Infrastructure Investment Plan 2008

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4.(iv) HEALTH AND WELLBEING

Introduction

The Health and Wellbeing portfolio is responsible for developing and running effective policies and programmes that:

  • protect and improve the health of the people of Scotland
  • tackle health inequalities
  • promote equality, and tackle discrimination, prejudice and disadvantage
  • provide high quality healthcare and social care services, person-centred and close to home
  • promote social inclusion and reduce poverty
  • increase the supply of good quality, affordable housing and prevent and tackle homelessness
  • regenerate communities; and
  • promote physical activity and participation and success in sport.

Policy Context

These policies and programmes support the achievement of our objective for a healthier Scotland, promoting greater wellbeing among all those living in Scotland, as well as the achievement of our Purpose and other Strategic Objectives. They also underpin the delivery of other programmes across portfolios to promote equality and to tackle poverty, disadvantage, discrimination and prejudice.

The Health and Wellbeing portfolio oversees the investment in the NHS, housing and regeneration and sport. The total capital investment comprises direct public expenditure, private sector activity which is generated by it, and also private sector investments in public infrastructure which is paid for over the duration of the concession. Table 4(iv).1 summarises the planned capital investment over the next 3 years (including forecasts of private investment) and, where possible, our forecast of expenditure in later years. The table distinguishes between the public funding which is included within the portfolio budget, and the specific housing grants to local authorities which are included within the local government plans in Chapter 4.(vii).

Table 4(iv).1: Forecast Infrastructure Investment - Health and Wellbeing

Forecast
Public
Expenditure
£m

Forecast
Private
Expenditure
£m

Total
Forecast
Expenditure
£m

2008/09-
2010/11

Annual
Investment
2011/12
onwards

2008/09-
2010/11

Annual
Investment
2011/12
onwards 14

Health

1,676

TBC

689

TBC

TBC

Housing and Regeneration

967

TBC

317

500

1,784

Sport

27

TBC

TBC

TBC

TBC

Local Authority Specific Grants
(all relating to housing and regeneration)

574

TBC

239

TBC

813

The investment comprises both direct public funding of projects as well as significant levels of private sector investment through for example, NPD projects in health or Urban Regeneration Companies.

The remainder of this chapter provides details on the individual investment opportunities within the health, housing and regeneration and sport areas and provides an indication of the key policy objectives the investment is addressing.

NATIONAL HEALTH SERVICE

Investment in the infrastructure of NHSScotland (whether property, equipment or IT) supports modern, effective and high quality patient care. Investment in infrastructure directly supports the effective diagnosis and treatment of patients. The effective acquisition, maintenance and disposal of these assets is therefore fundamental in supporting the efficient delivery of clinical and support services. The Net Book Value of NHSScotland assets was £4.3 billion at 31 March 2006. Of that total, £3.7 billion related to land and buildings.

Policy Context

The infrastructure investment programme for NHSScotland is clearly focused on the key aims of the new Administration in delivering a healthier Scotland. The " Better Health, Better Care" Action Plan launched on 14 December 2007 represents a comprehensive and targeted approach towards tackling the three main strands of the Government's Healthier Scotland objective through health improvement, tackling health inequality and improving the quality of healthcare. In support of these strands the infrastructure investment programme plays a number of roles.

Increasingly, the settings in which healthcare will be provided will change, becoming more local, with large acute settings focusing on specialised care. These strategies and priorities are delivered directly by NHS Boards and Special Boards. Their 5 year infrastructure investment strategies are contained within their Local Delivery Plans which make the link between service strategy and infrastructure requirements and are subject to Scottish Government scrutiny and approval.

In looking forward the strategy is not simply about replacement of our existing asset base. It is a challenge to existing service provision and directed to ensure delivery of modern, fit for purpose infrastructure suited to the delivery of modern and progressive health care. Faster, more responsive treatment is assisted by investment in premises, equipment and IT. Increased productivity and reduced waiting times are assisted by appropriate, modern infrastructure.

In delivering modern healthcare, focusing on multi-agency working our use of technology and information systems is key. The e-health strategy reflects the need for significant investment, a focus on new ways of working and improving the efficiency with which we deliver healthcare across Scotland: investment in improving access and diagnosis through technology; the use of telemedicine; improved access to information thereby facilitating faster and more effective diagnosis and treatment. There is also investment in business systems and processes to drive efficiency and productivity gains.

The focus is on outcomes, community-based services and the facilitation and support of joint planning and delivery of services. Better joint working across the public and private sectors is entirely consistent with the principles of efficient and leaner government. The strategy seeks to promote innovation in service provision, design and procurement and a focus on design and sustainability. The continued development of more efficient procurement tools such as the hub initiative also supports that agenda.

Longer-term delivery

Given the lead in times for delivery of capital schemes, a 5 year planning horizon has been used. This allows proper consideration of schemes for which approval will be required during the period covered by Spending Review 2007, but for which expenditure will be incurred during the following Spending Review period.

There are a number of significant developments that will be implemented beyond the Spending Review 2007 period but for which planning and procurement will be undertaken prior to 2011. These include the development of the New Southern and Children's Hospital in Glasgow, the redevelopment of Dumfries and Galloway Royal Infirmary, the redevelopment of Aberdeen Royal Infirmary and the implementation of acute and related service reviews in Lanarkshire, and Ayrshire and Arran.

Health: Public Investment

Table 4(iv).2 summarises the capital investment being undertaken by the various NHS bodies during the Spending Review 2007.

Table 4(iv).2: Health - Forecast Infrastructure Investment - Public Funding

Categories

2008/09
£m

2009/10
£m

2010/11
£m

NHS Boards

372

421

401

NHS Special Boards

28

28

28

Primary Care and Dental Provision

50

50

50

e-health Strategy

60

65

40

Flu Pandemic Vaccine

3

36

47

Cancer Strategy

9

9

14

Medical Equipment.

30

30

30

Sustainability/Energy Efficiency Measures

5

5

5

Total Gross

557

644

615

Capital Receipts

(32)

(91)

(17)

Total Net

525

553

598

Further details on individual publicly funded projects are provided below by NHS Board.

NHS Boards

Across all NHS Boards five year plans have been produced aligning the capital programme to strategic and service objectives. These are articulated within Local Delivery Plans covering service targets and financial plans (including the capital programme).

In line with current policy, the vast majority of capital resources have been allocated by formula to NHS Boards for them to identify their capital spending requirements and prioritise these in line with available resources. The overall service strategies are supported by Board-wide property strategies.

All projects with a capital investment in excess of the delegated limit for NHS Boards (currently £5 million) are subject to the approval of the Scottish Government Health Directorate. All capital investment is subject to the guidance and principles set down in the Scottish Capital Investment Manual ( SCIM) which is consistent with Green Book principles.

A strategic overview by NHS Board area is provided in Table 4(iv).3. This incorporates programmes and projects to be developed over the period to 2015. Further details of individual projects are provided at Table 4(iv).4.

Table 4(iv).3: Major Development by NHS Boards

NHS Boards

Major Developments

Ayrshire and Arran

There are a number of significant developments including, as part of a major service review, the creation of a number of community casualty units. Major investment is planned in Ayrshire Central Community Hospital. The outpatients department at Crosshouse Hospital, Kilmarnock is to be redeveloped and a new combined assessment unit created. A number of developments are planned in support of care of the elderly and mental health provision.

Borders

Major developments are centred around increasing dental provision (including training facilities) and redevelopments at Borders General Hospital which include the creation of the Borders Emergency Care Centre. These developments are part of the "Getting Fit for the Future" strategy.

Dumfries and Galloway

Major developments include the refurbishment of Dumfries and Galloway Royal Infirmary on a phased basis and mental health provision.

Fife

Projects are being progressed under the approved "Right for Fife" service strategy. The major developments are centred around the Victoria hospital with a new build being progressed through PPP and a phased refurbishment programme over the next 6 years on the existing estate at Victoria and Queen Margaret Hospital. Further investment is being made around mental health services and community provision, most notably in Cupar with a new Community Hospital.

Forth Valley

Implementation of agreed service strategy. Two PPP projects are in construction. Business cases for the redevelopment of remaining Community Hospitals will be developed at Stirling and Falkirk.

Grampian

Implementation of the "Healthfit" strategy will see major investment in Aberdeen Royal Infirmary including the development of an Emergency Care Centre and major refurbishment of the existing estate. The developments at ARI are complemented by investment in community based facilities to support local delivery of non-acute care.

Greater Glasgow & Clyde

Continuation of the agreed Acute Services review will see construction of the New Victoria and Stobhill Hospitals PPP projects, the opening of the Stobhill Forensic Unit, the Beatson Cancer Centre. Major new developments will include new Maternity provision on the Southern General site together with a major redevelopment of the Southern site and new children's hospital. A number of community based facilities are also being delivered.

Highland

The major development will be the Day Surgery Unit at Raigmore in Inverness which is targeted at improving productivity and reducing waiting times.

Lanarkshire

Significant investment in 3 acute sites and 22 community based projects.

Lothian

A large number of developments are planned within Lothian ranging from the reprovision of the Royal Edinburgh Hospital and Royal Hospital for Sick Children to a wider range of community based facilities including community hospitals in Haddington and Midlothian. Significant investment is also scheduled at the Royal Victoria Hospital.

Orkney

A number of community health facilities are in development. A feasibility study is being conducted on the redevelopment of the Balfour Hospital in Kirkwall, potentially as a joint procurement with Orkney Islands Council.

Shetland

Significant refurbishment of the Gilbert Bain Hospital will be taken forward on a phased basis.

Tayside

Major investment in Ninewells and Perth Royal Infirmary are planned as part of the agreed "Acute Balance of Care" strategy. NHS Tayside are currently procuring three mental health schemes as the first health NPD project. Significant investment is also being made in redeveloping the Royal Victoria Hospital in Dundee, together with the provision of intermediate care.

Western Isles

Proposals include provision of a new CT scanner and the rationalisation of accommodation.

NHS Special Boards

The capital budget allocations for Special NHS Boards (including the National Services Scotland) reflects a continuing minor works allocation, provision for individual projects already approved in accordance with SCIM by the Directorate's Capital Investment Group ( CIG) and a provision for projects identified outwith delegated limits contained within Local Delivery Plans.

Key developments within the spending plans of Special Boards include the ongoing replacement programme of the ambulance fleet (£8.3 million per annum), the redevelopment of the State Hospital (circa £90 million) and the relocation of 4 Special Boards from Edinburgh to Glasgow (£15 million).

Primary and Community Care Premises

The provision of more services in the community means that the infrastructure has to be clinically appropriate and safe, provided in accordance with legislation and good practice guidance, and accessible for patients and the public - having particular regard to obligations on the NHS such as the Disability Duty. To that end, there have now been 5 tranches of the Primary and Community Care Premises Modernisation Programme ( PCCPMP) totalling £139 million to augment local capital and revenue programmes for the period 1999-2008.

In addition to local investment on, for example, new purpose-built GP leasehold projects, PCCPMP resources have been invested to support community-based health and community care premises projects across Scotland. These have included Community Health Service Centre projects, new dental centres, and premises extensions and improvements to support GP training, which in turn improves GP recruitment and retention.

The immediate infrastructure development objectives in Primary Care fall under the following headings:

  • continued establishment of Community Health Centres as envisaged in Delivering for Health, both by provision of new facilities and by adaptation of existing facilities;
  • the development and extended role of Community Hospitals consistent with Developing Community Hospitals A Strategy for Scotland published on 20 December 2006 ( DH announced on 21 December 2006 the first deployment of £44.5 million on 4 Community Hospital projects from the £750 million they are making available over the coming 5 years for their equivalent strategy);
  • continuing targeted investment in new dental centres in areas of need, both for the salaried service and to support independent contractors who satisfy NHS commitment requirements;
  • provision of facilities that improve outcomes for patients through more effective Joint Working with other agencies, in particular local authorities, building on exemplars supported under the programme so far;
  • projects that are seen to be driven by Community Health Partnerships;
  • teaching and training facilities for medical students and GP registrars as part of formal strategies agreed between Deaneries and NHS Boards;
  • deliver on Disability Duty commitment and other forthcoming Duties, for instance in respect of availability of services for the elderly;
  • support for other recent initiatives such as the Review of Community Eyecare Services in Scotland published in December 2006.

eHealth Strategy

eHealth encompasses much more than the deployment of computer technology. It conveys the message of electronics in support of health and stimulates thought and discussion about the broad range of issues and opportunities that technology offers in the healthcare setting.

Partnership for Care states …

"Our goal is to deliver an Integrated Care Record jointly managed by patients and professional NHS staff with in-built security of access governed by patient consent… Integrated Care Records will take time to reach, but each step in their development will bring immediate benefits to patients, carers and healthcare professionals by enabling:

  • greater patient involvement in their own care;
  • service redesign and the shift in the balance of care provided in different settings;
  • quicker exchange of information between professionals;
  • quicker access to patient records (with built-in patient confidentiality); and
  • continuous improvement by providing routine monitoring of quality standards."

Partnership for Care extends to partnership with local authorities to develop more person-centred and integrated care in the community. This particularly applies to services provided to older people including single shared assessment and to children where the intention is to improve the co-ordination of children's care services through an integrated Children's Services Record developed in partnership with local authorities and other relevant agencies.

Our objectives now are to:

1. Progressively integrate, improve and deliver key information to the point of active care and self care.

2. Lead through the clinical and patient agendas.

3. Build commitment and collaboration between all stakeholders, and address all elements which make for success.

4. Build upon mandatory national components such as CHI and SCI Store.

5. Address the legacy of inconsistent systems by not sanctioning alternatives acquired locally where a national system has been established.

6. Address the lack of equity and modern systems across NHSScotland through collaborative and supported procurement and development.

Medical Equipment

This budget line recognises the need for continued and sustained investment in and replacement of medical equipment. This drive has been influenced by the need to improve efficiency in diagnostics, and the contribution that activity makes to driving down waiting times as well as the need to ensure that our investment strategy and replacement programmes ensure safe and efficient services to patients. NHSScotland continues to respond to and implement the recommendations of the Audit Scotland report "Better Equipped to Care?".

In addition to ongoing replacement and investment in new equipment which supports faster and more effective diagnosis and treatment, NHSScotland is facing a number of expenditure pressures associated with those hospitals which opened in the past 5-7 years where significant refresh of equipment was made and will need to be replaced. The term medical equipment is wide ranging and can cover items such as blood pressure monitors through to MRI scanners.

Cancer Strategy Implementation

The programme has been established to reflect the ongoing replacement and investment in radiotherapy equipment and the national implementation of Positron Emitting Tomography ( PET) scanning in four centres across Scotland in line with agreed national strategies. Both investment programmes are overseen by National Groups representing clinical and technical experts as well as policy and finance leads from within the Scottish Government Health Directorate ( SGHD).

Energy Efficiency

The proposed programme builds on the success of the Central Energy Efficiency Fund ( CEEF) in promoting measures to both improve energy efficiency and reduce carbon emissions across NHSScotland. The direct promotion and application of resources to support improved energy efficiency has direct revenue benefits as well as positive environmental impacts.

The spatial distribution of this investment is highlighted within the following map:

Health and Wellbeing Portfolio: Heath Projects £5m and over map

Details of the projects, with a capital value in excess of £5 million, within this sector are summarised in Table 4(iv).4.

Table 4(iv).4: Public Investment in Health Projects over £5m

Project

NHS
Board

Value
£m

Timing

Status 15

Narrative

Adult Continuing Care, Ayr

Ayrshire & Arran

5

TBC

Awaiting outcome of Review of Strategic Services Review

Awaiting outcome of Review of Strategic Services Review

Acute Adult Mental Health, Ayr

Ayrshire & Arran

10

TBC

Awaiting Outcome of Mental Health Strategic Review

New Community Hospital facility

Review of Services

Ayrshire & Arran

70

TBC

Awaiting outcome of Review of Strategic Services Review

Review of Services

Girvan Community Hospital, Girvan

Ayrshire & Arran

20

Procurement 2007-08
Construction January 2008 - July 2009

FBC Approved in October 2006

New Community Hospital

Ayrshire Central Community Hospital

Ayrshire & Arran

31

TBC

Awaiting outcome of Review of Strategic Services Review

Redevelopment of existing hospital site to form integrated inpatient/outpatient activity in line with community hospital strategy

Arran Community Hospital, Arran

Ayrshire & Arran

12

TBC

Awaiting outcome of Review of Strategic Services Review

New community hospital facility, consistent with national community hospital strategy

Care of the Elderly - Kilmarnock/Ayr

Ayrshire & Arran

7

TBC

Awaiting outcome of Review of Strategic Services Review

Reprovision of frail elderly beds/day hospital in line with strategy review

Borders General Hospital Re-design Projects, Melrose

Borders

18

In Construction

This project is made up of a number of small individual schemes and the Borders Emergency Care Centre which is estimated at £10m. Only the enabling scheme of £1.3m has commenced the remaining schemes have not yet been formally agreed by the Board and are still at the planning stages

Redesign of the current facilities in Borders General Hospital which is now 25 years old. The redesign will encompass Borders Emergency Care Centre

Modernisation of Mental Health Services, Dumfries

Dumfries & Galloway

24

Completion in 2012

OBC Approved

Integrated new build in-patient mental health facility

Dumfries & Galloway Royal Infirmary Refurbishment, Dumfries

Dumfries & Galloway

TBC

Completion in 2015

IA Approved. Range of options to be explored in the OBC to determine cost

Refurbishment of District General Hospital to provide high proportion of single room accommodation

Development of new GP Premises at Lochfield Road, Dumfries

Dumfries & Galloway

5

Completion in 2010

SBC Approved

Replacement of GP Premises and other specialist services

Mental Health Project - NHS Fife

Fife

11

In Procurement

FBC in First Quarter 2008

Strategic rationalisation and modernisation of Mental Health In-Patient facilities in Fife

Victoria Reconfiguration, Kirkcaldy/ Dunfermline

Fife

51

FBC due to be submitted for approval in April 2008

Detailed cost estimates in preparation with OBC to be submitted.

The GH& MS Project involves the re-alignment of services across two existing local general hospitals with the Victoria Hospital site extended through a PPP procurement. The existing Queen Margaret and Victoria Hospitals will be refurbished to include emergency medical care, diagnostic services including local Diagnostic and Treatment Centres, MRI and CT.

Cupar Community Hospital, Cupar

Fife

8

Procurement 2008-09 Completion 2010

OBC Approved. Progressing toward FBC approval stages

Refurbishment and reconfiguration of Community Hospital to form inpatient, outpatient, dentistry, podiatry and base for other NHS community services.

Health Centre Programme, Stenhousemuir

Forth Valley

8

OBC Approved

Third Party Development of New Health Centre in Stenhousemuir

Health Centre Programme, Stirling

Forth Valley

12

Not Yet Known. TBC in FBC

OBC Approved

Third Party Development of New Health Centre in Stirling

Community Hospitals, Stirling and Falkirk

Forth Valley

60

TBC in line with OBC

IA approved, OBC expected in 2008

Construction of two Community Hospitals on sites of (current) hospitals in Falkirk and Stirling

Aberdeen Royal Infirmary - Future Stages, Aberdeen

Grampian

300

TBC

IA approved by the SGHD in March 2008. Actual cost to be determined through option appraisal in the OBC

Redevelopment of Aberdeen Royal Infirmary

Cancer Centre

Grampian

50

TBC

Potential/Proposed - not yet approved by The Scottish Government CIG. Strategic Brief in Preparation

Modernisation of cancer facilities

OP/ MDO/ MRI

Grampian

50

TBC - Indicative timescale of 2011-12

OBC In Preparation

Redevelopment of ambulatory care services ( MRI/Outpatient/Endoscopy project)

Facilities/Rehab/ DTC Provision, Aberdeen

Grampian

15

TBC

Potential/Proposed - not yet approved by The Scottish Government CIG

Upgrade of existing facilities

Health Village, Aberdeen

Grampian

25

Estimated 2011-12

OBC in Preparation

Replacement of Aberdeen CHP facilities in Woolmanhill and Denburn Health Centre. Creation of intermediate care capacity for Aberdeen City CHP to support activity shifts

Forres Hospital/ Health Centre Scheme, Forres

Grampian

12

TBC

Potential/Proposed - not yet approved by The Scottish Government CIG

Hospital and Health Centre Development

Reprovision of Forresterhill Health Centre, Aberdeen

Grampian

5

TBC

Potential/Proposed - not yet approved by The Scottish Government CIG

Reprovision of Health Centre

Dental School - Phase 2, Aberdeen

Grampian

16

End 2009

IA approved, OBC currently being considered by The Scottish Government CIG

Dental Institute to include new Dental School to meet SGHD target

Emergency Care Centre, Aberdeen

Grampian

80

TBC in OBC

IA approved, Emergency Care centre and MRI/Outpatient Centre. Outline Business cases will be submitted after formal approval of the Health Campus Programme Initial Agreement to ensure that things are in logical order

The Health Campus Programme IA has been submitted for approval by The Scottish Government CIG in February. The Emergency Care and MRI/ OPOBCs being submitted in the following months

The Emergency Care Centre and MRI/Outpatients are being re-configured to become the early stages in the move towards the Foresterhill Masterplan which is nearing completion. The Emergency Centre will also include capacity to start the redevelopment of inpatient facilities at Aberdeen Royal Infirmary

Chalmers Hospital/ HC, Banff

Grampian

14

Construction 2008-2012

OBC Addendum approved

New build Health Centre, refurbishment of the existing Hospital Building and a new build Ward block

Acute Services Review - Phase 2 - Southern General and Children's Hospital, Glasgow

Greater Glasgow and Clyde

842

Completion in 2014

OBC submitted February 2008

Various significant new Build and Refurbishment Projects to provide for the modernisation of NHS Services throughout the Board's region of responsibility.

Provision of Gynaecology Facilities at the Princess Royal Maternity Hospital

Greater Glasgow and Clyde

9.5

Completion programmed for end 2009

Construction commenced on site

Contract provides for the "fit out" completion of previously created space within the Princess Royal Maternity Hospital to provide for the transfer of Gynaecology services

Maternity Strategy Project - Southern General Hospital

Greater Glasgow and Clyde

30

New build completion projected for Autumn 2009 with refurbishment completion projected for end 2010.

OBC Approved FBC being prepared for April 2008 for The Scottish Government CIG

Construction of a new 3 storey facility to provide a neonatal service with integrated medical and surgical intensive care cots, etc., along with the refurbishment of the existing labour ward for day care, triage and EPAS

Laboratory Tower Refurbishment - Glasgow Royal Infirmary

Greater Glasgow and Clyde

11

Site start projected for January 2009 with a projected completion of end 2010

OBC being prepared

Project comprises the rationalisation, modernisation and refurbishment of existing NHS and University laboratory facilities located in a 4-storey tower block at Glasgow Royal Infirmary

Inverclyde Royal Hospital Remedial Work to Cladding, Greenock

Greater Glasgow and Clyde

8

Remedial work to entire external cladding system

Royal Alexandra Hospital - Maternity Phase 2, Paisley

Greater Glasgow and Clyde

8

Construction completion programmed for 2009

Construction commenced on site

Refurbishment of remaining Maternity Department

Royal Alexandra Hospital Renal Unit, Paisley

Greater Glasgow and Clyde

6

Completion projected as being 2011

TBC - Part of ongoing Review of Health Service Strategy

New build and reconfiguration works to provide for new Renal Services

West of Scotland Adolescent Services - Stobhill Hospital

Greater Glasgow and Clyde

8

Construction end 2009

On Site

New Build Modern Mental Health Facility for Adolescents

Child & Family Centre - Drumchapel

Greater Glasgow and Clyde

6

TBC

Initial design being prepared for Planning Approval

West Glasgow C.H.C.P. Development in conjunction with Glasgow City Social Work Department to provide 3-storey New Build Child & Family Centre for Drumchapel and the surrounding areas

Remodel Inverclyde Royal Hospital, Paisley

Greater Glasgow and Clyde

8

TBC

TBC - Part of ongoing Review of Health Service Strategy

Provision for rationalisation and modernisation of Hospital Services

Remodel Royal Alexandra Hospital, Paisley

Greater Glasgow and Clyde

5

TBC

TBC - Part of ongoing Review of Health Service Strategy

Provision for rationalisation and modernisation of Hospital Services

Renfrew Health Centre, Renfrew

Greater Glasgow and Clyde

15

Construction 2008 - end 2009

FBC approved, March 2008

New build construction providing local health centre. This is a joint project with Renfrewshire Council which will house both GP services and social work services

Barrhead Health Centre, Barrhead, Glasgow

Greater Glasgow and Clyde

15

Construction 2008-10

OBC approved

The development of a multi-purpose health and care facility for the community of Barrhead. The development will be led by the East Renfrewshire Community Health and Care Partnership and brings together East Renfrewshire Council and NHS Greater Glasgow and Clyde in a venture which will progress the integration of services to the population of Barrhead

Care of the Elderly, Sutherland (Migdale), Golspie

Highland

7

Construction 2009-011

OBC approved

New 24-bedded community hospital

Day Surgery Centre, Raigmore, Inverness

Highland

14

Construction 2009-10

OBC Addendum approved

New Day Surgery Centre comprising theatres, Treatment Room and supporting areas with dedicated Day Surgical nursing and ancillary staff

Airdrie Resource Centre, Airdrie

Lanarkshire

27

Estimated completion 2010

OBC Approved. FBC expected end 2008

The development of a new Primary Care Resource Centre in Airdrie, replacing Airdrie Health Centre, Adam Avenue Clinic and three private GP premises

Carluke Resource Centre, Carluke

Lanarkshire

12

Estimated completion 2010

OBC approved

The development of a new Primary Care Resource Centre in Carluke

Hamilton Resource Centre, Hamilton

Lanarkshire

8

Not yet known - planned developments are being reviewed in the context of the overall A&E Review process

Potential/Proposed - not yet approved by The Scottish Government CIG

The development of a new Primary Care Resource Centre in Hamilton

Wishaw Health Centre, Wishaw

Lanarkshire

TBC

Not yet known - planned developments are being reviewed in the context of the overall A&E Review process

Potential/Proposed - not yet approved by The Scottish Government CIG

The development of a new Primary Care Resource Centre in Wishaw

East Kilbride Resource Centre, East Kilbride

Lanarkshire

19

Not yet known - planned developments are being reviewed in the context of the overall A&E Review process

Potential/Proposed - not yet approved by The Scottish Government CIG

The development of a new Primary Care Resource Centre in East Kilbride

Coatbridge Dental & Integrated Resource Centre, Coatbridge

Lanarkshire

12

Estimated completion 2010

OBC approved

The development of a new Dental & Integrated Resource Centre in Coatbridge, providing a dental centre (incorporating outreach training), and accommodation for two GP practices and the community mental health team

Learning Disability Assessment and Treatment Centre at Kirklands Hospital site, Bothwell

Lanarkshire

6.4

Estimated completion 2010

Potential/Proposed - not yet approved by The Scottish Government CIG

The development of a learning disability assessment and treatment centre

Adults with Complex Needs in North Lanarkshire - Coathill, Coatbridge

Lanarkshire

6

Estimated Completion 2009

OBC approved

The development of a new Unit for Adults with Complex Needs on the site of Coathill Hospital

Adults with Complex Needs in South Lanarkshire - Caird House, Hamilton

Lanarkshire

8

Estimated Completion 2010

OBC approved

With the proposed closure of Hartwoodhill Hospital and Airbles Road Centre, the opportunity has been taken to review the overall bed configuration and to relocate this provision within the communities they serve. This involves building new units at Caird House, Hamilton and Coathill Hospital, Coatbridge with a total of 55 beds

Kilsyth Health Centre, Kilsyth

Lanarkshire

17

Not yet known - planned developments are being reviewed in the context of the overall A&E Review process

Potential/Proposed - not yet approved by The Scottish Government CIG

The development of a new Health Centre in Kilsyth

Clydesdale Hospital

Lanarkshire

7

Not yet known - planned developments are being reviewed in the context of the overall A&E Review process

Potential/Proposed - not yet approved by The Scottish Government CIG

Project not yet developed

Monklands General Hospital

Lanarkshire

110

Not yet known - planned developments are being reviewed in the context of the overall A&E Review process

Potential/Proposed - not yet approved by The Scottish Government CIG

Project not yet fully developed

Acute Mental Health - Monklands

Lanarkshire

34

Estimated completion 2012-13

Potential/Proposed - not yet approved by The Scottish Government CIG

Proposed new bed unit

Acute Mental Health - Other, East Kilbride

Lanarkshire

29

Not yet known - planned developments are being reviewed in the context of the overall A&E Review process

Potential/Proposed - not yet approved by The Scottish Government CIG

Detailed scope to be determined through Business Case process

Acute - Hairmyres General Hospital

Lanarkshire

50

Not yet known - planned developments are being reviewed in the context of the overall A&E Review process

NHS Board considering options following outcome of Ministerial announcement on Accident and Emergency services.

Detailed scope to be determined through Business Case process

Acute - Wishaw General Hospital, Wishaw

Lanarkshire

13

Not yet known - planned developments are being reviewed in the context of the overall A&E Review process

NHS Board considering options following outcome of Ministerial announcement on Accident and Emergency services.

Detailed scope to be determined through Business Case process

Musselburgh PCC, Musselburgh

Lothian

20

Estimated completion 2011

OBC submitted to The Scottish Government. Outline planning permission pending

To provide a purpose built primary care centre in Musselburgh incorporating 3 GP primary care premises and a range of outpatient facilities located in the community

Royal Hospital for Sick Children and Young Peoples Unit, Edinburgh

Lothian

TBC

Not yet finalised but will be reflected in OBC to the Scottish Government CIG

IA approved. OBC expected 2008

Reprovision of existing Royal Hospital for Sick Children and Child and Adolescent mental health specialist services currently at Royal Edinburgh Hospital

Westerhailes PCC, Edinburgh

Lothian

10 16

Timescales being finalised

Approved by NHS Lothian in principle (within delegated limits)

The proposed centre will offer accommodation for the Wester Hailes Medical Practice and aligned Primary Care services as well as local authority staff from Children & Families and Health & Social Care. A community based health project would also be located in the centre. The centre would provide an opportunity for the partners to create a model of integrated service delivery in a disadvantaged area of the city. This will be a new build which will replace the existing health centre and social work offices in the area

Project

NHS
Board

Value
£m

Timing

Status 17

Narrative

Chalmers Hospital, Edinburgh

Lothian

8

Completion per SBC is November 2009

Approved by NHS Lothian (within delegated limits)

Redevelopment of the old Chalmers hospital into a fit for purpose accommodation for the Lothian family planning, well woman services and the genitourinary medicine departments, in a combined sexual health centre.

Western General Hospital Multi Storey Car Park, Edinburgh

Lothian

c.11 subject to review

Not yet known

The proposed project is currently having a follow-up Feasibility Study into the Enabling Works carried out. Project will be reviewed as part of Western General masterplan

Potential for building multi-storey Car Park or other car parking reprovision

Haddington Hospital

Lothian

c.34

Not yet known

Models of Care and site options being reviewed to allow OBC to be updated

To provide fit for purpose inpatient, outpatient, day hospital and community based services for the population of East Lothian. Rationalisation of patient services across Roodlands, Herdmanflat and Edenhall Hospital sites

Royal Edinburgh Hospital

Lothian

93

Not yet known

New Project Board setup to review models of care to progress OBC

Adult acute mental health beds, psycho geriatric beds, out patient and a range of support single system services

Royal Victoria Hospital

Lothian

40

May 2012

Due to be considered by SGHD in April 2008

Reprovision of all services at present based on the Royal Victoria Hospital site. This includes in patient and out patient services for Medicine of the Elderly and Psychiatry of Old Age, Laboratory Van depot, Adult Mental Health Day Unit

Clinical Neurosciences

Lothian

TBC

TBC

Initial Agreement being developed

Reprovision of Clinical Neurosciences facilities

Fauldhouse

Lothian

c.7 total value

March 2009 completion

Approved by NHS Lothian

Development of Fauldhouse Health Centre in partnership with West Lothian Council

Reprovision of Balfour Hospital

Orkney

N/K

Not yet known. Costs to be determined through option appraisal in OBC

IA approved by SGHD in March 2008. OBC in development

To reprovide the Balfour Hospital, and Dental surgeries either through developments on present site or through new build

Redevelopment of The State Hospitals, Carstairs

State Hospital

85

Completion 2010

FBC Approved

New-build facilities of approximately 19,000 m 2 plus adaptation (for alternative use) of a further 1,500 m 2 of existing buildings. The new-build facilities will be constructed in 3 phases to allow the high security psychiatric hospital to continue in operation during construction. The procurement will be publicly-funded and will be a Design and Build (Develop and Construct) contract

Main Block Development Project, Tayside

Tayside

6

Not yet known

Not yet known

Main Block Development Project

Perth and Kinross Integrated Dental Treatment and Training Centre, Perth

Tayside

6

Construction phase could commence in June 2008, for a period of 12 months and be completed in June 2009.

OBC approved

The development of a 20 place surgery integrated dental treatment and teaching centre in the City of Perth providing new, accessible salaried GDS to Perth and Kinross that will greatly improve NHS access for patients and relieve the current pressures placed upon the local CDS and Emergency Dental Service

Perth and Kinross Specialist Palliative Care Service

Tayside

5

Not yet known

FBC due to be submitted to The Scottish Government CIG in April 2008.

Provision of Inpatient Palliative Care in Perth & Kinross

Critical Care Unit, Development at PRI, Perth

Tayside

12

Not yet known

Potential/Proposed - not yet approved by The Scottish Government CIG

Development of a Critical Care Unit

New Stroke Unit at PRI, Perth

Tayside

10

Not yet known

Potential/Proposed - not yet approved by The Scottish Government CIG

Development of a Stroke Unit

Ninewells Nuclear Medicines

Tayside

8

Not yet known

Potential/Proposed - not yet approved by Ministers

Reprovision of a Nuclear Medicines Facility

Ninewells ICU/ HDU

Tayside

16

Not yet known

Potential/Proposed - not yet approved by Ministers

Extension and Refurbishment of ICU/ HDU Facility

Laboratory Development ( ABC 03)

Tayside

5

Not yet known

Potential/Proposed - not yet approved by Ministers

Reprovision of Laboratory facility

Wave 5 Linear Accelerator

Tayside

6

Under construction

Approved

Provision of an additional Linear Accelerator at Ninewells

ATC Development ( ABC 6)

Tayside

8

Not yet known

Potential/Proposed - not yet approved by Ministers

Reprovision of a new ambulatory treatment centre

Health: Private Investment

Investment in the infrastructure of NHSScotland has been made through a number of procurement routes including the use of PPP. Across NHSScotland there are currently 51 signed PPP type projects with a capital value of £822.23 million. These are Private Finance Initiative ( PFI) schemes and range from nursing home provision through to large hospital PPP/ PFI schemes. PPP projects under construction include the new Victoria and Stobhill Hospitals in Glasgow (£183 million), the new acute hospital in Larbert (£293 million), the Community Hospital in Alloa (£18 million) and the Community Hospital in St Andrews (£27 million).

Within NHSScotland there are currently a number of projects in various stages of development which may or may not proceed through PPP. Those decisions will be taken at the appropriate time, on the basis of a full Value for Money assessment. Current estimates of the capital investment that may be supportable through PPP over the next 5 years are in Table 4(iv).6. This includes those projects in procurement but yet to reach financial close.

Table 4(iv).6: Privately Financed Projects

Project

Value
£m

Timing

Status

Narrative

PPP/ PFI New Acute Hospital, NHS Forth Valley

296

Procurement: 2008-09
Construction: 2009-12

FBC approved

New hospital development in Larbert

PPP/ PFI Midlothian Community Hospital

20

In Procurement:
Construction:
June 2010 - Dec 2012

OBC approved

The replacement of Rosslynlee and Loanhead Hospitals, with the development of appropriate community services hospital

NPD Tayside Mental Health Development

100

Procurement: October 2007
Construction: 2009-11

OBC Approved

The modernisation of mental health inpatient facilities for General Adult Psychiatry, Psychiatry of Old Age and Low Secure Care Services and the development of a new regional Medium Secure Unit to provide a continuum of care

PPP/ PFI Clackmannanshire Community Hospital

18

Completion in 2008

FBC Approved

New hospital and community health centre development

PPP/ PFI St Andrews

27

Completion in 2009

FBC approved

New build which will bring all existing services from St Andrews Memorial Hospital and St Andrews Health Centre, plus additional services, on to a single site

PPP/ PFI Fife Acute

155

FBC to be submitted April 2008

OBC approved

New Build Works at the Victoria Hospital site

Third Party Development Wallacetown Health Centre

9

Not yet known

Potential/ Proposed - not yet approved by Ministers

Reprovision of Wallacetown Health Centre in Dundee

HOUSING AND REGENERATION

Investment in the housing and regeneration sector is delivered through close partnership working with local government, Registered Social Landlords and Urban Regeneration Companies. The Scottish Government will directly support the provision of affordable housing (both for rent and for sale), improving the condition of private sector housing, and regenerating communities. Further details are provided below.

Planned Public Investment

Table 4(iv).7 provides details of the planned public capital investment on housing and regeneration over the period 2008-11. Budgets from 2011-12 onwards will be determined by the next Spending Review.

Table 4(iv).7: Housing & Regeneration: Forecast Infrastructure Investment - Public Funding

2008/09
£m

2009/10
£m

2010/11
£m

Affordable Housing Investment Programme

178

251

276

Modernising Private Sector Housing

10

15

15

Central Heating Initiative/Warm Deal

45

45

45

Regeneration Programmes

26

41

20

Local authority specific grants, comprising:

a) Affordable Housing Investment Programme

119

119

119

b) assistance to Glasgow owners

15

15

15

c) Private Sector Housing Grant

68

68

d) Vacant and Derelict Land Fund

12

12

12

Total

473

566

502

The following should be noted in terms of the forecast level of investment:

  • The Affordable Housing Investment Programme supports the provision of affordable homes for rent and low cost home ownership. The figures shown are the amounts classed as capital investment. The full provision for the period 2008-11 (net of estimated annual receipts of £30 million, and excluding the amount allocated to Glasgow City and City of Edinburgh Councils - see below) is £343.9 million/ £416.7 million/£442.1 million.
  • Modernising Private Sector Housing will contribute to the implementation of the Housing (Scotland) Act 2006, which will offer home owners a more flexible regime of advice, assistance, loans and grants to improve the condition of their homes. Part of this funding will support lending activities and a loans brokerage/financial advice service.
  • Regeneration Companies - this funding will provide support to the pathfinder Urban Regeneration Companies: Clydebank Rebuilt, Riverside Inverclyde, Irvine Bay and Clyde Gateway.
  • Affordable Housing Investment Programme - this is the portion of the programme managed by Glasgow City and City of Edinburgh Councils.
  • Glasgow Owners - this is the funding allocated to assist owners affected by the programme of improvements to the stock of Glasgow Housing Association.
  • Private Sector Housing Grant - this funding supports improvements in the condition of private sector housing. In 2010-11, the ringfence will be removed from the Private Sector Housing Grant, and the amount of public funding invested will be at the discretion of local authorities. Therefore, no estimate of public funding has been made here.
  • Vacant and Derelict Land Fund - up to 2007-08, this provided grant to 4 local authorities - Glasgow, North and South Lanarkshire and Dundee - to bring vacant and derelict land back into productive use. Decisions on future allocations will be made in light of the 2007 edition of the Vacant and Derelict Land Survey.

Details of the Scottish Government's funding for Urban Regeneration Company projects, with a capital value in excess of £5 million, is summarised in Table 4(iv).8.

Table 4(iv).8: Urban Regeneration Company ( URC) Capital Investment over £5m

Project

Value
£m

Timing

Status

Narrative

Clydebank Rebuilt

5

10 year business plan (from 2003)

Ongoing

The URC aims to act as a catalyst for the economic, social and physical regeneration of Clydebank. The 2008-09 funding will be the fourth and final year of Government funding

Irvine Bay

6

0-12 year business plan (from 2006)

Ongoing

This URC covers Irvine, Kilwinning, Stevenston, Saltcoats and Ardrossan and includes the Ardeer peninsula

Riverside Inverclyde

19

12 year business plan (from 2006)

Ongoing

Focuses on a series of locations along the Inverclyde waterfront between Greenock and Port Glasgow. The area is within the 15% most deprived areas in Scotland and the URC's overarching strategic objective is to advance economic growth

Clyde Gateway

57

20 year business plan (from 2008)

Ongoing

Focuses on a former industrial area in the east end of Glasgow and extends into South Lanarkshire. The project incorporates some of the key sites for the 2014 Commonwealth Games and seeks to capitalise on the opportunities arising from the new M74 motorway link and the East End Regeneration Route. Further information can be found at: www.glasgow.gov.uk

Housing: Private Investment

Table 4(iv).9 provides further details of the estimated private sector investment generated by public expenditure on housing and regeneration over the period 2008-11. With the exception of the estimated private sector investment in Urban Regeneration Companies (see note 3 below), no estimates have been made of private sector investment beyond 2011. However, it is anticipated that private investment will play a strong part in meeting Scotland's needs for additional housing capacity over the next 10 years, in addition to that normally levered in through housing grants. The Government's recent discussion document, " Firm Foundations: The Future of Housing in Scotland", proposed that the rate of new housing supply in Scotland should increase from 25,000 a year currently to at least 35,000 a year by the middle of the next decade.

Table 4(iv).9: Housing & Regeneration: Forecast Infrastructure Investment - Private Funding

2008/09
£m

2009/10
£m

2010/11
£m

Future
Developments
£m

Affordable Housing Investment Programme

71

100

110

Modernising Private Sector Housing

1

15

20

Regeneration Programmes

500

Local authority specific grants, comprising:

a) Affordable Housing Investment Programme

48

48

48

b) assistance to Glasgow owners

5

5

5

c) Private Sector Housing Grant

18

32

d) Vacant and Derelict Land Fund

10

10

10

Total

153

210

193

500

The following should be noted in terms of the forecast level of investment:

  • Affordable Housing Investment Programme - Private finance levered into housing by housing grant is measured and agreed at grant approval point, so the estimate may change. In particular, private investment is expected to increase over the period 2008-11, depending on the implementation of the Government's proposals to reform the funding of the social housing sector. This is also an area under consideration for the proposed Scottish Futures Trust.
  • Modernising Private Sector Housing - these are best estimates of the private finance generated, and are subject to change. Included are estimates of the additional private investment generated by the shift to loans, rather than grants, to homeowners.
  • Regeneration Programmes - each of the pathfinder URCs being funded by the Government has submitted a business plan which gives a broad estimate of the anticipated levels of private sector investment to be generated by the URCs activities. In total, these estimates amount to in excess of £500 million. However, the estimates are over the lifespan of the business plan (generally 10-15 years) and relate to the totality of the URC's investment.
  • Private Sector Housing Grant - in 2010-11, the ringfence will be removed from the Private Sector Housing Grant, and the amount of public funding invested will be at the discretion of local authorities taking into account the single final settlement reached with the Scottish Government.
  • Vacant and Derelict Land Fund - the estimate of private sector investment is based on experience over the period 2004-06, and generally reflects the funding generated by the total package of public investment, not just Vacant and Derelict Land Fund.

SPORT

The availability, accessibility and quality of facilities influences whether people take part in sport, which sports they play, how often they play and how well they perform. The provision of sports facilities is the statutory responsibility of local authorities and they are best placed to assess the needs of the communities they serve through the community planning process and to take a strategic and comprehensive approach to the provision of facilities including the school estate, clubs and private sector providers. That said, the Scottish Government through sportscotland, and through the funding of community facilities as part of the £2.3 billion schools programme provided pump-priming funding to assist councils in developing strategic facility and sports pitch plans and implementation.

In addition, the Scottish Government and sportscotland is investing £50 million under the National and Regional Sports Facilities Strategy to develop quality state of the art facilities which will help our current and future athletes train and prepare for success.

Commonwealth Games

There is little infrastructure development required specifically for the Glasgow 2014 Commonwealth Games. Indeed, one of the key selling points of the Glasgow bid was that over 70% of Games venues are already in place, with the main new sites to be built being the National Indoor Sports Arena and Velodrome, a new 50m swimming pool at Tollcross Leisure Centre, and the SECC Entertainments Arena. Approximately £70 million of the Organising Company's ( OC) budget is allocated to capital expenditure (out of gross expenditure of £373 million). These costs will be split 80:20 between the Scottish Government and Glasgow City Council. The main items of capital expenditure falling to the OC are 50% of the costs of the Velodrome, the cost of the new 50m pool at Tollcross and the adaptation of Hampden Park for athletics. The success of the Glasgow 2014 Commonwealth Games also depends to varying degrees on approximately £2 billion of other infrastructure development, such as the East End Regeneration Route, the M74 extension, and the Glasgow Airport Rail Link.

Table 4(iv).10 provides further details on planned Sports investments receiving central government funding in excess of £5 million.

Table 4(iv).10: Forecast Sports Projects - Scottish Government investment of £5m or more

Project

Description - National and Regional Facilities

Total
Direct
Capital
£m

Royal Commonwealth Pool - City of Edinburgh Council

RCP refurbishment will provide modern standards for competition, training and community use. It will help to meet the needs of Scottish Swimming and provide Scotland with its only international standard diving centre. The RCP is the proposed diving venue for the 2014 Commonwealth Games

7

Chris Anderson Stadium - Aberdeen City Council

The proposals include an indoor athletics training facility, an indoor synthetic pitch for football and other sports, and sports hall for competition and training. Also included are squash courts, fitness conditioning suite, outdoor synthetic and grass pitches

5

East End - Glasgow City Council

The proposals for National Indoor Sports Arena and Velodrome include a 200m 6 lane indoor track, 60m 8 lane sprint straight and field event area for indoor competitions; seating for 5,000 spectators, competition facilities for court sports; an indoor athletics training facility; a 12 court sports hall of competition and training; and a wide range of support facilities. The indoor velodrome will comprise a 250m track with seating for 2,000 spectators. This is also the proposed location of sportscotland's HQ

8

Ravenscraig - North Lanarkshire Council

The proposals include an indoor athletics training facility, an indoor synthetic grass pitch for football and other sports and a sports hall for competition and training. In addition, there will be an outdoor synthetic grass pitch on site and other supporting pitches nearby

5

Sport scotland investment in infrastructure

Table 4(iv).11 shows the provisional amounts to be invested through sportscotland's Building for Sport ( BFS) programme. It should be noted that the maximum award available from this programme is £1 million and that investment is solely based on applications received. Therefore, it is not possible to identify specific projects at this stage.

The table also shows proposed exchequer investment, and forecast lottery investment although this is subject to change.

Table 4(iv).11: Sportscotland Investment

2008/09
£m

2009/10
£m

2010/11
£m

2011/12
£m

2012/13
£m

BFS - Exchequer

5

5

7

n/a

n/a

BFS - Lottery

2

4.5

4

2

2

Future Sports Investment

Quality, accessible facilities are vital if sport is to thrive in Scotland. The 2006 sportscotland National Audit of Scotland's Sports Facilities (which covered outdoor, golf and indoor facilities (including swimming pools) operated by clubs, schools, further education, the private sector and local authorities) identified a range of factors that all need to be considered in addressing facility planning and investment.

Of particular significance is the changing pattern of demand for sports facilities taking account of both demographic trends and the changing popularity of different sports. This means that many existing facilities need to be replaced rather than refurbished and the replacement facilities will need to differ in scale and specification from those they will replace. In addition, new facilities will be required in areas of under-provision.

The Audit found that the cost of upgrading and maintaining all Scotland's facilities over a 25 year period is equivalent to £110 million per annum. This is not so surprising given the large number of facilities involved, the costs of maintaining this enormous estate in terms of both buildings and land. The age of much of this stock, the quality of initial design and construction and the level of investment in both refurbishment and maintenance over a long number of years all contribute to the projected costs. The Audit report concludes that the levels of expenditure on maintenance have been insufficient to keep facilities in an acceptable condition.

With many facilities in need of major refurbishment, local government and its partners need to take a more strategic approach to facility planning and investment. Table 4(iv).12 details the investment required to upgrade existing facilities.

Table 4(iv).12: Summary of Required Investment in Sports facilities 18

Upgrade costs over
25 years to 2031 (£m)

Sports Pitches

210

Multi-Courts/ MUGAs

4

Tennis Courts

22

Bowling Greens

14

Athletics Tracks

2

Outdoor Pavilions

231

Outdoor Facilities

483

Golf Courses

87

Golf Clubhouses

72

Golf Facilities

159

Sports Halls

441

Swimming Pools

297

Fitness Suites

321

Gymnastic Halls

42

Indoor Bowls

60

Squash Courts

73

Climbing Walls

6

Ice Rinks

45

Indoor Tennis

26

Indoor Facilities

1,311

Total

1,952

Table 4(iv).13 details future sports projects which if approved will require Government investment in excess of £5 million.

Table 4(iv).13: Possible Future Sports Investments - Government Investment Above £5m

Project & Location

£m

Sports Halls

Network of Regional Sports Halls

Dundee ( NRSFS)

7

Replacement of Major Sport Centres

Meadowbank (Dry)

7

Swimming Pools (New Provision)

Aberdeen 50m

5

Football & Rugby

To implement National Facilities Strategies

£500m over 10 years

Miscellaneous Investment Below £5m

A range of sports projects

38