Case study: Wilberforce Health Centre variation

Wilberforce Health Centre is a high quality clinical building in the centre of the city. However, there was approximately 30% of void space and cost, with the majority of the third floor of the building being unoccupied.

One of the main objectives was to provide a solution to this so that the building could be utilised more effectively and facilitate a higher level output of clinical service delivery.

Citycare were subsequently tasked with a strategic review of the estate need for the building; to identify works and occupancy requirements that could be delivered within the existing financial constraints and reduce void space and cost, whilst ensuring consistency with and supporting delivery of the local area estates and commissioning strategies.

Other key objectives to be met through the proposed variation were:
– Retention and maximisation of clinical space within the existing LIFT estate
– Provision of additional standardised clinic rooms to better support evolving clinical services
– Obtain flexibility on usage and allocation of rooms/providers
– To reduce the revenue consequence to NHS Hull CCG by reducing void costs

Solutions:

Following a review carried out by a series of meetings and correspondence with the service providers for the area and data collection and analysis against future service development requirements, a proposal was developed in close partnership with NHS Hull CCG.

Utilising the available funding most effectively, the proposal was to primarily reconfigure the third floor, all of which was void space previously configured for dental services, to provide clinical rooms for flexible multi-disciplinary integrated use. This significantly reduces the space and cost within the building from roughly 30% down to 9.3% as well as decreasing the void cost to NHS Hull CCG.

It also provides more clinical resource to support flexible working and shared provider occupancy, resulting in a more efficient estate utilisation that supports the delivery of service strategies for the area by consolidation of services and delivery of services out of hospital, providing the facilities to operate a flexible hub model effectively.

The proposed schedule comprised of 21 additional clinic rooms (consulting and treatment rooms) to current capacity, increasing standardised clinic room capacity by 43% against the existing 49 standardised clinic rooms.

The strategic proposal was to introduce non-leased space that will support operations for the future integrated services model and support its development through offering flexibility in usage and shared usage across providers and services.

Leases could be held centrally with the CCG who would have agreements in place with the providers setting out the expectations and responsibilities to ensure an effective system that supports optimised utilisation.

Results:

The brief was delivered through collaborative working with the CCG and service providers, collecting local service data and analysing against the strategic estate objectives and disposal strategy outlined in the Hull Primary Care Estates Strategy (Citycare on behalf of CHP, 2015). Applying this analysis to future service development requirements of delivery of out of hospital services and integration of health and social care services, the ratio of room types and capacity needed was calculated to ensure optimised usage suitable for a wide range of services that will be sustainable in the long term.

Overall, we developed a proposal from this strategic review that:

– Uses available capital to reconfigure a high quality clinical LIFT building whilst still supporting delivery of the wider area estate strategy requiring a higher level of investment to fully realise.
– Supports delivery of a flexible hub model of GP and community services for patients.
– Provides the platform for eradication of leases and creation of a shared pool of standardised clinic rooms, to optimise and increase utilisation and provide a flexible sustainable healthcare facility to support the intended future Multispecialty
– Community Provider contract.
– Significantly reduces void space and cost to the CCG.

Through working closely with NHS Hull CCG and service providers throughout, an operationally appropriate design was developed that is both deliverable and will help to service the area in the long term.

Citycare managed to deliver the strategic work and proposal in a short space of time to allow the variation completion to meet the constraints of the financial timeframe for delivery.