ITEM 5 Chryston Hub Update
North Lanarkshire Council · 21 February 2024
Back to IJB Performance, Finance and Audit Committee — 21 February 2024 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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1 REPORT Item No: 5 SUBJECT: Progress Update: Development and Delivery of Chryston Community Health Clinic TO: Integration Joint Board Performance, Finance & Audit Committee Lead Officer for Report: Ross McGuffie, Chief Officer NL HSCP Author(s) of Report Maggs Thomson, Head of Health DATE: 21st February 2024 1. PURPOSE OF REPORT This paper is coming to the IJB PFA to provide an update on the development and delivery of Chryston Community Health Clinic For approval For endorsement To note 2. ROUTE TO THE BOARD This paper has been: Prepared By: Reviewed By: Endorsed By: Prepared by Maggs Thomson, Head of Health in consultation with both Chryston Community Health Clinic Mobilisation Group and the Northern Corridor Service Repatriation Group. 3. RECOMMENDATIONS The IJB PFA is asked to: 1) Note the active and ongoing progress with the delivery of this capital programme.
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2 2) Note the progress with the repatriation of the clinical services from NHS Greater Glasgow & Clyde (NHSGG&C) and their associated Health and Social Care Partnerships (HSCP’s) 3) Note the previously identified financial gap reported Feb 2023 and reflect on work to date to progress towards final conclusion. 4. VARIATIONS TO DIRECTIONS? 5. BACKGROUND/SUMMARY OF KEY ISSUES 5.1 Background 5.1.1 From 1st April 2014, Health Board boundaries were realigned with those of the Local Authorities across Scotland, with the aim of reducing administrative barriers and ensuring full alignment with the integration of health and social care services as set out in the Public Bodies (Joint Working) (Scotland) Act. 5.1.2 This boundary change aimed to facilitate the development of integrated services across all areas of Scotland. The change resulted in the Northern Corridor (covering the areas of Moodiesburn, Muirhead, Chryston, Stepps, Gartcosh and Auchinloch) being transferred into the NHS Lanarkshire (NHSL) boundary. 5.1.3 This geographical area has one health facility located within Muirhead (Muirhead Clinic), which is small and at the time of transfer, dilapidated and not fit for function. The facility required backlog maintenance and asbestos work to be undertaken which was completed. 5.1.4 Despite the upgrade and refurbishment which improved compliance with healthcare standards, the facility could still not support the provision of all services for the local population. 5.1.5 Consideration was given to providing a new build facility on the existing site, however the footprint and parking limitations would not allow for the size of centre required to meet the clinical ask. 5.1.6 Due to the limited capacity of this facility, NHSL was unable to fully repatriate services from NHSGG&C, resulting in northern corridor residents having to travel significant distances across Glasgow to access some health services, with teams and clinics based in a range of areas including Shettleston, Kirkintilloch, Easterhouse and Bridgeton. 5.1.7 The services identified below continue to be delivered via a Service Level Agreement (SLA) with NHSGG&C and the associated HSCP’s. • Community Diabetic Service Yes No N/A
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3 • Community Mental Health Teams • Dietetics • Physiotherapy • Sexual and Reproductive Health Services • Substance Misuse 5.1.8 An opportunity emerged with the development of North Lanarkshire Council’s (NLC) ‘The Plan for North Lanarkshire’ which set out an ambitious estates strategy that looked to develop Community Hubs / Campuses. Further to consideration of this approach, NHSL working in partnership with NLC, invited hub South West Scotland to deliver a single campus for the replacement of Muirhead Community Health Clinic and Chryston Primary School. 5.1.9 There was extensive engagement with all stakeholders including NLC and NHSL project teams which resulted in the optimum design being developed to the satisfaction of all the stakeholders. The agreed design went through wide- ranging routes of engagement with key stakeholders including NHSL staff, H&SCP staff, teachers, support staff and pupils at Chryston Primary School. This process also included joint engagement with representatives of the Parent Council and elected members, culminating in an online public consultation to inform residents of the design outcome. 5.1.10 The business case for the Development of Chryston Community Health Clinic was considered by the NHSL Board on December 2021 at a cost of £3.65M and signed off with all legal agreements completed in January 2022. 5.1.11 The build programme began on Monday 14th February 2022 with a completion date of early August 2023 identified. 5.1.12 In tandem with the facility development, a process was initiated with NHSGG&C (and associated H&SCP’s) to begin the process of repatriation of the identified clinical services. 5.1.13 A Service Level Agreement (SLA) continues to be in place and as of January 2024 a notice of cessation is now formally lodged with GG&C. This exposed H&SCNL to a £392k financial gap if services where to be delivered with the known funded establishment and skill mix of the NHS Lanarkshire service model. 5.1.14 It was also recognised in February 2022 that to support the smooth transition, clinical safety and continuity of care there would be an expectation of double running costs for a period of 3 months, equating to an increased cost of £212k for that quarter. 5.1.15 All work was progressed on the basis of the funding being agreed in February 2022 calculation.
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4 Update 5.2 Chryston Community Health Clinic 5.2.1 The build programme experienced a delay and handover completed to NLC in late September 2023. To support school term and safe transfer of equipment it was agreed to open the school for business on 25th October 2023 following the mid-term break (see Appendix 1 for visual update). 5.2.2 H&SCNL mobilisation group progressed their operational plan in line with the school timeline and worked towards mid-November transfer of Muirhead clinic. Unfortunately, due to some critical snagging and IT challenges this further delayed to December 2023 with the first patient being received on the 18th. 5.2.3 At time of reporting all Muirhead Clinic services have transferred to Chryston Community Clinic. 5.2.4 Midwifery and CAMHS have also been supported to provide services the new health clinic 5.2.5 The intention was to decommission Muirhead Clinic, however NHSL has offered this accommodation to another service and the site responsibility will transfer to SLH&SCP at the end of January 2024. 5.3 Repatriation of Services 5.3.1 This process has proved challenging due to build delays and agreements with NHSGG&C resulting in the mutual agreement to repatriate services from 1st April 2024. 5.3.2 Finance has now been agreed and recruitment is progressing to repatriate all services identified above (5.1.7). 5.3.3 The finance identified from the SLA exceeds what was previously reported and gives a level of comfort that the shortfall previously reported may be closer to a break even. At time of reporting this has not been confirmed, however a verbal update will be provided. 6. CONCLUSIONS 6.1 In conclusion, this paper confirms that Chryston Community Health Centre has been delivered for service provision from 18th December 2023. 6.2 All services have transferred from Muirhead Clinic and are being delivered in Chryston Community Health Clinic with the addition of Midwifery and CAMHS
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5 6.3 Muirhead Clinic will not be decommissioned but handed over the SLH&SCP by 31st January 2024. 6.4 The IJB has already approved additional funding (£212K) to support double running costs for one quarter to allow safe transition of repatriated services. There is however some comfort that the £392K funding gap previously identified may not be required. The confirmed finance position will be verbally updated when this report is presented. 7. IMPLICATIONS Noted within the content of the paper 7.1 NATIONAL OUTCOMES The repatriation of services will support improvements in a range of service performance measures, particularly around mental health and substance misuse. Link(s) to National Health and Wellbeing Outcomes People are able to look after and improve their own health and wellbeing and live in good health for longer ☒ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonable practicable, independently and at home or in a homely setting in their community ☐ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☒ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☐ Health and Social Care Services contribute to reducing health inequalities ☒ People who use Health and Social Care Services are safe from harm ☐ People who work in Health and Social Care Services feel engaged with the work they do and are supported to continuously improve the information, support, care and treatment they provide ☒ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☒ 7.2 ASSOCIATED MEASURE(S) None. 7.3 FINANCIAL This paper has been reviewed by Finance: Yes No N/A
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6 At this time the £212k non-recurring allocation will still be required to support any potential double running costs. The £392k recurring revenue gap has been reduced with the possibility of a break-even position (yet to be confirmed).. Finance teams are reviewing our known position and will provide contemporary costs by the end of February 2024. 7.4 RISK ASSESSMENT/RISK MANAGEMENT Risks around the repatriation of services, including the transfer of complex treatment packages, ongoing recruitment challenges and the funding gap already identified and will be built into the operational risk register. Relevant Risk Register Details Current Risk Level Risk Owner Choose an item. 7.5 ENGAGEMENT & PARTCIPATION Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details regarding the engagement and participation that was undertaken. Objectives Further Details ☒ Involve stakeholders in the development work aimed at achieving the national outcomes There was full stakeholder involvement at every level of the development of this new health clinic. This ranged from presentation of project, through design development and delivery of the facility. There were dedicated meetings to progress the project and all updates were provided locally via community board structures. ☒ Provide stakeholders with information on how to get involved a/a ☒ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs a/a ☒ Measure how well we involve community stakeholders in the planning, design and delivery of our services a/a ☒ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery a/a
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7 ☒ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings ☐ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff ☐ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership A significant programme of engagement has taken place as part of the development of the business case. 7.6 INEQUALITIES & FAIRER SCOTLAND DUTY EQIA Completed & Fairer Scotland Impact Assessment Form Completed and attached to previous report as an appendix Developed as part of the business case. EQIA added to website: 8. BACKGROUND PAPERS NHS Lanarkshire Chryston Community Health Clinic Business Case https://www.nhslanarkshire.scot.nhs.uk/download/2021-december-20-board- papers/ 9. APPENDICES Please include a glossary of terms if not already included. Yes ☒ No ☐ N/A ☐ Yes / Date added ☐ No ☐ N/A ☐
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8 Appendix 1 Photographic views of the completed exterior and internal reception and waiting area December 2023. CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact the following; Maggs Thomson, maggs.thomson@lanarkshire.scot.nhs.uk
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9 Direction from North Lanarkshire Integration Joint Board (IJB) 1 Reference Number 2 Report Title 3 Date direction issued by IJB 4 Date from which direction takes effect 5 Direction to: 6 Does this direction supersede, revise or revoke a previous direction – if yes, include reference number(s) 7 Functions covered by direction 8 Full text of direction 9 Budget allocated by Integration Joint Board to carry out direction 10 Performance Management / Governance arrangements 11 Date direction will be reviewed
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10 Appendix 1 1: Main Entrance 2: Reception and Waiting Area