Case Study: A collaborative approach to Strategic Estates Planning The Urgent Care Centre at Widnes Health and Resource Centre

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1 Case Study: A collaborative approach to Strategic Estates Planning The Urgent Care Centre at Widnes Health and Resource Centre

2 Case study: The Urgent Care Centre at Widnes Health Care Resource Centre To reduce the pressure on the acute sector, Clinical Commissioning Groups (CCGs) have been tasked with cutting Accident and Emergency admissions by 15 per cent over five years. The redevelopment of the Health Care Resource Centre at Widnes in Halton, which is currently in the design phase, will do just that, improving patient care and saving the health system 150,000 a year in the process. The project is the result of carefully considered strategic estate planning and a close collaboration between Halton CCG, Halton Borough Council, Renova Developments Ltd (the LIFT Company covering St Helens, Knowsley and Warrington), Community Health Partnerships and NHS Property Services. to create the new Urgent Care Centre will answer the need for a real primary carefacing alternative to A&E, while also integrating services like mental health, providing wellbeing services, social activities and opportunities for evidencebased brief interventions. The centre, which has been open for 8 years on a 25-year lease, is a busy building that s popular with patients. However, the site had lots of available capacity so the CCG wanted to put more services in there, get best value and use it to its full potential. A clear vision Over the last year, the CCG and Renova have worked hard to establish a collaborative approach and a strong working relationship. Together they ve developed an estate plan for Halton, overlaying the NHS and Halton Borough Council plans. These also allow the CCG to meet the Public drive priorities and fit with the CCG s drive to improve health and wellbeing in the area. Dave Sweeney, Director of Transformation at NHS Halton CCG and Halton Borough Council, is responsible for driving the project forward: The existing Widnes Health Care Resource Centre site The local picture Widnes Health Care Resource Centre (HCRC) had been identified by the CCG as a key site to support commissioning plans in Halton. Work to redevelop the existing Widnes Health Care Centre site into an Urgent Care facility is underway, with the first phase of construction due for completion in Autumn With the closest Accident and Emergency department eight miles away and one of the lowest levels of car ownership in the country, the redevelopment of the centre We had the opportunity to reduce unwanted NHS estate, reconfigure the remaining space and improve patient care, and that just made perfect sense to me. We came together very quickly, set our stall out and established our joint vision. The thinking behind the development of the centre is very clear, as Damian Nolan, Commissioning lead for Urgent Care Services at NHS Halton CCG, says: The overarching desire is to provide our local population with high quality, accessible, local health and social care services that support our community to maintain and improve their health and wellbeing.

3 Striking a balance A clear goal, but a complex development, as Dr Neil Martin, a GP Principal and the Clinical Lead for Urgent Care for Halton NHS CCG, explains: This development has been complicated by the fact that the population of Halton is split into two towns, separated by the River Mersey and with differing identities. Following a period of consultation with the public, it became clear that there is a need to provide an Urgent Care Centre in both towns. In order to do this we have had to work closely with a number of providers including Warrington & Halton Hospitals NHS Foundation Trust, St Helens & Knowsley NHS Trust, Bridgewater Community Healthcare NHS Trust, Halton Borough Council and Unplanned Care 24. This has been a challenging but fruitful exercise so far. We have had to keep a balance between providing a good level of service in both centres, but not replicating some services that would be better provided in one Centre of Excellence. Plans for a 21 st century health hub Truly meeting local need is only possible through collaboration and sharing information. Nicola Goodwin, Community Development Manager at Halton Borough Council, explains the role played by the local authority: Halton has been developing and strengthening collaborative working to support an integrated approach to health and wellbeing in the Borough. "In doing so we developed Health & Wellbeing profiles bringing together demographic data, public health data, performance indicators and local intelligence in a single document for each of the Borough s seven Area Forum areas. "These documents provide a broad context of information from grass roots activity to local positioning with national indicators to provide a contextual document for each ward in the Borough. Phased approach to development The redevelopment is being implemented in phases, with the first new facilities due to be up and running in Autumn The work is being carried out with an 800,000 investment from a combination of public and private funds. The top floor of the building was previously home to 25 administration rooms and offices. These were underused and inefficient, so the plans include returning them to clinical use with sinks and beds, which provides the best value accommodation and responds directly to need. Planned work at the site also includes: A single new reception and waiting room, consolidating the previous six spread throughout the building New X-ray facilities with leaded rooms Imaging and ultrasound facilities Diagnostics and an on-site pharmacy Widening doors and corridors to accommodate trolleys Children s areas with soft play equipment In addition, the space has been redesigned so it adapts to future needs. Mike Hill, Head of Technical and New Projects at NHS Property Services in Merseyside said: We have been in consultation with people who use the building to ensure everything we do makes it better. The CCG wanted X-ray equipment on site and diagnostics but the rest of the space has been made to be multifunctional, so it can be used by different services, providers and organisations and can continue to be flexible and usable as needs change.

4 Delivering real savings and service improvements The projected impact of the development is impressive. Evidence suggests that by offering these services locally, along with a robust marketing plan to encourage local people to use them, the Urgent Care Centre will help deliver: 150,000 savings to the health system annually 15% reduction in A&E attendances over five years 15% reduction in non-elective admissions through A&E 23% reduction in A&E attendances over time Bringing commissioning and estates together So what s made these ambitious plans possible? Dave Sweeney is convinced that the strategic use of NHS estate from a commissioning perspective has long been overlooked. In Halton, we were heading down the same old road until a presentation from the LIFT Company, Renova, opened my eyes to how we could integrate commissioning with estate planning and delivery to ensure our estate is used in the most efficient way, isn t a drain on resources, and actually improves patient care. Becky Caffrey, General Manager at Renova, is responsible for delivering the project on the ground. She supports Dave s view, saying it would not have been possible without the integrated approach. Estates are often seen as something that will stop change from happening, but it s essential to use the estate as an enabler to commissioning plans. It s costly so it needs to contribute. It s about combatting unnecessary costs and maximising the value. The keys to success In fact, many are convinced that the future success of CCGs will be based on taking a broader view of the wider benefits of estate planning. Good relationships are key to this. Forget old school commissioning and think fizzy people put the best people in the room and let them get on with it, says Dave Sweeney. We have challenged all the providers of primary, community and secondary health services to work collectively to achieve this project in a time of change and uncertainty, adds Damian Nolan. And they are rising to the challenge, creating networks of collaboration and producing innovative ways of working, to get this centre up and running. CHP: effectively supporting estate planning Community Health Partnerships (CHP) is providing important links with the NHS and other public services; helping to create the conditions needed for successful estate planning with the aim of reshaping the community and primary care estate to support commissioner s needs and deliver better value to the NHS and its partners. Mike Chambers is Area Director for CHP in the North West says: We re well known on the patch and provide that bridge between public and private sectors. Rather than implementing plans from above, our partners rely on us to lead from alongside them. "In Halton, success is down to energy and enthusiasm of the CCG. We have a local authority that is naturally collaborative, and a LIFT Company with a great track record. Trust and cooperation are earned and those are the ingredients that give real cause for optimism, because the resulting projects are owned by local organisations and local people.

5 Of course, good relationships result in other benefits too. Renova s local networks have allowed Becky Caffrey and her team to realise cost efficiencies by securing the best, mainly local, contractors at the most competitive rates. It s been a challenging project, she says. But there s a real drive and a belief that this is the best thing for the local economy. "The MPP brings CCGs together with NHS Property Services, CHP and the LIFT Companies to develop plans and deliver savings in both CCG localities and the wider area. In the case of Halton, I m sure the energy, shared commitment and combined expertise will get us there. And for local people. The aim of the redevelopment of Urgent Care in Halton is to bring the management of Urgent Care closer to patients homes, in an appropriate safe setting and in a timely manner, says Dr Neil Martin. Patients will benefit from the knowledge that when they are ill, they do not need to travel outside the Borough of Halton in order to receive an excellent level of care. First phase of development on track for completion The first wave of work on the Urgent Care Centre at is on track to be complete in the Autumn 2014 and the process is also underway for the centre to hopefully become the first NICE (National Institute for Health and Care Excellence) accredited centre. Halton is an area where there s a real need. People are recognising that things will be better when we work together, says CHP Area Director, Mike Chambers. Merseyside as a wider area is setting the pace in linking strategic planning with the provision of estate and infrastructure. The Merseyside Property Partnership (MPP) has completed an assessment of the estates capacity to serve current and anticipated needs. Approaches have been modelled in each of the CCG areas to reflect approaches to getting the best out of existing estates provision both now and in future scenarios that may see services being routinely delivered for longer hours, on more days from local facilities.