HIGHLAND NHS BOARD
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MINUTE of MEETING of the
NHS Board Asset Management Group
Ante Room, Assynt House, Inverness
Tuesday 14th January 2014,
2pm
Present:
Alasdair Lawton, Non Executive Director and Chair
John Crossley, Section Head, Medical Physics
Bruce Merchant, Public Representative
Carol Marlin, Monitoring Accountant
Ian Scott, Clinical Director, South & Mid
David Garden, Head of Financial Planning
(representing Nick Kenton, Director of Finance)
Eric Green, Head of Estates
David Matheson, Procurement
Alex Javed, Service Manager
Mary Morton, Head of Community Pharmaceutical Services
(representing Area Clinical Forum)
Elaine Wilkinson, Non-Executive (by VC)
Derek Leslie, Director of Operations, A & B (by VC)
Michael Hall, Clinical Director, A & B (by VC)
George Morrison, Director of Finance, A & B (VC)
In Attendance:
Kirsteen Stewart, Estates Support Manager (minutes)
WELCOME/INTRODUCTIONS
Alasdair Lawton welcomed everyone to the meeting.
Apologies for absence were received on behalf of Nick Kenton, Bob Summers, Ray Stewart,
Brenda Dunthorne and Bill Reid.
1.
MINUTE OF THE MEETING HELD ON 17TH DECEMBER 2013
Approval of the minutes of 17th December was proposed and seconded by Carol Marlin and
David Matheson.
2.
MATTERS ARISING
ARUP
Eric Green advised that the meeting with ARUP regarding the 20/20 Vision was very positive
and we are already doing a lot of things that would be required. Eric Green has arranged for
a second discussion with Maimie Thompson to map out where work is required and will take
this back to the next meeting.
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Action: Eric Green to report back to next meeting following meeting with Maimie Thompson.
Catering Equipment List
Eric Green advised that this involved a lot more work than first anticipated, and requested
that this be carried forward to next meeting.
Action: Eric Green to report back to next meeting.
Obstetrics Scanning Machines – Occupational Health
Item 5 on Agenda.
Argyll & Bute Integrated Equipment Store
Derek Leslie discussed a report, which had been prepared by the Estates Engineer, following
a site visit, and which provided answers to Ray Stewart’s questions from the preivous AMG
meeting. Derek Leslie confirmed that the equipment is 6 years old, with an expected lifespan
of 15 years. Further, all components, such as they could be checked, appear to be in good
condition, plus, there are a number of recommendations, which are qualifications of NHS
Highland’s purchase, to give some reassurance. Before concluding the deal, NHS Highland
would be looking for a number of guarantees from the seller. Derek Leslie advised that, in
his view, as Director of Operations, he was happy with the proposal, given price quoted
versus price of a new one.
Carol Marlin confirmed that the virement was included in the financial plan.
Pharmacy Isolator Project
Two isolators have been approved through the Detecting Cancer Early (DCE) Capital monies
and two additional isolators to deal with the TPN requirements where funding is sought
specifically by Capital. Carol Marlin has identified that there is a balance within the DCE
Capital allocation and agreement required in how the funds are utilised.
3.
MONITORING REPORTS
Carol Marlin advised that there is no change in funding, and for expenditure only, the lead
lining funds approved at the last AMG, included.
Carol Marlin also informed the group that she had just been made aware that only £12k, of
the £200k, requested for Tain equipment, was going to be spent this year, resulting in
slippage of £188k. This brings total slippage to around £340k.
Action: Alasdair Lawton asked Eric Green to investigate why this has happened, and why
it’s only coming to light in January, then to report back to Carol Marlin.
Eric Green informed the group that the work on the Towerblock is progressing faster than
anticipated, and that he is still working through the full effect of this, but it means that more
could possibly be spent on the scheme this year.
Eric Green also advised that adverse weather had delayed construction work on the
Endoscopy and Boilerhouse on the Biomass cladding by 3 weeks, so, again, need to
understand the full effect of this, but any underspend could allow for a possible overspend on
the Towerblock.
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Last page of report shows that only £7m of £17m has been spent, so £10m to be spend in
the remaining weeks of the financial year.
Alex Javed confirmed that the large invoice for the CT scanner was expected; there are no
issues and the equipment is installed.
eHealth schemes still to spend, but no representation at this meeting.
Argyll & Bute issue to buy site from Argyll & Bute Council for Equipment Store, which the
Estate Manager and Helen Emery are dealing with; George Morrison is going to chase this
one.
Carol Marlin asked the group if anybody had anything that needed to be brought forward
from next year, in the event that Tain slips. It was agreed that the best way forward would be
to issue an email requesting update on all schemes with a balance to pay.
Eric Green discussed catering trolleys as a way to utilise slippage. It’s thought that there
may be a National Contract; Eric Green is going to discuss with David Matheson.
Draft Capital Plan
Carol Marlin explained that the 2 unhighlighted columns show funding already notified by the
Scottish Government. The subsequent 3 years are estimates for now.
Expected disposals and impairments shown over the next 2 pages.
Final pages were plans submitted by individual departments, showing requirements.
Estates shows £2m every year for backlog maintenance, as agreed by the Board. However,
some concerns with other departments’ requirements in excess of funding available, having
these department plans can identify shortfalls in funding.
Eric Green suggested that a current list of medical equipment was required, which is now
beyond its expected replacement date, in order to produce a Risk Assessment. John
Crossley agreed that further development was required and advised that they were trying to
incorporate a scoring system into the existing replacement plan. Eric Green suggested that
a group was required for this and other departments, e.g. I.T, to analyse requirements to
feed into the Asset Management Strategy. John Crossley added that there was a need for
clinical involvement and that items should be risk scored and prioritised.
Ian Scott wondered whether the Professional Executive Committee (PEC) would be a
possible solution to this, as it is a source of clinical advice to Senior Board Management, and
draws a variety of medics together, with a variety of backgrounds. Ian Scott also suggested
the Clinical Advisory Group (CAG) as a solution, as there is a need for objective advice. The
CAG is chaired by Public Health and the PEC is chaired by Paul Davidson/Deborah Jones.
Mary Morton suggested that there may also be a role for the Area Clinical Forum.
Action: Alasdair Lawton to follow up with Deborah Jones.
George Morrison raised issue of C R Readers in Argyll & Bute Community Hospitals, and it
was confirmed that they are on the Radiology plan to be replaced next financial year. Alex
Javed confirmed that there were 5 or 6 of them.
Eric Green advised that Estates have included Adult Social Care in the plan for the first time,
with Highland Council funding this aspect.
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Carol Marlin advised that she was seeking approval from the group to submit the paper to
the Scottish Government by the end of this week. Alasdair Lawton advised that, as long as
Nick Kenton had approved this, then he was ok with it. Carol Marlin added that there would
be a chance to revise it before LDP and submission to the Board.
4.
PHARMACY ISOLATORS
John Crossley advised the group that the 4 pharmacy isolators are slipping, and may not be
here and installed by the end of this financial year, however, there may be a possibility of
taking ownership of them in time for financial year end. David Matheson added that the
contract has not yet been awarded as Pharmacy staff want to see the items in situ, and are
visiting the warehouse next week.
John Crossley added that a period of 12 weeks is anticipated for delivery and installation.
Carol Marlin advised that there were 2 options:
1) Order the goods and take “transfer of title”, which means that they legally become the
property of NHS Highland, even though they’re not on site.
2) Let funding for both DCE and normal Capital slip, if there was planned expenditure
which could be brought forward from next year.
It was confirmed that delivery on, or before, 31st March 2014, is required for items to be
included in Capital spend in year.
Eric Green advised that Estates did transfer of title last year so could offer advice if needed.
David Matheson has also approached Central Legal Office (CLO) for advice.
Bruce Merchant felt it was important to identify individual machines in the warehouse that
would belong to NHS Highland and aired concerns around waiting until 31/03/14.
David Garden explained that there was legal transaction and an accounting transaction
required, and the latter could be actioned on 31st March, with Alasdair Lawton stressing need
to make sure that everything was in place for all possiblities.
Carol Marlin suggested that it would be best to wait until the Pharmacy visit the site next
week, and take from there.
5.
OBSTETRICS & GYNAE ULTRASOUND SCANNER AND PROBES
John Crossley explained the issue with the obstetrics scanners being heavy, and may
contribute to staff suffering RSI, this theory is now being supported by Occupational Health,
who support purchase of lighter weight scanning heads.
From a Capital perspective this issue scores high. John Crossley added that the purchase
will solve a number of problems, and is following best advice. Carol Marlin asked if they
could be bought in this year? John Crossley has asked for this information and will have for
next meeting.
Action: John Crossley to confirm if light weight scanning heads can be purchased this
financial year, and to confirm at next meeting.
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6.
GUIDANCE NOTE – TIMING OF CAPITAL CONTRIBUTIONS
From Nick Kenton, who was not in attendance at this meeting – carry over to next meeting.
7.
NASOENDOSCOPES
John Crossley provided the background on this item, and explained the requirement for
single use of endoscopes, with changes to disinfection processes. Glasgow Consultants will
not work with anything other than single use following recent national guidelines. John
Crossley added that central decontamination facilities will be in place as of April, but to make
this work there is a requirement for additional nasoendoscopes, and this will be the position
elsewhere as it is a policy change following national guidance.
In Oban there is a request for 6 additional nasoendoscopes at a total approximate cost of
£35k, with a Revenue cost of around £1k per scope for maintenance. The service will come
to a halt if not followed through and purchase scores 39 on the database.
George Morrison added that a fair bit of money has been spent creating the decontamination
units in Oban and elsewhere so it would be logical to follow through and provide the
necessary equipment.
No estimate has been provided for the rest of Highland and discussion took place around
who will provide this information. It was suggested that Donna Janssens be first point of
contact for Raigmore, to find out how many more ‘scopes will be required. Meantime the
purchase of 6 for Oban was approved to proceed without delay of waiting on information for
other areas.
Action: proposal approved for Argyll & Bute, for purchase this financial year, but require
information for other areas.
8.
A.O.C.B
Derek Leslie discussed letter sent to Nick Kenton on 18/12/13, from a legal representative of
Dr Knowles, a GP, who, prior to retiring 2 years ago worked in Argyll & Bute for NHS
Highland.
The letter suggests that if NHS Highland don’t purchase the property (The Surgery,
Geirhilda, Port Ellen, on the Isle of Islay) at price of £460k, then Dr Knowles will sell on the
open market, with the property no longer being available for use by the current independent
practitioner, Dr Angus MacTaggart. There appears to be no formal lease agreement
between the GPs, more a loose partnership agreement, with an exchange of rent, and the
former GP now wants to bring the issue to a head. Approximately 18 months ago NHS
Highland instructed the District Valuer Office (DVO) to undertake a valuation, which was
confirmed at the top end of £220k. It’s also thought that around £100k would require to be
spent on the property to bring it up to proper standards e.g fire precautions, disabled access,
etc.
Derek Leslie advised that, at present, there is no contingency plan and he was seeking from
the group 2 or 3 principles, which could be explored formally (through Nick Kenton), in terms
of how NHS Highland might engage with Dr Knowles. Derek Leslie added that there will be a
service and severe property difficulty in due course, with no chance of alternative premises
being found in Port Ellen, in the medium term.
It was agreed that an up to date valuation should be arranged with the DVO.
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The advice from NHS Highland’s Property Manager was that there was no benefit in NHS
Highland leasing from Dr Knowles, then leasing to Dr MacTaggart.
It was also suggested that Derek Leslie, George Morrison, David Garden and Eric Green
have a discussion around how a previous situation (Riverside) was handled, with view to
preparing a positive response to Dr Knowles.
Eric Green suggested that, with the current market, it may be best to offer to buy the property
at the current valuation, once known from the DVO, as there appears to be at least a 5-10
year need for this property. NHS Highland would then be in a position to take into account
the conditon of the building and how much it would cost to bring up to level of repair which
would be required, and this could be reflected in negotiations.
Carol Marlin added that, if we were to lease the property, we would not be able to spend
£100k of Capital money to bring the property up to standard.
David Garden also suggested speaking to Stephen Pollock, our current valuer, as there may
be option to value as existing use as opposed to open market value, as it’s a surgery.
Actions: Derek Leslie to seek valuation from DVO and speak to Dr Knowles. Derek Leslie
then to report back at next meeting.
The meeting concluded at 15.20 hours.
9.
DATE OF NEXT MEETING
12th February 2014 at 2pm, Ante Room, Assynt House
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