Download NORTH HAMPSHIRE CCG LOCAL ESTATES STRATEGY 2017 -2021

Governing Body Approved December 2016
North Hampshire Local Estates Strategy 2017-2021
NORTH HAMPSHIRE CCG LOCAL ESTATES STRATEGY 2017 -2021
Driving best value from NHS property in North Hampshire
22 December 2016
Final Published
[Type text]
Governing Body Approved December 2016
North Hampshire Local Estates Strategy 2017-2021
CONTENTS
Executive Summary ..................................................................... 3
1. Introduction ............................................................................. 6
2. Purpose and Governance ......................................................... 7
3. Scope ....................................................................................... 8
4. Methodology ......................................................................... 10
5. Population and Locality Profile............................................... 11
6. National and Local Context ................................................... 13
7. Local Authority Development Plans ....................................... 16
8. The Current Estate in North Hampshire .................................. 22
9. Primary Care .......................................................................... 30
10. Sustainable Estate - Environmental Impact .......................... 37
11. Estate Related Finance ........................................................ 39
12. Next Steps ............................................................................ 41
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Annex 1 - Terms of Reference for Local Estates Strategy Forum ....................... 42
Annex 2 - Population Changes........................................................................ 44
Annex 3 - Out of Hospital Care Model Overview ............................................. 45
Annex 4 - Greenfield Sites Assessed for Housing in Basingstoke ...................... 46
Annex 5 - Six Facet Survey Methodology ........................................................ 48
Annex 6 - General Practice……………………………………………………………………….. 50
- Pharmacy ..........................................................................................
- Opticians ...........................................................................................
- Dental Services ..................................................................................
Annex 7 - Natural Communities of Care Integrated Care Teams ....................... 57
Annex 8 Sustainability Interventions from Public Health England .................... 59
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EXECUTIVE SUMMARY
Purpose
Looking to the future the “NHS Five Year Forward View” outlines the direction of travel for the NHS; it
describes a vision for a fundamentally different NHS, one which can support an increasingly ageing
population, who have more complex health conditions, at a time when there is also constrained finance.
In the NHS the cost of Estate is after the cost of the workforce one of the biggest forms of expenditure,
in North Hampshire our NHS Estate occupies 95,000m2 at an annual revenue cost (excluding running
costs) of £25.5m.
The environment in which care is provided has a material impact upon the patient experience, clinical
outcome, the healing process and the well-being of staff that provide the care itself.
Only by working together to plan strategically for the Estate needs for the future will we deliver “the
right property in the right place”.
This Strategy will support the Five Year Forward View and aims to:
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Facilitate buildings which are fit for purpose, cost effective and are able to support anticipated
changes in population demography and health needs.
Respond to the requirement for new ways of working facilitating improved integration of services
in an out of hospital setting and ensuring that there are good clinical outcomes for our patients
Achieve effective utilisation of physical and technological resources available.
Population and Locality Profile
There is an expected change in the demographic of the North Hampshire population in the future, with
an average population growth of 8% across North Hampshire over the next 5 years. With the greatest
population growth in Basingstoke and Deane (13%). Life expectancy is also increasing and as a result
there will need to be increased focus upon community based pro-active care particularly for those
patients who are experiencing a long term conditions.
The CCG serves an area of 315 square miles much of which is rural with limited public transport. One of
the CCG’s key roles is to improve our population health and to reduce health inequality; our estate can
be a key enabler in this respect with location and functional suitability contributing to easing access to
effective health and social care services. Local access to health promotion services, self-care and early
intervention also helping to reduce the need for emergency care.
Local Authority Development Plans
This Strategy details the 18,000 planned new dwellings through the housing developments set out in
the plans of Basingstoke and Deane Borough Council, Hart and East Hampshire District Councils (where
appropriate to North Hampshire). Primary Care provision is a key consideration in respect of major new
housing developments and it is important that this aspect is planned for to enable timely provision of
changes such as expansion to existing primary care facilities or new facilities. The major housing
developments are detailed in the strategy, with the most significant (3,400 new houses) being in the
Manydown development in West of Basingstoke, with slightly smaller developments expected in Hook
and Alton.
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Current Estate
The Estates plans of our partners are detailed, Hampshire Hospitals Foundation Trust is the provider of
services in Basingstoke and their estate located in North Hampshire is predominately on the one site.
The Trust aspirations to centralise critical treatment services will have a significant impact upon the
estate in North Hampshire, but the impact will be different depending upon the final solution agreed.
Nevertheless it is helpful to understand the detail relating to the HHFT estate this includes; the
significant level of backlog maintenance (Trust wide c£24m with c£12m relating to the Basingstoke and
North Hampshire site), cost of refurbishment to meet standards (8 wards @ c£4-6m each) and possible
disposal opportunity as well as the Trust long term plans for Cancer and Pathology.
Southern Health Foundation Trust as a provider for community and mental health services to North
Hampshire population, has a number of buildings across the area, there are already plans in place to
consolidate and dispose of some property.
It is recognised that there are too many patients with long term conditions receiving care in acute
hospitals, care is also fragmented between different providers of health and social care, but also in
different parts of the same organisation.
Our Primary Care General Practices and the estate from which they operate will play an important part
in delivering the new models of care. Primary care will become the focal point for integrated Out of
Hospital Care bringing GP’s; Consultant Physicians; Geriatrician Community Nurses, Mental Health
Community Teams and Social Workers together. Progressive GP’s are seeking to try to create scale in
Primary Care. The CCG has a vision to commission a hub and spoke model with a small number of
primary care centres located within a natural community across the area of North Hampshire. The
estate model would comprise of:
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A small number of appropriately located functionally suitable health centres/primary care hubs
providing appropriate settings for community clinics and hospital outreach services with access to a
range of shared community facilities enabling health promotion, self-care and clinics providing long
term condition activity to take place.
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A network of appropriately located, functionally suitable GP premises – ensuring that all areas of
the community are equally well served.
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Local grouping of premises to ensure specialist primary care expertise/facilities can be shared to
benefit a neighbourhood.
Sustainable Estate Environmental Impact
The NHS has a Carbon reduction target to deliver and the CCG has a role in promoting local action,
energy consumption is the single largest contributor of carbon emissions, with energy being responsible
for 22%, travel 18% and procurement 60%. There are 35 sustainability interventions being promoted
under the Carter review which the CCG and its partners will need to prioritise and deliver for its
business as usual activities. Where there are estate redevelopments (including proposed Critical
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Treatment Services and New Models of Care) environmental sustainability are expected to feature
highly in the associated business case proposals.
Estate Related Finance
Both capital and revenue funding in the NHS is constrained and as such the importance of a local robust
Estate Strategy, which is aligned with the STP cannot be overstated. It is only when we are able to
evidence that an individual case for funding accords with the health and social care strategic direction
that the CCG will be successful in securing approval for expenditure and where applicable NHS capital
funding.
However, NHS capital is not the only source of funding and the CCG will work to maximise the
alternative sources; for major new NHS infrastructure these include local authority related funding e.g.
Section 106 agreements and Community Infrastructure Levies. There remain opportunities to work with
the private sector including primary care developers and LIFT companies.
Next Steps
The Estate Strategy is a live document as such it is not unexpected that at this stage further work is
necessary, this will include:
 A detailed Estate survey of General Practice to understand the existing estate and its ability to
expand and/or accommodate the services required under new models of care.
 Explore and secure agreement as to which services are planned to be provided in a community or
primary care hub.
 Identify options and evaluate which would offer the most effective configuration of community
and Primary Care Services in North Hampshire under a Hub and Spoke model. This should take into
account population increases, the need to be future proof; the aspirations of the practices and our
providers; the existing availability; location and suitability of NHS estate. This would include the
options open to the North Hampshire system to deliver Primary Care to the population of
Manydown
 To conclude the review on the potential centralisation of acute care critical treatment services
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1. INTRODUCTION
Property and the built environment play an important part in the delivery of high quality healthcare
services for the population we serve. It also represents a significant cost and therefore given the
financial constraints in the public sector, it is more important than ever that the property used for NHS
Care is fit for purpose and cost effective so that best value is achieved from every £1 spent.
There are continually growing demands and
expectations placed both on the health and
wider public sector. With current ways of
working and care models considered to be
unsustainable in the long term, there is a real
need and opportunity for public service
organisations to work collaboratively. The CCG
is committed to fostering links with the local
authorities who are key partners and have a
major role to play in impacting upon the social
determinants of health and health inequality. By sharing an understanding of needs ambitions and
challenges we can jointly shape the change in a co-ordinated way to make the most of opportunities.
To ensure that public service property decisions are taken robustly and will be sustainable for the long
term, a more strategic approach to planning, ownership and management is necessary. This North
Hampshire CCG Local Estates Strategy is the first step in ensuring that the Health and Social Care System
is able to secure “the right property in the right place”, in a timely manner.
National Guidance
The Department of Health and NHS England have issued joint national guidance on the development of
a Commissioner led Local Estates Strategy [LES]. Each CCG commissioner (working collaboratively with
local providers of NHS Care and Local Authorities) has been asked to work together with Community
Health Partnerships (CHP), NHS Property Services (NHSPS) and NHS England (NHSE) to compile estate
strategies for their areas. This approach also aligns with the ‘One Public Estate’ Phase 3 programme led
by Hampshire County Council which is working with public and third sector organisations to deliver best
value from public money.
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2. PURPOSE AND GOVERNANCE
Purpose
The aims of a system wide approach to strategic Estate Planning are to respond to:
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Forecast changes in population demography and health needs.
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The need to increase efficiency to realize savings (estate and running costs), through maximising the
utilisation of property assets, as well as securing a sustainable environment.
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The availability and use of new technology, treatments (telephones, networks, WIFI) and local
provision of diagnostics.
Changes in the way health care services will be provided in the future – to achieve the delivery of
integrated health and social care services in community based settings in line with new models of
care.
Governance
This Strategy was developed by the members of the North Hampshire Estates Strategy Forum (terms of
reference are set out in Annex 1)
Organisational Members of the group which contributed to the Strategy are:
North Hampshire CCG
Community Health Partnership
NHS Property Services
Hampshire Hospitals NHS Foundation Trust (HHFT)
Southern Health NHS Foundation Trust (SHFT)
Solent NHS Trust (Solent)
Hampshire County Council (HCC)
Hart District Council
Basingstoke and Deane Borough Council
NHS England (NHSE)
South Central Ambulance Service NHS Trust (SCAS)
North Hampshire Alliance (NHA)
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3. SCOPE
The LES covers the geographical area covered by the North Hampshire CCG. Where there is close
proximity or relationship with adjacent CCG’s the document should also be read in conjunction with
each of their Estate Strategies, particularly applicable for the Mid Hampshire part of West Hampshire,
North East Hampshire and Farnham and South Eastern Hampshire CCG’s.
Its scope comprises the estate used to provide NHS care which includes GP surgeries but excludes
residential accommodation (e.g. care homes) and stand-alone office used solely for administrative
purposes.
This Strategy covers the geographical area served by North Hampshire CCG.
Area covered by North Hampshire CCG
The population of North Hampshire receives the majority of its health care from four NHS Foundation
Trusts, a number of Independent Sector Providers, Third Sector Organisations and 19 GP Practices. The
CCGs major provider partners are:
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Acute, Community, Mental Health and Ambulance Service
Hampshire Hospital NHS Foundation Trust (HHFT)
Southern Health NHS Foundation Trust (SHFT)
Solent NHS Trust (Solent)
Frimley Healthcare NHS Foundation Trust (FHFT)
BMI
North Hampshire Urgent Care (NHUC)
Headway
St Michaels Hospice
South Central Ambulance Service NHS Trust (SCAS)
Primary Care
The North Hampshire Alliance
19 GP Practices
Dentists
Opticians
Pharmacists
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4. METHODOLOGY
Following discussions at national level, CHP and NHSPS agreed arrangements for the development of
Local Estates Strategies for the NHS in England. Each CCG supported by CHP has the lead responsibility
for the development of its strategy working with NHSPS, with our providers playing a major role as the
significant property owners and landlords.
NHS England also recognised the connectivity between Estate and the Digital aspirations for the NHS, it
is imperative to align the strategy and resultant operational plans to make use of technology and to
promote enhanced accessibility to all sites e.g. including meeting and conference facilities. Such
connectivity must be compatible with other public services in Hampshire, to allow shared back office
functions and information sharing. In production of the LES the CCG followed a structured format with a
number of key steps shown below:
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Gathering information and meeting with partner organisations to discuss future plans and to
understand their building stock.
Information collected from relevant organisations recorded on to SHAPE (an estate related
database)
Understanding the estate required to serve the population of North Hampshire through the gaining
of understanding of the direction of travel for services being commissioned and the service and
estate plans of our key provider organisations
The strategy is not expected to be a detailed route-map setting out the precise location for every service
in the future but it has set out broad principles and will provide a strategic framework to guide the
system partners. It has also identified where further work is required (chapter 12).
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5. POPULATION AND LOCALITY PROFILE
Population
The ONS derived population in North Hampshire is 217,077 (2014) and it is a relatively young
population, with a high proportion of people under the age of 16 years old when compared with the
rest of Hampshire. Life expectancy in the area is continuing to increase being 81 years for males and
83.3 for females (Source: ONS via Public Health England). The forecast population estimates (further
detail is set out in Annex 2) indicate that compared to the rest of Hampshire and the Isle of Wight
(HIOW) North Hampshire is to experience one of the largest increases in population (over 8%) over the
next 5-6 years; largely as a result of the substantial increase in number of new dwellings being built. In
Basingstoke itself using the Edge Analytics data associated with the local plan the population is expected
to rise by 22,800 (13%) between 2015 and 2029.
Deprivation
Whilst the CCG has an overall lower level of deprivation when compared to England, there are small
pockets of deprivation in a number of areas (parts of South Ham, Popley East in Basingstoke and East
Brooke Ward in Alton).
Health Needs
Although the deprivation levels are low, when compared to England averages, the population does have
a number of health and well-being challenges these are:
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Long Term Conditions – higher prevalence of Hypothyroidisms, Cancer, Palliative Care, Depression
and Chronic Kidney Disorder.
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Cardiovascular Disease is the main cause of death.
Likely undiagnosed prevalence of COPD and Diabetes.
Higher than expected incidences of Cancer, particularly Breast Cancer.
Binge drinking, smoking and obesity are also a concern.
In addition our population utilization of services is higher than comparable populations in a number of
specialties, particularly for MSK, Respiratory, Neurology, Chronic Pain and Gastroenterology Services.
Emergency hospital admissions also exceeding the numbers expected particularly for the under 19’s
(Asthma, Diabetes and Epilepsy).
Transport
The CCG covers an area of 316 square miles much of which is rural in nature; there are good road
connections to Basingstoke and North Hampshire Hospital and to Alton Community Hospital. However
at peak times there is traffic and congestion in Basingstoke. However there is relatively limited public
transport availability in many parts of North Hampshire particularly in the more remote areas, with car
use being the only real option for travel. This limits accessibility to facilities and services. The scattered
pattern of settlements also affects journey times for emergency services including ambulance and out
of hours services.
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When planning for services and deciding upon scale and location it will be vital to achieve a balance
between working at scale and locally based services, the travel needs of children and older persons will
require special consideration when deciding upon the location for our proposed new models of care.
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6. NATIONAL AND LOCAL CONTEXT
National Policy and Direction of Travel
There are a number of key strategies at national and local level which will impact on the need for a
quality public estate in North Hampshire and are a call to collaborative action for all our partner
agencies.
One Public
Estate
Five Year
Forward View
Sustainability &
Transformation Plan
One Public Estate
This initiative is being led by our local government colleagues there are four key principles:
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Regeneration – release or development of assets to support local growth and regeneration.
Service Delivery – having the right space in the right place to improve service delivery.
Finance – reduction of operational costs each year and asset disposal to increase capital receipts.
Efficiency – provide workspaces that are fit for purpose and support higher productivity; sharing
assets and facilities across the public sector.
Five Year Forward View - New Models of Care
The challenges facing the NHS are unprecedented necessitating new models of care which can respond
to an increasingly aging population who may have multiple long term conditions and against a backdrop
of reducing public finances. The new models of care are being piloted under a number of Vanguard
initiatives. These Vanguard initiatives include:
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Multispecialty Community Providers (MCP) – This will deliver care out of a hospital setting into the
community. Bringing together groups of GPs to combine with nurses, other Community Health
Services, hospital specialists and perhaps Mental Health and Social Care to create a horizontally
integrated Out-of-Hospital service delivery model.
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Urgent and Emergency Care Services – which are looking at new approaches to improve the coordination of services e.g. A & E, Out of Hours, NHS111, Ambulances in order to reduce pressures
on A & E Departments.
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Integrated Primary and Acute Care Systems’ (PACS) - which aim to join up GP, Hospital and
Community and Mental Health Services in an integrated model, similar to the Accountable Care
Organisations
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Enhanced Health in Care Homes – aiming to offer older people better joined up health care and
Rehabilitation Services.
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Smaller hospitals will have new options to help them remain viable, including forming partnerships
with other hospitals further afield, and partnering with specialist hospitals.
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Modern Maternity Services will allow Midwives to take charge of the maternity services they offer.
Sustainability and Transformation Plan (STP)
Every Health and Care system in England is required to provide a STP to show how local services will
evolve and become sustainable over the Five years to 2021. The “Footprint” area, in which North
Hampshire is part of, covers Hampshire and the Isle of Wight.
One of the functional work streams of the Hampshire and Isle of Wight STP relates to Estate. As such
the plans set out in this strategy contribute to those outlined in the STP. Capital resources are tight; as
such prioritisation across the STP Footprint will depend upon the strength of this strategy and each
business case which follows.
Local Direction of Travel
The North Hampshire Alliance which is a federation of General Practices in the CCG area is a recent
partner in the Hampshire MCP Vanguard Programme, “Better Local Care”. This programme aligns with
the CCG vision to further develop its Integrated Care Teams. Although the Vanguards are designing and
testing new ways of working it is certain that the community based estates has a significant part to play
in the longer term sustainability of the Vanguard initiatives. The Out of Hospital care model is outlined
in Annex 3. However care models will continue to evolve and therefore it is important to ensure
flexibility is available in the design of the health and wider public estate.
The increase in provision of care in the community will affect the Estate configuration in North
Hampshire. The buildings may not be in a location which optimises Health Care, they are of a variable
condition, and some may be unable to expand or be configured in a way which is suitable for future
services.
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The estate at individual building level may also have the following challenges:
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Space not fully utilised – for example, a treatment room may be used by one provider for one
session a day, three days a week
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Void space in core buildings which are planned to be retained in the longer term
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The inability to facilitate of joint working across functions or organisations – this can lead to a
poorer than expected patient experience.
Bookable space that is not fully utilised
Inappropriate tenants – for example, core clinical space is often used by administration and support
service teams. In most cases, these services could be relocated more cheaply and the space could
be used to accommodate integrated clinical services
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7. THE LOCAL AUTHORITY DEVELOPMENT PLANS
Background
National policy places Local Development Plans at the heart of the planning system. Each planning
authority is required to set out in their Local Plans a vision and a framework for the future development
of a geographical area, addressing needs and opportunities in relation to the economy, housing,
community facilities and infrastructure – as well as a basis for safeguarding the environment, adapting
to climate change and securing good design. The plans are also a critical tool in guiding the local
authority’s planning decisions about individual development proposals. This involves a national
planning policy which requires local planning authorities to establish their housing need and prepare a
local plan to deliver their housing target.
The CCG has a significant role to play in partnership with the three local authorities in the area to
ensure that the health related impact of new development is recognized, understood and planned for.
Noting that from an estate perspective a major new building, refurbishment or reconfiguration of an
existing building has a long lead in period from the time the need is identified to the opening of the
physical infrastructure. Primary Care Service provision particularly General Practice is a key
consideration in respect of major new housing developments.
General practice has changed considerably over the last decade. In order to be able to respond to the
health needs of a 21st Century population, General Practice has moved from a model of provision
having 1 or 2 GP’s in a small practice to larger multi GP arrangements which work closely with
Community Teams and also offer a facility for Outpatient and Diagnostics Facilities. It is worth noting
that a population size likely to be served by each GP is c1, 800 registered population.
This Strategy reflects the recently approved Local Plans in relation to North Hampshire for:
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Basingstoke and Deane Borough Council (adopted October 2016)
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East Hampshire District Council
The local plan for Hart is still being prepared but there has been productive engagement between the
CCG and Hart District Council planning officers.
This chapter highlights where there is major change in the scope, location and scale of housing
development over the next 15 years. Across North Hampshire 18,000 new dwellings are planned. It is
particularly important for the CCG to understand the location and impact of new developments coming
to fruition within the next 5 years (to ensure NHS services are sufficient for the population increase) this
information will help to inform the size, location and timescales relevant to the provision of NHS related
estate infrastructure going forward. But also recognising premises infrastructure has a life much longer
than the period covering this strategy therefore the CCG has to get its estate delivery right first time.
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Basingstoke and Deane Borough Council
The Government is helping local councils and developers work with local communities to plan and build
better places to live. The requirement for healthcare facilities and other supporting infrastructure is a
fundamental issue for residents in considering proposals for new housing developments. This involves a
national planning policy which establishes a target allocation of new housing to be delivered in each
local authority area.
Basingstoke and Deane Borough Council adopted its local plan 2011-2029 in the summer 2016. This set
out the Council’s vision and strategy for the area until 2029. Included in the plan are identifiable sites
which will be developed to provide the Council’s target housing requirements. Below is a map showing
the major sites allocated around Basingstoke in the Basingstoke and Deane Local Plan the pink areas
identify the significant areas of housing development.
Basingstoke and Deane Borough Council Area Plan
The tables below identify the housing development sites in the Basingstoke and Deane locality.
Individual Locality maps relating to the bigger developments can be found on the Council web site (the
link to the web site is detailed on the next page).
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Table 1 Summary of the Housing Development Sites in Basingstoke and Deane 2011-2029
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Table 2: Components of Housing Land Supply 2011 – 2029 as at April 2015
Number of Homes required to be Built: 850 x 18 years
Homes Built (Completions) in 2011 – 2014
What is currently available in the future (supply)
15,300
1,951
Sites with planning permission
Small site windfall
Urban/brownfield opportunities
Regeneration
4,668
550
1,323
200
Total supply
Remaining requirement to be met through Local plan allocations
6,741
6,608
The Basingstoke and Deane local plan sets out the spatial strategy for the borough from 2011-2029,
focusing development within and around the main town of Basingstoke through a number of strategic
site allocations, regeneration schemes and development within the town. The local plan also makes
provisions for new housing development in the borough’s other larger towns and villages including
Whitchurch, Overton, Bramley, Oakley and Kingsclere. A number of other smaller villages are preparing
neighbourhood plans. For a detailed list of sites that are forecast to come forward, see the councils land
supply position. This can be found at http://www.basingstoke.gov.uk/content/doclib/1006.pdf
Manydown Development
Manydown is the major development in western Basingstoke where the CCG will need to deliver
significant new Primary Care provision. Basingstoke and Deane Borough Council under its requirement
to deliver its allocation of additional housing has allocated in its local plan the development of a new
community to the west of Basingstoke. This will comprise approximately 3,400 new homes with
associated community infrastructure. The local plan policy SS3.10 (c) requires the provision of
healthcare facilities and development brief principle 3b requires that an appropriate site for healthcare
facilities should be provided.
From a health perspective the local NHS welcomes the Council’s vision “to encourage attractive vitalised
neighbourhood that create inviting places and community where people want to live can thrive and feel
they belong”. The Council is also seeking to deliver; an effective and efficient transport system, with
appropriate social and community infrastructure to create a sustainable healthy community. There will
be a mix of homes including single and elderly one person homes, it is also expected that the
development will have a high proportion of young families. When looking at the size, location and scope
of Primary Care health facilities to serve the Manydown area, the CCG needs to consider (with
appropriate consultation with the public and health partners) the building configuration taking into
account the following potential opportunities and timing of provision:
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To improve access to care, particularly for those who are less inclined to use the services needed.
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North Hampshire Local Estates Strategy 2017-2021
To be located with other community related activities therefore offering the opportunity to
encourage use of those which support health and wellbeing.
To include a wide range of NHS and Social Care services (e.g. a hub) enabling more of a one stop
shop. Particularly to support those with a long term condition.
A possible relocation of health care services where existing accommodation is unsuitable or in a
poor condition.
Encourage energy efficiency and buildings which are designed to be future proof.
The CCG is being asked to advice upon which of the Manydown community infrastructure sites is the
best location for health related infrastructure (if required) noting that a replacement General Practice
new build is underway in Rooksdown to the north of the Manydown area.
Given the size of the development, the number of complexities to consider and the once in a generation
opportunity to design fit for purpose facilities to serve Manydown, the CCG will be undertaking an
option appraisal in order to identify the most appropriate way forward. The appraisal will take into
account the primary care infrastructure nearby (comprised of the wards of Rooksdown, Winklebury,
Buckskin, South Ham, Kempshott, Hatch Warren and Beggarwood) together with the CCG aspiration to
deliver an “out of hospital model of care”. It will also consider which of the possible locations (hatched
in the concept diagram shown below) would be best suited should a new build be found to be the
preferred option. The map below is the landowners emerging plan, a planning application is expected to
be received by the council early in 2017.
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N.B.: The plan on the previous page is a concept plan only and therefore will be subject to change.
Hart District Council
The geographical area of Hart from a NHS commissioning perspective is split between North Hampshire
CCG and North East Hampshire and Farnham CCG; this largely reflects the acute patient flows from
North Hampshire to Basingstoke and from North East Hampshire and Farnham to Frimley Park Hospital.
The new local plan will plan for at least 8,022 new dwellings between 2011 and 2032 across Hart (382
dwellings per annum). At 1st April 2016 1,830 of these had already been built, and 2,224 were
committed (i.e. with planning permission) and two sites totalling 553 dwellings had a resolution to grant
planning permission subject to a legal agreement being completed, this includes North East Hook
(14/00733) for 548 dwellings.
A draft Local plan for public consultation is anticipated early in 2017 which will show the preferred sites
for new housing growth. There is a significant amount of land being promoted for housing development
by landowners and developers with the NHCCG area, including entire new communities at Murrell
Green (approximately 1,800 dwellings), Winchfield (approximately 3,000 dwellings), and Rye Common
(approximately 1,500 dwellings) and some large extensions to Hook. At present these are only options
that the Council is looking into. Once the Draft Local plan is produced there will be greater clarity on
where the new homes are likely to go, and thus how many of those homes will be within the NHCCG
area.
East Hampshire District Council (EHDC) in relation to Alton and Four Marks
The geographic area of EHDC from a NHS commissioning perspective is split between North Hampshire
and South Eastern Hampshire CCG’s reflecting the acute patient flows from the Alton area to
Basingstoke and in Winchester. For those living south of Selbourne the patient flows also go south to
the Queen Alexandra Hospital in Portsmouth. Alton and Four Marks both have expected new housing
growth of 700 and 174 (respectively.)
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Rural Areas
Other housing allocations in the North Hampshire area have been scoped but are fairly insignificant, and
as such the current plans are not expected to have a major impact on the health system. It is thought
that those health needs of these smaller developments will be absorbed by the current health system.
We will continue to work with the General Practices in these areas to ensure that the impact is
understood and planned for.
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North Hampshire Local Estates Strategy 2017-2021
8. THE CURRENT ESTATE IN NORTH HAMPSHIRE
Overview
The Estate covered by this Strategy comprises of a General Acute Hospital in Basingstoke together with
a number of Health Centres and Primary Care facilities which are the base for General Practice,
Community and Mental Health Services.
There are 4 large community facilities in Basingstoke and Alton comprising:




Parklands Hospital (Inpatients: Adult Mental Health (MH) and Older Persons MH, Community
Services, Older Persons MH, Integrated Community Teams and Children’s Community Services).
The Bridge Centre is the base for the Adult Mental Health Community and Outpatients Clinics.
Alton Community Hospital (Inpatient beds: Elderly Care, Diagnostic and Screening services, MH
(Adult and Older Persons), Long-Term Conditions and Physical Disability, Dementia, Sensory
Impairment, Outpatients, and Rehabilitation Service).
Alton Health Centre – includes Children’s Services Health Visitors & School Nurses).
The overall size of the health related estate in North Hampshire is 95,000 m². The combined floor area is
c24 acres which is equivalent to around 10 football pitches. The total cost for the NHS related premises
is £25.5m. Ownership and organisational responsibility for the NHS estate lies primarily with:



Hampshire Hospitals NHS Foundation Trust (HHFT)
Southern Health NHS Foundation Trust (SHFT)
NHS Property Services (NHS PS)
Primary Care – where there is a mixed economy of ownership comprising of GP owned practices
leased via NHS PS or privately owned landlords.
Table 2
Size of NHS Estate in North Hampshire
Type
Number
of
locations
Floor
(m2)
Acute
1
Community/Mental Health
Area
Floor Area
(%)
Annual Cost
(£m)
Annual Cost
(%)
61,000
64%
£18.2m
71%
9
21,500
23%
£4.0m
16%
General Practice
24
12,500
13%
£3.3m
13%
Total
34
95,000
100%
£25.5m
100%
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The NHS has a well-defined methodology known as 6 Facet Surveys, with which it periodically reviews
each building to grade it against key attributes. Each facet survey will look at; the physical condition,
functional suitability, space utilization, environmental quality, and compliance with legal duties and
environmental management. These attributes are set out more fully in Annex 5.
Geographical Review
This Strategy does not begin with a clean sheet of paper; the health estate in North Hampshire has
evolved over a long period of time in response to: individual organisational aims, to the condition of
buildings and the availability of funding (Capital and Revenue). The following is a review of Estate used
by the major NHS Service providers located in North Hampshire.
Hampshire Hospitals NHS Foundation Trust
Background
At the time of writing this Strategy Hampshire Hospitals NHS Foundation Trust has in place an Interim
Strategy which covers its entire estate (maybe subject to change according to direction of travel on
critical treatment services). For the purpose of this CCG related Estate Strategy, relevant information
relating to Basingstoke and North Hampshire Hospital has been used, giving a wider context (where
appropriate) e.g. including Royal Hampshire County Hospital in Winchester and Andover Community
Hospital.
HHFT Interim Strategy was developed by the Trust during a period of intensive examination of how best
to configure the Trust estate in support of delivering high-quality, seamless and sustainable services for
the local communities. It included the:





Profile of the Trust’s estate profile and how it performs in supporting modern service provision
An assurance to HHFT staff that wherever they work, there is a commitment to provide an
appropriate working environment.
A commitment to sustainable development, to meet environmental targets and legislative
requirements.
A commitment to the disposal of operationally-surplus assets.
A commitment to Commissioners and the Trust’s regulators that estates quality issues and backlog
maintenance will be addressed over a reasonable period.
The Basingstoke and North Hampshire Hospital site is categorized into a number of locations:
Location 1 –The Sherborne Unit
Location 2 – Main Hospital Building
Location 3 – MRI Unit
Location 4 – The Ark
Location 5 – Affordable Housing Flats
Location 6 – The Firs
Location 7 – Acute Assessment Unit
Location 8 – The Candover Centre
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The main hospital site was identified as having the following characteristics:
1)
2)
3)
4)
5)
A clear boundary with a reasonable profile
Separate access for service vehicles
Separate parking for staff and patients/visitors
Room for service expansion
Parking provision is just adequate for capacity, although the northern staff car park (adjacent the
Candover Centre) is a temporary surface and prone to flooding in bad weather
HHFT also have lease agreements on other property in the geographical area of North Hampshire, in
Alton Community Hospital for the provision of Outpatient Clinics and at Kingsclere Health Centre, also in
respect of Outpatient Clinics
Backlog Maintenance Cost Assessment
The combined Physical Condition and Health & Safety and Fire compliance costs make up the backlog
maintenance figure reported by the Trust to the Department of Health. The total backlog for HHFT and
that applicable to the Basingstoke site is shown below:
Table 3
Summary of Financial Value of Backlog for HHFT
Summary of Backlog by Site (2015/16)
Low
Moderate
Location
£m’s
£m’s
BNHH
4.985.10
2.579,40
Trust Total
11.905.35
4.869.25
Significant
£m’s
4.214.04
6.903.74
High
£m’s
0.65
Total
£’000’s
11.778.54
23.743.34
%
49.61
100.00
Within the significant rated total of £6.9 million, £2.7m relates to work required to replace roof
coverings at BNHH (main block and Sherborne) and RHCH (Florence Portal and Nightingale). BNHH has
the higher proportion of backlog rated as ‘significant’.
Across the entire Trust whilst 91% of the estate is full, it should be noted that many of the wards are
much smaller than design standards dictate today. For example using Health Building Note 04-01 a
typical ward for 25 patients would equate to circa 1100m2, whereas wards of this size at both
Winchester and Basingstoke sites are smaller at circa 600m2.
In Winchester the Burrell wing at RHCH principally acts as the Diagnostic Treatment Centre (DTC) but is
only 70% full. As the building is circa 10 years old, it is considered to be a priority for the Trust for the
DTC to be brought into full use. Pathology and Microbiology accommodation is also under-utilised.
Practice has changed in the 25 years since the facilities were completed, as such the Trust is currently
appraising options for creating a central function; this would mean that only 140m2 of laboratory
accommodation would be required at RHCH.
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Quality
The quality facet assesses the amenity, the environment and design across A- D ratings with A being
excellent and D less than acceptable. The BNHH main site is achieving a mixed result;


Levels B, C, D, G broadly achieved a B rating
Level F which has a mix of inpatient and day case accommodation (Elderly Care, Wessex, Lyford and
Basing Day Unit), scored a C, arising from a poor entrance/reception and inadequate storage
Looking to the Future
The Trust recognises that the provision of more care outside hospitals provides the opportunity to
improve the quality of care, improve efficiency and lower costs. This includes an acknowledgement of a
focus on preventative care and enabling more people to take charge of their own health.
The Trust also has prepared a case for change with a focus on the need to further develop the most
acute and specialist elements of the Trust clinical services. This included the aspired centralisation of
some services where there are benefits for patients including improved clinical outcomes, with the
majority of other care provided as close to people’s homes as possible.
The case for change has led to the Trust seeking to centralise its Critical Treatment Services (CTS) and
Specialist Cancer Treatment Centre Services, and this is supported by a separate comprehensive
business case.
Proposals have been developed in respect of centralised services with the area of space identified as
being necessary equating to 42,278 (m2) for the priority 1 development which would comprise:
The decision making process is one which will take into account the benefits of centralising critical
treatment services and options available to achieve this. The Trust aspires to centralise on a new site in
preference to other options which would accommodate the critical treatment services on existing
hospital sites. However; other options are also considered by commissioners to be worthy of further
exploration the CCG together with its partner commissioners have requested that the option of
developing the existing hospital sites are appraised.
The impact of a new site on the existing site of Basingstoke and North Hampshire Hospital is explored
below:-
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Table 4
Functional content of a building for Critical Treatment Services
Proposed Priority 1 Development Functional Content And Areas
Critical Treatment Hospital
Public entrance
Emergency Department
Acute Diagnostic Unit (30 beds)
Diagnostic Imaging
Interventional Radiology and Vascular Intervention Unit (12 beds)
Theatre Suite
Critical care (24 spaces)
Local Neonatal Unit (24 spaces)
Maternity Unit (44 beds/6 day spaces/17 delivery suites/8
Women’s health)
Central staff zone
Ward central core
Inpatient wards (184 beds plus 12 private)
Paediatrics (34 beds/10 day spaces/8 assessment)
Pharmacy
Body Store
Essential Services Lab
Support Services
Risers, communications and engineering
Cancer Treatment Centre
Entrance/Reception and Waiting
Outpatients and Treatment
Chemotherapy
Cytoxic Pharmacy
Proposed Priority 1 Development Functional Content and Area
Critical Treatment Hospital
Radiotherapy
Supportive Care
Staff Facilities
Risers, communications and engineering
Core Pathology Laboratory
Gross Internal Floor Area
External and Enabling Work
Car parking (507 staff and 338 visitors spaces), paths, security,
lighting, and external landscaping
Incoming utilities (gas, power, electricity and communications),
an energy centre (3,311 m2) and services distribution
Drainage, soakways etc.
Link road and paths formation
Dept. Area (m2)
781.2
1,074.3
1220
864.4
1,693.3
2,571.2
1,698.1
1,233.4
Totals (m2)
3,973.8
1,388.2
536.1
7,894.8
2,119.2
98
188.8
174.9
2,293.9
7,515.6
37,319
293
448
610
184
Dept. Area (m2)
1,174
442
636
1,172
Totals (m2)
4,959
42,278
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A Priority 2 development has also been scoped and is anticipated to include:


Core pathology Laboratory (providing services to all Trust sites and other services as services
expand)
A central ambulance depot (to be developed by South Central Ambulance Service on the basis of a
ground lease)
Centralised Site Impact (under the new site option)
Under this option, the utilisation of the BNHH will have changed significantly, with ‘critical’ related
services transferring from the existing site. The table below provides a schedule of areas which will be
vacated:
Table 5
Schedule of vacated Areas Following Central Hospital Development
Release
Area affected by central Hospital Development
m2
Main Block 9total 43,167 m2)
Level C: High Dependency Unit
386
Level C: Intensive Care Unit
448
Level C: Complex surgery (from wards C2, 3 & 4)
485
Level D: Complex elective/unplanned surgery
535
Level E: High acute elderly care
567
Level E: Isolation ward
281
Level F: Oncology ward
874
Level G: Children’s ward
994
Sherborne Unit (total 6900m2)
Special care Baby Unit (SCBU)
426
Consultant led Maternity
2,287
Cardiology
1,359
The Firs (630m2)
High acute elderly/stroke care
630
Total Space Released
Total m2
Block %
4,570
11%
4,072
59%
630
9,271
100%
The Trust has made an assessment of opportunities to dispose of particular areas or buildings on the
BNHH site against a number of criteria; building condition; compliance with estate related regulatory
requirements; efficiency; modernisation of ward requirement; partnership options e.g. use by Primary
Care, Community and Social Care partners; and site developments options. A number of options were
considered as detailed below
Dispose of the Sherborne Block: whilst it is possible to release the Sherborne Unit (and car park) to gain
a capital receipt, the cost of relocating the departments which remain after Critical Treatment Hospital
transfer would be prohibitive (at circa £10m). In addition, filling the main block up would prevent ward
sizes being increased to achieve modern standards of care.
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Dispose of the Associated Services Block/Uplands: This site could be released for a capital receipt. The
move would involve the transfer of Uplands to the Firs building, and for diversion of a local High Voltage
(HV) cable, generating a combined enabling cost. With a net capital receipt, this was identified as being
a possible disposal opportunity.
Modernised ward profiles: With accommodation being cramped; bay sizes accommodating up to 6 bed
spaces currently there is limited En-Suite provision.
Instead of having 2 cramped wards with 48 beds, a merged ward would offer enhanced nursing space,
with smaller bay sizes, more En-Suites, therapeutic accommodation and easy gender separation. With
refurbishment costs projected at between £4-6m for creation of each merged ward, the Trust are
anticipating that investment would need to be phased over the next 10-15 years to create circa 8
modernised wards and deliver the Trust General Hospital target of 200 beds in both Basingstoke and
Winchester.
Car Park Development – the Trust has identified possible opportunity to work under a joint venture to
develop a multi-storey Car Park
Partnership Working - The Trust identified that the vacation of acute hospital space would generate a
unique opportunity for Primary Care, Community and Social Care partners to make use of space
released enabling non-acute services to operate side by side with their acute sector partners. This
opportunity is greater for the Winchester site.
Solent NHS Trust
Solent has no freehold buildings in the North Hampshire area although the Trust does have services
delivered from a number of facilities in the area. Their Estate strategy is aligned with that of Southern
Health and they have been discussing the use of each other’s estate. Their preferred location hubs from
which to operate clinical services would be in:
 Parklands Hospital, Basingstoke
 Alton Community Hospital
 Crown Heights in Basingstoke being the current location for Sexual Health Services.
Southern Health NHS Foundation Trust
The Trust has a well-developed plan with regard to consolidating its premises; its longer term use of
premises is as follows;
 Adult Community Services are being reconfigured to align with the 4 Integrated Community Teams
(ICT) covering North Hampshire. It is also proposed that an Integrated Single Point of Access (ISPA)
will be provided in the Parklands Hospital which will provide support to the Adult Community Teams
working in the area.
 The Trust has identified the Bridge Centre in Basingstoke as a key strategic building for Mental
Health Community Services to operate from with satellite sites at Alton, Tadley and Odiham.
 It is also is seeking to relocate Enhanced Recovery Services to Basingstoke and North Hampshire
Hospital
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 The Trust vision is to work more closely with primary care, with an intention not to base community
teams permanently in Primary Care facilities but to retain drop-in space in General Practices and
where applicable to provide clinical services on a sessional basis
 To support (those CCGs where are aligned with Hampshire County Council) aspirations relating to
commissioned Children’s and Young Persons (0-19 years) Strategy, it is proposed to co-locate all
community based Children’s Services into one building (multi provider including social care). The
first stage will be to develop the co-located services with the Integrated Care Teams to enable
integrated pathways of delivery.
 There is an aspiration by Southern Health to create a Health and Wellbeing Centre in both
Basingstoke and Alton this is explained more fully in the next chapter.
Looking forward ideally the Trust would like to see a Multispecialty Community Provider (MCP) in
North Hampshire as part of the South Hampshire MCP Vanguard programme. The South
Hampshire Vanguard is one of the 29 National Vanguards sites chosen for the New Care Models
programme, as part of the Five Year Forward View and supporting improvement and integration of
services.
South Central Ambulance Service (SCAS)
The Ambulance Service operates its services using drive zones, each are supported by a localised hub
and spoke model, which comprises of an ambulance station and standby points. SCAS has a station next
door to the Basingstoke and North Hampshire Hospital Site (in Aldermaston); it operates 24 hours a
day.
The standby points comprise of a large room with basic office and rest facilities currently these are
located in:



Whitchurch (also owned by SCAS) but underutilised due to its location
Sutton and Scotney Fire Station
Basingstoke Business Centre Winchester Road (Basingstoke south)
Looking to the future the current station whilst serviceable is old and tired, and not ideally suited to
minimise ambulance response times. One of the options for Critical Treatment Services proposed by
Hampshire Hospitals has a new hospital location near to the M3 south of Basingstoke. This would be
ideally located for an ambulance station it would also offer an added benefit in respect of SCAS ability
to recruit and retain ambulance staff many of whom live to the South of Hampshire. Currently there are
difficulties SCAS finds it difficult to attract individuals from the North Hampshire area due to move
favourable employment opportunities in Reading and London. However, a new station is at conceptual
stage only. A full options appraisal and supporting business case will be required this would take into
account possible sites and locations, such options could include linkages with other blue light services.
When looking at primary care and community facilities in North Hampshire the CCG will ensure that the
standby estate needs of the Ambulance Service are considered.
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9. PRIMARY CARE
Introduction
Primary health care which comprises General Practice, Pharmacist, Opticians and Dentists normally
provide the first point care for a patient, 90% of all contacts are with a clinician in Primary Care. Details
of Primary Care providers are shown in Annex 7. General Practice provides a wide scope of healthcare
to our population with the aim being to maintain optimal health for the patients who are registered
with the practice. Doctors are generalists having a breadth of knowledge enabling them to diagnose,
treat and co-ordinate the care of each patient this includes prevention, health education, support and
treatment for chronic physical, mental health conditions.
The CCG is a membership organisation and as such every General Practice is a member of CCG, they
have a dual role (as a clinical leader in the CCG and as a provider of NHS care) as such have considerable
opportunity to influence and transform our NHS services. Yet at the same time our General Practices
are experiencing; an increase in the number of appointments and in the complexity of patient care.
There is also a shortfall in the number of GPs and other clinicians available compared to those required.
This resultant pressure in General Practice has also created additional impetus to the need to
strengthen and redesign Primary Care services.
Primary Care Strategy
The CCG has set out its vision for Primary Care in its Primary Care Strategy, the associated strategic
direction of travel and work programmes will have a significant impact on the Estate requirements in
the short and long term and so it is vital that the Estates Strategy is aligned with the Primary Care
Strategy. The Primary Care and Community based Estate used to provide NHS care will need to
support:


Person centred care supporting self -management of health and wellbeing.

An increase in working “at scale” such arrangements can take varying forms; such as Practice
mergers, Practices taking a role to specialize and provide care on behalf of a group of Practices, and
shared service arrangements for back office functions

The ability to offer group based care for patients having a long term condition giving an opportunity
to share their experience and learn from others.

Greater integrated working with multi-disciplinary teams which are comprised of Health
and Social Care professionals, clinicians, (and where applicable the Voluntary Sector). This
way of working will support holistic care planning and provision.

A different skill mix of clinicians; expanding the number of non-GP clinicians e.g. Specialist Nurses
and Therapists.
The provision of effective care, in a setting and environment that can enhance rather than hinder
the service and care, it is recognized that the standard and image of premises impacts upon quality
of care, perception and patient confidence in the Local NHS
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
Greater use of digital technology including telephone triage and online advice, with
good access to WFI to enable online access to multiple provider systems and the ability to
undertake multi-disciplinary care and case management reviews.

New ways of working, particularly in respect of Urgent and Out of Hours care, reflecting the
requirements set out in the ‘Five Year Forward View’ to provide 7 day services and reduce
unnecessary admission to hospital.
New Models of Care
North Hampshire CCG was at the forefront of developing an integrated care model. It has four
Integrated Care Teams which are multi-disciplinary. Their objective is to provide “integrated care for
people with long term conditions and frailty by integrated locality based teams.” So far it has not been
possible for all team members to work in the same building although two of the Community Provider
teams are located together in Parklands Hospital. Use is also being made of ‘Digital Technology’ to
undertake case management and ensure the benefits of multi-disciplinary working are maximised.
There are Four Integrated Care Teams (ICT) which cover the whole population in North Hampshire, each
ICT are comprised of a group of GP practices working with Community and Specialist clinicians. Their
role is to carry out multi-disciplinary care planning, to offer rapid response support to prevent a hospital
admission and to secure early discharge from hospital. The ICTs do this by co-ordinating a range of
health and personal care interventions in a timely manner.
Currently the provider based teams are based in the following buildings:




Basingstoke East located in Parklands
Basingstoke West located in Parklands
North Hampshire Rural East located in Alton Community Hospital
North Hampshire Rural West located in Tadley
Further details of the Integrated Care Teams and the geographical natural communities they serve are
detailed in Annex 7.
MCP Vanguard
The federation of General Practices in North Hampshire (known as the North Hampshire Alliance) has
recently joined into the South of Hampshire MCP Vanguard (noting that lessons learned have featured
highly in the HIOW STP). The model of care that is being promoted is based upon a “hub and spoke
model. There is no definitive description of what constitutes a ‘hub’ or a ‘spoke’ and there will
inevitably be local variation depending upon the availability of resources (workforce, estate, finances).
The CCG is supportive of a mixed economy model of Primary Care provision but is encouraging large
scale practices and/or collaborative working; this has the advantage of better accessibility for patients
and more resilient General Practice. Using the hub and spoke model a large proportion of the workload
could still be undertaken in the premises occupied by those GPs who are not located in a Hub. There is a
strong desire to have a Community hub in both Alton and Basingstoke. The CCG Alton Review is
considering the services and models of care for which would be provided in Alton serving the local area.
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The outcome of this review will inform the Estate requirement for the Alton geographical area. The
same model may also be applicable to Basingstoke.
Two types of hubs are being described in the HIOW STP:

A community hub serving a population of between 100k and 200k population. Such a facility could
be with or without beds with the beds being used to support step down or step up care. It would
also offer a base for Integrated Care Team(s), Outpatients, Diagnostic and Therapy Services with the
range of services being determined to suit the particular locality need.

Primary Care hubs there may also be the need for facilities to support working at scale in primary
care as well as for other public and third sector services.
General Practice – Current Estate
The CCG has 19 practices that provide Primary Medical Care (PMS) in 23 locations (including branch
surgeries). There is a mixed economy of ownership arrangements comprising of an individual GP or
Practice Partnership owned under a lease with NHS Property Services or the private sector.
Although there has been limited major premises development taking place in North Hampshire over the
last 5 years the new build for the Rooksdown practice has recently received approval from NHS Property
Services to go ahead with a development which will see the long awaited replacement of temporary
porta-cabins.
Unfortunately, the CCG has limited Estate information in relation to our Practices. The estate in Primary
Care is going to be fundamental to support local implementation of the Five Year Forward View. As such
the CCG as part of its next steps (chapter 12) is undertaking a survey of each building; this will make use
of the six facet survey. This information will be helpful when exploring options for new development,
expansion and reconfiguration or to bid for investment to reduce backlog maintenance.
Minor Improvement Grants
NHS England has approved a small number of minor improvement grants for General Practices in the
last year. Future funding will require bids to be being aligned to this strategy and will be assessed
against the CCG prioritisation criteria as follows:

To ensure that practices are able to cope with a growing and aged population, improving access,
particularly for the vulnerable and for those living in our areas of deprivation

To provide fit for purpose facilities to support both Primary Care and the provision of out of
hospital care, and to prevent avoidable emergency care particularly hospital attendance and
admission.
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General Practice – Future Estate Location Scale and Scope
In order to deliver new models of care the local Health and Social Care system has similar Estate
requirements to those elsewhere in the country however the major decision with regard to critical
treatment services has locally added some considerable complexity and uncertainty which in the short
term could lead to planning blight and at worst could impact upon patient care; e.g. patient access to
services; and the slowing down of the transformation required to make the local NHS sustainable.
However there is much information contained in this strategy which will enable decisions to be made
(noting the fairly urgent requirement to plan for the Manydown development). The success criteria
which will be used to prioritise investment will be based upon securing:
 Enhanced quality of care
 The right care in the right place
 Benefits from the investment
 Measurable improvement
 Flexible environment
Estate reconfiguration very often can be viewed as a puzzle e.g. moving services around to provide
space to meet service requirements on a temporary basis but working towards the ultimate
configuration. Given the phasing of the new housing development in Manydown and its location close
to Parklands and Basingstoke and North Hampshire Hospital as well as other General Practices the range
of opportunities need to be considered.
Delivering a Hub and Spoke Model
There is also a need for the CCG to further define its aspiration for new models of care and to establish
what community Mental Health and Primary Care services would be best sited together, in a hub model
of configuration.
Meeting Required Standards
It is clear that in the short term the CCG should be encouraging and supporting its practices deliver care
in premises which are of the required standards measured against those set out in the Six Facet Survey
methodology.
Planning for Population Growth
It is anticipated that where there is a significant planned population growth that the CCG supports
building extension and reconfiguration subject to ensuring that there is also flexibility to enable new
models of care to be provided. This is particularly relevant to:



The Whitewater Practice in Hook and Hartley Wintney which is likely to be affected by further
housing development in the Hook and Hartley Wintney areas.
Chineham Medical Practice – close to 1,425 new homes proposed (Razors farm 420; Upper Cufaude
Farm 390; Reedlands 165; East of Basingstoke 450)
Beggarwood Surgery – close to 2,060 new homes
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Basingstoke
In Basingstoke itself the CCG will particularly need to consider:



The Primary Care estate necessary to serve the population of Manydown. This option appraisal will
include the range of estate options available e.g. expansion of nearby practices, use of other NHS
provider buildings together with the opportunity for a Primary Care Hub.
How to support new models of care in the short and longer term. In the town the practices have
indicated a desire to establish an Urgent Care Access Centre. Location options being considered by
the North Hampshire Alliance include Crown Heights, Gillies and utilizing council owned property.
The centre would be a collaborative arrangement across a number of practices, starting the service
at first on an “In Hours” basis; the benefit would be to relief some of the pressures in A & E and
enable GP’s to have more time to spend to support their patients who have a Long Term Condition.
There is also an aspiration to establish multi-disciplinary treatment clinics in the community; also to
support patients with a long term condition, facilitating self-care with the help of specialist nurses.
E.g. Diabetes. There is unlikely to be an opportunity to undertaken a capital development such as
new build or major refurbishment in the short term, so the CCG will be seeking to understand the
space available currently which could be used for such community based clinics.
A second option appraisal for the medium/longer term will also take into account:
-
The impact of the Critical Treatment Services business case if a centralized critical treatment
hospital in a new location is approved. Then as set out in the Hampshire Hospitals Foundation
Trust draft estate strategy a building of approximately 12,000 m2 at the front of the hospital
(ASB\Uplands site) may be available (2021) and could be used as part of the
community/primary care network.
-
Conversely should the CTH new hospital not come to fruition then there may be a need to
reconfigure existing buildings, which could offer the requirement or opportunity to transfer a
greater number of services into a community setting which would create a need for a larger
facility(s) outside of the main hospital site.
-
Southern Health has recently consolidated on Parklands and The Bridge Centre. In the event of
a significant amount of accommodation being possible in other locations then the use of these
buildings should be reviewed. The Bridge Centre has a total internal floor area approximately
1,000m2) which could be considered as a small hub. The location could be Parklands Hospital;
the hospital is of good standard (CAT2) and suitable location, the centre could integrate primary
care as well as other public services.
In the short term the CCG will consider an option appraisal which evaluates the possible premises which
could be used by a Basingstoke Collaborative of General Practices who are looking to set up Urgent Care
facility in Basingstoke town.
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Alton
The population of Alton comprises of c.30,000 people served by the four GP practices: Boundaries
Surgery, Chawton Park Surgery, the Wilson Practice and Bentley Village Surgery. There is a second
General Practice in Four Marks which is aligned with West Hampshire CCG. Given the proximity to Alton
it is entirely sensible to ensure that the needs of this practice are included (as appropriate) in any future
proposals for Alton.
Alton has a Community Hospital, a modern building which has 18 inpatient (step up, Step down) beds,
the hospital is currently the base for the Chawton Park General Practice; there are also a number of
community services provided from the building. The building is underutilized and offers considerable
opportunity to evolve into a community hub to serve the population of Alton and surrounding areas.
The CCG has worked with our providers and the population to determine the future scope of local
services in Alton.
The review found that there is a high level of satisfaction with the quality of services provided in Alton
and a strong desire to see the range of services expanded and to support patients in playing a more
active role in managing their own health. Ideally there was a consensus of the need for urgent care
services in Alton outside normal working hours. The transport challenges when travelling outside the
Alton area to appointments was also evident.
Proposals in Adjacent Localities
The CCG is aware of the South Eastern Hampshire CCG proposals in Whitehill and Bordon, given the
proximity to Alton (10 km away) the plans for the adjacent locality need to be understood. The
population from this area access acute care from Hospitals located Basingstoke (50%), Guildford (40%),
and Portsmouth (10%).
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Geographical Location of Proposals in Whitehill and Bordon
South Eastern Hampshire and EHDC were successful in their bid to be Healthy new town development
site. There is an intention to create a new Health campus on the site of the Chase Community Hospital.
The new build would incorporate services currently provided in the Chase Hospital, allow for primary
care to be provided at scale and the facility would also be the base for the MCP.
Acute related outpatients services are provided by HHFT (both in Alton and at Chase Hospital), although
the population size, and transport links render merger of the Alton Community Hospital and the new
Health campus at Bordon to be unviable. However there is opportunity to work to have the same
service provider and to share services where applicable e.g. mobile diagnostics/MRI.
SCAS currently also have a standby facility at the Chase Hospital site, in order to be able to provide a
blue light response to this locality.
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10. SUSTAINABLE ESTATE ENVIRONMENTAL IMPACT
Overview
This chapter looks at sustainability from the perspective of social, economic and environmental factors.
This will be a focus for the CCG as the social determent of health and health inequalities such as
regeneration, economic growth, employment, housing, and social isolation have long term health
implications. The Estates Strategy provides an umbrella for the estates related aspects of sustainability.
Public Health England and NHS England have identified 35 interventions which Lord Carter of Coles has
promoted under the Carter review these are detailed in Annex 9.
These interventions are ranked showing the carbon reduction and financial savings possible across
England, they are also applicable locally. Whilst capital funding is required for the larger initiatives e.g.
combined heat and power facilities, many are achievable without such investment. The NHS has been
identified as the largest public sector contributor to climate change. As such the Government has stated
that it is critical that the NHS takes action to reduce its carbon emissions and hence its part in achieving
government carbon reduction targets.

Energy Consumption - Energy consumption is the single contributor for carbon emissions, within
the NHS carbon footprint of 18 million tonnes CO2 per year, energy is responsible for 22%, travel
18% and procurement 60%. HM Treasury forecast that energy prices will increase above inflation to
2020, so both direct and supply chain efficiency gains will be essential in order to keep costs down.

Waste Management and Water - Waste management and water consumption are both costly and
are subject to legislation requirements.

Transport - The area of North Hampshire comprises a significant rural area; community transport
plays a key part in accessing and delivery of NHS services. The CCG’s strategic aim to have an
increased focus upon supporting our population to maintain good health, support patients to stay
independent for as long as possible and provide NHS services in out of hospital settings. This will
also have a positive environmental impact, as well as ease pressure on the need for Hospital
Services particularly Unplanned Care.

Procurement - Identified as being 60% responsible for carbon emissions, procurement impacts
upon many areas of Estate and Estate related areas from Facilities Management (waste, catering,
linen) to major capital expenditure (new developments, refurbishments and maintenance). The
CCG has an expectation that its main providers will adopt the NHS Environmental Assessment Tool
(N.E.A.T) on every major capital project. This will ensure that the environmental impact is
considered.

Facilities Management, Building Maintenance and Capital Planning - Facilities Management, (such
as Waste, Catering, Linen,). The CCG has an expectation that its main providers will adopt the NHS
Environmental Assessment Tool (N.E.A.T) on every major capital project. This will ensure that the
environmental impact is considered.
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Local Delivery
Wessex Academic Health Science Network is working with partners across the HIOW STP area to
secure building energy reduction opportunities e.g. lighting, smart building management systems,
combined heat and power, air handling ventilation.
Organisational sustainability Development Management plans (SDMP) are required from all
providers through the NHS standard contract and are a key performance indicator in the Public
Health Outcomes Framework. The CCG will be seeking to actively influence the plans and change
performance delivery.
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11. ESTATE RELATED FINANCE
Background – NHS related Capital Funding
Capital funding in the NHS has become constrained, however the CCG and its providers of NHS Care
have a number of capital finance avenues that can be followed in order to secure a new development.
Foundation Trusts have the ability to borrow, either from the Foundation Trust Financing Facility (FTFF)
as well as from the open market. This includes commercial loans from banks and private lending
organisations. All significant transactions have to be submitted for approval to NHS Improvement the
key underlying principle being, that borrowing must be affordable. The main source of capital funds for
maintenance and minor development is from the Trust internally generated funds e.g. retained
surpluses, depreciation and receipts from the sale of fixed assets.
The premises in which the General Practice operate their business activity are a mixed economy of
arrangements; owned by (GP’s as an individual or by Partners) leased from NHS Property Services, or
leased via a private landlord which could include a LIFT company (partnership between the NHS and
private sector). Minor improvements will be expected to be met as a running cost although for smaller
capital projects such as a minor extension/refurbishment or improvement. General Practices may also
have the opportunity to bid against local/national funds for some (2/3 rds.) of the capital costs.
Where a major redevelopment in Primary Care is planned, a business case is required; the approval
process will be determined by the value of the capital required and the revenue impact e.g. whether it
results in an increase in day to day running costs to the systems e.g. provider/Commissioners of NHS
care (NHS England/CCG).
Other funding opportunities including national funding initiatives; which includes the Estate and
Technology Transformation Fund (ETTF) this is part of the national Sustainability and Transformation
Fund. The ETTF comprises a component of the £1.8bn new funding made available to the NHS in
2016/17.
Availability of Local Authority Sourced Funding
There are two potential sources of funding available to support the NHS to meet the one-off costs
arising from a new development these being; Section 106 agreement and the Community Infrastructure
Levy (CIL). Noting; that it is not possible to use both planning obligation and CIL for the same piece of
infrastructure.
Section 106 (S106) Legal Agreements
These are legal agreements between Local Authorities and Developers; these are linked to planning
permissions and can also be known as planning obligations. Planning obligations are used to make a
development that would otherwise be unacceptable. There are many types of planning obligation but
commonly they provide infrastructure or funds to deliver it, to mitigate the impact of the development.
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The local authority would test any funding request from the NHS against specified criteria which would
take into account whether a S106 is:



Necessary to make the development acceptable in planning terms
Directly related to the development
Fairly and reasonable related in scale
Community Infrastructure Levy
The Community Infrastructure Levy is a planning charge introduced by the Planning Act 2008 as a tool
for local authorities in England and Wales to help deliver infrastructure to support the development of
their area. It came into force in April 2010. It is up to each local authority to decide whether to apply a
levy. The levy can be used to fund a wide range of infrastructure including transport, schools, Health
and Social Care facilities, green space, culture and sport facilities. It is the Local Authority that decides
upon what new infrastructure is needed and how the levy will be spent. At least 15% must be on
priorities agreed with the local community where the development is taking place.
The table below sets out the indicative funding opportunities which would apply to the capital projects
set out in the report. Noting that this list not exhaustive and maybe subject to change.
Future Initiative – Project Phoenix
A national project has been established to delivering a new public, private partnership which will help
to deliver the capital investment necessary to support local estate related transformation plans. The
intention is to have a network of special purpose vehicles (SPV’s), NHS organisations would be
shareholders. The project is in the early stage and would use OJEC Procurement to secure a private
sector partner (10 year partnership agreement).
Table 6 Capital Funding sources by Type of provider of NHS care.
Organisation Type
Source of Capital
Foundation Trust Financing Facility.
Commercial Loan
NHS Trust and Foundation Charitable Fund
Trust
Internally generated funds e.g. Depreciation
Bids against Estate and Technology Fund (ETTF) part of the Sustainability
and Transformation Fund (STF)
Primary Care
Business Loan
Minor Improvement Grant
Landlord cost with resultant increase in lease charged to the tenant.
Bids against ETTF
Possible contribution via Section 106 or Community Infrastructure Levy.
Private, Public Partnership e.g. LIFT or other SPV
Disposals
Capital receipts from the sale of NHS owned Estate are recorded in the financial accounts of the
property owner.
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North Hampshire Local Estates Strategy 2017-2021
12. NEXT STEPS
The CCG will undertake the following actions in the latter part of 2016/17:

Undertake a Six Facet survey of General Practice to understand the Estate ability to provide good
quality medical care for existing patients, and to understand the scope for expansion to existing
buildings. Using the outcome of the surveys the CCG would encourage practices to make any minor
capital improvements required, and prioritize capital bids received.

Understand the opportunity to utilise existing space to enable early implementation of specific
proposals; e.g. Community Diabetes Services and an Urgent Care Access Centre in Basingstoke.

Explore and secure agreement as to which services are planned to be provided in a community or
primary care hub (begin to understand the activity and any specific estate requirements e.g. sound
proofing for audiology testing; protection fixtures for x-ray etc.)

Identify options and evaluate which would offer the most effective configuration of community and
Primary Care Services in North Hampshire under a Hub and Spoke model. This should take into
account the need to be future proof; the aspirations of the practices and our providers; the existing
availability; location and suitability of NHS estate. Evaluate each of the options against agreed
evaluation criteria.

Undertake an option appraisal in conjunction with NHS England as co-commissioners to inform
discussion with Basingstoke and Deane Borough Council in relation to the provision of NHS services
(particularly Primary Care) to support the population of the Manydown. Explore the potential to
deliver infrastructure through a planning obligation or future Community Infrastructure Levy.

Conclude the review on the potential centralisation of Acute Care Critical Treatment Services
Public Consultation
This strategy sets the scene, and will be widely shared with our partners and our population to ensure
that there is a community involvement through on-going dialogue. At this stage there are no specific
service change related proposals to formally consult upon.
However, the CCG recognises the benefits of including the public in developing the future estate
proposals which are detailed above, once developed; these will be subject to public engagement and
consultation as applicable.
The information set out in this strategy does not represent a commitment to any particular course of
action on the part of the organisations involved.
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Annex 1
Terms of Reference for the North Hampshire CCG Estate Strategy Forum
High Level Principles and Objectives
The following principles and objectives will guide and deliver the vision of the forum:
The core purpose of the NH Strategy Estates Forum (SEF) is to consider and make recommendations on
the optimal use of the NHS estate across the health system. This includes:




Improving effective utilisation of the estate
Rationalising estate (including disposal and/or acquisition)
Improving the management of the estate
Reshaping the estate to support wider service redesign, emerging new models of care and support
the shift of services into the community
Key considerations will be to:







Improve patient and staff experience by maximising the use of the existing most ‘fit for purpose’
estate and vacating the worst estate
Aim for solutions that provide the best overall value to the population of North Hampshire
Explore ways of incentivising services to relocate if necessary
Address the inequality of health outcomes by investing in areas of high deprivation
Promotion of health and wellbeing for the population of North Hampshire
Support the development which create communities by embedding healthcare including 3rd sector
services into core sites
Ensure the integrated health and care service model that is developing in North Hampshire is
accommodated efficiently and effectively
The NHSEF will adopt a whole system approach and act to the benefit of the health and social care
system as a whole; that solves problems rather than shifts them. The Group does not have powers
formally delegated to it by the boards of its membership. Instead they provide a forum where the senior
estates leads of the system’s main health organisations meet to agree shared positions that can be
taken forward by the individual organisations acting together. The focus of the SEF will be the use of
physical assets and real estate for the health care system within the NHCCG area.
Accordingly, the SEF will adopt a strategic “whole system” approach to considering the imperatives
listed above. This means that in addition to considering the utilisation of NHS buildings, the Group will
identify and examine shared-use opportunities – e.g. the co-location of NHS and Local Authority or
other public service or independent sector teams involved in the delivery or commissioning of public
sector services to the people of North Hampshire.
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In carrying out its functions, the SEF will act as the Project Board for the NHCCG Local Estates Strategy
(LES) and the Programme Board for implementation of its recommendations once agreed. The LES will
oversee the creation and dissolution of Task and Finish Groups and/or ad hoc Project Teams established
to undertake delegated strands of work. As part of this, the LES will provide Task and Finish Groups/ad
hoc Project Teams with Terms of Reference and arrange membership
This has included:












Southern Health NHS Foundation Trust
Neighbouring CCG’s
NHS Property Services
Hampshire Hospitals NHS Foundation Trust
Basingstoke and Deane Borough Council
Hampshire County Council
Solent NHS Trust
North Hampshire Urgent care
Community Health Partnership
NHS England
South Central Ambulance Services
North Hampshire Alliance who represent the North Hampshire practices:
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Annex 2
North Hampshire Population Change 2014 to 2021
Population Change 2014 to 2021
Age band
NHS North Hampshire
Hampshire
England
2014
2021
Difference
% Change
% Change
% Change
Age 0 To 19
52,530
56,652
4,122
8%
6%
5%
Age 20 To 39
52,732
54,651
1,919
4%
6%
3%
Age 45 To 59
46,624
49,084
2,460
5%
1%
2%
Age 60 To 74
32,692
37,030
4,338
13%
8%
10%
4,810
7,095
2,285
48%
26%
20%
217,077
234,853
17,776
8%
6%
5%
Age 85+
Total
Basingstoke and Deane estimated Population Change
Year
Population
Cumulative
% increase
2015
176,440
2017
180,508
2020
186,313
2023
191,768
2026
196,570
2029
200,868
2.3%
5.6%
8.7%
11.4%
13.8%
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Governing Body Approved December 2016
North Hampshire Local Estates Strategy 2017-2021
Annex 3
KEY ELEMENTS OF THE MODEL
Cost effective planned pathways
Improved GP access to specialist advice
Transfer activity from high cost
Hospital based services to the community
Systematic redesign creating greater
standardisation
People spend appropriate time
in hospital
Rapid access to high quality
Hospital care when needed
Decisions in line with agreed care plan
Discharge planning starts at admission
and involves the ICT
Early supported discharge to minimise
Length of hospital stay
Option to step-down into the
community
Effective
planned
pathways
Advice and information through village agents
Carer support
Day opportunities
Falls prevention, telehealth, telecare meals on wheels
Housing and extra care
Winter warmth
Crime and disorder
Employment
Gardening schemes
Early
Intervention
Appropriate
time in
hospital
I am able to
liveresponse
the life
Rapid
want
in aI crisis
Responsive
Primary
My
carers are
Care
supported
Proactive
My
environment
Care
Isintegrated
suitable for
my needs
Rapid response in a crisis
24/7 rapid triage 1 hour when urgent
Assessment through ambulatory care whenever possible
Short term stabilisation then retune to community
Community bed alternatives
Patient management aligns with ACP; 111 able to access this
Access to responsive primary
care services
Improving the way we organise and
deliver primary care to better meet needs
GPs at the centre of an expanded primary
healthcare team
Shifting the balance from reactive to
more proactive care
Proactive Integrated Care Team
Integrated Care Teams serving clusters
of practices with 50,000 population
Risk stratification of cluster population
with proactive multidisciplinary care
planning and case management
All patients with LTCs have a personal
health plan with strong emphasis on
self management
Single point of contact via central
administrative hub
Single, integrated clinical record
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Governing Body Approved December 2016
North Hampshire Local Estates Strategy 2017-2021
Annex 4 (page 1 of 2)
Future Developments within Settlement Boundaries 2017-29
The following tables are the current plans as at November 16, an updated land supply position is due to
be published in the next few months.
Local Plan Site
Site Address
(See also Annex 5 Page 3)
Reference
BAS153
Basing View, Basingstoke
BAS168
Buckskin & South Ham Regeneration Areas
BAS026
Normondy House, Alecon Link
BAS069
Playing Field, Pack Lane
BAS165
Former Smiths Industries Site, Winchester Road
BAS084
Central Car Park
TAD008
Land between Mulfords Road & Silchester Road
TAD003
Burnham Corpse Infant School
BAS064
Castons Car Park, South of New Road
BAS083
Brinkletts Car Park
BAS021
The Hampshire Court Hotel, Great Binfields Road
BAS156
May Street/Lower Brook Street, Brookvale, Basingstoke
BRAM007
Royal British Legion Grounds & car park
TAD007
38 New Road
BAS163
West Ham Lane
BAS060
Land North of Churchill Way
BAS059
Land East of Ringway West
Total Number of New Dwellings within settlement boundaries
20172022
170
110
100
100
50
40
40
36
30
20
16
10
10
7
0
0
0
739
20232029
130
90
0
0
0
0
0
0
0
0
0
0
0
0
50
45
25
340
46
Total
300
200
100
100
50
40
40
36
30
20
16
10
10
7
50
45
25
1,079
Governing Body Approved December 2016
North Hampshire Local Estates Strategy 2017-2021
Greenfield sites assessed for potential housing outside the settlement policy Boundaries
Site
Reference
BAS104
BAS105
BAS114
OV002
BAS024
WHIT006
OV007
SOL002
BRAM005
OV003
BRAM010
OV004
OV006
WHIT010a
WHIT018
BAS107
BAS133
BAS098
BAS099
BAS102
BAS106
BAS115
BAS116
BAS141
BAS154
BAS121
WHIT007
BAS122
BAS148
BAS139
SOL008
BAS132
BAS103
BAS140
Grand Total
Site Address
North of Popley Fields
Worting Farm
Kennel Farm
Overton Hill, London Road
Swing Swang Lane
Land south of Bloswood Lane
Land north of Court Farm
Redlands
Minchens Lane
Land west of Kingsclere Road
Land at Strawberry Fields
Two Gate Lane
Land off Pond Close
East of The Knowlings
Land lying off Winchester Road, Whitchurch
Razors Farm
Hounsome Fields
Manydown
Scrapps Hill Farm
Lodge Farm
Roman Way
Land at Worting
Land at Worting
Land at Worting Road, Basingstoke
Kite Hill Nursery, Worting
East of Basingstoke
Manor Farm (some overlap with Bloswood Lane
site WHIT006)
Upper Cufaude Farm
Land adjacent to Upper Cafaude Farm House,
Cufaude Lane
West of Cafaude Lane
Redlands (House)
Basingstoke Golf Club, Kempshott
Poors Farm
Land at Wildwood Cottage & Frog's Castle
Newham Lane
No of
units
450
70
310
120
100
83
35
150
200
150
200
150
200
200
200
425
750
3,140
80
650
30
130
20
250
10
450
Phasing (years)
60
390
2020-2022
2020-2026
27
400
15
1,000
900
2020-2026
2020-2027
2021-2026
2021-2028
2025-2029
150
11,495
2025-2029
2015-2023
2016-2019
2016-2019
2016-2020
2017 -2019
2017-2019
2017-2020
2017-2020
2017-2021
2017-2021
2017-2022
2017-2022
2017-2022
2017-2022
2017-2022
2017-2023
2017-2028
2017-2029
2017-2029
2017-2029
2017-2029
2017-2029
2017-2029
2017-2029
2017-2029
2018-2023
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Governing Body Approved December 2016
North Hampshire Local Estates Strategy 2017-2021
Annex 5
Six Facet Assessment of the Estate
Facet 1: Physical Condition
The physical condition profile takes account of the building structure together with the mechanical and
electrical engineering installations. There are five condition categories against which each building is
assessed, with an expectation that category B is the expected minimum attainment. The Estate code
categories are:
A. The Building/element is as new and can be expected to perform adequately for its full normal life.
B. The building/element is sound, operationally safe and exhibits only minor deterioration.
C. The building/element is operational but major repair or replacement will be needed soon (that is
within three years for building and one year for engineering).
D. There is a serious risk of imminent breakdown.
Facet 2: Functional Suitability
This analysis describes how effectively a site, building or part of a building supports the delivery of a
specific service. This will take account of





Space relationships
Amenity
Location
Environmental conditions
Overall effectiveness
The Estate code categories for functional suitability are:
A.
B.
C.
D.
X.
High degree of satisfaction
Acceptable/reasonable (minor change necessary)
Below acceptable standard (major change required)
Unacceptable in its present condition
Facility is below standard, nothing but a total rebuild will suffice.
Facet 3: Space Utilisation
The space utilisation identifies under/over utilisation of floor space. Under use of represents wasted
resource e.g. energy, maintenance. Over-utilised space may impend the effective delivery of healthcare.
The Estate code categories are:




Empty
Under-used
Fully used
Over crowded
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Governing Body Approved December 2016
North Hampshire Local Estates Strategy 2017-2021
Facet 4: Environmental Quality
The assessment takes into account three elements amenities, comfort engineering and design.
 Amenity – is the building attractive e.g. in terms of privacy, dignity, comfort, working conditions.
 Comfort engineering – is the building well lit, adequately heated and cooled, noise and odour free.
 Design – is the building attractively designed e.g. well furnished, landscaping, views etc.
Facet 5: Compliance with Fire, Statutory and non-Statuary Standard including Disability
Discrimination Act (DDA)
This facet is split into fire compliance and health and safety. The fire element being scored between 110 for compartmentation, fire doors, means of escape, alarms and detection system, textiles and
furniture, storage. The Health and Safety element is also scored between 1 and 10. This includes
electrical services, asbestos, control of legionella, Health & Safety, food hygiene and control of
hazardous substances.
The DDA assessment considers the external approaches, entrance and reception, internal areas,
sanitary facilities.
The Estate code categories are:
A.
B.
C.
D.
E.
New building which complies with all Firecode guidance and statutory requirements.
Existing buildings which comply
A building which falls short
Areas which are dangerous
Structural improvements are either impractical or too expensive to be tenable.
Facet 6: Environmental Management
This facet includes energy programme, water consumption, waste management. The NHS target for the
health estate is 35-55 GJ/100m3.
The Estate code categories are:
A.
B.
C.
D.
E.
35-55 GJ/100m3
55-65 GJ/100m3
65-75 GJ/100m3
75-100 GJ/100m3
Improvement to B performance is impossible or uneconomic.
Ways of assessing standards


The care quality commission makes an assessment as to a provider’s compliance with all of the
fundamental standards.
Patient led assessments of the care environment (PLACE) were introduced with the key purpose of
ensuring that patients are at the centre of all hospital environments.
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Governing Body Approved December 2016
North Hampshire Local Estates Strategy 2017-2021
Annex 6 (Page 1 of 6)
Primary Care Services
Map of all General Practices
General Practice Details
Practice
Addresses
Registered List Size
Beggarwood Surgery
Broadmere Road, Basingstoke
Hampshire RG22 4AQ
7,346
Bentley Village Surgery
Hole Lane, Bentley
Farnham. GU10 5LP
3,410
Bermuda and Marlowe Practice
Shakespeare Road, Basingstoke
Hampshire. RG24 9DT
13,569
Branch Surgery
Fort Hill Surgery,
Winklebury. RG23 8BU
Boundaries Surgery
17 Winchester Road, Four Marks
Alton, Hampshire. GU34 5HG
9,634
Bramblys Grange
Dickson House,
Alencon Link, Basingstoke. RG21 7AP
11,678
50
Governing Body Approved December 2016
North Hampshire Local Estates Strategy 2017-2021
Camrose Medical Partnership
St Andrews Centre, Western Way
Basingstoke. RG22 6ER
11,478
Chawton Park Surgery
Chawton Park Road
Alton. GU34 1RJ
9,634
Chineham Medical Practice
Reading Road, Chineham
Basingstoke. RG24 8ND
11,771
Minchens Lane
Bramley, Tadley
Hampshire. RG26 5BH
6,512
2 Dickson House, Alencon Link
Basingstoke
Hampshire. RG21 7AN
24,579
Sullivan Road, Brighton Hill
Basingstoke
Hampshire. RG22 4EH
19,871
Essex House, Essex Road
Basingstoke. RG21 8SU
13,466
Kingsclere Health Centre
North Street, Kingsclere
Newbury, Berkshire. RG20 5QX
5,538
The Surgery, Station Road
Overton, Basingstoke
Hampshire. RG25 3DU
11,335
Deer Park View, Odiham
Hampshire. RG29 1JY
Old Basing Health Centre, Manor Lane,
Old Basing. RG24 7AE
11,001
Mill Road, Rooksdown
Basingstoke
Hampshire. RG24 9SP
6,562
Clift Surgery
Crown Heights Medical Practice
Branch Lynchpit surgery
Gillies Health Centre
Hackwood Partnership
Kingsclere Medical Practice
Oakley & Overton Partnership
Odiham Health Centre
Branch Surgery
Rooksdown Practice
Tadley Medical Partnership
Branch Morland Surgery
Whitewater Health (previously
Hook Hartley Wintney Surgery)
Branch Surgery
The Wilson Practice
Holmwood Health Centre
Franklin Avenue, Tadley
Hampshire. RG26 4ER
40 New Road,
Tadley. RG26 3AN
The Surgery
Reading Road, Hook
Hampshire
RG27 9EP
1 Chapter Terrace
Hartley Wintney. RG27 8OS
Alton Health Centre
Anstey Road, Alton
Hampshire. GU34 2QX
19,664
17,040
14,103
51
Governing Body Approved December 2016
North Hampshire Local Estates Strategy 2017-2021
Annex 6 (Page 2 of 6)
PHARMACY PROVISION IN NORTH HAMPSHIRE
Property Name
ODS/SHA
PE or
Local
Property
Reference
Address line 1
Address line 2
Town/City
Postcode
Alliance Pharmacy
FW632
Beggarwood Surgery
6 Broadmere Road
Kempshott Park
Basingstoke
RG22 4FP
Anstey Road Pharmacy
FDC67
Alton Health Centre
Anstey Road
Alton
GU34 2QX
Boots
FAW77
Store F, Chineham Dis Ctr
Chineham
Basingstoke
RG24 8BQ
Boots UK Limited
FD490
52 High Street
Alton
GU34 1ET
Boots UK Limited
FHA97
15 Old Basing Mall
Basingstoke
RG21 7LW
Buckskin Pharmacy
FXR87
Units 1-2 Buckskin Centre
Basingstoke
RG22 5BW
Cohens Chemist
FWW83
4 Dickson House
Basingstoke
RG21 7AH
Day Lewis Pharmacy
FPQ05
Manor Lane
Old Basing
Basingstoke
RG24 7AE
Fastfare Pharmacy
FNM12
Unit 3, Abbey Parade
Abbey Road, Popley
Basingstoke
RG24 9ES
Blackdown Close,
Buckskin
Crown Heights,Alencon
Lnk
52
Governing Body Approved December 2016
North Hampshire Local Estates Strategy 2017-2021
Four Marks Pharmacy
FLK07
4 Oak Green Parade
Winchester Road Four
Marks
GU34 5HQ
Holmwood Pharmacy
FVJ17
Franklin Avenue
Tadley
RG26 4ER
Instore Pharmacy
FPM84
District Shopping Centre
Chineham
Basingstoke
RG24 8BE
Kingsclere Pharmacy
FR683
Swan Street
Kingsclere
Newbury
RG20 5PP
Lloyds Pharmacy
FFD45
Essex House
Essex Road
Basingstoke
RG21 8SU
Lloyds Pharmacy
FYX99
Shop 2 High Street
Hartley Wintney
RG27 8NX
Lloyds Pharmacy
FH259
34 Guinea Court
Chineham North
Basingstoke
RG24 8XJ
Lloyds Pharmacy
FCC36
201 Oakridge Road
Basingstoke
Lloyds Pharmacy
FJC45
The New Medical Centre
Shakespeare Road
Popley
Lloyds Pharmacy
FQV33
68 High Street
Alton
Lloyds Pharmacy
FTF72
138 High Street
Odiham
Morland Pharmacy
FN444
40 New Road
Tadley
Neil's Pharmacy
FKG67
Gillies Health Centre
Brighton Hill Parade
Basingstoke
RG22 4EH
Oakley Pharmacy
FNA61
Gemini House
22c Oakley Lane
The Vale, Oakley
Basingstoke
RG23 7JY
Overton Pharmacy
FEX31
4 Winchester Street
Overton
RG25 3HS
Pharmacy Link
FFF85
3 Winklebury Centre
Winklebury Way
Rooksdown Pharmacy
FHE37
Park Prewett Road
Basingstoke
SR Pharmacy
FJ593
4 Kings Furlong Parade
Winchester Road
Basingstoke
RG21 8YT
Sainsbury's Pharmacy
FJ647
Sainsbury's Supermarket
Wallop Drv, Hatch
Warren
Basingstoke
RG22 4TW
Sainsbury's Supermarkets
Ltd
FQX07
30a/B Mulfords Hill
Tadley
North Basingstoke
RG26 3JE
Superdrug Pharmacy
FNA78
10-13 Hampstead House
The Walks Shopping
Centre
Basingstoke
RG21 7LG
Whitewater Pharmacy
FGF50
Reading Road
Hook
RG27 9ED
Your Local Boots Pharmacy
FK893
2-3 The Hook Parade
Station Road
Hook
RG27 9HB
Your Local Boots Pharmacy
FEW25
St Andrews Church
Western Way
Basingstoke
RG22 6ER
Your Local Boots Pharmacy
FLA83
3 Brighton Hill Parade
Basingstoke
RG22 4EH
Your Local Boots Pharmacy
FQM29
Chawton Park Surgery
Alton
GU34 1RJ
Chawton Park Road
RG21 5TA
Basingstoke
RG24 9BW
GU34 1ET
Hook
RG29 1LT
RG26 3AN
Basingstoke
RG24 9RG
53
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Annex 6 (Page 3 of 6)
OPTICIAN SERVICES LOCATIONS IN NORTH HAMPSHIRE
Property Name
ODS/SHAPE or
Local Property
Reference
Brown and White Opticians
Ltd (Hook)
TP4F6
D & A (Basingstoke)
TP6A3
Leightons Opticians (Alton)
TP1Y4
Leightons Opticians
(Basingstoke)
Town/City
Postcode
Hook
RG27 9DJ
Basingstoke
RG21 7BE
90 High Street
Alton
GU34 1EN
TP4A1
9-11 Church Street
Basingstoke
RG21 7QG
Rawlings Opticians (Alton)
TP1X9
36 High Street
Alton
GU34 1BD
Richard Ward Ltd
TP4GV
113 High Street
Odiham
Hook
RG29 1LA
Specsavers (Alton)
TP2H9
43 High Street
Alton
GU34 1AW
Basingstoke
RG21 7JR
Basingstoke
RG24 8BE
Specsavers (Chelsea House,
Basingstoke)
Tesco Opticians
(Basingstoke)
TP6WJ
TP22A
Address line 1
Bourne House
London Road
Unit 16
Festival Place
9 Chelsea House
Town Centre
District Shopping Centre
Chineham
54
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Annex 6 (Page 4 of 6)
DENTAL SERVICES LOCATIONS IN NORTH HAMPSHIRE
Property Name
ODS/SHAPE or
Local Property
Reference
Address line
2 London Road
V14134
2 London Road
74/76 Franklin Avenue
V11388
Alton Dental
V07080
Associated Dental
Practices
Address line
Address line
Town/City
Postcode
Hook
RG27 9DJ
Tadley
RG26 4ET
54 Anstey Road
Alton
GU34 2RE
V07086
Shakespeare House
Health Centre
Shakespeare Road
Basingstoke
RG24 9DS
Associated Dental
Practices
V07085
Gillies Health Centre
Sullivan Road
Basingstoke
RG22 4EH
Beggarwood Dental
Practice
V00389
Beggarwood Lane
Beggarwood
Basingstoke
RG22 4AQ
Bounty Road Dental
Practice
V06006
74 Bounty Road
Basingstoke
RG21 3BZ
Brighton Hill
55
Governing Body Approved December 2016
North Hampshire Local Estates Strategy 2017-2021
Chequers Dental
Surgery
V07091
Chequers Dental
Surgery
3 Chequers
Road
Chineham Dental
Surgery
V06002
Chineham Dental
Surgery
54 Reading
Road
Claremont Dental
Surgery
V07092
Claremont Dental
Surgery
Dental Surgery
V06007
Dental Surgery
Basingstoke
RG21 7PU
Basingstoke
RG24 8LT
39 Worting
Road
Basingstoke
RG21 8TZ
Dental Surgery
17 Turk
Street
Alton
GU34 1AG
V01764
Dental Surgery
102 Stratfield
Road
Basingstoke
RG21 5SA
Dental Surgery
V07103
Dental Surgery
Quaintways
Cottage,
High Street
Hook
RG27 8NS
East Barn Dental Clinic
V80219
Great Binfields Road
Lychpit
Basingstoke
RG24 8TF
Family Dental Practice
V07081
Family Dental
Practice
Apollonia
House
2 Amery
Street
Alton
GU34 1HN
Guinea Court Dental
Surgery
V07096
Guinea Court Dental
Surgery
22 Guinea
Court
Chineham
Basingstoke
RG24 8XJ
Gwynne Dental
V80075
41 Cliddesden Road
Basingstoke
RG21 3EP
Hook Dental
V07111
Hook Dental
Stanley
House
London Road
Hook
RG27 9GA
Kingsclere Health
Centre Dental
V06004
Kingsclere Health
Centre Dental
North Street
Kingsclere
Newbury
RG20 5QX
Lenten Street Dental
Centre
V12331
Lenten Street Dental
Centre
19 Lenten
Street
Alton
GU34 1HG
Linden Court Dental
Surgery
V06280
Linden Court Dental
Surgery
1 Linden
Court
Old Basing
RG24 7HS
Newchurch Road
Dental Surgery
V06019
Newchurch Road
Dental Surgery
Newchurch
Road
Tadley
RG26 4HN
Odiham Dental Centre
V91010
The Dental Centre
Odiham
Hook
RG29 1QT
Omnia Dental Practice
V06014
Omnia Dental
Practice
Basingstoke
RG21 3ET
Roland Smith
Orthodontist
V06018
Roland Smith
Orthodontist
Basingstoke
RG22 5LY
Stanford Dental
Practice
V07108
Stanford Dental
Practice
29 Stanford
Road
Brighton Hill
Basingstoke
RG22 4LQ
The Dental Practice
V01757
The Dental Practice
King Street
Odiham
Hook
RG29 1NJ
Winchester Road
Dental Surgery
V06005
Winchester Road
Dental Surgery
33
Winchester
Road
Basingstoke
RG21 8UL
Chineham
Hartley
Wintney
Linden
Avenue
32
Cliddesden
Road
309
Kempshott
Lane
56
Governing Body Approved December 2016
North Hampshire Local Estates Strategy 2017-2021
Annex 7
NATURAL COMMUNITIES OF CARE
57
Governing Body Approved December 2016
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58
Governing Body Approved December 2016
North Hampshire Local Estates Strategy 2017-2021
Annex 8
SUSTAINABILITY INTERVENTIONS FROM PUBLIC HEALTH ENGLAND
1
2
Theatre kits in
hospitals - reducing
packaging
Sugar reduction in soft drinks
-31,600
329
-7,380
1,420
3,750
7,030
4,180
84,500
28,400
11,500
0 (saving in 2026:
32,200)*
26,400
3
4
5
6
Combined Heat and Power (CHP)†
Reducing medicine waste
Active staff travel
Psychiatric liaison
-6,340
-4,430
-3,790
-2,000
7
Biomass boilers
-1,870
8
Effective use of long-acting injections
-1,620
166
9
10
11
Driver training for fuel efficiency and safety
Reducing social isolation in older people
Teleconferencing
-1,570
-1,320
-981
3,960
62
4,100
12
13
14
Furniture reuse scheme
Telehealth/Telecare for long term
conditions
Solar - photovoltaic
-527
-341
-261
175,000
6,740
2,690
425
2,550
1,030
15
Variable speed drives
Staff energy awareness & behaviour
change
Lighting - controls
Building Management System (BMS) optimisation of existing systems
-231
10,300
3,930
-210
75,100
21,500
-167
2,250
863
-153
14,100
3,440
Lighting - high efficiency
Optimising office electrical equipment
Temperature set points - '1 degree C'
Building Management Systems (BMS) new systems
-141
-125
-111
18,800
11,100
46,200
7,190
4,250
6,260
-93
29,200
4,440
-91
-87
18,200
18,000
2,470
2,430
-76
-45
2,050
1,240
278
387
-24
11,400
1,540
-15
-15
11,900
27,900
201
3,780
16
17
18
19
20
21
22
23
24
Heating upgrade
28
29
Decentralisation of hot water boilers
Boiler plant optimisation
Dry recycling of general waste
Building fabric - glazing, insulation
& draft proofing
Reducing waste anaesthetic
gases
District heating
30
Boiler replacement
-3
6,160
31
32
Smoking cessation
Solar - thermal
Prescribing non-propellant
inhalers for asthma
-1
0
42,200
2,350
25
26
27
33
34
Travel planning
35
Reducing fuel poverty through
referrals for home insulation
341,000
1
48,900
1,480
Grand total savings in 2020
Interventions' direct financial
savings for the sector not
realised until 2026 so excluded
from total.
From 2021 gas CHP is higher
carbon than grid electricity is
expected to be.
0
17,400
1.1 million tonnes
37,500
0 (saving in 2026:
19,500)*
259,000
4,690
297
1,480
0 (saving in 2026:
421)*
5,020
834
0 (saving in 2026:
248)*
319
0
23
0 (saving in 2026:
171,800)*
£414 million
Product and procurement innovation
Waste reduction
Healthcare delivery/service innovation
Energy saving
Health Protection (£ saving not until
2026)
Travel
59