SaHF DMBC Volume 1 Edition 1.1.pdf - Shaping a healthier future

Process for development of local hospital service models
For each hospital, we have estimated the financial and estates implications of providing
these services at each local hospital site. This process is summarised in Figure 8.15.
Figure 8.15: Process of development of local hospital service models
1
2
3
4
5
Site context and
Shaping a Healthier
Future (SaHF)
implications
Description of
clinical services and
activity
Space requirement
for service mix
Current site
configuration
Required capital
expenditure
Description of step
▪ Describe the existing activities on the site
▪ Outline the proposals in the Shaping a healthier
future consultation and site implications
▪
▪
▪
▪
Identify main services on site
Quantify activity at the site after the reconfiguration
Generate estate plans for preferred service model
Analyse the required gross capital expenditure and
net of disposal capital expenditure to deliver the
preferred option for the site
Methodology
▪ Review existing activity information from Trust
▪ Sense check against site visits
▪ Test information with Trust
▪ Review consultation document
▪ Describe constraints on site use
▪ Update modelling
▪ Test with CCGs and Trusts
▪ Identify the space requirements to deliver services ▪ Identify room requirements to deliver proposed services
provided at the site
▪ Calculate the whole hospital area required for the site (i.e.
total square meters required)
▪ Identify the existing estate and service configuration ▪ Identify existing estate and service configuration using Trust
▪ Carry out initial site inspections and review against
information from Trust
▪ Develop baseline estate data 1
▪ Develop surveyor/architect block plans for the site
▪ Calculate required capital expenditure based on
assumptions of refurbishment/new CapEx costs
▪ Develop broad phasing and timing of build option plans
6
7
Site economics
(include revenue
and costs)
Align with CCG
strategy
▪
Estimate the income and expenditure surplus/deficit
at the local hospital site
▪ Ensure alignment with CCG Out-of-Hospital strategy ▪ Test with CCGs
▪
Model the income, operating and capital costs at the site
1 Does not include updating existing Trust plans if out of date
This process has supported the further work undertaken to address how the local hospitals
under the recommendation will be clinically and financially sustainable and be developed
including changes to estates and capital expenditure requirements. More information on this
can be found in Chapter 16.
8.11.2. Hubs / health centres
In their out of hospital strategies pre-consultation, the CCGs articulated their vision for
delivering out of hospital services and looked in detail at the activity to be re-provided in
response to activity avoided in acute. Since then, we have engaged with the CCGs to
describe the distribution of services across different hubs/health centres, specify the space
requirements, and estimate the volumes associated with the estates being planned. In
parallel, a survey of potential sites was conducted to assess high level capacity and
condition at these estates. The process of developing models for hubs/health centres is
outlined in Figure 8.16.
8c. Out of hospital estates 243