Qualitative: improved care for local families and
babies delivered at the JR site; improved
transport service to network as a whole with
overall reduced ex-utero transfer of sick infants.
Qualitative: improved privacy for families within
the Neonatal Unit
Non- cash releasing: increased activity, providing
additional income for the NICU
Qualitative: improved service for babies with
complex needs
The main ‘dis-benefit’ identified is the potential for reduced capacity which will be in
place for at least a month during the final stage of construction, as the construction team
‘break through’ from the existing unit to the new extension. The Trust is seeking to
mitigate this disbenefit through careful scheduling of the construction work, to maximise
25 March 2012
Page 20 of 43
the cot numbers available throughout the construction process.
Since the OBC was approved, the Trust has developed detailed plans for internal
decanting within the Newborn Intensive Care Unit. These are shown at Appendix R.
These plans mitigate the activity risks posed by the construction phase of the project.
2.9 Main risks
The main business and service risks associated with the potential scope for this project are
shown below, together with their counter measures.
Table 4: main risks and counter measures
Table 4 has been updated for the FBC, as has the Risk Register at Appendix E.
Main Risk
Procurement Risks:
• that costs will escalate
beyond funds available
Design:
• That design will not
meet user needs
Development risks:
Supplier, Specification,
Timescale
• Change management
and project
management:
recruitment of required
new staff
Implementation Risks:
• Implementation timing
risk
• Construction effects (eg
noise) on operational
services
Operational Risks:
Counter measures
• Early implementation of P21+ has identified Careful
cost control, monitored at each Project Group meeting
and cemented by GMP.
• Early involvement of User Group with experience of
expansion projects, continued involvement of User
Group and clear sign-off of designs by key stakeholders
• Development Construction Risks will be mitigated
through the use of the P21+ process, which has been set
up to minimise project risks.
• A detailed staffing plan, including recruitment and
training needs, has been developed for this FBC and is
at Appendix O. It is intended to ensure staff required
are in place when needed.
Termination Risks:
•
•
•
•
Detailed internal decant plans completed for activity
during construction phase
Close liaison with contractors before and during
construction
There are no operational risks specific to these works
which fall outside the risks generally managed by the
Trust
None, as contract is for construction not services
A risk register showing risks involved in the project is at Appendix E.
25 March 2012
Page 21 of 43
2.10 Constraints
The project is subject to the following constraints:
•
•
Restrictions on the space available for expansion, and in particular the need not to
prejudice future growth of the unit or other services at the JR
Availability of capital, which is limited to that available within the Trust as no external
source of capital can be accessed. This is £0.5m in 2011/12 and £3m in 2012/13.
Since the OBC for the project was approved, £2.8m of public dividend capital has
been allocated to the Trust by South of England SHA for this project. The impact of
this capital is detailed in the financial case below.
2.11 Dependencies
The project is supported by plans to increase capacity and improve patient flows within
the Women’s Centre to accommodate the increase in complex referrals, currently thought
to be between 40-60 high-risk deliveries per year based on network activity modelling
(Appendix A). There are projects underway to provide an early birth assessment area
adjacent to delivery suite which will improve delivery suite capacity. The Observation
Area will also have three additional high dependency beds for mothers and there are
plans to increase the number of obstetric consultants.
25 March 2012
Page 22 of 43
3. The Economic Case
3.1 Introduction
In accordance with the Capital Investment Manual and requirements of HM Treasury’s
Green Book (A Guide to Investment Appraisal in the Public Sector), this section of the
FBC documents the wide range of options that have been considered in response to the
potential scope identified within the strategic case.
3.2 Critical success factors
The critical success factors (CSFs) shown within the SOC and OBC were as follows:
CSF1: that the cots required are available as quickly as possible
CSF2: that the implementation of agreed changes disrupts existing services as little as
possible
CSF3: that future development is not unduly constrained by the new facilities
These were re-visited in the context of the OBC and remain valid.
3.3 The long-listed options
The long list shown within the SOC and OBC was as follows:
Table 5: long list – summary of inclusions, exclusions and possible options
Option
Shortlisting Decision
A
Do Nothing
Shortlist as baseline for comparison –
Option 1
B
Do Minimum – Redevelop
existing space
Do not shortlist as will not increase
available cots, despite disruption
C
Use space vacated by other
services in the JRII building
Do not shortlist, as it would be too far
from the Delivery Suite
D
Extend Children’s Hospital
Do not shortlist, as it would be too far
from the Delivery Suite
E
Use space vacated by other
services in the Women’s
Centre building
Do not shortlist, as no space to be
vacated
F
Extend existing
Shortlist - Option 3
25 March 2012
Page 23 of 43
Option
Shortlisting Decision
accommodation to provide
a completely new neonatal
area with 60 cots. Preferred
Option from SOC.
G
Extend existing
accommodation to provide
a new neonatal area,
continuing to use existing
space, total of 53 cots
Shortlist - Option 2
H
Build a new Women’s
Centre, including neonatal
facilities and a Delivery
Suite, adjacent to the
Children’s Hospital
Do not shortlist, as insufficient funds
would be available so clearly
impracticable
The options have been re-visited in the context of the FBC and remain valid. Plans for
Option 2, the preferred option, have been developed in considerably more detail and
are shown at Appendix H.
3.4 Short-listed options
The short-listed options are shown in detail below. A detailed Revenue Costs Model has
been created to compare the revenue and capital costs of the 3 options. This is at
Appendix F. The Revenue Costs Model compares all 3 options in details, and also
includes a financial assessment of the implications of opening only 4 of the additional cots
initially as well as once all cots are operating. This was done to ensure that the project is
financially viable from the outset.
Option 1 – do nothing: A floor plan of the existing unit is at Appendix G.
This option provides the benchmark for VFM and is predicated upon the following
parameters:
Scope:
provides what is currently available
Solution:
no change, including use of cots at higher than recommended
occupancy rates
25 March 2012
Page 24 of 43
Implementation:
immediate
Funding:
no change
Option 2 –
extend existing accommodation to provide a maximum of 53 cots, 16 of
them in new facilities. Detailed 1:50 plans of Option 2 are at Appendix H.
This option provides:
Scope:
provides enough cots to meet predicted Network demand, including
all babies of less than 27 weeks gestation and repatriated babies from
outside the Network, and allow for limited further expansion of
activity
Solution:
16-cot extension to rear of current NNU which will allow a gradual
expansion of activity as follows:
Cot Types
ICU/HD
U
SCBU/
rooming
in
Total
2011
Activity
baseline
11/9
March
2013
Sept
2013
March
2014
Sept
2014
March
2015
15/9
17/9
19/9
20/10
20/10
21
21
21
21
21
23
41
45
47
49
51
53
The 8-cot bay configuration is the most efficient, so 2 bays will deliver
16 new cots. Six cot spaces (equivalent to 7 cots’ of activity at current
occupancy levels) will be lost in the construction of the extension, and
2 additional cot spaces could be created in space on the Unit which is
currently unused, so there will be an overall increase of 12 cots once
the Unit has reached its maximum capacity.
Opening the cots in a phased programme will allow a viable staffing
plan to be developed and implemented, to ensure that staff are
available when they are needed. If demand does not increase at the
predicted rate, then the rate at which cots are opened can be slowed
or stopped. The Neonatal Network Transport service is managed by
the OUH Trust, and will enable a degree of control over the rate at
which activity is transferred to the new Unit.
The proposal also includes the introduction of an Electronic Patient
Record (EPR) system throughout the ICU/HDU/LDU area. This will
allow much more efficient use of medical staff and thus reduce
ongoing revenue costs.
25 March 2012
Page 25 of 43
The new cots will be on the first floor of a 2-floor extension, on the
same level as the existing Neonatal area, with new plant to serve the
new area on the ground floor.
Service delivery:
current service model to be used in new facilities with cots used at
recommended occupancy rates as shown in the network Activity
Model at Appendix A.
Implementation:
construction from Q1 12/13 to Q4 12/13, occupation Q4 12/13
Funding:
Following approval of the OBC, a final GMP for the project has
been received, with a total build cost of £3.453m including VAT. A
further £22k will be spent on equipment during the construction of
the extension. The Trust was allocated £2.8m of capital for this
project by South of England SHA, which was used during 2011/12
to fund equipment and some site preparation works. Previous
plans for a charitable appeal for equipment costs have
consequently been revoked.
This option will produce an overall annual surplus rising to £231k
with all cots open
Option 3 – extend existing accommodation to provide a maximum of 62 cots, all in new
facilities, and a dedicated operating theatre. A floor plan of Option 3 is at Appendix J.
This option provides:
Scope:
provides enough cots to meet predicted Network demand and
assumes some activity transferred in from beyond Network (unmet
demand from other network areas)
Solution:
62-cot extension to side of current NNU, existing space reconfigured
for use by non-clinical service elements (offices, storage, parent
accommodation) and a dedicated operating theatre
Service delivery:
current service model to be used in new facilities
Implementation:
construction from Q2 12/13 to Q2 14/15, occupation Q3 14/15
Funding:
capital cost of £27.43m, supported by charitable funding of £1.82m for
equipment. The campaign would only launch upon approval of the
FBC by the SHA, OUH Trust Board and OUH Charitable Funds
Section 11 Trustees.
Overall annual revenue loss of £2.37m. The
increased capital charges on this development are the principal
25 March 2012
Page 26 of 43
reason for the annual loss which would be made.
On the basis of the details set out above, the only affordable way in which the Trust
can meet the project objectives is to implement Option 2. Option 1 will not provide the
capacity required by commissioners or the Network, while Option 3 is unaffordable.
Option 2 is, therefore, the preferred option.
[Sections 3.5 to 3.10 including Tables 6 to 14 below omitted, as economic appraisal will not
provide any further confirmation regarding relative value for money of the options]
25 March 2012
Page 27 of 43
4. The Commercial Case
4.1 Introduction
This section of the FBC outlines the proposed deal in relation to the preferred option
outlined in the economic case. This is for the provision of a 16-cot extension under a P21+
contract. The ProCure21+ National Framework is a framework agreement with six
Principal Supply Chain Partners (PSCPs) selected via an OJEU Tender process for certain
types of capital investment construction schemes in England. The Trust is able to select a
Supply Chain for this project without having to go through a separate OJEU procurement
exercise.
This project has been combined with two other, smaller projects (the Kadoorie Centre and
the Wolfson Centre) within the Trust to form an overall programme of work which it was
anticipated would be more attractive to potential P21+ partners than any of the projects
alone. This proved to be a sensible assessment, and following a competition between 5
potential PSCPs, Willmott Dixon has been identified as the PSCP for this project. Willmott
Dixon’s supply chain Architects will be Keppie Design and their M&E Engineers will be
Cundall.
Since 2005 Willmott Dixon has delivered over 150 healthcare projects including 10
Intensive Care Projects (including NICU) and 18 Research Facilities. In respect of their
specific experience of Neonatal/ Intensive Care and Maternity environments, Willmott
Dixon’s supply chain Architect has recently designed the following schemes:
•
Maternity Hospital, Cork University Hospital: 66 obstetric beds, 20 pregnancy
related gynaecology beds, 34 cot neonatology unit, supporting facilities.
•
NICU Extension, Royal Blackburn Hospital: Extension to the existing facility,
providing 14 intensive care cots in a new modern and flexible care environment.
The design of the new facilities will be essential to its success.
4.2 Required services
The required services are the construction of an extended neonatal facility, consisting of 16
cot spaces. The planned extension is shown at Appendix H. The drawings have been
signed off by all key stakeholders, including Infection Control and the key users. Some
derogations from the DH Estates guidance issued in June 2011 have been agreed.
For the FBC, derogations have been assessed in detail. They are shown at Appendix P.
Key derogations are:
•
Cot bay sizes are slightly smaller than the guidance would suggest, and in a slightly
different configuration. The size and layout proposed are the result of considerable
work within the unit and with the User Group, including membership from the
25 March 2012
Page 28 of 43
infection control team:
all support the proposals as a safe and effective
configuration, as is shown in the plans at Appendix H.
•
The project proposes 8 cots per bay (rather than 6) because of the need for a total of
24, rising to 31 ICU/HDU cots. With 8 to be retained initially and a further 5
potential cot spaces, the overall requirement is best met with 2 x 8 cot bays. This is
also judged locally to be the most efficient configuration for nursing.
•
The proposal is for wall mounted services rather than the pendants recommended
by the guidance. Wall mounted services meet clinical needs and practise in the
Unit, while pendants were considered to make the environment more intimidating
for parents by increasing the sense of technology being in control.
•
Although a new build facility would normally be expected to achieve a BREEAM
rating of ‘Excellent’, in this instance the very small size of the extension relative to
the size of the John Radcliffe site means that only a rating of ‘Pass’ is possible. The
Trust is undertaking a range of other efficiency measures which will improve the
Trust’s overall BREEAM rating.
In order to facilitate future expansion of and improvements to the ventilation system
within the Women’s Centre, in areas not included in the project detailed in this FBC,
the Plant Room at Level 1 of the new extension below the new Clinical space will, as
part of this project, be physically sized such that it could accommodate additional
mechanical ventilation equipment and associated services. This will permit the Trust to
proceed with the option separately after completion of this project when funds and
circumstances permit. A detailed survey in this respect is planned and covered in the
GMP confirmation letter at Appendix Q at a cost of £20,000. The survey will generate
recommendations and proposals for consideration in due course but this process will
not be allowed to delay this project.
The mechanical ventilation system to the existing building is around forty years old,
unsatisfactory in a number of respects, and in need of upgrading not only to improve
the environment for patients, staff, and visitors but also to reduce risk related to age,
state, and condition.
4.2 (i) Design
For the FBC, detailed designs have been developed. These show the content of the
scheme at 1:50 scale and are accompanied by Room Data Sheets for all rooms in the
extension. These are shown at Appendix H. These designs were developed with the
close involvement of the Project Group, and in particular the clinical team led by Dr
Eleri Adams, the Clinical Director, and Kate Convery, the Unit Matron. All designs and
room data sheets have been signed off by Trust leads for Infection Control, Fire Risk,
relevant mechanical and electrical specialists and ‘Authorised Persons’.
25 March 2012
Page 29 of 43
The AEDET Evolution tool has been used to assess the designs, and this resulted in
scores of between 4.6 and 5.7. The appraisal was carried out by the Project Team and is
at Appendix U, and it shows that the designs score well against all critieria.
4.3 Potential for risk transfer
The general principle is that risks should be passed to ‘the party best able to manage
them’, subject to value for money. Under the P21+ process, risks are allocated
accordingly, with an emphasis on the joint management of risk and a mutual process of
risk reduction.
This section provides an assessment of how the associated risks might be apportioned
between the Trust and its P21+ partners, Willmott Dixon. In accordance with standard
P21+ arrangements, the following will apply, subject to agreement of the final contract:
Table 15: risk transfer matrix
Risk Category
1. Design Risk
2. Construction and Development risk
3.Transition and Implementation risk
4. Availability and performance risk
5. Operating risk
6. Variability of revenue risks
7. Termination risks
8. Technology and obsolescence risks
9. Control risks
10. Residual value risks
11. Financing risks
12. Legislative risks
13. Other project risks
Potential Allocation
Public
Private
Shared















4.4 Proposed charging mechanisms
The Trust intends to make payments in relation to the proposed development in line with
standard P21+ project terms. As the contract is for the construction of the extension, and
does not include operation of the new facilities, payments will be complete once the
facilities are satisfactorily in place.
A capital cash flow forecast is included in the FBC forms at Appendix I.
25 March 2012
Page 30 of 43
4.5 Proposed contract lengths
The contract length is anticipated to be approximately 9 months, from June 2012 to
February 2013 inclusive.
The contract length has not changed since OBC, but the start and finish dates have
moved back by 3 months.
4.6 Proposed key contractual clauses
The key contractual clauses are as in the standard P21+ contract. This will include
compliance with all relevant NHS standards other than where derogations have been
agreed as noted at para 4.2 above.
4.7 Personnel implications (including TUPE)
It is anticipated that the TUPE – Transfer of Undertakings (Protection of Employment)
Regulations 1981 –will not apply to this investment as it is a straightforward construction
project, with no services being provided.
For the FBC, a detailed staffing plan has been developed. This shows how many staff
will be needed at each stage of the project, including during the construction period,
and how and when they will be recruited. The staffing plan is at Appendix O.
4.8 Procurement strategy and implementation timescales
The procurement strategy will follow the standard process for P21+ projects.
Business Case timescales are set out in Appendix K.
Projected
For the FBC, a detailed project programme has been developed. This is at Appendix K.
A final ‘Guaranteed Maximum Price’ (GMP) has been agreed for the scheme. This is
shown at Appendix Q and headline details are as follows:
•
•
•
•
The project will be completed with a construction cost of £2,420,662 plus VAT
Early works to the value of £30k will be carried out in advance of the formal
Stage 4 agreement. The Trust will carry the financial risk of these works.
The project will start on site on 11th June 2012 and construction will be complete
by 8th February 2013
The agreement is subject to approval by both the Trust Board and South of
England SHA.
25 March 2012
Page 31 of 43
4.9 FRS 5 accountancy treatment
The assets underpinning delivery of the service will be on the balance sheet of the Trust.
25 March 2012
Page 32 of 43
5.0 The Financial Case
5.1 Introduction
The purpose of this section is to set out the forecast financial implications of the preferred
option (as set out in the economic case section) and the proposed deal (as described in the
commercial case).
5.2 Impact on the Trust’s income and expenditure account
For the FBC, all financial details have been reviewed and, where necessary, updated. In
particular:
•
£2.8m of capital has been granted to the Trust to support the project. This
funding was received and spent (on equipment and some preparative works) in
2011/12. The revenue model has been adjusted to take account of the impact of
this injection of funds, and the consequent decision not to launch a fundraising
campaign to support the implementation of the project. Changes include the
requirement to pay VAT on equipment which would not have been the case with
most charitably donated assets and the purchasing of all equipment at the start
of the project rather than on a phased basis. Depreciation on equipment
purchased in March 2012 but not brought into use until the new extension is
fully open at the end of 2013 will not be charged until 2013/14. The equipment
purchased is shown at Appendix F. The list includes some items which were to
have been funded from the Trust’s equipment replacement programme (MEPG)
but which were purchased as part of this exercise in order for the Trust to benefit
from economies of scale in purchasing. The impact of these items, such as
maintenance costs and depreciation, is included in other Trust budgets so it has
been excluded from the revenue impact calculated for this project.
The changes in equipment expenditure between OBC and FBC is as follows:
Equipment for clinical areas charitably funded
Equipment for clinical areas - publicly
funded
Other equipment
purchase during construction - publicly
funded
MEPG
total spend equipment
EPR
VAT
total
•
OBC
FBC
1,562,201
135,025
2,008,152
18,718
27,434
1,697,226
272,270
22,504
1,992,000
-308,502
1,745,803
500,000
449,161
2,694,963
The GMP for the project has been identified (see Appendix Q) and included in
25 March 2012
Page 33 of 43
•
•
•
•
•
•
the costs, both as a capital cost and in terms of revenue consequences.
A detailed staffing plan has been developed (see Appendix O) showing when
staff will be recruited
Detailed projected costs for clinical support services have been identified, to
ensure that the costs can be managed within the income available from the
increased number of cots.
The contribution to corporate overheads required because of the extension has
been recalculated. It had been based on a ratio of costs (15%) but in practice, the
extension will require funding for some overheads (such as cleaning, linen and
portering) but will not make a material difference for others (such as HR and
Finance). Accordingly, actual cost increases have been assessed and included in
the revenue model.
Revenue funding for 4 en-suite double rooms in Arthur Sanctuary House have
been included in the project costs, to provide accommodation for parents on an
‘as required’ basis.
Revenue costs for the construction phase of the project have been calculated on a
month-by-month basis, taking account of the impact of construction on cot
numbers (see internal decant plan at Appendix R) and the cost of additional staff
as they are recruited. This detailed, month-by-month assessment of the revenue
consequences of the project for the year of construction is at Appendix Fi. This
analysis shows that the NICU will operate with costs within income levels
throughout the construction period.
Optimism Bias has been reduced to 0, reflecting the fact that a Guaranteed
Maximum Price is now in place.
Details below reflect the additional information which is now available.
The anticipated payment stream for the project over its intended life span is set out in
Appendix F and in the following table:
Table 16: Summary of Financial Appraisal for Preferred Option
ICU cots
HDU cots
Do Nothing
Current
SCBU cots
staff costs
non-pay costs
subtotal direct costs
Indirect costs
capital charge and
25 March 2012
11
9
21
41
16 Cot Expansion
16 Cot Expansion
Option 2 2013/14
Option 2 - final
ICU cots
16 ICU cots
20
HDU cots
9 HDU cots
11
SCBU
cots
21 SCBU cots
22
46
53
7,024,372
1,131,756
8,156,128
7,776,099
1,456,360
9,232,459
9,501,075
1,774,325
11,275,400
678,666
82,534
1,012,741
530,848
1,351,185
530,848
Page 34 of 43
depreciation
corp overheads
HGH costs
Total Revenue
Costs
1,325,219
1,910,039
1,427,077
1,910,039
1,427,077
1,910,039
12,152,586
14,113,163
16,494,548
total Income
12,359,655
14,363,255
16,725,255
207,069
250,091
230,706
Surplus/(Deficit)
The Revenue Costs Model at Appendix F sets out the revenue consequences of the project
in detail. It has been populated on a pessimistic basis, assuming higher rather than lower
costs and lower rather than higher income wherever a judgment has had to be made.
For the FBC, all costs have been identified on an ‘actual’ basis, rather than ratios being
applied to existing costs. A detailed staffing plan ensures that pay costs (the major
change to revenue) are precise. The ‘pessimistic’ principle has been applied in
assuming that new staff will be paid the average of existing staff on the relevant grade,
rather than that all new staff will be appointed at the bottom of a scale. This allows for
the recruitment of experienced staff from other units, should they wish to apply.
In line with this pessimistic principle, no increase in revenue for other clinical services
supported by the Neonatal Intensive Care Unit has been assumed. For example, although
the development will enable an expansion of high-risk maternity services which is
predicted to deliver around £250k per year in increased revenue surplus, this has not been
included.
5.3 Impact on the balance sheet
The proposed expenditure will increase the value of the Trust asset base, although the
increase will not be material given the overall scale of the Trust asset base.
5.4 Overall affordability
The project will be affordable for the Trust. This will be the case from initial opening with
4 additional cots, and the affordability will improve as further cots open over time.
For the FBC, an analysis of income and expenditure during the construction phase of
the project has been produced. This shows that the unit will secure enough income to
cover its costs during the construction phase.
25 March 2012
Page 35 of 43
6. The Management Case
6.1 Introduction
This section of the FBC addresses the ‘achievability’ of the scheme. Its purpose, therefore,
is to build on the SOC and OBC by setting out in more detail the actions that will be
required to ensure the successful delivery of the scheme in accordance with best practice.
6.2 Programme management arrangements
The scheme is not part of a wider programme, but is intended only to address the issues
around neonatal capacity within the Trust. There is not, therefore, a separate programme
management structure. The Children’s and Women’s Divisional Executive functions as
the Project Board within the Trust and the Divisional Director for Children’s and
Women’s Division, Dr Anne Thomson, is the Project Sponsor.
6.3 Project management arrangements
The project is being managed in accordance with the principles of PRINCE 2
methodology.
6.3.1 Project reporting structure
A Project Group has been established which meets monthly and reports in to the
Divisional Executive as Project Board. Membership of the Project Group includes:
Table 17 - NICU Project Group Members List
Tony McDonald – Project
Director
Divisional General Manager
Children's & Women's Division
Eleri Adams
Clinical Lead, Neonatal Unit
Kate Convery
Matron, NNU
Alison Clark
Equipment Lead for Estates and Parent
representative
Susan Brown
Senior Communications Manager
Craig Merrifield
Estates Development Manager
Geoff Wakeling
Project Manager - Estates Development
Team
Adele Winsey
Finance Manager, Children's & Women's
Division
25 March 2012
Page 36 of 43
Sara Taylor
Corporate Planning Manager
Una Vujakovic
Neonatal Network Lead and Specialist
Services Commissioner
Lily O’Connor
Infection Control
Alison Massingham
Administration & Project Support
Lynda Atkins
FBC Project Manager
Following the allocation of £2.8m of capital by the SHA, a charitable appeal supporting
the project is no longer required. Accordingly, charitable bodies are no longer
represented on the Project Group. The NICU team continues to work closely with both
SSNAP and the hospital Charitable Funds team on fundraising issues more generally.
A formal project structure has also been established to manage the procurement and
construction of the project. This is structured as follows:
P21+0155 Oxford University Hospitals Scheme Team Structure
P21+0155 Oxford Radcliffe Hospitals Scheme Team Structure – Membership
OUH Scheme
25 March 2012
Core Group
P21+0155.01
Kadoorie Centre
Core Group
P21+0155.02
Newborn Intensive
Page 37 of 43
Core Group
P21+0155.03
Wolfson Centre
Principals Group
Care Unit
Mark Trumper
Trust Project
Director
Craig Merrifield
Trust Project
Manager
Martin Adie
PSCP Operations
Director
Stephanie Brada,
PSCP Development
Manager
Reference
P21+0155.01
Kadoorie Centre
Project Team
Structure
Reference
P21+0155.02
Newborn Intensive
Care Unit Project
Team Structure
To be confirmed
Richard Clark,
PSCP Project
Manager
Terms of Reference
Review Monthly Monitoring System submitted to DH & exception reporting of Projects.
Frequency
Monthly
Note membership will flex, dependent on tasks being reviewed.
25 March 2012
Page 38 of 43
P21+0155.02 Newborn Intensive Care Unit Project Team Structure
P21+0155.02 Newborn Intensive Care Unit – Membership
Principals
Group
Tony
McDonald
Trust General
Manager
Core Group
(Delivery)
Design
Team
Stephen
Hill
PSCP
Design
Manager
Eleri Adams
Eleri Adams
Neil
Trust, User
Trust, User
Whatford
Representative Representative PSCM
Architect
25 March 2012
Geoff
Wakeling
Trust Project
Manager
Commercial
Neil
McMullen
Trust Cost
Advisor
Alan
Redman
PSCP Cost
Planner
Equipment
Alison Clark
Trust
Assistant
Planning
Manager
Sharon Gilbert
Trust
Procurement
Manager
Commissioning/
Handover
Alison Clark
Trust Assistant
Planning
Manager
Richard Clark
PSCP Project
Manager
Richard Clark
PSCP Project
Manager
Sara Lees
PSCM
Structural
Eng
Eleri Adams
Matt Brooks
Trust, User
PSCP
Representative Operations
Manager
Matt Brooks
PSCP
Operations
Manager
William
H D’Arcy
PSCM
Mech
Eng
Norma
Preedy, Trust
Clinical
Engineering
Page 39 of 43
Geoff Wakeling
Client Project
Manager
Others
tbc
User Rep,
APs/AE’s,
Infection
Control, Safety
Risk,
Operational
Estates, CDM-C,
and others tbc
Terms of Reference
Frequency - To be established
Note membership will flex dependent on tasks being reviewed.
For the FBC, an Equipment Project Group has been established to manage the
identification, procurement and installation of equipment for the project. Members
are:
Tony McDonald – Project Director, Divisional General Manager, Children's &
Women's Division
Simon Lazarus – Deputy Director of Finance
Eleri Adams - Clinical Lead, Neonatal Unit
Kate Convery - Matron, NNU
James Richards – Interim Head of Procurement
Mathew Edwards – Senior Procurement Manager
Clare Watts – Buyer, Procurement
Alison Clark - Equipment Lead for Estates and Parent representative
Alison Massingham - Administration & Project Support
Norma Preedy - Medical Devices Strategy & Project Manager, Clinical Engineering
Sharon Gilbert - Assistant Procurement Manager, Estates Corporate Services
Lynda Atkins - OBC Project Manager
6.3.2 Project roles and responsibilities
These are as set out above.
6.3.3 Project plan
25 March 2012
Page 40 of 43
The proposed project plan is set out in Appendix K. Key dates are as follows:
Table 18: project plan
Milestone Activity
FBC approval by Trust
FBC approval by SHA
Start on Site
Construction complete
Commissioning
Services running
Month
May 2012
June 2012
June 2012
February 2013
March 2013
March 2013
Since the OBC for this project was approved, the Trust has been granted full planning
permission for the proposed development. This is shown at Appendix T. The updated
Project Plan is at Appendix K.
6.4 Use of special advisers
As this is a relatively small-scale project, with a standard procurement process, no special
advisors other than for estates have been engaged by the Trust.
Table 19: Specialist Advisors
Specialist Area
Quantity Surveyor (Cost Advisor)
Adviser
Neil McMullen, Regional Director,
Cyril Sweett Limited
6.5 Outline arrangements for Change Management
A detailed Staffing Plan (Appendix O) and an Internal Decant Plan (Appendix R) have
been developed for this FBC. These show:
• How many staff will be needed at each stage of the project, including during the
construction period, and how and when they will be recruited. Recruitment has
been timed to allow induction training before staff are allocated to rotas.
• How the space and cots available within the NICU will be managed during the
construction phase of the project in order to ensure maximum availability of cots
while minimising the impact of construction (eg noise and vibration) on the
babies being cared for, their families and the staff in the Unit.
The changes to take place within the Newborn Intensive Care Unit will be led and
managed by Dr Eleri Adams, the Clinical Lead, and Kate Convery, the Matron. The major
changes to take place are the recruitment of additional staff for the additional cots,
25 March 2012
Page 41 of 43
implementation of the full EPR system and clinical responsibility for maintaining safe and
sustainable services during build implementation. A detailed staffing plan, showing how
and when staff will be recruited has been developed for the FBC.
An Equality Impact Assessment is at Appendix N. This demonstrates that the proposed
extension will very slightly improve equality of access to the Unit, and will not result in
any detrimental changes.
6.6 Outline Arrangements for Benefits Realisation
Benefits realisation will follow the same management process as change management,
with a plan in place for the FBC which will be implemented by the Unit team under the
overall supervision of the Divisional Board. The Benefits Realisation Plan is at Appendix
M. All benefits lie within the scope of the team other than those associated with the
construction of the new facilities.
6.7 Outline Arrangements for Risk Management
A copy of the project risk register is attached at Appendix E. This details who is
responsible for the management of risks and the required counter measures, as required.
For the FBC, the Risk Register has been compiled as part of the P21+ process. This is at
Appendix E.
6.8 Outline arrangements for post project evaluation
For the FBC, outline arrangements for post project evaluation have been established.
These are shown at Appendix S.
The outline arrangements for post implementation review (PIR) and project evaluation
review (PER) have been established in accordance with best practice.
6.8.1 Post implementation review (PIR)
These reviews ascertain whether the anticipated benefits have been delivered and are
timed to take place immediately after the new facilities open and then 2 years later to
consider the benefits planned.
6.8.2 Project evaluation reviews (PERs)
The project will be evaluated in the first few months after commissioning to evaluate the
design and construction process, and then 2 years after opening to evaluate the changes to
patient flows and clinical care.
25 March 2012
Page 42 of 43
6.9 Gateway review arrangements
The impacts/risks associated with the project have been scored against the risk potential
assessment (RPA) for projects. The RPA score is 24, indicating that the project is relatively
low risk. The report is attached at Appendix L.
6.10 Contingency plans
In the event that this project fails, the Unit will continue to function as it does at present.
There is no scope for extending the capacity of the Unit without a physical extension of
the facilities.
Signed:………………………………………………………….
Date: …………………………………………………………
Senior Responsible Owner
Project Team
25 March 2012
Page 43 of 43
Appendix A - Neonatal Network Capacity Model Oct 2011
Model of Oxford Capacity Expansion - Using 1 year Growth
JR
IC declared cots 11/12
HD declared cots 11/12
SC declared cots 11/12
IC cots needed, from activity
HD cots needed, from activity
SC cots needed, from activity
IC extra cots needed
HD extra cots needed
SC extra cots needed
MK
10
10
20
11
9
21
1
-1
1
RBH
3
0
13
1
2
15
-2
2
2
WPH
4
6
13
4
4
15
0
-2
2
Bucks
4
4
20
4
4
18
0
0
-2
2
3
17
2
3
16
0
0
-1
Change in activity associated with Under 27wk Infants
JR
Episodes
Change in IC activity
Change in HD activity
Change in SC activity
Change in IC cots needed
Change in HD cots needed
Change in SC cots needed
30
673
162
76
2.5
0.6
0.2
IC predicted cots (activity)
HD predicted cots (activity)
SC predicted cots (activity)
13
10
21
MK
-2
-11
-24
-23
-0.0
-0.1
-0.1
RBH
-13
-299
-64
-16
-1.1
-0.2
-0.1
1
2
15
WPH
-15
-363
-74
-36
-1.3
-0.3
-0.1
3
4
15
3
4
18
Bucks
0
0
0
0
0.0
0.0
0.0
2
3
16
Change in activity associated with Ventilated babies
JR
Episodes
Change in IC activity
Change in HD activity
Change in SC activity
Change in IC cots needed
Change in HD cots needed
Change in SC cots needed
21
268
81
74
1.0
0.3
0.2
IC predicted cots (activity)
HD predicted cots (activity)
SC predicted cots (activity)
14
10
21
MK
0
0
0
0
0.0
0.0
0.0
RBH
-8
-82
-38
-38
-0.3
-0.1
-0.1
1
2
15
WPH
-12
-175
-43
-36
-0.6
-0.2
-0.1
3
4
15
2
4
18
Bucks
-1
-11
0
0
-0.0
0.0
0.0
2
3
16
Repatriating Out of Network Activity
JR
MK
WPH
Bucks
0
1
44
0.0
0.0
0.1
0
15
83
0.0
0.1
0.3
0
10
76
0.0
0.0
0.2
0
27
2
0.0
0.1
0.0
IC predicted cots (activity)
HD predicted cots (activity)
SC predicted cots (activity)
16
10
22
1
2
15
3
4
15
2
4
18
2
3
16
MEDIUM GROWTH MODEL
Change in IC activity
Change in HD activity
Change in SC activity
Change in IC cots needed
Change in HD cots needed
Change in SC cots needed
-17
-8
0
-0.1
-0.0
0.0
-1
-2
0
-0.0
-0.0
0.0
-1
-2
0
-0.0
-0.0
0.0
-2
-3
0
-0.0
-0.0
0.0
Bucks
-1
-2
0
-0.0
-0.0
0.0
IC predicted cots (activity)
HD predicted cots (activity)
SC predicted cots (activity)
16
10
22
1
2
15
3
4
15
2
4
18
2
3
16
RBH
WPH
1326
320
298
5
2
1
6
1
2
-12
-25
21
0
0
1
-2
2
3
-382
-89
29
-1
0
1
-1
-2
3
-540
-110
4
-1
0
1
-1
0
-1
-12
24
2
0
1
1
0
1
0
SUMMARY - LOW GROWTH
IC activity change
HD activity change
SC activity change
IC cot change (activity)
HD cot change (activity)
SC cot change (activity)
IC cot change (declared)
HD cot change (declared)
SC cot change (declared)
RBH
402
85
148
1.5
0.3
0.5
LOW GROWTH MODEL
JR
MK
Change in IC activity
Change in HD activity
Change in SC activity
Change in IC cots needed
Change in HD cots needed
Change in SC cots needed
JR
MK
HIGH GROWTH MODEL
RBH
WPH
Bucks
JR
MK
RBH
WPH
Bucks
Change in IC activity
Change in HD activity
Change in SC activity
Change in IC cots needed
Change in HD cots needed
Change in SC cots needed
25
14
34
0.1
0.1
0.1
2
3
20
0.0
0.0
0.1
2
4
26
0.0
0.0
0.1
2
4
29
0.0
0.0
0.1
2
4
25
0.0
0.0
0.1
Change in IC activity
Change in HD activity
Change in SC activity
Change in IC cots needed
Change in HD cots needed
Change in SC cots needed
46
28
54
0.2
0.1
0.2
3
6
33
0.0
0.0
0.1
4
8
42
0.0
0.0
0.1
4
9
47
0.0
0.0
0.2
4
7
41
0.0
0.0
0.1
IC predicted cots (activity)
HD predicted cots (activity)
SC predicted cots (activity)
16
10
22
1
2
15
3
4
15
2
4
18
2
3
16
IC predicted cots (activity)
HD predicted cots (activity)
SC predicted cots (activity)
16
10
22
1
2
15
3
4
15
2
4
18
2
3
16
1368
342
331
5
2
2
6
1
3
-9
-20
41
0
0
1
-2
2
3
-379
-83
56
-1
0
1
-1
-2
3
-536
-103
33
-1
0
1
-1
0
-1
-9
30
27
0
1
1
0
1
0
1389
355
352
6
2
2
7
1
3
-8
-17
53
0
0
1
-2
2
3
-377
-79
71
-1
0
1
-1
-2
3
-534
-99
51
-1
0
1
-1
0
-1
-7
34
42
0
1
1
0
1
0
SUMMARY - HIGH GROWTH
SUMMARY - MEDIUM GROWTH
IC activity change
HD activity change
SC activity change
IC cot change (activity)
HD cot change (activity)
SC cot change (activity)
IC cot change (declared)
HD cot change (declared)
SC cot change (declared)
IC activity change
HD activity change
SC activity change
IC cot change (activity)
HD cot change (activity)
SC cot change (activity)
IC cot change (declared)
HD cot change (declared)
SC cot change (declared)
Model of Oxford Capacity Expansion - Using 5 Year Growth
JR
IC declared cots 11/12
HD declared cots 11/12
SC declared cots 11/12
IC cots needed, from activity
HD cots needed, from activity
SC cots needed, from activity
IC extra cots needed
HD extra cots needed
SC extra cots needed
MK
10
10
20
11
9
21
1
-1
1
RBH
3
0
13
1
2
15
-2
2
2
WPH
4
6
13
4
4
15
0
-2
2
Bucks
4
4
20
4
4
18
0
0
-2
2
3
17
2
3
16
0
0
-1
Change in activity associated with Under 27wk Infants
JR
Episodes
Change in IC activity
Change in HD activity
Change in SC activity
Change in IC cots needed
Change in HD cots needed
Change in SC cots needed
30
673
162
76
2.5
0.6
0.2
IC predicted cots (activity)
HD predicted cots (activity)
SC predicted cots (activity)
13
10
21
MK
-2
-11
-24
-23
-0.0
-0.1
-0.1
RBH
-13
-299
-64
-16
-1.1
-0.2
-0.1
1
2
15
WPH
-15
-363
-74
-36
-1.3
-0.3
-0.1
3
4
15
3
4
18
Bucks
0
0
0
0
0.0
0.0
0.0
2
3
16
Change in activity associated with Ventilated babies
JR
Episodes
Change in IC activity
Change in HD activity
Change in SC activity
Change in IC cots needed
Change in HD cots needed
Change in SC cots needed
21
268
81
74
1.0
0.3
0.2
IC predicted cots (activity)
HD predicted cots (activity)
SC predicted cots (activity)
14
10
21
MK
0
0
0
0
0.0
0.0
0.0
RBH
-8
-82
-38
-38
-0.3
-0.1
-0.1
1
2
15
WPH
-12
-175
-43
-36
-0.6
-0.2
-0.1
3
4
15
2
4
18
Bucks
-1
-11
0
0
-0.0
0.0
0.0
2
3
16
Repatriating Out of Network Activity
JR
MK
WPH
Bucks
0
1
44
0.0
0.0
0.1
0
15
83
0.0
0.1
0.3
0
10
76
0.0
0.0
0.2
0
27
2
0.0
0.1
0.0
IC predicted cots (activity)
HD predicted cots (activity)
SC predicted cots (activity)
16
10
22
1
2
15
3
4
15
2
4
18
2
3
16
Change in IC activity
Change in HD activity
Change in SC activity
Change in IC cots needed
Change in HD cots needed
Change in SC cots needed
232
140
278
0.8
0.5
0.9
15
30
167
0.1
0.1
0.5
20
40
217
0.1
0.1
0.7
WPH
22
44
242
0.1
0.2
0.8
Bucks
19
38
208
0.1
0.1
0.7
IC predicted cots (activity)
HD predicted cots (activity)
SC predicted cots (activity)
17
11
23
1
2
16
3
4
16
2
4
19
2
3
17
1575
468
575
6
2
2
7
1
3
4
7
187
1
1
1
-1
3
3
-361
-47
246
-1
0
1
-1
-2
3
-516
-63
245
-1
0
1
-1
0
-1
8
65
210
1
1
1
1
1
0
MEDIUM GROWTH MODEL
Change in IC activity
Change in HD activity
Change in SC activity
Change in IC cots needed
Change in HD cots needed
Change in SC cots needed
-83
-41
0
-0.3
-0.2
0.0
-6
-9
0
-0.0
-0.0
0.0
-7
-12
0
-0.0
-0.0
0.0
-8
-13
0
-0.0
-0.0
0.0
Bucks
-7
-11
0
-0.0
-0.0
0.0
IC predicted cots (activity)
HD predicted cots (activity)
SC predicted cots (activity)
16
10
22
1
2
15
3
4
15
2
4
18
2
3
16
RBH
WPH
1260
286
298
5
2
1
6
1
2
-17
-32
21
0
0
1
-2
2
3
-388
-98
29
-1
0
1
-1
-2
3
-546
-121
4
-1
0
1
-1
0
-1
-18
15
2
0
1
1
0
1
0
SUMMARY - LOW GROWTH
IC activity change
HD activity change
SC activity change
IC cot change (activity)
HD cot change (activity)
SC cot change (activity)
IC cot change (declared)
HD cot change (declared)
SC cot change (declared)
RBH
402
85
148
1.5
0.3
0.5
LOW GROWTH MODEL
JR
MK
Change in IC activity
Change in HD activity
Change in SC activity
Change in IC cots needed
Change in HD cots needed
Change in SC cots needed
JR
MK
HIGH GROWTH MODEL
RBH
WPH
Change in IC activity
Change in HD activity
Change in SC activity
Change in IC cots needed
Change in HD cots needed
Change in SC cots needed
124
69
169
0.5
0.3
0.5
8
15
102
0.0
0.1
0.3
11
19
132
0.0
0.1
0.4
12
22
147
0.0
0.1
0.5
Bucks
10
19
127
0.0
0.1
0.4
IC predicted cots (activity)
HD predicted cots (activity)
SC predicted cots (activity)
16
10
23
1
2
15
3
4
16
2
4
18
2
3
16
1467
397
467
6
2
2
7
1
3
-3
-8
122
0
0
1
-2
2
3
-370
-67
161
-1
0
1
-1
-2
3
-526
-86
151
-1
0
1
-1
0
-1
-1
45
129
0
1
1
0
1
0
MK
RBH
SUMMARY - HIGH GROWTH
SUMMARY - MEDIUM GROWTH
IC activity change
HD activity change
SC activity change
IC cot change (activity)
HD cot change (activity)
SC cot change (activity)
IC cot change (declared)
HD cot change (declared)
SC cot change (declared)
JR
IC activity change
HD activity change
SC activity change
IC cot change (activity)
HD cot change (activity)
SC cot change (activity)
IC cot change (declared)
HD cot change (declared)
SC cot change (declared)
Model of Oxford Capacity Expansion - Using 10 Year Growth
JR
IC declared cots 11/12
HD declared cots 11/12
SC declared cots 11/12
IC cots needed, from activity
HD cots needed, from activity
SC cots needed, from activity
IC extra cots needed
HD extra cots needed
SC extra cots needed
MK
10
10
20
11
9
21
1
-1
1
RBH
3
0
13
1
2
15
-2
2
2
WPH
4
6
13
4
4
15
0
-2
2
Bucks
4
4
20
4
4
18
0
0
-2
2
3
17
2
3
16
0
0
-1
Change in activity associated with Under 27wk Infants
JR
Episodes
Change in IC activity
Change in HD activity
Change in SC activity
Change in IC cots needed
Change in HD cots needed
Change in SC cots needed
30
673
162
76
2.5
0.6
0.2
IC predicted cots (activity)
HD predicted cots (activity)
SC predicted cots (activity)
13
10
21
MK
-2
-11
-24
-23
-0.0
-0.1
-0.1
RBH
-13
-299
-64
-16
-1.1
-0.2
-0.1
1
2
15
WPH
-15
-363
-74
-36
-1.3
-0.3
-0.1
3
4
15
3
4
18
Bucks
0
0
0
0
0.0
0.0
0.0
2
3
16
Change in activity associated with Ventilated babies
JR
Episodes
Change in IC activity
Change in HD activity
Change in SC activity
Change in IC cots needed
Change in HD cots needed
Change in SC cots needed
21
268
81
74
1.0
0.3
0.2
IC predicted cots (activity)
HD predicted cots (activity)
SC predicted cots (activity)
14
10
21
MK
0
0
0
0
0.0
0.0
0.0
RBH
-8
-82
-38
-38
-0.3
-0.1
-0.1
1
2
15
WPH
-12
-175
-43
-36
-0.6
-0.2
-0.1
3
4
15
2
4
18
Bucks
-1
-11
0
0
-0.0
0.0
0.0
2
3
16
Repatriating Out of Network Activity
JR
WPH
Bucks
0
1
44
0.0
0.0
0.1
0
15
83
0.0
0.1
0.3
0
10
76
0.0
0.0
0.2
0
27
2
0.0
0.1
0.0
IC predicted cots (activity)
HD predicted cots (activity)
SC predicted cots (activity)
16
10
22
1
2
15
3
4
15
2
4
18
2
3
16
Change in IC activity
Change in HD activity
Change in SC activity
Change in IC cots needed
Change in HD cots needed
Change in SC cots needed
480
289
562
1.8
1.1
1.8
32
63
337
0.1
0.2
1.1
42
81
438
0.2
0.3
1.4
WPH
46
91
489
0.2
0.3
1.6
Bucks
40
78
422
0.1
0.3
1.4
IC predicted cots (activity)
HD predicted cots (activity)
SC predicted cots (activity)
18
11
24
1
2
16
3
4
17
2
4
20
2
3
17
1823
617
860
7
3
3
8
2
4
21
40
358
1
1
2
-1
3
4
-339
-5
468
-1
0
2
-1
-2
4
-492
-17
493
-1
0
2
-1
0
0
29
105
423
1
1
2
1
1
1
MEDIUM GROWTH MODEL
Change in IC activity
Change in HD activity
Change in SC activity
Change in IC cots needed
Change in HD cots needed
Change in SC cots needed
-161
-83
0
-0.6
-0.3
0.0
MK
-11
-18
0
-0.0
-0.1
0.0
IC predicted cots (activity)
HD predicted cots (activity)
SC predicted cots (activity)
15
10
22
1
2
15
3
4
15
2
4
18
2
3
16
1182
245
298
5
1
1
6
0
2
-22
-41
21
0
0
1
-2
2
3
-395
-110
29
-1
0
1
-1
-2
3
-554
-134
4
-2
0
1
-2
0
-1
-24
4
2
0
1
1
0
1
0
JR
MK
HIGH GROWTH MODEL
RBH
-14
-23
0
-0.1
-0.1
0.0
WPH
-16
-26
0
-0.1
-0.1
0.0
Bucks
-13
-22
0
-0.0
-0.1
0.0
Change in IC activity
Change in HD activity
Change in SC activity
Change in IC cots needed
Change in HD cots needed
Change in SC cots needed
257
140
345
0.9
0.5
1.1
17
30
207
0.1
0.1
0.7
22
40
269
0.1
0.1
0.9
25
44
301
0.1
0.2
1.0
Bucks
21
38
259
0.1
0.1
0.8
IC predicted cots (activity)
HD predicted cots (activity)
SC predicted cots (activity)
17
11
23
1
2
16
3
4
16
2
4
19
2
3
17
1600
468
643
6
2
3
7
1
4
6
7
228
1
1
1
-1
3
3
-359
-47
299
-1
0
1
-1
-2
3
-513
-63
304
-1
0
1
-1
0
-1
10
65
261
1
1
1
1
1
0
SUMMARY - LOW GROWTH
IC activity change
HD activity change
SC activity change
IC cot change (activity)
HD cot change (activity)
SC cot change (activity)
IC cot change (declared)
HD cot change (declared)
SC cot change (declared)
RBH
402
85
148
1.5
0.3
0.5
LOW GROWTH MODEL
JR
MK
Change in IC activity
Change in HD activity
Change in SC activity
Change in IC cots needed
Change in HD cots needed
Change in SC cots needed
RBH
WPH
MK
RBH
SUMMARY - HIGH GROWTH
SUMMARY - MEDIUM GROWTH
IC activity change
HD activity change
SC activity change
IC cot change (activity)
HD cot change (activity)
SC cot change (activity)
IC cot change (declared)
HD cot change (declared)
SC cot change (declared)
JR
IC activity change
HD activity change
SC activity change
IC cot change (activity)
HD cot change (activity)
SC cot change (activity)
IC cot change (declared)
HD cot change (declared)
SC cot change (declared)
Model of Oxford Capacity Expansion - Changing Assumptions will amend this Model
JR
IC declared cots 11/12
HD declared cots 11/12
SC declared cots 11/12
IC cots needed, from activity
HD cots needed, from activity
SC cots needed, from activity
IC extra cots needed
HD extra cots needed
SC extra cots needed
MK
10
10
20
11
9
21
1
-1
1
RBH
3
0
13
1
2
15
-2
2
2
WPH
4
6
13
4
4
15
0
-2
2
Bucks
4
4
20
4
4
18
0
0
-2
2
3
17
2
3
16
0
0
-1
Change in activity associated with Under 27wk Infants
JR
Episodes
Change in IC activity
Change in HD activity
Change in SC activity
Change in IC cots needed
Change in HD cots needed
Change in SC cots needed
30
673
162
76
2.5
0.6
0.2
IC predicted cots (activity)
HD predicted cots (activity)
SC predicted cots (activity)
13
10
21
MK
-2
-11
-24
-23
-0.0
-0.1
-0.1
RBH
-13
-299
-64
-16
-1.1
-0.2
-0.1
1
2
15
WPH
-15
-363
-74
-36
-1.3
-0.3
-0.1
3
4
15
3
4
18
Bucks
0
0
0
0
0.0
0.0
0.0
2
3
16
Change in activity associated with Ventilated babies
JR
Episodes
Change in IC activity
Change in HD activity
Change in SC activity
Change in IC cots needed
Change in HD cots needed
Change in SC cots needed
21
268
81
74
1.0
0.3
0.2
IC predicted cots (activity)
HD predicted cots (activity)
SC predicted cots (activity)
14
10
21
MK
0
0
0
0
0.0
0.0
0.0
RBH
-8
-82
-38
-38
-0.3
-0.1
-0.1
1
2
15
WPH
-12
-175
-43
-36
-0.6
-0.2
-0.1
3
4
15
2
4
18
Bucks
-1
-11
0
0
-0.0
0.0
0.0
2
3
16
Repatriating Out of Network Activity
JR
MK
WPH
Bucks
0
1
44
0.0
0.0
0.1
0
15
83
0.0
0.1
0.3
0
10
76
0.0
0.0
0.2
0
27
2
0.0
0.1
0.0
IC predicted cots (activity)
HD predicted cots (activity)
SC predicted cots (activity)
16
10
22
1
2
15
3
4
15
2
4
18
2
3
16
MEDIUM GROWTH MODEL
Change in IC activity
Change in HD activity
Change in SC activity
Change in IC cots needed
Change in HD cots needed
Change in SC cots needed
-17
-8
0
-0.1
-0.0
0.0
-1
-2
0
-0.0
-0.0
0.0
-1
-2
0
-0.0
-0.0
0.0
-2
-3
0
-0.0
-0.0
0.0
Bucks
-1
-2
0
-0.0
-0.0
0.0
IC predicted cots (activity)
HD predicted cots (activity)
SC predicted cots (activity)
16
10
22
1
2
15
3
4
15
2
4
18
2
3
16
RBH
WPH
1326
320
298
5
2
1
6
1
2
-12
-25
21
0
0
1
-2
2
3
-382
-89
29
-1
0
1
-1
-2
3
-540
-110
4
-1
0
1
-1
0
-1
-12
24
2
0
1
1
0
1
0
SUMMARY - LOW GROWTH
IC activity change
HD activity change
SC activity change
IC cot change (activity)
HD cot change (activity)
SC cot change (activity)
IC cot change (declared)
HD cot change (declared)
SC cot change (declared)
RBH
402
85
148
1.5
0.3
0.5
LOW GROWTH MODEL
JR
MK
Change in IC activity
Change in HD activity
Change in SC activity
Change in IC cots needed
Change in HD cots needed
Change in SC cots needed
JR
MK
HIGH GROWTH MODEL
RBH
WPH
Bucks
JR
MK
RBH
WPH
Bucks
Change in IC activity
Change in HD activity
Change in SC activity
Change in IC cots needed
Change in HD cots needed
Change in SC cots needed
25
14
34
0.1
0.1
0.1
2
3
20
0.0
0.0
0.1
2
4
26
0.0
0.0
0.1
2
4
29
0.0
0.0
0.1
2
4
25
0.0
0.0
0.1
Change in IC activity
Change in HD activity
Change in SC activity
Change in IC cots needed
Change in HD cots needed
Change in SC cots needed
46
28
54
0.2
0.1
0.2
3
6
33
0.0
0.0
0.1
4
8
42
0.0
0.0
0.1
4
9
47
0.0
0.0
0.2
4
7
41
0.0
0.0
0.1
IC predicted cots (activity)
HD predicted cots (activity)
SC predicted cots (activity)
16
10
22
1
2
15
3
4
15
2
4
18
2
3
16
IC predicted cots (activity)
HD predicted cots (activity)
SC predicted cots (activity)
16
10
22
1
2
15
3
4
15
2
4
18
2
3
16
1368
342
331
5
2
2
6
1
3
-9
-20
41
0
0
1
-2
2
3
-379
-83
56
-1
0
1
-1
-2
3
-536
-103
33
-1
0
1
-1
0
-1
-9
30
27
0
1
1
0
1
0
1389
355
352
6
2
2
7
1
3
-8
-17
53
0
0
1
-2
2
3
-377
-79
71
-1
0
1
-1
-2
3
-534
-99
51
-1
0
1
-1
0
-1
-7
34
42
0
1
1
0
1
0
SUMMARY - HIGH GROWTH
SUMMARY - MEDIUM GROWTH
IC activity change
HD activity change
SC activity change
IC cot change (activity)
HD cot change (activity)
SC cot change (activity)
IC cot change (declared)
HD cot change (declared)
SC cot change (declared)
IC activity change
HD activity change
SC activity change
IC cot change (activity)
HD cot change (activity)
SC cot change (activity)
IC cot change (declared)
HD cot change (declared)
SC cot change (declared)
Please NOTE - cells highlighted in yellow can be amended and these will impact the model
There are hidden sheets which shows details behind data
Declared Cots 2011/12
IC
HD
IC/HD Combined
SC
JR
10
10
20
20
MK
3
0
3
13
RBH
4
6
10
13
WPH
4
4
8
20
Bucks
2
3
5
17
HGH
0
0
0
8
Total
23
23
46
91
Previously have looked into Thames Valley
PCT data, which is higher activity. Using
Booked, as seems more likely to be able to
Historical Activity to use:
10/11
0
Inappropriate Activity to use:
10/11
0
Babies needing > 4 days
ventilation
Move to NICU (on day
3)
Out of Network to look at:
Booked into Thames Valley
10/11
09/10
3 yr Average
10/11
09/10
3 yr Average
DH Toolkit advises infants requiring >48hrs ventilation being at a NICU. However if infant is likely to
come off ventilation soon, they are likely to remain at the LNU. Model only considering moving infants
Move to NI Keep at LNU
whom have been ventilated for over 5 days, and will assume moved on 3rd day.
8
Data provided by Clevermed, based off 10/11 data.
Booked int Thames Valley PCT
Increase in activity
Growth Plan
Low Scenario
Medium Scenario
High Scenario
1 Year
IC
HD
-0.4%
0.6%
1.1%
1
-0.3%
0.5%
1.0%
SC
1 Year
0.0%
0.5%
0.8%
For Repatriated babies, the care day split that will go to Oxford
100%
IC
50%
HD
20%
SC
Remainder to be split by booking hospital
Aimed Cot Occupancy
IC
HD
SC
RBH
100%
37%
20%
By BookingEvenly between 4 LNUs
WPH
100%
37%
20%
SMH
100%
63%
20%
Current HD/SC percentage is based off last few years
of Oxford activity for Milton Keynes/Stoke Mandeville
infants, and when they were returned to LNU. This
level could be lowered if believed Oxford could return
babies earlier.
75%
75%
85%
New Activity: Percentage to Oxford
General
Increase in
Activity /
Population
IC
HD
SC
75%
48%
25%
How remainder of activity will be split between LNUs:
20%
Milton Keynes General
26%
Royal Berkshire, Reading
29%
Wexham Park, Slough
25%
Buckinghamshire Hospitals
100%
10 Year
Assumption is that out of network activity is out of
network due to lack of capacity. Hence expect most
IC to be done at NICU.
For current LNU activity moving to Oxford, the % care done at Oxford
MK
100%
IC
63%
HD
20%
SC
Remainder will go to where originally admitted
5 Year
Growth projections provided by SPH.
Further details on source of this data available on
'Percentage Growth' workbook.
General increase based off 1011 current split, taking into account
inappropriate activity.
Based off adjusted past activity
1
Growth Projections
1 year
Low Scenario
Medium Scenario
High Scenario
IC
-0.4%
0.6%
1.1%
HD
-0.3%
0.5%
1.0%
SC
0.0%
0.5%
0.8%
5 year
Low Scenario
Medium Scenario
High Scenario
IC
-2.0%
3.0%
5.6%
HD
-1.5%
2.5%
5.1%
SC
0.0%
2.5%
4.1%
10 year
Low Scenario
Medium Scenario
High Scenario
IC
-3.9%
6.2%
11.6%
HD
-3.0%
5.1%
10.5%
SC
0.0%
5.1%
8.3%
The method we used was to extract counts of births by birth weight category (Under 1,000; 1,000 1,499; 1,500 - 1,999; 2,000 - 2,499; 2500+) in for each PCT in Thames Valley [Source: ONS Annual
Districts Births database, SEPHO]
We then calculated expected level of admissions to each of the unit types (ICU, HDU and SCBU)
based upon the birth weight specific risk [Source: based on 'LevelOfCare Activity.xls' - analysis of SE
and London NICU Activity (Lee Wemyss)]
We calculated a weighted population based on the age specific population for females [Source:
ONS MYE populations] and age specific fertility rates [ONS Vital Statistics]
This was used to calculate an admission rate to each of the unit types per weighted population and
applied to the age specific population projections [Source: ONS 2008-based Subnational Population
Projections by sex and quinary age, May 2010] for each PCT to obtain an expected rate.
Sir Jonathan Michael
Chief Executive
Oxford Radcliffe Hospitals NHS Trust
Headley Way
Headington
Oxford
OX3 9DU
28 September 2010
Oxfordshire Primary Care Trust
Jubilee House
5510 John Smith Drive
Oxford Business Park South
Cowley
Oxford OX4 2LH
Telephone: 01865 336730
Fax: 01865 337094
Website: www.oxfordshirepct.nhs.uk
Email:sonia.mills@oxfordshirepct.nhs.uk
Dear Jonathan
Re: Board of Commissioners Decision re additional ORH NICU (Level 3) Cots
I am pleased to confirm that further to the South Central SHA Board of Commissioners
meeting on 6th August 2010, (following presentation of a proposal to commission additional
Level 3 (NICU) cots at the John Radcliffe Hospital for the northern cluster), there was
agreement that a business case should be developed with the ORH as the preferred
provider as quickly as possible.
The business case will need to make the following assumptions:
•
•
•
This is revenue neutral with additional revenue generated through repatriated activity
Capital investment will be the responsibility of the ORH Trust
Specialist Commissioning Group and the Neonatal Network will take responsibility for
validating figures and activity projections.
The SCG and Neonatal Network have identified Una Vujakovic, Neonatal Network manager
and Kate Barker, Senior Commissioner, to work with the Trust to develop the business
case. It would be helpful if the previous project management structure and team who
developed your internal Strategic Outline Case and Outline Business Case could be
reconvened, to ensure that arrangements and key personnel are in place to facilitate the
development and completion of the new business case.
I can confirm that both Julie Burgess, at Heatherwood & Wexham Park Hospitals NHS Trust
and Edward McDonald at Royal Berkshire NHS Foundation Trust, have been informed of
this decision, and they will inform their Neonatal Clinical Leads. The SHA Board of
Commissioners will continue to monitor the progress and development of the business
case.
Yours sincerely
Sonia Mills
Chief Executive
Headquarters
Oakley Road
Southampton
Hampshire
SO16 4GX
Tel: 023 8072 5600
27 September 2011
Sir Jonathan Michael
Chief Executive
Oxford Radcliffe Hospitals NHS Trust
John Radcliffe Hospital
Headley Way
Headington
Oxfordshire
OX3 9DU
Dear Jonathan
I am writing to you in my capacity as Chair of the South Central Neonatal Network regarding the very
positive neonatal intensive care developments on the Oxford Radcliffe Hospital site.
The resolution of long-standing neonatal intensive care capacity issues in South Central North is
obviously now well underway with infants and families soon to benefit. This welcome development will
support the provision and commissioning of services appropriate to those defined in the NHS/DH
‘Toolkit for High Quality Neonatal Services’.
I am aware that comprehensive progress reports on the capital project to increase cots at the
Neonatal Intensive Care Unit located in Oxford have been received in June this year by the
Operational Review Group. In addition, the Network Board was pleased to hear a presentation on
14th September from Mr Tony McDonald and Dr Eleri Adams outlining further progress towards the
opening of the additional intensive care cots.
I write to confirm that the Network Board is in full support of this crucial development for neonatal care
in the north of our region and, through our network quality monitoring, look forward to the anticipated
improvements in patient care. I am also able to confirm that your Trust will receive appropriate support
from the South Central Neonatal Network and the South Central Specialised Commissioning Group
(SCSCG) throughout the transition period, to fully implement the patient pathways across network
partner hospitals once all cots have been opened in Oxford.
In my role as Lead PCT Cluster Chief Executive for the neonatal network I should also like to confirm
that the PCT Cluster CEOs continue to support this development, following the former Board of
Commissioners approval in July 2010. We will therefore continue to support the network practice
improvements and capacity solution under development at the ORH.
Southampton City PCT, Hampshire PCT, Isle of Wight PCT and Portsmouth City Teaching PCT
working together as a Cluster
I understand that Simon Jupp, Director of SCSCG, is writing to you separately to express the SCG
commissioning intentions to support ORH as the single Neonatal Intensive Care Unit for South
Central North.
I hope that this letter is helpful in confirming the support of the Neonatal Network and the PCT Cluster
Chief Executives regarding this important development, which will significantly improve the quality of
care provided within South Central.
Yours sincerely
D.M. Fleming (Mrs)
Chief Executive, SHIP PCT Cluster
Chair, South Central Neonatal Network
cc Una Vujakovic, South Central Neonatal Network Manager
Eleri Adams, South Central Neonatal Network Lead Clinician North
Hampshire Primary Care Trust Headquarters
Omega House
112 Southampton Road
Eastleigh
Hampshire
SO50 5PB
Office Telephone:
023 8062 7444
Facsimile:
023 8065 2976
Direct Dial:
023 8062 7423
Web:
www.scscg.nhs.uk
Email Address: Simon.jupp@scscg.nhs.uk
15th September 2011
Ref:-SJ/UV/CR
Sir Jonathan Michael
Chief Executive
Oxford Radcliffe Hospitals NHS Trust
John Radcliffe Hospital
Headley Way
Headington
Oxford OX3 9DU
Dear Sir Jonathan
Re: Neonatal Services
I am writing regarding the current developments for neonatal services at the John Radcliffe Hospital
site and to set out the broad commissioning intentions of the South Central Specialised
Commissioning Group with regard to Oxford as the Lead Centre and single Neonatal Intensive Care
Unit (NICU) for the South Central North area.
In relation to the current project to provide capacity expansion, I am aware that validated activity
modelling undertaken by the Neonatal Network has demonstrated the ‘network’ cot requirement
across the categories of care and for the additional ‘ intensive care’ cots to be located at the NICU.
This will support the national strategy to commission and deliver neonatal services to NHS/DH ‘Toolkit
for High Quality Neonatal Services’ ( 2009) and the NICE ‘Quality Standard for Specialised Neonatal
Care’( 2010). In addition, this will facilitate the repatriation of a proportion of South Central activity
currently sent out of network due to the constraints in access to the NICU.
I understand that your project to expand neonatal intensive care is on schedule to open intensive care
cots in the new development from c. November 2012.
In advance of this date the SCG commissioning team intend to support the transitional phase for the
network providers by introducing incremental thresholds for transfer to Oxford as your capacity comes
on-line.
This has been expressed through CQUIN arrangements this year and in the SC Neonatal Network
Service Specification and network guidelines .This issue will be a key element in determining the detail
South Central Specialised Commissioning Group is hosted by Hampshire Primary Care Trust
110915 Letter to Sir Jonathan Ref Neonatal from SJ
of contractual arrangements with Local Neonatal Unit providers as we ensure services are planned to
these quality standards through 2012 and 2013.
I am very encouraged by the positive work which has already been achieved to facilitate these
changes and for your Trust to action the decision of the former South Central Board of Commissioners
to provide additional neonatal intensive care cots on the Oxford NICU site.
I hope this letter provides you with assurance that our commissioning intentions are to support a single
location for the designated Neonatal Intensive Care Unit and that in this position you can progress the
expansion of the service to support high quality neonatal care across the network.
Yours sincerely
Simon Jupp
Director
Cc Una Vujakovic
2
Appendix E - Risk Register (V12)
Project Title: John Radcliffe - Newborn Intensive Care Unit - P21+ Scheme ID: P21+0155.02
Date Updated: 16th March 2012
(Trust)
Date Register First Created: 16/09/2011
Probability
(1-5)
Prior to Mitigation
Impact
Risk Rating
(1-5)
(1-25)
Revision Number: 12 (TRUST)
Mitigation
Updated by: Trust - FBC
Post Mitigation
Probability Impact
Risk Rating Closed Out
(1-25)
(1-5)
(1-5)
Ref
No:
Risk
Category
Risk Description
1
Constr
Buried services: Location of existing buried services in vicinity 5
of proposed new building; Inadvertent disruption to existing
services, loss of supply to site / part of site.
Specific concerns
adjacent generator - buried electrical supplies;
Telecoms manhole covers in bank
Buried services from cryogen store
Existing drainage locations / manholes / levels
5
25
Locations, depths, routes and extent of existing services:
3
Surveys carried out.
Residual risk remains post-survey.
UPDATE 12 12 11 - Survey has indicated drainage, water
supply and fibre optics all need moving or protecting.
Allowance in main pricing, including risk allowance.
Note - existing fibre optics bank not to be moved, but protected
with a concrete cap along its length in the vicinity of the new
works.
Foundation solution designed around known buried services.
Residual H&S risk.
4
12
2
FBC
Incoming services (M): Location & capacity of existing gas
supply to be confirmed; Insufficient capacity available,
Existing main too small.
Excessive distance (pressure drop too great).
Route to new building obstructed / infeasible.
Connection to existing may disrupt essential services.
Future planned loads may reduce available capacity.
5
5
25
Change to Works Info to be raised to cover change from
feasibility stage, but boilers now not required for NICU
extension and therefore fuel gas supply not needed.
1
1
1
3
FBC
Internal incoming services (M): Location and capacity of
existing water services to be confirmed; Insufficient capacity
Location for connections obstructed.
Routes shown impractical.
5
5
25
Location of existing services, connection locations, proposed 2
routes to be confirmed: Some site surveys carried out.
Some residual risk remains post-survey.
UPDATE 14.12.11 - client requires incoming services to come
through building. Route yet to be finalised and asbestos and
working time to be agreed.
Therefore a risk remains that costs will increase, but an
allowance included within priced work.
5
10
4
FBC
Design error: design does not accord with HTM / HBN
requirements
3
4
12
Rigour during design process. Clarity where derogations
required. Use of experienced designers.
1
3
3
5
FBC
Clinical
5
Medical Gases: Upgrade of existing medical gases to
maternity block
Medical gases serving Maternity Block is (according to
Halcrow Yolles) currently at capacity and an upgrade to the
oxygen, medical air and vacuum services are required and is
to be included within the project scope.
No details provided of extent of work required, upgrades, if any
to existing plant and confirmation that the upgrades described
in the Halcrow Yolles brief are adequate and correct; Route of
upgraded Oxygen, Medical air and vacuum services to
maternity block unknown.
Capacity of existing medical gas plant insufficient to
accommodate new Newborn Intensive Care beds.
Design risk of proposed upgrade (sizes of mains specified).
Impact on other departments in Maternity Block Post 1:50
drawing review cots 11/12/15 & 16 to have 6 gas points not
4.Keppie to re-issue drawings to show this variation. New
oxygen pipework required to tunnel to feed new born
extension.
5
25
Copy of Appendix 'B' Quote from K & H Medical services not
provided with project documentation.
Confirmation of what options A, C & D entail.
1
3
3
Y
Y
Cost Impact Agreed PSCP
Provision (time
allowed for in
programme float)
Risk Owner
£0
PSCP
£0
Trust
£0
PSCP
£0
PSCP
£0
PSCP
Not all available quotes from K&H provided at the time of the
Affordability Check. The only one provided at the time related
to an initial proposal for the mains work getting the medi gases
to the new extension. Subsequent clarity obtained on missing
scope and quotes during Stage 3.
Price for GMP has increased significantly, but reflects what we
understand to be the right scope. EWN 002 raised during
Stage 3.
1
6
Constr
7
Constr
8
FBC
9
Constr
Failure of existing heating system: According to Halcrow
5
Yolles brief, the heating system to the Maternity block (and the
existing Neonatal Dept) is 40 years old, at the limit of its
capacity and nearing the end of its economic life.
The new heating plant is serving only the new Newborn
Intensive Care cot area ventilation system.; Parts of level 2
adjacent to the new build / refurbished areas will be served off
the existing heating system. Whilst failure of the existing
heating system will not directly affect the new build /
refurbished areas, there may be knock on effects, especially
as the reception area may be heated by both existing and new
systems
Extension of existing Hot & Cold water Services: The existing 5
services at level 1 are to be extended through level 1 to serve
the New build area from below. This will require access
through the ceiling voids of level 1 corridor and room 1264
(Utility room??). The proposed route will pass outside at least
4 bedrooms, and several other undefined rooms.; Disruption
to existing operation of level 1
Access into occupied areas
Availability of sufficient space within ceiling voids to route new
DHWS & CWS pipework
Condition of existing hot and cold water services: The Halcrow 5
/ Yolles brief notes that the heating systems are 40 years old,
at the limit of their capacity and at the end of their economic
life. No such statement is made in relation to the hot and cold
water services.; Failure of the existing hot and cold water
services due to age and condition
Insufficient available capacity.
5
25
Trust & Users are happy with the level of risk associated with 1
the existing heating system and any potential knock on effects
on the new build / refurbished areas.
1
1
5
25
Confirmation of route for services, availability of adequate
space: Detailed surveys within ceiling voids.
UPDATE 14.12.11 - detailed surveys not yet completed. Risk
remains in terms of route, space etc.
3
4
5
25
Confirmation that the existing hot and cold water service
3
system is of acceptable condition for the proposed new works,
and has a remaining life of at least 3 years (length of design /
construction project plus warranty period of 2 years for P21 +
contract).
In lieu of that confirmation, a residual risk remains in terms of
the scope of works for this project, but as a Trust risk any
resulting additional works required in this respect can be
addressed through the change control process.
Condition of existing hot and cold water services isolation
valves: Failure of isolation valve which will be relied upon for
the safe and dependable isolation of the existing systems to
allow for the connection of new services.; Failure of valves to
isolate may result in a Health and Safety risk to operatives
(scalding from hot water) and mean that greater areas of the
building will need to be isolated and drained down.
5
5
25
Confirmation from the Trust as to the anticipated condition of
the existing isolating valves and that regular maintenance
checks have been carried out.
Y
£0
Trust
12
£1,000
PSCP
4
12
£0
Trust
3
6
£0
Trust
3
3
£0
Trust
2
4
£0
PSCP
E/over allowance for additional mitigation measures to
minimise disruption for these works.
2
Visual surveys alone cannot necessarily determine if a failure
is to occur.
10
FBC
Clinical
Legionella: Existence of legionella within the existing hot and
cold water systems will prevent the completion and handover
of the new build and refurbishment works.; Positive test for
legionella during testing and commissioning, tested using
culture, robust testing measure, guidance from Trust engineer
5
5
25
11
FBC
Cooling to room 2504: Additional DX cooling unit to be
5
provided to room 2504 (hub room); Disruption to existing
operation of level 2
Access into occupied areas
Availability of sufficient space within ceiling voids to route new
DX pipework
Connection point for condensate not available locally
Lack of space within room to locate unit
Disruption or damage to existing equipment within the
operational hub room
Security of patient data
5
25
Residual risk is beyond PSCP's control but any resulting
defects will be flagged up to the Trust for determining course of
action
Confirmation from Trust that the hot and cold water services
1
systems are free from legionella, testing is undertaken by the
Trust on a regular basis and suitable water treatment systems
are provided, used correctly and well maintained.
Legionella tests to be carried out on the existing water services
systems prior to commencement of works, and prior to the
testing and commissioning to prove that the existing systems
are free from legionella. Trust has confirmed that all
necessary procedures are in place.
Heat gains for existing and proposed equipment confirmed by
Trust.
2
Y
Residual risk remains against this item in terms of associated
works etc, but allowance within BWIC in priced works.
2
12
13
FBC
FBC
Air transport system extension: Connection to the existing
5
pneumatic tube system in riser; Insufficient capacity in existing
system to accommodate additional station
Existing system is out of date and compatible equipment is no
longer available
No space to accommodate new diverter in riser
Inadequate space within ceiling void to allow new pneumatic
tube pipework to be installed, in particular bends (can be
800mm diameter or greater)
Necessity to relocate / divert existing services to allow for new
tube to be installed
5
Missing information: Four specialist supplier quotes referred to 5
in the Halcrow Yolles document are not included within the
information issued by the Trust at tender stage, or following the
P21 workshop.; Unknown special requirements, especially in
relation to medical gases.
5
25
Size of existing system (tube diameter).
2
Confirmation of additional capacity.
Confirmation of adequate space in ceiling void for new tube.
Confirmation of size and available capacity by Trust,
confirmation of available space in riser / ceiling void by survey.
Survey undertaken, no significant difficulties anticipated.
2
4
Y
£0
PSCP
1
3
3
Y
£0
Trust
1
1
1
£0
Trust
CCTV has been carried out. Results to be issued.
1
Indicates some residual maintenance issues including standing
water in drain runs and tree root penetration.
5
5
£0
Trust
Proposed works priced within GMP, but residual risk remains
against this item in case unforeseen modifications need to be
made to the existing installation.
25
Copies of all specialist supplier quotes: Trust to issue
information.
GMP pricing based on new quotes, but some gaps have come
to light since the info provided at the time of the Affordability
Check (ref EWN 002). Issues now resolved in rev GMP.
Price for GMP has increased significantly, but reflects what we
understand to be the right scope. No residual risk allowance
carried here against this specific item.
14
15
FBC
Clinical
FBC
Above ground drainage: Drainage pipework in refurb area
drops down to connect into existing above ground drainage
located in room 1269 (bedroom) and 1241 (corridor); Access
to the existing drainage pipework in ceiling voids may be
impractical / restricted due to existing services
Disruption to operation of department
Capacity of existing drainage pipework
Poor condition of existing drainage pipework
Effect on upper floors of temporary unavailability of system to
allow connections
Contaminated waste from above
5
Below Ground Drainage: Location and capacity of existing
drainage pipework; Lack of capacity of system
Location of proposed connection not suitable
5
5
25
Confirmation of condition and capacity of system
Access to drainage pipework
Confirmation of any contamination
Confirmation of what areas are served by the stacks being
altered.
UPDATE 14.12.11 - to be closed out during detailed design.
Any residual risk relating to the poor condition or capacity of
the existing pipework can be determined in due course, and
any extra works from the original brief addressed via the CEN
system.
5
25
Trust to confirm course of action subject to receipt of survey
info.
No residual risk carried here by PSCP.
16
FBC
SVP drop: SVP drops to below ground at the perimeter of the
NW façade of L2; Pipe is exposed at level one and
susceptible to damage.
5
5
25
Design coordination: Provide suitable support
1
1
1
Y
£0
PSCP
17
FBC
Humidification (1): Provision of humidification in AHU was
included as an option in the Halcrow Yolles brief, with the
intention that confirmation will be provided by the Trust. No
information as to whether humidification is required is
provided.; Additional costs for inclusion of humidification
(water supply, power supply and cost of unit).
5
5
25
: Trust Confirmation of requirements
1
1
1
Y
£0
Trust
18
FBC
Humidification (2): Compliance with HTM humidity guidance; 5
Omission of humidification may result in a non compliance with
guidance in regards to minimum humidity levels.
5
25
: Trust Confirmation that the minimum humidity guidance can
be derogated against
1
1
1
Y
£0
Trust
3
19
FBC
Boiler resilience: The Halcrow Yolles schematic outlines
5
ventilation flow rates and temp rises across heater batteries.
These summate to around 110-115kW (to be confirmed by
detail design), the boiler plant is two boilers at 65kW each,
which ignoring the CHP unit equates to each boiler rated at
55% - 60% of the peak load.; If one boiler fails, the available
boiler power will be less than the peak heating load, therefore
we will not have n+1 resilience on boiler power.
The key risk here is that if one boiler fails, there may not be
sufficient boiler power available to meet the heating demand
and the room temperatures in the NICU unit may not be able to
be maintained (temperature will reduce).
5
25
EWN to be raised to cover change from feasibility stage, but
boilers understood to now not be required for NICU extension
and therefore fuel gas supply not needed.
1
1
1
Y
£0
Trust
20
FBC
Spare Capacity (mechanical and electrical systems): Latest
5
Guidance document (6898:0.1 - General Engineering
Principles) states that all engineering systems and equipment
should have an allowance of 25% for future expansion. Has
the designs proposed by Halcrow Yolles already taken this
25% spare capacity into account (boiler power, chiller, AHU air
volumes, electrical loads etc).; If we are to comply with this
document and the Halcrow Yolles schemes has not already
taken this into account, then there is the risk of the major plant
having to be increased in size by up to 25% (larger boilers,
pumps, AHUs, electrical switchgear etc.
5
25
Is there a requirement for 25% spare capacity? Trust to
2
confirm whether we are to comply with 6898:0.1 General
Engineering Principles. Reviewed during design development,
not a significant issue as Trust aware of limitations and has
identified requirements in terms of capacity.
2
4
Y
£0
Trust
21
FBC
Incoming gas capacity: If risks M&E 18 and M&E 19 require
5
that the boiler plant is increased in size, this could result in two
boilers rated at approx 150kW (giving N+1 and 25% spare
capacity).; The gas supply must be sized at the total boiler
capacity ignoring that fact that the boilers are n+1 (Gas Safety
Regulations requirements).
The risk here is that whilst there may be sufficient capacity for
a new gas supply based upon the Halcrow Yolles design, there
may not be sufficient capacity for the increased boiler load.
5
25
Change to Works Info to be raised to cover change from
feasibility stage, but boilers now not required for NICU
extension and therefore fuel gas supply not needed.
1
1
1
Y
£0
Trust
22
FBC
Chiller capacity and resilience: The Halcrow Yolles schematic 5
shows a single chiller rated at 87kW. There is no second
chiller shown to provide resilience in case of failure.; Is there a
requirement for a second chiller in order to provide n+1 (duty /
standby) cooling capacity. If the chiller fails, then there is the
risk that the NICU unit may overheat
5
25
Is there a requirement for a standby chiller? Trust to confirm
whether a standby chiller is required.
1
4
4
£0
Trust
5
Ventilation system outline design: The Halcrow Yolles
schematic shows that the ventilation system has two zones
with reheat batteries serving the NICU unit (one serving each
of the 8 cot wards) but each zone also serves other staff and
visitor areas. The two ventilation zones will be controlled
based upon the heating / cooling requirements of the cot
areas.; The risk is that the non cot areas (Near patient testing,
ward clerk, drug prep, reception & waiting corridors and quiet
room) will be provided with supply air at a temperature based
upon the requirements of the cot areas resulting in over
heating and / or over cooling of these other areas.
5
3
4
12
£0
Trust
Capacity of existing electrical supply: Halcrow Yolles
5
feasibility report suggests that the load for the building is 100A
3-phase and suggests that the existing neonatal department
draws less than its existing 100A supply.; Insufficient capacity
to support new building. Existing 200A busbar feeding existing
neonatal which is also to serve the new building may need
uprating.
5
3
4
12
£0
Trust
23
24
FBC
FBC
In lieu of confirmation, the 2nd chiller has not been included in
the latest GMP figure. No residual risk allowance determined
for this item.
25
Confirmation that Cundall may redesign the ventilation layout
to provide each of the ancillary room with supply air served
from a third zone (at an increased cost - additional ductwork,
reheat coils, pipework, controls etc): Trust to confirm whether
we are to amend design. To be discussed further.
No residual risk allowance made at the moment.
25
Confirmation of existing electrical loadings to bed-head
equipment and total load to the existing neonatal department:
Sub-meters to be installed.
No residual risk allowance made at the moment.
4
25
FBC
Electrical distribution: The Halcrow Yolles feasibility report
5
details a new 125A cubicle (switch) to replace an existing
spare 100A cubicle to serve the new extension and a new
125A cubicle off the (to be extended) essential busbar, but the
schematic shows both off the essential busbars.; Ambiguity.
5
25
Confirmation that supplies are to be normal supply & essential 3
supply and not two essential supplies: Trust to confirm
requirements. Survey to confirm existing distribution.
4
12
£0
Trust
3
4
12
£0
Trust
No residual risk allowance made at the moment.
Cables to run externally around the existing building in the soft 2
and ducted where necessary under areas of hardstanding.
2
4
Y
£0
Trust
No residual risk allowance made at the moment.
Confirmation that existing essential supplies & generator/s
have sufficient spare capacity.: Trust to confirm of spare
capacity is available.
26
FBC
Essential supplies: Halcrow Yolles feasibility report calls for
5
new 125A supply to be taken from the essential busbar in substation B2 to serve the new building.; Insufficient capacity in
existing essential supplies & generator/s
5
25
27
FBC
5
25
28
FBC
New electrical supplies from B2 sub-station: The Halcrow
5
Yolles drawing shows the mains & essential supplies running
through the existing building to serve the new building.;
Cables shown running through numerous rooms. Risks
associated with access and working in occupied areas.
Possible contamination risks.
Lighting and controls manufacturer: Halcrow Yolles feasibility 5
report details lighting and control requirements but makes no
mention of manufacturer for controls or light fittings; Trust may
have preferred manufacturers that are already used on site.
5
25
Confirmation of any preferred manufacturers.: Confirmation
from Trust of any preferred manufacturers.
1
2
2
Y
£0
Trust
29
FBC
Capacity of existing fire alarm system: Halcrow Yolles
5
feasibility report states that Pyrotec have been consulted in
order to ascertain if the loops from the existing panel can be
extended to cover the new area, and are to report back after
surveying the system.
Insufficient capacity to cover the new building / need to provide
interface between existing a new fire alarm to new building.
5
25
New system designed accordingly.
2
2
4
Y
£0
Trust
Y
£0
Trust
No residual risk allowance made at the moment.
Trust Fire Officer confirmed that panel has sufficient capacity.
30
FBC
Intruder alarms: Halcrow Yolles feasibility report makes no
5
mention of any intruder alarm requirements.; Not included for.
5
25
Confirmation that intruder alarm is not required.: Confirmation 1
from Trust that intruder alarm is not required
2
2
31
FBC
Ground conditions: Existing tunnel is located below proposed
extension. Tunnel may impact on location of plant rooms, and
both above and below ground structure.
Made ground.
Possible contamination.
5
5
25
Tunnel located by surveys/ exposure. Foundation solution
designed to suit current understanding.
Care to be taken during construction works, but minor
adaptations to proposed foundation solution might be needed
depending on actual conditions. Residual risk allowance
carried here accordingly.
3
4
12
£5,000
PSCP
32
FBC
Condition of existing tunnel. Existing tunnel is located below
proposed extension where piling is proposed. Risk of damage
to tunnel due to piling in close proximity
5
5
25
Tunnel location surveyed and foundation solution designed to- 3
suit. Care to be taken during construction activities.
4
12
£0
Trust
£0
PSCP
£0
PSCP
Arisings and muckaway assumed to be inert.
Pre-start condition/ dilaps survey of inside of tunnel is required
to record existing defects. No allowance made by PSCP for
any repairs to the tunnel.
33
FBC
Buried Services. Buried services may require diversion or sub- 5
structure to be designed to avoid buried services
5
25
Some residual risk remains for Trust in terms of defects preexisting or exacerbated by works above
No residual risk allowance included at the moment, over and
above current provisions in priced works.
2
5
10
34
FBC
Drainage Design. Information required for below ground
5
drainage design and CCTV survey of the condition of the drain
runs.
Existing drainage provision is insufficient for additional building
area.
Risk of additional attenuation or improvements to existing
drainage network being required.
5
25
Refer Item 15 above.
1
4
4
Y
5
35
FBC
Clinical
Noise and Vibration. Sensitivity of newborns to noise,
vibrations. Discussed ppe for the babies, e.g. ear plugs when
very noisy
5
5
25
Possibility of piling, consider low noise and low vibration
methods.
Exploring opportunities to maximise OSM for other
construction elements to minimise effects.
Some residual risk remains. Identify clear programme and
communication plan.
2
5
10
36
Constr
Site access below link bridge. Existing pedestrian bridge at
first floor level may limit the size of vehicles for deliveries,
possibility of needing to crane to lift over the bridge is likely to
result in the bridge needing to be temporarily shut.
3
5
15
37
FBC
Fixity of feasibility: further sign off process required if changes 5
to layouts / services proposals are caused by structural /
services review following WD appointment
5
25
Address through EWN process during detailed design.
Residual risk remains.
38
Constr
Aspergillus: preventative measures required because of
proximity of immune-suppressed patients
5
5
39
Constr
Asbestos: records prove unreliable; further surveys required;
additional asbestos discovered
5
5
Residual risk allowance included for e/over measures to
mitigate effects of potentially disruptive works
This rather depends on the method of construction adopted.
1
Temporary closure of footbridge during deliveries - times to be
agreed with hospital
1
1
1
1
25
Dust to be mitigated through selection of construction
1
techniques and site protocols.
Residual risk remains. Carefully monitoring and screened with
clear material.
25
Trust has provided access to minimal asbestos records for
review.
Further survey work will need to be carried out in a number of
locations, but no cost or time allowances can yet be made by
PSCP for removal of unknown quantities of asbestos.
Limited asbestos in affected area, surveys will be undertaken
prior to intrusive work/activities.
As much information to be ascertained during Stage 3 as
possible in timescales.
Residual risk remains for PSCP post investigation. See
allowances against specific Items elsewhere on this register.
£5,000
PSCP
Y
£0
PSCP
1
Y
£0
PSCP
1
1
Y
£0
PSCP
2
3
6
£0
Trust
1
1
1
£0
PSCP
40
FBC
Existing information: information regarding the existing building 5
is non-existent or of poor quality, or is found to be inaccurate
once tying in works commence
5
25
41
Constr
Existing information: information regarding the existing building 5
is found to be inaccurate once tying in works commence
5
25
To be ascertained during Stage 3.
Residual risk remains post investigation.
1
4
4
Y
£0
Trust
42
Constr
Security: theft of materials or delivered equipment from site
4
4
16
Plant and materials to be secured. Suitable storage to be
used. Vigilance by site staff. Adequate insurance cover.
2
2
4
Y
£0
PSCP
43
Constr
Blue light routes: construction hinders blue light access to site 4
4
16
Strictly not allowed. Effective traffic management plan. Site
induction communication. Clarity in sub-contract orders.
1
3
3
Y
£0
Trust
44
Constr
Strike action by private sector or public sector parties
4
16
Austere times. Industrial unrest likely and possibly
unannounced.
4
4
16
£0
Joint
4
Difficult to determine the cost and/or time impact at this stage.
Risk to both parties.
45
Constr
Late receipt of design information
3
4
12
Mitigate risk through robust programming, IRS, clarity of brief,
regular monitoring
1
4
4
Y
£0
PSCP
46
FBC
P21+ Process: failure to follow process - reputational impact
4
4
16
Seek support where unclear. Training available. Resource
accordingly.
2
2
4
Y
£0
PSCP
6
47
FBC
GMP figure is agreed before design is fully developed in detail 3
4
12
Design has been progressed from a feasibility scheme to
roughly RIBA Stage D/E to enable GMP pricing.
3
4
12
£32,000
PSCP
Design still to be developed in detail through to Construction
Issue.
Allowance provided here for residual risks associated with
design development (e.g. at interfaces etc) as the coordinated
design is progressed to Construction Issue.
48
FBC
Increase in commodity prices post-GMP impacting on Trust
4
4
16
Track pricing trends and assess suitable risk allowance.
Low risk for Group 2/3 items because of advance equipment
purchasing.
2
2
4
£0
Trust
49
Constr
Increase in commodity prices post-GMP impacting on PSCP
4
4
16
Track pricing trends and assess suitable risk allowance if
possible within GMP.
Packages to be procured fairly soon after GMP agreed.
Low residual risk to PSCP.
1
4
4
£0
PSCP
50
FBC
Clinical
Approvals: Trust is late in issuing approvals to proceed
3
4
12
Residual risk remains
2
3
6
£0
Trust
51
FBC
Approvals: assumption that planning decision is received in 8
weeks is incorrect
3
5
15
Some comfort already received from Planning Officer that
2
there were no substantial objections to the development.
Some residual risk, until approval received formally.
Recent delay notified under EWN 003 due to missing tree
information. Planning Officer has made recommendations for
its approval, subject to committee approval on 8-2-12. Trees
have now been felled thus no remaining issues other than
replanting in due course.
2
4
£0
Joint
52
Constr
Supply chain insolvency
3
4
12
Careful selection of suppliers from established supply chain
where possible. Thorough checks before placing orders.
Austere times. Some residual risk remains, but difficult to
quantify at this stage. Action plan to be agreed in the unlikely
event that this risk materialises.
2
4
8
£0
PSCP
53
Constr
Inclement weather
3
5
15
Residual risk remains
2
4
8
£0
Trust
54
Constr
Site traffic: impacts on access around hospital site (blocking
roads / additional movements)
3
3
9
Effective traffic management plan. Site induction
communication. Clarity in sub-contract orders.
1
3
3
Y
£0
PSCP
55
Constr
Suicide: scaffold etc is an allurement for potential suicide
attempts
3
4
12
Secure hoarding. Ladders made-safe. Opportunities
minimised as far as reasonably practicable.
1
4
4
Y
£0
PSCP
56
FBC
Approvals: planning application is unsuccessful
3
5
15
Some comfort already received from Planning Officer that
there were no substantial objections to the development.
Some residual risk, until approval received formally.
Recent delay notified under EWN 003 due to missing tree
information. We understand that the Planning Officer has
made recommendations for its approval, subject to committee
approval on 8-2-12. Planning approval obtained, minor
conditions are not onerous.
2
2
4
Y
£0
Joint
57
FBC
Approvals: planning application is successful but conditioned
3
3
9
Residual risk remains, but based on Kadoorie's planning
conditions, potential impact on PSCP considered to be low
risk. Conditions now known and not onerous.
1
3
3
Y
£0
PSCP
58
FBC
Clinical
Brief: brief is not translated into design (communication)
2
4
8
Regular and effective communication. Use of EWN/CEN etc
process as required.
Residual risk remains for PSCP, but risk allowances made
against other items here accordingly.
1
4
4
£0
PSCP
Y
7
59
Constr
Discovery of the unknown above and beyond separate risk
3
items identified in this register, or possibility of major disruption
to PSCP works due to significant but reasonably
unforeseeable event.
5
15
Force majeure.
Residual risk remains.
3
5
15
£0
Trust
60
Constr
Craneage: lifting and dropping over live areas
3
5
15
Clear and robust lifting plan. Pre-arranged lifts. Clear
communication. Competent lifting team. Additional control
measures including policing at ground level.
1
1
1
Y
£0
PSCP
61
Constr
Parking: public car parking spaces are lost during the works
3
2
6
Effective traffic management plan. Site induction
communication. Clarity in sub-contract orders.
1
3
3
Y
£0
PSCP
62
Constr
Completion: failure to provide O&M manuals at Completion
2
3
6
Start collating early. Robust management of suppliers. Clarity 1
in subcontract orders.
3
3
Y
£0
PSCP
63
Constr
Unable to obtain sufficient resources
2
3
6
Identification of resource requirements beforehand.
Management of resource.
1
3
3
Y
£0
PSCP
64
Constr
Unable to achieve BREEAM Excellent rating
2
4
8
Initial BREEAM Assessment indicates "Pass" achievable for
1
this project, assuming further monies spent on additional
surveys.
EWN 001 raised during Stage 3.
Derogation certainly required from NHS new-build requirement
of "Excellent", but Trust to confirm aspirations for certification
when derogation still required. See also Item 95 below.
BREEAM rating assessed and confirmed (PASS) - no longer
an issue.
1
1
Y
£0
Trust
65
Constr
Consequential Improvements (under Part L). "Extension"
works. 10% value of works to be spent on Consequential
Improvements to existing building.
5
5
25
Assumed to be not applicable.
1
No allowances made for it, either in the priced works or risk, at
feasibility or GMP stages.
4
4
Y
£0
Trust
66
FBC
Clinical
Equipment: co-ordination of design with items of Employer
selected / supplied Group 2 equipment
5
5
25
Consider during detailed design. Current requirements known. 1
Allowance within BWIC.
4
4
£0
PSCP
67
FBC
Clinical
Phasing: method of maintaining cot numbers and decanting
whilst meeting infection control concerns cannot be agreed
4
5
20
Discussed at length with the Trust/ clinical team. Agreed
scheme included with GMP proposals.
1
4
4
£0
PSCP
68
FBC
Clinical
Service connections: downtime during connections impacts on 5
operation of unit
5
25
Consider during detailed design. Robust planning. Effective 2
communication and agreement beforehand.
Residual risk remains, allowance included for e/over mitigation
measures.
5
10
£1,500
PSCP
69
Constr
Trailing dirt, mud etc through existing building
3
3
9
Robust management of suppliers. Site inductions. Mitigation
measures (boot-scrapers/ over-shoes etc)
1
3
3
Y
£0
PSCP
70
Constr
Impact on adjacent (not neonatal buildings - research
laboratories?)
3
3
9
Robust method statements. Robust site management.
Adjacent baby unit arguably more sensitive than other nearby
building uses, but still important to mitigate disruption.
1
3
3
Y
£0
Joint
71
FBC
Clinical
Disruption to operation of existing neo-natal unit
5
5
25
Robust method statements. Robust site management.
2
Effective communication. Good design. Appropriate selection
of building components.
Residual risk remains, with allowance for e/over mitigation
measures.
5
10
£1,500
PSCP
72
FBC
Approvals: derogations are proposed which the Trust cannot
accept
5
5
25
Develop during detailed design. EWN process to avoid
surprises. Derogations identified and accepted.
2
2
4
£0
Joint
73
FBC
Clinical
Methodology for connection into new building cannot be
agreed / impacts on operation of the unit
4
5
20
Robust method statements. Robust site management.
2
Effective communication. Good design. Proposals discussed
and agreed in-principle with stakeholders already.
Residual risk remains that further measures have to be taken,
but no allowance determined as contingency against this Item.
5
10
£0
PSCP
Y
8
74
FBC
Clinical
Commissioning: cannot commission the building and services
installations to meet the design criteria
4
5
20
Robust method statements. Robust site management.
Effective communication. Proper planning and design of
works.
Residual risk remains but no allowance determined as
contingency.
2
5
10
£0
PSCP
75
Constr
Unable to maintain existing cycle parking during the works
5
1
5
Temporary relocation of facility. To be discussed further with
Trust.
2
1
2
£0
Trust
76
FBC
Clinical
Commissioning: commissioning process not agreed up front /
takes longer than programmed
4
5
20
Robust method statements. Robust site management.
Effective communication. Proper planning and design of
works.
Residual risk remains but no allowance determined as
contingency.
2
5
10
£0
PSCP
77
Constr
Conflict between multiple projects on site
5
4
20
Potentially a positive between NICU and Kadoorie, because of 2
synergies for site management. Uncertainties remain with
other non-P21+ scheme projects, but expectation for dialogue/
interface with Capita main entrance project team.
Some residual risks remain, but no risk allowance made at the
moment.
4
8
£0
Joint
78
FBC
Clinical
Infection risk in tap selection
4
5
20
Good design. Robust method statements. Robust site
management.
Must have sign off for the taps
1
5
5
£0
PSCP
79
FBC
Clinical
Additional disabled WC required within the unit
3
3
9
Change of Works Information to be raised to cover additional
client requirements from feasibility stage.
1
3
3
Y
£0
Trust
Y
In the meantime, Trust have confirmed that provision is to be
made within the GMP pricing for the additional disabled toilet.
80
Constr
Access to cryogen store, gas store and generator affected by
the works
3
5
15
Robust method statements. Proper planning. Scheduled
deliveries. Good communication. Good site management.
1
1
1
Y
£0
Trust
81
FBC
Clinical
Charitable funding of equipment is insufficient to fit out the new 3
unit
5
15
Austere times. Funding targets never guaranteed. Mitigation
by Trust? Funding obtained, equipment purchased.
1
2
2
Y
£0
Trust
82
FBC
Clinical
Funding for staffing is not forthcoming
4
5
20
Mitigation by Trust? Staffing planned - approved VCF's within
the FBC.
2
2
4
Y
£0
Trust
83
Constr
Accidents
3
4
12
Effective site management. Proper planning. H&S Plan.
Competency of personnel. H&S equipment/ site set-up
appropriate.
1
4
4
Y
£0
PSCP
84
FBC
Design errors due to scaling inaccuracies on existing
information
3
5
15
Avoid scaling off existing information. Further surveys
required on site to confirm.
1
5
5
£0
PSCP
85
FBC
Clinical
Security: risk of harm to children / babies / vulnerable mothers 4
5
20
CRB checks of all WD employees and subcontractors working 1
within unit.
4
4
£0
PSCP
86
FBC
AHU in proposed location may take in fumes from existing
stand-by generator location
3
5
15
AHU plant to be positioned within ground level plantroom with
appropriately placed air intakes.
1
4
4
£0
PSCP
87
Constr
Constraints on compound location compromise effective
management of the works
3
4
12
Main office compound located in ex. BAM offices. Relatively
small welfare set-up required local to site works.
1
3
3
£0
PSCP
Design development contingency covered in Item 47.
Procedure clarified and agreed with Trust.
Y
9
88
Constr
Environmental: possible birds nests etc
3
2
6
Ecology check required. Tree removal to be performed preMarch'12 to avoid nesting season.
2
2
4
Y
£0
Joint
89
FBC
Peculiarities of existing building (no lintels, prone to thermal
movement etc etc)
4
2
8
Consider interfaces during detailed design.
Residual risk remains in terms of allowances to treat
interfaces.
4
1
4
Y
£0
PSCP
90
Constr
Constraints imposed on working in close proximity to cryogen
store
3
3
9
Robust method statements. Robust site management.
Effective communication. Proper planning of works.
1
1
1
Y
£0
PSCP
91
Constr
Asbestos report, routes for services and refurb survey
requirement
5
5
25
Risers for medical gases clash with amosite ceiling. See also 2
Item 39 above. Appropriate surveys will be undertaken prior to
intrusive work/activities.
3
6
£0
Trust
92
FBC
Route for services through building including incoming
supplies; and the issue of maintaining access, whilst testing
and removing for asbestos and then continuing with the work
5
5
25
See also Item 39 above.
4
4
16
£0
Trust
93
FBC
There is an unidentifiable buried service on site, which could
5
delay the scheme, or result in disruption of existing buildings if
not considered and designed around
5
25
Trust to identify service and advise.
4
4
16
£0
Trust
Additional builders work to M&E services for service route
requirements not yet fully determined
4
2
4
8
£2,500
PSCP
£0
Trust
94
FBC
3
No costs included at GMP stage.
12
Not yet fully bottomed-out in time available prior to GMP
submission. Further detailed survey work required.
Residual risk allowance included as e/over to priced bswk
allowance.
95
FBC
Additional costs for fees in respect of a flood risk assessment, 3
ecology and monitoring of services to achieve a BREEAM
"Pass"
3
9
See also Item 64 above. Trust to confirm aspirations.
BREEAM rating assessed and confirmed (PASS) - no longer
an issue.
1
1
1
Y
96
Constr
LADs at £1,500 per day on final completion
3
4
12
Works to be properly planned and executed so as to avoid
delays. EWN process to be utilised where delays are
foreseen.
1
4
4
£0
PSCP
97
Constr
Unforeseen out-of-hours working above and beyond current
WD supervisor allowances
2
3
6
Residual allowance for e/over costs for supervisors
2
2
4
£5,000
PSCP
98
FBC
GMP exceeds Affordability Amount
5
5
25
Initial GMP figure submitted 21-12-11 in excess of Affordability 2
Amount.
2
4
£0
Joint
3
6
£0
Trust
Y
Updated GMP figure submitted 27-1-12. Implications to be
discussed and action plans agreed. Rev GMP agreed 14th
March 2012, subject to SHA and Trust Board approvals, thus
no longer an issue.
99
Constr
Existing high-temperature heating mains.
Capable of isolation.
Sufficient capacity therein.
3
5
15
PSCP assumes that the existing high-temperature heating
main has sufficient capacity for the proposed connections to
the new extension, and that its isolation to make the
connections will be possible (at an agreed time).
2
Total:
£53,500
10
Appendix F - Revenue Costs Model
Changes from Outline Business Case to Full Business Case
1
2
3
4
5
6
7
Change
updated clinical support costs from ratios to
actual
amended current SpR staffing to 11
amended planned staffing numbers to match
staffing plan
added parent accommodation in Arthur
Sanctuary House
added IT support
adjusted for change to construction dates and
increase of first 4 cots at end of March 2013
amended equipment to show actual spend in
2011/12 for Option 2
Details
4 rooms at 480 per month in non-pay costs
0.5 Band 7 WTE in A&C staffing
2013/14 now has an average of 5 additional ITU cots: 4
from April 2013 and 6 from September 2013
Preferred Option - Option 2
11
9
21
41
16 Cot Expansion
Option 2 - 2013/14
ICU cots
16
HDU cots
9
SCBU cots
21
46
1086
1538
1538
staff costs
non-pay costs
subtotal direct costs
7,024,372
1,131,756
8,156,128
7,776,099
1,456,360
9,232,459
9,501,075
1,774,325
11,275,400
Indirect costs
capital charge and depreciation
corp overheads
HGH Costs
678,666
82,534
1,325,219
1,910,039
1,012,741
530,848
1,427,077
1,910,039
1,351,185
530,848
1,427,077
1,910,039
Total Revenue Costs
12,152,586
14,113,163
16,494,548
total Income
12,359,655
14,363,255
16,725,255
207,069
250,091
230,706
ICU cots
HDU cots
SCBU cots
Do Nothing
Current
m2
Surplus/(Deficit)
16 Cot Expansion
Option 2 - final
ICU cots
HDU cots
SCBU cots
20
11
22
53
Neonatal Expansion - Summary
Do Nothing
Current
Direct revenue costs
16 Cot Expansion
Option 2 - final
ICU cots
HDU cots
SCBU cots
11
9
21
41
Existing m2
1086
Staff
Consultants
Junior Medical
Nursing
Agency
ICU cots
HDU cots
SCBU cots
total m2
New & refurb
Option 3
20
11
22
53
1538
ICU cots
HDU cots
SCBU cots
Max m2
26
12
24
62
1850
1,087,320
1,352,247
3,526,305
825,000
1,417,320
1,536,228
5,757,053
412,500
1,506,420
1,857,737
7,938,596
412,500
Non Clinical
Directorate Mgmt
Total Staff
185,833
47,667
7,024,372
330,307
47,667
9,501,075
723,051
47,667
12,485,970
Non-Staff
1,131,756
1,774,325
2,191,439
Subtotal Direct costs
8,156,128
11,275,400
14,677,410
Clinical Support
Radiological Sciences
Clinical Measurement
Pharmacy
Dieticians
Physiotherapy
Laboratory Medicine
84,000
9,282
144,161
7,640
83,895
231,973
168,000
27,846
196,161
19,350
100,050
496,437
207,014
27,846
241,715
17,565
165,351
674,888
Equipment Maintenance
117,715
343,341
668,730
Subtotal Indirect costs
678,666
1,351,185
2,003,109
59,782
22,752
82,534
376,359
154,488
530,848
560,969
1,135,202
1,696,171
1,325,219
1,427,077
2,502,078
1,910,039
12,152,586
1,910,039
16,494,548
1,910,039
22,788,806
Indirect revenue costs
Equipment - capital charges (av. Annual)
Buildings - capital charges (av. Annual)
Capital Charge & Depreciation
Contribution to Corporate Overheads,
current @ 15%
15%
HGH costs
TOTAL REVENUE COST
Income (as per SLAM report 2010/11 Horton excluded)
PCT - CC Neonatal Intensive Care
PCT - CC Neonatal High Dependency
PCT - CC SCBU without carer
PCT - CC SCBU with carer
PCT - CC Neonatal normal care
PCT - Drugs Viral B&C Hepatitis &
Respiratory Syncytial Virus
PCT - Drugs Pulmonary surfactants
PCT - NEL
PCT - NELNE
PCT - NELXBD
PCT - OPFASPCL
PCT - OPFASPNCL
PCT - OPFUSPCL
PCT - OPFUSPNCL
Activity
2,756
2,471
5,992
118
111
4,063,000
2,277,000
3,369,000
33,000
10,000
5,011
3,020
6,277
124
143
7,387,000
2,783,000
3,530,000
34,000
13,000
6,514
3,295
6,848
135
168
9,603,000
3,036,000
3,851,000
37,000
15,000
80
607
2
521
224
389
219
20,000
3,000
104,000
1,158,000
0
73,000
27,000
60,000
13,000
0
0
103
785
3
521
224
389
219
20,000
3,000
135,000
1,496,000
1,000
73,000
27,000
60,000
13,000
0
0
121
918
3
521
224
389
219
20,000
3,000
158,000
1,750,000
1,000
73,000
27,000
60,000
13,000
1,704
1,058,883
1,704
1,058,883
1,704
1,058,883
HGH Income
community nurse follow up
Private Patient
R&D
Other non NHS clinical
Charitable Funds
SIFT (est)
Other - SHA funding for salary replacement
Other - Brookes University contribution to LP post
RSV immunisation
Total Income
SURPLUS / (DEFICIT)
10
0
0
0
0
33,167
13,221
22,374
22,000
0
0
0
0
33,167
13,221
22,984
22,000
0
0
0
0
33,167
13,221
22,984
22,000
12,359,655
16,725,255
19,797,255
207,069
230,706
-2,991,552
PAY
baseline
Option 1
ICU cots
HDU cots
SCBU cots
Do Nothing
Option 1
11
9
21
41
ICU cots
HDU cots
SCBU cots
New build
Option 2
11
9
21
41
ICU cots
HDU cots
SCBU cots
New & refurb
Option 3
20
11
22
53
ICU cots
HDU cots
SCBU cots
New build
Option 2 2013/14
26
12
24
62
ICU cots
HDU cots
SCBU cots
16
9
21
46
Existing
WTE
Existing
cost £
Av cost
per WTE £
Revised
WTE
Revised
cost £
Revised
WTE
Revised
cost £
Revised
WTE
Revised
cost £
Revised
WTE
Revised
cost £
Medical - Consultant
Medical - ST 4-6
Medical - ST 1-3
Nursing - band 8a
Subtotal
8.49
11.00
10.00
2.20
31.69
1,087,320
792,627
559,620
141,304
2,580,871
110,000
72,057
55,962
64,229
8.49
10.00
10.00
2.20
30.69
1,087,320
720,570
559,620
141,304
2,508,814
11.49
12.00
12.00
5.20
40.69
1,417,320
864,684
671,544
333,991
3,287,539
12.30
13.20
16.20
9.20
50.90
1,506,420
951,152
906,584
590,907
3,955,064
10.00
12.00
12.00
3.20
37.20
1,253,420
864,684
671,544
205,533
2,995,181
Nursing - band 8a
Nursing - band 7
Nursing - band 6
Nursing - band 5
Nursing - band 4
Nursing - band 3
Nursing - band 2
3.00
16.45
12.61
45.75
4.83
5.94
2.07
0.00
90.65
0.00
1.00
2.21
2.32
1.68
192,687
813,815
504,002
1,545,171
149,005
144,013
36,308
0
3,385,001
64,229
49,472
39,968
33,774
30,850
24,245
17,540
3.40
16.81
15.13
49.99
4.83
5.94
2.07
218,379
831,625
604,722
1,688,374
149,005
144,013
36,308
3.00
21.81
28.61
77.75
4.83
5.94
5.07
192,687
1,078,985
1,143,497
2,625,946
149,005
144,013
88,928
8.40
22.41
54.53
92.29
4.83
5.94
6.27
539,524
1,108,668
2,179,479
3,117,024
149,005
144,013
109,976
3.00
17.81
19.61
55.75
4.83
5.94
3.07
192,687
881,097
783,781
1,882,913
149,005
144,013
53,848
49,472
38,000
26,700
24,700
18,800
98.17
0.00
1.00
2.21
2.32
1.68
3,672,426
0
38,000
59,007
57,304
31,522
147.01
1.50
1.00
4.21
5.00
3.00
5,423,062
74,208
38,000
112,407
123,500
56,400
194.67
1.50
2.00
13.21
8.72
4.20
7,347,689
74,208
76,000
352,707
215,384
78,960
110.01
1.50
1.00
2.21
4.00
2.00
4,087,344
74,208
38,000
59,007
98,800
37,600
7.21
185,833
7.21
185,833
13.21
330,307
28.13
723,051
9.21
233,407
Subtotal
Clerical / Admin - band 7
Clerical / Admin - band 6
Clerical / Admin - band 4
Clerical / Admin - band 3
Clerical / Admin - band 2
Subtotal
Agency/Bank
Total
Directorate Mgmt
Cost increase
38,000
59,007
57,304
31,522
825,000
129.55
6,976,705
412,500
136.07
47,667
6,779,572
412,500
200.91
9,453,408
47,667
15.02
412,500
273.70
47,667
98.55
2,476,703
Notes
i) All staff costed at 11/12 pay rates including unsocial enhancements and employers oncosts.
ii) All other staff have been included eg retrieval team, Community Sister etc.
iii) The costs associated with staff used in other medical specialities have not been removed for this exercise eg medical staff post baby checks.
12,438,303
412,500
156.42
47,667
149.36
5,461,599
7,728,432
47,667
47.85
751,727
Neonatal Expansion - Non Pay (using activity model occupancy rates)
Existing
ICU cots
HDU cots
SCBU cots
ICU
HDU
SCBU
parent accommodation rooms
Total
Do Nothing
Option 1
11
9
21
41
4
ICU cots
HDU cots
SCBU cots
16 Cot Extension
Option 2
11
9
21
41
662,886
359,737
109,134
662,886
359,737
109,134
1,131,756
Cost increase
ICU cots
HDU cots
SCBU cots
642,569
1,059,683
324,603
HDU
Weighting
SCBU
Weighting
Total
Weighting
Drugs
Consumables
TPN
HSSU
Blood & Blood Products
Other misc
£218371
£551421
£0
£31987
£53612
£83890
£138582
£10919
£27571
£0
£1599
£2681
£4195
£6929
£229290
£578992
£0
£33586
£56293
£88085
£145511
6.00
6.00
5.00
5.00
6.50
6.50
6.00
2.50
2.75
4.00
5.00
3.00
2.50
2.50
1.50
1.25
1.00
0.00
0.50
1.00
1.50
10.00
10.00
10.00
10.00
10.00
10.00
10.00
£1077863
£53893
£1131756
41.00
22.25
6.75
70.00
2010/11
Cot Days
Weighting
Weighted
Cot Days
Quantum
Cost per
Cot day £
3000
1814
7000
41.00
22.25
6.75
123000
40362
47250
660,961
216,889
253,906
220
120
36
11814
70.00
210612
1,131,756
Option 2
Increase in
Cot no's
Days
per Annum
Estimated
Occupany
Rate %
Estimated
Cot days
per Annum
Cost per
Cot day £
Estimated
Cost
Increase £
9
2
1
365
365
365
75%
75%
85%
2464
548
310
220.32
119.56
36.27
542,814
65,461
11,253
ICU
HDU
SCBU
619,529
3322
Option 3
Increase in
Cot no's
Days
per Annum
Estimated
Occupany
Rate %
Estimated
Cot days
per Annum
Cost per
Cot day £
Estimated
Cost
Increase £
15
3
3
365
365
365
75%
75%
85%
4106
821
931
220.32
119.56
36.27
904,690
98,192
33,760
1,036,643
5858
Option 2 initial
Increase in
Cot no's
Days
per Annum
Estimated
Occupany
Rate %
Estimated
Cot days
per Annum
Cost per
Cot day £
Estimated
Cost
Increase £
5
0
0
365
365
365
75%
75%
85%
1369
0
0
220.32
119.56
36.27
301,563
0
0
5
1369
16
9
21
46
0
ICU
Weighting
21
ICU cots
HDU cots
SCBU cots
1,131,756
Total
Cost £
ICU
HDU
SCBU
26
12
24
62
964,449
359,737
109,134
23,040
1,456,360
11/12
Inflation
5.00%
12
ICU cots
HDU cots
SCBU cots
1,567,576
457,929
142,894
23,040
2,191,439
2010/11
Actual
Spend £
ICU
HDU
SCBU
20
11
22
53
New build
Option 2 2013/14
1,205,700
425,198
120,387
23,040
1,774,325
Workings
ICU
HDU
SCBU (estimate by P Rankin 17/6/09)
New & refurb
Option 3
301,563
Neonatal Expansion - Clinical Support Services
Existing
ICU cots
HDU cots
SCBU cots
Radiology (D Tolley 17/10/11)
Clinical Measurement (E Palawiya)
Pharmacy (B Vadesh 29/9/11)
Pharmacy - Baxters (increase to TPN share of service contrac
Dieticians (C Middleton)
Physiotherapy (J Higham)
SaLT - 0.05 Band 8A
Laboratory Medicine (G Davis)
Do Nothing
Option 1
11
9
21
41
ICU cots
HDU cots
SCBU cots
16 Cot Extension
Option 2
11
9
21
41
ICU cots
HDU cots
SCBU cots
New & refurb
Option 3
20
11
22
53
ICU cots
HDU cots
SCBU cots
26
12
24
62
86,923
84,000
168,000
207,014
9,282
9,282
27,846
27,846
144,161
144,161
196,161
241,715
0
0
10,000
12,322
7,640
7,640
19,350
17,565
83,895
83,895
100,050
165,351
2,145
2,145
3,282
4,044
231,973
231,973
496,437
674,888
566,019
563,096
1,021,125
1,350,745
-2,923
455,106
784,726
milk bank in clinical staff costs
Total
Cost increase
Neonatal Expansion - Non-theatre Equipment
Existing
Do Nothing
Option 1
ICU cots
HDU cots
SCBU cots
11
9
21
41
Capital equipment
Charitable equipment
ICU cots
HDU cots
SCBU cots
12
8
21
41
£0
£0
£0
CRITICOOL
VENTILATOR
PHILLIPS MONITOR with ECG, Resp, non invasive BP, invasive BP,
GIRAFFE OMNI-BED INCUBATOR
X-ray Mobile DaRt Evolution 27x35cm detector
ULTRASOUND SCANNER -Acuson S2000 (Siemens)
BRAINZ MONITOR (aEEG)
3
3
3
3
3
3
3
3
19
29
13
1
1
3
40,428
570,017
421,516
346,366
116,590
95,415
61,200
40,428
570,017
421,516
346,366
116,590
95,415
61,200
VAPOTHERM
3
10
53,400
53,400
BILISOFT GE healthcare ( 056069)
Breast Pumps
Giraffe shuttle
PHOTOTHERAPY UNIT (NATUS NEOBLUE)
3
3
3
10
10
1
10
33,566
23,212
16,007
15,390
33,566
23,212
16,007
15,390
NEOPUFF
Medicon workstation for cardiac ultrasound
BILIRUBINOMETER
ECG MACHINE
3
3
3
3
16
1
1
1
9,868
7,200
4,752
3,240
9,868
7,200
4,752
3,240
CENTRIFUGE
Blood Glucose monitors
CO-Boxes to go with the Glucose Meters
3
3
1
4
4
2,234
2,580
1,680
2,234
2,580
1,680
THERMOMETERS
ULTRASOUND SCANNER -Cardio/head
Intraoperative cranial ultrasound
Digital Docking stations for infusion devices 7-bay
Saturation Monitors (small and mobile)
Cosytherm
Pasteuriser
Criticool trolley
jaundice meters
Video EEG
3
3
3
3
3
3
2
3
3
3
16
1
1
20
13
6
2
1
10
1
1,920
117,000
78,786
59,025
13,509
12,168
28,152
3,654
36,540
59,862
1,920
117,000
78,786
59,025
13,509
12,168
28,152
3,654
36,540
59,862
transilluminators
human milk analyser
Desk top PCs
3
2
1
10
3,225
15,132
3,225
15,132
WRIST BAND PRINTER
3
1
335
335
3
1
3,369
3,369
2/3
3
3
3
1
1
3
57,078
403
3,450
1,331
57,078
403
3,450
1,331
ITU NURSING TROLLEYS
3
16
9,453
9,453
NURSES DRUG TROLLEYS incl sharps bins
3
8
3,095
3,095
TALL STOOLS (cotside)
3
32
3,379
3,379
staff (90)/parent (20) half hight lockers
2
110
11,682
11,682
COMFORTABLE ARMCHAIRS (cotside)
3
16
4,524
4,524
MOBILE SCREENS
3
4
1,557
1,557
MOBILE SCREENS
3
4
1,660
1,660
Office desks
3
8
1,315
1,315
RESUS TROLLEY
3
2
730
730
Ergotron trollies
corner desk + pedestal
document scanner
Ipads
OFFICE CHAIRS
HAYWOOD 3 SEATER UNIT REF B320-3A WITH ARMS DUCK
EGG BLUE VIFLEX 155
HAYWOOD 2 SEATER UNIT REF B320-2A WITH ARMS DUCK
EGG BLUE VIFLEX 155
3
3
18
1,555
GRP2MED0
375
602
06
LIG025
GRP3MED0
08
cot bed space
GRP3MED0
03
GRP3MED0
18
near patient
cot bed space
near patient
testing
GRP3MED0
31
GRP3MED0
cot bed space
equipment
GRP3MED0
Cot bed
cot bed space
GRP3MIS00
6
WARD
CLERK
AREA HDU
equipment
bay
GRP3MIS00
1
GRP3MIS00
2
GRP3FUR0
10
GRP3FUR0
GRP3FUR0
01
GRP3MIS01
2
GRP3MIS01
2
GRP3MIS00
3
GRP3MIS00
4
GRP3MIS00
5
GRP3MIS01
0
1,221
1,221
IV TROLLEYS
3
2
774
774
LP trolleys
3
2
753
753
NON CLINICAL WASTE SACKHOLDER (BLACK REFUSE)
3
12
1,548
1,548
CLINICAL WASTE SACKHOLDER (YELLOW)
3
12
1,117
1,117
GRP3MIS00
9
LARGE DRUG CUPBOARD INC CD CUPBOARD
3
1
601
601
GRP2MIS00
3
FILING CABINETS
3
10
974
974
LARGE MILK FRIDGE LABCOLD REF RLWF1010
3
2
711
711
LARGE LINEN TROLLEY
3
1
583
583
DRUGS FRIDGE
3
1
1,665
1,665
GLOVE & APRON DISPENSERS
2
14
588
588
4
291
291
3
3
1
10
504
50
504
50
3
1
736
736
3
1
648
648
DRUGS FRIDGE SMALL TO FIT ON WORKTOP REF RLDF0210
3
1
531
531
cot bed space
cot bed space
cot bed space
cot bed space
reception and
cot bed space
cot bed space
cot bed space
Administratio
n offices
GRP3FUR0
16
2
3
cot bed space
room 2804
room 2807
3
LINEN BINS
cot bed space
4,800
LONG LINE TROLLEY
Sonarwarm Diagnostic Sonar jelly warmer
Office Bins
THREE SEATER SOFA THORPK4623X FABRIC PANVILLE
VIFLEX 609 ROSE
TWO SEATER SOFA THORPK4622X FABRIC PANVILLE VIFLEX
609 ROSE
bed space
bed space
bed space
bed space
equipment
cot bed space
GRP3FUR0
09
375
602
cot
cot
cot
cot
GRP3MED0
GRP3MED0
GRP3MED0
11
GRP3MED0
07
GRP3FUR0
11
1
Room
Location
Cubicle 7 in
GRP3MED0
13
GRP3MED0 VEN900
GRP2MED0
GRP3MED0 INC900
1,555
2
ADB Room
Data Sheet
Code
600,000
39,157
2,724
Unique Ref
Code
600,000
39,157
2,724
COST
2012/13
ordered
during
construction
1
4
10
TOTAL
ORDERED
3?
2
3
Total incl
VAT
Quantity
Option 2
estimated NICU contribution to ITU EPR system
DIAGNOSTIC QUALITY PACS with a CRIS monitor
weighing scales
THEATRE LIGHT
ICU cots
HDU cots
SCBU cots
0
0
0
0
Equipment
Group
Items
16 Cot Extension
Option 2
GRP2MIS00
5
GRP3MIS00
7
GRP2MIS00
4
GRP2MIS00
1
GRP3MIS01
1
parking bay
CHA003
reception,war
d clerk office
and staff
base (6),
admin offices
(10)
reception
cot bed space
cot bed space
cot bed space
cot bed space
All clinical
whb, scrub
troughs,
clean utility,
drugs prep
etc
drugs prep
room
ward clerk
office (2) +
admin offices
(8)
drugs prep
room
parking bay
drugs prep
room
cot bed space
parking bay
SLUICE
New & refurb
Option 3
20
11
22
53
ICU cots
HDU cots
SCBU cots
26
12
24
62
2,694,276
0
2,878,611
1,856,975
2,694,276
4,735,586
SAFETY CABINET WITH YELLOW DOOR
3
1
352
352
LARGE MEDICAL FREEZERS
3
1
1,141
1,141
3
20
2,852
2,852
seminar room
3
4
1,282
1,282
908
908
seminar room
Room 2707
Milk Prep
ROOM 2710
HDU
PARENTS
ROOM +
STAFF
ROOM
ROOM 2808
OFFICE
SPCE (2)
WAS
PRAYER
ROOM
BREAST
FEEDING
ROOM
KYOS STACKING CHAIRS WITH ARMS REF KS3A SILVER
FRAME FABRIC CADET VENTURE 609 ROSE
HARLEY FOLDING TABLES ,WHEELS BEECH REF HP7RC
ROOM 2707
MILK PREP
ROOM
STORAGE RACK DOUBLE
3
TV/DVD
3
2
816
816
DESKS IN BEECH
3
5
810
810
DROP DOWN ARM PATIENT CHAIRS MODEL 743 WITH
HOUSEKEEPING WHEELS COLOUR VYFLEX 155 DUCK
3
2
609
609
LINEN TROLLEY REF WT42/WT /COVER FLEXIBLE FRONT
COVER
3
1
583
583
(2nd trolley)
DISHWASHER SLIMLINE
2
1
218
218
DISWASHER REGUALR SIZE REF DWD5411W
OPERATORS CHAIRS FABRIC VINYL JUST COLOUR APPLE
MINT
TOY STORAGE CUPBOARD
MOBILE PEDESTALS IN BEECH
2
218
218
ITU
DOCTORS
OFFICE
KITCHEN
3
5
432
432
3
3
2
6
840
1,030
840
1,030
3
1
283
283
3
1
283
283
3
1
235
235
3
2
173
173
3
3
3
3
1
1
1
1
164
164
157
119
164
164
157
119
MICROWAVE REF KOR6L65
3
1
50
50
CLOCK
2
1
19
19
SMARTBOARD AND PROJECTOR
MOBILE TV AND DVD
UNDER BENCH MOBILE PEDESTALS IN BEECH REF UTM3XD
2
3
3
1
1
2
2,496
810
343
2,496
810
343
2 DRAWER FILING CABINET GREY REF CC2H1A
3
1
78
78
78
78
PATIENT ARMCHAIR PERRY REF 730WAI 730W WITH
HOUSEKEEPING WHEELS FABRIC PANVILLE VYNAL VIFLEX
609 ROSE
PATIENT ARMCHAIR PERRY REF 732 MED HIGH WITH
HOUSEKEEPING WHEELS FABRIC PANVILLE VYNAL VIFLEX
609 ROSE
90 DEGREE CORNER UNIT
OPERATORS CHAIRS FABRIC VINYL JUST COLOUR APPLE
MINT
DESK
DESK
DESK SIZE 1400MM BEECH
COFFEE TABLE BEECH RECTANGLE REF 712
ROOM 2723
ROOM 2713
HDU
EXPRESSIN
G ROOM
LDU
EXPRESSIN
G ROOM
ROOM 2717
ROOM 2718
ROOM 2709
KITCHEN
HDU
TRANSPORT
ROOM
seminar room
seminar room
ROOM 2723
Room 2602
Sisters
Room 2827
Clinical
Educators
2 DRAWER FILING CABINET GREY REF CC2H1A
3
1
Desk top PCs
3
10
TV/DVD (waiting area)
2
1
0
960
reception
Suction mounting brackets
2
16
0
960
cot bed space
Catheter holders
3
16
0
Medical air flow meters
3
16
0
1,411
cot bed space
4,800
GRP2FUR0
01
GRP2MED0
03
GRP3MED0
960
24
cot bed space
GRP3MED0
22
GRP3MED0
23
GRP3FUR0
156
15
GRP3FUR0
480
14
GRP3FUR0
720
13
Suction Controllers low suction
3
16
0
2,899
cot bed space
medical Oxygen flow meters (15 l per minute) (doubles)
3
16
0
2,208
cot bed space
COFFEE TABLE
3
1
0
SMALL ARMCHAIRS
3
2
0
SOFA
3
1
0
Office printers
3
4
0
NOTES TROLLEY
3
2
0
1,680
Office computers
3
8
0
4,800
0
GRP2FUR0
4,200
02
artwork/film
MEPG
2
1
TOTALS
total committed/spent
Items
STEPHANIE VENTILATOR
GIRAFFE OMNI-BED INCUBATOR
PHILLIPS MONITOR with ECG, Resp, non invasive BP, invasive
BP, temp x2, SA02, end tidal co2 & transcutaneous o2 & co2
ASENA CC SYRING PUMP
NICU EPR system- licences central stations, printer etc
ALARIS IV PUMP
BRAINZ MONITOR
ULTRASOUND SCANNER -Cardio/head
ULTRASOUND SCANNER -Other?
Group
quantity
quiet room
quiet room
quiet room
Administratio
n offices
1,200
3,032,245
-370,203
2,662,042
3,032,245
-370,203
2,662,042
Cost per
unit Excl
VAT
forecast
VAT
GRP3FUR0
03
doctors' office
Administratio
n offices
reception
32,234
Option 3
cost incl VAT
total
charity
0
0
30,000
33,000
660,000
726,000
18,683
0
18,683
354,986
354,986
2,295
7,165
3,288
17,801
45,000
45,000
0
0
0
0
0
0
2,295
7,165
3,288
17,801
45,000
45,000
183,600
343,920
98,640
71,204
90,000
90,000
183,600
343,920
98,640
71,204
90,000
90,000
3
3
22
22
30,000
33,000
2
19
3
3
3
3
3
3
80
48
30
4
2
2
660,000
726,000
VAPOTHERM
3
19
3,500
0
3,500
66,500
66,500
PHOTOTHERAPY UNIT (NATUS NEOBLUE)
3
19
3,113
0
3,113
59,142
59,142
ECG MACHINE
3
2
2,340
0
2,340
4,680
4,680
BILISOFT
3
19
1,650
0
1,650
31,350
31,350
CRITICOOL
3
4
5,615
0
5,615
22,460
22,460
NEOPUFF
3
223
843
0
843
187,989
187,989
Mounting solution for EPR
BLOOD GAS ANALYSER
BILIRUBINOMETER
2
3
3
48
2
2
600
2,500
5,000
0
0
0
600
2,500
5,000
28,800
5,000
10,000
28,800
5,000
10,000
Masimo Saturation Monitors
3
4
1,450
0
1,450
5,800
5,800
Medigenic keyboards
CENTRIFUGE
Medical air flow meters
Suction Controllers
Suction mounting brackets
Catheter holders
Oxygen controllers (doubles)
NITRIC OXIDE
spare ventilator tubing
DIAGNOSTIC QUALITY PACS
Ventilator blocks
PHILLIPS MONITOR mobile spares for repair/servicing
EPR trolley for existing cotspaces if cannot wall-mount?
SAFETX
BLOOD GLUCOSE ANALYSER
THERMOMETERS
3
3
3
3
2
3
3
3
3
2
3
3
3
3
3
3
48
2
25
25
25
25
25
4
19
3
19
4
22
3
6
12
256
2,950
100
100
50
50
100
0
50
800
2,500
18,500
2,000
2,000
645
236
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
256
2,950
100
100
50
50
100
0
50
800
2,500
18,500
2,000
2,000
645
236
12,288
5,900
2,500
2,500
1,250
1,250
2,500
0
950
2,400
47,500
74,000
44,000
6,000
3,870
2,832
12,288
5,900
0
0
0
0
0
0
950
0
0
0
44,000
0
3,870
0
capital
Unique Ref
Code
0 GRP3MED00
0 GRP3MED00
GRP2MED00
0
1
0 GRP3MED01
0 GRP3MED00
0 GRP3MED00
0 GRP3MED01
0 GRP3MED01
0 GRP3MED02
GRP3MED01
0
1
GRP3MED00
0
6
0 GRP3MED00
GRP3MED00
0
7
GRP3MED01
0
3
GRP3MED00
0
8
0 GRP2MED00
0 GRP3MED01
GRP3MED01
0
7
GRP3MED01
0
2
0 GRP3MED00
GRP3MED01
0
8
2,500
2,500 GRP3MED02
1,250 GRP2MED00
1,250 GRP3MED02
2,500 GRP3MED02
0 GRP3MED01
0GRP3MED025
2,400GRP2MED004
47,500GRP3MED026
74,000GRP3MED027
0GRP3MED028
6,000GRP3MED029
0GRP3MED030
2,832GRP3MED031
25
12
16
3
3
2
20
2
2
14
2
3
5
2
14
48
25
800
850
90
650
600
600
90
850
800
450
550
200
100
380
38
140
230
160
170
18
130
120
120
18
170
160
90
110
40
20
76
8
28
46
960
1,020
108
780
720
720
108
1,020
960
540
660
240
120
456
46
168
276
24,000
12,240
1,728
2,340
2,160
1,440
2,160
2,040
1,920
7,560
1,320
720
600
912
638
8,064
6,900
0
0
0
0
2,160
1,440
0
0
1,920
7,560
0
0
0
0
0
8,064
6,900
24,000 GRP3MIS001
12,240 GRP3MIS002
1,728 GRP3MIS010
2,340 GRP3MIS003
0 GRP3MIS004
0 GRP3MIS005
2,160 GRP3MIS009
2,040 GRP2MIS003
0 GRP3MIS006
0 GRP3MIS012
1,320 GRP2MIS004
720 GRP2MIS005
600 GRP3MIS011
912 GRP3MIS007
638 GRP2MIS001
0 GRP3FUR010
0 GRP3FUR001
2
1
3,500
700
4,200
4,200
4,200
3
3
3
3
2
3
3
3
3
3
3
3
3
12
4
40
6
1
3
8
1
2
3
2
1
4
150
700
40
450
800
800
100
600
200
150
110
130
80
30
140
8
90
160
160
20
120
40
30
22
26
16
180
840
48
540
960
960
120
720
240
180
132
156
96
2,160
3,360
1,920
3,240
960
2,880
960
720
480
540
264
156
384
0
0
0
0
960
0
0
720
480
540
0
156
0
GRP2FUR002
0
2,160 GRP3FUR009
3,360 GRP3FUR003
1,920 GRP3FUR008
3,240 GRP3FUR004
0 GRP2FUR001
2,880 GRP3FUR016
960 GRP3FUR011
0 GRP3FUR013
0 GRP3FUR014
0 GRP3FUR006
264 GRP3FUR007
0 GRP3FUR015
384
3,348,778
3,142,180
1,856,975
0
ITU NURSING TROLLEYS
NURSES DRUG TROLLEYS
NON CLINICAL WASTE
LONG LINE TROLLEY
IV TROLLEYS
LP trolleys
CLINICAL WASTE
LARGE DRUG CUPBOARD INC CD CUPBOARD
THEATRE LIGHT
MOBILE SCREENS
DRUGS FRIDGE
SMALL MILK FRIDGES
LINEN BINS
LARGE LINEN TROLLEY
GLOVE & APRON DISPENSERS
TALL STOOLS (cotside)
COMFORTABLE ARMCHAIRS (cotside)
3
3
3
3
3
3
3
2
3
3
2
2
3
3
2
3
3
Glazed screen - artwork/film (artist fee plus supply and installation)
WAITING AREA CHAIRS
NOTES TROLLEY
PARENTS LOCKERS
COMPUTERS
TV/DVD (waiting area)
RESUS TROLLEY
OFFICE CHAIRS
SOFA
SMALL ARMCHAIRS
PARENTS CORDLESS PHONE
NORMAL PHONE
COFFEE TABLE
FILING CABINETS
Total
charity cap
INTEGRATED THEATRE
Medical Equipment
Laparascopy video processor
Camera head
Light source
Insufflator
Computer control unit
Video printer
HD LCD monitors x 3
HD/Sdi input adaptor
Endoscopy processor
Endoscopy light source
Touch screens x 2
Total medical equipment
18,000
11,700
6,665
6,650
28,900
2,350
11,700
1,170
17,900
10,100
3,440
Integration equipment
OR Controller
OR Panel and devices
Installation
Loudspeakers x 2
Microphone
Connection cable
System cable
S-VHS video cables x 3
Total integration equipment
143,960
28,403
32,200
576
145
130
380
105
Extension arms, screen
supports, video cables
Outlets and installation
Surgical pendant
Anaesthetic pendant
Total pendants and installation
Building work and installation
Building work
Electrical installation
Structural engineer
Medical gases
Company's own project manager
Total Building works & installation
Additional input to server
Ability to review and edit from remote
computers in offices, etc.
Total Information technology
Cost excluding
VAT
Cost including
VAT at 20%
118,575
142,290
205,899
247,079
8,270
9,924
42,061
50,473
79,155
94,986
8,300
9,960
44,990
53,988
8,270
23,035
19,026
36,465
27,500
2,500
2,790
9,900
1,500
6,800
SD bridge
HD Bridge
Total for links to AV system
19,995
24,995
Operating table
39,500
39,500
47,400
546,750
546,750
656,100
38,700
38,700
46,440
98,000
72,000
48,000
27,000
117,600
86,400
57,600
32,400
0
144,000
Subtotal for equipment
Special instruments
Endoeyes (or equivalent) total for three
Specialist equipment
Neurosurgery microscope
Ophthalmic microscope
ENT/ Plastics microscope
Specialist diathermy
Harmonic scalpel via consumables
Paediatric flexible scopes
120,000
98,000
72,000
48,000
27,000
0
120,000
Basic theatre equipment
Anaesthetic machine complete
with patient monitoring
Transfer monitor
Transport incubator
Warming devices
C-Arm
Ultrasound (theatre - Sonosite style)
Defibrillation/Resusc equipment
19,473
16,500
7,500
35,250
8,000
85,000
21,500
7,000
19,473
16,500
7,500
35,250
8,000
85,000
21,500
7,000
23,368
19,800
9,000
42,300
9,600
102,000
25,800
8,400
5,000
5,000
0
6,000
608,923
608,923
730,708
1,155,673
1,155,673
1,386,808
Estates costs
Clinical cleaning, independent
assessors, possible CDM regs
Subtotal additional items
Total
Integrated theatres revenue costs
Consumables at £945 pa 7 years
Neonatal Expansion - Equipment Summary
Existing
ICU cots
HDU cots
SCBU cots
Do Nothing
Option 1
12
8
21
41
ICU cots
HDU cots
SCBU cots
16 Cot Extension
Option 2
11
9
21
41
ICU cots
HDU cots
SCBU cots
New & refurb
Option 3
20
11
22
53
ICU cots
HDU cots
SCBU cots
26
12
24
62
Capital equipment
Charitable equipment
0
0
0
0
2,694,276
0
2,878,611
1,856,975
Capital equipment - Theatres
0
0
0
1,386,808
Subtotal
0
0
2,694,276
6,122,393
Less Charitable Funding
0
0
0
0
Total
medical equipment
0
0
2,694,276
2,506,955
6,122,393
30,955
86,760
30,955
86,760
30,955
86,760
30,955
86,760
0
0
225,626
551,015
117,715
117,715
343,341
668,730
Annual Maintenance Charge
Existing equipment contracts
Existing ad hoc repairs (estimate)
New equipment - % assumed on medical
equipment
Total additional cost
9%
Neonatal Expansion - Equipment Capital Charge Summary
Existing
ICU cots
HDU cots
SCBU cots
Do Nothing
Option 1
11
9
21
41
ICU cots
HDU cots
SCBU cots
16 Cot Extension
Option 2
11
9
21
41
ICU cots
HDU cots
SCBU cots
New & refurb
Option 3
20
11
22
53
ICU cots
HDU cots
SCBU cots
26
12
24
62
Total New Publicly funded equipment - see detail
0
0
2,694,276
2,878,611
Capital equipment - Theatres
0
0
0
1,386,808
Subtotal
0
0
2,694,276
4,265,418
Total
0
0
2,694,276
4,265,418
Existing equipment
New equipment (see separate worksheet)
59,782
0
59,782
0
59,782
316,577
59,782
501,187
Total
59,782
59,782
376,359
560,969
Equipment - average annual Capital Charge (10 year lifetime assumed)
Neonatal Expansion - Capital Building Costs incl Gp 1 fixed equipment
Existing
ICU cots
HDU cots
SCBU cots
Do Nothing
Option 1
11
9
21
41
ICU cots
HDU cots
SCBU cots
16 Cot Extension
Option 2
11
9
21
41
ICU cots
HDU cots
SCBU cots
New & refurb
Option 3
20
11
22
53
ICU cots
HDU cots
SCBU cots
26
12
24
62
Construction costs refurb costs
Optimism Bias
0
0
0
0
0
0
0
2,957,102
0
142,576
0
22,440,000
1,200,000
2,300,000
0
Total
0
0
3,099,678
25,940,000
Existing buildings
New Build (see separate working papers - 40 years)
Refurb (see separate working papers - 30 years)
22,752
0
0
22,752
0
0
22,752
131,736
0
22,752
1,051,450
61,000
Total
22,752
22,752
154,488
1,135,202
Buildings - average annual Capital Charge
Notes
Building asset life of 40 years assumed for options 2 & 3 (new builds). Options 3 includes are refurbishment and a lower 30 year life has been used here to match the estimated remaining life of the
No assumptions made on potential impairments in value by the DV on opening the buildings. Revenue costs of capital have to be taken into account, whether through depreciation or a combination
Neonatal Expansion - Equipment capital Charges
Ref PC2010
All monetary values are in £000s and are at 2011/12 prices, i.e. inflation has not been included
Option 1
Capital equipment
Capital equipment - Theatres
£K
Total
Life of equipment in years
Capital charge
Capital charges data
Year
Opening net book value of assets
Depreciation in year
Closing net book value of assets
Average net book value of assets
Capital charge
0
0
0
10
3.5%
1
0
0
0
0
0
Capital charges over life of project
Depreciation
Capital charges
Total capital cost at 2011/12 prices
0
0
0
Capital charges per year
Depreciation
Capital charges
Total capital charge at 2011/12 prices
0
0
0
2
0
0
0
0
0
3
0
0
0
0
0
4
0
0
0
0
0
5
0
0
0
0
0
6
0
0
0
0
0
7
0
0
0
0
0
8
0
0
0
0
0
9
0
0
0
0
0
10
0
0
0
0
0
Total
0
0
Neonatal Expansion - Equipment capital Charges
Ref PC2010
All monetary values are in £000s and are at 2011/12 prices, i.e. inflation has not been included
Option 2
Capital equipment
Capital equipment - Theatres
£K
2,694,276
0
Total
2,694,276
Life of equipment in years
Capital charge
Capital charges data
Year
Opening net book value of assets
Depreciation in year
Closing net book value of assets
Average net book value of assets
10
3.5%
1
2
3
4
5
6
7
2,694,276 2,424,849 2,155,421 1,885,994 1,616,566 1,347,138 1,077,711
269,428 269,428 269,428 269,428 269,428 269,428 269,428
2,424,849 2,155,421 1,885,994 1,616,566 1,347,138 1,077,711 808,283
2,559,563 2,290,135 2,020,707 1,751,280 1,481,852 1,212,424 942,997
8
808,283
269,428
538,855
673,569
9
538,855
269,428
269,428
404,141
10
Total
269,428
269,428 2,694,276
0
134,714
Capital charge
23,575
14,145
Capital charges data
Year
Opening net book value of assets
Depreciation in year
Closing net book value of assets
Average net book value of assets
Capital charge
1
2
3
4
5
6
7
8
4,265,418 3,838,876 3,412,335 2,985,793 2,559,251 2,132,709 1,706,167 1,279,625
426,542 426,542 426,542 426,542 426,542 426,542 426,542 426,542
3,838,876 3,412,335 2,985,793 2,559,251 2,132,709 1,706,167 1,279,625 853,084
4,052,147 3,625,605 3,199,064 2,772,522 2,345,980 1,919,438 1,492,896 1,066,355
141,825 126,896 111,967
97,038
82,109
67,180
52,251
37,322
9
853,084
426,542
426,542
639,813
22,393
Capital charges over life of project
Depreciation
Capital charges
Total capital cost at 2011/12 prices
4,265,418
746,448
5,011,866
Capital charges over life of project
Depreciation
Capital charges
Total capital cost at 2011/12 prices
Capital charges per year
Depreciation
Capital charges
Total capital charge at 2011/12 prices
89,585
80,155
70,725
61,295
51,865
42,435
33,005
4,715
471,498
2,694,276
471,498
3,165,775
269,428
47,150
316,577
Neonatal Expansion - Equipment capital Charges
Ref PC2010
All monetary values are in £000s and are at 2011/12 prices, i.e. inflation has not been included
Option 3
Capital equipment
Capital equipment - Theatres
£K
2,878,611
1,386,808
Total
4,265,418
Life of equipment in years
Capital charge
Capital charges per year
Depreciation
Capital charges
Total capital charge at 2011/12 prices
10
3.5%
426,542
74,645
501,187
Neonatal Expansion - Equipment capital Charges
Ref PC2010
All monetary values are in £000s and are at 2011/12 prices, i.e. inflation has not been included
Option 2a
Capital equipment
Capital equipment - Theatres
£K
2,694,276
0
10
Total
426,542
426,542 4,265,418
0
213,271
7,464 746,448
Total
Life of equipment in years
Capital charge
2,694,276
10
3.5%
Capital charges data
Year
Opening net book value of assets
Depreciation in year
Closing net book value of assets
Average net book value of assets
Capital charge
1
2
3
4
5
6
7
2,694,276 2,424,849 2,155,421 1,885,994 1,616,566 1,347,138 1,077,711
269,428 269,428 269,428 269,428 269,428 269,428 269,428
2,424,849 2,155,421 1,885,994 1,616,566 1,347,138 1,077,711 808,283
2,559,563 2,290,135 2,020,707 1,751,280 1,481,852 1,212,424 942,997
89,585
80,155
70,725
61,295
51,865
42,435
33,005
Capital charges over life of project
Depreciation
Capital charges
Total capital cost at 2011/12 prices
2,694,276
471,498
3,165,775
Capital charges per year
Depreciation
Capital charges
Total capital charge at 2011/12 prices
269,428
47,150
316,577
8
808,283
269,428
538,855
673,569
23,575
9
538,855
269,428
269,428
404,141
14,145
10
Total
269,428
269,428 2,694,276
0
134,714
4,715 471,498
Neonatal Expansion - Building capital Charges
Ref PC2010
All monetary values are in £000s and are at 2011/12 prices, i.e. inflation has not been included
Option 1
Construction
Optimism bias
£K
Total
Life of building in years
Capital charge
Capital charges data
Year
Opening net book value of assets
Depreciation in year
Closing net book value of assets
Average net book value of assets
Capital charge
0
0
0
0
0
0
40
3.5%
1
0
0
0
0
0
Capital charges over life of project
Depreciation
Capital charges
Total capital cost at 2011/12 prices
0
0
0
Capital charges per year
Depreciation
Capital charges
Total capital charge at 2011/12 prices
0
0
0
2
0
0
0
0
0
3
0
0
0
0
0
4
0
0
0
0
0
5
0
0
0
0
0
6
0
0
0
0
0
7
0
0
0
0
0
8
0
0
0
0
0
9
0
0
0
0
0
10
0
0
0
0
0
11
0
0
0
0
0
12
0
0
0
0
0
13
0
0
0
0
0
14
0
0
0
0
0
15
0
0
0
0
0
16
0
0
0
0
0
17
0
0
0
0
0
18
0
0
0
0
0
19
0
0
0
0
0
20
0
0
0
0
0
21
0
0
0
0
0
22
0
0
0
0
0
23
0
0
0
0
0
24
0
0
0
0
0
25
0
0
0
0
0
26
0
0
0
0
0
27
0
0
0
0
0
28
0
0
0
0
0
29
0
0
0
0
0
30
0
0
0
0
0
31
0
0
0
0
0
32
0
0
0
0
0
Neonatal Expansion - Building capital Charges
Ref PC2010
All monetary values are in £000s and are at 2011/12 prices, i.e. inflation has not been included
Option 2
Construction
Optimism bias
Total
Life of building in years
Capital charge
£K
2,957
143
0
0
0
3,100
40
3.5%
Capital charges data
Year
Opening net book value of assets
Depreciation in year
Closing net book value of assets
Average net book value of assets
Capital charge
1
3,100
77
3,022
3,061
107
Capital charges over life of project
Depreciation
Capital charges
Total capital cost at 2011/12 prices
3,100
2,170
5,269
Capital charges per year
Depreciation
Capital charges
Total capital charge at 2011/12 prices
2
3,022
77
2,945
2,983
104
3
2,945
77
2,867
2,906
102
4
2,867
77
2,790
2,828
99
5
2,790
77
2,712
2,751
96
6
2,712
77
2,635
2,673
94
7
2,635
77
2,557
2,596
91
8
2,557
77
2,480
2,518
88
9
2,480
77
2,402
2,441
85
10
2,402
77
2,325
2,364
83
11
2,325
77
2,247
2,286
80
12
2,247
77
2,170
2,209
77
13
2,170
77
2,092
2,131
75
14
2,092
77
2,015
2,054
72
15
2,015
77
1,937
1,976
69
16
1,937
77
1,860
1,899
66
17
1,860
77
1,782
1,821
64
18
1,782
77
1,705
1,744
61
19
1,705
77
1,627
1,666
58
20
1,627
77
1,550
1,589
56
21
1,550
77
1,472
1,511
53
22
1,472
77
1,395
1,434
50
23
1,395
77
1,317
1,356
47
24
1,317
77
1,240
1,279
45
25
1,240
77
1,162
1,201
42
26
1,162
77
1,085
1,124
39
27
1,085
77
1,007
1,046
37
28
1,007
77
930
969
34
29
930
77
852
891
31
30
852
77
775
814
28
31
775
77
697
736
26
32
697
77
620
659
23
5
22,266
619
21,648
21,957
768
6
21,648
619
21,029
21,338
747
7
21,029
619
20,411
20,720
725
8
20,411
619
19,792
20,101
704
9
19,792
619
19,174
19,483
682
10
19,174
619
18,555
18,864
660
11
18,555
619
17,937
18,246
639
12
17,937
619
17,318
17,627
617
13
17,318
619
16,700
17,009
595
14
16,700
619
16,081
16,390
574
15
16,081
619
15,463
15,772
552
16
15,463
619
14,844
15,153
530
17
14,844
619
14,226
14,535
509
18
14,226
619
13,607
13,916
487
19
13,607
619
12,989
13,298
465
20
12,989
619
12,370
12,679
444
21
12,370
619
11,752
12,061
422
22
11,752
619
11,133
11,442
400
23
11,133
619
10,515
10,824
379
24
10,515
619
9,896
10,205
357
25
9,896
619
9,278
9,587
336
26
9,278
619
8,659
8,968
314
27
8,659
619
8,041
8,350
292
28
8,041
619
7,422
7,731
271
29
7,422
619
6,804
7,113
249
30
6,804
619
6,185
6,494
227
31
6,185
619
5,567
5,876
206
32
5,567
619
4,948
5,257
184
77
54
132
Neonatal Expansion - Building capital Charges
Ref PC2010
All monetary values are in £000s and are at 2011/12 prices, i.e. inflation has not been included
Option 3 - new build
Construction
Optimism bias
Total
Life of building in years
Capital charge
£K
22,440
2,300
0
0
0
24,740
40
3.5%
Capital charges data
Year
Opening net book value of assets
Depreciation in year
Closing net book value of assets
Average net book value of assets
Capital charge
1
24,740
619
24,122
24,431
855
Capital charges over life of project
Depreciation
Capital charges
Total capital cost at 2011/12 prices
24,740
17,318
42,058
Capital charges per year
Depreciation
Capital charges
Total capital charge at 2011/12 prices
619
433
1,051
2
24,122
619
23,503
23,812
833
3
23,503
619
22,885
23,194
812
4
22,885
619
22,266
22,575
790
33
0
0
0
0
0
34
0
0
0
0
0
35
0
0
0
0
0
36
0
0
0
0
0
37
0
0
0
0
0
38
0
0
0
0
0
39
0
0
0
0
0
40
0
0
0
0
0
33
620
77
542
581
20
34
542
77
465
504
18
35
465
77
387
426
15
36
387
77
310
349
12
37
310
77
232
271
9
38
232
77
155
194
7
39
155
77
77
116
4
40
33
4,948
619
4,330
4,639
162
34
4,330
619
3,711
4,020
141
35
3,711
619
3,093
3,402
119
36
3,093
619
2,474
2,783
97
37
2,474
619
1,856
2,165
76
38
1,856
619
1,237
1,546
54
39
1,237
619
619
928
32
40
619
619
0
309
11
77
77
0
39
1
Total
0
0
Total
3,100
2,170
Total
24,740
17,318
Neonatal Expansion - Refurbishment capital Charges
Ref PC2010
All monetary values are in £000s and are at 2011/12 prices, i.e. inflation has not been included
Option 3
Construction
Optimism bias
Total
£K
1,200
0
0
0
0
1,200
Life of equipment in years
Capital charge
30
3.5%
Capital charges data
Year
Opening net book value of assets
Depreciation in year
Closing net book value of assets
Average net book value of assets
Capital charge
1
1,200
40
1,160
1,180
41
Capital charges over life of project
Depreciation
Capital charges
Total capital cost at 2011/12 prices
1,200
630
1,830
Capital charges per year
Depreciation
Capital charges
Total capital charge at 2011/12 prices
40
21
61
2
1,160
40
1,120
1,140
40
3
1,120
40
1,080
1,100
39
4
1,080
40
1,040
1,060
37
5
1,040
40
1,000
1,020
36
6
1,000
40
960
980
34
7
960
40
920
940
33
8
920
40
880
900
32
9
880
40
840
860
30
10
840
40
800
820
29
11
800
40
760
780
27
12
760
40
720
740
26
13
720
40
680
700
25
14
680
40
640
660
23
15
640
40
600
620
22
16
600
40
560
580
20
17
560
40
520
540
19
18
520
40
480
500
18
19
480
40
440
460
16
20
440
40
400
420
15
21
400
40
360
380
13
22
360
40
320
340
12
23
320
40
280
300
11
24
280
40
240
260
9
25
240
40
200
220
8
26
200
40
160
180
6
27
160
40
120
140
5
28
120
40
80
100
4
29
80
40
40
60
2
30
40
40
0
20
1
Total
1,200
630
Appendix Fi 2012-13 - Monthly Revenue Costs
Summary of Revenue Changes
baseline
Jun-12
Jul-12
Aug-12
Sep-12
Oct-12
Nov-12
Dec-12
Jan-13
Feb-13
Mar-13
11
9
21
10
9
21
10
9
21
10
9
21
10
9
21
10
9
21
10
9
21
11
9
21
11
9
21
11
9
21
15
9
21
Expenditure
staff costs
non-pay costs
subtotal direct costs
£
585,364
94,313
679,677
598,096
94,313
692,409
586,096
94,313
680,409
586,096
94,313
680,409
588,596
94,313
682,909
591,449
94,313
685,762
637,567
96,113
733,680
616,199
94,313
710,512
656,743
94,313
751,056
665,915
94,313
760,228
665,915
96,513
762,428
Indirect costs
capital charge and depreciation
corp overheads
subtotal indirect/other costs
56,556
6,878
110,435
173,868
56,556
6,878
110,435
173,868
56,556
6,878
110,435
173,868
56,556
6,878
110,435
173,868
56,556
6,878
110,435
173,868
56,556
6,878
110,435
173,868
56,556
6,878
110,435
173,868
56,556
6,878
110,435
173,868
56,556
6,878
110,435
173,868
56,556
6,878
110,435
173,868
56,556
6,878
110,435
173,868
Total relevant Revenue Costs
853,546
866,278
854,278
854,278
856,778
859,630
907,548
884,380
924,925
934,096
936,296
Income
ITU
HDU
SCBU
Other
338,583
189,750
280,750
125,083
307,803
189,750
280,750
125,083
307,803
189,750
280,750
125,083
307,803
189,750
280,750
125,083
307,803
189,750
280,750
125,083
307,803
189,750
280,750
125,083
307,803
189,750
280,750
125,083
338,583
189,750
280,750
125,083
338,583
189,750
280,750
125,083
338,583
189,750
280,750
125,083
461,704
189,750
280,750
125,083
total income
934,166
903,386
903,386
903,386
903,386
903,386
903,386
934,166
934,166
934,166
1,057,287
80,620
37,108
49,108
49,108
46,608
43,756
-4,163
49,786
9,241
70
120,991
-70,930
-70,930
-70,930
-70,930
-70,930
-70,930
-70,930
-70,930
-70,930
-70,930
-70,930
9,690
-33,822
-21,822
-21,822
-24,322
-27,174
-75,093
-21,144
-61,689
-70,860
50,061
ITU
HDU
SCBU
Surplus/(Deficit)
HGH subsidy
with HGH
total
401,614
-307,686
Pay Costs
baseline
Mar-12
Jun-12
Existing
WTE
Existing
cost £
Av cost
per WTE £
Medical - Consultant
Medical - ST 4-6
Medical - ST 1-3
Nursing - band 8a
Subtotal
8.49
11.00
10.00
2.20
31.69
1,087,320
792,627
559,620
141,304
2,580,871
110,000
72,057
55,962
64,229
Nursing - band 8a
Nursing - band 7
Nursing - band 6
Nursing - band 5
Nursing - band 4
Nursing - band 3
Nursing - band 2
3.00
16.45
12.61
45.75
4.83
5.94
2.07
0.00
90.65
0.00
1.00
2.21
2.32
1.68
192,687
813,815
504,002
1,545,171
149,005
144,013
36,308
0
3,385,001
Subtotal
Clerical / Admin - band 7
Clerical / Admin - band 6
Clerical / Admin - band 4
Clerical / Admin - band 3
Clerical / Admin - band 2
Subtotal
7.21
Agency/Bank
Total
Directorate Mgmt
Cost increase
monthly impact
129.55
38,000
59,007
57,304
31,522
185,833
Revised
WTE
Jul-12
Sep-12
Revised
WTE
Revised
cost £
8.49 1,087,320
11.00
792,627
10.00
559,620
2.20
141,304
31.69 2,580,871
8.49 1,087,320
11.00
792,627
10.00
559,620
2.20
141,304
31.69 2,580,871
8.49
11.00
10.00
2.20
31.69
1,087,320
792,627
559,620
141,304
2,580,871
64,229
49,472
39,968
33,774
30,850
24,245
17,540
3.00
192,687
16.45
813,815
14.61
583,939
49.75 1,680,268
4.83
149,005
5.94
144,013
2.07
36,308
3.00
192,687
16.45
813,815
14.61
583,939
49.75 1,680,268
4.83
149,005
5.94
144,013
2.07
36,308
3.00
16.45
14.61
49.75
4.83
5.94
2.07
49,472
38,000
26,700
24,700
18,800
96.65 3,600,035
0.00
0
1.00
38,000
2.21
59,007
2.32
57,304
1.68
31,522
96.65 3,600,035
0.00
0
1.00
38,000
2.21
59,007
2.32
57,304
1.68
31,522
96.65
0.00
1.00
2.21
2.32
1.68
185,833
Revised
WTE
Aug-12
Revised
cost £
7.21
Revised
cost £
7.21
185,833
825,000
618,750
618,750
6,976,705
135.55 6,985,489
135.55 6,985,489
47,667
47,667
47,667
15.02
8,784
732
98.55
8,784
732
Notes
i) All staff costed at 11/12 pay rates including unsocial enhancements and employers oncosts.
ii) All other staff have been included eg retrieval team , Community Sister etc.
iii) The costs associated with staff used in other medical specilaities have not been removed for this exercise eg medical staff post baby checks.
iv) Bank/agency usage reduced by 25% against target of 50% reduction
7.21
135.55
149.36
Oct-12
Jan-13
Feb-13
Mar-13
Revised
cost £
Revised
WTE
Revised
cost £
Revised
WTE
Revised
cost £
Revised
WTE
Revised
cost £
Revised
WTE
Revised
cost £
8.49 1,087,320
11.00
792,627
10.00
559,620
2.20
141,304
31.69 2,580,871
8.49 1,087,320
11.00
792,627
10.00
559,620
3.20
205,533
32.69 2,645,100
8.49
11.00
10.00
3.20
32.69
1,087,320
792,627
559,620
205,533
2,645,100
8.49
11.00
10.00
3.20
32.69
1,087,320
792,627
559,620
205,533
2,645,100
9.49
11.00
12.00
3.20
35.69
1,197,320
792,627
671,544
205,533
2,867,024
10.49
12.00
12.00
3.20
37.69
1,307,320
864,684
671,544
205,533
3,049,081
10.49
12.00
12.00
3.20
37.69
1,307,320
864,684
671,544
205,533
3,049,081
192,687
813,815
583,939
1,680,268
149,005
144,013
36,308
3.00
192,687
16.45
813,815
14.61
583,939
49.75 1,680,268
4.83
149,005
5.94
144,013
2.07
36,308
3.00
192,687
16.45
813,815
14.61
583,939
49.75 1,680,268
4.83
149,005
5.94
144,013
2.07
36,308
3.00
16.45
18.61
51.75
4.83
5.94
2.07
192,687
813,815
743,813
1,747,816
149,005
144,013
36,308
3.00
16.45
18.61
51.75
4.83
5.94
2.07
192,687
813,815
743,813
1,747,816
149,005
144,013
36,308
3.00
16.45
19.61
55.75
4.83
5.94
3.07
3.00
16.45
19.61
55.75
4.83
5.94
3.07
192,687
813,815
783,781
1,882,913
149,005
144,013
53,848
3.00
16.45
19.61
55.75
4.83
5.94
3.07
192,687
813,815
783,781
1,882,913
149,005
144,013
53,848
3,600,035
0
38,000
59,007
57,304
31,522
96.65 3,600,035
0.00
0
1.00
38,000
2.21
59,007
2.32
57,304
1.68
31,522
96.65 3,600,035
0.00
0
1.00
38,000
2.21
59,007
2.32
57,304
1.68
31,522
102.65
0.00
2.00
2.21
2.32
1.68
3,827,457
0
76,000
59,007
57,304
31,522
102.65
0.00
2.00
2.21
2.32
3.36
3,827,457
0
76,000
59,007
57,304
63,106
108.65
0.00
2.00
2.21
2.32
3.36
192,687
813,815
783,781
1,882,913
149,005
144,013
53,848
0
4,020,062
0
76,000
59,007
57,304
63,106
108.65
0.00
2.00
2.21
2.32
3.36
4,020,062
0
76,000
59,007
57,304
63,106
108.65
0.00
2.00
2.21
2.32
3.36
4,020,062
0
76,000
59,007
57,304
63,106
223,833
9.89
255,417
9.89
255,417
9.89
255,417
9.89
185,833
Revised
WTE
Dec-12
Revised
WTE
7.21
Revised
cost £
Nov-12
Revised
cost £
185,833
Revised
WTE
7.21
185,833
618,750
618,750
618,750
6,985,489
135.55 6,985,489
136.55 7,049,718
47,667
47,667
47,667
8,784
732
47.85
8,784
732
47.85
73,013
6,084
8.21
618,750
143.55
7,315,140
618,750
145.23
47,667
47.85
338,435
28,203
7,346,724
618,750
154.23
47,667
47.85
370,019
30,835
7,761,253
618,750
156.23
47,667
47.85
784,548
65,379
7,943,310
156.23
47,667
47.85
966,605
80,550
255,417
618,750
7,943,310
47,667
47.85
966,605
80,550
Additional Staff
baseline
Mar-12
Existing
WTE
Medical - Consultant
Medical - ST 4-6
Medical - ST 1-3
Nursing - band 8a
Subtotal
8.49
11.00
10.00
2.20
31.69
Nursing - band 8a
Nursing - band 7
Nursing - band 6
Nursing - band 5
Nursing - band 4
Nursing - band 3
Nursing - band 2
3.00
16.45
12.61
45.75
4.83
5.94
2.07
0.00
90.65
Subtotal
Jun-12
cumulative
additional
Jul-12
cumulative
additional
Aug-12
cumulative
additional
Sep-12
cumulative
additional
Oct-12
cumulative
additional
Nov-12
cumulative
additional
Dec-12
cumulative
additional
Jan-13
cumulative
additional
Feb-13
cumulative
additional
Mar-13
cumulative
additional
WTE
WTE
WTE
WTE
WTE
WTE
WTE
WTE
WTE
WTE
0.00
1.00
0.00
2.00
1.00
4.00
2.00
1.00
2.00
1.00
6.00
2.00
1.00
2.00
1.00
6.00
7.00
10.00
7.00
10.00
7.00
10.00
1.00
1.00
1.00
0.00
0.00
0.00
0.00
0.00
0.00
1.00
1.00
2.00
4.00
2.00
4.00
2.00
4.00
2.00
4.00
2.00
4.00
6.00
6.00
6.00
6.00
6.00
0.00
1.00
1.00
0.00
0.00
0.00
1.00
1.00
6.00
6.00
6.00
6.00
12.00
12.00
18.00
18.00
18.00
1.00
1.00
1.00
1.00
1.00
1.68
0.68
1.68
0.68
1.68
0.68
1.68
0.68
Clerical / Admin - band 7
Clerical / Admin - band 6
Clerical / Admin - band 4
Clerical / Admin - band 3
Clerical / Admin - band 2
0.00
1.00
2.21
2.32
1.68
Subtotal
7.21
0.00
0.00
0.00
0.00
0.00
1.00
3.36
3.36
3.36
3.36
129.55
6.00
6.00
6.00
6.00
7.00
14.00
16.36
25.36
27.36
27.36
Agency/Bank
Total
Baseline Financial Model (from Appendix F Revenue Model , excl HGH)
staff costs
non-pay costs
subtotal direct costs
7,024,372
1,131,756
8,156,128
Indirect costs
capital charge and depreciation
corp overheads
subtotal indirect costs
678,666
82,534
1,325,219
2,086,419
Total Revenue Costs
10,242,547
total Income
11,300,772
Surplus/(Deficit)
1,058,225
notes
DO NOT SCALE FROM
THIS DRAWING
trees
trees
parking / roadway below
existing fire escape stair,
single storey storage building
BRI
DGE
to be removed as part of
building works
2618
2685
2686
Quiet Room
Ward Clerks
2707
2707
2674
Accom m odat
i
on
2618A
Par
ent
s’
2636
2638 Long Room
ITU Nurseries
2631A
2635
HDU
Nurseries
2687
2617
2674
Doctors’
2634
2639
2651
2681A
2706
Office
2697
2617A
revision
2633
by
date
index
2614A
2605
2632
2640
gbs architects | St Thomas House
2682 Hot Room
6 Becket Street | Oxford OX1 1PP
t: 01865 305130 | f: 01865 246424
e: architecture@gbs-ox.co.uk
w: gbs-ox.co.uk
2614
2627
2641
2666
ORH NHS Trust
John Radcliffe Hospital
Feasibility Study Level 2 NNU
Existing Plan
Womens Centre - Level 2
2603
2655
2657
2667
2661
2651
drawing number
6055.04
scale
1:100 @ A3
status
preliminary
date
01/03/11
drawn KJP
&
'
!
%
(
)
*
!%
(
)
*
! +
-
/
1
.
!0 %
!
!
"#$
! "#$
"
,)$
'%
, + -
+
(
%% .
* -
+
," /
3
"%
/0
#$ %% & $ %%
# ) *& ) *
)*
%
% * "
"
,)$
0
$
0"
1 '
2
*
#3
+
+
41 &
/ - !0 .$
2
3&2. & 2
%
&
%
&
3
#
%
5
"#
) '
'%
(%
. - '%
(
*
"
6 - +
% %
*
*
'
+ *
+
7 8 9
7 8" / *7 8
- * "
(- ( 9
9 *++
- * *
(- ( ''
9
" #3
* + ' - '
:
'
&
!3 +$
"
") !3 +$
&
.
!3 +$
/
/ - 3 ")
5
"
'
"2 /
/
"
) '
%
:
;
4
7 (%
7 '%"
(-
( + -
'%
:
'
(-
:
-
(
*
"
:
-
(
2
4&%
-1
(
&
)
'
%
!
5
%
)
-
57
!5
-
) )#
6
* 5 *
= :
2 = +" 1/>
<
! $
3 '$
/3
5%
3
/ !/ $
83 9/ ! $:
'
;
/
/
$
2
% 1
.
.
%
6
( +;
( +;
<
!
!
"#$
"#$
<
2
1&
5
'%
'
*
9 ( "
$' ?
-
9,
, 9
" #)
@ '
A
1
#
/ =
.
2 > "
5
-
$ %
(/
"
&
>
61
/
(-
$% *
$
@ 9 (
$% *
$
@ 9 (
$% *
$
@ 9 (
$% *
)
-
9,
, 9
% ) /
7
;# /
@ =B
1 $B
<
/
/
/
/ <
/ <
34 B
34 B
3 B
=4 <
$4=B
$>6 0
$/ B
/43 B
/43B
/=
A $B
G
A $B
G
64$
64$
64$
B
2
# /
4A$B
7
<
B
-
-
=
<
6#
B
B
@$ <
@$ <
@$ <
0
4
A
$
*
7
C
*9 - *
9 %.9
'
@
= = 7 4$ . 9 '
1 =D
/47
@1 4@ $ =A
$ /= C E
9 - )
9 *< '% 9 . ) $ ++
' ( * * 9 (
*
'%
) $ ++ * - * 9 (
*
'%
/7 / *
.+
. < '%. *
('
$
C /
. 9 *- . < '%.
(
$
C /
9 *< '% 9 .
? (
'
$
C /
* .9
? (
'
$
C /
. * '%
.
( .*
(
'
$4 /4=; 4 C 34 72 3$ % F 0 6
$4 /4=; 4 C 34 72 3$ % F
6
3 A / E A =/ 47 3 7 . 9 ( % '%
+ ) #9:
&
=4 7. * *
: %' . 9 '
.
''
$
* 4'+
3=. 9 '
6 =C/ 3. * * . +
+ * ('
(
*
.
60 @
$ =A
$ /= C E $;$/ > +
* *
% 9 .
(9
/43.
. ) '' - '
*') .
' *
*
.
%
.
*-. 1/>
/ 1
/43. 1 '
% - ' /- '
*> * / %
/=
E1 *
%. - %
%
.
.
( . 0 '' %
.
6
@" 1/> $ 1
A *
$
*
# *
2 ) ) (
. )A * '
. )> * 4 . )@
. )@
$ *?
&
A *
$
*
# *
2 <) ) (
. )A * '
. <)> * 4 . )@
. )@
$ *?
&
64$/ .
+ -(
.'
. "
"
1/> 6/
/=43.
. "
.%
*
("
1/> /== 3
H 4$ . '
'. - %
%
.
*- .
%.
+ 9. * *
9
.
6
@" 1/> 7 1>" = % *
2 4$
.
@ $3 $
@ $3 $
*
.9
@ $3 $
%
=. % %
=.
%.
'
=.
%
% .9
-
9 .9
%
(
'
(
*
( .
+<
'
9,
, 9
% ) /
7
;# /
2
# /
14
<
14
> <<
>
<
<
@=4
B
-
-
=
<
<
6#
B
1 7
1 7
B
5
7E
>
B
$B
$>/
$/
$/
/=
A
0
<
B
14 =. - (0B .
( *?.
+
. 9 .
.
(
14 =
(9 %
>3 / = C ; 4=@
>3 / = >
/ =. IF /5/. (
+ %
% .
? %
@=46 =
/.
9 . *?
.
*
.
1
6
@
1 7@ =. *?. 9 +
%
.'
'.
+
(. 0 1 < 6 < @
1 7@ =. - %
). % 0
* % * .
- ( 9 '
. 0 1
6
@
4/ =.
. E ++
'
.
6
' ) <B 1
@
5 $
' * % '%.
1
6 @
7 > 4 = ' * %- % %(*
* - %
' . :
(.
- (.'
.
1 0 6 0 @. #%
+
$/4
&
>
/ =. /5/. (
+ %
% .*
(
'
* )
E
/= 77 ;. '
( .
(
% + ' .
*
(9 ? %. 9 - %
+
+
+ * (
.
10< 6
@
$/
7. - (.< 1
"
$/
7. '
+ ' . %. 0 - (/= 77 ;.
(
' .
.
++
. 0 1
6
@
A
9 - 5> '
2
6 << 1
@
-
<
<
<
<
<
<
<
<
<
<
<
<
<
<
<
<
<
9,
, 9
&
'
!
%
(
)
*
!%
(
)
*
! +
-
/
1
.
!0 %
!
!
"#$
! "#$
"
,)$
'%
, + -
+
(
%% .
* -
+
," /
3
"%
/0
#$ %% & $ %%
# ) *& ) *
)*
%
% * "
"
,)$
0
$
0"
1 '
2
*
#3
+
+
41 &
/ - !0 .$
2
3&2. & 2
%
&
%
&
3
#
%
5
"#
) '
'%
(%
. - '%
(
*
"
6 - +
% %
*
*
'
+ *
+
7 8 9
7 8" / *7 8
- * "
(- ( 9
9 *++
- * *
(- ( ''
9
" #3
* + ' - '
:
'
&
!3 +$
"
") !3 +$
&
.
!3 +$
/
/ - 3 ")
5
"
'
"2 /
/
"
) '
%
:
;
4
7 (%
7 '%"
(-
( + -
'%
:
'
(-
:
-
(
*
"
:
-
(
2
4&%
-1
(
&
)
'
%
!
5
%
)
-
57
!5
-
) )#
6
* 5 *
= :
2 = +" 1/>
<
! $
3 '$
/3
5%
3
/ !/ $
83 9/ ! $:
'
;
/
/
$
2
% 1
.
.
%
6
( +;
( +;
<
!
!
"#$
"#$
<
2
1&
5
'%
'
*
9 ( "
$' ?
-
9,
, 9
" #)
@ '
A
1
#
/ =
.
2 > "
5
-
$ %
(/
"
&
>
61
/
(-
$% *
$
@ 9 (
$% *
$
@ 9 (
$% *
$
@ 9 (
$% *
)
-
9,
, 9
% ) /
7
;# /
@ =B
1 $B
<
/
/
/
/ <
/ <
34 B
34 B
3 B
=4 <
$4=B
$>6 0
$/ B
/43 B
/43B
/=
A $B
G
A $B
G
64$
64$
64$
B
2
# /
4A$B
7
<
B
-
-
=
<
6#
B
B
@$ <
@$ <
@$ <
0
4
A
$
*
7
C
*9 - *
9 %.9
'
@
= = 7 4$ . 9 '
1 =D
/47
@1 4@ $ =A
$ /= C E
9 - )
9 *< '% 9 . ) $ ++
' ( * * 9 (
*
'%
) $ ++ * - * 9 (
*
'%
/7 / *
.+
. < '%. *
('
$
C /
. 9 *- . < '%.
(
$
C /
9 *< '% 9 .
? (
'
$
C /
* .9
? (
'
$
C /
. * '%
.
( .*
(
'
$4 /4=; 4 C 34 72 3$ % F 0 6
$4 /4=; 4 C 34 72 3$ % F
6
3 A / E A =/ 47 3 7 . 9 ( % '%
+ ) #9:
&
=4 7. * *
: %' . 9 '
.
''
$
* 4'+
3=. 9 '
6 =C/ 3. * * . +
+ * ('
(
*
.
60 @
$ =A
$ /= C E $;$/ > +
* *
% 9 .
(9
/43.
. ) '' - '
*') .
' *
*
.
%
.
*-. 1/>
/ 1
/43. 1 '
% - ' /- '
*> * / %
/=
E1 *
%. - %
%
.
.
( . 0 '' %
.
6
@" 1/> $ 1
A *
$
*
# *
2 ) ) (
. )A * '
. )> * 4 . )@
. )@
$ *?
&
A *
$
*
# *
2 <) ) (
. )A * '
. <)> * 4 . )@
. )@
$ *?
&
64$/ .
+ -(
.'
. "
"
1/> 6/
/=43.
. "
.%
*
("
1/> /== 3
H 4$ . '
'. - %
%
.
*- .
%.
+ 9. * *
9
.
6
@" 1/> 7 1>" = % *
2 4$
.
@ $3 $
@ $3 $
*
.9
@ $3 $
%
=. % %
=.
%.
'
=.
%
% .9
-
9 .9
%
(
'
(
*
( .
+<
'
9,
, 9
% ) /
7
;# /
2
# /
14
<
14
> <<
>
<
<
@=4
B
-
-
=
<
<
6#
B
1 7
1 7
B
5
7E
>
B
$B
$>/
$/
$/
/=
A
0
<
B
14 =. - (0B .
( *?.
+
. 9 .
.
(
14 =
(9 %
>3 / = C ; 4=@
>3 / = >
/ =. IF /5/. (
+ %
% .
? %
@=46 =
/.
9 . *?
.
*
.
1
6
@
1 7@ =. *?. 9 +
%
.'
'.
+
(. 0 1 < 6 < @
1 7@ =. - %
). % 0
* % * .
- ( 9 '
. 0 1
6
@
4/ =.
. E ++
'
.
6
' ) <B 1
@
5 $
' * % '%.
1
6 @
7 > 4 = ' * %- % %(*
* - %
' . :
(.
- (.'
.
1 0 6 0 @. #%
+
$/4
&
>
/ =. /5/. (
+ %
% .*
(
'
* )
E
/= 77 ;. '
( .
(
% + ' .
*
(9 ? %. 9 - %
+
+
+ * (
.
10< 6
@
$/
7. - (.< 1
"
$/
7. '
+ ' . %. 0 - (/= 77 ;.
(
' .
.
++
. 0 1
6
@
A
9 - 5> '
2
6 << 1
@
-
<
<
<
<
<
<
<
<
<
<
<
<
<
<
<
<
<
9,
, 9
29 ?9 9
E
3 ? (
&
'
!
%
(
)
*
!%
(
)
*
! +
-
/
1
.
!0 %
#6/& 6
#$/& 4
*
+
"#$
! "#$
,)$
,)$
4
+
'%
+ '
+ '
(*
2 '
'%
'
- (-
(*
!
'
- (-
'%
'%
"
*
+
'%
'%"
(*
(
"%
/0
"
"
+
"
$
1 '
2
*
/ - !0 .$
2
3&2. & 2
%
&
%
&
3
#
%
!3 +$
") !3 +$
&
!3 +$
/
/ - 3 ")
"
'
"2 /
/
7 (- ( + '
(- (
:
-
- + + -
2
4&%
-1
(
&
)
'
%
!
5
%
/ !/ $
! $
3 '$
/3
5%
)
-
57
!5
-
) )#
6
83 9/ ! $:
'
/
/
$
2
% 1
.
.
%
6
( +;
( +;
<
!
!
"#$
"#$
<
1
$ + * 2 <@ (
%
-
**
2
1&
5
'%
'
*
9 ( "
$' ?
-
9,
, 9
" #)
E
3 ? (
@ '
> 5
$3
*
9 (
A
1
#
29 ?9 9
(/
"
$% *
/ =
&
.
2 > "
)
-
9,
, 9
% ) /
E
7
<
-
29 ?9 9
3 ? (
-
;# /
2
# /
=
<
6#
<
<
4A$B
/
/ <
4
$
$
'
A
C /
C /
$
*
. 9 *-
/ <
/ 0
63=B
63=B
>8=B
$ B
/7 /. ?3 * '%
.' *
/7 /. ) ( . ' *
6 3
*
.7 (9
6 3
*
. $- .
(- (>
8= 2
6 B< 1
<@
>
$*
2
6 << 1
@
-
. < '%. 9
* .9
? (
9
<
<
9,
, 9
@9 A 9
J
<
= * %
&
'
!
%
"#$
! "#$
(
)
*
!%
(
)
*
! +
1
.
!0 %
<
-
/
#6/& 6
#$/& 4
*
+
"
"
,)$
,)$
'%
+ '
2 '
'%
'
- (-
(*
#$ %% & '
%
%
'%
'%
!
.
: %'
(
"
"
$
"%
/0
+
"
$
1 '
2
*
/ - !0 .$
2
3&2. & 2
%
&
%
&
3
#
%
<
!3 +$
") !3 +$
&
!3 +$
/
/ - 3 ")
"
'
"2 /
/
;
7 (%
( + -
:
'
(-
-
- + + -
(
2
4&%
-1
(
&
)
'
%
!
5
%
/ !/ $
/3
5%
)
-
57
!5
-
) )#
6
<
<
! $
3 '$
83 9/ ! $:
'
/
/
$
2
% 1
.
.
%
6
( +;
( +;
<
!
!
"#$
"#$
<
1
$ + * 2
(
%
-
**
2
1&
5
'%
'
*
9 (
$' ?
-
9,
, 9
" #)
J
<
@ '
>
3
"
/ =
&
.
= * %
5
-
A
1
#
@9 A 9
2 > "
(
$
@ 9 (
$% *
$
@ 9 (
$% *
$
@ 9 (
$% *
)
-
9,
, 9
% ) /
J
7
=
<
6#
-
@9 A 9
= * %
-
;# /
2
# /
47B
47B
B
@ =B
/
/
/ <
= 4B
$/ B
63=B
7
14 <
> <<
> <
>
>B
@=4
=
B
>
*
(
'%
'%
/ =/ 3. = * %
.
'' %
6B @
1
= = 7 4$ . 9 '
C /
. 9 *- . < '%. 9
C /
9 *< '% 9 .
.
@
$
$
? (
'
$
C /
* .9
? (
'
$9 %
=
$ =A
$ /= C E $;$/ > +
* *
% 9 .
(9
6 3
*
.7 (9
7
C
.9 '
14 =. - (0B .
( *?.
+
. 9 .
.
(
>3 / = C ; 4=@
>3 / = 3= / =.
.4 .
1< 6 <
>3 / = >
/ =. IF /5/. (
+ %
% .
? %
/A >
/ =. I /5/. (
+ %
%
? %
@=46 =
/.
9 . *?
.
*
.
1
6
@
@A@ =
=@ =. < 6
@
1
-
<
@
<
<
<
.
<
<
<
9,
, 9
@
J
6
&
!
"#$
"#$
!
(
)
*
!%
(
)
*
! +
!0 %
<
-
/
.
(4
'
%
1
BB
,)$
,)$
#$ %% & > ' '
# ) *&
%%
%
%
+
(
"%
/0
"
"
"
$
1 '
2
*
/ - !0 .$
2
3&2. & 2
%
&
%
&
3
#
%
5
!3 +$
") !3 +$
&
!3 +$
/
/ - 3 ")
"
'
"2 /
/
7 (%
( + -
:
'
(-
-
- + + -
(
2
4&%
-1
(
&
)
'
%
!
5
%
/ !/ $
! $
3 '$
/3
5%
)
-
57
!5
-
) )#
6
83 9/ ! $:
'
/
/
$
2
% 1
.
.
%
6
( +;
( +;
<
!
!
"#$
"#$
<
1
$ + * 2 <!
%
-
**
"
2
1&
5
'%
'
*
9 ( "
$' ?
-
9,
, 9
" #)
J
6
(( -
(/
"
/ =
&
.
BB
(4
-
A
1
#
5
@
2 > "
$% *
$
@ 9 (
$% *
$
@ 9 (
$% *
$
@ 9 (
$% *
)
-
9,
, 9
% ) /
J
7
=
6#
6
-
@
BB
(4
-
;# /
2
# /
433B
/
/
63=B
=4 <
@$
=4
B
/A>
<
B
14
/4
4**
3 -3
$
C /
. 9 *- . < '%. 9
$
C /
.
( .9 '
6 3
*
.7 (9
=4 C /. /A. - (.9 '
@ $3 $ =. *
.
? (9
. #+
&.
#* % *
<"< - &. +
(
=4 C.
+ % '%- .
*
.9 .9 '
.< 1
6
@
/ 7 A$
'
.*
.+ %
. ( .9
'
.9
% % .0 1
"
14 =. % (- . 9 - ' . %.
*? (
/4 7 . **
.
.
1
''
"
-
<
<
<
9,
, 9
@
J
7 *?
&
!
"#$
"#$
!
(
)
*
!%
(
)
*
! +
-
/
.
4
'
%
1
BB
!0 %
,)$
"
,)$
(
"%
/0
$
/ - !0 .$
2
3&2. & 2
%
&
%
&
3
#
%
!3 +$
") !3 +$
&
!3 +$
/
/ - 3 ")
"
'
"2 /
/
7 (%
( + -
:
'
(-
-
- + + -
(
2
4&%
-1
(
&
)
'
%
!
5
%
/ !/ $
! $
3 '$
/3
5%
)
-
57
!5
-
) )#
6
83 9/ ! $:
'
/
/
$
2
% 1
.
.
%
6
( +;
( +;
<
!
!
"#$
"#$
<
2
1&
5
'%
'
*
9 ( "
$' ?
-
9,
, 9
" #)
J
7 *?
(( A
1
#
/ =
.
2 > "
BB
4
-
$ %
(/
"
&
5
@
/
(-
$% *
$
@ 9 (
$% *
$
@ 9 (
$% *
$
@ 9 (
$% *
)
-
9,
, 9
% ) /
6#
J
7
=
7 *?
-
@
BB
4
-
;# /
2
# /
7
B
34 < 0
34 B <
/43B
/=
@$ <
@$ <
1
1 7
7
C =. (( (
(. * '% '
.
1)
6)
@
$4 /4=; 4 C 34 72 3$ % 2 0 6
$4 /4=; 4 C 34 72 3$ % 2 ) (
+ '
/43. 1 '
% - ' /- '
*> * / %
/=
E1 *
%. - %
%
.
.
( . 0 '' %
.
6
@" 1/> $ 1
@ $3 $ =. % %
9 .9 '
@ $3 $ =.
%.
%
( *
( .
*
.9 '
1
C. * .
1 7@ =. *?. 9 +
%
.'
'.
+
(. 0 1 < 6 < @
-
<
9,
, 9
@
BB
J
&
'
!
%
(
)
*
!%
(
)
*
! +
-
/
1
.
!0 %
#6/& 6
#$/& 4
*
+
"#$
! "#$
,)$
,)$
'%
+ '
2 '
'%
'
- (-
(*
'%
'%
!
"
"
"
(
"%
/0
+
"
$
1 '
2
*
/ - !0 .$
2
3&2. & 2
%
&
%
&
3
#
%
5
!3 +$
") !3 +$
&
!3 +$
/
/ - 3 ")
"
'
"2 /
/
7 (%
( + -
:
'
(-
-
- + + -
(
2
4&%
-1
(
&
)
'
%
!
5
%
/ !/ $
! $
3 '$
/3
5%
)
-
57
!5
-
) )#
6
83 9/ ! $:
'
/
/
$
2
% 1
.
.
%
6
( +;
( +;
<
!
!
"#$
"#$
<
1
$ + * 2 <
(
%
-
**
2
1&
5
'%
'
*
9 ( "
$' ?
-
9,
, 9
" #)
@
BB
J
@ '
(/
"
/ =
&
.
5
-
A
1
#
>
2 > "
$% *
$
@ 9 (
$% *
$
@ 9 (
$% *
$
@ 9 (
$% *
)
-
9,
, 9
% ) /
6#
-
@
BB
J
7
-
;# /
433B
/
/ <
B
2
# /
=
B
$6
63=B
4**
$
C
$
C
'
$6 /
6 3
3
/
/
-3
. 9 *-
1
*
. < '%. 9
* .9
'% *
( %
.7 (-
-
. 9 .9
9
? (
'
9,
, 9
@
J
<
* 7
&
'
!
%
"#$
"#$
!
(
)
*
!%
(
)
*
! +
-
/
1
.
BB A
!0 %
,)$
"
,)$
(
"%
/0
$
/ - !0 .$
2
3&2. & 2
%
&
%
&
3
#
%
!3 +$
") !3 +$
&
!3 +$
/
/ - 3 ")
"
'
"2 /
/
7 (%
( + -
:
'
(-
-
- + + -
(
2
4&%
-1
(
&
)
'
%
!
5
%
/ !/ $
! $
3 '$
/3
5%
)
-
57
!5
-
) )#
6
83 9/ ! $:
'
/
/
$
2
% 1
.
.
%
6
( +;
( +;
<
!
!
"#$
"#$
<
2
1&
5
'%
'
*
9 ( "
$' ?
-
9,
, 9
" #)
J
<
@ '
* 7
>
(/
"
/ =
&
.
BB A
5
-
A
1
#
@
2 > "
$% *
$
@ 9 (
$% *
$
@ 9 (
$% *
$
@ 9 (
$% *
)
-
9,
, 9
J
7
=
% ) /
6#
<
* 7
-
-
@
BB A
;# /
2
# /
-
9,
, 9
3 A9?
7 <
3
&
!
"#$
"#$
!
(
)
*
!%
(
)
*
! +
!0 %
<
-
/
.
(
'
%
1
/
"
,)$
'%
, + -
+
(
%% .
* -
+
," /
3
"%
/0
#$ %% & $ %%
# ) *& ) *
)*
%
% *
"
,)$
"
$
1 '
2
*
/ - !0 .$
2
3&2. & 2
%
&
%
&
3
#
%
@ ?
I/- A
!3 +$
"
") !3 +$
&
/
/ - 3 ")
"
'
"2 /
/
F + A@/K % F 2 $
'
+ @ %
$*
$ 7 (- ( E
I4
'
7E<
$
.
!3 +$
K %
"
$
;
4
7 (%
( + -
:
'
(-
:
:
-
(
2
4&%
-1
(
&
)
'
%
!
5
%
/ !/ $
)
-
57
!5
-
) )#
6
* 5 *
1
1
6
2
$ + * 2
= :
2 = +" 1/>
<
! $
3 '$
/3
5%
3
83 9/ ! $:
'
;
/
/
$
2
% 1
.
.
%
6
( +;
( +;
<
!
!
"#$
"#$
<
#$
!
*
-
%
*
**
9
-
&
"
2
1&
5
'%
'
*
9 (
$' ?
-
9,
, 9
" #)
7 <
3
(( $ %
1
#
&
(
A
(/
"
/ =
.
5
/
3 A9?
$% *
$
@ 9 (
$% *
$
@ 9 (
$% *
2 > "
)
-
9,
, 9
% ) /
7 <
7
3
/
3 A9?
(
;# /
2
# /
4$
7
<
3B<07
3B 7
<
3B
7
/
/
<
-
-
=
<
6#
<
/ <
34 < 0
34 B
3 =B
3/$B
$1 B<
$ B
$/ B
/43
/43 <
/43 B
64$
0
6 =B <G
6 =B <G
6 =B <G
@$ <
@$ <
4 4B
B <
1 7
4$ . '
'. - %
%
.
*- .
%.
+ 9.
(
*?
.
6
@" 1/> 7 1>
7
C
*9 - *
9 %.9
'
3 4=@
/. B 1
6
@. 7 *?
4$
/. *
.+
'
@ B 1.
7 *?
$ C
3 4=@
/. B 1
6
@.
7 *?
$
C /
. 9 *- . < '%.
(
$
C /
9 *< '% 9 .
? (
'
$
C /
* .9
? (
'
$4 /4=; 4 C 34 72 3$ % 2 0 6
$4 /4=; 4 C 34 72 3$ % 2 ) (
+ ' 0 6) 0 1
3=@ * .*
('
3/$.
$1 75. < @.
(9
$ C.
.$
$
.< 1
6
@
$ =A
$ /= C E $;$/ > +
* *
% 9 .
(9
/43.
.*
9
/43.
.- 9
/43.
. ) '' - '
*') .
' *
*
.
%
.
*-. 1/>
/ 1
/=43.
. "
.%
*
("
1/> /== 3
6 ? %. $
7
*- (.
6 ) 0 @ ) B< 1
6 ? %. $
7
*- (.
6 ) 0 @ ) B< 1
7
B 6 ? %. $
*- (.
6 ) 0 @ ) B< 1
@ $3 $ =. % %
9 .9 '
@ $3 $ =.
%.
%
( *
( .
*
.9 '
4 47;$ =.
= %
E
4
.
6
1
@
> = 5 E .
*- '
6< @
1
1 7@ =. *?. 9 +
%
.'
'.
+
(. 0 1 < 6 < @
-
<
<
<
9,
, 9
(9 B
>
6
&
'
!
%
"#$
"#$
!
(
)
*
!%
(
)
*
! +
.
!0 %
<
-
/
1
?
"
"
,)$
,)$
%
%
.
: %'
(
"
$
"%
/0
#$ %% & '
# ) *&
"
$
1 '
2
*
/ - !0 .$
2
3&2. & 2
%
&
%
&
3
#
%
<
!3 +$
@
A@/K % F 2 $
$ 7 (-
(
$
!3 +$
/
/ - 3 ")
+
$
") !3 +$
&
?
"
'
"2 /
/
;
7 (%
( + -
:
'
(-
-
- + + -
(
2
4&%
-1
(
&
)
'
%
!
5
%
/ !/ $
5%
)
-
57
!5
-
) )#
6
* 5 *
1
$ + * 2
= :
2 = +" 1/>
<
<
! $
3 '$
/3
3
83 9/ ! $:
'
;
/
/
$
2
% 1
.
.
%
6
( +;
( +;
<
!
!
"#$
"#$
<
!
%
-
**
"
2
1&
5
'%
'
*
9 (
$' ?
-
9,
, 9
" #)
>
6
@ '
(/
"
/ =
&
.
5
?
-
A
1
#
>
(9 B
2 > "
$% *
$
@ 9 (
$% *
$
@ 9 (
$% *
$
@ 9 (
$% *
)
-
9,
, 9
% ) /
>
7
6
-
(9 B
?
-
;# /
2
# /
=
<
6#
<
3B
/
/
/
7
/ <
$1 B
$/ B
$6
6 =B <G
4 <0
7
4
4
14
0
<
> <<
> <
>
@=4
3= B
3 4=@
/. 0 1
6
@
$
C /
. 9 *- . < '%.
(
$
C /
. 9 *- . < '%. 9
$
C /
9 *< '% 9 .
? (
'
$
C /
* .9
? (
'
$1 75. +
'
$ =A
$ /= C E $;$/ > +
* *
% 9 .
(9
$6 / 1 '% *
( % . 9 .9 '
6 ? %. $
7
*- (.
6)0 @)0 1
4=@. ' ? . 9.
9% . 9 - %
.9 '
.B 1
6
7
C
.9 '
4
/. + (.
9 . < 1
6
@
4
/. + (.
9 .0 1
6 0 @
14 =. - (0B .
( *?.
+
. 9 .
.
(
>3 / = C ; 4=@
>3 / = 3= / =.
.4 .
1< 6 < @
>3 / = >
/ =. IF /5/. (
+ %
% .
? %
@=46 =
/.
9 . *?
.
*
.
1
6
@
3= / =. 9
.
*- '
.
6
@
1
-
<
<
<
<
<
<
<
<
9,
, 9
(9C
> 0
L
&
!
"#$
"#$
!
(
)
*
!%
(
)
*
! +
-
/
.
'
'
%
1
=
!0 %
"
,)$
#$ %% &
# ) *&
,)$
%
%%
$
"%
/0
%
"
$
1 '
2
*
/ - !0 .$
2
3&2. & 2
%
&
%
&
3
#
%
<
!3 +$
@ ''
9 -
'
*+
?
") !3 +$
&
!3 +$
/
/ - 3 ")
"
'
"2 /
/
;
7 (%
( + -
:
'
(-
-
- + + -
(
2
4&%
-1
(
&
)
'
%
!
5
%
/ !/ $
5%
)
-
57
!5
-
) )#
6
* 5 *
1
$ + * 2
= :
2 = +" 1/>
<
<
! $
3 '$
/3
3
83 9/ ! $:
'
;
/
/
$
2
% 1
.
.
%
6
( +;
( +;
<
!
!
"#$
"#$
<
!
%
-
**
"
2
1&
5
'%
'
*
9 ( "
$' ?
-
9,
, 9
" #)
> 0
L
@ '
(/
"
/ =
&
.
5
'
-
A
1
#
>
=
(9C
$% *
$
@ 9 (
$% *
$
@ 9 (
$% *
2 > "
)
-
9,
, 9
% ) /
> 0
7
L
=
-
(9C
'
-
;# /
2
# /
=
<
6#
<
/
/
/ <
=4 B
$6
7
B
14 0
/4
$
C /
. 9 *$
C /
. 9 *$
C /
'
=4 7. *
.
* #
$6 / 1 '% *
(
7
C
.9 '
.9
% % .0 1
14 =. % (- . %/4 7 . **
.
-
. < '%.
(
. < '%. 9
* .9
9 * % 9
% . 9 .9
.
.
"
*? (
1
''
? (
9&
'
"
<
<
<
9,
, 9
9BAB 9A
/
<
<
@ ( 3 %
&
'
!
%
"#$
"#$
!
(
)
*
!%
(
)
*
! +
-
/
1
.
!0 %
<
"
"
,)$
,)$
3
"%
/0
"
$
1 '
2
*
/ - !0 .$
2
3&2. & 2
%
&
%
&
3
#
%
!3 +$
$
") !3 +$
&
$
!3 +$
/
/ - 3 ")
"
'
"2 /
/
7 (%
( + -
:
'
(-
-
- + + -
(
2
4&%
-1
(
&
)
'
%
!
5
%
/ !/ $
5%
)
-
57
!5
-
) )#
6
* 5 *
1
$ + * 2
= :
2 = +" 1/>
<
<
! $
3 '$
/3
3
83 9/ ! $:
'
;
/
/
$
2
% 1
.
.
%
6
( +;
( +;
<
!
!
"#$
"#$
<
!
%
-
**
"
2
1&
5
'%
'
*
9 ( "
$' ?
-
9,
, 9
" #)
/
<
<
(( $ %
1
#
&
@ ( 3 %
A
(/
"
/ =
.
5
9BAB 9A
$% *
$
@ 9 (
$% *
$
@ 9 (
$% *
2 > "
)
-
9,
, 9
% ) /
/
7
<
<
9BAB 9A
@ ( 3 %
;# /
2
# /
4$
3B< 7
<
3B<B7
7E <
>$6B
<
-
-
=
<
6#
/
/
/
<
/
B
/ <
34 < 0
34 B
3 =B
$1 B <
$/ B
/43 B
64$
64$
0
4 <0
7
3
@$ <
@$ <
1 7
= 5
4$ . '
'. - %
%
.
*- .
%.
+ 9.
(
*?
.
6
@" 1/> 7 1>
4$
/.
(
*?. +
'
6
@
B 1. 7 *?
4$
/. *
.+
'
6
@
B 1. 7 *?
7 > 4= .
*
(*
( * %
%
6 =C/ 3.. +
'' + * (
*
.
0 @ '
.
(9 . 1/>0
$
C /
. 9 *- . < '%.
(
$
C /
. 9 *- . < '%. 9
$
C /
9 *< '% 9 .
? (
'
/
/ 9 *< '%. + ).
*
($
C /
* .9
? (
'
$4 /4=; 4 C 34 72 3$ % 2 0 6
$4 /4=; 4 C 34 72 3$ % 2 ) (
+ ' 0 6) 0 1
3=@ * .*
('
$1 75 + +
.
6
@
1
$ =A
$ /= C E $;$/ > +
* *
% 9 .
(9
/43.
. ) '' - '
*') .
' *
*
.
%
.
*-. 1/>
/ 1
64$/ .
+ -(
.'
. "
"
1/> 6/
/=43.
. "
.%
*
("
1/> /== 3
4=@. ' ? . 9.
9% . 9 - %
.9 '
.B 1
6
7
C
.9 '
3 4=@. *
( .
. *?
.9 9
( (- . 9 '
.B 1
6< @
@ $3 $ =. % %
9 .9 '
@ $3 $ =.
%.
%
( *
( .
*
.9 '
1 7@ =. *?. 9 +
%
.'
'.
+
(. 0 1 < 6 < @
= 5= E =4/ =. * % * <B
.
1
6
B @
-
<
<
9,
, 9
D ,
56$' 788
'9%,
>
) 9*+ $ 1 0+,
, ,+, 9 4,
* )9* :
'1 +
:7 ,9
9*
) 9*+ $ 1 0+,
, ,+, 9 4,
1+ ,++ :
!9 9 ,%, : -% + 9 4,
1+ 6 2,)
*
#
9,
5 ,-
%%, + :
-
+
!)
5 ,4,
1
9*
= + 1
+
A
3, ,9-
)
@1)
5(
** ,*,49 !F( (
,, ;+ 9 5 1) 1 9* (
,, ;+ - 9
+ 3,
,2, ,** - %, + + 9 , 39+,+ )9*
+1 4, 2 %9
9 - 9 21** +1 4,
+ 1*- 3, 1 -, 9=,
9
) + 1)
=+
9%
5, ,
* -
? * , > @,) !9 9 ,
1+ (+ 9 ,+ ,4,* %,
'
$
$
94 <,
1+ !,- )9*
$9+,+ >
-
'7 (5A
9
5 ,4,
<9
D
!A
/9E9 - (* % 9
F += ,-1)
9+ 3,, 1 -, 9=, 9 ,) -,,,9
9 ,D 9)) -9 ),
, ,G1 ,%, +
2H ,
+ 1)
,+
9 - !9 9 ,%,
, 1*9
+
H
9 - , H6 -1+ $1 -9 ), 2
,+ , +H
9*-
1+ 8 , 592,
+=
!9 9 ,
, ,+
8 1 ,- - %, + + * 9 , 3, 9=, 2 % + - 9
** - %, + + 9 , 3, ) ,)=,+ , 3,2 , 9
9 - 68 6' 70
5
*
7;
1+ 592,
+=
'
* )9*
>
91,
(*,
-9%+
>
1+ 7 , 9
(+ 9 ,+
5
$, 22
<9=,*
.
#
#
#
#
#
%&
2
3 4,
2
(
#
%&
(
3 4,
2
(
( #
3 4,
2
3 4,
(
(
,4 +
!
%&
"
!
"
%&
2
"
"
3 4,
2
3 4,
2
3 4,
2
9 A
,4 +
. %&
3 4,
(
$
#
!"
9
A
=;-A
9 ,A
=;-A
9 ,A
!
#
. %&
$
#
"
$
"
%
. %&
(
# #
(
(
%&
( #
#
"
(
#
(
!
%&
%&
%&
!
%&
%&
9)
"
.
,) 1 , B
,
-,+
B
*9
B *9 -+)9 , B 1 39 -,+
"
%&
"
!
$ &&
%&
! ' /(5 (
> *9 - 5 ,,
!9 ) ,+ ,
!
(
,*A #
#
=,
,-,+
) 1=
#
*,
7J2 - 0 4, +
1+
%&
/ +
9*+ '/5
#
> @,)
%&
"
9-)* 22, / +
(J , +
#
9* '6 0
9
%&
/ 0 '1 +, ,+
#
'
#
( )* +,-
# .
>
+,- (G1 %,
5,) - 8*
9
1
%&
> @,) '
'
( )* +,-
%&
9
'
,4
$
5 9 1+
' ()*+,+ ++
A
!"
$
-
-
49*
,9 ,9,
B
$>
B
:
( 8 5 B ( 6' 0 $/ B $
,)=,:
5)9*,
B '"<
B
+
I
- )9 ,-
5$7< B 6'C( '(55 B ! ' /(5 (
B >(
/
Appendix I - FBC for Option 2
GMP Reconciliation
Neo-Natal Unit, John Radcliffe Hopsital, Oxford
Project Budget Reconciliation
23 March 2012
Note: GMP is priced on the basis of economies from having parallel programme with Kadoorie.
Notes:
Re-planting trees to suit planners'
requirement to be attributed to client
contingency
Excludes £100K of other early works
Construction
New Build
Refurbishment
Sub Total £
Fees
OUT TURN BUDGET
As Project OB1 31/8/2011
Beds
GIFA
As Approval
Nr
m2
A
£
16
606
planning fee by Trust
Phase 3 survey by WD direct for Trust
Scion works
Non Works Costs Genrally
Scion miscellaneous
Options in addition to GMP
Commercial offer 8/3/12
Optimism Bias
Out Turn Total (Excluding VAT)
new build PSCP
refurb PSCP
Trust direct fees
Trust Charity Medical Equipment
VAT Balance
Out Turn Total (Including VAT)
£
1,657,983
165,797
1,823,780
15.90%
290,000
-2,680
20.00%
8.52%
30.00%
100.00%
213,368
GIFA
Total
Nr
m2
B
£
16
606
23,837
2,680
15.69%
75,000
138,368
4,088,835
2,186,100
1,902,735
0
0
0
0
PSCP
Trust
£
£
£/m2
311,985
2,680
14,778
3,220
1,988,858
14.49%
288,148
2,245,230
3.09%
B-A
£
3,282
25,000
75,975
1,712,850
3.55%
Allocation
1,988,858
25,000
1,712,850
5.51%
Total
VAT
VAT reclaim
313,837
0
£
25,000
Equipment
Planning Contingency
2,736
1,823,780
17.21%
Beds
Proposed Allocation
PSCP
Trust
£/m2
Rev 12
VARIANCE
TO BUDGET
CURRENT OUT TURN PROJECTION
Willmott Dixon GMP Position 14/3/2012
141,423
165,078
23,837
2,680
14,778
3,220
-1,852
2,680
14,778
3,220
25,000
75,975
0
75,975
2,245,230
532,380
56,596
84,827
-71,945
4,809,148
2,333,601
2,475,547
720,313
102,061
-15,000
102,061
-15,000
2.49%
102,061
112,852
0
112,852
0
0
0
4,201,687
2,186,100
2,015,587
4,896,209
2,420,662
2,475,547
694,522
840,337
-37,250
0
-4,767
437,220
-37,250
403,117
979,242
-92,469
0
-7,723
0
484,132
-92,469
495,109
138,904
-55,220
0
-2,956
0
7
5,775,258
2,812,326
-4,767
-7
5,000,000
20.00%
19.10%
30.00%
100.00%
-7,723
-7
2,586,070
Check:
2,413,930
£5,000,000
Check:
n/a
2,962,933
775,258
£5,775,258
£775,258
15.51%
Revisions:
1 Updated to reflect GMP submitted by WD dated 21/12/2012
2 Planning fees updated - see WD e-mail 18/10/11
3 VAT Recovery updated following advice from S Walker 28 Nov 2011
4 Equipment costs include EPR (G. Wakeling e mail 19/1/2012)
5 VAT on Charity funded equipment taken as ZERO rated for VAT as G. Wakeling e mail dated 19/1/2012 with enclosures
8 WD revised GMP dated 10/2/2012 incorporated
9 Reflecting WD e-mail 14/3/2012 agreeing GMP position. Equipment updated. Note added re planting and exclusion of early works funded separately
# Equipment updated for L Atkins e-mail 18/3/11. FB1 added
11 Updated equipment estimates - L Atkins e-mail 20/3/12
12 Updated fee / equipment / non works estimates - G Wakeling e-mail 21/3/12
Optional Additional Elements required by Trust - from WD GMP Summary
1 HTHW & LTHW Heating Services
a) Increase plant & pipework capacities to allow for future refurbishment works in Phase 3
(from 190kw to 400kw)
2 Chilled Water Services
a) Increase in Chiller load & add additional chiller unit c/w accoustics for contingency
b) Increase plant capacities to allow for future Phase 3 work
3 Building Management system
a) Increase plant capacities to allow for future Phase 3 works
4 Ventilation & Cooling Services
a) Standby Hub Room DX system (N+1) additional for contingency
5 Medical Gas Services
a) Mecical Gases valve sets for future adaptions and to ease shutdowns
b) Medical Gas Valve unfit for purpose removal
6 Thermal Insulation & Trace heating
a) Increase in pipework due to Phase 3 works
7 Rooflight blackout provision
a) Providing buildable blackout solution to rooflights
Total Options
Inc PSCP Fee £
4,299
Review of Trust risk allowances:
GMP provided by WD
Planning contingency
Optimism Bias
Planning contingency and optimism bias
3,271
22,930
1,000
1,402
16,000
102,061
% of GMP
3.50%
0.00%
3.50%
Equipment Requirement at GMP:
Total advised by Trust
Additional orders being processed
35,495
16,542
1,122
2,420,662
84,827
0
84,827
Inc VAT
2,893,000
60,000
External funding being provided for equipment
Equipment Cost £
Exc VAT
2,410,833
50,000
2,460,833
150,000
2,310,833
Cashflow:
Willmott Dixon's last estimate in Feb 2012:
Cash Flow Forecast
0155.02 Newborn ICU (Dated 20/2/12)
2010 - 2011
Select year
Original Target
Monthly Forecast
2011 - 2012
Compension
Original Target
Event
Monthly Forecast
Monthly
Compension Event
Monthly
Feb-2012
April
May
June
July
August
September
October
November
December
January
February
March
2012 - 2013
Revised Target + CE's
Monthly
Defined Cost
+ Fee Monthly
Original Target
Monthly Forecast
Compension
Event
Monthly
£0
Revised Target + CE's
Monthly
Defined Cost + Fee
Monthly
£0
£0
£24,255
£24,255
£0
£193,116
£193,116
£0
£392,966
£392,966
£0
£642,410
£642,410
£0
£409,591
£409,591
£12,982
£12,982
£106,590
£106,590
£12,280
£12,280
£79,418
£79,418
£29,276
£29,276
£243,702
£243,702
£52,731
£52,731
£63,009
£63,009
£28,399
£28,399
£0
£18,256
£18,256
£0
£24,620
£24,620
£0
Yearly
£0
£0
£178,544
£0
£178,544
£0
£2,155,057
£0
£2,155,057
£0
Cumulative
£0
£0
£178,544
£0
£178,544
£0
£2,333,601
£0
£2,333,601
£0
GW's adds/omits:
£102,061 additional options /
allowances excl from GMP
Commercial offer to achieve GMP
- reduction of £15,000
Trust Cost Advisor Fees
Planning Fees (paid by Trust)
Fees for Scion works
"Phase 3" Survey (committed
2011/12, may not be paid until
2012/12)
Trust Non Works Costs (mostly
IT/comms)
Trust Non Works Costs (Scion
Works)
Equipment
Trust Risk Pot (Planning
Contingency)
GW's adds/omits total:
Annual Cashflow net
VAT (assuming VAT relief on
constrn, currently assumed to be
average 19.10%, plus relief on
Trust fees)
VAT relief - prov - PSCP
VAT relief - prov - Trust
Annual Cashflow gross incl VAT
£102,061
£12,241
£2,680
£3,220
-£15,000
£11,596
£14,778
£25,000
£75,975
£2,218,368
£26,862
£2,312,484
£84,827
£250,124
£2,491,028
£2,405,181
£498,206
£481,036
-£6,820
-£85,649
-£2,448
-£5,275
£2,979,965
£2,795,293
£5,775,259
FULL BUSINESS CASE FOR PREFERRED OPTION
COST FORM FB1 (ROCR/OR/0043)
TRUST/ORGANISATION: Oxford University Hospitals NHS Trust
ORGANISATIONAL CODE:
SCHEME: Neo-Natal Intensive Care Unit Alterations
STATEGIC HA:
PHASE:
PROJECT DIRECTOR: Mark Trumper
CAPITAL COSTS SUMMARY
Cost Excl.
VAT
1
Departmental Costs (from Form FB2)
2
On Costs (from Form FB3)
3
Works Cost Total
n/a
of Departmental Cost)
(1+2) at
VAT
£
Cost Incl.
£
inc
inc
VAT
£
inc
inc
inc
inc
MIPS FP/VOP*
inc
inc
inc
(b)
inc
(Tender Price index level 1975 = 100 base)
4
Provisional location adjustment (if applicable)
5
Sub Total (3+4)
6
Fees
7
Non-Works Costs (from Form FB4) (e)
(0.00 % of Works Cost)
inc
405,801
(c)
n/a
of sub-total 5)
325,145 xxxxxxxxxxxx
LAND
8
Equipment Costs (from Form FB2)
9
Contingencies
10
TOTAL (for approval purposes)
n/a
of Departmental Cost)
11
Optimism Bias
12
Sub Total (10+11)
13
Inflation adjustments (f)
FORECAST OUTTURN BUSINESS CASE TOTAL (12+13)
0
0
0
19,739
118,432
2,194,490
438,898
2,633,388
138,227
27,645
165,872
4,785,560
892,083
5,677,643
0
0
0
4,785,560
892,083
5,677,643
110,649
22,130
132,779
0
-35,163
-35,163
4,896,209
879,050
5,775,259
2010/11
2011/12
2012/13
SOURCE
EFL
£
OTHER GOVERNMENT
0
2,929,597
2,748,046
325,145
98,693
VAT reclaim
Cash Flow:- Year
yy/yy
2,434,806
(d)
OTHER
14
inc
2,029,005
PRIVATE
0
0
TOTAL
0
0
2,929,597
2,748,046
0
0
0
0
5,677,643
0
0
Total Cost (as 10 above)
Total (for approval purposes) match against Cashflow
0K
escape
stair
only
parent / carer
scrub room
bedroom
large
10m†
22m†
rooming in room
32m†
plant space
01
02
03
rooming in room
rooming in room
26m†
26m†
anaesthetic
04
15m†
operating theatre
57m†
hand
washing
station
96m†
8 bay SCBU
dirty utility
10m†
stabilisation area
06
05
07
08
20m†
19m†
base
recovery
20m†
11
10
09
male
15m†
female
change
96m†
& storage
8 bay SCBU
6m†
bed l
i
f
t
wc
wc
15
10m†
resus area
disposal
linen cupboard
14
clean prep.
dis.wc
12
& baby
13
m obi
l
e
& laser room
nurse
equi
pm entbay
treatment room
hold
13m†
sitting room
entrance
with play area
waiting area
20m†
40m†
16
clean utility
15m†
17
18
19
20
nicu reception /
cloakroom
dirty utility
96m†
ward clerk office
10m†
8m†
22m†
8 bay SCBU
hand
washing
station
21
23
22
24
hand
washing
station
01
02
hand
washing
station
03
38
"hotdesks"
antibiotics
37
36
doctors offices
room
staff wcs
radiology office
16m†
20m†
6 bay ITU space
consulting
linen cupboard
rooms
& storage
9m†
6m†
6 bay ITU space
clinical research
nurse
04
05
nurse
laboratory
06
base
20m†
08
09
physi
cal
m easur
em ent
5m †
07
near
patient lab
6 bay ITU space
10
11
7m†
13
14
32
31
30
& ophthalmic
6 bay ITU space
store
12m†
clean utility
8m†
15m†
base
35
ultrasound
12
15
34
x-ray,
dirty utility
nurse
33
base
treatment
op. assessment
room
24m†
27
28
29
26
25
24
nurse
base
single cot ITU
double cot ITU
single cot ITU
double cot ITU
6 bay ITU space
single cot ITU
single cot ITU
19
16
17
20
18
21
hand
washing
station
22
23
hand
washing
station
D R A F T
temperature controlled corridor
revision:
by:
date:
index:
St Thomas House
6 Becket Street
scrub room
10m†
anaesthetic
dirty utility
15m†
10m†
recovery
dirty utility
anaesthetic
10m†
15m†
scrub room
Oxford OX1 1PP
10m†
T: 01865 305 130
F: 01865 246 424
20m†
W:
gbs-ox.co.uk
BAM Construction Ltd
New NICU
John Radcliffe Hospital
operating theatre
operating theatre
recovery
57m†
57m†
20m†
clean prep.
clean prep.
10m†
10m†
NICU - all clinical space on one level
Draft Layout
scale: 1:100 @ A1
date: June 09
drawn:sw
drawing no:
5775.37
P21+0155.02 2010.402 JR1 NICU Alterations ‐ Programme
P21+0155.02 2010.402 JR1 NICU Alterations 2011 Project
Last Update: 02/03/2012
2012
Duration
Start
Finish
w/c
Planning Permission granted (Oxford City Council 11/02888/FUL)
0 days
Fri 10/02/2012
Fri 10/02/2012
Finalise GMP for FBC
0 days
Thu 15/03/2012
Thu 15/03/2012
Trust Director of Clinical Services Review
0 days
Tue 03/04/2012
Tue 03/04/2012
Trust Strategic Planning Committee
0 days
Tue 03/04/2012
Tue 03/04/2012
Trust Board
0 days
Thu 03/05/2012
Thu 03/05/2012
Strategic Health Authority
0 days
Mon 04/06/2012
Mon 04/06/2012
Willmott Dixon Pre-construction activities
Remove trees (pre-nesting season)
3 days
Mon 12/03/12
Wed 14/03/12
Remove existing staircase & chemical store
5 days
Mon 19/03/12
Fri 23/03/12
Place order/sign off for Structural Steelwork
0 days
Mon 07/05/12
Mon 07/05/12
Place cladding order/procurement materials
0 days
Mon 14/05/12
Mon 14/05/12
Place order/sign off cost for piling
0 days
Mon 28/05/12
Mon 28/05/12
Setting out / erect hoardings / site accommodation
5 days
Mon 11/06/12
Fri 15/06/12
Decant long room ref 2638
2 days
Mon 11/06/12
Tue 12/06/12
Hardstandings / site strip & piling mat
4 days
Tue 12/06/12
Fri 15/06/12
Erect acoustic screens to both levels 1 & 2
2 days
Fri 15/06/12
Mon 18/06/12
Piling
3 days
Tue 19/06/12
Thu 21/06/12
Foundations including curing
10 days
Fri 22/06/12
Thu 05/07/12
Construct Structural Steel Frame
5 days
Fri 06/07/12
Thu 12/07/12
Scaffold edge / mobile platform access.
3 days
Fri 13/07/12
Tue 17/07/12
Metal deck & concrete upper floor
5 days
Fri 13/07/12
Thu 19/07/12
Construct Ground floor slab
5 days
Fri 20/07/12
Thu 26/07/12
Single ply roofing including rooflight
15 days
Fri 20/07/12
Thu 09/08/12
Blockwork to the plantrooms including scaffolding
15 days
Fri 27/07/12
Thu 16/08/12
Weather protection to external walls
4 days
Fri 20/07/12
Wed 25/07/12
Decant rooms 2685 & 2686
4 days
Wed 25/07/12
Mon 30/07/12
Decant rooms 2618,2636 & 2637
4 days
Wed 25/07/12
Mon 30/07/12
External claddings
5 wks
Thu 26/07/12
Wed 29/08/12
Internal fit out
56 days
Thu 26/07/12
Thu 11/10/12
Services first fix
15 days
Thu 26/07/12
Wed 15/08/12
Willmott Dixon Construction period (Stage 4)
2013
FEB FEB FEB FEB MAR MAR MAR MAR APR APR APR APR APR MAY MAY MAY MAY JUN JUN JUN JUN JUL JUL JUL JUL JUL AUG AUG AUG AUG SEP SEP SEP SEP OCT OCT OCT OCT OCT NOV NOV NOV NOV DEC DEC DEC DEC DEC JAN JAN JAN JAN FEB FEB FEB FEB MAR
6
13
20
27
5
12
19
26
2
9
16
23
30
7
14
21
28
4
11
18
25
2
9
16
23
30
6
13
20
27
3
10
17
24
1
8
15
22
29
5
12
19
26
3
10
17
24
31
7
14
21
28
4
11
18
25
4
P21+0155.02 2010.402 JR1 NICU Alterations ‐ Programme
Process of Connection of Extension to Existing Building
20 days
Wed 01/08/12
Tue 28/08/12
Erect protective screening within existing ward
2 days
Wed 01/08/12
Thu 02/08/12
Remove fixtures & fittings on existing walls
2 days
Fri 03/08/12
Mon 06/08/12
Divert services as necessary
3 days
Tue 07/08/12
Thu 09/08/12
Install temporary works as necessary
3 days
Fri 10/08/12
Tue 14/08/12
Demolitions
3 days
Wed 15/08/12
Fri 17/08/12
Services/Finishes & making good
5 days
Mon 20/08/12
Fri 24/08/12
Remove protective screen & make good
2 days
Mon 27/08/12
Tue 28/08/12
Hand back to Trust rooms 2618, 2636 & 2637
0 days
Tue 28/08/12
Tue 28/08/12
Plantroom installations
41 days
Fri 17/08/12
Fri 12/10/12
Metal stud partitions
9 days
Thu 09/08/12
Tue 21/08/12
Complete studwork / plasterboard & skim
5 days
Wed 22/08/12
Tue 28/08/12
Soffits, fascia, rainwater goods & flashings
5 days
Thu 30/08/12
Wed 05/09/12
External windows
5 days
Thu 23/08/12
Wed 29/08/12
Suspended ceilings
15 days
Wed 29/08/12
Tue 18/09/12
Joiner second fix
10 days
Wed 12/09/12
Tue 25/09/12
Services second fix
15 days
Wed 12/09/12
Tue 02/10/12
Paint & decorate
5 days
Wed 26/09/12
Tue 02/10/12
Soft floor finishes
3 days
Wed 03/10/12
Fri 05/10/12
Fixtures & fittings
5 days
Mon 08/10/12
Fri 12/10/12
Strip scaffold/clear area
5 days
Thu 06/09/12
Wed 12/09/12
Complete external tidy up, new paving etc.
10 days
Thu 13/09/12
Wed 26/09/12
Commission gases / M & E
19 days
Mon 15/10/12
Thu 08/11/12
Defect free and builder's clean
19 days
Mon 15/10/12
Thu 08/11/12
Erect temp acoustic screen before clinical clean to
phase 1
3 days
Tue 06/11/12
Thu 08/11/12
Handover new Extension (Willmott Dixon partial
completion)
0 days
Thu 08/11/12
Thu 08/11/12
14 days
Fri 09/11/12
Thu 22/11/12
3 days
Fri 23/11/12
Sun 25/11/12
Clinical clean (Phase 1) by Trust
3 days
Mon 26/11/12
Wed 28/11/12
Decant into part of new Extension (Phase 1) by Trust
0 days
Wed 28/11/12
Wed 28/11/12
Phase 1 (8 cots) live
0 days
Wed 28/11/12
Wed 28/11/12
Clinical equipment fit out by Trust
Trust training, familiarisation, stocking, cleaning etc (Phase
1)
Re-model existing Long Room & adjacent area
P21+0155.02 2010.402 JR1 NICU Alterations ‐ Programme
Set up noise and dust screens
2 days
Wed 28/11/12
Thu 29/11/12
Isolate services
2 days
Fri 30/11/12
Mon 03/12/12
Strip out
3 days
Tue 04/12/12
Thu 06/12/12
New walls one side
2 days
Fri 07/12/12
Mon 10/12/12
First fix & pattresses
3 days
Tue 11/12/12
Thu 13/12/12
Second side of walls
2 days
Fri 14/12/12
Mon 17/12/12
Second fix
3 days
Tue 18/12/12
Thu 20/12/12
Carpentry
2 days
Fri 21/12/12
Mon 07/01/13
Decorations
3 days
Tue 08/01/13
Thu 10/01/13
Ceilings
4 days
Fri 11/01/13
Wed 16/01/13
Final fix
4 days
Thu 17/01/13
Tue 22/01/13
Commission M & E
11 days
Wed 16/01/13
Wed 30/01/13
Defect free and clean.
8 days
Thu 24/01/13
Mon 04/02/13
Remove screens acoustic and dust
2 days
Tue 05/02/13
Wed 06/02/13
Clean
2 days
Thu 07/02/13
Fri 08/02/13
0 days
Fri 08/02/13
Fri 08/02/13
Clinical equipment installation, testing, commissioning
(Phase 2)
14 days
Mon 11/02/13
Mon 25/02/13
Trust supplementary training, familiarisation, stocking,
cleaning etc (Phase 2)
6 days
Tue 26/02/13
Sun 03/03/13
0 days
Mon 04/03/13
Mon 04/03/13
Construction Handover (Willmott Dixon construction
completion & handover)
Trust Activities Post Construction Handover
Unit becomes fully operational
Introduction
Purpose of the Project Profile Model (PPM)
The Project Profile Model is intended to provide a standard set of high level criteria against which Senior Responsible Owners
(SROs)/Project Owners (POs) can assess the intrinsic characteristics and degree of complexity of a proposed procurement
project, in order to establish the appropriate:
• control structures (including Gateway Review)
• risk profile and corresponding risk strategy
• design approach (for example, delivering the project in several increments or modules to help reduce complexity).
Using the PPM
This version of the PPM is to be used from the 1st March 2003
Four worksheets are provided. These are:
• Project details -details of the project, key staff and, for IT-enabled Business Change projects, additional information
• IT-enabled Business Change - all business change projects involving an IT element which, if not delivered, would
significantly impact upon the project's ability to deliver its intended benefits
• Property and Construction - projects procuring property (existing or to be constructed) as a supply of works or service
• Other Services (eg. environmental management, facilities management, property and estates advice etc)
SROs/POs should complete the relevant project details and select one of the other three worksheets most appropriate for their
project. Please note that the first two worksheets are applicable to those IT-enabled Business Change and Property and
Construction management projects procuring services. While such projects may be seeking to pass responsibility to service
providers for some of the criteria addressed within the PPM (eg. the degree of innovation used) these factors will still be
fundamental to the ultimate success or otherwise of the project. These factors will need to be monitored throughout the project
lifecycle by the SRO/PO.
The PPM should be used as a starting point in assessing complexity in terms of the likely levels of risk associated with the project.
It is a high level indicator, it is not an exhaustive project risk analysis model, although it can form the basis of a fuller project risk
analysis. The model requires the SRO/PO to assess the project against a number of criteria to provide an overall score for the
project. These initial scores will be validated by OGC; the current approach is that:
• total score of 30 or less indicates that the project is relatively low risk. Gateway Reviews will be managed by the
departmental Centre of Excellence or Gateway Co-ordinator.
• total score in the range 31–40 indicates that the project is medium risk. Gateway Reviews will require a Review Team
Leader nominated by the OGC Gateway Team and independent of the department. The Review Team Members are sourced
by the departmental Centre of Excellence or Gateway Co-ordinator.
• total score 41 or more indicates that the project is high risk and will require both a Review Team Leader and Review Team
Members nominated by the OGC Gateway Team and independent of the department.
However, it is important to stress that the assessment model is designed as a guide to help the SRO/PO make their assessment.
There may be issues that are not explicitly covered by the model but which affect the assessment. In particular, there may be other
factors that increase the complexity or risk to the project and therefore warrant a higher rating. If in any doubt, SROs/POs should
discuss these issues with their departmental Centre of Excellence or Gateway Co-ordinator in the first instance before contacting
OGC.
The questions in the worksheets are designed to be self explanatory. Where a precise response to a question is not available the
SRO/PO should use their best estimate in the light of their knowledge and experience.
The initial PPM is updated prior to each subsequent Gateway review
Additional considerations for IT-enabled Business Change projects
The PPM project details and appropriate worksheet should be completed as for any project to give a PPM score. However
additional considerations are required for IT-enabled Business Change programmes and projects. The outcome may affect the
risk rating or identify actions that need to be undertaken if the rating is high risk. The PPM project details worksheet has been
extended to capture this additional information and to provide a record that the additional preparatory work required by Cabinet
Ministers has been completed.
Automatic classification as high risk
It should be noted that there are two criteria for an IT-enabled Business Change project that will automatically result in it being
classed as high risk, irrespective of the overall score generated by the worksheet. These are:
• Any IT-enabled Business Change project using a 'Big Bang' development and/or implementation approach is
automatically classed as high risk, irrespective of the overall score generated by the worksheet. Centres of Excellence or
Gateway Co-ordinators are required to submit 'Big Bang' projects to a central scrutiny group for approval.
• Any IT-enabled Business Change project that has been prioritised as 'Mission Critical' is automatically classed as high
risk, irrespective of the overall score generated by the worksheet.
High risk projects
• Any IT-enabled Business Change project identified as high risk, either from using the above classifications or by having a
score of 41 or more from the PPM, will need to have (i) clearly identified responsible Minister (ii) SRO and Project Manager with
good relevant track records.
• Any IT-enabled Business Change project identified as high risk has a requirement that, before a project commences, it is
assessed against the NAO/OGC list of common causes of failure.
For further information on the above, please contact your departmental Centre of Excellence or Gateway Co-ordinator.
Alternatively see:
www.ogc.gov.uk/sdtoolkit/keyissues/centexcel/coeintro.html
What should you do next?
SROs/POs are asked to notify the OGC Gateway team, after confirming the PPM details with their Centre of Excellence, if their
proposed project is medium or high risk. OGC is not recording information for low risk projects. They should email a copy of the
completed PPM to Gateway.Helpdesk@ogc.gsi.gov.uk. OGC will advise SROs/POs on the initiation of the Gateway process. The
OGC Gateway team will then be in contact with you to arrange an assessment meeting, following which the team needs 6-8 weeks
in order to undertake the necessary planning and team selection.
For enquiries about the use of the PPM, please call the Gateway team on 020 7271 1396.
Issue Date: 04 August 03
© Crown Copyright 2003. This material falls outside the scope of HMSO's Click-Use Licence
1 of 1
Version 2.2
Project Details
Project details
Project Name or Title
Project Description
Department, Agency or NDPB name
Name of Parent Department
Total (whole life) Project Costs
• If at Gateway 2 or beyond, please state the current forecast
whole-life cost of any contract.
• If at Gateway 2 or beyond, please state the current forecast
whole-life business costs of the project (ie excluding any
contract).
Proposed contractual arrangements (Conventional/PFI/PPP)
Expected Gateway (0, 1, 2, 3, 4 or 5)
Gateway review requested for week commencing dd/mm/yyyy
(Note that 6-8 weeks notice is required)
Date of first issue of PPM dd/mm/yyyy
Date of current update / Version number
Senior Responsible Owner / Project Owner
SRO/PO Name
SRO/PO Address
SRO/PO Town
SRO/PO Postcode
SRO/PO Telephone No
SRO/PO Fax No
SRO/PO E-mail Address
Project Manager
PM Name
PM Address
PM Town
PM Postcode
PM Telephone No
PM Fax No
PM E-mail Address
If not the PO, SRO or PM, please provide details of official who completed the return
Name
Postal Address
Telephone No
Fax No
E-mail Address
In addition, for IT-enabled projects, the following details are required:
Further information is available from your departmental Centre of Excellence, Gateway Co-ordinator or at:
www.ogc.gov.uk/sdtoolkit/keyissues/centexcel/coeintro.html
Project prioritisation
• What is the prioritisation of the project?
Mission Critical
Highly Desirable
Desirable
(Note: IT-enabled projects with no prioritisation are not ready for review)
A project that is Mission Critical is treated as high risk, but the PPM details need to be completed to help
understand the nature of the project and its associated complexity.
Further information is available from your departmental Centre of Excellence, Gateway Co-ordinator or at:
www.ogc.gov.uk/sdtoolkit/keyissues/centexcel/coeintro.html
Project approach
• What is the project development or implementation
approach?
Modular/incremental
'Big Bang'
Please confirm that any 'Big Bang' approach has central
scrutiny group approval.
(Note: IT-enabled projects without these entries completed are not ready for review)
A project with 'Big Bang' development or implementation is treated as high risk, but the PPM details need to
be completed to help understand the nature of the project and its associated complexity.
High risk projects for review from 1st July 2003 onwards
• If the project is identified as high risk:
Please enter the name of the responsible Minister
Confirm that the track record of the SRO has been verified
Confirm that the track record of the PM has been verified
Confirm that the project has been assessed against the
NAO/OGC list of common causes of failure
Confirm that, for projects that are at Gate 2 or beyond, the
Accounting Officer has assured him/herself that the project
does not include any of the NAO/OGC listed common causes
of failure.
(Note: High risk IT-enabled projects without these entries completed are not ready for review)
Data Protection Act 1998
It is intended that the data collected via this form will be used by the Office of Government Commerce (OGC) for its own
purposes and also to inform other areas of Government business. The data may also be used to make you aware of services,
advice and guidance. Issues related to the use of personal data within this form should be addressed to the OGC Service
Desk on 0845 000 4 999 or by email at ServiceDesk@ogc.gsi.gov.uk
Issue Date: 04 August 03
© Crown Copyright 2003. This material falls outside the scope of HMSO's Click-Use Licence
1 of 1
Version 2.2
IT-enabled business change
WORKSHEET FOR IT-ENABLED BUSINESS CHANGE PROJECTS
Business impact
Criteria
Comments
Total value of the
Total (as opposed to annual) value,
business benefits in £. calculated in line with HM Treasury
guidance1.
Total value of the
business costs in £.
Number of individuals
affected.
Impact on business
processes (includes
changed processes).
Total (as opposed to annual) costs,
calculated in line with HM Treasury
guidance1. Excludes IT costs which
are covered later.
Refers to internal personnel within
Government – i.e. includes technical
and business staff and users, but
excludes citizens, suppliers, etc.
Refers to the impact that the project
will have on the organisation (both
during development and after
implementation). Allocate a score
between 1 and 6.
Value
Up to £10m
£10m to £100m
More than £100m
Up to £5m
Major new legislation or
significant new processes
requiring new skills, new
organisation and major
new procedures.
Impact on other
The degree to which the project is
Stand alone project.
projects and changes. dependent on and connected to other
projects and changes. Allocate a
score between 1 and 8.
Supporting wider
departmental change
initiative.
Supporting cross-cutting
change initiative.
Supporting EU or 3rd
country initiative.
Degree of innovation.
2
4
Comments
Value
Total (as opposed to annual) IT
Up to £10m
costs, calculated in line with HM
Treasury guidance1. For commercial
contracts this will be the total charge
to department rather than cost to
supplier.
£10m to £100m
More than £100m
Up to 50
4
6
1
6
1
6
1
3
6
8
Score
The degree to which the project will Greenfield development.
need to develop interfaces to existing
systems and data stores. Allocate a
score between 1 and 4.
Extensive data conversion,
migration and integration
issues, and bespoke
interfaces to existing
applications and platforms
needed.
Scope of IT supply.
The range of activity that will be
Deliver infrastructure.
(Note: for this criterion undertaken by the IT supplier, and
score for each
the extent to which these will impact
element, i.e. may be
on the business processes of the
cumulative.)
organisation.
Deliver packaged software.
Deliver bespoke
application.
Deliver new business
processes.
Deliver package with
significant bespoke
elements.
Transfer of IT staff.
1
2
3
2
3
1
4
1
4
1
3
3
4
4
Client and Supplier Side Organisation
Criteria
Comments
The complexity of the client-side
arrangements. Allocate a score
between 1 and 4.
The complexity of the supply-side
arrangements.
Value
Single business stream
within department.
Cross-cutting involving
multiple departments.
Single internal.
Single external.
Multiple with prime
contractor.
Multiple without prime
contractor.
Note that a
score should
be entered for
each line where
applicable
1
Total Score for Technical Impact (Max 30):
Supply-side
organisation.
0
Project
Score
1
50 to 100
More than 100
The extent to which the project
Stable, proven technology,
involves innovative solutions, and the widely implemented,
level of familiarity and experience
familiar to organisation and
available. Allocate a score between 1 suppliers.
and 4.
Technology or scale of its
planned use unproven,
and organisation and some
suppliers inexperienced in
its application.
Impact on legacy
systems and data.
Client-side
organisation.
Actual score
entered must
be one of the
allowed eg. one
of 1, 2 or 4
2
4
Total Score for Business Impact (Max 34):
Criteria
Number of IT
practitioners (including
internal and outsourced suppliers).
1
1
1,000 to 10,000
More than 10,000
No significant change to
organisation.
Impact potentially
disruptive to large sectors
of the public and business.
Technical impact
Project
Score
1
£5m to £50m
More than £50m
Less than 1,000
Impact on Government Refers to the impact that the project Impact contained internally
services at
will have outside the organisation, for within the organisation.
implementation.
example on the public and
businesses (both during development
and after implementation). Allocate a
score between 1 and 6.
Total IT costs.
Score
Score
0
Project
Score
1
4
1
2
3
4
Total Score for Client/Supplier Arrangements (Max 8):
0
Total Score for Business Impact (Max 34):
Total Score for Technical Impact (Max 30):
Total Score for Client/Supplier Arrangements (Max 8):
0
0
0
Project Profile Model Total Score (Max 72):
0
Note 1. In the first instance, SROs/POs or Project Managers are advised to contact their central departmental
finance and economist experts for assistance with the calculation of business costs and benefits.
Note 2. Those completing the PPM for IT-enabled projects should note that projects classed as Mission
Critical or "Big Bang" or incorporating one or more of the NAO/OGC listed common causes of failure with no
acceptable mitigation plan, are all classed as high risk projects, irrespective of the PPM score.
Issue Date: 04 Aug 03
© Crown Copyright 2003. This material falls outside the scope of HMSO's Click-Use Licence
1 of 1
Version 2.2
Appendix L GTC Gateway PPM - ORH Neonatal Unit Jun 2011.xls
WORKSHEET FOR PROPERTY & CONSTRUCTION PROJECTS
Business impact
Criteria
Comments
Value
Total value of the
Total (as opposed to annual)
Up to £10m
business benefits in £. value, calculated in line with HM
1
Treasury guidance .
£10m to £100m
More than £100m
Total value of the
Total (as opposed to annual)
Up to £5m
business costs in £.
costs, calculated in line with HM
Treasury guidance1. Excludes
construction/contract costs which
are covered later.
£5m to £50m
More than £50m
Number of individuals Refers to internal personnel
Less than 1,000**
affected.
within Government – i.e.
includes technical and business
staff and users, but excludes
citizens, suppliers, etc.
1,000 to 10,000
More than 10,000
Impact on business
Refers to the impact that the
No significant change to
processes (includes
project will have on the
organisation.
changed processes). organisation (both during the
period of work and afterwards).
Allocate a score between 1 and
5.
Major new legislation,
significant new processes,
disruption to staff and
business processes during
the work period or significant
change to the business
environment following
completion.
Refers to the impact that the
Impact contained internally
Impact on
within the organisation.
Government services project will have outside the
organisation, for example on the
at implementation.
public and businesses (both
during development and after
implementation). Allocate a
score between 1 and 6.
Impact potentially disruptive
to large sectors of the public
and business.
Criteria
Impact from other
Government or
external organisations
e.g. Heritage Trust,
HSE, Regulators,
Environment etc.
Comments
Refers to the impact and
influence that 3rd party
organisations may have on the
project. Allocate a score
between 1 and 6.
Impact on other
The degree to which the project
projects and changes. is dependent on and connected
to other projects and changes.
Allocate a score between 1 and
5.
Technical impact
Criteria
Total costs.
Value
1
1
Total (as opposed to annual)
costs, calculated in line with
1
Actual score
entered must
be one of the
allowed eg.
one of 1, 2 or 4
1
2
4
1
1
4
6
1
1
5
1
1
6
Score
Project
Score
1
1
Impact potentially disruptive
to the project.
6
A standalone building project
for a sole government
organisation.
1
Co-location of departmental
staff from dispersed
locations into one location as
part of a programme of
interrelated change.
Co-location of staff from
more than one Government
department into one building
and a key component of an
intricate programme of
change.
3
Value
Score
Up to £10m
1
commercial contracts this will be
the total charge to department
rather than cost to supplier.
£10m to £100m
More than £100m
Up to 50
Issue Date: 04 Aug 03
© Crown Copyright 2003. This material falls outside the scope of HMSO's Click-Use Licence
7
Project
Score
1
2
3
1
50 to 100
More than 100
1
5
Total Score for Business Impact (Max 36):
Comments
Project
Score
2
4
Minimal impact upon the
organisation.
HM Treasury guidance1. For
Total workforce
(including internal and
out-sourced
suppliers).
Score
2
2
3
1 of 2
Version 2.2
Appendix L GTC Gateway PPM - ORH Neonatal Unit Jun 2011.xls
Number of specialists
within the workforce
e.g professionals;
technicians;
management
Up to 50
1
50 to 100
More than 100
Degree of innovation. The extent to which the project Stable, proven technology,
involves innovative solutions,
widely implemented, familiar
and the level of familiarity and
to organisation and
experience available. Allocate a suppliers.
score between 1 and 6.
Technology or scale of its
planned use unproven, and
organisation and some
suppliers inexperienced in its
application.
Impact on technical
Type of development e.g new
New Development
infrastructure e.g
building project, refurbishment
building systems;
project or extensions involving
networks;
migration and integration of
security/alarms
new/existing technologies.
Refurbishment
Extensions
Project characteristics The building and site
New standard building.
characteristics and the extent to
which these will technically
impact the project.
Unique building
Listed building
Greenfield site
Brownfield site
Serviced site
Unserviced site
2
2
3
1
1
6
1
3
2
3
1
2 or 3
3
1
3
1
2
Total Score for Technical Impact (Max 26):
Enter 1, 2 or 3
2
3
1
Enter 1 or 3
Enter 1 or 2
15
Client-side & supplier organisation impact
Criteria
Client-side
organisation.
Supply-side
organisation.
Comments
Value
The complexity of the client-side Single business stream
arrangements. Allocate scores within department.
between 1 and 4.
Cross-cutting involving
multiple departments.
Involvement of client-side in
Frequently
similar projects.
A few times
Never
The complexity of the supplySingle internal.
side arrangements. Allocate
scores between 1 and 4.
Single external.
Multiple with prime
contractor.
Multiple without prime
contractor.
Involvement of supplier in similar Frequently
projects.
A few times
Never
A
B
C
Calculation Formula
D = A*0.92
E = B*0.92
F = C*0.92
Score
1
1
4
1
2
4
1
1
2
3
1
4
1
2
4
1
Total Score for Client/Supplier Arrangements (Max 16):
4
Score for Business Impact (Max 36):
Score for Technical Impact (Max 26):
Score for Client-side & Supplier Organisation (Max 16):
7
15
4
Project Profile Model Actual Score (Max 78) :
26
Consolidated Score for Business Impact (Max 36):
Consolidated Score for Technical Impact (Max 26):
Consolidated Score for Client-side & Supplier Organisation
(Max 16):
Project Profile Model Consolidated Score (Max 72) :
Calculation Formula
(D*1.0)*0.72
(E*1.4)*0.72
(F*2.25)*0.72
Project
Score
Weighted Score for Business Impact:
Weighted Score for Technical Impact:
Weighted Score for Client-side & Supplier Organisation:
Project Profile Model Total Score (Max 72) :
6.46
13.85
3.69
24
4.65
13.80
5.98
24
Note 1. In the first instance, SROs/POs or Project Managers are advised to contact their central
departmental finance and economist experts for assistance with the calculation of business costs and
Note 2. The first 'balancing' (PPM Consolidated Score) is necessary to maintain consistency with the IT
Project Profile Model that uses a maximum score of 72. The second 'balancing' (PPM Weighted Score) is
used to ensure an equal weighting (1/3rd) for Business Impact, Technical Impact and Client-side &
Supplier Organisation Impact
Issue Date: 04 Aug 03
© Crown Copyright 2003. This material falls outside the scope of HMSO's Click-Use Licence
2 of 2
Version 2.2
Other Services
WORKSHEET FOR PROJECTS INVOLVING THE PROCUREMENT OF
A SERVICE
Business Impact
Criteria
Comments
Value
Total value of the
business benefits in
£.
Total (as opposed to
Up to £10m
annual) value, calculated in
line with HM Treasury
1
guidance .
£10m to £100m
More than £100m
Total value of the
Total (as opposed to
Up to £5m
business costs in £.
annual) costs, calculated in
line with HM Treasury
1
guidance . Excludes
contract costs which are
covered later.
£5m to £50m
More than £50m
Number of individuals Refers to internal
Less than 1,000
affected by the
personnel within
contract
Government – i.e. includes
technical and business
staff and users, but
excludes citizens,
suppliers, etc.
1,000 to 10,000
More than 10,000
Impact on business
Refers to the impact that
No significant change
processes (includes
the contract will have on
to organisation.
changed processes). the organisation (both
during development and
after implementation).
Allocate a score between 1
and 6.
Major new legislation or
significant new
processes requiring
new skills, new
organisation and major
new procedures.
Impact on
Refers to the impact that
Impact contained
Government services the contract will have
internally within the
at implementation.
outside the organisation,
organisation.
for example on the public
and businesses (both
during development and
after implementation).
Allocate a score between 1
and 6.
Impact potentially
disruptive to large
sectors of the public
and business.
Criteria
Comments
Impact on other
contracts and
changes.
The degree to which the
Stand alone contract.
contract is dependent on
and connected to other
contracts and changes.
Allocate a score between 1
and 6.
Supporting wider
departmental change
initiative.
Supporting crosscutting change
initiative.
Criteria
Comments
Total costs.
Number of
practitioners
(including internal and
out-sourced
suppliers).
Degree of innovation.
Contract
Characteristics
1
Value
Total (as opposed to
Up to £10m
annual) costs, calculated in
line with HM Treasury
1
guidance . For commercial
contracts this will be the
total charge to department
rather than cost to supplier.
£10m to £100m
More than £100m
Up to 50
1
1
Client-side
organisation.
Supply-side
organisation.
Value
The complexity of the client- Single business stream
side arrangements.
within department.
Allocate score between 1
and 4.
Cross-cutting involving
multiple departments.
Involvement of client-side Frequently
in similar contracts
A few times
Never
The complexity of the
Single internal
supply-side arrangements.
Allocate score between 1
and 3
Multiple with prime
contractor.
Multiple without prime
contractor.
Involvement of supplier in Frequently
similar contracts. Allocate
score between 1 and 4
A few times
Never
1
1
6
1
1
6
Score
Project
Score
1
1
3
6
Score
1
10
Project
Score
2
2
3
1
2
3
1
2
5
1
3
4
Note that a
score should
be entered for
each line
where
applicable.
1
3
3
3
4
5
Score
1
11
Project
Score
2
4
1
2
4
2
1
2
2
3
1
2
4
2
Total Score for Client/Supplier Arrangements (Max 15):
8
Score for Business Impact (Max 32):
Score for Contract Impact (Max 31):
Score for Client & Supplier Organisation (Max 15):
10
11
8
Project Profile Model Actual Score (Max 78):
Calculation
D = A*0.92
E = B*0.92
F = C*0.92
4
1
Client & Supplier Organisation Impact
Comments
Actual score
entered must
be one of the
allowed scores
eg. one of 1, 2
or 4
4
6
Total Score for contract impact (Max 31):
Criteria
2
2
4
1
50 to 100
More than 100
The extent to which the
Stable, proven, widely
contract involves innovative implemented, familiar
solutions, and the level of to organisation and
familiarity and experience suppliers.
available. Allocate a score
between 1 and 5.
Scale of its planned
use unproven, and
organisation and
supplier inexperienced
in its application.
The degree to which the
Greenfield contract
contract will need to
develop interfaces to the
existing business. Allocate
a score between 1 and 4.
Extensive integration
issues.
Deliver straightforward
The range of activity that
standard items
will be undertaken by the
supplier, and the extent to
which these will impact on
the business processes of
the organisation.
Delivery of complex
items/services
Integrates with new
business processes
Significant bespoke
elements
Transfer of staff.
Project
Score
2
4
Total Score for Business Impact (Max 32):
Contract Impact
Impact on existing
business
Value
Score
Consolidated Score for Business Impact:
Consolidated Score for Contract Impact:
Consolidated Score for Client-side & Supplier Organisation:
Project Profile Model Consolidated Score (Max 72) :
29
9.23
10.15
7.38
27
Note 1. In the first instance, SROs/Pos or Project Managers are advised to contact their central
departmental finance and economist experts for assistance with the calculation of business
costs and benefits.
Note 2. The PPM consolidated score is necessary to maintain consistency with the IT Project
Profile Model that uses a maximum score of 72.
Note 3. Those completing the PPM for IT-enabled projects should note that projects classed as
Mission Critical or "Big Bang" or incorporating one or more of the NAO/OGC listed common
causes of failure with no acceptable mitigation plan, are all classed as high risk projects,
irrespective of the PPM score.
Issue Date: 04 Aug 03
© Crown Copyright 2003. This material falls outside the scope of HMSO's Click-Use Licence
1 of 1
Version 2.2
Appendix M
Newborn Intensive Care Unit – Benefits Realisation Plan
Objective/Benefit
Outcome measure
Target date
Lead
1
Repatriate activity currently outside
network (saving to commissioners)
Reduction in number of inappropriate
babies cared for outside network (target 5%)
From Jan 13
Newborn ICU
Clinical Leads
2
Meet national quality standards:
centralise intensive care for babies
from the Network area.
Babies of less than 27 weeks gestation in
Network area treated in NICU
From Jan 13
Newborn ICU
Clinical Leads and
Neonatal Network
Lead
3
Accommodate all babies of less than
27 weeks gestation.
4
Allow increased activity in other
specialties, generate additional
income for the NNU
Increase in activity: fetomaternal, paediatric
specialty areas
From Jan 13
Newborn ICU
Clinical Leads
5
Provide appropriate facilities for
babies needing specialist care
Compliance with building standards for
new NICU cots
From Jan 13
Estates Team – Geoff
Wakeling
6
Maintain reduction in HAI, and thus
reduced lengths of stay
Trust HAI monitoring data – non increase or Jan 13
reduction in HAI
Dr Mark Anthony
7
Reduced risk of unit closures as new
area will have separate, new plant
Estates monitoring data on reliability of
plant
Geoff Wakeling
8
1
From Jan 13
Appendix M
Objective/Benefit
Outcome measure
Target date
Lead
9
Improved environment enabling
greater privacy for families within the
new cots in the Neonatal Unit
Cot spacing achieved
Jan 13
Newborn ICU
Clinical Leads
10
Increased activity, providing
additional income for the NNU
Activity data
From Jan 13
Newborn ICU
Clinical Leads
11
Reduction in number of mothers and
babies requiring transfer out of JR
due to lack of neonatal cot capacity
Number of inappropriate in-utero and exutero transfers out of JR
From Jan 13
Neonatal ICU
Clinical Leads
12
Improved opportunities for research
Additional activity range and number of
patients enrolled in research projects
From Jan 13
NICU Clinical
Director – Dr Eleri
Adams
13
Environment more attractive to staff
Fewer vacant posts, lower sickness absence
level
From Jan 013
Matron – Kate
Convery
2
Appendix N
EQUALITY IMPACT ASSESSMENT
STAGE 1
To ensure that discrimination is eliminated, equality of opportunity is promoted and
good race relations are promoted.
Please consider whether the policy or function/service/proposal, is likely to have an
adverse impact on grounds of: race, disability, age, religion or belief, gender, gender
reassignment, pregnancy or maternity, sexual orientation, marriage or civil
partnerships, deprivation or human rights.
Policy or function name: Extension of Newborn Intensive Care Unit
Date written: October 2011
Date policy is due for review: N/A
Lead person responsible for policy & assessment: Eleri Adams, Clinical Lead,
Neonatology
1. Identify the main aim and objectives of the proposal.
What is the intended outcome of the proposal?
•
To increase the capacity of the Newborn Intensive Care Unit by 10 cots, through the
construction and commissioning of a 16 cot extension to give an eventual total of 53 cots
between Special Care, High Dependency and Newborn Intensive Care
2. Have you current reliable information about the different groups the proposed
proposal is likely to affect?
The proposed extension will affect approximately xx babies each year who are currently
treated in the Unit. Following the expansion, more babies will be able to be treated here: up
to xxx over time as the new cots open on a phased basis.
3. Is there a potential for the policy or strategy to discriminate?
Does the policy promote good relations and eliminate discrimination on grounds of
Race: No discrimination
Disability: No discrimination. The proposed service will improve access to cots spaces for
parents, as there will be more space around each cot, including (for some cots) enough space
for a mother on a bed to be brought to the cot.
Age: No discrimination
Religion or belief: No discrimination
Gender: No discrimination
Gender reassignment: No discrimination. All parents will continue to have un-discriminated
access to the service.
Sexual orientation: No discrimination
Marriage or civil partnership: No discrimination
Deprivation or human rights: No discrimination
Appendix O
OUH Newborn Intensive Care Unit Extension Staffing Plan
The OUH Newborn Intensive Care Unit is to be extended between 2013 and 2015.
Staffing numbers will increase to provide the staff necessary to care for the babies in
the additional cots. This plan sets out how and when staff will be recruited, trained
and allocated in order to ensure that staff are in place as and when they are needed.
Background
Cot numbers in the NICU will expand between March 2013 and March 2015 as
follows:
Cot Types
ITU/HDU
SCBU/
rooming in
Total
2011
Activity
baseline
11/9
21
March
2013
Sept
2013
March
2014
Sept
2014
March
2015
15/9
21
17/9
21
19/9
21
20/10
21
20/10
23
41
45
47
49
51
53
A total of 68.5 whole time equivalents (WTE) additional staff will be needed in the
following staff groups:
Additional Cots
Nurses
band 7
band 6
band 5
band 2
Medical Staff
Consultants
ST 4-6
ST 1-3
Band 8a
Admin &
Clerical
A&C 7
A&C 4
A&C 3
A&C 2
Feb
13
4
7
10
1
1.5
1
2
1
1
1.68
0.68
Aug
13
6
Feb
14
8
Aug
14
10
Feb
15
12
total
1
2
5
1
2
6
1
1
2
5
2
1
6
1
5
14
32
3
1
3
1
2
3
1.5
1
1
1
1
0.64
1
2
2.68
1.32
Recruitment and training for each staff group will be organised separately to meet
the needs of the staff group involved. All will, however, be phased so that staff are
in post and suitably trained before the relevant cots open.
Nursing
The highest number of new staff needed is in nursing. Different approaches will be
adopted for each staff band.
Band 8a nurses are employed to work as part of the medical rota and thus are shown
within the medical staff group in the table above. They participate in a set training
pattern, and the timing of the recruitment shown fits with the end of courses,
allowing for a period of orientation training within the NICU. No problems are
anticipated in the recruitment of Band 8a nurses, so other than routine intra-NHS
advertising no costs are anticipated. An assumption of a 10-week supernumerary
period has been included in costings.
Band 7 nurses are generally appointed following promotion of Band 6 staff. There
are a number of suitable candidates within the current staff team, and believed to be
a number in other local units, so no problem is anticipated in finding suitable staff in
the numbers required. Advertising will be via intra-NHS arrangements (eg NHS
Jobs). The timing of appointments is linked to the numbers of new cots being
introduced and the configuration in which they will open, to ensure the right level of
supervision is available in each clinical area. Staff recruited externally will be
provided with a local orientation programme and internally promoted staff may
require orientation in a new area (for example, a nurse promoted from a Band 6 post
in HDU to a Band 7 post in SCBU would need to become familiar with the new area)
so an assumption of a 2-week supernumerary period has been included in cost
profiles.
Band 6 nurses have proved to be difficult to recruit in the past, and the total of 14
new posts will present a challenge. Posts have been phased to match increasing cot
numbers with an additional post in the initial expansion for training across the Unit.
Again, a standard 2-week supernumerary period has been assumed to allow
orientation on the Unit, but it has also been assumed in 2012/13 revenue costs that 3
of the 7 new nurses will be in post a month before the new cots open. This will allow
flexibility in recruitment so that staff can take up posts as they become available, and
will also allow extra staff to be available as the complex process of commissioning
and occupying the new clinical areas is implemented.
£2,500 has been included in the revenue costs model to allow for a national advert for
these posts in 2012/13 and also for agency fees for all the posts. This has been
necessary in the past, so a budget has been included on this occasion. Agency fees
are assumed at £xk per post.
Band 5 nurses have been straightforward to recruit in the past and no particular
problems are anticipated. In view of the numbers involved, they will be recruited
via both NHS Jobs and the national advert process required for Band 6 nurses. As
Band 5 nurses will have less experience than those at higher grades, a month has
been allowed for orientation and general training on the unit for each post. In view
of the numbers of new staff involved, it has also been assumed that some will be
recruited a further month ahead of the new cots opening so that the impact on the
Unit is staggered. As with Band 6 staff, this will also allow some additional capacity
during the most complex stage of decanting within the Unit. Band 5 staff needed for
NICU will be transferred from HDU, those needed for HDU will be transferred from
SCBU and those newly recruited to the Unit will work in SCBU to begin with, as it is
the least intense and complex area. This will ensure that nursing staff are developed
through the Unit and assigned to the area most appropriate to their level of
experience.
Band 2 nurses will be working primarily on the care and preparation of equipment
such as incubators. They have been straightforward to recruit in the past, and no
problems are anticipated in using NHS Jobs for these posts. A 1-week orientation
programme has been assumed.
Medical Staffing
A total of 5.5 new medical posts will be introduced as cot numbers are expanded. As
with nursing staff, different strategies will be adopted with different types of medical
staff.
Consultants will be recruited in the earlier stages of the expansion. This is shown in
revenue costs as 1.5 doctors in December 2012 and 1.5 in May 2013, but in practise, a
total of 3 doctors will be recruited in stages between the autumn of 2012 and the
summer of 2013 as the right individuals are ready to take up posts. No assumption
is made about full or part time working, to ensure maximum flexibility.
Consultants may be recruited from a range of backgrounds, but must have a CCT in
the specialist care of neonates. A single recruitment exercise, will be used, with staff
subsequently taking up posts over a period of some months. A similar process in
2009 for neonatal consultants resulted in 3 successful appointments while in 2010 the
Trust recruited 11 new paediatric consultants so there is a track record of successful
appointments to similar posts.
ST 1 – 6 staff will be recruited through a range of processes. While overall medical
trainee numbers are reducing, all paediatric specialist trainees require neonatal
experience, so a reasonable supply of trainees can be relied upon. In addition, the
Trust has a 2-year international trainee programme, which has resulted in 3 doctors
working in the Unit over the past 18 months. The Unit has good contacts with
services in Australia, India, Sri Lanka, South Africa and Europe and is developing
links with Basle through the new professor of Paediatrics which may result in further
opportunities for medical exchanges or training. Training programmes sponsored by
Oxford University are also being developed. This range of opportunities to attract
medical staff in training is robust and very likely indeed to provide the range and
number of staff needed for the expansion programme.
Admin and Clerical
A total of 7 additional Admin and Clerical staff will be needed. Six of these posts
will allow us to extend clerical cover at the Unit reception area to 24 hours a day.
These appointments will be phased to expand the service as cot numbers increase. A
one-week orientation programme is assumed.
A further, A&C Band 7 post will be recruited as a data analyst and programme
developer for the NICU EPR system. This post will be recruited 3 months prior to
the implementation of EPR system to support training and develop the EPR package
to suit the needs of the neonatal unit. There have been no problems in recruiting
A&C staff for posts such as these, on both full- and part-time bases, so NHS Jobs will
be used.
Implementation
Overall staffing numbers are linked to the numbers of cots opening. Increases in cot
numbers are spaced at 6-monthly intervals so that expansion can be paused or halted
if activity does not expand at the rate predicted. As each round of recruitment takes
from 3 to 6 months from a decision to fill a post to the point where staff are in post,
the recruitment process for each stage of expansion will not begin until the previous
round has been implemented and reviewed. There may also be scope for increasing
the speed of recruitment if demand is greater than expected. This means that this
staffing plan is flexible and can be adjusted very easily to meet changing needs.
Vacancy Control forms for all posts in the first tranche of recruitment are included in
Appendices to the FBC for the project to ensure clarity about staffing requirements,
and to ensure that recruitment can proceed quickly once the case is approved.
Appendix P
6.0 Derogations;
Architectural – General
6.0.1
Statutory Guidance: Neonatal Units - Planning and Design Manual 8720:0.6. Cot Bays to be 3500 x 3600 as opposed to 4130 x 3870. Users
have agreed that the designed space is what they require.
6.0.2
Gas provision to Cot Bays will be as follows: x2 Vac, x4 O2 and x4 Medical
Air (MA4) in 12 of the 16 cot bays. 4 No. Cot bays to have x2 Vac, x6 O2
and x6 Medical Air (MA4). The Guidance states the following
requirements x2 Vac, x3 O2 and x4 Medical Air (MA4). The provision of
outlets have been instructed by the Trust
6.2 Derogations;
Electrical & Mechanical;
6.2.1 Medical Gases - incoming Oxygen main, extend existing from undercroft
below main block through to the Women's Block rather than install short
section of pipe as per original K&H quote. To avoid the need to isolate the
main block of the Hospital.
6.2.2 Omission of gas fired boilers, replace with connection to HTHW heating
mains. The Halcrow Yolles feasibility study proposed using gas fired boilers
located in the plant room below the NICU Nursery’s. This contravenes
HTM’s and fire code (high risk plant located below high dependency) and
the requirement for a standby fuel (e.g. oil). The proposed scheme
connects to the existing HTHW mains in Level 0 of the Women’s Block and
provides LTHW via plate heat exchangers and secondary circulating
pumps. This also means that the Halcrow Yolles proposals to extend the
existing gas are not require.
6.2.3 Rooms 2636 and 2637 to remain on existing ventilation system, rather
than change to new system. The two existing rooms (2636 and 2637) are
served from the existing dual duct ventilation system, which provides
heating, cooling and fresh air, therefore, it is not necessary to provide
supply air into these two rooms of the new NICU air handling Unit.
6.2.4 Humidification. Humidification has not been allowed for, although space
within the air handling unit has been left for the future installation of a
steam humidifier.
6.2.5 HTM requirements for Nursery temperatures - HTM 03-01 states 18°C to
25°C. The HTM requirements are inappropriate for a nursery, where the
temperature range would be between 22°C to 25°C. We have therefore
designed the ventilation system to be able to control the space
temperature in each of the two nursery’s within the range of 22°C to
25°C.
Oxford University Hospitals
ril/:kj
NHS Trust
The John Radcliffe
Headley Way
Headington
Oxford
OX39DU
16 March 2012
Tel: 01865 572882
Fax: 01865220863
Email: marktrumper@ouh.nhs.uk
Martin Adie
Operations Director
Willmott Dixon Construction
Chantry House
High Street
Coleshill
Birmingham
B463BP
Dear Martin
Re: P21 +0155.02 Proposed Newborn Intensive Care Unit Extension - GMP & Programme
I am writing to confirm the Trust's conditional acceptance of your revised Guaranteed Maximum
Price (GMP) of £2,420,662 exel VAT as detailed in Richard Clark's email to Geoff Wakeling dated 14th
March 2012, on the assumption that the overall Construction Period will be 11th June 2012 to 8th
February 2013.
There is, as you know, a requirement for formal approval of the Full Business Case for this project by
both the Strategic Health Authority and Trust Board (anticipated early June 2012). My agreement to
the GMP is necessarily conditional upon obtaining those approvals, and there will be associated
constraints upon the level of activity and expenditure until approvals are all in place.
I appreciate that updating your Stage 4 Submission and signing the Form of Agreement will take
some time. Therefore, I would be grateful if you would accept this letter as confirmation that in the
meantime the Trust will accept financial liability in relation to:
1. Early Works already instructed in respect of tree felling and elements of site elearance to the value
of £10,000 inel VAT
2. Phase 3 Survey (mechanical ventilation systems) and associated investigations up to the value of
£20,000 inel VAT
From the Director of Development and the Estate
Oxford University Hospitals NHS Trust
It would be prudent for the timing and scale of any further early works, or any commitments by
Willmott Dixon to steelwork and piling suppliers prior to SHA and Trust Board approval, to be the
subject of further separate discussion between us. The Trust will facilitate what is reasonably possible.
Yours sincerely
~
Mark Trumpet
Director of Development and the Estate
cc: Geoff Wakeling, Client Project Manager
Craig Merrifield, Estates Development Manager
From the Director of Development and the Estate
Oxford University Hospitals NHS Trust
APPENDIX R
8th December 2011
Plan for Newborn intensive Care area during building works
Phase 1 – 3rd June – 3rd December 2012 (approximately)
Administration
•
•
•
•
Office 2686 will be relocated to 2668
2668 will require some portable desks ( minimum 2 ) plus datapoints for 2
computers, 2xphone sockets, and sufficient plugs for 2x computers,
wristband printer and standard printer/photocopier. Space will be shared
with current stores in this room and with the blood gas machines/ centrifuge
2686 will continue to be used for some admin storage and will have full access
by clerical and clinical staff during this phase
Buzzer link (or temporary phone ) between 2668 and main NICU doors
required aswell as current buzzer system if possible
Quiet Room
• Quiet room will move from 2707 to 2689 (currently resus room). Shelf storage
to remain for some items.
Resus Room
• Equipment from this room will be moved to 2638 (long room) and a space set
up for resus near the current entrance to that room. The remainder of the room
should be used for general storage of items that will need to be vacated from
temporary office area eg echo machine
Rooming in Rooms
• Reduced use of 2618 to parent overnight stay only
• 2636 and 2637 will continue to be used for storage
Clinical Space
• Room 2638 ( long room) currently houses 5 intensive care patients. This room
will be shut to clinical use most likely for the duration of this phase
• Hot room ( 2686) will continue as at present with 3 nursing staff for 5 infants
• Room 1 (2666) will be used for 2 ITU patients and will require 2 nurses
• Room 2704 ( nursery 3 in HDU) will have 2 ITU patients with 2 nurse
Therefore potentially reduced from 10 to 9 cots during phase 1, and will require
1 additional nurse per shift due to additional rooms being used.
Phase 2 – 2nd December 2013- 20th February 2013 (approximately)
Administrative
•
•
•
•
Temporary office in the corridor outside new ICU nursery 2 opposite the new
Quiet Room
Requires some portable desks ( minimum 2 ) plus datapoints for 2
computers, 2xphone sockets, and sufficient plugs for 2x computers,
wristband printer and standard printer/photocopier to be available in
corridor on this side
Small stationary store in corridor required. Remainder of stationary/notes to
go to ?2636 and or 2627 if required
Buzzer link (or temporary phone ) between temporary office area and main
NICU doors required
Clinical Lab
•
2636 to become temporary clinical lab – will require some desktop space to
house gas machine and centrifuge. Will need to check with clinical
engineering as to how they will manage without chemical sink in the room
during this period
Resus Room
•
2637 ( shared with LDU) – no change required to this room
Storage
• 2639 currently LDU nursery to become storage if unable to be used – however
please note this room must be out of clinical use for the minimum time
period possible due to clinical disruption caused – therefore could noisy
work on Drug prep room and near patient testing be done together to
minimise time out of this room – would be good to have an estimate on times
for this
Clinical Area
• ITU to go to new nursery – 8 patients (6 nurses)
• 2639 contains 3 low dependency babies – move to 2704 ( nursery 3 in HDU)
with 1 nurse (when not needed for LDU decant use this room for additional
2 ITU patients ( 2 nurses)
• Assume soundproofing will be provided between 2639 and 2640 if decant is
required and that 3 babies will remain in 2640
Therefore during phase 2 when 2639 is out of use there will potentially be a
reduction from 10 to 8 ITU cots and there will be no additional nurse needed
on each shift
During phase 2 when 2639 is NOT out of use, there will be 10 ITU cots and
there will be two additional nurses required per shift
Legend:
Start Demolition
Cut down trees (end of Feb 2012 TBA)
Buffer Zone
Removal of Stairs and Digging New Drain
Notes: Rev A: Phasing
Plans Updated In-Line
with Outline
Programme Version 12
Envelope and Roof on by
04/07/2012
Phase 1 Starts
4th May 2012
Install Screens 7th – 8th
May 2012, Both Levels
will Lose all Daylight,
Level 1 and 2.
Decant 19/06/12
Start 25/06/12
Hand Back
23/07/12
Decant 04/05/12 – Hand
Back 21/12/12
Buffer Zone “Clinical”
Decant 19/06/12 – Hand
Back 21/02/12
First Fix Starts 20/06/12
Midlands Region
Chantry House
High Street
Coleshill
Birmingham
B46 3BP
Oxford University
Hospitals NHS Trust
Feb 2012
John Radcliffe Hospital
Medical Gates
NICU Extension
Asbestos Survey Required and
May Need Notice to Remove.
Phasing Nr 1 – Rev A
Legend:
Temp Screen Acoustic & Fire 30mins
(Up before Clinical Clean Phase 1)
Live 23/10/12
Notes: Rev A: Phasing
Plans Updated In-Line
with Outline
Programme Version 12
Dust
Screen
PHASE 1 HANDOVER 04/10/12
WARD LIVE 23/10/12
Part Commissioned & Sealed
Form Doors and Remove Panels
Start 24/10/12 Subject
to Decant
Hand Back 21/12/12
Move 2639/ 2682
Midlands Region
23 & 24 /10/12
Chantry House
High Street
Coleshill
Birmingham
B46 3BP
Oxford University
Hospitals NHS Trust
Feb 2012
Block Up Windows During
Phase 2
John Radcliffe Hospital
NICU Extension
Power & Data to Temporary Offices, Use in
these Locations for Phase 1 Operations
Phasing Nr 2 – Rev A
Legend:
Screen Removed before
Clinical Clean Phase 2
Live 23/01/13
Notes: Rev A: Phasing
Plans Updated In-Line
with Outline
Programme Version 12
PHASE 2
HANDOVER
21/12/12
Midlands Region
Chantry House
High Street
Coleshill
Birmingham
B46 3BP
Oxford University
Hospitals NHS Trust
Feb 2012
John Radcliffe Hospital
NICU Extension
Phasing Nr 3 – Rev A
Appendix S
Post Project Evaluation
This project will be evaluated as part of the overall project. The Post Project
Evaluation Plan is set out below.
In accordance with current guidance, this Post Project Evaluation Plan will:
•
State the proposed membership of the Evaluation Steering Group;
•
Identify the resources and budget for the evaluation (including the
need for written reports and dissemination activities);
•
Develop a dissemination plan for ensuring the results from the
evaluation are used to re-appraise the project; and
•
Clarify the timing of the evaluation (expected start and finish dates).
In accordance with current guidance and good practice, the Project will be
evaluated in 3 stages:
1. Monitor progress and evaluate the project outputs on completion of the
new facilities. This will take place at each stage as new facilities are
completed
2. initial post-project evaluation of the service outcomes six to 12 months
after all the relevant facilities have been commissioned
3. follow-up post-project evaluation to assess longer-term service outcomes
two years after the facilities have been commissioned
For each stage of evaluation, the Plan will:
•
•
•
•
•
Set out the objectives and scope of the evaluation
Define the success criteria for assessing the success or otherwise of the
project;
Define performance indicators/ for these criteria;
Indicate the performance measures to be used and the methods that
will be used to obtain the information;
Indicate the team who will be responsible for undertaking the
evaluation and their respective roles;
The Evaluation Steering Group
Appendix S
The evaluation process will be overseen by the Divisional Board, which
functions as Project Board for the project. It is well equipped to function as
the Evaluation Steering Group as it includes expertise from all relevant areas
such as clinical, management, financial and HR. It will undertake the role of
Evaluation Steering Group for all stages of the evaluation process.
Resources and Budget for the Evaluation
Resources for Post Project Evaluation will be provided from within
departmental budgets.
Dissemination Plan
At each stage of the evaluation, a formal report will be issued. This will be
submitted to the Trust Board for information and approval. Once the report
has been finalised, the plans for the subsequent stage of evaluation will be
reviewed and, where appropriate, rewritten to ensure that it reflects the
findings of earlier stage(s) of evaluation or that issues of concern are reevaluated as the Project develops.
Timing of the Evaluation
As outlined above, the evaluation will begin after the first phase of new
facilities and are brought into use and relevant services have been relocated.
A further evaluation will take place after 6 – 12 months and a subsequent
evaluation after a further 2 years.
Content of the Evaluation
At each stage, the project evaluation on completion will determine what went
well during the procurement of the new facilities, what went less well and
what lessons may be learnt from the process. This will be addressed through
the following specific issues:
♦ To what extent relevant project objectives have been achieved To what
extent the project went as planned
♦ Where the plan was not followed, why this happened
♦ How plans for the next phase of the project should be adjusted as a
consequence of any divergence from plans thus far
DH INFORMATION READER BOX
Policy
HR / Workforce
Management
Planning /
Clinical
Estates
Commissioning
IM & T
Finance
Social Care / Partnership Working
Document Purpose
Best Practice Guidance
ROCR Ref:
0
Title
Gateway Ref:
9276
Achieving Excellence Design Evaluation Toolkit documentation
Author
DH Estates and Facilities
Publication Date
10 Jan 2008
Target Audience
PCT CEs, NHS Trust CEs, SHA CEs, Care Trust CEs, Foundation Trust CEs ,
Estates and Facilities Directors
Circulation List
#VALUE!
Description
AEDET Evolution toolkit is part of a benchmarking toolkit to assist trusts in
measuring and managing the design quality of their healthcare facilities (new
and existing).
Cross Ref
AEDET Evolution documentation; AEDET/ ASPECT Evidence Layer
0
AEDET Evolution toolkit (NHS Estates site)
0
N/A
0
Superseded Docs
Action Required
Timing
N/A
Contact Details
Brian Coapes
Design and Costing (GREFD)
3N10 Quarry House
LEEDS
LS2 7UE
0113 25 45696
0
0
For Recipient's Use
Achieving Excellence Design Evaluation Toolkit (AEDET Evolution)
Project details:
Title
Oxford University Hospitals Newborn Intensive Care Unit
Workshop details:
Completed by:
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:
32:
Location
Date (dd.mm.yy)
OUH - virtual
Feb 2012
First name
Tony
Eleri
Kate
Geoff
Craig
Penny
Lynda
Last name
McDonald
Adams
Convery
Wakeling
Merrifield
Hambridge
Atkins
Organisation
OUH
OUH
OUH
OUH
OUH
OUH
Under the Rainbow Ltd
Job title
General Manager
Clinical Director
Matron
Estates
Estates
Charitable Funds
Business Case Project Manager
Email address
● Average score: 4.6
IMPACT: Character and innovation
The four IMPACT sections deal with the extent to which the building creates a sense of place and contributes
positively to the lives of those who use it and are its neighbours.
Section A deals with the overall feeling of the building. It asks whether the building has clarity of design intention,
and whether this is appropriate to its purpose. A building that scores well under this heading is likely to lift the
spirits and to be seen as an exemplar of good architecture of its kind.
ID
Description
A.01
There are clear ideas behind the design of the building
High (2) ▼
Strong agreement (5) ▼
A.02
The building is interesting to look at and move around
in
Normal (1) ▼
Fair agreement (4) ▼
The extension is relatively small, and so not
much moving around! What there is is not
uninteresting
A.03
The building projects a caring and reassuring
atmosphere
High (2) ▼
Fair agreement (4) ▼
The nature of NICU services is such that it
necessarily presents a clinical rather than
comfortable aspect. The extension is set out in
such a way that services will be accessible and
A.04
The building appropriately expresses the values of the
NHS
Normal (1) ▼
Virtually total agreement (6) ▼
The extension will express the values of the NHS
throughout
A.05
The building is likely to influence future designs
Normal (1) ▼
Fair agreement (4) ▼
The building is at the cutting edge of design for
tertiary newborn intensive care, so it will influence
the design of similar facilities elsewhere. This is
particularly so in relation to the use of bed head
◄ Project workshop setup
Weighting
Score
►► Results summary
Notes
The building was designed with considerable
user input and is clearly designed to meet their
needs. Not quite all needs are met as well as
might be hoped (eg quiet room) but most are
Form and materials ►
● Average score: 5.6
IMPACT: Form and materials
Section B deals with the nature of the building in terms of its overall form and materials. It is primarily concerned
with how the building presents itself to the outside world in terms of its appearance and organisation. Although it
deals with the materials from which the building is constructed it is not concerned with these in a technical sense
but rather the way they will appear and feel throughout the life of the building.
ID
Description
B.01
The building has a human scale and feels welcoming
Normal (1) ▼
Strong agreement (5) ▼
subject to the constraints of an intensive care
area, the extension is on a human scale. The use
of 2 8-cot nurseries, each with 2 4-cot bays,
brings the ICU area down to a human and
B.02
The design takes advantage of available sunlight and
provides shelter from prevailing winds
Normal (1) ▼
Strong agreement (5) ▼
prevailing winds are not a problem, and indirect
sunlight (as opposed to direct sunlight) will be
brought into the unit via roof lights and tall but
narrow windows
B.03
Entrances are obvious and logically positioned in
relation to likely points of arrival on site
Normal (1) ▼
Virtually total agreement (6) ▼
B.04
The external materials and detailing appear to be of
high quality
Normal (1) ▼
Virtually total agreement (6) ▼
B.05
The external colours and textures seem appropriate and
attractive
Normal (1) ▼
Virtually total agreement (6) ▼
◄ Character and innovation
Weighting
Score
►► Results summary
Notes
Staff and patient environment ►
● Average score: 5.1
IMPACT: Staff and patient environment
Section C deals with how well an environment complies with best practice as indicated by the research evidence.
ID
Description
C.01
The building respects the dignity of patients and allows
for appropriate levels of privacy and dignity
Normal (1) ▼
Fair agreement (4) ▼
yes within the constraints of an intensive care
area. The quiet room is not as large as would
have been hoped, due to limitations of current
space which has to be adapted
C.02
There are good views inside and out of the building
Normal (1) ▼
Fair agreement (4) ▼
views are not relevant from NICU
C.03
Patients and staff have good access to outdoors
Normal (1) ▼
Strong agreement (5) ▼
C.04
There are high levels of both comfort and control of
comfort
Normal (1) ▼
Virtually total agreement (6) ▼
C.05
The building is clearly understandable
Normal (1) ▼
Virtually total agreement (6) ▼
C.06
The interior of the building is attractive in appearance
Normal (1) ▼
Virtually total agreement (6) ▼
C.07
There are good bath/toilet and other facilities for
patients
Normal (1) ▼
Virtually total agreement (6) ▼
C.08
There are good facilities for staff, including convenient
places to work and relax without being on demand
Normal (1) ▼
Fair agreement (4) ▼
◄ Form and materials
Weighting
Score
►► Results summary
Notes
Staff and parents do, patients don't!!
yes, with inclusion of parent toilet
as existing
Urban and social integration ►
● Average score: 5.3
IMPACT: Urban and social integration
Section D deals with the way the building relates to its surroundings. It asks whether the building plays a positive
role in the neighbourhood whether that is urban, suburban or rural. A building that scores well is likely to improve
its neighbourhood rather than detract from it.
ID
Description
D.01
The height, volume and skyline of the building relate
well to the surrounding environment
Normal (1) ▼
Virtually total agreement (6) ▼
D.02
The building contributes positively to its locality
Normal (1) ▼
Strong agreement (5) ▼
D.03
The hard and soft landscape around the building
contribute positively to the locality
Zero (0) ▼
Fair agreement (4) ▼
D.04
The building is sensitive to neighbours and
by
Normal (1) ▼
Strong agreement (5) ▼
◄ Staff and patient environment
Weighting
passers-
Score
►► Results summary
Notes
Performance ►
● Average score: 5.7
BUILD QUALITY: Performance
The three BUILD QUALITY sections deal with the physical components of the building rather than the spaces.
This is therefore what might be thought of as the more technical and engineering aspects of the building. It asks
whether the building is soundly built, will be reliable and easy to operate, last well and is sustainable. It is also
concerned with the actual process of construction and the extent to which any disruption caused is minimised.
Section E is concerned with the technical performance of the building during its lifetime. It asks whether the
components of the building are of high quality and fit for their purpose. However we are not concerned here with
how well the building functions in relation to the human use of it which belongs in another section.
ID
Description
E.01
The building is easy to operate
High (2) ▼
Virtually total agreement (6) ▼
Essential for ICT area
E.02
The building is easy to clean
High (2) ▼
Virtually total agreement (6) ▼
Essential for ICT area
E.03
The building has appropriately durable finishes
High (2) ▼
Virtually total agreement (6) ▼
Essential for ICT area
E.04
The building will weather and age well
Normal (1) ▼
Fair agreement (4) ▼
◄ Urban and social integration
Weighting
Score
►► Results summary
Notes
as far as it possible to judge
Engineering ►
● Average score: 5.2
BUILD QUALITY: Engineering
Section F is concerned with those parts of the building that are engineering systems as opposed to the main
architectural features. It asks whether the engineering systems are of high quality and fit for their purpose, will be
easy to operate and if they are efficient and sustainable.
ID
Description
F.01
The engineering systems are well designed, flexible and
efficient in use
Normal (1) ▼
Strong agreement (5) ▼
within constraints of existing building/services
F.02
The engineering systems exploit any benefits from
standardisation and prefabrication where relevant
Normal (1) ▼
Strong agreement (5) ▼
within constraints of existing building/services
F.03
The engineering systems are energy efficient
Normal (1) ▼
Strong agreement (5) ▼
within constraints of existing building/services
F.04
There are emergency backup systems that are designed
to minimise disruption
Normal (1) ▼
Virtually total agreement (6) ▼
F.05
During construction disruption to essential services is
minimised
Normal (1) ▼
Strong agreement (5) ▼
◄ Performance
Weighting
Score
►► Results summary
Notes
all included
as far as possible, in conjunction with decant plan
Construction ►
● Average score: 5.3
BUILD QUALITY: Construction
Section G is concerned with the technical issues of actually constructing the building and with the performance of
the main components. A building that scores well is likely to be constructed as quickly and easily as possible
under the circumstances of the site and to offer a robust and easily maintained solution.
ID
Description
G.01
If phased planning and construction are necessary the
various stages are well organised
Zero (0) ▼
Virtually total agreement (6) ▼
G.02
Temporary construction work is minimised
Zero (0) ▼
Virtually total agreement (6) ▼
G.03
The impact of the building process on continuing
healthcare provision is minimised
High (2) ▼
Fair agreement (4) ▼
G.04
The building can be readily maintained
Normal (1) ▼
Virtually total agreement (6) ▼
G.05
The construction is robust
Normal (1) ▼
Virtually total agreement (6) ▼
G.06
The construction allows easy access to engineering
systems for maintenance, replacement and expansion
Normal (1) ▼
Virtually total agreement (6) ▼
G.07
The construction exploits any benefits from
standardisation and prefabrication where relevant
Normal (1) ▼
Virtually total agreement (6) ▼
◄ Engineering
Weighting
Score
►► Results summary
Notes
as far as possible within constraints of extension
to exisitng building
use of area below clinical area, with separate
access
Use ►
● Average score: 5.7
FUNCTIONALITY: Use
The three FUNCTIONALITY sections deal with all those issues to do with the primary purpose or function of the
building. It deals with how well the building serves these primary purposes and the extent to which it facilitates or
inhibits the activities of the people who carry out the functions inside and around the building.
Section H is concerned with the way the building enables the users to perform their duties and operate the
healthcare systems and facilities housed in the building. To get a good score the building will be highly functional
and efficient, enabling people to have enough space for their activities and to move around economically and
easily in a way that relates well to the policies and objective of the Trust. A high scoring building is also likely to
have some flexibility in use.
ID
Description
H.01
The prime functional requirements of the brief are
satisfied
H.02
Weighting
Score
Notes
High (2) ▼
Virtually total agreement (6) ▼
The design facilitates the care model of the Trust
Normal (1) ▼
Strong agreement (5) ▼
H.03
Overall the building is capable of handling the projected
throughput
Normal (1) ▼
Virtually total agreement (6) ▼
H.04
Work flows and logistics are arranged optimally
Normal (1) ▼
Virtually total agreement (6) ▼
H.05
The building is sufficiently adaptable to respond to
change and to enable expansion
Normal (1) ▼
Fair agreement (4) ▼
H.06
Where possible spaces are standardised and flexible in
use patterns
Normal (1) ▼
Virtually total agreement (6) ▼
cot spaces are standard throughout
H.07
The layout facilitates both security and supervision
High (2) ▼
Virtually total agreement (6) ▼
essential for NICU area
◄ Construction
►► Results summary
Capacity of unit matches activity model and
commissioner requirements
extension would be impossible to extend, but it is
designed to allow extension of the NICU in other
areas if necessary in future
Access ►
● Average score: 4.9
FUNCTIONALITY: Access
Section I focuses on the way the users of the building can come and go. It asks whether people can easily and
efficiently get onto and off the site using a variety of means of transport and whether they can logically, easily and
safely get into and out of the building.
ID
Description
I.01
There is good access from available public transport
including any on-site roads
Normal (1) ▼
Strong agreement (5) ▼
as existing
I.02
There is adequate parking for visitors and staff cars
with appropriate provision for disabled people
Normal (1) ▼
Fair agreement (4) ▼
as existing
I.03
The approach and access for ambulances is
appropriately provided
Normal (1) ▼
Strong agreement (5) ▼
as existing
I.04
Goods and waste disposal vehicle circulation is good
and segregated from public and staff access where
appropriate
Normal (1) ▼
Strong agreement (5) ▼
as existing
I.05
Pedestrian access routes are obvious, pleasant and
suitable for wheelchair users and people with other
disabilities / impaired sight
Normal (1) ▼
Fair agreement (4) ▼
as existing
I.06
Outdoor spaces are provided with appropriate and safe
lighting indicating paths, ramps and steps
Normal (1) ▼
Strong agreement (5) ▼
as existing
I.07
The fire planning strategy allows for ready access and
egress
Normal (1) ▼
Virtually total agreement (6) ▼
◄ Use
Weighting
Score
►► Results summary
Notes
design meets all fire standards
Space ►
● Average score: 5.3
FUNCTIONALITY: Space
Section J concentrates on the amount of space in the building in relation to its purpose. It asks if this space is well
located and efficient and whether people can move around in it efficiently and with dignity.
ID
Description
J.01
The design achieves appropriate space standards
Normal (1) ▼
Strong agreement (5) ▼
J.02
The ratio of usable space to the total area is good
Normal (1) ▼
Virtually total agreement (6) ▼
J.03
The circulation distances travelled by staff, patients and
visitors are minimised by the layout
Normal (1) ▼
Virtually total agreement (6) ▼
J.04
Any necessary isolation and segregation of spaces is
achieved
Normal (1) ▼
Virtually total agreement (6) ▼
J.05
The design makes appropriate provision for gender
segregation
Normal (1) ▼
Virtually total agreement (6) ▼
J.06
There is adequate storage space
Normal (1) ▼
Little agreement (3) ▼
◄ Access
Weighting
Score
►► Results summary
Notes
marginally below national standard, but entirely
adequate for needs
no gender segretation needed for NICU
storage space not as plentiful as would be hoped
Achieving Excellence Design Evaluation Toolkit (AEDET Evolution)
Project details:
Title
Oxford University Hospitals Newborn Intensive Care Unit
Workshop details:
Location
Date
OUH - virtual
Feb 2012
Results summary:
● 4.6
● 5.6
● 5.1
● 5.3
● 5.7
● 5.2
● 5.3
● 5.7
● 4.9
● 5.3
A: ► Character and innovation
B: ► Form and materials
C: ► Staff and patient environment
D: ► Urban and social integration
E: ► Performance
F: ► Engineering
G: ► Construction
H: ► Use
I: ► Access
J: ► Space
1
2
3
4
5
7 of 5 scored
5 of 5 scored
8 of 8 scored
3 of 4 scored
7 of 4 scored
5 of 5 scored
6 of 7 scored
9 of 7 scored
7 of 7 scored
6 of 6 scored
6
NOTE: A filled traffic light dot [●] in the table above indicates a valid average score, a hollow dot [○] indicates that one or more statements have been marked as 'unable
to score'.