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Wrington Vale Medical Practice Development Detailed Business Case. Extraordinary Board Meeting 17 th December 2010. Background. OBC approval May 2009 - financial envelope £170k, clarity on benefits, consultation, space

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wrington vale medical practice development detailed business case

Wrington Vale Medical Practice Development Detailed Business Case

Extraordinary Board Meeting

17th December 2010

  • OBC approval May 2009 - financial envelope £170k, clarity on benefits, consultation, space
  • Consultation – Nov.2009 to March 2010. Report received by Board in July 2009.
    • Strong message re potential loss of local service in Wrington
  • Detailed Business Case received – Nov 2010
  • 6 week Assurance Process
  • Addendum from practice reflecting changes arising from the assurance process.
public involvement and engagement
Public Involvement and Engagement
  • PCT collated post-consultation feedback
  • Health Overview and Scrutiny Panel update
  • Project Board with lay membership
  • Two recent public meetings by the practice:
    • Stronger voice from patients in other areas served by the practice in support of single site
    • Concerns from Wrington people re longevity of solution to meet their needs
assurance process
Assurance Process
  • Consultation outcomes reflected in Practices review of options appraisal
  • Non-financial Benefits Appraisal
  • Space requirements that are in line with national guidance, list size and service needs
  • Financial Appraisal
  • Project Board consideration; PCT Directors, Lay members drawn from Consultation Reference Group
non financial benefits appraisal
Non-financial Benefits Appraisal
  • Weighting of criteria reflected response from consultation
    • Ease of access most important
    • More services for patients next in importance
  • 5 service delivery model options appraised
  • Remaining 3 options scores close but practices preferred option, single site + presence in Wrington, consistently highest
financial assurance space comparisons
Financial Assurance – Space comparisons
  • List size, GP full time equivalents, no of clinical sessions have informed table below:
value for money
Value for Money
  • District Valuer’s opinion led to consideration of and changes to baseline assumptions including build cost, fees and developer costs
  • Benchmark of other schemes in region
  • National guidance on space for practices of the size of WVMP
  • Reduction in build cost saves 5%
  • Car park spaces significantly reduced in number
conclusion of financial appraisal
Conclusion of Financial Appraisal
  • Space allowance = 890m2
  • Car park spaces reduced to 56
  • Project cost brought below £2m
  • Build cost £m2 reduction
  • Site value appraised independently
  • Fees and developer costs reduced
  • Current market rent p.a. £145k for main site
key benefits for patients
Key Benefits for Patients
  • Sustainable high quality, local, primary healthcare
  • Better patient experience and environment
  • Additional services
    • Extra clinics, GP and nurse, some more evenings and at weekend
    • New services e.g. Physiotherapy, Hot Foot clinic, visiting consultants and nurse specialist
    • Preventative and self-care health shop
  • Opportunities for the future:
    • One stop shops and visiting diagnostics e.g. ultrasound
    • Increased collaboration with community groups
benefits for the practice and staff
Benefits for the Practice and Staff
  • Improved working environment and facilities
  • Expansion of training facilities
  • Better communications between multi-disciplinary team
  • Strengthens recruitment and retention
  • Improved job satisfaction due to integrated team working
  • More efficient business model
  • Reinvestment of productivity in services to attract and retain patients
key challenges planning permission
Key challenges - planning permission
  • Sequential test will apply to any development site eg consideration of:
    • Forest of Avon/area of protected species and habitats
    • Settlement boundaries
    • Flood zones
    • Safeguarding of land by policy
  • Pudding Pie Lane site constrained but:
    • All other sites more constrained at time of appraisal for this business case
    • Centrally located for the practice population
    • Best meets Practice’s business model
other key challenges
Other Key Challenges
  • Time of uncertainty
    • Policy direction - detail of this emerging
    • Economic challenge ahead
  • Timeliness of development:
    • Meeting CQC standards by 2012
    • Practice sustainability
    • NHS delivery challenges; QIPP, shift closer to home, integration of services
  • Note the outcome of the assurance process
  • Approve the Practice’s preferred service option of consolidating onto one main site
  • If main site is Pudding Pie Lane/Langford, approve a presence in Wrington
  • Approve a maximum financial envelope of £158.5k per annum:
    • £145k for Current Market Rent (CMR) on the new main site and
    • £13.5k per annum rent for the presence in Wrington if required.
next steps for the pct
Next Steps for the PCT
  • Support the practice/developer in relation to the planning application etc
  • Support and advise the practice on public involvement and engagement
  • Agree detailed benefits realisation plan (service and facilities) and timescales with the practice
  • Continue to work with practice to demonstrate value for money solution
  • Rent review detail to be agreed with practice/ developer as part of DV “sign off”