Accident and Emergency Department / Radiology Extension Phase 2 Approval of Drawings.

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A decision made (04/08/2008) regarding: Accident and Emergency Department / Radiology Extension Phase 2 Approval of Drawings.

Decision Reference: MD-HSS-2008-0036
Decision Summary Title :	Accident and Emergency Department / Radiology Extension Phase 2 Approval of Drawings	Date of Decision Summary:
Decision Summary Author:	Mr M Le Fevre, Director of Estates and Hotel Services	Decision Summary: Public or Exempt? (State clauses from Code of Practice booklet)	Public
Type of Report: Oral or Written?	Written	Person Giving Oral Report:
Written Report Title :	Accident and Emergency Department / Radiology Extension Phase 2 Approval of Drawings	Date of Written Report:	17th July 2008
Written Report Author:	Mr M Le Fevre, Director of Estates and Hotel Services	Written Report : Public or Exempt? (State clauses from Code of Practice booklet)	Public
Subject: Accident and Emergency Department / Radiology Extension Phase 2 - Approval of Drawings.
Decision(s): The Minister agreed the drawing numbered 4520/L02 showing the relocated Radiology department and the Accident and Emergency department extension subject to final Planning approval.
Reason(s) for Decision: The Health and Social Services department has the sum of £2,523,503 and has re-prioritised other capital sums to fund this high priority capital project which has a total estimated cost of £3,790,794.
Resource Implications: There are no resource implications of this project.

Action required:

1) Seek the approval in principle of the Minister for Treasury and Resources to reallocate existing Health and Social Services capital sums and approve the drawings under States of Jersey Standing Order 168.

2) Instruct the Director of Estates and Hotel Services to progress the Planning approval and seek tenders from contractors to carry out the work.

Signature:

Position:

Date Signed:

Date of Decision (If different from Date Signed):

Accident and Emergency Department / Radiology Extension Phase 2 Approval of Drawings.

STATES OF JERSEY

HEALTH AND SOCIAL SERVICES DEPARTMENT

Estate Management Services

Accident and Emergency Department / Radiology Extension Phase 2

Approval of Drawings

1. Background

1.1 In February 2003 a capital bid was submitted requesting £2m at December 2002 prices to relocate the Radiology Department’s administration, waiting area and filing into the main Granite Block of the General Hospital, followed by the expansion of the Accident and Emergency (A&E) Department into the vacated Radiology space.

1.2 The existing A&E Department was developed in 1987 as part of the last major development of the Parade Block of the General Hospital.

1.3 In 2001 it was necessary to install some temporary portacabins to provide additional space for the overcrowded and outdated A&E facility.

1.4 In addition to providing a replacement for the portacabins, the new A&E Department will provide:

improved access for the public from The Parade
new safer waiting area
access control for the staff
a separate minor treatment area
better located triage space where patients are first assessed
improved number and quality of the major treatment bays
a decontamination area
a bespoke gynaecology treatment room
a bespoke psychiatric treatment room
an improved staff base with 360 degree vision
a new isolation facility

1.5 The capital bid was approved by the States and was included in the 2006 capital programme at a cost of £2.377m.

2. Present

2.1 Due to pressures on the Capital Programme and the need to complete the combined Day Surgery Extension and A&E / Radiology Phase 1 project, the A&E / Radiology Phase 2 extension was delayed to 2008.

2.2 During the period 2004 to 2008 detailed design work has been carried out along with surveys of the existing structure and services.

2.3 As a result of detailed design and the state of the existing services, significant additional costs have been identified. These include:

(i) the installation of a new ventilation system

(ii) moving Ultrasound to provide additional space

(iii) the creation of a new mezzanine floor structure for future growth

(iv) the installation of a moveable file rack system

(v) the complete upgrading of all electrical services to comply with the latest electrical regulations

(vi) additional fees to cover the above

(vii) additional contingency due to the complicated phasing of works to be undertaken.

2.4 In addition to the above it will be necessary to create a new office to relocate the clinical coders whose present space is required for the new Radiology consultants offices no’s 1 to 3. The cost of this is likely to be in the order of £25,000.

2.5 The estimated total building cost of the project to completion in June 2010 is now £3,790,794 and includes:

Building costs £2,747,414

Fees £ 778,221

Other contract works £ 151,793

Furniture and fittings £ 91,366

Clinical coders office £ 22,000

Total £3,790,794

2.6 It is proposed to re-prioritise a number of other Health and Social Services capital budgets to cover the increased cost of this A&E / Radiology Phase 2 project as follows:

Capital Sum in 2008 Business Plan £2,523,000

(inflation to completion in June 2010)

Crematorium Gardens Extension £ 327,752

Part Tube System Extension £ 567,164

Shortfall £ 362,375

Total £3,790,794

2.7 The amount of the projected shortfall of £362,375 will very much depend on tenders received for the main contract. Assuming the Quantity Surveyors estimate is accurate this could be funded from either the Day Surgery budget and / or 2009’s Minor Capital budget.

2.8 It is now proposed to submit the drawings for final Planning Approval and to go out for tenders in August 2008.

2.9 It will be necessary to gain the Treasury Minister’s approval in principle to transfer funds from other capital votes to the high priority A&E / Radiology Phase 2 project.

2.10 The final design of the new A&E / Radiology Phase 2 is shown on architects drawing 4520 / LO2.

2.11 It must be recognised that this will be the only opportunity to make a significant improvement to the A&E Department for many years and it addresses many of the problems that exist within the present out of date and cramped facility. If the additional funding is not released the upgrading of the existing A&E major treatment bays will not be possible. This will include provision of the gynaecology, psychiatric, and isolation treatment rooms along with the new decontamination area. A new ventilation system to comply with all the latest Hospital Technical Memorandum guidelines would also be unfunded.

2.12 Due to the re-prioritising of capital funds it will be necessary for Health and Social Services to submit a new capital bid for its Crematorium garden extension which will now also need to include an element for land acquisition. The tube system extension costs will be added to all future General Hospital project costs when it is necessary to extend the tube system.

3.0 Recommendation

The Health and Social Services Minister is recommended to:-

(i) approve (subject to Planning and Environment approval) drawing 4520/LO2, detailing the plans for the Radiology / A&E Department Phase 2 project.

(ii) request the Treasury Minister to approve in principle the reprioritising of existing other Health and Social Services capital votes to fund the above project.

Mike Le Fevre

Director of Estates and Hotel Services

17th July 2008