The Management of the Facilities (FM) Services in the main concession period Still Friend or Foe?

1. The Management of the Facilities (FM) Services in the main concession periodStill Friend or Foe? Presentation to the Best Hospital Group 17th July 2012 Glen Hewlett Director of Estates and Facilities Services

2. Introduction • This is an update from a previous presentation to the Group earlier in the main concession period • Following work by the Trusts Estates and Facilities Management (FM) monitoring team concerns were raised with The Hospital Company (THC) and Carillion Services Limited (CSL) about the Estates Service performance • An independent consultancy (E C Harris) was brought in by THC • The outcome of the audit substantiated many of the concerns raised by the Trust team about the processes in place and the performance of the CSL Estates team • An action plan has been drawn up by CSL to address the findings of the external audit • The Trust team have asked that additional items be included • The action plan looks backwards as well as forwards!

3. Audit Findings • The findings centred up on formal reporting processes, monitoring processes, assumptions made, lack of training, management structures and access by the trust to information • These issues are being addressed in the action grid • A new CSL FM Director (Ian Haithwaite) has been appointed • A thorough reconciliation is taking place (Feb 11 to Dec 11 • In 2011/12 PHT benefited from applied deductions of circa £100,000

4. Processes Review Processes to be reviewed include: • Deferred Rectification (June 2012) (Access/timing issues plus holding of specialist spares) • Temporary repair (June 2012) (relates to the return to service of systems whilst a permanent repair is prepared) • Method statement and Quality plan (Aug 2012) • Equipment Responsibility Matrix (Nov 2012) (Review due to changes since commissioning of new build in June 2009) • CSL Self Monitoring/Self declaration (June 2012) • Schedule of Accommodation (Nov 2012) (“White space”) • Control on recording of Issues (June 2012) (Changes to CSL Control room) • Stock Control/Specialist contractors agreements (Sept 2012)

5. Estates/FM processes • Procurement/Spare parts held (Sept 2012) • Deliberate Act (Aug 2012) – see definition • Excusing Clauses (Aug 2012) – making operational PA definition • Repeated Rectification (Sept 2012) - making operational PA definition • Retained Estate Condition (Aug 2012) – condition B (PHT position defined • Life Cycle process (May 2012) – 1 year plan - 5 year plan - urgent unplanned • FM Contingency plans (May 2012) - on intranet • Joint Risk Registers (July 2012) – 1st draft in place

6. Timetable Some issues are more easily addressed and have taken place Others have a long implementation time In addition to the review of the process (where I have detailed the completion date) the other major milestones are: • Task reconciliation – May 2012 (from Feb 11 to Dec 11 – being assessed) • Review of resource and their skills –May 2012 (Estates control room strengthened. New senior management in place and about to be) • Trust access to further CAFM modules–Aug 2012 • Introduction of PDA devices – Nov 2012 • Improving reporting– June 2012 - ongoing • Security of access/control of data (CAFM)– July 2012 – in place, being validated

7. Please see Handout Revised processes for: • Deferred rectification • Event Postponement • Temporary repair • Mitigation of Service Failure Points process The examples sheets show the complexity of the processes being put in place.

8. Deliberate Act • Under clause 8 of the Project Agreement Project Co indemnifies the Trust for • any claim for death/personal injury from any employees of Project Co or Project Co party regardless of any act or omission of the Trust • any claim for death/personal injury from any third parties unless the claim has been caused by any Unreasonable Act by the Trust or Trust Party, breach of any express provision of the PA by the Trust or Trust Party or any deliberate act or omission of the Trust or any Trust Party • any physical loss of or damage to Trust Assets  unless the claim has been caused by breach of any express provision of the PA by the Trust or Trust Party, Latent Defects or any deliberate act or omission of the Trust or any Trust Party • loss or damage to third party property unless the claim has been caused by breach of any express provision of the PA by the Trust or Trust Party or any deliberate act or omission of the Trust or any Trust Party If effect PHT will not except claims unless CSL have first tried to mitigate by education, training, signage etc however if there are repeated offences and mitigation has been carried out the Trust could be liable

9. Example of Monthly Points Summary

11. Formal Meetings Structure Trust Board QAH Redevelopment Committee Sustainable Facilities Group Local Health Economy St Mary’s Decommissioning & Disposal Group Director of Redevelopment Liaison Committee Combined Contract Monitoring Group FM Services monitoring Utilities Working Group Captain’s Rounds Patient’s Experience Steering Group Patient Experience Partnership Group Membership includes: Modern Matrons Infection Control PALS Divisional reps Client ContractorGroup HR Monitoring Technical Group

12. Director of Finance Director of Redevelopment Director of Estates and FM Services FM Monitoring team highlighted in red Head of Planning Head of FM Monitoring Major Incident Planning Assistant Fire Consultancy/ Fire Officer Transport manager Band 6 Project Manager Band 7 Soft FM Monitoring Manager Band 7 Supervisor Band 5 Management of Car Parking (1 wte) SMH Education Centre Management Residence Management Team (2 wte) Management of the Admin team (2 wte) Project Manager (Hard FM) Band 6 Transport team Project Manager Band4 Project Manager Band 4 Project Manager Band 4 Project Manager Band 4

13. Processes/Reviews/Initiatives by PHT • Flow chart issued to wards related to escalation • Fire information issued to wards as risk assessments take place • Information related to waste recycling/segregation and Sustainability issued • New process as to how someone makes changes to their area

14. Changes to your area Fixed Price works process on Trust Intranet Application goes to Trust development team Sense check carried out by Trust Development team Not Approved to quoted. Returned to user with a reason Development team Issues e.g. fire, signage, small works progress Extn 6605 User Issues Clinical Equipment cleaning/clutter Food e.g. extra meals Cleaning e.g. Vent cleaning extra cleans, scrubs etc Repairs Environment e.g. too hot, too cold Decoration e.g. knocks, scrapes physical damage Does the repair relate to the building or the equipment within it i.e. doors, lifts, lights etc Is the item connected to the patient (i.e. bed, drivers etc)? No Modern Matron to address Yes Clinical Engineering Helpdesk Extn 6101 Carillion(CSL)Helpdesk Extn 6321 CSL Processes Approved to quote User to submit approval to CSL Helpdesk FM Helpdesk Estates Helpdesk For Emergency call e.g. fire, security issues etc please call 2222

15. User makes a request to the CSL Helpdesk User unhappy with response/rectification from CSL User still unhappy with response/rectification from CSL – escalates to Trust Development Team CarillionServicesHelpdesk User makes a complaint to the CSL helpdesk Trust FM Monitoring Team investigates CSL Service Manager responds back to the User and records in the monthly report Trust FM Monitoring Team reports back to the user and CSL FMHelpdesk EstatesHelpdesk Trust Development Team If not resolved escalated Failure Failure Client~Contractor group meeting (minuted forum with terms of reference) Informal Escalation Route (Safety Valve”) Rectified Rectified Combined Contract Review Group (CCRG) – formal contract meeting with minutes and terms of reference. Participants THC/CSL/PHT Reported in Monthly Report CSL FM Director PHT Director Of Development & Estates Liaison Committee – formal contract meeting with minutes and terms of reference. Participants THC/CSL/PHT Dispute Resolution Procedure AND WHAT DO I DO IF THINGS GO WRONG?

16. NHS Sustainability Day28th March 2012 • The Trust has signed up to participate in the first of what is hoped will be an annual event. • Come to the Main Entrance Atrium at any time during the day to see and hear about; • The Trust’s carbon footprint and what we need to do to reduce it. • What you can do to help and what difference that will make. • How you can reduce your own carbon footprint, your effects on the environment and improve your health all at the same time. • Have a look at alternative ways to travel to work. • Check out an electric bike or even an electric car. www.nhssustainabilityday.co.uk

17. Fire Safety Update The Trust has embarked upon a programme of rapid improvement in our management of fire safety. Fire Safety consultants will be visiting up to 140 departments in the coming months to help managers to deliver the improvements. They will need to meet with the person in charge of each department, go through the risk assessment and fire response planning processes and provide training to senior staff. The person in charge will be expected to complete the risk assessment, response plan and cascade the training down to all staff. The consultant will provide support and advice as required and will return after four weeks for a review with the person in charge. Each department will have a fire safety manual where important information can be maintained by the person in charge. Hampshire Fire and Rescue Service will be invited to audit all departments. Further information is available on the intranet under “Departments/Fire Safety”. Page 17

18. Improving waste disposal Clinical Waste at QAH We need to segregate our clinical waste differently; Infectious Waste From known or suspected infectious cases – Orange bags. Offensive Waste Other clinical waste (but not drugs, chemicals, anatomical or sharps). – Yellow and Black “Tiger” bags. Other Clinical waste disposal remains unchanged Guidance and support will provided in the change over period. Both of these initiatives are required to meet legislation but will save money, reduce our carbon footprint and our environmental impact. Both are being piloted now in a few areas. Roll out to all of QAH very soon. Look out for publicity. Page 18 • Recycling at QAH • We are stepping up our recycling rate as follows; • Cardboard boxes – will be separately collected from disposal holds. We still need you to flatten boxes please. • Mixed Recycling (paper/plastics/card etc)– very similar to what you probably do at home already. - Clear bags • Other recycling initiatives to follow.

19. Recycling – It’s Here! So what’s next???? Recycling at work! We all do it at home, let’s do it here too. A large percentage of our domestic waste is recyclable, now we just need your help to get it into the right bag. Many black bags will be replaced with clear bags for recycling, in particular at desk bins. A black bag will still be provided in central locations such as beverage bays and staff rooms for non-recyclables (e.g. food!). Look out for a clear bag – coming to a bin near you soon! Page 19 Did you know that some recycling is already done at Queen Alexandra Hospital? Glass, confidential waste paper, batteries, Waste Electrical and Electronic Equipment (WEEE), scrap metal, cooking oil, kitchen food tins, fluorescent tubes…. Large cardboard boxes – these are now recycled! Please continue to break them down and put them into the designated cardboard cages in disposal rooms, or where there are no cages present please continue to use the blue bins. We have a target to recycle 150 tonnes of cardboard this year – we’ve already sent 29.6 tonnes in just over 2 months, so let’s keep it up!

20. How To Request Changes to Your area • The way staff will be able make requests for Fixed Price Work (FPW) is changing.  • A new system will be introduced to standardise the process, ensure works are done in a timely manner and ultimately minimise costs. • The new process involves a first stage sense check undertaken by the Trust’s Development Team which will streamline the process, identify alternatives and ensure compliance with all statutory acts, guidance and best practice at an early stage. Users will be able to track the progress of their individual tasks on the Trust Intranet • Managing the whole process centrally via the Development Team, ensures close monitoring of job requests and quotation costs.  The Development team are able to investigate where appropriate the value of the work being requested, and also challenge when necessary costs provided by CSL. • This new process also provides a valuable support mechanism to the Trust Landlord Function and enable the Trust to use and develop its facilities in the most cost effective and compliant manner. • The details of the new process will be cascaded through each CSC • The target date for introduction is the 1st November 2011

21. Development Team send approved Small works form to CSL FM helpdesk to proceed with works. CSL FM helpdesk respond to small works inbox with the FPW number allocated to the request. CSL carry out works and send completed costings back to the small works inbox. Works under £200 * CSL issue the FPW number that has been allocated to the request and quote back to the small works inbox. (Quotes requiring a design will incur a cost charged to the budget holder.) Development Team approve request to go to quote and send to CSL FM helpdesk. User fills in Small works request form found on the Intranet, budget holder approves and sends to the Small works inbox. Development Team carry out a sense check of the works, either by visiting the department or by meeting with the users. Development Team do not approve quote and send back to CSL FM helpdesk for re costing. Works over £200 * Development Team send request back to the budget holder for further information, to suggest alternatives or to decline the works. Development Team approve quote and send back to Budget holder for approval. Budget holder approves quote and sends back to small works inbox. CSL carry out works and send final costings back to the small works inbox. Development Team send approved small works form to the CSL FM helpdesk to proceed with works. * Threshold will be reviewed on a regular basis. Page 21

22. FM Services provided by Carillion Services Limited Post Receipt & Distribution Security Telecommunications Laundry & Linen Waste Estates / Upholstery Help Desk Energy & Utilities • Car Parking management  • Catering Patient • Catering Non Patient • Domestics • Grounds & Gardens • Pest Control  • Portering • Housekeeper

23. Informed Client Team Responsibilities • The Trust’s “Policemen” – ensuring we receive what we pay for! • Technically responsible for the Estates and Soft FM services. • Authorisation of payments to the Project Co. • Responsible for the development of services and the estate. • Monitoring the compliance with the contract and all best practice, guidance and statutory acts related to FM services • Changes to the services received via the Variation procedure

24. Why Have a client/contractor relationship? • In any transaction there are at least two parties. The buyer and the vendor. • The relationship is between the Trust and its Partner - the contractor. The Partnership = real money. • The contractor sees these service payments as fundamental to the affordability of the PFI solution. • We should now work on the principle of ‘no service no payment’! PARTNERSHIP

25. The Answer? It still has to be Partnership & Respect