Trust Board Meeting: Wednesday 12th November 2014
TB2014.123
Title
Business Case for the Redevelopment of the Churchill Day
Surgery Unit
Status
A paper for decision
History
04/03/2014:Business Planning Committee
25/03/2014:Surgery and Oncology Divisional
Executive
Management
25/09/2014:Trust Management Executive
Board Lead(s)
Key purpose
Mr Paul Brennan, Director of Clinical Services
Strategy
Assurance
TB2014.123 FBC Redevelopment of Churchill Day Surgery Unit
Policy
Performance
Page 1 of 23
Oxford University Hospitals
TB2014.123
Executive Summary
1.
The redevelopment of the Churchill Day Surgery Unit is necessary in order to provide
a permanent solution to the issue of mixed sex accommodation. The current use of
curtains does not satisfy national guidelines and failure to act would result in the Trust
risking significant financial penalties from commissioners - potentially the loss of
income for all patients passing through the Day Surgery Unit.
2.
The current facilities are providing a sub-optimal patient experience, specifically with
regard to privacy and dignity, and this has been the source of patient complaint. This
was noted in the CQC “Should Do” Action Plan with the Day Surgery Unit highlighted
by the Trust as a specific area for redevelopment. Additionally the poor patient
environment has been noted as in need of improvement at two executive
walkarounds.
3.
The proposed redevelopment has consciously sought to both maximise benefits and
minimise costs: Extensive consultation has been undertaken with all key stakeholders
and the resulting plans prioritise both patient privacy and remedy existing problems
with the Day Surgery Unit environment. These include the provision of an enema
room and sufficient private spaces for pre and post-operative consultations.
Additionally the plans have allowed for the flexible use of the consulting rooms for
other services such as pre-operative assessment and outpatients when not in use by
the Day Surgery Unit.
4.
To minimise costs the redevelopment has been limited to the existing Unit footprint
and foregone development of the courtyard space. In addition, the building work will
be phased, so that the Day Surgery Unit will continue to function on its existing
premises whilst the work is being carried out. This means that the costs of needing to
provision an additional ward whilst the redevelopment work is carried out have been
saved.
5.
In summary, the redevelopment, whilst a necessity to satisfy national guidance for
single sex, will enhance the experience of patients being operated on in Churchill
Theatres and also improve the utilisation of space on the Churchill site.
6.
How the proposal will improve quality:
 Patient Experience: compliance with same sex accommodation rules is currently
only satisfied by use of curtains. Redevelopment will provide a permanent
solution, which will safeguard patient privacy and dignity through allocation of
gender specific areas and re-designed patient flow
 Patient experience: the current ward environment means there is a lack of privacy
for clinicians consulting with patients both pre-and post-operatively, a situation
which has been the subject of patient complaints and repeated consultant
concern. The redeveloped Unit will remedy these shortcomings.
 Patient experience: Redevelopment will replace nurse station with “touch bases”,
meaning that nurses are both more visible and able to meet patient needs in a
more timely manner
 Patient experience: provision of an enema room for Lower GI patients preoperatively. Currently these patients need to go to the Lower GI ward preoperatively which leads to delays to lists starting and so reduces theatre
efficiency.
 Access: Redevelopment will allow for pre-operative consulting rooms to be
converted for use by pre-assessment or an outpatient clinic. This will improve
TB2014.123 FBC Redevelopment of Churchill Day Surgery Unit
Page 2 of 23
Oxford University Hospitals
TB2014.123
outpatient capacity on the Churchill site, a rate-determining step in the provision of
additional clinic capacity.
7.
It is predicted that the capital cost of the redevelopment will be £1.83 million against
an allocation in the approved capital programme of £900k. Charitable funds could
provide £400-£500k towards the cost of the redevelopment.
Additional revenue costs are expected to be £2.6k per annum for equipment
maintenance. It is not anticipated there will be any other pay or non-pay revenue
costs once the redevelopment is completed.
8.
Implications if the case is not approved:
 Policy: non-compliance with NHS Constitution (2009) and Department of Health
Delivering Same Sex Accommodation (DSSA) policy and guidance (2009, 2010).
This is in line with the Trust Delivering Same Sex Accommodation Policy
(CGC2013.236)
 Financial: potential deduction by commissioners equivalent to the total cost of the
service or treatment for all patients affected by a breach of the same sex
accommodation requirements. In 2013 9530 patients used the Churchill DSU.
Recommendation
It is recommended that capital funding of £1.83 million is approved for the redevelopment
of the Churchill Day Surgery Unit.
TB2014.123 FBC Redevelopment of Churchill Day Surgery Unit
Page 3 of 23
TB2014.123
Oxford University Hospitals
Business Case for the Redevelopment of the Churchill Day Surgery Unit
Appendices
Appendix 1
Patient Feedback
Appendix 2
Cost Summary
Appendix 3a Capital
expenditure
and
revenue
Appendix 3b Capital and depreciation
Appendix 4 Architect’s plans
Appendix 5 Redevelopment phasing plan
Background papers
Department of Health (DH). Elimination of
mixed-sex hospital accommodation. DH
May 2005.
Department of Health (2007) A report by the
Chief Nursing Officer into mixed sex
accommodation in hospital. DH, London.
NHS Constitution (2009)
Department of Health Delivering Same Sex
Accommodation policy and guidance (2009,
2010).
Strategic Objective(s) that the case will
help deliver
SO1 To be a patient-centred organisation,
providing high quality, compassionate care
with integrity and respect for patients and
staff– “delivering compassionate
excellence”
SO3 To meet the challenges of the current
economic climate and changes in the NHS
by providing efficient and cost-effective
services and better value healthcare –
“delivering better value healthcare”
Proposed date that revenue spend will
begin:
n/a
Proposed date that capital spend will
begin:
February 2015
Conclusion of Equality Analysis
Business Case will improve equality due to
improved privacy and dignity for male and
females.
Review Date
November 2015
Acronyms and abbreviations used
CORU Churchill Overnight Recovery Unit
CQC Care Quality Commission
DSU Day Surgery Unit
TB2014.123 FBC Redevelopment of Churchill Day Surgery Unit
Page 4 of 23
TB2014.123
Oxford University Hospitals
PID
Project Initiation Document
TDA Theatre Direct Admissions
Authors
Mark Stoneham, Clinical Lead, Churchill
Theatres
Ben Wright, OSM, Gastroenterology,
Endoscopy and Churchill Theatres
Directorate
Julia Wood, Matron, Gastroenterology,
Endoscopy and Churchill Theatres
Directorate
Lead Finance Manager
Rob Tovey, Senior Business Partner,
Surgery and Oncology Division
Bob Bateman, Business Partner, Surgery
and Oncology Division
TB2014.123 FBC Redevelopment of Churchill Day Surgery Unit
Page 5 of 23
Oxford University Hospitals
TB2014.123
Strategic Context and Case for Change
1.
It is the stated policy of Oxford University Hospitals NHS Trust (OUHT) to provide a
culture where the privacy, dignity and respect of all patients, relatives and carers
using the Trust services is paramount (CGC2013.236). This extends to
demonstrating full same sex compliance as detailed in the NHS Constitution (2009)
and Department of Health Delivering Same Sex Accommodation (DSSA) policy and
guidance (2009, 2010).
2.
Currently the Churchill Day Surgery Unit (DSU) maintains same sex compliance
through the use of curtains to maintain patient privacy and dignity. The Churchill DSU
therefore requires a redevelopment in order for it to meet same sex accommodation
requirements.
3.
In addition to complying with legislation, consistent patient and clinician feedback on
the current Day Surgery Unit environment has been that it provides a sub-optimal
patient experience due to the lack of privacy when discussing theatre procedures.
Risks associated with current situation
Financial
4.
Failure to comply with national same sex criteria risks a potential deduction by
commissioners equivalent to the total cost of the service or treatment for all patients
affected by a breach of the same sex accommodation requirements. The current
situation therefore represents a significant financial risk to the Trust as approximately
eighty-five per cent of patients operated on in Churchill Theatres pass through the
DSU, which equated to 9530 patients in 2013. The financial risk to the Trust of failing
to comply therefore cannot be underestimated.
Patient Experience
5.
Patient privacy pre-operatively: At peak times the Unit has up to twenty-two patients
being consulted with by nurses, surgeons and anaesthetists. Although patients are
physically screened off by curtains, due to their proximity conversations between
clinician and patient can often be overhead. This is particularly problematic between
7:30 and 8:30am when a large number of clinicians are all seeking to meet with their
patients. As a result of the confined spaces, which are just curtained off,
conversations can become very loud and discussion of intimate surgical proceduresfor example breast reconstruction- overhead in neighbouring bays. This situation has
resulted in patient complaints to the Unit and concerns raised by clinicians over
patient confidentiality. When reviewing the proposed plans with patients these
observations have been reinforced (see Appendix One).
6.
Patient privacy post-operatively: currently there are no side rooms available for
wound examination post-operatively. This has been of particular concern to the
Breast surgeons, who are increasing the number of patients operated on as day
cases.
7.
Lack of an enema room: In November 2012 Theatre Direct Admissions (TDA)
relocated to the DSU. This meant that Lower GI patients requiring an enema needed
to be admitted through DSU rather than TDA. As a result this has led to issues with
accommodating patients on the ward at 7:30 and surgeons not having patients
cohorted in one place, with attendant reduction in theatre efficiency and patient flow.
TB2014.123 FBC Redevelopment of Churchill Day Surgery Unit
Page 6 of 23
Oxford University Hospitals
8.
9.
TB2014.123
Sub-optimal patient environment: The activity passing through the DSU has
increased significantly in the last 18 months. This has been caused by:
8.1 Movement of TDA into DSU: the number of patients using the DSU space
increased by 30-40 per cent (depending on case mix and day of the week).
8.2 Increase in theatre sessions: from 41 a week in February 2013 to 50 a week in
February 2014.
8.3 Increase in theatre hours: all lists have been extended from eight hours to either
nine or ten hours. As a guide, monthly theatre operating time has increased
from 1,136 hours in April 2012 to 1,470 in January 2014- a 29% increase.
As a result of the above development DSU has had to expand into areas which
provide sub-standard accommodation. This has included having two consulting bays
in an old procedure room and three overflow recovery beds in part of the old
theatres. These ad hoc arrangements were noted as being areas of concern in both
the CQC “should do” action plan (point SD5) and during a walk around by the
Medical Director in November 2013.
Opportunities created by development
10. Improved pre-assessment: The recently-opened Churchill pre-assessment unit will
improve the communication between pre-assessment, specialty and theatres. An
audit of on the day theatre cancellations has demonstrated that sixty per cent of on
the day cancellations in theatre are due to patient DNA, patient being unfit or the
operation not being required- arguably issues that can be traced to pre-assessment
and its communication with individual specialties. However to undertake preassessment for all patients using Churchill theatres, it requires more consulting room
space.
11. The nature of Day Surgery activity means that after 2:30pm consulting rooms are no
longer required and the space is therefore unutilised. As noted above, consultations
currently take place in screened-off bays, however a redeveloped unit with consulting
rooms would provide space for other outpatient consultation to take place. The
newly-developed Churchill pre-assessment unit has given a strong indication that it
would wish to use these rooms on at least two days a week due to capacity
constraints in its new unit. This would also improve patients’ experience as the same
patients who use these rooms would be coming back to DSU for their procedures.
Objectives and Benefit Criteria
12. Consultations were undertaken with the following stakeholders:












Patients using the Day Surgery Unit
Surgery and Oncology Division’s Clinical Directors
Clinical Leads for all specialties which use Churchill Theatres
Rainer Buhler, General Manager, Surgery and Oncology Division
Ali Cornall, Divisional Nurse, Surgery and Oncology Division
Lily O’Connor, Infection Control Manager
Churchill Day Surgery Unit Sister, Deputy Sister and staff
Anita MacQueen, Matron, General Surgery
Jenny Hayes, Matron, Urology
Rebecca Turner, Matron, Blenheim Ward
Sue Smith, Deputy Matron, Churchill Theatres and all theatre sisters
Dr John Griffiths and Usha Nair, Churchill Pre-Assessment Team
13. In addition, the following research was undertaken:
TB2014.123 FBC Redevelopment of Churchill Day Surgery Unit
Page 7 of 23
TB2014.123
Oxford University Hospitals




Audit of patient flows through the unit by time of day over a month: this showed
that the maximum number of patients in a consultation was sixteen, however the
average at peak times (between 8am and 9am) was twelve.
Audit of patient by gender by day over six months: this showed that the number
of males and females in the unit could vary significantly- from three of one
gender to twenty-one of the other.
Review of other hospitals: of the hospitals reviewed no DSU could be found that
had a comparable footprint and combination of day case and TDA admissions.
Review of space on Churchill site: no other suitable space was identified.
14. As a result of these consultations, the following criteria were identified, in order of
priority:
Priority
1
Criterion
To deliver a permanent solution which would make the Unit same sex compliant
2
To deliver a solution offering best value for money
3
To provide privacy and dignity to patients at all times, pre and post-operatively
4
To provide a solution which was “future proofed”- a Unit which could support
increased activity in the future
5
6
To stay within the existing footprint of the Day Surgery Unit
To provide an enema room
7
To offer an opportunity to use consulting space flexibly for either preassessment or outpatient clinics.
Options
15. The long list of options considered was:
No
1
2
2a
2b
Option
Do nothing
Bed spaces v. Hybrid
Combination of bed spaces and consulting rooms
Just bed spaces
3
3a
Use of consulting room space after 2:30pm
Use of consulting rooms for outpatients after
2:30pm
Use of consulting rooms for Day Treatment Unit
after 2:30pm
3b
3c
Use of consulting rooms for discharge lounge after
2:30pm
4
4a
4b
Location of Day Surgery Unit
Use space minus courtyard
Use space with courtyard
TB2014.123 FBC Redevelopment of Churchill Day Surgery Unit
Shortlist?
Yes
Yes
No: max. of nine bed spaces needed
currently. Consult room would provide more
privacy
Yes: synergy between pre-assessment and
DSU
No: lack of synergy between DSU and DTU
and concerns over amount of space needed
No: concerns that this would mean enlarging
the existing footprint of DSU and therefore
prove more costly.
Yes
No: too expensive
Page 8 of 23
Oxford University Hospitals
TB2014.123
16. Following consultation and discussion, it was decided that the preferred option was to
use a combination of bed spaces and consulting rooms. This would have the
advantage of:


Providing more private spaces for consultations to happen at peak times.
Allow the consulting rooms to be used for other purposes in the afternoon.
17. The use of consulting space for day treatment unit and a discharge lounge was
discounted as it was judged that the project would compromise on its principal
objectives. It was also judged that these options would necessitate enlarging the
existing footprint of the DSU, which would have significant cost implications.
18. On balance, it was judged that activity would only marginally increase in the future:



Some head and neck patients, who currently go to Blenheim Ward preoperatively, could come through TDA.
Increasing operating times beyond 10 hours would increase the number of
patients, but these would be spread throughout the day. If this were the case
then the consulting rooms would continue to be used for TDA/ DSU rather than
pre-admissions.
With regards to case mix, day case rates at the Churchill are already in line with
national standards so would not increase significantly. For example,
Laparoscopic cholecystectomies have a day case rate of 72%; British
Association of Day Surgery target is 60%. Additionally the trend towards more
complex surgery would mean that fewer patients would be served by TDA and
DSU, not more.
19. Finally, the project does not anticipate a change in the hours the DSU is open.
Currently the Unit is open from 7am until 10pm and it is considered that discharging
patients after 10pm does not provide a good patient experience. A detailed six month
project was also undertaken to consider the feasibility of opening the Unit as a 23hour ward. The conclusion of this project was that there were insufficient numbers of
procedures being undertaken in Churchill Theatres to compensate for the additional
cost of staffing the ward overnight. However the planned redevelopment will not
prevent the option of DSU becoming a 23-hour ward in the future.
Financial Analysis of Preferred Option
20. It is estimated that the capital cost of the redevelopment will be £1.83 million against
an allocation in the approved capital programme of £900k. The detailed costings are
shown in appendix two. It should be noted that:




The £1.83 million figure contains £329K for optimism bias and planning
contingencies.
There will be minimal relocation costs as the redevelopment work will be phased.
This has the additional advantage that there will be minimal disruption to theatre
processes and patients.
Charitable trustees have indicated a desire to support the project with a
contribution of approximately £400-500k.
It is expected that there will be recurrent revenue costs of £2.65k for
maintenance of the new equipment.
TB2014.123 FBC Redevelopment of Churchill Day Surgery Unit
Page 9 of 23
TB2014.123
Oxford University Hospitals
Market Assessment (including commissioner discussions)
21. The changes made to the Day Surgery Unit will mean that the Unit is same sex
compliant and improve patient experience and flow through the Hospital. However
there are no implications for commissioning as the Day Surgery Unit is a derived
demand and therefore the project will not alter activity levels or income.
Benefits Realisation
22. The table below shows the quantifiable benefits of the proposal and the plan for
achieving them.
Benefit
Performance
Measure
Current Value
Target Value
Target Date
Compliance with
single-sex
accommodation
with built in
flexibility of male
to female ratios
Privacy and
dignity
Single sex
segregation is
maintained
using curtains
only
All gender
segregation is
maintained in
accordance
with DoH
guidance
As soon as
building work
is complete
Improved patient
environment as
some areas are not
being used in the
manner in which
they were
originally designed
Patient
satisfaction
surveys
No concerns
raised in
response to
post op phone
call
Positive
feedback
As soon as
building work
is complete
2 complaints in
past 6 months
0 complaints
Average two
patients per
week
All patients
As soon as
who require an building work
enema to have is complete
it in an en suite
facility
Complaints
Provision of ensuite single rooms
for pre-operative
bowel prep
Provision of ensuite single rooms
for patients
requiring an escort
Privacy and
dignity
Opportunity to
offer outpatient
clinics / pre
assessment
facilities at times of
less TDA activity
Outpatient
activity
Not
quantifiable
Equality and
diversity
Preassessment
waits
Facility not
currently
available
Additional 20
patients seen
each week
As soon as
building work
is complete
23. Additionally, the provision of additional pre-assessment space will lead to the more
timely provision of pre-assessment appointments which in turn should reduce the
number of unnecessary cancellations on the day.
TB2014.123 FBC Redevelopment of Churchill Day Surgery Unit
Page 10 of 23
TB2014.123
Oxford University Hospitals
24. A recent analysis of the on the day cancellations found that on average twelve per
month were associated with pre-op assessment. This equated to an aggregate loss
of over 250 hours of theatre time per year, or the equivalent of thirty one eight-hour
lists. The cost of provisioning these additional sessions at weekends would equate to
£114k in pay alone.
25. It is therefore expected that the additional pre-assessment space provided will lead to
a cost saving related to theatre time saved.
Management of Risks of Implementation of Proposal
26. The table below lists the risks that would remain if the proposal is agreed and the
plan to manage them:
Risk
Impact
(I)
Disruption of
provision of DSU
service whilst work
is carried out
4
Likelihood
(L)
3
Reduction in
accommodation
and reduced
operating in
theatres
5
3
Total
(IxL)
Mitigating
Action
Residual
Risk
12
Work to be
phased and all
non-essential
services to be relocated
9
15
Work to be
phased and all
non-essential
services to be relocated.
8
Delays in theatres
due to bottle neck
in DSU due to
reduced capacity
3
2
6
Poor patient
experience whilst
work is carried out
2
4
8
Increased focus
at theatre
planning
meetings over
patient numbers
and anticipating
problems
Close working
with estates to
ensure optimal
number of
recovery beds
are available
during each
phase of
development,
especially on
Mondays and
Fridays when
CORU is not
open.
Provision in
2014-15 budget
for additional
staff member to
attend to patient
needs.
Contingency
plan to address
risk
Working closely
with Estates and
contractors
before and
during building
works
4
Provision made
TB2014.123 FBC Redevelopment of Churchill Day Surgery Unit
Page 11 of 23
TB2014.123
Oxford University Hospitals
Risk
Impact
(I)
Loss of staff due
to disruption of
work environment
2
Likelihood
(L)
2
Total
(IxL)
Mitigating
Action
Residual
Risk
Contingency
plan to address
risk
in costs for signs
and posters
explaining works.
4
Increased patient
surveys during
redevelopment.
Staff closely
involved in
planning of
redevelopment
and to be kept
informed of
development’s
progress through
regular staff
briefings
2
Implementation Plan
Action
Timeline
Divisional Board Approval of PID
March 2014
Trust Business Planning Approval of PID (including Business Case
procedure)
March 2014
Estates Feasibility
April - August 2014
Feasibility Drawing Sign-off
Investigation/survey work (i.e. asbestos, structural, mechanical &
electrical)
Phasing Drawing Sign-off
Update initial cost estimate
Review and Sign-off by Senior Finance Business Partners
05/09/2014
Business Planning Meeting
16/09/2014
Support from Trust Management Executive
25/09/2014
Approval by Trust Board
12/11/2014
Estates Detailed Design
8 weeks
Room Data Sheets
Drawings by design team
Pre Measure Cost Estimate
TB2014.123 FBC Redevelopment of Churchill Day Surgery Unit
2 weeks
Page 12 of 23
TB2014.123
Oxford University Hospitals
Action
Timeline
Contractor Lead-In
4 weeks
Phased Construction (42 weeks)
Phase 1
10 weeks
Phase 2
8 weeks
Phase 3
8 weeks
Phase 4
4 week
Phase 5
8 weeks
Phase 6
4 weeks
When and how will the impact and intended effect be reviewed and reported on?
27. An implementation review will be carried out one year after completion of
redevelopment work.
Conclusion
28. The redevelopment of the Churchill Day Surgery Unit is necessary in order to provide
a permanent solution to the issue of mixed sex accommodation. The current use of
curtains does not satisfy national guidelines and failure to act would result in the
Trust risking significant financial penalties from commissioners - potentially the loss
of income for all patients passing through the Day Surgery Unit. Additionally, the
current facilities are providing a sub-optimal patient experience, specifically with
regard to privacy and dignity.
29. The proposed redevelopment has consciously sought to both maximise benefits and
minimise costs: Extensive consultation has been undertaken with all key
stakeholders and the resulting plans prioritise both patient privacy and remedy
existing problems with the Day Surgery Unit environment. These include the
provision of an enema room and sufficient private spaces for pre-and post-operative
consultations. Additionally the plans have allowed for the flexible use of the
consulting rooms for other services such as pre-operative assessment and
outpatients.
30. To minimise costs the redevelopment has been limited to the existing Unit footprint
and foregone development of the courtyard space. In addition, the building work will
be phased, so that the Day Surgery Unit will continue to function on its existing
premises whilst the work is being carried out. This means that the costs of needing to
provide an additional ward whilst the redevelopment work is carried out have been
saved.
31. In summary, the redevelopment, whilst a necessity to satisfy national guidance for
single sex, will enhance the experience of patients being operated on in Churchill
Theatres and also improve the utilisation of space on the Churchill site.
Recommendations
32. It is recommended that capital funding of £1.87 million is approved for the
redevelopment of the Churchill Day Surgery Unit.
TB2014.123 FBC Redevelopment of Churchill Day Surgery Unit
Page 13 of 23
Oxford University Hospitals
TB2014.123
Paul Brennan, Director of Clinical Services
Prof Freddie Hamdy, Divisional Director, Surgery and Oncology Division
Dr Mark Stoneham, Clinical Lead, Churchill Theatres
Ben Wright, OSM, Gastroenterology, Endoscopy and Churchill Theatres Directorate
Julia Wood, Matron, Gastroenterology, Endoscopy and Churchill Theatres
Directorate
September 2014
TB2014.123 FBC Redevelopment of Churchill Day Surgery Unit
Page 14 of 23
Oxford University Hospitals
TB2014.123
Appendix One: Patient feedback on proposals
A survey of patient views was conducted in March 2013 regarding the proposed plans.
The following feedback was received:
Patient
CE
(Pre-op)
Comments
Looks good. Tea/ coffee machine for waiting relatives would be a good
idea.
AR
(Post-op)
The extra privacy would be much appreciated, but I'm very thankful
for the way I have been treated today. It seems like a good plan.
MR
(Post-op)
CS
JH
(Post-op)
AR
EL
SA
AL
Looks like a very good plan. Privacy definitely needed when
procedures are explained. TV in waiting area is a good distraction for
relatives when drinking tea/ coffee. Very happy with care today. Thank
you.
The new plans look very good with more room in the consulting rooms.
The staff where excellent. First class treatment. Thank you for taking so
good care of me.
Plans appear to offer more privacy which is good. Repositioning of
office also, and toilet facilities for visitors an improvement. Staff facilities
catered for. My second time on day surgery ward and thanks again for
the care received.
Plans seem to have all areas covered. Having separate male and
female areas is super. Courtyard is nice and relaxing; will be nice for
all seasons. As long as consulting rooms have enough
soundproofing then confidentiality will be kept. There's nothing
worse than one hearing someone else's private appointments.
Single rooms/ toilets between male and female areas are a good divide.
Is there only one toilet for those in the waiting area?
Having had a brief run through of the proposed changes with the
nurses, I think the plans will benefit the day surgery area, even though I
have been very pleased with how everything went for me today.
The consulting rooms are a good idea. It looks an improvement to the
day surgery unit for the future.
The need for improved privacy is a positive step whilst achieving
segregation for female and male patients is a welcome
improvement. Additional toilets will also benefit patients. Might a news
channel TV be a consideration?
TB2014.123 FBC Redevelopment of Churchill Day Surgery Unit
Page 15 of 23
Appendix 2 - Cost Summary
Please note that this Initial Estimate is a preliminary cost based upon
outline sketch proposals and is subject to change.
Project Number
Project Name
Project Manager
DATE:
Work Stage
Procurement Strategy
2014/
Capital Programme
Refurbishment Works to Churchill DSU
Capital Code:
Capital Outturn 13/14:
12th August 2014
Capital Allocation 14/15:
Stage 0 - 1
Charitable Funds:
MTC therefore no allowance for prelims
Total
Maintenance - total p.a:
Notes: e.g. cost does not include the following: i) medical
equipment - new or relocated
Initial Estimate base docs~
Construction costs
Construction costs
-Building Costs
-M&E Costs
Total exc. Contingency
Construction contingencies
Area cost
Cost per m2
m2 cost based on HPCG's
plus allowances for
abnormals
sub total
GBS Feasibility Report REV A dated
01.08.2014
Solid Structrures Report dated
05.08.2014
%
10.00%
sub total
£0
£
0
£964,800 Notes/ Qualification
Included
£964,800
£96,480
£1,061,280
Professional fees (VAT 100% recoverable)
Assumed 15% of Construction Costs
sub total
£159,192.00
Non works costs
Assumed 2.5% of Construction Costs
sub total
£26,532
Group 2 & 3 equipment
Allowance of 2.5% Construction Cost Made
sub total
Sub total of Construction
Cost (incl. Contingency),
Professional fees, NonWorks costs, Group 2 & 3
Equipment costs
Planning contingencies %
based upon Risk Analysis. %
range form 5%-30% (30%
advised by NHS at Stage 0)
£26,532
£1,273,536
10.00
Total
£127,354
% applied to Construction costs (incl. Contingency), Professional
fees, Non works costs and Group 2&3 equipment costs
£1,400,890
Optimism Bias
14.41
£201,868
Inflation - Excluded
0.00
£0
VAT (Excluding Fees)
20.00
£288,713
Recoverable VAT 20,40 or 75%.
No independent objective
assessment of VAT abatement
has been undertaken
20.00
£57,743
Total Scheme Cost
% applied to total Construction costs (inc. Contingency),
Professional fees, Non works costs, Group 2&3 equipment costs
and Planning contingencies
20% VAT applied to Construction costs (incl. Contingency), Nonworks costs, Group 2 & 3 Equipment costs
£1,834,000
Page
16 of
23
TB2014.XXX Appendix Two Churchill DSU
Cost
Summary
APPENDIX 3A
Business Case:
EXPENDITURE
Churchill Day Surgery Unit
2014/15
WTE
2015/16
WTE
2016/17
WTE
2017/18
WTE
2018/19
WTE
2019/20
WTE
2020/21
WTE
2014/15
£000s
2015/16
£000s
2016/17
£000s
2017/18
£000s
2018/19
£000s
2019/20
£000s
2020/21
£000s
A. Direct revenue costs
Staff (specify grade & wte)
Baseline costs
Consultant
Sub total
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0
0
Sub total
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0
0
Sub total
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0
0
Sub total
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0
0
Sub total
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0
0
Sub total
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Junior Medical
Nurse - band7 (includes Saturday cover)
HCA - band 2 (includes Saturday cover)
Scientific & Therapeutic
Radiographer - band7 (includes Saturday)
Other Clinical
Band 3 admin - (includes Saturday cover)
Total Staff
Non-Staff (inc VAT)
Baseline
Radiographers - training course
Maintenance Costs
Purchase equipment - trolleys
Total non staff
Total Direct Revenue costs
A
B. Indirect revenue costs
Staff (specify grade & wte)
Radiological Sciences
Sub total
Pharmacy
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0
0
0
0
0
0
0
Sub total
Therapies
Physiotherapy - band 5
Occupational Therapy - band5
Dietetics - band 6
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0
0
0
0
0
0
0
Sub total
Laboratory Medicine
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0
0
0
0
0
0
0
Sub total
Theatres/Anaesthetics
Consultant - Anaesthetics
Theatre nursing staff
Sub total
Critical Care
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0
0
0
0
0
0
0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0
0
0
0
0
0
0
Sub total
Others
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0
0
0
0
0
0
0
Sub total
Total Staff
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
92
0
91
0
90
0
89
0
88
0
87
92
91
90
89
88
87
Non Staff (please insert lines and descriptions)
Radiological Sciences
Pharmacy
Laboratory Medicine
Theatres/Anaesthetics
Critical Care
Equipment servicing
Revenue set up costs (e.g. IT, Furniture, fittings etc)
Outpatient costs
Facillities Costs (e.g. catering, linen)
Others
Total non staff
Total Indirect Revenue costs
B
C. Capital Expenditure
Construction Costs
Construction Contingency Costs @10%
Professional Fees
Non work Costs
Planning contingencies
Optimism Bias
Group 2 & 3 Equipment
VAT
Medical Equipment (not included in estimate)
C. Capital Expenditure
D. Capital Charge & Depreciation
C
D
E. Contribution to Corporate Overheads @ 15%
E
F. TOTAL REVENUE COST
F
965
96
159
26
127
202
27
232
0
1,834
0
Page 17 of 23
TB2014.XXX Appendix Three (a) Capital and Revenue Expenditure Churchill DSU 04/11/2014
1
Business Case:
Churchill Day Surgery Unit
Activity & Income
G. Activity (specify HRGs)
2014/15
2015/16
2016/17
2017/18
2018/19
2019/20
2020/21
A & E attendances
Emergency HRGs
Subtotal emergency
Elective HRGs
IF bed days
0
0
0
0
0
0
0
Subtotal elective
Day Case HRGs
0
0
0
0
0
0
0
Subtotal daycase
Outpatient new
Outpatient follow-up
Subtotal outpatient
ITU/HDU bed days
MDT
0
0
0
0
0
0
0
0
0
0
0
0
0
0
H. Income
£000s
£000s
£000s
£000s
£000s
£000s
£000s
A & E attendances
Emergency HRGs
Elective HRGs
Day Case HRGs
Outpatient new
Outpatient follow-up
ITU/HDU bed days
MDT
Subtotal NHS/PCT
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Private Patient
R&D
Other non NHS clinical
Charitable Funds
Other
Total Income
Analysis of income by PCT
The following table is to indicate changes to current PCT income flows. If future years will alter significantly
from this please make clear reference in your business case narrative.
2013/14
Activity
Spells
Source of Income
A&E
Emergency
Elective
Day case
OP- New/Fup
Other
Commissioner
Oxford CCG
Milton Keynes CCG
Buckinghamshire CCG
Sub total NHS/PCT
0
0
0
0
0
0
0
0
0
0
0
0
Private Patient
R&D
Other non NHS clinical
Charitable Funds
Other
Total
2013/14
Income
Source of Income
Spells
A&E
Emergency
Elective
Day case
OP- New/Fup
£000s
£000s
£000s
£000s
£000s
Other
£000s
Commissioner
Oxford CCG
Milton Keynes CCG
Buckinghamshire CCG
Sub total NHS/PCT
0
0
0
0
0
0
0
0
0
0
0
0
Private Patient
R&D
Other non NHS clinical
Charitable Funds
Other
Total
Page 18 of 23
TB2014.XXX Appendix Three (a) Capital and Revenue Expenditure Churchill DSU 04/11/2014
2
Business Case:
Churchill Day Surgery Unit
SUMMARY
2014/15
WTE
2015/16
WTE
2016/17
WTE
2017/18
WTE
2018/19
WTE
2019/20
WTE
2020/21
£000s
2014/15
£000s
2015/16
£000s
2016/17
£000s
2017/18
£000s
2018/19
£000s
2019/20
£000s
2020/21
£000s
A. Direct revenue costs
Staff
Consultants
Junior Medical
Nursing
Scientific & Therapeutic
Other Clinical
Non Clinical
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Total Staff
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Non-Staff
Subtotal Direct costs
A
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0
0
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
B. Indirect revenue costs
Staff
Radiological Sciences
Pharmacy
Therapies
Laboratory Medicine
Theatres/Anaesthetics
Critical Care
Others
Total Staff
Non Staff
Subtotal Indirect costs
B
0.00
0.00
0.00
0.00
0.00
0.00
0.00
C. Capital Expenditure
D. Capital Charge & Depreciation
C
D
1,834
0
0
92
0
91
0
90
0
89
0
88
0
87
E. Contribution to Corporate Overheads @ 15%
E
0
0
0
0
0
0
0
F. TOTAL REVENUE COST
F
0
92
91
90
89
88
87
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
-92
-91
-90
-89
-88
-87
H. Income
Total PCT
Private Patient
R&D
Other non NHS clinical
Charitable Funds
Other
Total Income
H
SURPLUS (DEFICIT)
TB2014.XXX Appendix Three (a) Capital and Revenue Expenditure Churchill DSU 04/11/2014
Page 19 of 23
3
Business Case:
Churchill Day Surgery Unit
INCREMENTAL SUMMARY
2014/15
WTE
2015/16
WTE
2016/17
WTE
2017/18
WTE
2018/19
WTE
2019/20
WTE
2020/21
£000s
2014/15
£000s
2015/16
£000s
2016/17
£000s
2017/18
£000s
2018/19
£000s
2019/20
£000s
2020/21
£000s
A. Direct revenue costs
Staff
Consultants
Junior Medical
Nursing
Scientific & Therapeutic
Other Clinical
Non Clinical
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Total Staff
0.00
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0
0
0
0
0
0
0
Non-Staff
Subtotal Direct costs
A
0.00
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
B. Indirect revenue costs
Staff
Radiological Sciences
Pharmacy
Therapies
Laboratory Medicine
Theatres/Anaesthetics
Critical Care
Others
Total Staff
Non Staff
Subtotal Indirect costs
B
0.00
0.00
0.00
0.00
0.00
0.00
0
0
0
0
0
0
-1,834
92
0
-1
0
-1
0
-1
0
-1
0
-1
C. Capital Expenditure
D. Capital Charge & Depreciation
C
D
1,834
0
E. Contribution to Corporate Overheads @ 15%
E
0
0
0
0
0
0
0
F. TOTAL REVENUE COST
F
0
92
(1)
(1)
(1)
(1)
(1)
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
-92
1
1
1
1
1
H. Income
Total PCT
Private Patient
R&D
Other non NHS clinical
Charitable Funds
Other
Total Income
H
SURPLUS (DEFICIT)
TB2014.XXX Appendix Three (a) Capital and Revenue Expenditure Churchill DSU
4
Page 20 of 23
APPENDIX 3B -CAPITAL AND DEPRECIATION
Capex and capital charges £K
Year ended March 31
Building work
Opening NBV
Expenditure
Depreciation
Closing NBV
2016
-
0
0
0
-
0
0
0
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
0
1,834,000
61,133
1,772,867
1,772,867
0
61,133
1,711,733
1,711,733
0
61,133
1,650,600
1,650,600
0
61,133
1,589,467
1,589,467
0
61,133
1,528,333
1,528,333
0
61,133
1,467,200
1,467,200
0
61,133
1,406,067
1,406,067
0
61,133
1,344,933
1,344,933
0
61,133
1,283,800
1,283,800
0
61,133
1,222,667
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2,044
1,222,667
0
61,133
1,161,533
1,161,533
0
61,133
1,100,400
1,100,400
0
61,133
1,039,267
1,039,267
0
61,133
978,133
978,133
0
978,133
978,133
0
978,133
978,133
0
978,133
978,133
0
978,133
978,133
0
978,133
978,133
0
978,133
978,133
0
978,133
978,133
0
978,133
978,133
0
978,133
978,133
0
978,133
978,133
0
978,133
978,133
0
978,133
978,133
0
978,133
978,133
0
978,133
978,133
0
978,133
0
Equipment
Opening NBV
Expenditure
Depreciation
Closing NBV
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Total Opening NBV
Total Closing NBV
Total Average NBV
Capital charge
0
0
0
0
0
0
0
0
0
1,772,867
886,433
31,025
1,772,867
1,711,733
855,867
29,955
1,711,733
1,650,600
825,300
28,886
1,650,600
1,589,467
794,733
27,816
1,589,467
1,528,333
764,167
26,746
1,528,333
1,467,200
733,600
25,676
1,467,200
1,406,067
703,033
24,606
1,406,067
1,344,933
672,467
23,536
1,344,933
1,283,800
641,900
22,467
1,283,800
1,222,667
611,333
21,397
1,222,667
1,161,533
580,767
20,327
1,161,533
1,100,400
550,200
19,257
1,100,400
1,039,267
519,633
18,187
1,039,267
978,133
489,067
17,117
978,133
978,133
489,067
17,117
978,133
978,133
489,067
17,117
978,133
978,133
489,067
17,117
978,133
978,133
489,067
17,117
978,133
978,133
489,067
17,117
978,133
978,133
489,067
17,117
978,133
978,133
489,067
17,117
978,133
978,133
489,067
17,117
978,133
978,133
489,067
17,117
978,133
978,133
489,067
17,117
978,133
978,133
489,067
17,117
978,133
978,133
489,067
17,117
978,133
978,133
489,067
17,117
978,133
978,133
489,067
17,117
978,133
0
0
0
Total capital charge
0
0
92,159
91,089
90,019
88,949
87,879
86,809
85,740
84,670
83,600
82,530
81,460
80,390
79,321
78,251
17,117
17,117
17,117
17,117
17,117
17,117
17,117
17,117
17,117
17,117
17,117
17,117
17,117
17,117
978,133
0
0
0
0
0
0
0
Notes & assumptions
Life of building work - years
30
Life of equipment - years
10
Capital charge - %
3.5%
Contingency is included in capex
Capex occurs evenly throughout the setup years
Maintenance @ 10% of equipment
TB2014.xxx Appendix Three (b) Capital and Depreciation Churchill DSU
Page 21 of 23
1
Appendix 4
notes
This plan assumes bays can be similar size to existing, 2700mm
deep and 2500mm wide. 2 bays in the blue zone are smaller.
This option retains the internal courtyard. There are 2 single
en-suite rooms and 6 consulting rooms.
The trolleys shown are 1000mm wide and 2200mm long.
Access to/
from Theatres
WC
dirty
linen
Sister’s
Consulting
Office
Consulting
5.4 sqm
Patients’
Consulting
Consulting
Room 2
Lobby
Main
Consulting
12.3 sqm
9.1 sqm
Entrance
Room 6
Room 5
Room 4
Room 3
8.0 sqm
8.6 sqm
8.6 sqm
8.0 sqm
Property
rooflight over
Waiting
Room
51.6 sqm
Dirty
Utility
2
Cleaner
WC
2.7 sqm
3.3 sqm
staff notes
8.1 sqm
Courtyard
Cubicle
Bay
Reception
5.5 sqm
staff notes
23.6 sqm
Consulting
Reception
Office
Room 1
12.0 sqm
Patient
Records
trolley
staff notes
trolley
staff notes
9.1 sqm
5.6 sqm
Alterations to orange zone and minor
Staff
WC
1500
500
WC
changes elsewhere
mb
6.5.14
E
Dirty Linen storage moved
mb
29.4.14
D
Various amendments
mb
25.4.14
C
bed tracking removed
mb
17.4.14
B
utility and medication room
mb
17.4.14
revision
by
date
linen
various revisions inc consulting room 4, dirty
Single
4
Room
Cubicle
13.0 sqm
Staff
Single
WC
Room
4
2
2.5 sqm
13.0 sqm
Cubicle
Cubicle
WC
Equipment /
Bay
Bay
Bay
Clean Supplies
Store
36.0 sqm
36.0 sqm
22.9 sqm
17.0 sqm
Room
A
index
15.0 sqm
WC
2.5 sqm
gbs architects | St Thomas House
6 Becket Street | Oxford OX1 1PP
t: 01865 305130 | f: 01865 246424
e: architecture@gbs-ox.co.uk
w: gbs-ox.co.uk
Oxford University Hospitals NHS Trust
Day Surgery Unit
Churchill Hospital Block 85
Feasibility Option F
Floor Plan
0
1
2
3
4
5M
drawing number
6395 . 006 E
scale
1:100 at A2
status
preliminary
date
17.4.14
drawn mb
Page 22 of 23
Appendix 5
notes
WC
access
to/from
theatres
wc
wc
wc
85G03
85G02
wc
wc
85G01
staff
Dirty
Utility
85G04
wc
contractor’s
access
wc
wc
wc
staff
Dirty
Utility
wc
access
to/from
theatres
cubicles
WC
wc
access
Medication to/from
theatres
patient
access
wc
wc
wc
staff
Dirty
Utility
wc
access
to/from
theatres
Sister’s
Office
Waiting
Room
patient
access
Waiting
Room
85G05A
85G05
temporary
staff
base
85G05B
85G05C
cubicles
Reception
Reception
Office
Consulting
Room 1
Patient
Records
Staff
WC
85G06
reception
temporary
staff
base
Patient
Records
85G09
85G08
Reception
Office
Consulting
Room 1
staff
base
cubicles
2
Cubicle
Bay
Reception
Staff
WC
WC
85G12
cubicles
WC
Equipment
Store
temporary
waiting
cubicles
Staff
Room
WC
4
Cubicle
Bay
85G10
Equipment
Store
Staff
Room
85G07
office
cubicles
cubicles
85G11
patient
access
contractor’s
access
Phase 1
contractor’s
access
Phase 2
Phase 3
WC
access
Medication to/from
theatres
wc
wc
wc
wc
staff
Dirty
Utility
wc
access
to/from
theatres
Sister’s
Office
WC
wc
patient and
contractor
access
wc
wc
staff
Dirty
Utility
Waiting
Room
wc
access
to/from
theatres
2
Cubicle
Bay
Reception
Office
Consulting
Room 1
patient and
contractor
access
Single
Room
WC
Single
Room
4
Cubicle
Bay
2
Cubicle
Bay
WC
Equipment
Store
2
Cubicle
Bay
Reception
Reception
Office
Consulting
Room 1
Consulting
Room 4
patient and
contractor
access
Consulting
Room 3
Waiting
Room
Consulting
Room 6
Dirty
Utility
Reception
Staff
Room
4
Cubicle
Bay
Single
Room
WC
Single
Room
4
Cubicle
Bay
2
Cubicle
Bay
WC
Equipment
Store
Staff
WC
WC
Staff
Room
4
Cubicle
Bay
WC
Phase 5
Reception
Office
Consulting
Room 1
Patient
Records
Staff
WC
WC
WC
Phase 4
Consulting
Room 5
Patient
Records
Staff
WC
4
Cubicle
Bay
access
to/from
theatres
Sister’s
Office
Consulting
Room 6
Dirty
Utility
Patient
Records
WC
Medication
Waiting
Room
Sister’s
Office
Reception
2
Cubicle
Bay
wc
Medication
WC
Single
Room
WC
Single
Room
4
Cubicle
Bay
2
Cubicle
Bay
WC
Equipment
Store
Staff
Room
WC
Phase 6
revision
Key to colours:
by
date
index
gbs architects | St Thomas House
6 Becket Street | Oxford OX1 1PP
Solid, sealed dustproof
hoarding
t: 01865 305130 | f: 01865 246424
Contractor’s working area
Oxford University Hospitals NHS Trust
e: architecture@gbs-ox.co.uk
w: gbs-ox.co.uk
Day Surgery Unit
Churchill Hospital Block 85
Proposed Phasing
drawing number
6395 . 010
scale
1:200 at A1
status
preliminary
date
29.1.14
drawn mb
Page 23 of 23