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19-21 Broad Street | St Helier Jersey | JE2 3RR
Deputy Mary Le Hegarat
Health and Social Security Scrutiny Panel BY EMAIL
22 November 2021 Dear Chair
Health and Social Security Scrutiny Panel Response to Letter re Government Plan 2022-2025 Review
Thank you for your letter dated 3 November outlining additional questions from the Panel following the Government Plan 2022-2025 Review hearing on 28 October 2021. Please find below the responses to these questions.
Capital Programmes
Learning Difficulties - Specialist Accommodation HCS
- What was the outcome of the pre-feasibility work in 2020, and was this delivered within the £100,000 budget?
The pre-feasibility study was delivered well within the allocated budget in December 2020. This piece of work was to identify a preferred site for the 'Phase 2'' element of the capital allocation, the closure of Aviemore and the re-provision/location of the service.
- How much of the £2 million allocated for 2021 has been spent?
Spend to date totals £1.05m. There is further forecast spend of £0.45m for the remainder of 2021. £0.5m of 2021's budget allocation has been requested to be transferred to 2022 for spend that has been delayed into the following year. It should be noted that "request for funds to be transferred to future years" is still subject to review and approval as part of the year end process under the Treasury Minister's powers; it is not guaranteed.
- On page 136 of the proposed Government Plan, please can you clarify why there are 2 separate lines relating to this project, namely: one under Central Planning Reserves' for £50,000, and one under Major Projects' for £3.3 million?
The original pre-feasibility funding requested totalled £150k and was made up of £100k 2021 and £50k 2022 (page 143 of GP 2021-24). Subsequently, the pre-feasibility was required earlier than planned, therefore £100k was allocated in 2020 (spend being £21k) with the remaining balance transferred into 2021. The update to the Government Plan 2022-25 was completed during the early part of this year and at the time it was not understood that the £50k would not be required; therefore, it was included in page 136 of the Government Plan 2022-25, as you state. As pre-feasibility has been completed, the £50k is no longer required and can be retained within reserves.
- Please can you provide an update on the feasibility work and confirm how this differed to the pre-feasibility work undertaken in 2020?
The 2020 pre-feasibility was a piece of work to find which site would be best suited to re- provide/locate Aviemore. The 2021 detailed feasibility work has developed the preferred site into a more robust detailed designed' package that is currently sitting with HCS Senior Leadership Team (SLT). Once approved by SLT, a planning application can be submitted.
Replacement Assets – various
- Please can you provide us with some further detail about the capital programme for Health and Community Services replacement assets for the period 2022-2025?
Health and Community Services requires a significant number of assets (both revenue and capital) to maintain the range of services it provides. The timely replacement of these assets is essential to the provision of safe patient / client care as well as the effective operation of the hospital and other HCS services. Many pieces of medical equipment have fixed' lives where suppliers recommend / require replacement / upgrade in order to manage risk / litigation and ensure safe operation.
The impact of not replacing this range of equipment is directly on the service provision, be it a support service or front-line service. If the equipment is not safe or appropriately up to date so that it can be maintained, the service delivered via that equipment would be directly impacted.
The replacement programme is based on the Department's Fixed Asset Register and is overseen by clinicians and service leads responsible for providing the services supported by this equipment. The Capital & Revenue Equipment Committee meets on a monthly basis. Below is the planned equipment replacement schedule for 2022:
Planned Equipment replacement 2022 | |
Bronchoscopes, K006627 | 25,800.00 |
Dental Chair System | 1 16,689.00 |
Electroconvulsive Therapy Equipment | 25,000.00 |
Endoscopic Ultrasound Scope | 80,000.00 |
Eye laser Carlton Oculight, | 15,000.00 |
Garment Tunnel Finisher PARENT | 81,190.00 |
Giraffe Omnibed | 32,000.00 |
Incubator | 50,000.00 |
Interventional Radiology Room 4 - New Technologies | 3 20,000.00 |
Radiology Room 4 | 6 80,000.00 |
Ventilators | 1 03,550.00 |
Compact Air Drives | 75,000.00 |
Endoscopic Camera Stack | 58,871.00 |
Flexible Cystoscope | 16,900.00 |
Laser - ENT & Urolgy | 1 03,000.00 |
Radiology - Room 2 | 4 00,000.00 |
Microscope (Eyes) | 97,000.00 |
Portable Ultrasounds | 3 20,000.00 |
Total Planned 2 ,602,022.00 | |
The above will undergo a further review and prioritisation with clinicians and service leads, the HCS estates team and with the involvement of the corporate procurement team.
Below is a summary of the equipment that is identified as requiring replacement in the years 2023 – 2025. Again, this will be subject to review and prioritisation:
Description 
Sum of 2023 Sum of 2024 Sum of 2025
Autoclave Microbiology LTE 49,500
Bath Beech Arjohuntleigh 11,200
Bronchoscope Olympus Keymed 23,710
Call system General Hospital 298,200
Capillarys - Blood 38,000
Cardiac Clinical Investigations 10,000
Colonoscope Olympus Medical 13,000
Cryomatic Unit Keeler 15,600
Cryostat Histology Leica 14,000
Defibrillator Zoll Medical 38,820
Dental equipment 90,175
Dialysis Renal Unit 72,000 48,000
ECP Day Surgery 29,075
Edge System Emergency 26,200
Electroencephalograph Optima Medical 24,950
Electromylography Optima Medical 31,995
Exercise Investigations Cosmed 30,907
Field Dept 27,000
Gastroscope 130,920 101,824
Hi-Lo Care Packages 16,000
Hi-Lo Ward Arjo 11,500
IN Inflight Co-ordinator 10,162
Intensive care equipment 175,975 19,050 112,000
Isolette Care Baby 13,000
KNS800 Power Tool 13,000
Major Major Incident 95,550
Microdebrider Console Day 10,500
Microscope 64,000 69,500
Microtome - Histology 20,200
Minor Day Surgery 208,000
Navigation ENT Medtronic 80,000
OCT Dept 48,000 43,072
Ortho Olympus Operating 25,330 Orthoconnect - General 10,500
Paed Aubin Ward 224,828
Paed Ward Olympus 114,800
Pathology equipment 36,195 55,860
Portable Investigations Philips 40,892
Progressa Care Hill-Rom 16,000
PSA Mgmnt & 380,000
Radiology equipment 58,105 2,999,237 576,973 Rhinolaryngo Olympus Medical 26,000
Robotic Becton Dickinson 398,700
Televideo Investigations VideoSouth 18,773
Theatre Equipment 193,974 109,367 114,350
Tracking Ward Hill-Rom 22,300
Transport Care Baby 139,998
Ultrasound 126,700 130,500
Urology Olympus Operating 22,293
UV Estates Mgmnt 54,000
Video Ward Keymed 37,848
Video Xion Gmbit 32,955
Visual Analyser Eye 11,640
Washer Ward Cantel 254,000
Grand Total 2,293,679 4,644,571 1,428,453
In-patient/support services refurbishments
- How much of the £1.044 million funding has been spent in 2021?
There has been no spend or commitment for this project and this has been requested to be transferred to 2022. Progress has been hindered by the pandemic restrictions on clinical environment/project delivery.
It should be noted that "request for funds to be transferred to future years" is still subject to review and approval as part of the year end process under the Treasury Minister's powers; it is not guaranteed.
- No further budget for maintenance work has been requested after 2022. Do you expect that further capital expenditure will be required between 2023-2025, to keep the Jersey General Hospital well maintained until the new hospital is operation?
2021 & 2022 funding allocation has been requested for transfer to 2022 & 2023. Clinical model/strategy required prior to requesting additional funding.
Health Services Improvements
- Please can you advise what areas have been identified as a priority for this budget in 2022 – 2025?
The HCS Estates team has a RAG-rated long list of cr.75 infrastructure priority projects. This is a fluid schedule that can be adapted to suit the ever-changing health environment. As we did during the pandemic, 2022-2023 will focus on the in-patient areas (Maternity, Robin, Sorel, Bartlett & Rayner wards) to continue the installation of Pyxis pharmaceutical dispensing machines, fire and general compliance works. New air handling plant to Day Surgery and Pathology, and fire compartmentation across the campus.
- Please advise why the proposed budget reduces to £2 million in 2024, but is £5 million per year in 2022-23 and again in 2025.
This is not HCS; £5m was requested. I believe the thought process from central finance was that if the Our Hospital Project (OHP) is on target, funding could be reduced and risk managed. The allocation for 2025 is the safety net in case of delays with the OHP.
- Can you confirm whether any of this funding has been used, or will be used, for the IT development of digital records projects?
This fund will not be used for IT improvements. There are separate bids for IT. Regulation of Care - income deferred
- We understand that this funding relates to increased costs as a result of the Regulation of Care Law. Please can you provide a breakdown of the 2021 costs this relates to, for the Panel's reference?
- The funding for this item is proposed to continue at £200,000 per annum. Will it become part of the base budget in future?
The answers to these questions will be provided as soon as possible.
Obstetric and Gynaecological (O&G) Services - CSP2-3-07
- Please could you provide some further detail about the 7 roles this allocation will fund?
2 additional consultants to take consultant establishment to 7 to ensure we are able to provide a range of services across O&G and provide consultant cover on labour ward 24/7 along with meeting best practice guidance in relation to safety.
The investment is in moving from 5 to 7 Consultants in O&G. The medics will cover the following services:
• General Gynaecology
• Hysteroscopy (Outpatient with procedure)
• Colposcopy (Outpatient with procedure)
• EPAU (Early Pregnancy Assessment Unit)
• Uro-gynaecology
• Gynaecology Oncology (Including Gynaecology Oncology Colposcopy)
• Termination of pregnancy (ToP)
• Assisted Reproduction
• Menopause
• Labour ward
• Medical Disorders Clinic
• High Risk ANC Care/Multi Pregnancy
• Fetal Medicine
• Psychosexual
• Gynaecology Theatre
• O&G Governance
Mental Health and Mental Health Legislation
- How much of the £4.8 million funding for 2021 has been spent? Please can you provide a breakdown of this.
- Please can you provide a breakdown of the proposed £4.1 million budget for 2022?
- Please can you provide a breakdown of the £629,000 funding for Mental Health Legislation' in 2022.
- What is the focus of the mental health team for the priority of services in 2022? The answers to these questions will be provided as soon as possible.
Health Service Recovery
- Please can you provide a breakdown of how the £1.296 million funding for 2022 will be used.
Investment into the business case will support services to return to pre-Covid positions for waiting lists and service delivery. This investment cannot be met from existing budgets.
Funding approved: £3,012,567:
Period | £ |
Q3 and Q4 2021 | 1,740,527 |
Q1 to Q3 2022 | 1,272,040 |
Total | 3,012,567 |
The business case covers the following services within HCS:
- Primary, Preventative and Intermediate Care
- Medical Services
- Surgical Services
- Therapy Services
- Mental Health Services
- Social Care
- Support Services.
Yours sincerely
Deputy Richard Renouf
Minister for Health and Social Services