NHS Issue 14 14.pdf · (Bottom L-R) Cynon Valley Hospital Courtesy of Trevor Burrows Photography....

The estate we’re inThe estate we’re in Issue 14Spring 2013

A publication by NHS Wales Shared Services Partnership - Facilities Servicesfor health estate and facilities personnel in Wales

NHS Issue 14 4/16/13 8:32 pm

contents

© Copyright NHS Wales Shared Services Partnership – Facilities Services

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by anymeans, electronic, mechanical, photocopying, recording or otherwise without the prior permission of the copyright owner.All photographic material is by NHS Wales Shared Services Partnership – Facilities Services, unless otherwise stated.Front cover: (Top) Manchester Square Health Centre, Milford Haven. Courtesy of John Evans Photography.

(Bottom L-R) Cynon Valley Hospital Courtesy of Trevor Burrows Photography. The Kier Hardie Health Park, Merthyr Tydfyl.Courtesy of Cwm Taf HB and Laing O’Rourke.

❖ Designed for Life: Building for Wales - Update 2❖ The NHS Estate in Wales: performance health check 2011/12 4❖ Fire safety management in practice 8❖ Primary Care Estate News 12❖ e-PIMS Property Database 16❖ Care by Design - A can do approach in the Cynon Valley 17❖ Environmental News 25❖ The NHS Estate in Wales: What the 2011/12 Facilities Performance Report

has to say about hotel services 27❖ The hospital patient environment programme 10 years on 30❖ Project Gallery 33❖ Hospital residential accommodation - Health Boards implement the

new standards 37❖ Goodbye to Space for Health 39❖ Library and Website News 41❖ Staff News 44

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A view from the centre…

Irecently attended the National Assembly for Wales’ Finance Committee to giveevidence on behalf of NHS Wales. The Finance Committee is conducting an Asset

Management Inquiry and is taking evidence from a range of stakeholders fromacross the Welsh Government and public sector in Wales and I know a number of Health Boards haveparticipated in this process. The Inquiry follows on from the Wales Audit Office’s June 2010 BuildingsManagement National Briefing.

Much of the Inquiry is aimed at the management of the Welsh Government’s own estate but theCommittee is also interested in how other parts of the Welsh public sector manage their assets. Much ofthe focus of the Inquiry is to try to encourage greater collaboration across the public sector to ensuremaximum value is drawn out of the estate.

Whilst more work can always be done, I think that the NHS in Wales has demonstrated a strongcommitment to asset management over many years. One of the main criticisms of many asset managementplans is that they are not always shaped by the strategic service delivery plans of the organisation and cansometimes exist in their own estates bubble. Well, as you know, that certainly isn’t the case in the NHSwhere asset management plans can usually be traced right through from Welsh Minister’s policies, toHealth Board’s service strategies, to local estate needs.

Other criticisms tend to focus on a lack of critical mass within certain organisations to carry the rangeof expertise needed to manage a complex estate. Furthermore, where such weaknesses exist, someorganisations are still reluctant to collaborate and share resources. Again, NHS Wales appears to be farmore accepting of this model than some parts of the public sector, both through the maintenance ofa shared service organisation for all Wales activities and local collaboration between Health Boards andTrusts.

Quality of estate data is another area that receives criticism. Whilst I think it is probably fair to say thatNHS estate management is not at the cutting edge in terms of the quality and quantity of estates data, allHealth Boards and Trusts operate estate management systems and have made significant strides overrecent years to improve the quality of their estates data. Running alongside these systems is e-PIMS, whichis not only used by NWSSP-FS in its NHS property management role but is also the conduit through whichthe Welsh Government requirements, such as the Affordable Housing and Land Transfer Protocols, aremanaged.

Closely allied with estate data is the concept of benchmarking. Again, in this area, the NHS appears tobe ahead of the pack and has for many years collaborated across the UK to ensure a consistent set of keyperformance indicators supported by clear definitions are collected, analysed and disseminated. In Walesthe primary vehicle for this activity has been the national Estates and Facilities Performance ManagementSystem (EFPMS), now in its 12th year of operation. Headline data from the EFPMS is distributed annuallyto NHS Wales through two reports; one focussing on the estate, the other on facilities management.

The Finance Committee is still considering the evidence presented during the Inquiry but I suspect thatit might recommend a stronger role for the Welsh Government, greater collaboration across the publicsector and more training for those involved in asset management. However, whatever its conclusions, I’mconfident that NHS Wales will rise to the challenge once again and lead the way in strategic assetmanagement.

Head of NHS Wales Shared Services Partnership – Facilities Services

Intranet: howis.wales.nhs.uk/whe 1

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n our last update we reported the planned closure inJune 2012 of the original Designed for Life: Building forWales construction procurement framework established

in 2006. We also highlighted the setting up of twosuccessor frameworks: Designed for Life: Building forWales 2 (Regional Frameworks for projects with aconstruction value between £4m and £10m) operationalsince October 2011 and Designed for Life: Building forWales 3 (National Framework for projects with aconstruction value over £10m) which became operationalin October 2012.

Since 2006, projects with a value exceeding £1.4 billionhave been completed, are on site or in planning. Thisupdate focuses on just one of those projects, Health VisionSwansea Phase 1b, started on site in September 2012 andforming a key part of the Health Vision Swansea multiphased development at Morriston Hospital.

Procured via the original Designed for Life: Building forWales framework, the project will provide state of the art,fit for purpose facilities that will replace ageing, outdatedhospital accommodation across a wide range ofdepartments. The scheme is at the centre of a programmeof works developed and managed by Abertawe BroMorgannwg University Health Board, which will result inimprovements to healthcare for the local population.

The completed project will provide a new 13,300m2 unitsplit over four floors, to support a wide range of serviceswhich are currently located in accommodation no longer fitfor purpose at the south of the hospital site. The projecthas a two-year construction period, with construction worksdue to complete in September 2014.

Designing and constructing the new-look facilities hasinvolved close involvement with over 21 OperationalGroups consisting of staff from each department to beaccommodated in the building, together with other keystakeholders, for example, Swansea University and theDisability Reference Group. Their input has been essential

in ensuring the new environment is fully accessible andsupports the enhanced clinical model for the 21st century.

Commenting on the new development, Paul Stauber,ABMU’s Director of Planning, said:

“This significant investment on the Morriston Hospital

site will replace existing sub standard accommodation,

currently provided in buildings constructed for World

War II and the 1940s. The new Outpatients Department

will be adjacent to the multi-storey car park, so patients

will either be dropped off close by or may park close to

the new main entrance to attend for their clinic

appointment”.

The project is being constructed utilising the latest inconstruction techniques, for example, a PERI formworksystem is being used to create the floors. This entails theuse of a formwork system which enables the concrete slabsto be poured and finished completely flat, with nodownstand beams. This allows off site manufacture ofservice modules which are installed to carry pipework,ductwork and cables. The prefabrication and off-sitemanufacturing results in greater quality control andincreased efficiencies in the design and constructionprocesses. This results in programme and cost savings andthe delivery of a higher quality project.

The Project Team and Supply Chain Partner - BAMConstruction are also committed to ensuring that theproject delivers real benefits to the local community. Theproject requires a Supply Chain Partner management teamof 15 people, and an on-site workforce which, estimated atits peak, could reach 200 people. Significant efforts arebeing made to ensure that the Welsh economy benefitsfrom the project - and these are being realised – nearly allthe workforce live in Wales and the majority of materialsand sub contracted works are sourced within Wales. Theproject has also afforded opportunities for workplacements for young people in the local area. This has

Internet: www.wales.nhs.uk/whe2

Designed for Life: Building for WalesUpdate

I

Morriston Hospital Development Phase1b - Artists impression. Courtesy of ABMU Health Board & BAM

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served to promote the construction industry in Wales andoffer young people in the local area the opportunity togain valuable experience.

When the project completes, the new facility will providestaff, patients and the local population with a purposebuild 21st Century healthcare facility that is amongst thebest in Wales. It is also anticipated that the design andconstruction processes themselves will have created realbenefits for the Welsh economy and the local population.

❖ Schedule of functional content

Ground Floor

■ Main entrance and reception

■ Renal department with 26 dialysis stations

■ Outpatients department with consulting rooms andsupport accommodation

■ Lung function department

■ Phlebotomy department

■ Fracture clinic

■ Radiology suite with 4 general rooms

■ Administration department

■ Hotel services

■ Security

■ Retail units

■ Main waiting area

■ Secondary waiting area

■ Ambulance liaison

■ Chaplaincy services

■ Medical records

First Floor

■ Endoscopy with 2 examination rooms

■ Paediatric outpatients

■ Head and neck outpatients including:

■ Dental specialities

• Ear/Nose/Throat including Audiology facilities

• Cleft lip and palette

• Ophthalmology

■ Waiting areas

■ Pre operation assessment unit

■ Maxillo Facial laboratory

■ Staff rest and changing facilities

First and Second Floors

■ Integrated Education Centre which will provide arange of training facilities including lecture theatres,seminar rooms and clinical skills laboratories

General Areas

■ Plant rooms, circulation, Combined Heat and PowerUnit

■ Patient communication and call system linked tobooking and appointment systems

Project DetailsClient: Abertawe Bro Morgannwg University

Health BoardProject director: Paul StauberHealth Board Project Manager: Lindsey JonesProject Manager: Gardiner & TheobaldCost Advisor: Davis LangdonSupervisor: Abertawe Bro Morgannwg University

Health BoardSupply Chain Partner: BAM Construction (Western) LimitedArchitects: Nightingale AssociatesEngineers: ArupCost Manager: Turner & TownsendHealth Planner: TribalGross Floor Area: 13,300m2

Construction Cost: £37,500,000Start on site: September 2012Completion: September 2014Opened to patients: Autumn 2014

For further information contact:Iain Worby on 029 2031 5500 ore-mail: [email protected]

Morriston Hospital Development Phase1b - Construction phase.Courtesy of ABMU Health Board & BAM


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he latest NHS Wales Shared Services Partnership –Facilities Services Estate Condition and PerformanceReport is now

available online.Covering thereporting periodApril 2011- March2012 the report waspublished once againagainst a gloomyeconomic context forthe NHS in Wales.Estates, like every partof the NHS, are feelingthe squeeze, facing thechallenge of deliveringsafe and appropriateservices at a time whenbudgets are beingreduced. Against thisbackground, what doesthe latest report tell usabout the performance of the health estate?

A cursory look at the health estate in Wales might suggestthat it is in steady decline. After all, we can all point toplenty of examples of poor infrastructure, deterioratingbuilding fabric and engineering plant in urgent need ofreplacement. However, the age profile data shown inFigure 1 points to an on-going modernisation programmethat over the last ten or so years has seen the proportionof the estate built since 1995 increase from 8% to 27%.Recent examples of new facilities replacing old andunsuitable ones include Ysbyty Aneurin Bevan in Ebbw

Vale, Ysbyty Ystrad Fawr in Ystrad Mynach and YsbytyCwm Cynon in Mountain Ash.

At the other end of the age spectrum, the figures areunderpinned by a robust disposal programme reflected inthe proportion of the estate pre-dating 1948 shrinkingfrom 32% to 19%. Recent examples of properties closingand going through the disposal process include YstradMynach Hospital, Caerphilly District Miners’ Hospital andAberdare General Hospital.

❖ Age profile of the health estate tells a story

The NHS estate in Wales:performance health check 2011/12

T The NHS Estate in Wales Estate Condition andPerformance Reports are based on annual estate datareturns submitted to the on-line Estate and FacilitiesPerformance Management System by seven HealthBoards, Velindre NHS Trust and the Welsh AmbulanceServices NHS Trust. The system, which replaced theannual Estate Data Returns, has been in operation since2001/02 and is managed by NHS Wales Shared ServicesPartnership – Facilities Services.

The reports serve two main functions:1. They provide the Welsh Government with high-

level data and information on the condition of thehealth estate in order to monitor year-on-yearperformance trends, inform the strategic planningprocess and assist in the prioritisation andallocation of resources.

2. They provide Health Boards and NHS Trusts withdata and information that enables them tocompare their own performance with that ofother Health Boards/Trusts, as well as againstnational trends.

THE NHS ESTATE IN WALES

Estate Condition and Performance Report

2011/12

Figure 1: Comparison of all-Wales age profiles between 2001/02 and 2011/12

Pre 1948 1948 to 1954 1955 to 1964 1965 to 1974 1975 to 1984 1985 to 1994 1995 to Present

All-Wales Age Profile 2001/02

32%

2%

5%

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15%

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8%

All-Wales Age Profile 2011/12

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National All-Wales target Performance in Performance inPerformance Indicators 2001/02 2011/12

Physical Condition 90% Condition ‘B’ 69% 82%

Statutory and safety compliance 90% Condition ‘B’ 70% 83%

Fire safety 90% Condition ‘B’ 76% 91%

Functional suitability 90% Condition ‘B’ 78% 80%

Space utilisation 90% Condition ‘F’ 79% 91%

Energy performance 410 kWh/m2 or less Figure not available 407 kWh/m2

DefinitionsPhysical condition: Condition ‘B’ Buildings that are sound, operationally safe and exhibit only minor

deterioration

Statutory and safety compliance: Condition ‘B’ Buildings where action will be needed in the current plan period tocomply with relevant guidance and statutory requirements

Fire safety Buildings where action will be needed in the current plan period tocomply with relevant guidance and statutory requirements

Functional suitability: Condition ‘B’ Buildings that are satisfactory and minor changes are needed

Space utilisation: Condition ‘F’ Buildings that are fully utilised

Energy performance: ‘B’ rating or better Buildings with an energy consumption of 410 kWh/m2 or less

Figure 2: National Performance Indicator all-Wales averages

Reporting year 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12

£ (millions) 304 243 252 227 259 232 215 185

Figure 3: All-Wales risk adjusted backlog maintenance costs

Energy consumption performance bands introduced by NWSSP-FS

Energy consumption: 410 kWh/m2 or below

Energy consumption: 411-479 kWh/m2

Energy consumption: 480 kWh/m2 or above

❖ National Performance Indicator Targets – Some way to goThe performance of the health estate continues to bemeasured against national performance indicator targetsset by the Welsh Government in 2002. At that time therewas an expectation that the 90% target would be met by2008. In fact, Figure 2 shows that, over the 11-year periodsince the targets were set, performance has been rather

disappointing. It is perhaps not surprising that Spaceutilisation is one of only three indicators where the targetwas met, the others being Fire safety, a subset of theStatutory and Safety Compliance PI and Energyperformance.

❖ Risk-adjusted backlog maintenance costsThe disposal of old, high maintenance, facilities not fit forpurpose supporting the delivery of modern clinical services,is probably the most effective way of reducing the backlogmaintenance burden of the health estate. Such aprogramme has been vigorously advocated and supportedby Shared Services Partnership – Facilities Services for manyyears along with the need to replace such facilities with

modern, fit for purpose ones that carry no backlogmaintenance burden. The latest figures showing areduction in risk-adjusted backlog maintenance costs of£30 million in the last year, seem to support this view.Figure 3 shows the trend in risk adjusted backlog costssince 2004/05.

❖ The future of backlog maintenance risk assessmentsWe indicated in our last feature that the review into thecurrent methodology for assessing backlog maintenanceand its possible replacement with a methodology focused

on financial drivers was on-going. Regrettably, that reviewis still on-going and a decision concerning its possible roll-out has yet to be made.

❖ Energy performanceWith a figure of 407 kWh/m2 the all-Wales energy performance showed asignificant improvement on the previousyears’ 441 kWh/m2 figure and falls withinthe green consumption performancebands.


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The latest figures show that net energy consumption forthe whole of Wales fell from 730 million kWh in 2010/11to 694 million kWh last year, a fall of 4.9%. Whenweather-correction factors are applied to take into accountthe mild winter, consumption for 2011/12 is estimated to

have been 692 million kWh, 14.1% below the 1999/2000base year. Figure 4 shows the trend in net energyconsumption. CHP on-site generated electricity continues tomake a significant contribution, totalling 39.6 million kWh,which was 17.9% of the total electrical consumption.

Carbon emissions fell 0.77% during the reporting periodwith an improvement in the carbon intensity performanceindicator falling from 119.78 kgCO2 /m2 in 2010/11 to115.54 kgCO2 /m2 last year.

The total cost of energy across the NHS last year was£34.2 million compared with £32 million the previous year,an increase of 6.7%. Although no clear trend can bepredicted, forecasts are anticipating further rises.

❖ WasteWaste is another area where the NHS can make a

significant contribution to the environment. Whilst there

was a small increase in the total quantity of waste

disposed of, with a corresponding increase in the total cost

of waste disposed, Figure 5 shown below, suggests that

the overall trend since 2004/05 is encouraging.

Figure 4: Graph showing net energy consumption and trend

Figure 5: Overall waste trend 2003/04 to 2011/12

500,000

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0 2 3 4 5 6 7 8 9 0 2

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Tonnes Trendline


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❖ What is the verdict?The significant reduction in risk-adjusted backlogmaintenance costs for the third year running suggests thatthe policy of disposing of old, inappropriate and highmaintenance facilities, and implementing a modernisationprogramme as seen in the opening of new hospitals inAneurin Bevan and Cwm Taf Health Boards is having asignificant impact on backlog. Whether capital fundingwill continue to be made available to support themodernisation programme remains to be seen. What iscertain, however, is that, given the current economicclimate, the NHS cannot afford to include within itsproperty portfolio poorly utilised, high-risk and high-maintenance facilities that are not able to support thedelivery of safe and appropriate patient care.

In terms of the performance of the health estate, targets

have been met on an all-Wales basis in respect of spaceutilisation, fire safety and energy performance. As forphysical condition, statutory and safety compliance andfunctional suitability, only a radical modernisationprogramme will see the targets being met. Again thequestion needs to be asked: is it time to stop pretendingthat the target for achieving physical condition ‘B’ willever be met and that the performance of the health estateshould be much more about achieving acceptable riskprofiles?

Figure 6: Trend in water consumption

Waste performance at a glance

2010/11 2011/12

Total quantity of waste disposed of 17,965 tonnes 18,239 tonnes

Total cost of waste disposed of £5.13 million £5.46 million

Total clinical waste disposed of 7,344 tonnes 8,451 tonnes

Total cost of clinical waste disposed of £3.49 million £3.95 million

Average cost of clinical waste disposed of £475 £467

Total landfill waste disposed of 10,517 tonnes 9,678 tonnes

Average cost of landfill waste disposed of £152/tonne £150/tonne

Average recycling as a percentage of total 13.4% 15%domestic waste

❖ Water usageThe total water consumption was just over 2.4 million m3,

an increase of 1.3% on the previous year’s figure. Figure 6

shows, however, that, over the last 12 years, there has

been a general downward trend in water consumption

which is now 10% lower than in 2000. The average cost of

water, including sewage and other charges, was £2.36/m3,

compared with £2.58/m3 the previous year.

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For further information contact:Peter Wiles on 029 2031 5542 ore-mail: [email protected]

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ffective fire safety not only relies on the physicalmeasures provided within a building but also on themanagement structure that supports it. The NHS in

Wales benefits from a structured approach to themanagement of fire safety through Health TechnicalMemorandum 05-01 Managing healthcare fire safety

(Welsh Edition) which ismandated for the NHS inWales by the WelshGovernment. However,even with thissupporting structure,the management of firesafety presents manychallenges for HealthBoards/NHS Trusts.With increasingactivity from the Fireand Rescue Servicethrough audit andenforcement togetherwith a rise in fireincidents in 2012,failures can have far

reaching outcomes both for organisations andindividuals. This article discusses the structures in place formanaging fire safety, the enforcement process and somecase studies of notable fires in healthcare.

❖ NHS management structureHTM 05-01 Managing healthcare fire safety provides theframework for fire safety management in Wales. Thedocument states that it builds upon the WelshGovernment’s fire safety policy. The aims of this policyrequire those responsible for fire safety within healthcarepremises in Wales to:

• Comply with legislation;

• Implement fire safety precautions through a risk-managed approach;

• Comply with monitoring and reporting mechanismsappropriate to the management of fire safety; and

• Develop partnership initiatives with other agenciesand bodies in the provision of fire safety.

HTM 05-01 also sets out the responsibilities for thosetasked with the management of fire safety. These extendthrough five distinct levels:

• The Health Board/NHS Trust – has overallaccountability for the activities of the organisation.

• The Chief Executive - responsible for ensuring thatcurrent fire legislation is met and that there are

appropriate policies and programmes of work in placeto improve and maintain fire precautions.

• The Board Level Director with responsibility forchampioning fire issues at board level.

• The Fire Safety Manager has a wide ranging set ofresponsibilities that include risk awareness,compliance with legislation, development of firestrategy and training programmes amongst manyothers.

• The Fire Safety Advisor provides technical expertise tothe Fire Safety Manager on items such as applicationand interpretation of Firecode, advising on policy anddeveloping training programmes.

The NHS in Wales then has a well developed, tried andtested model in place for the management of fire safety inits buildings. As part of the NHS Wales Shared ServicesPartnership, the Facilities Services directorate maintains afire safety section that also supports Health Boards on firesafety matters.

❖ Fire safety enforcementThe introduction of theRegulatory Reform (FireSafety) Order 2005 (FSO)brought all aspects ofHealthcare activities underthe legislative umbrella forfire safety. This piece oflegislation was the firstOrder to be introducedunder the RegulatoryReform process andreplaced over 100 piecesof legislation associatedwith fire safety. Previousfire legislation did notcapture all areas ofhealthcare buildings. TheFSO, which came into forcein 2006, is enforced by the local Fire and Rescue Service(FRS) for the vast majority of buildings, including all thoseassociated with healthcare. The legislation places theresponsibility for the management of fire safety matters inhospital buildings firmly on the owners of the risk i.e. theHealth Boards/NHS Trusts. The legislation requires that asuitable and sufficient fire risk assessment is in place thatidentifies any shortcomings in fire safety provisions andthat there is an action plan in place to address those issues.The FSO also requires the appointment of a ‘responsibleperson’ to oversee the fire safety arrangements for theorganisation and the building.

Fire safety management in practice

E


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FRSs carry out audits of the fire safety arrangements toassess the adequacy or otherwise of the measures in placein order to ensure good fire safety standards. This can anddoes include night time visits to hospitals to check on suchitems as escape routes, housekeeping and staff trainingissues. Where these arrangements are not up to standard,the FRS can issue notices to improve certain arrangementsand in extreme circumstances can close down areas orbuildings and prosecute those responsible for thedeficiencies.

As well as general fire precautions, the FSO also requiresthat equipment provided for fire safety is also maintainedto an appropriate level. Those responsible for maintenanceissues may well come under some scrutiny by the FRS inthe event of failings due to lack of maintenance. Indeed, afire alarm engineer served a custodial sentence for failingto properly maintain a fire alarm system in a case broughtby an English FRS.

In terms of enforcement, the FSO carries someconsiderable risk to individuals who the courts find guiltyof breaches of this legislation. It is likely that when the FRSproceeds with a prosecution, the action will be takenagainst those with managerial responsibility for thefailings. It will ultimately be for the FRS to decide who isprosecuted but those who have some form of managerialresponsibility for fire safety will not be immune fromprosecution unless they can demonstrate due diligence byproving that they themselves are not at fault in thecommissioning of the offence. These may be senior staff orat local level.

Interest from the FRS can come from a number of routes.It has been mentioned earlier that the audit process is oneof those routes. A second route is action following a fireon the premises. The FRS will always carry out a ‘post fire’review of the incident and will visit the scene of theincident from the fire safety perspective where it isdeemed necessary. Again, any shortcomings in theresponse to the incident or the events that haveled to it may result in enforcement action. Theannual report into Fire Incidents for 2012, shortlyto be published, will show an increase in thenumber of fire incidents.

❖ The ‘management’ offire safety

Good management is an essential ingredient inensuring not only compliance with fire safetylegislation but also in ensuring that policies andprocedures are well developed and properlyimplemented and complied with. Also, where anincident occurs, the outcome is greatly influencedby the management of that incident. Investigationsinto unsuccessful incident outcomes frequentlyreveal poor management as a considerable factorin the failings. Even a fire incident on an occupiedward can be considered as an event that requiresto be effectively ‘managed’.

External butts & lighter – Poor waste control together with control ofignition sources in the mental health sector

Butts below radiator – Poor waste control in patient bedroom in the mentalhealth sector


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There are many fire incidents across Wales each year thathave been managed effectively with successful outcomes.This was highlighted by the recent fire at Wrexham MaelorHospital on 8 February 2013 which required the fullevacuation of two wards and a special care baby unit atnight. However, the need to continually monitor andimprove fire safety management is something that shouldnot be taken lightly.

❖ Case Studies

Over the years there have been a number of high profilefire incidents in premises providing healthcare. Those thathave made the press includewhat is referred to as the‘5 London Fires’, theRosepark Fire and veryrecently, a fire in theWoodlands Psychiatric Unitof Ipswich Hospital.It is interesting to reviewboth the Rosepark incidentand the one at Ipswich fora number of reasons. Theincidents have a significantsimilarity in that aprosecution did not followeither incident despite therebeing multiple fatalities inthe former incident and aninjury in the latter. Bothincidents, though, hadsimilarities where ineffectivemanagement controlswere evident.

* Rosepark

In January of 2004 a fire broke out in the Rosepark CareHome in Uddingston, Scotland. The fire resulted in thedeaths of 14 residents. The catalogue of failings on thenight were documented in a Fatal Accident Inquiry chairedby the Sheriff Principal Mr. Brian A. Lockhart some 7 yearslater following a protracted and complex investigationinto the incident. Without going into the incident indepth, the Inquiry revealed huge failings in managementof fire safety. Sheriff Lockhart stated that ‘Managementdid not have a proper appreciation of its role andresponsibilities in relation to issues of fire safety’. However,

the owners of the care home were not theonly ones to receive criticism from MrLockhart. The authorities charged withoverseeing the care home, the BuildingRegulations process and the StrathclydeFire and Rescue Service itself receivedvarying degrees of criticism. He said the"critical failing" was not to identifyresidents at the home as being at risk inthe event of a fire, as well as failing toconsider the "worst-case scenario" of a firebreaking out at night.

A further "serious deficiency" was foundin the "limited attention" given to howresidents would escape from the home inthe event of a fire.

The sheriff said an adequate fire planwould have revealed the problems whicheventually led to the deaths, such as staffnot being properly trained in fire safetyand the presence of an electricaldistribution board in a cupboard which

Radiator ashtray – Poor control of smoking in the mental health sector


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opened onto a "critical escape route" alongside flammablematerials. He also highlighted "inadequate arrangements"for calling the fire brigade, a lack of fire dampers and toomany people being housed in one corridor in order toevacuate them effectively.

However, despite this horrific incident, no persons wereprosecuted as a result. Despite two attempts ofprosecution, both failed. At the time of this incident therewas no ‘direct’ fire legislation in place on this type ofoccupancy. The story is quite different today of course andthose tasked with the management of fire safety in theNHS in Wales would be well advised to appraisethemselves of the content of the report. It seems almostunbelievable that no one was prosecuted as a result of thisincident. It is very likely that, had this incident occurredunder current legislation, a prosecution would have beensuccessful and a custodial sentence would have followedfor those charged.

The outcomes of the Inquiry were summarised in FSN12/02 issued by NWSSP-Facilities Services.

* Woodlands Psychiatric Unit, IpswichIn October 2011, a fire occurred at the Woodlands PsychiatricHospital Ipswich. The following information is taken from areport produced by the Suffolk Fire and Rescue Service (SFRS)following an investigation into the incident.

‘At 15:20 on Wednesday 26th October 2011, theWoodlands’ AFA (automatic fire alarm) system activatedshowing a fire had been detected in ‘Poppy Bed 19’. TheSFRS fire investigation which followed concluded that apatient had set the bedding in their room alight with acigarette lighter and then stayed in the room as the firedeveloped.CCTV footage of events in Woodlands at the time of thefire, requisitioned by SFRS from SMHPT as part of thefire safety investigation following the fire, has been aninvaluable source of information on what occurred.The CCTV shows that staff members on the Poppy andAvocet wards did not respond immediately to the firealarm and check the indicated location as would beexpected by the units fire emergency plan, but carriedon with their normal activities whilst a patient withmental health issues in their care was breathing in thetoxic products of combustion in a room which was onfire.The CCTV footage shows that 5 minutes and 20 secondspassed, and the Woodlands fire alarm log records thatthe fire alarm was silenced and reset several times,before any member of the Woodlands staff went tocheck the source of the fire alarm in the patientsbedroom; despite all the fire alarm panels available tostaff showing exactly where a fire had been detected.As a consequence of that delay, the patient wasunresponsive and the conditions in the room were sobad that their assisted evacuation was not possible. Thepatient was therefore left in the smoke-filled bedroomuntil they were rescued by SFRS firefighters at around15:48’.

The FRS carried out a full investigation into the incidentand determined that there were several breaches of theFSO and that only recourse to the courts would be theappropriate action in these circumstances. However, due tolegal issues surrounding a relatively recent Trust merger, itwas found that the new Trust did not carry over legalliability for the former Trust and therefore a prosecutioncould not be pursued.

Given the serious nature of this incident together withthe failings identified, it is very likely that, had theprosecution proceeded, there would have been someserious outcomes for individuals involved in this incident.

❖ Liability: corporate or personal?Prosecutions under the FSO are increasing, as is the auditand enforcement activity by the FRS. Across Wales thereis some inconsistency of approach to the enforcement ofthe FSO in healthcare facilities. Nowhere is this moremarked than in Abertawe Bro Morgannwg where theBoard’s area is straddled by two FRSs. In South Wales inparticular, where the FRS maintain a dedicated team ofofficers specialising in the healthcare sector, there is aclear difference in activity when compared with the othertwo FRSs in Wales. This has resulted in a number ofenforcement notices being issued in the South Walesarea. At least one incident caused the FRS involved toconsider a prosecution. Deliberations are on going acrossthe three FRSs with a view to having a more consistentapproach to enforcement of the FSO across Wales butthis is in its embryonic stages with no guarantee ofchange at the end of it.

So, where does the liability fall? In a severe failingwhere loss of life is experienced through fire it is likelythat at least two actions will follow. These would mostlikely be through the Corporate Manslaughter legislationand most definitely through the FSO route. In the case ofthe former, liability falls on the organisation as the titlesuggests. However, in the case of the FSO, the liabilityfalls directly on individuals who the FRS deemsresponsible for the failings. These individuals may besenior people in the organisation or local managers atward or department level although those having directresponsibility for fire safety management would be thefirst port of call for the FRS. Those responsible formaintenance of equipment may also find themselves thesubject of attention from the FRS if they are deemedresponsible for the failings.

If an offence has been committed and a prosecutionfollows, the FRS will decide who those charges arebrought against. It is almost certain that, at the end of asuccessful prosecution, the defendant will end up with acriminal record, a fine and possibly a custodial sentence.

For further information contact:Gareth Lloyd on 029 2031 5530 ore-mail: [email protected]


NHS Issue 14 4/16/13 8:32 pm

ver the past 12 months, the Primary Care team hasbeen actively involved in the delivery of 12 new

primary care schemes on site. Of these, six havebeen completed, totalling 9,685m2 of space with a totalconstruction cost of £17.35 million.

A further 6 projects totalling 7696m2, with a totalconstruction cost of £17.32 million are currently on siteand are due to be completed this calendar year.

A brief synopsis of each project is included below.

❖ Completed projects ❖ Manchester Square Health Centre, Milford Haven

Project details: Manchester Square Health Centre,Milford Haven

Client: Hywel Dda Health Board,Barlow House Surgery &Robert Street Practice

Third Party Developer: LSP Developments Ltd &Assura Medical Centre Ltd

Floor area: 2067m2 GIACost (TOTAL): £2.8mArchitects: West Hart Partnership LtdBuilding Contractor: Opco LtdProject Managers: Carl Dean Associates LtdM & E Engineers: Chapman Bathurst LtdStart on Site: 29 September 2011Completion date: 22 October 2012

❖ Gelligaer Health Centre, Rhymney Valley

Project details: New Gelligaer Health CentreClient: Aneurin Bevan Health Board &

Gelligaer and Gilfach SurgeryThird Party Developer: LSP Developments Ltd &

Assura Medical Centre LtdFloor area: 891m2 GIACost (TOTAL): £1.7mArchitects: West Hart Partnership LtdBuilding Contractor: Opco LtdProject Managers: Carl Dean Associates LtdM & E Engineers: Waterman Building Services LtdStart on Site: 18 July 2011Completion date: 11 June 2012

❖ Grangetown Medical Centre, Cardiff

Project details: Grange Medical Centre,Grangetown, Cardiff

Client: Cardiff and Vale Health Boardand Dr Lush & Partners

Third Party Developer: MedicX Floor area: 1,248m2 GIACost (TOTAL): £3.5mArchitects: Powell Dobson Building Contractor: Vinci Construction LtdProject Managers: Riley ConsultingM & E Engineers: MLMStart on Site: September 2011Opened to patients: October 2012

Primary Care Estate News

O

Courtesy of John Evans Photography

Courtesy of John Evans Photography

Courtesy of Cardiff and Vale UHB, MedicX and Vinci Construction Ltd


NHS Issue 14 4/16/13 8:32 pm

❖ Hirwaun Medical Centre, Cynon Valley

Project details: Hirwaun Medical Centre Client: Cwm Taf Health Board and

Dr George & PartnersThird Party Developer: MedicX Floor area: 1,324m2 GIACost (TOTAL): £2.8mArchitects: West Hart Partnership Building Contractor: Dawnus Construction LtdProject Managers: Davis LangdonM & E Engineers: MLMStart on Site: September 2011Opened to patients: July 2012

❖ The Wye Valley Surgery, Trellech, Monmouthshire

Project details: The Wye Valley Surgery, Trellech Client: Wye Valley Practice &

Aneurin Bevan Health BoardThird Party Developer: Ashley House Plc Floor area: 473m2 GIACost (TOTAL): £1.1mArchitects: Ashley House Plc, In-house

architects Building Contractor: Cowlin Construction LtdProject Managers: Ashley House PlcCivil and Structural Eng.: Such Salinger Peters

(Design Stage)M & E Engineers: Design & Build sub-contractorStart on Site: 30 August 2011Opened to patients: 30 April 2012

❖ Aberystwth Primary Care Centre

Project details: Aberystwyth Primary Care CentreClient: Padarn Surgery & University

of WalesThird Party Developer: Gaufron Healthcare Limited Floor area: 3,682m2 GIACost (TOTAL): £5.45mArchitects: Austin Smith Lord Building Contractor: Par Homes LimitedProject Managers: Austin Smith LordM & E Engineers: Unitec Webber LenihanStart on Site: December 2010Completion date: March 2012

Courtesy of Cwm Taf HB, MedicX and Dawnus Construction Ltd

Courtesy of David Stewart

Courtesy of Janet Baxter Photography - Aberystwyth


NHS Issue 14 4/16/13 8:32 pm

❖ Beacon Development, SA1, Swansea

Project details: Beacon Development, SA1,Swansea

Client: Tawe Medical Centre, Port TennantPractice, ABMU Health Board,Eastside Dental Centre,University of Swansea College ofMedicine and Coop Pharmacy

Third Party Developer: Apollo Capital Projects Floor area: 3,100m2 GIACost (TOTAL): £7.25m total development costArchitects: B3 Architects Building Contractor: Dawnus ConstructionProject Managers: RPA LtdM & E Engineers: McCann & PartnersStart on Site: October 2011Practical Completion date: 26 April 2013Opened to patients: 13 May 2013

❖ Cloughmore Surgery, Cardiff

Project details: Cloughmore Surgery, Cardiff Client: Cloughmore Surgery – Dr Foy &

PartnersThird Party Developer: Apollo Capital Projects Floor area: 1,050m2 GIACost (TOTAL): £2.5mArchitects: Boyes Rees Architects Building Contractor: Dawnus ConstructionProject Managers: RPA LtdM & E Engineers: McCann & PartnersStart on Site: August 2012Practical Completion date: 2 August 2013Opened to public: 19 August 2013

❖ North Caerphilly Integrated Resource Centre

Project details: Integrated Health & Social CareResource Centre, Rhymney,North Caerphilly

Client: Aneurin Bevan Health Board,Caerphilly County BoroughCouncil, Dr Evans and Dr Potts

Third Party Developer: MedicX Floor area: 3,718m2 GIACost (TOTAL): £7.7mArchitects: Powell Dobson Building Contractor: Dawnus Construction LimitedProject Managers: E C HarrisM & E Engineers: Hicks TitleyStart on Site: 30 April 2012Estimated completion

date: 26 July 2013

❖ On site projects

Courtesy of Apollo Capital Projects Developments Ltd


Courtesy of Aneurin Bevan HB, MedicX and Dawnus Construction Ltd


NHS Issue 14 4/16/13 8:32 pm

❖ Rumney Primary Care Centre, Cardiff

Project details: Rumney Primary Care Centre Client: Rumney Medical Centre,

Cardiff & Vale University HealthBoard and GS Bhogal Pharmacy

Third Party Developer: Apollo Capital Projects Floor area: 2,386m2 GIACost (TOTAL): £6mArchitects: Boyes Rees ArchitectsBuilding Contractor: Vinci ConstructionProject Managers: RPA LtdM & E Engineers: McCann & PartnersStart on Site: August 2012Practical Completion date: 13 September 2013Opened to public: 30 September 2013

❖ Felinheli Primary Care Centre, Gwynedd

Project details: Felinheli Primary Care Centre Client: Betsi Cadwaladr University

Health Board andFelinheli Surgery

Third Party Developer: Amcen Floor area: 880m2 GIACost (TOTAL): £1.9mArchitects: W M DesignBuilding Contractor: Watkin Jones & SonProject Managers: Adeiladol CyfM & E Engineers: Carpenter Davies PartnershipStart on Site: 10 September 2012Estimated completion

date: 30 July 2013

❖ Crymych Extra Care Housing and Health Scheme,Pembrokeshire

Project details: Crymych Extra Care Housing andHealth Scheme

Client: Hywel Dda LHBThird Party Developer: Family Housing Association

(Wales) Ltd Floor area: 712m2 GIACost (TOTAL): £1.715mArchitects: B3 Architects Building Contractor: Cowlin ConstructionProject Managers: Ivor Russell and PartnersM & E Engineers: SABA Consult Start on Site: 23 July 2012Estimated completion

date: 2 May 2014

Acknowledgements

NWSSP – FS is grateful for the information and imagesprovided by each of the individual developers to enablepublication of this feature.

For further information contact:Nicola Powell on 029 2031 5509 ore-mail: [email protected]

SOLAR SHADING BRISE SOLEIL TO SAME DEPTH AS THE SLATEWALL FEATURE PANELS. TO COMPRISE TIMBER LOUVRES ONSAE 316 MARINE GRADE STAINLESS STEEL FRAME

WG - 01WG - 02WG - 18WG - 19

WF - 27 WF - 26 WF - 25 WF - 24 WF - 23 WF - 22 WF - 21

WG - 13WG - 14WG - 15WG - 16WG - 17

ALUMINIUM/TIMBER COMPOSITEWINDOW SYSTEM, NATURAL TIMBERFINISH INTERNALLY AND LIGHT GREYEXTERNALLY AS L10/35A

LINDAB GALVANISED STEEL GUTTERINGAND DOWNPIPES

MOVEMENT JOINT INMASONRY AND RENDER

MOVEMENT JOINT INMASONRY AND RENDER

ASHLAR SLATE WALLING, RANDOMCOURSED BLOCKS AND SIZES

WESTERN RED CEDER CLADDING

SPECIALIST DESIGN GLASSCANOPY OVER MAIN ENTRANCESUPPORTED OFF MARINE GRADESTAINLESS STEEL.

NATURAL SLATE ROOF OFUNIFORM COLOUR AND TEXTURE22.5 DEGREE PITCH AND 100MMMINIMUM HEADLAP

ASHLAR SLATE WALLING, RANDOMCOURSED BLOCKS AND SIZES

100X25MM SQUARE EDGEWESTERN ReD CEDaR AT 150MMVERTICAL CTS ACTING AS SOLARSHADING.

WG - 04WG - 05WG - 03 WG - 20

ED - 02 ED - 01 S - 02

WF - 28

2,1

00

ALUMINIUM/TIMBER COMPOSITEWINDOW SYSTEM, NATURAL TIMBERFINISH INTERNALLY AND LIGHT GREYEXTERNALLY AS L10/35A

IBSTOCK HOLBROOK SANDFACED DARKFACE BRICKWORK BELOW DPC LEVEL

NDAB GALVANISED STEEL GUTTERINGND DOWNPIPES

LINDAB GALVANISED STEELGUTTERING AND DOWNPIPES

FROSTED GLASS TO EXTERNALFIRE ESCAPE DOORS.

MOVEMENT JOINT IN MASONRYAND RENDER

MOVEMENT JOINTIN MASONRYALONG LINE OFSTONE FACING

EXTERNAL LETTERBOX MODEL 6362V BYMAILBOXES GB. SIZE 362X322X104MMMOUNTED AT 850MM TO LETTER SLOTABOVE EXTERNAL GROUND LEVEL

Felinheli HealthCentre

CanolfanIechyd

Prif FynedfaMain Entrance

NORTH EAST ELEVATION 1:100

SOUTH EAST ELEVATION 1:100


Courtesy of W M Design & Architecture LTD

Courtesy of B3 Architects


NHS Issue 14 page 17 5/14/13 3:50 pm Page 4

ecords of all known NHS Wales property holdings arenow stored on the electronic Property Information

Mapping Service (e-PIMS). e-PIMS was originally developed as a central database of

government civil estate properties and land. It has beenadopted and promoted by the Welsh Government and isnow used by almost every public sector body in Wales withover 15,000 property entries including the NHS, localauthorities, national parks, the education sector andemergency services. At the National Government propertyConference on 7 February Wales was commended forleading in the use of e-PIMS as a tool to assist and supportcollaboration.

The system records the precise location of eachproperty, along with associated information such asproperty address, tenure, land and floor areas, landlordand tenant details, lease details and usage.

Users are able to locate individual properties on theelectronic map, access their core property details onlineand view individual properties on interactive maps. Userscan also interrogate the system to identify surplusproperty or vacant space and produce summary schedulereports to list their holdings and associated data. It canalso be set up to send users e-mail notifications offorthcoming lease events such as lease expiries, leasebreaks and rent reviews so that important deadlines arenot missed.

NHS property records are entered onto the e-PIMSsystem and maintained by NWSSP - Facilities Services(NWSSP-FS) who ensure that the database is kept up todate. There are currently over 500 leases and 400 freeholdentries on the system for NHS Wales.

A bespoke e-PIMS report has been developed withNWSSP-FS to record details of all known leasearrangements to enable NWSSP-FS to produce an annualreport for each NHS body highlighting actions which theymay need to take e.g. whether to action a break clause orterminate a lease.

The system also offers the ability to register meeting andconference space (known as Find me Some GovernmentSpace). This information is hosted on a platform that runsalongside e-PIMS and is fully searchable with links to thehost organisation to book space.

As the e-PIMS name suggests, mapping links are a keyaspect in ensuring the veracity of the data contained. Eachproperty holding is linked to its Ordinance Survey gridreference and is viewable on a GIS layer.

The ability to search and list current, future or potentialsurplus vacant space property holdings is available throughe-PIMS. A quarterly update on public sector vacantspace/available property is issued, in electronic format, toe-PIMS users.

Access to the NHS Wales e-PIMS database allows NHSWales bodies to manage their estate more effectively thanever before as they now have a comprehensive, live andup to date record of all of their property interests storedcentrally, but accessible to them online. With the assistanceof NWSSP-FS, the system will help NHS Wales organisationsto take a more informed strategic approach to themanagement of their NHS property assets.

e-PIMS Property Database

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For further information contact:Andrew Nash on 029 2031 5548 ore-mail: [email protected]


NHS Issue 14 4/16/13 8:33 pm

Care by Design

Main entrance

❖ Background

The Cynon Valley wasacknowledged as a typicallydeprived area in South Wales.Coal mining and thenmanufacturing had bothsuffered decline as had thehealth and well being of itspeople. At the beginning of thelast decade, a large proportionof the ageing population wasprone to chronic disease without easy access to medicalservices. When the £58 million Ysbyty Cwm Cynon, CynonValley Hospital, was completed in Spring 2012 the newfacility heralded a new dawn and provided a service pointfor several community teams.

The context to the design brief was the merging of twolocal community hospitals which were approaching theend of their functional lives. While onsite upgrades hadbeen considered there was a concern that this wouldfavour one or the other site and that future provisioncould be prejudiced by the area available for development.The reality was that a disparate collection of buildingscould not provide a service suitable for the future primaryand intermediate care needs of the Cynon Valleycommunity.

From the outset the clear prime objective of the projectwas healthcare improvement for a constituency with a

history of disadvantage. Themerging of local Trusts andthe partnering withneighbouring Trustsdemonstrated a commitmentto growth but presentedearly challenges. For examplethe inclusion of a communitydental unit - a component ofthe Cardiff & Vale dentalschool - expanded theservices provided to the local

community.The Health Board’s ambition was to build a single new

facility to provide a distinct, appropriate twenty firstcentury service. When the lengthy and necessary processeswere finalised and the Outline Business Case work wasvalidated, the proposition was a simplified coherentsolution. The advantage to the design team was that abrand new building could be designed for a greenfieldsite, with focus on the clinical model and an appropriatearchitectural response. There would be many ValueEngineering challenges to meet sustainable objectives butcomplex acute services did not need to be accommodated.

Funded by the Welsh Assembly Government, andmonitored by Welsh Health Estates (now part of NHSShared Services Partnership), the new facility takes forwardand significantly improves the previous provision ofservices, ranging from community and children’s

A Can Do approach inthe Cynon Valley.

‘The best way to predict the futureis to create it’

Peter Drucker’s aphorism applies readily to thenew neighbourhood hospital in Mountain Ash.

Seen in historical context it is an inspiringcommunity asset which demonstrates thepotential of design delivered with both

ambition and sensitivity.


NHS Issue 14 4/16/13 8:33 pm

outpatients to physio and occupational therapy, fromcommunity mental health to in-patient mental health forthe elderly.

❖ Community Engagement, Briefingand Aspiration

In 2004 the architects and Local Health Board began theirengagement with local authorities and community forumsaddressing concerns of the community about the closure ofthe old Aberdare and Mountain Ash Hospitals.

The design team recognised that change is often metwith concern and scepticism rather than enthusiasm;equally they hoped that change could be a catalyst forgrowth and a real benefit for the community. Imposingfacades and high-tech finishes would be considered tooalien. The development of the brief and the evolution ofthe building design was structured almost entirely aroundthe user process and the need to meet expectations of thestaff of each department as well as the wider community.

With an agenda to produce a sustainable building theteam drew on the early lessons learnt from communityconsultation to develop a design philosophy where aquality public building would emerge from a holisticapproach. Respect for context and community wasparamount.

In addition to community forums, the team also beganengaging with the local school as an immediate neighbourand in support of its syllabus. Early consultation kept theschool abreast of the practical implications of the

construction process, as well as facilitating educational sitevisits. Enthusiasm from the school could give rise topractical and far reaching interests, aspirations and futurecareers in construction.

The brief and initial concept was shaped by theaspiration that a calm, well designed environment wouldbe a place that could engender pride of place and assist inthe recruitment and retention of staff by providing goodworking conditions.

The simplicity and structure of the essential form beganto take shape after the initial rounds of user consultation,with future department functions and requirementsdiscussed around the table. With new ways of workingproposed and future merging Trusts being considered, thedesign quickly took on board the requirement to have alevel of functional flexibility. The final design form was tobe as simple as possible, its primary axes and flowsrecognising the balance between security and access.

As well as being a landmark neighbourhood hospital,this was to be a facility promoting a strong focus onhealth, social integration and reinforcement of the localidentity.

An attractive site in Mountain Ash, formerly a MiddleDuffryn colliery tip, alongside a meandering river provideda sympathetic setting for the designers to create a non-institutional environment. To do this the team looked tothe surrounding community and landscape, drawing onthe scale of the local buildings and vernacularsupplemented by form, articulation, colour and integratedpublic artwork.

Aerial view


NHS Issue 14 4/16/13 8:33 pm

❖ Realisation

Externally the first impression is of clean lines and apristine palette of organic materials: white renderaccented by areas of stone walling (notably at thecanopied main entrance) and external stair pods clad withvertical natural finish timber boarding. The sedum coveredroof planes blend with the landscape from the higherlevels of the valley. The standard of construction andfinishes throughout are of a very high order.

The articulation and composition of these materials isboth elegant and inviting which serves to take away anydiscomfort about entering an institution. Many people areuncomfortable about going into hospitals even if it is justto visit or attend an out patients appointment.

The layout of the building is simple, and therefore quitelogical with the plan based on a simple curved axial modelallowing a focus on fenestration with views out and

daylight in. The radius of the main circulation ‘streets’softens the user experience and avoids the institutionalcharacteristic of long straight corridors.

The ground floor accommodation comprises: MinorInjuries, Radiology, Therapies and OPD (Physiotherapy,Occupational Therapy, Speech and Language, Audiology,Podiatry, Orthotics, Dietics, Orthoptics). The Mental HealthDepartment covers many bases and includes continuingcare beds, an Adult Day Unit as well as Community Drugand Alcohol Team facilities. The Children’s Centre

incorporates its own dedicated OPD. Thereis a Community Dental Unit incorporating18 chairs which provides training facilities.Palliative Care and POA wards, Pharmacyand Mortuary are also included.

The first floor accommodates the wards,100 Rehabilitation and Intermediate Carebeds, Restaurant, Multi Faith Centre,Offices, Medical Records andAdministration.

At around 18,500m2 and two-stories, thelayout of the building is driven by userprocesses, departmental relationships,way-finding and matters of security. Thefocus on community health, rehabilitationand continuing care means thatcommunity hospitals are less intensively

serviced than their acute counterparts, with a wider scopefor features that encourage natural light and ventilationand a resultant economy of energy use.

The whole interior environment is planned aroundcourtyards provided for the wellbeing of both patients andstaff and to make a peaceful and pleasant environment.The courtyards have been lovingly detailed with hard andsoft landscaping as well as commissioned sculpture works.

Front elevation

Site Plan

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NHS Issue 14 4/16/13 8:33 pm

First Floor Plan

Ground Floor Plan


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Inside the building a clean neutralpalette of interior finishes have beenlayered with colour and community art,features that aspire to lift the building.The applications are both cosmetic andpractical; in the atrium, colour isintroduced as part of the way-findingstrategy, providing visual contrast wherenecessary. These colours correspond withthose used in the designation ofdepartments. Each departmentalentrance point is punctuated by a curvedand coloured coded projection into thecirculation space. To enhance the idea ofa living building, subtlewashes of LED colour, thatcycle over the course ofthe day, wash over theexposed columns andbeams of the entrancespace.

A further feature of thedesign was the inclusionof public spaces beyondmere access and amenity.The hospital restaurantwas given pride of place,with generous provision ofa terraced external area.Its design was integrated

Project Details

Start on site: December 2008

Completion: April 2012

Floor area: 18,500 m2

Outturn cost: £70+ million

Client: Cwm Taf Health Board

Architects: HLM

Structural Engineers: Buro Happold

M&E Engineers: Arup

Quantity Surveyors: Gleeds

Project Manager: Capita

Main Contractor: Vinci Construction UK

Atrium, showing washes of LED lighting

Atrium, showing washes of LED lighting and mural


NHS Issue 14 4/16/13 8:33 pm

as an extension of the main atrium, as was access tooutside space generally. In keeping with the intendedfunction of the public space, the atrium/concourse is beingused as a venue for community activities.

❖ Energy and sustainabilty

With the opportunity to design a building on a greenfieldsite from inception, the design team and client were ableto review technical solutions to energy saving and todevelop functional solutions based on holistic principles.An example of this was the need to evolve the essentialprovision of working space for the Local Health Board,with new concepts such as hot-desking, shared meetingareas and collaborative working forming part of themanagement plan. As part of the development, the HealthBoard also initiated a green travel plan.

The design approach was led by the use of passivemeasures such as natural daylight and natural ventilation,complemented by the landscape, spatial quality andmaterials, functioning cohesively to provide anenvironment that is intended to evoke well being.

With the absence of intensive care and surgicaltreatment, the model of care is often more centred on a

longer term treatment. A communityhospital typology also lends itself to alower energy model. Acute medicalbuildings are often characterised by deepplan arrangements which requiremechanical ventilation. Smaller scalebuildings can rely on natural and crossventilation.

With cost effectiveness a priority, severalsustainable technical solutions wereexplored with others ultimately excluded,even though the original criteria set by theclient were not nearly as stringent ascurrent guidance would suggest. Thiswhole process was managed through aseries of workshops with the client andsteered by cost benefit analyses.

The solutions agreed and ultimatelyadopted are the use of Biomass fuel and aSUDS drainage system, both relatively new

technologies for Welsh Trusts at the time they werechosen. The remaining building systems were based on alow energy model with an overarching strategy of lowcarbon emissions whilst simultaneously improvingoccupant comfort levels. Where clinical requirements donot dictate the system the building adopts ‘mixed-mode’ventilation. Notable examples are the ward areas whichare naturally ventilated and passively moderated byexposed soffits. This natural ventilation design provideshigh levels of occupant control, with restricted openingwindows providing good air movement through theoccupied ward areas and clinical spaces around the

Waiting area

Restaurant terraced external area

Curved circulation space and natural daylighting


NHS Issue 14 4/16/13 8:33 pm

perimeter of the building. The large window openings arebalanced by appropriate low-e glazing and internalscreening to promote well controlled natural daylight.Roof lights, several courtyards and upper level light wellsdistribute natural light to areas that would not normallyreceive any.

In terms of support and monitoring,energy meters are provided to enable atleast 90% of the annual energyconsumption of each fuel to be assigned toend use categories. Zones of the buildingwith different solar exposure, occupancy oruse have separate time and temperaturecontrols and central plant is intended tooperate only when the zone systemsrequire it. At design stage the range ofenergy consumption was modelled asbeing between 11% and 34% better thanthat of the ‘good practice’ communityhospital and between 27% and 48% betterthan the ‘good practice’ general hospitalwhile the Energy Performance Certificationwas a ‘B’ rating (33%), commendable giventhe size and function.

In the selection of materials the aim was to avoidunsympathetic and alien products, focusing on naturalrenders, local stone and the ‘green’ sedum roof in order toproduce a building that sits naturally in its valley setting.

❖ Healing Arts

The central role public art would play was established atthe outset with a Healing Arts group set up involving theHealth Board’s design champion and the design team. TheArts programme was developed through consultation withstaff and local arts consultants. Focusing on the naturalenvironment, the Arts brief was formulated to providemurals, wall mounted art, photography and sculpture

procured through a process of competition, bid andinterview.

Throughout the development of the brief, the earlyconceptual design, the design development and finally thelandscape and interior design strategy, the architectsworked to a set of core principles as a guide and measure,

so that there would alwaysbe scope to extend theseinto a more creative realm:Simplicity, Colour, Light,The River, Bringing theoutside in, Natural Assetsand the NaturalEnvironment.

As an extension of theguiding principles, the artsbrief suggested developingthese various sensory linksby exploring: Texture,Sustaining new growth,Blue Skies, Growth, Sewingthe seeds, New Beginnings,New Shoots,Animals/insects, Nurturingnew growth.

During the programme, the artists were asked toconduct workshops with the community, staff and localstudents. In parallel, workshops took place at 3 localprimary schools, while second year Art Practice students atthe University of Glamorgan were commissioned toproduce artworks for the hospital. Eighteen studentsopted to pitch for the commission within their professionalstudies’ live project module, a part of their degree. Basedon a brief from the Health Board they produced acombination of paintings, drawings, photographs, prints,computer generated images and textiles.

Spaces were identified as opportunities for artworkwithin the overall scheme: Café/dining area, Atrium,Ground and First Floor Storage walls, ward corridors

Nurse station

4-Bed room


NHS Issue 14 4/16/13 8:33 pm

Children’s Centre, Mental Health ‘gallery’ wall andTherapies courtyards.

In the atrium, colour is introduced as part of the way-finding strategy. Bold, vibrant hues are used to supplementthe signage. These correspond with the same bold use ofcolour in the designation of departments and the inclusionof coloured glass panes in the fenestration.

The placement and colour of the artworks were basedon their location – the amount of light and departmentcolours being the guide.

❖ In Summary

The creative balance of its sustainability targets ofrenewable resources with sensitive architecture andintegrated artwork is testament to the level of careinvested in the project and its achievement.

This collaborative and holistic approach to the projectprovides added value delivering much more than a newmedical facility which meets narrow functional objectives.The approach demonstrates and surpasses the classictheme ‘care by design’ which characterised the acclaimedWelsh Community Hospitals of earlier years.

The story began with consultation with a communitysceptical about change and closure of two old hospitals.The client and design team had worked closely with localauthorities and the community forum from the outset andthe collaboration has certainly delivered dividends.

The new facility has not yet been open for a year butthe atrium is already being used as a venue for communityactivities. Included are local churches whose congregationshave conducted afternoon services in the Dining room. Theterrace overlooking the river has hosted a brass bandperformance. Other visitors have been the local ladies

choir "Cytgord"from the CynonValley, as well asthe performing artsgroup fromMountain AshComprehensiveSchool. Staff havecommented thatthe atrium is anattractive socialgathering space on a normal day but looks and sounds likea theatre when a performance takes place.

That the new hospital can bring significant serviceimprovements and deliver so much more to its users istestament to its pride of place and its evolution as a truecommunity hospital.

Acknowledgement

The review of Ysbyty Cwm Cynon was carried out by PhilWithecombe on behalf of NHS Wales Shared ServicesPartnership – Facilities Services. Phil is an Architect withmany years’ experience in the health design sector. We aregrateful for the assistance provided by Cwm Taf HealthBoard as well as HLM Architects who also supplied theplans and photographs.

All Photographs courtesy of HLM and Trevor BurrowsPhotography.

Artwork



NHS Issue 14 4/16/13 8:33 pm

❖ Safe & Sustainable BuildingsSeminar

n November 29th 2012 NWSSP - Facilities Servicesheld the latest in a series of Safe & Sustainable

Buildings seminars at the Royal Welsh Showgroundin Builth Wells. Aimed at estates professionals workingacross the NHS in Wales, the seminars always focus ontopical subjects covering a range of engineering,environmental and energy efficiency issues.

The latest seminar was very well attended with 25delegates representing all the Health Boards and Trusts inWales. It featured a series of interesting and informativepresentations on topics as diverse as the application of LEDlighting technology from Thorlux Lighting; developmentsin sustainable low carbon building cladding materials fromTata Steel (Becky Marks of Tata Steel pictured); and theapplication of ultraviolet (UV) sterilisation techniques forventilation systems by Steril-Aire Ltd.

As always, the event stimulated much debate anddiscussion, providing useful food for thought for delegatesto take away. It is hoped to hold further Safe &Sustainable Buildings events during 2013.

Environmental News

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❖ The shape of things to come

o, we are not talking about a H.G. Wells novel, butthe Welsh Government’s Sustainable DevelopmentBill due to become law this autumn.

The Welsh Government has published a SustainableDevelopment White Paper “Better Choices for a BetterFuture “. Its key objective is to bring in legislation that willplace a duty on organisations delivering public services inWales, to have sustainable development as their centralorganisational principle. The White Paper also includes forthe creation of an independent sustainable developmentbody for Wales that will:

■ Provide expert advice and guidance to organisationsto help them embed sustainable development.

■ Support collaboration between organisations,emphasising an integrated and collaborative approachto sustainable development.

■ Be an independent advocate for the future.

The fine details of how this is all going to work and theduties of the independent body are still to be determined,but there will also be an enhanced role for Local ServiceBoards and the Auditor General for Wales.

There will be a phased implementation following theformation of the independent sustainable developmentbody, with Local Health Boards and NHS Trusts beingsubject to the requirements of the bill from 2016.

The consultation on the White Paper was concluded inearly March this year. NWSSP – Facilities Services willtherefore be monitoring closely the progress of this billand, as details emerge, will be assessing its impact on theNHS in Wales.

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For further information contact:Eric Thomas on 029 2031 5519 ore-mail: [email protected]

For further information contact:Eric Thomas on 029 2031 5519 ore-mail: [email protected]


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❖ Welsh Government consults on Site Waste Management Plan proposal

he Welsh Government is currently consulting onproposals to introduce requirements for Site WasteManagement Plans in Wales. The regulations were

introduced in England in 2008, but the current proposalsfrom Welsh Government differ from the Englishregulations in a number of ways.

In short, a Site Waste Management Plan (SWMP) is aplan to help clients, developers and contractors in theconstruction and demolition sector think before the startof a project about the waste that will be produced, how toreduce this waste and how to plan to sustainably managewaste that does arise.

The hope is that SWMPs will have a positive impact, forexample, by:

■ Helping to tackle the large volume of waste sent tolandfill by the Construction and Demolition sector;

■ Addressing the number of illegal waste sites in Wales;

■ Helping to tackle the number of fly-tipping incidents;

■ Improving resource efficiency;

■ Reducing the sector’s carbon footprint.

The key difference between England and Wales is that inEngland the scheme only applies to projects over £300,000in size. However, in Wales the proposal is to have no lowerthreshold meaning that any construction or demolitionproject that requires planning and building regulationapproval would also require a Site Waste ManagementPlan. This could be anything from a major hospitaldevelopment project down to a private householder who

is building an extension to their kitchen for example!A second key difference in Wales is to make the client

fully responsible for compliance with the regulationsrather than a ‘principal contractor’ as is the case across theborder. In the case of the NHS this would obviously meanthat there would be a much greater onus placed uponLocal Health Boards to be an informed and pro-activeclient, which is no bad thing. But at the other extreme, itsuggests that the private individual building their kitchenextension would need to ensure that they fully understandthe requirements, what an SWMP entails and how theirwaste is being handled.

As you can see, these proposals have the potential toimpact on everyone involved in construction anddemolition both at a corporate level and at a householderlevel. But currently these proposals are still being debatedand consulted on and so the message as usual is “watchthis space”.

The consultation is open until April 25th 2013 with theintention to introduce the regulations in 2014, withrequirements taking effect from 2015. For moreinformation and to download the consultation documents,go to:

http://wales.gov.uk/consultations/environmentandcountryside/site-waste-plans/?status=open&lang=en

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For further information contact:Chris Lewis on 029 2031 5498 ore-mail: [email protected]


NHS Issue 14 4/16/13 8:33 pm

n December 2012 NHS Wales Shared Services Partnership Facilities Services (NWSSP-FS) published the FacilitiesPerformance Report 2011/12. As with the Estates

Condition and Performance Report featuredon pages 8-11, the information contained inthis report is based on data submitted byNHS Health Boards and Trusts in Wales tothe on-line Estates and FacilitiesPerformance Management System (EFPMS)for the period April 2011 to March 2012.The system, which is managed by NWSSP-FS and has been operational since 2001/02,provides data on the following services:

■ Catering

■ Cleaning

■ Portering

■ Laundry and linen

■ Telecommunications

■ Security

■ Postal

In addition, the report includesinformation on car parking.

Hotel services are critical to thedelivery of patient care and have amajor influence on the patient experience. In 2011/12these services cost the NHS in Wales approximately£168 million, a reduction of over £6 million on the

previous year. It is reasonable to expect the NHS to providethese services cost effectively whilst ensuring the quality ofthe service is not compromised. This is where the EFPMSand the NWSSP-FS annual performance reports can provide

useful benchmarkinginformation forindividual NHS HealthBoards and Trusts tomonitor theirperformance. By way ofillustration, Figure 1shows the cost/m2 forthe above serviceswithin each HealthBoard/Trust. Acomparison betweenorganisations shouldlead one to question thewide variation in cost/m2

and should be a driver toimprove performance.However, a word ofcaution is necessary: thereporting system does notlook at the quality of theservice provided. Adding aquality dimension wouldgreatly enhance the valueof such a cost comparison

table. Currently, however,such information is not available.

The NHS estate in Wales:What the 2011/12 Facilities PerformanceReport has to say about hotel services

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£/m2

Organisation

Abertawe Bro Morgannwg University Health Board 28.51 32.95 18.39 7.07 8.51 2.38 3.91

Aneurin Bevan Health Board 26.19 26.21 10.46 7.06 5.98 1.63 2.37

Betsi Cadwaladr University Health Board 29.66 27.78 16.67 5.07 7.10 1.87 3.59

Cardiff and Vale University Health Board 28.84 27.11 8.56 7.09 3.97 3.66 1.88

Cwm Taf Health Board 30.94 42.78 20.02 8.58 7.85 2.57 2.68

Hywel Dda Health Board 32.46 37.40 16.06 7.45 6.17 0.51 4.17

Powys Teaching Health Board 38.01 50.51 12.22 3.44 9.65 0.04 4.39

Velindre NHS Trust 18.87 23.50 14.28 4.11 8.18 4.46 3.15

Average cost/m2 across Wales 29.18 31.24 14.44 6.72 6.57 2.18 3.08

Figure 1: Cost comparison of individual hotel services provided by NHS Health Boards/Trusts

THE NHS ESTATE IN WALESFacilities Performance Report

2011/12

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Figure 2: Cost comparison of hotel services provided by NHS Health Boards/Trusts

Organisation Total cost of hotel services (£/m2)

Abertawe Bro Morgannwg University Health Board 101.92

Aneurin Bevan Health Board 79.47

Betsi Cadwaladr University Health Board 91.76

Cardiff and Vale University Health Board 81.11

Cwm Taf Health Board 126.82

Hywel Dda Health Board 104.22

Powys Teaching Health Board 118.26

Velindre NHS Trust 76.54

Percentage of total hotel services costs for each organisation

Organisation

Abertawe Bro Morgannwg University Health Board 27.97 32.33 18.04 6.94 8.55 2.34 3.84

Aneurin Bevan Health Board 32.96 32.96 13.17 8.88 6.99 2.05 2.98

Betsi Cadwaladr University Health Board 32.32 30.27 18.17 5.53 7.76 2.04 3.91

Cardiff and vale University Health Board 35.56 33.43 10.55 8.74 4.90 4.51 2.31

Cwm Taf Health Board 33.39 33.73 15.78 6.76 6.19 2.02 2.11

Hywel Dda Health Board 31.14 35.89 15.41 7.15 5.92 0.49 4.00

Powys Teaching Health Board 32.14 42.71 10.33 2.91 8.16 0.03 3.72

Velindre NHS Trust 24.65 30.70 18.65 5.37 10.69 5.82 4.11

Average percentage across Wales 32.03 33.06 15.28 7.11 6.95 2.31 3.26

Figure 3: Percentage of total hotel services costs for each NHS Health Boards/Trust

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❖ Catering servicesApproximately £54 million was spent on cateringoperations in the NHS in Wales, of which, labour costsaccounted for just over £30 million (approximately 56%).The cost of feeding one patient for one day performanceindicator was replaced for the first time with the cost of apatient meal. This averaged £3.34.

The percentage of food waste relating to untouchedmeals was 7.7%, falling well within the 10% target set bythe Welsh Government and costing the NHS approximately£937,000. Performance in terms of wastage variedsignificantly between organisations, with examples ofparticularly high rates, several exceeding 20% forindividual hospitals.

It is clear from the data submitted to the EFPMS that avariety of methods of food service systems are used toprovide meals to patients in Wales, ranging fromconventional cooking to cook-chill and cook-freeze. The

decision on which systems are adopted is left to individualHealth Boards and Trusts. Figure 4 opposite, provides abreakdown of food services used. It is interesting to notethat conventional cooking is the most widespread cookingmethod employed.

Figure 2 shows the total cost of hotel services provided byNHS Health Boards/Trusts. Again, it is interesting to note

the variation in costs between organisations.

Of interest is also the proportion of the total hotel servicescosts spent on each service by individual organisations. Thisis summarised in Figure 3. By far the biggest proportion ofhotel services costs was spent on cleaning services

(approximately 33%) and catering services (approximately32%). Effective management of these particular services istherefore important. A few interesting facts about thesetwo services are included in the remainder of this article.


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Since the publication of the Wales Audit Report ‘HospitalCatering and Patient Nutrition’ in March 2011, NWSSP –Facilities Services has been working closely with the WelshGovernment, Health Boards and NHS Trusts on three keyinitiatives:

1. The development of an all-Wales menu recentlylaunched by the Health Minister.

2. Exploring options around the introduction of all-Walescatering costing software designed to improve thedelivery of catering services, improve cost control andachieve greater consistency in data reporting.

3. Exploring the scope for achievinggreater collaboration betweenHealth Boards/Trusts in the deliveryof catering services, looking, forexample, at the role of CentralProduction Units.

❖ Cleaning servicesJust under £56 million was spent oncleaning operations in the NHS inWales, an increase of 1.2% on theprevious year. The all-Wales averagecost of cleaning operations was justover £31/m2.

The service was provided by just over2,300 whole time equivalent staffworking over 4.2 million hours. Boththe number of hours worked and thenumber of whole time equivalent staffdecreased by approximately 3.5% sincethe previous year.

Cleaning is the only hotel service where a measure ofquality is recorded in the EFPMS. The figures are based onself audits. The all-Wales average was just under 90%(down from 91% the previous year) and ranged between70% and 99%. Clearly there is scope for improvement.Credits 4 Cleaning software continues to be utilised byHealth Boards/Trusts to monitor their cleaning operationsand its use to provide central returns is mandatory.

For further information contact:Martin Allen on 029 2031 5529 ore-mail: [email protected]

Figure 4: Percentage of patient meals provided according to type of service

Hybrid 6%

Cook freezebulk 35%

Cook chill bulk 3%

Cook freeze plated 2%Conventional

bulk 30%

Conventionalplated 24%


NHS Issue 14 4/16/13 8:33 pm

esley Griffiths, Minister for Health and Social Careconsiders the HPE programme very worthwhile and a

reliable barometer of the state of the hospitalenvironment year on year’ reported Carol LamymanDavies, Director, Board of Community Health Councils inWales at the 2012 HPE Evaluation day. The 10-yearmilestone since the publication of the first Hospital PatientEnvironment (HPE) programme provides an opportunity tolook at some of the key recommendations that theCommunity Health Councils (CHC) are making to HealthBoards to improve patient care.

The seeds of the HPE assessments were sown inresponse to the Welsh Assembly Government’s plans forthe health service in Wales set out in Improving Health inWales: a Plan for the NHS with its Partners published in2001, which states that ‘the people in Wales, and thehealth professionals who care for them, have the right toexpect health care delivered in a modern, clean, well-maintained environment’. As a result, the first round ofHPE assessments carried out by CHCs were completedin 2003.

HPE assessments currently apply to all patient areas inhospitals except those dedicated to caring for the mentallyill. They focus on issues such as decoration of patient areas,the adequacy of hospital signage, environmentalcleanliness and the quality and availability of meals. Inessence, they seek to establish whether patients’experiences whilst in the care in the NHS are good or poor,and ascertain how widespread those experiences may be.Initially, the programme assessed major acute hospitalsonly; this was expanded in 2005 to include a selection ofcommunity hospitals.

The first step in the process is for Health Boards toconduct a one-off comprehensive ‘baseline’ self-assessment of the facilities to be inspected when these arefirst introduced into the HPE programme. Baselineassessments are followed by annual independent externalassessments conducted by CHC teams consisting of staffand volunteers. The standard of facilities and serviceprovided is recorded on the basis of predefined criteria.Findings are fed back to Health Board staff and, whereappropriate, actions are agreed. Progress is monitoredthrough follow-up visits.

❖ Evolution of PEARSThe first Trust baseline self-assessments were submitted inhardcopy in May 2003 and the results were entered andheld in a database maintained by the former Welsh HealthEstates (WHE) in order to provide reports of the findingsto the CHCs prior to their visits.

The Association of Welsh Community Health Councils(AWCHC) co-ordinated the Federation HPE Teams andprovided training for members and staff on the HPEprogramme. The Federation Teams carried out their initialvisits in September 2003, and submitted their findings inhardcopy to WHE for database entry, collation andanalysis.

The Teams had access to reports of the Trust baselineassessments relevant to the sites they visited and sampledareas for independent external assessment. This allowed arepresentative view of the hospital to be made and areview of progress by Trusts with their action plans ifrequired. An Annual Report of the visits was produced bythe AWCHC for the Welsh Assembly Government inJanuary 2004.

In May 2004, WHE (now NWSSP - Facilities Services)approached Health Solutions Wales (now NHS WalesInformatics Service (NWIS)), to develop a system thatallowed Health Boards and Trusts to enter theirassessments through a simple web-based interface. Thesystem, known as PEARS (Patient Environment AssessmentReporting System) was delivered in readiness for theNovember 2004 CHC inspections which were part of the2004/5 HPE programme.

Since its launch in 2004, PEARS has been enhancedincrementally under the stewardship of the CorporateApplications Team within NWIS, in response to feedbackgained from CHC feedback days and other stakeholders:

■ In 2005, the system functionality was enhanced toallow data from the assessments to be submittedand finalised so as to prevent further alteration; italso allowed follow-up assessments to be generatedfrom previous assessments, enabling CHCs tomonitor progress against action points.

■ In 2006, for the first time, Health Boards wereprovided with the facility to include comments onCHC action plans within PEARS.

■ In 2009, it became possible for assessments to bemarked as daytime and/or night time.

■ In 2011, the scoring system was simplified – nowaspects could be marked as ‘unsatisfactory’,‘satisfactory’ or ‘highly satisfactory’.

■ In 2012 a new dashboard (see Figure 1 opposite) wascreated to give users more of the context of the HPEprocess, showing related news items and documents,and displaying at a glance the most recentassessments for viewing.

The Hospital PatientEnvironment Programme 10 years on

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NHS Issue 14 4/16/13 8:33 pm

New video guides were also createdin 2012 (see Figure 2) to guide usersthrough some of the main featuresof PEARS.

In 2011 a Task and Finish Group was set up to review theHPE Assessment forms. The conclusions/recommendationsmade by the group were as follows:

■ A need to simplify the paperwork

■ A need to reduce scoring categories from 5 to 3grades: ‘unsatisfactory’, ‘satisfactory’ and ‘highlysatisfactory’.

■ Provide for comments to be made for all entries.

■ To design a new aide memoir.

■ Provide clarification regarding the definition of‘common areas’.

■ CHC HPE leads should be more proactive and decideon common areas to be visited from a map of thepremises. This would aid clarity for the visiting teamsand avoid duplication of activity.

■ A need to change the Assessment Form design fromportrait to landscape.

Most, if not all of the recommendations have beenimplemented.

Figure 1: PEARS Dashboard

Figure 2: Video guide

❖ Summary of the 2012 Board of Community Health Councils’ annual reportrecommendations

External Areas

• Security provision should meet the requirements of theNational Framework for Security Management and thisinformation should be communicated to CHCs eitherthrough the action plan or recorded within PEARS.

• Litter, particularly cigarette butts continues to cause acleanliness problem. Although there has beenimprovement, this is a long-standing issue that requiresenforcement.

• Pavements should be well maintained to allow for safeaccess and should not pose a hazard.

• External signage should be appropriate and visible at alltimes of day and be compliant with the Equality Act 2010.

Entrances and Main Reception Areas

• Communication support equipment (e.g. inductionloops) should be made available at all entrance andreception areas. Where equipment exists it should beclearly signed and staff aware of and trained in its use.


NHS Issue 14 4/16/13 8:34 pm

• Reception furniture should adequately provide for awide range of diverse needs (e.g. arm rests, raised seats).

• You-are-here maps and other signage should bedisplayed clearly at appropriate locations and shouldconform to existing Wayfinder scheme guidelines.

• Maintenance issues relating to toilet facilities should bedealt with in a timely manner and sufficient accessibletoilets that do not include baby changing facilitiesshould be available. Baby changing facilities shouldfeature in both male and female toilets.

• Alarm systems should be provided in all toilets.

Corridor, Lift and Stair Areas

• All lifts should be functional, clean and free from clutter.Signage should be clearer.

• Directional aids and clear You-are-here maps should bedisplayed at appropriate distances within hospitalcorridors within areas that are free from clutter.

• Public telephones should be available within thehospitals and be clearly signposted. Where these are notavailable, the public should be made aware ofalternative arrangements.

• The cleaning of corridor, lift and stair areas should becarried out paying more attention to detail and shouldbe more closely monitored.

• Clinical waste disposal should be closely monitored giventhe risks of cross infection.

Ward

• Investigate inconsistencies in the provision of handhygiene facilities, focusing on problems in the provisionof hand hygiene at mealtimes.

• Consistency should be achieved in the provision of handhygiene facilities at mealtimes and a decision should bemade on the appropriateness of providing bedsidefacilities or supplying individual sachets.

• The National Protected Mealtimes policy should beadhered to. Ward staff should not prevent relatives orfriends from attending during mealtime periods if theyare there to provide assistance to patients.

• On-going problems of space utilisation and in particularthose associated with the inappropriate storage ofequipment should be addressed.

• Toilet facilities on wards should be appropriate in termsof numbers, single sex use, signage and privacy.

• Day rooms on wards should be used for the purpose forwhich they were provided and should not be filled withequipment and used for storage.

• Policies, procedures and systems relating to the supply ofclean linen should be reviewed to ensure sufficientstocks are available at all times.

Departments Areas

• Appropriate signage should be displayed in alldepartments with attention to clarity and accuracy ofwording. Clear and up-to-date ‘You are here’ mapsshould be appropriately located.

• Sufficient accessible toilets should be provided. Where

space does not permit, clear directions to the nearestfacilities should be provided.

• Effective hand hygiene practices should be publicisedthrough visible literature.

• Instructions on the telephone policy relating to mobiletelephones should be provided along with theavailability and location of the nearest public telephone.

❖ What difference has the HPEprogramme made over the lastdecade?

It is a fact that certain topics, such as the inadequacy ofstorage, the inappropriateness of signage and evidence ofsmoking in non-smoking areas regularly feature in annualboard reports. Does this mean that the HPE programmeover the last decade has failed to deliver improvements inthe patient environment? Not at all! Typically, problemsidentified in specific areas assessed by CHC teams areaddressed, even if they are not always rolled out across theHealth Board concerned.

Importantly, however, the HPE programme delivers moregeneral benefits:• It ensures that, on a regular basis, the patient

environment comes under the scrutiny of independentassessors whose only interest is the patient and thequality of the patient experience.

• Deficiencies are brought to the attention of HealthBoards with recommendations for improvements. Thisfresh, critical, view of healthcare facilities is appreciatedby Health Boards.

• Patients find it helpful to be able to discuss issues withCHC members who are there specifically to look afterthe interests of patients.

• CHCs have the ability to escalate severe concerns to theWelsh Government on behalf of patients.

• Health Boards are using actions and recommendationsarising from the HPE programme to inform serviceplanning.

• The HPE programme is seen as a process of ContinuousQuality Improvement.

For further information contact:Martin Allen on 029 2031 5529 ore-mail: [email protected]

Ysbyty Ystrad Fawr. Courtesy of Aneurin Beavan Health Board and BAM


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he idea behind the Project Gallery is to provide a fewexamples of projects recently completed or nearingcompletion in the NHS in Wales. They are a reminder that

significant capital investment continues to be directed to theNHS estate.

NWSSP – Facilities Services is grateful for the assistanceprovided by Health Boards/Trusts in producing this feature.

Project Gallery

T Further information on the projectsincluded here can be obtained fromNigel Davies, Head of EstateDevelopment Section at NWSSP - FacilitiesServices on 029 2031 5543 ore-mail [email protected]

CWM TAF HEALTH BOARDThe Kier Hardie HealthPark, Merthyr TydfylCompleted in June 2012 andofficially opened by the HealthMinister on 31st January 2013,this facility provides a mix ofCommunity Healthcare facilities,including: Primary Care, AdultLearning, Mental Health, Dentalservice and Therapy services.

The building was designed andconstructed using the WelshGovernment’s Designed for Life:Building for Wales framework.

ABERTAWE BRO MORGANNWG UNIVERSITY HEALTH BOARDSpecialist Rehabilitation Centre, Morriston Hospital

This new Centre has extended an existing buildingto provide purpose designed accommodation forthe Artificial Limb and Appliance Centre,Rehabilitation Engineering Unit and OrthoticsService. The building will include clinical consultingand treatment facilities for people who have lostlimbs, for those who require sophisticated seatingand mobility aids, and for those requiring structural

and functional support to returnto and maintain their day to dayactivities.

As would be expected in acentre of this type, the buildingis fully accessible in compliancewith The Equality Act and comescomplete with the latest assistedchanging facilities and callsystems.

A second phase is currentlyunderway to refurbish theexisting building, update themanufacturingfacilities and provide a medicalequipment library and

accommodation for the Medical EquipmentManagement Service.

At an overall project cost of approximately£9.5 million, the clinical accommodation wascommissioned into use in January 2013 and thecompletion of the refurbishment work is due inApril 2013.

Photo courtesy of ABMU Health Board

Photo courtesy of Cwm Taf HB and Laing O’Rourke


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Since opening in December2012, Ysbyty Glan Clwyd’sMortuary and BereavementCentre has already receivedattention for its modernfacilities.

Laing O’ Rourke alongwith Supply Chain PartnerMTX Contracts Ltd werecontracted to design andbuild a new stand-alone,550m2 state of the artMortuary facility. Theproject was handed over tothe Betsi CadwaladrUniversity Health Boardwithin a period of just 28weeks (June to December2012) and came in wellwithin budget.

The modular build wasrecently awarded the Denbighshire County CouncilBuilding Control Excellence Award 2013 in the BestHealthcare / Community Project Category. The standalone building was recognised for the quality andfinish of the build both inside and out.

The new, modern, facility contains a post mortemroom, body fridges, offices, changing rooms,viewing room and observation area, all of which areserviced by a dedicated plant room located on thefirst floor. The modular building is unique andcompares to that of a traditional building with clearopen spans and solid concrete floors to all areas.

The new facility is externally finished withbespoke coloured spandrel panels and a Kingspan

micro-ribbed cladding system providing a clinical,energy efficient and modern look whilst remainingsympathetic with the building’s purpose. Thebuilding installation has been built to BREEAM verygood rating, a pre-requisite of the Health Board forall of their new buildings. In addition Solar PVPanels have been installed on the roof of themodular facility to help serve some of thedepartment’s energy requirements.

The project concluded in a state of the art facilitythat is comparable to that of a traditional building.A significant advantage of the chosen constructionsolution allowed for a minimal amount of time onsite as the building was constructed off site. This was

particularlyadvantageous early on inthe constructionprogramme as the localhabitat was suited forGreat Crested Newts andsubsequently anenvironmental clean ofthe area was completedprior to constructionworks commencing. Thisperiod traditionallywould have created asignificant delay to theprogramme but as thebuilding was beingconstructed off site theprogramme wasmaintained.

Courtesy of BCUHB and Laing O’ Rourke

BETSI CADWALADR UNIVERSITY HEALTH BOARDMortuary and Post Mortem Room, Ysbyty Glan Clwyd


Courtesy of BCUHB and Laing O’ Rourke

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WELSH AMBULANCE SERVICESNHS TRUSTHazardous Area Response Team (HART)The Welsh Ambulance Services NHS Trust wasrequired to implement a Hazardous AreaResponse Team (HART) that has very specificestates requirements for vehicle garaging,equipment, maintenance and storage. Therefurbishment of an existing retail and warehouseunit in the South Wales area providesaccommodation for HART, a Special OperationsResponse Team (SORT) and Emergency Planningfunctions on one site. The site provides internaland external training facilities that exceedspecialist requirements of the team.

The scheme cost a total of £2.899 million andwent fully operational on July 1st 2012.

POWYS TEACHING HEALTH BOARDSatellite Renal Dialysis UnitWelshpoolThe new facilities, located on the WelshpoolHospital site, accommodate 12 dialysis stationstogether with associated consulting rooms andwaiting areas. The unit, hosted by PowysTeaching Health Board, is run by Betsi CadwaladrUniversity Health Board.

The building is constructed on columns as theaccommodation was required at upper groundfloor level. It includes a number of sustainabilityfeatures such as cedar cladding and a sedumliving roof.

Designed by George + Tomos Architect andbuilt by Reads Construction, the satellite RenalDialysis Unit became operational on 7 January 2013.

Photo courtesy of WAST

ABERTAWE BRO MORGANNWG UNIVERSITY HEALTH BOARDMorriston Hospital Emergency Department

This £6 million project extended and refurbished theentire Emergency Department (A&E) at MorristonHospital. It almost doubled the amount of spaceavailable to treat those who are critically ill orinjured, helping to reduce waiting times forpatients.

The new facilities include a five-bedded section,with a separate minor surgery room and waitingarea, for the treatment of children. Internal re-configurations to clinical and support areas reflectbest practice and create additional space in themajor injury section, increasing the number of bedsfor adults from 9 to 15.

The department has also been extended to include adedicated triage area for ambulance patients.


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ABERTAWE BRO MORGANNWGUNIVERSITY HEALTH BOARDTy Garngoch, Garngoch Hospital

Ty Garngoch is a new £4.4 million unit whichprovides treatment for older people with mentalhealth conditions, such as depression, dementia oranxiety disorders. It includes consultation rooms for

outpatient appointments, a purpose built dayhospital, and provides an enhanced workingenvironment for older persons’ community mentalhealth team staff.

Also incorporated into the unit is accommodationfor Alzheimer’s Society staff and social workers,which has enabled partnership working withexternal agencies to be developed. The improvedclinic and office space has improved efficiency, andhas also increased capacity to see patients andcarers, who have provided positive feedback aboutthe building and their experience of the service.

Recently awarded ‘Best Sustainable Project’ by theCity & County of Swansea Building Control’s BuildingExcellence Awards 2013, it is one of the firstbuildings in the UK to be fitted with GlassReinforced Plastic (GRP) windows. These aredesigned to keep rooms at a comfortabletemperature, need no maintenance and arecompletely recyclable. Ty Garngoch is also fitted withenergy saving heating, lighting and power systems.

ABERTAWE BRO MORGANNWGUNIVERSITY HEALTH BOARDTy Einon, GorseinonTy Einon is a purpose built adult communitymental health team base and outpatientUnit. It enables adults with mental healthconditions to remain at home and receivetreatment. For patients who do needhospital admission, Ty Einon’s communitybased services allow their stay to be muchshorter.

At approximately £3.2 million, this investmentprovides consultation rooms where patients canmeet with different members of a multi-disciplinaryteam. The centre also has a purpose built wing for

podiatry and dental services so that patientsaccessing general clinical services in the area canreceive their treatment locally, rather than having totravel to hospital.

VELINDRE NHS TRUSTLinac 5Velindre Cancer Centre has recently takendelivery of its latest replacement LinearAccelerator (linac) and is now undertaking theimportant task of pre-clinical commissioningprior to the system entering clinical service laterthis year. The scheme, which included majorrefurbishment of the bunker and all associatedengineering services to support the linac andimprovements to the patient experience, wasfunded by the Welsh Government. The multi-million pound project is the latest of a numberof improvements to radiotherapy services inVelindre.


Photo courtesy of Velindre NHS Trust

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WELSH AMBULANCE SERVICESNHS TRUSTArea Ambulance CentreThe Area Ambulance Centre (AAC) inFlintshire is a new, high quality,purpose built development and is thefirst Make Ready project being rolledout as part of the Welsh AmbulanceServices NHS Trust’s National EstatesStrategy. The project is aligned to thisStrategy by implementing the service model of acentralised make-ready system to clean and restockambulance vehicles, and by providing an estatewhich is fit for purpose and in the correct locationbased on service need.

The building is based at a former communityhospital site in Dobshill, Flintshire, North Wales.All Flintshire emergency and patient care serviceswill operate from this site. The site developmentincludes a single storey building, associated parkingfor staff and ambulance vehicles, vehicle wash areaand cycle shelter. An external secure bottled gasstore and waste disposal area are also provided for

under the roof canopy. The building provides staff welfare, meeting and

administration facilities, garaging and chargingfacilities for ambulance vehicles and a make-readybay to facilitate the cleaning and restocking ofambulance vehicles.

Enabling works, followed by construction works,commenced in January 2012, with the buildingbeing handed over to the Welsh AmbulanceServices NHS Trust in early September 2012.

Following a period of operational commissioning,the site became fully operational in October 2012.

n Issue 13 of The estate we’re in published last year, wereported on the launch of the new Standards forHospital Residential Accommodation and Associated

Support Facilities and the need to achieve and maintainthese standards.

The new standards were published following the settingup of the Accommodation Review Group (ARG) whichincluded representatives from the Welsh Government(WG), the British Medical Association Cymru Wales, WalesDeanery, the Cardiff University School of Medicine HealthBoards, Junior Doctors and NWSSP – Facilities Services.

This group has been more recently working on aproposed monitoring scheme and action plans to put inplace over the next year. A self assessment checklist hasbeen developed for Health Boards, which will be sent outover the next few months, which will allow the ARG toprioritise visits and work with Health Boards to meet therequirements.

In addition, NWSSP – Facilities Services has been workingwith and advising a number of Health Boards, whereconcerns had previously been identified. Action plans arenow being implemented which will see positiveimprovement to the standard of accommodation on site.

❖ Investment at the Royal GwentHospital, Newport

Aneurin Bevan Health Board has recently commencedworks on the complete refurbishment of Block 6 at theRoyal Gwent Hospital, to provide fit for purposeaccommodation for some 27 rooms. The Health Board has

Hospital residential accommodation: Health Boards implement the new standards

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Royal Gwent Hospital Block 6 – Work in progress.

Photo courtesy of Aneurin Bevan Health Board


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undertaken a review of accommodation needs on site andhas decided to focus investment on one block to provideimproved accommodation for Junior Doctors. Thisaccommodation was previously identified as requiring animmediate action plan.

Although the architects appointed have had to designthe scheme within the constraints of the existing structure,it is clear that the facilities will be a huge improvement onthe accommodation they are replacing. The Health Boardhas approved a total renovation budget of £755,000(inclusive of VAT). This significant investment demonstratesthe Board’s willingness to make a substantial financialcommitment towards meeting the standards.

The accommodation was vacated in February 2013, witha specialist company carrying out an asbestos surveyshortly after this. Work has commenced on site, focusinginitially on window replacement, boiler and water storagereplacement with new controls and advanced furnitureprocurement. The full refurbishment programme is due tocomplete in September 2013 with the aim ofaccommodating F1 doctors thereafter.

❖ Short and long-term plans in Hywel Dda

Hywel Dda Health Board has specifically set up a sub-groupof its Doctors Accommodation Group to look at the futureprovision of Junior Doctors’ accommodation. The grouphas been undertaking a review looking at options for eachof its sites and completing an assessment of capacityrequirements and occupancy levels. This work is feedinginto a wider estate planning exercise which will look atprocurement routes to allow the Health Board to meet thenew standards.

❖ Next stepsJunior Doctors’ accommodation continues to be high onthe agenda with the Junior Doctors Review Group. Thenext step will be for the ARG to seek self assessmentchecklists from each Health Board using the traffic lightsystem previously used to inform action plans. Followingthis work, a prioritised round of visits will be undertakento monitor progress against the Essential QualityRequirements and hopefully see more Best Practice inplace to continue to raise standards at hospital sitesthroughout Wales.

Acknowledgement

NWSSP-FS is grateful to Jamie Marchant and Steve Daviesat Aneurin Bevan Health Board for their assistance inproviding details of the works at the Royal GwentHospital. Also, thanks to Paul Williams of Hywel DdaHealth Board for the permission to use the photographsand for providing information on the works at GlangwiliGeneral Hospital.

For further information contact:Nicola Powell on 029 2031 5509 ore-mail: [email protected]

In the meantime, while long-term planning is beingresolved, short-term improvements have been made tothose areas identified as of immediate concern, includingthe windows at Glangwili General Hospital in

Carmarthen. Works started on site in February 2013 tothe top two floors of Block 11 (residential areas) toreplace the windows with UPVC replacements. This hasinvolved circa £100,000 investment from the HealthBoard in the improvement works.

Works to refurbish certain kitchen/dining areas hasalso been completed which improve the quality of theaccommodation.

Further work is planned to create a common roomarea within Block 11 as soon as funds are identified.


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arch 31st 2013 saw the demise of the Space forHealth website with technical guidance returning as

pdf documents to the NHS Wales Shared ServicesPartnership - Facilities Services website.

Are we sorry to have seen it go?In many ways, yes.

In Wales, as in the rest of the UK, there was aperception that much of the technical guidance pre-dating Space for Health was out of date; difficult toupdate; contained much duplication; was not alwaysrelevant and failed to reflect the differences between thehealth administrations in England, Wales, Scotland andNorthern Ireland.

The ideas for change in Wales began in 2006 whendelegates from across NHS estates departments gatheredfor a workshop at Bevan House to discuss the wayforward for technical guidance. The conclusions reachedat that event were fed into the UK Information ReviewProject Steering Group where Peter Wiles of the formerWelsh Health Estates represented Wales.

The outcome of the many discussions and pan-UK userworkshops that followed was that a web-based systemshould be created which would address the issues outlinedabove. It should have a single point of entry but withareas for each of the UK home countries thereby enablingindividual differences to be accessed easily. Guidancewould be presented as web-based content which could beupdated quickly, searched easily, collected into a pdfdocument, if required, and archived guidance would bereadily available.

With the Department of Health (DH) in England as thelead, the Group worked, in conjunction with the CentralOffice of Information, to bring the system to fruition andSpace for Health was launched at the IHEEM Conferencein 2009.

Considerable time and effort went into the creation,development and maintenance of the site, not least bystaff at Welsh Health Estates, now Facilities Services.There were many challenges and frustrations although itwas felt that in time these could be overcome and thevision achieved. However, times change and the healthservices in the four home countries diverged ever further.By 2012 DH’s role in the provision of guidance had comeunder review and the Central Office of Information, a keycomponent as administrators of the system, wasdisbanded. To compound the difficulties, the governmentin Westminster had taken the decision that all EnglishGovernment publications should be available free ofcharge from the .gov website, running counter to Spacefor Health’s cost recovery policy. Time had run out forSpace for Health.

The question for Wales was, What shall we donow?

The answer was that all guidance previously on Spacefor Health would become available free of charge fromthe Publications page of both the Intranet and Internetwebsites of Facilities Services.

Existing PDFs, both current and archived, would beavailable and guidance that had been turned into web-based content would be reconstituted into PDF format.

In Wales we have, for a number of years, been creatingindividualised core guidance, including HBNs and HTMs. Infuture such core guidance will be prefixed with a W, e.g.HBN 09-02 Maternity Services will become WHBN 09-02,i.e. Welsh Health Building Note, and will have a distinctivecover design. Documents originating from DH which are

Goodbye to Space for Health

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not considered to be core guidance willcontinue to be available and, wherenecessary, be provided with a StatusNote identifying their status in Wales.

The transition from HBNs/HTMs toWHBNs/WHTMs will be challenging and,given the impossibly short timescale setby DH for the closure of Space forHealth, it has not been possible to effectthe change by the end of Marchdeadline. All is not lost, however, becausea contingency plan has kicked into actionand as a short term measure the guidancethat had been disaggregated will beavailable in the ‘Collect for PDF’ formatpreviously available in Space for Health.The layout is not easy to navigate but willmake the information accessible until thenew format documents are ready.

So, are we sorry to see Space forHealth disappear? Yes and no.

The vision was excellent but politics turned a dream todust. However, on a positive note it does mean thataccessing guidance applicable to Wales is now in ourcontrol and when contacting Facilities Services forassistance we will now be able to help and not have toanswer, ‘Sorry, I can’t help, you’ll have to contact Spacefor Health’.



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Library and Website News

During the year the Bevan House library moved fromits own room into the Directorate area. Thisrequired some downsizing, with a small store room

being utilised as an overflow library and older materialbeing archived off site.

However, the major event for the library since our lastissue has been the closure of the Space for Health website,details of which can be found on pages 39-40. A great dealof time in the last few months has been spent checkingthat all the publications previously on the Space for Healthsite have been transferred correctly to our intranet andinternet sites and any necessary amendments made to theexisting Status Notes. A more complex task has beenensuring that the disaggregated web content has beenconverted into PDFs with the correct information andreferences so that they become the new WHBNs (WelshHealth Building Notes) and WHTMs (Welsh HealthTechnical Memorandums) as applicable.

Many of you were irritated by the unfriendly nature ofSpace for Health and we in Facilities Services were equallyfrustrated by our inability to provide assistance. Now thatguidance has returned to us we hope that you will be ableto find the information you need more easily and we areonly a phone call or e-mail away if you need assistance.

Please do let us know if you have any comments on thewebsites. If you don’t let us know if you have any problemswith the sites, such as difficulty in finding a particular pieceof information or links that are broken, we may not beaware of the problem. Your feedback really helps us toimprove our service.

❖ Did you know...Did you know that the catalogue of the library at BevanHouse is available from the Intranet site and you cansearch it from the Publications page? Why not see if whatyou want is available for loan.

❖ Recent additions to theBevan House Library

BSRIACommissioning Water Systems BG 2/2010

This guidance is based on theApplication Guide 2/89.1. It has beenrevised to include the most recentknowledge and experience forcommissioning building engineeringservices.

BSRIAThe Illustrated Guide to Mechanical Building Services,BG 31/2012

This second edition superseded thepreviously published AG 15/2002. Inaddition to updating the originalpublication, it includes additionalinformation on: ■ Pumps■ Pressurisation■ Low-carbon heat sources■ MVHR systems■ Commissioning, handover and

project evaluation

BSRIAPre-Commission Cleaning of Pipework Systems BG 29/2012

This updated guide replaces theprevious edition (BG 29/2011) andreflects new British and Europeanstandards, corrects some minor errors inthe 2011 edition and clarifies certainpoints.

The guide provides the latest thinkingand good practice cleaning techniques

and aims to clarify the roles and responsibilities of theparties, improve the exchange of information betweenthem and provide consistency between service offerings ofthe pre-commission cleaning contractors.


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BSRIARules of Thumb - Guidelines for building services 5th edition BG 9/2011

This publication has been updated andexpanded to include more detailedinformation and is now in spiral-boundformat. The new additions include:■ Greatly increased guidance about spaceand weight allowances■ CO2 emissions benchmarks

■ Clearer guidance about costs, expanded to includeenergy consumption, maintenance, operation and life cyclecost information■ A system features section that has been subdivided intomechanical and electrical systems and clarified■ Guidance about compliance with Part L of the BuildingRegulations, renewable technologies and air permeabilityof buildings

FIRE PROTECTION ASSOCIATION

Fire prevention on construction sitesThe new edition of the joint code ofpractice on the protection from fire ofconstruction sites and buildingsundergoing renovation incorporatesthe Construction Site Fire PreventionChecklist. It features some importantchanges relating to general on-site fireprecautions as well as some brand new

requirements for large timber-frame structures.

PAMELA MICHAEL and STEVEN THOMPSONPublic Health in Wales (1800-2012) - A brief history

This book traces the many changes inpublic health that have taken placesince the early period ofindustrialisation in Wales andacknowledges the distinctive Welshtradition.

SHARED SERVICES PARTNERSHIP - FACILITIES SERVICESThe NHS estate inWales - Estate conditionand performance report2011/12The NHS estate in Wales- Facilities performancereport 2011/12

Hard copies of these reports can be obtained from thelibrary and are also available for downloading from thewebsite.

BRONWYN MITCHELL and BARRY TREBES

Managing reality 2nd edition

The 2nd edition of the ManagingReality series, places great emphasis onoffering ‘practical tips’ at appropriatepoints in the text and highlightedexamples. Standard forms are includedwith their usage explained togetherwith checklists. These are practicalmanuals designed to aid both existing

and new users in implementing the NEC and are vital foranyone involved in preparing, administering orcontributing to a NEC contract.

FACILITIES SERVICES NOTIFICATIONS (FSNs)

■ FSN 12/04 - NHS Estate in Wales - Fire statistics report:Fire incidents and unwanted firesignals 2011Issue of the report reviewing the fireincidents and unwanted fire signals(UwFS) reported by Health Boards andNHS Trusts in Wales through the onlinefire and UwFS incident reportingsystem.

■ FSN 12/05 - Nomination of Estates Board LevelDesignated Persons

Requested information required to update the list ofDesignated Persons drawn up following Health Boards’and Trusts’ responses to WHEN 09/18 issued on 15December 2009.

■ FSN 12/06 - NHS Estate in Wales - Fire statistics report:Fire Safety Audit Review 2010 and2011Issue of the report reviewing the datasubmitted by Health Boards and NHSTrusts in Wales through the intranet-based Fire Audit Information System

■ FSN 12/07 - Estates and Facilities PerformanceManagement System (EFPMS)Submission of data for April 2011 to March 2012

Informed Health Boards and NHS Trusts that the changesto the EFPMS for 2011/2012 had been made and datacould be input with immediate effect.

■ FSN 12/08 - Authorising Engineer (High Voltage)Requested necessary documentation to appoint SimonRussell as Authorising Engineer (High Voltage) followingthe retirement of Nigel Porter.

■ FSN 12/09 - Sequence of Components on SpecialisedVentilation in Healthcare Premises

Identifies a problem discovered during pre–clinicalvalidation of specialist ventilation systems and identifies


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the relevant sections of HTM 03-01 Part A that should befollowed.

■ FSN 12/10 - Independent Reviews of Fire SafetyInform NHS Health Boards and Trusts of proposedimprovements to Facilities Services’ approach to fulfillingits responsibility to monitor NHS fire precautions on behalfof the Welsh Government, which also builds on theAuthorising Engineer (Fire) duties.

■ FSN 12/11 - Fire Safety Adviser (Authorised Person -Fire) Register

Informs Health Boards and NHS Trusts of the establishmentof a register of Fire Safety Advisers (Authorised Persons –Fire) and seeks nominations from them to the register.

■ FSN 12/12 - Guide to commissioning, in-serviceinspection, in-service test and frequency of testing

Thermostatic Mixing Valves (TMV)Informs Health Boards and NHS Trustsof the issue of this industry-standardguide produced by the BuildCertIndustry. It is designed to work with allmanufacturers/types of TMV3approved products.

■ FSN 12/13 - Publication of the 2011/12 NHS Estate inWales Estate Condition and Performance Report andFacilities Performance Report

Informs Health Boards and NHS Trusts of the publication ofthe 2011/12 reports.

■ FSN 13/01 - Fire Safety Audit SystemInformation for Health Boards and NHS Trusts oncompletion of the 2012/13 audit submission.

■ FSN 13/03 - Closure of Space for Health: The healthcareestates and facilities guidance website

Notification of the closure of Space for Health and thetransfer of guidance to the Facilities Services website.

■ FSN 13/03 - NHS Wales Emissions Reduction ToolNotification of the availability of the Emission ReductionTool and related guidance from the Facilities Serviceswebsite.

Website and Information Assistance:Ann Konsbruck on 029 2031 5512 ore-mail: [email protected]

n the 1st of April 2011 Welsh Health Estates became partof the NHS Wales Shared Services Partnership and is nowNHS Wales Shared Services Partnership – Facilities Services

(NWSSP-FS). It provides a core of professional and technical estatemanagement expertise for the Welsh Government and the NHS inWales. It is organised into six sections within two divisions:

❖ Policy and Performance DivisionIts remit is to ensure that the existing estate is managed andmaintained to a high standard and that the NHS in Wales hasaccess to appropriate independent estates and facilities expertiseand guidance. The Division consists of three sections:

■ Environmental Management andEngineering Section

Takes the lead role in NWSSP-FS on all aspects of environmentalmanagement and provides advice and support on specialisthealthcare engineering systems. Services are provided in areas asdiverse as decontamination, diagnostic imaging, high voltagesystems, medical gases and specialist ventilation and airconditioning.

■ Facilities, Performance Management andInformation Section

Provides advice and support on a range of FM and performancemanagement issues. It is responsible for managing a number ofelectronic data systems for direct input by NHS Trusts to facilitateand monitor improvements in the health estate in Wales. TheSection is also responsible for overseeing the technical libraryservice and NWSSP-FS’ website facility.

■ Estates Development SectionProvides advice and support on the development andimplementation of estate strategies, the procurement of capitalassets and business cases. In addition, the section provides advice onarchitecture and design quality, and major scheme capital andrevenue costs.

❖ Strategic Planning DivisionIts remit is to assist the Service in delivering strategic change in thehealthcare estate consistent with the policy of the WelshGovernment as well as meeting local needs. The Division consists ofthree sections:

■ Designed for Life: Building for Wales SectionManages the Designed for Life: Building for Wales constructionprocurement and delivery frameworks on behalf of the WelshGovernment through the use of integrated supply chains,collaborative working and continual improvement.

■ Property Management SectionProvides advice and support on all aspects of healthcare propertymanagement expertise including acquisitions, disposals andlandlord and tenant relations. In addition it maintains the computerbased Land and Property Portfolio for the NHS in Wales.

■ Primary Care SectionTakes the lead role on all aspects of the strategic development ofthe primary care estate. It provides advice and support to LocalHealth Boards on the development and implementation ofintegrated estate strategies and project development advice inrespect of primary care schemes.

More information on the services provided and contact detailsare available on the NWSSP-FS intranet and internet websites at:http://howis.wales.nhs.uk/whe and www.wales.nhs.uk/whe

About NHS Wales Shared ServicesPartnership – Facilities Services

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StaffNews•StaffNews•StaffNews•StaffNews

Hello and Goodbye

Hello toAndrew Collier

Andrew is a CharteredBuilder, having graduatedfrom the University ofReading with a MastersDegree in ConstructionManagement. He spent thefirst two years of his careerworking as a graduatequantity surveyor in London

for a leading private practice. He then returned to SouthWales and worked for another quantity surveying practicebefore moving into Project Management. Working as aProject Manager for Faithful + Gould for eight years hemanaged a wide variety of projects ranging from airportextensions through to water works and residentialapartment developments.

Joining Facilities Services in 2012 as a FrameworkManager on the Designed for Life: Building for Wales teamAndrew brings with him practical knowledge andexperience of cost and project management processes andsystems. He is a chartered member of the CharteredInstitute of Building and has a keen interest in constructiontechnology and techniques.

Andrew lives in Pontypridd with his wife Jacqui. Despitespending his early 20’s travelling and working abroad, henow lives a mile from where he was brought up. Althoughenjoying travelling, hiking and mountain biking in his sparetime this is very limited as he is always busy renovating hisdilapidated house.

Stephen Rees

Stephen has had a variedworking life which began asan electrical apprentice withOgwr Borough Councilworking on buildingmaintenance. Qualifying asan electrician in 1986, hewent on to gain an HNC in1986 and has since held a

number of senior and principal electrician posts in a varietyof public and private organisations.

His first encounter with the health service was his yearspent with the Welsh Health Common Services Authority.After time spent with the Property Services Agency,working on various Ministry of Defence and Lord

Chancellor’s properties, the private sector beckoned and amove to Oscar Faber followed where he worked onnumerous schemes from art galleries to schools. Livingaway from home during the week became the norm for anumber of years, moving on to WSP and projects thatincluded the Birmingham Bullring upgrade.

Stephen joins Facilities Services as Performance StandardsEngineer from Atkins where his projects have includeddesigning Royal Glamorgan’s switchboard, performancespecifications for residential accommodation in Swanseaand, perhaps his favourite project, acting as clientrepresentative on laser facilities at the AWE.

Now back home in Wales, Stephen has recently becomeengaged and hopes to have more time to indulge hishobby of modern jive dancing.

Simon Russell

Simon also joined FacilitiesServices from Atkins wherehe was in charge of the M& E department of theirBristol Office. Simon took adegree in electrical andelectronic engineering atCardiff University becominga graduate engineer in

1989. He joined the Property Services Agency and, re-grading as an electrical engineer, worked on projectsthroughout Wales, including the electrification of the tankrange at MoD Castlemartin.

With the demise of the PSA Simon was made redundantbut found a post with Hoare Lea where he becameinvolved in projects such as Scott Harbour in Cardiff Bayand the Department of the Environment’s Eland House inLondon, where he would ride in the lift with the thenDeputy Prime Minister, John Prescott.

A period with Capita followed, working on healthprojects at the Royal Glamorgan Hospital, rationalisation atthe University Hospital of Wales and a Day Surgery atLlandough Hospital.

No longer having to commute to Bristol, Simon is nowable to spend more time with his wife and two children.


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Goodbye toMallory Armstrong

Congratulations to MalloryArmstrong who has retiredfrom NWSSP-FS after 11years’ service. Before joiningNHS Wales Mallory’s careerincluded a period in theDistrict Valuer’s Office basedin Abergavenny as well astime with a number of

housing associations, including Charter Housing in Newportand Glamorgan and Gwent Housing in Cardiff. Mallory alsoenjoyed a spell in Mid Glamorgan County Council as GroupManager in the Land and Buildings Department.

Mallory was initially appointed as a Strategic EstatesPlanner with the former Welsh Health Estates and wassubsequently promoted to Assistant Director – Primary Carewhere she helped to facilitate a period of growth in thedevelopment of a new generation of community facilitiesthat supported the Welsh Government’s move to encouragegreater collaboration between GPs, social services andother agencies involved in providing local support services.

Outside work Mallory has a huge range of interestsranging from animal welfare, to homeopathy through toher true passion, golf.

We wish Mallory well and, now that she has more timeto spend on the golf course, look forward to hearing of herever decreasing handicap.

Gwilym Hugh Jones

After 38 years with theHealth Service Gwilymretired on 15th July 2012.He joined the WelshHospital Board on 11thMarch 1974 as a SeniorQuantity Surveyor, afterspending 6 years and 8months with Swindon

Borough Council. Gwilym survived many changes in theHealth Service from the Welsh Hospital Board to WelshHealth Technical Services Organisation, Welsh HealthCommon Services Authority, Welsh Health Estates andfinally NHS Wales Shared Services Partnership - FacilitiesServices. He was promoted from Senior Quantity Surveyorto Principal Quantity Surveyor in February 1985 and then toSenior Estates Advisor within Welsh Health Estates. Gwilymwas a valued member of the Estate Development Team,providing estates advice to both the Welsh Government

and NHS organisations. He was also the organisation’sexpert on building contracts, especially the NEC form ofcontract.

One of Gwilym’s many claims to fame was when hereversed a £1 million claim against Gwent Healthcare NHSTrust, by a housing developer, into a £1 million award toGwent Healthcare NHS Trust.

We wish him a long and happy retirement with his familyand time to indulge in more backstage work with amateurdramatic groups.

Adrian Johnson

Congratulations also toAdrian Johnson who hasleft NWSSP-FS to joinCardiff and Vale UniversityHB as Head of StrategicCapital. Adrian was aDesigned for Life: Buildingfor Wales FrameworkManager who had a

significant role in the procurement of both Designed forLife: Building for Wales 2 and 3 as well as overseeing anumber of Designed for Life: Building for Wales 1 projectsin South and West Wales.

Adrian is a Chartered Quantity Surveyor with over 30years experience in consulting and contracting. Prior tojoining NWSSP-FS in January 2010 Adrian was the Head ofCost and Design Management at Somerfield Stores. TheDesigned for Life: Building for Wales team will miss hisknowledge, insight and maturity.

Outside work Adrian and his wife Clare have a busyfamily life bringing up three daughters but he is able tofind some time to support Liverpool football club and playsome golf.

We send Adrian good wishes and success in his new role.

StaffNews•StaffNews•StaffNews•StaffNews


NHS Issue 14 4/16/13 8:34 pm

Feedback and comments should be addressed to:Peter WilesHead of Policy and Performance Division

NHS Wales Shared Services Partnership – Facilities ServicesPO Box 182, Bevan House24-30 Lambourne Crescent, Llanishen, Cardiff CF14 5GS

GIG Cymru Partneriaeth Cydwasanaethau – Gwasanaethau CyfleusterauPO Box 182, Ty Bevan24-30 Cilgant Lambourne, Llanisien, Caerdydd CF14 5GS

Telephone/Ffôn: (029) 2031 5500Fax/Facs: (029) 2031 5501E-mail: [email protected]

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