the nhs estate in wales

THE NHS ESTATEIN WALES

Facilities Performance Report2004/05

W E L S H H E A LT H E S TAT E SYSTADAU I ECHYD CYMRU

THE NHS ESTATE IN WALES

Facilities Performance Report

2004/05

W E L S H H E A LT H E S TAT E SYSTADAU I ECHYD CYMRU

1.1 Estates and facilities condition and performance reports1.2 The 2004-05 Facilities Performance Report1.3 Facilities functions1.4 Good practice

2.1 Context of the report2.2 Facilities performance

3.1 Overview of facilities management services3.2 Performance management and the balanced scorecard approach

4.1 Expenditure on NHS facilities services4.2 Telecommunications4.3 Car parking4.4 Cleaning services4.5 Catering services4.6 Laundry and linen services4.7 Security services4.8 Portering services4.9 Postal services4.10 Outsourced services

5.1 Overall analysis5.2 Car parking5.3 Cleaning services5.4 Catering services5.5 Laundry and linen services5.6 Security services5.7 Portering services5.8 Postal services

Appendices I – XIV Observations on FM-related operating costsAppendix XV Occupancy costs for different hospital typesAppendix XVI Cost comparisons of individual FM services

1 INTRODUCTION 5-8

2 EXECUTIVE SUMMARY 9-14

3 FACILITIES MANAGEMENT PROFILE 15-16

4 ANALYSIS OF TRUST-WIDE DATA 17-39

5 ANALYSIS OF MAJOR ACUTE HOSPITAL DATA 40-48

6 APPENDICES 49-141

CONTENTS

1.1 Estates and facilities condition and performance reports

1.1.1 Annual Facilities Performance Reports along with the Estate Condition and Performance Reports are

based on the returns from the on-line Estates and Facilities Performance Management System

(EFPMS) introduced by the Welsh Assembly Government (WAG) in April 2002. The system is managed

by Welsh Health Estates (WHE) and allows Welsh Trusts to gain access to estates and facilities data

submitted by other Trusts in Wales as well as English Trusts, thus enabling them to compare their

performance against a much larger database.

1.1.2 The reports produced by WHE are intended primarily to provide the WAG with high-level data and

information on the performance of Trusts in respect of their facilities functions, in order to monitor

year-on-year performance trends, inform the strategic planning process and assist in the prioritisation

and allocation of resources.

1.1.3 The reports are also intended to provide NHS Trusts with data and information that will enable them

to compare their own performance with that of other Trusts, as well as against national trends and

should, therefore, be a driver in the process of improving the performance and efficiency of health

care facilities at a local and national level.

1.1.4 An EFPMS User Group, with representatives from each Trust, was set up in 2003 to provide data input

training for the Service and deliver improvements in the quality and consistency of reporting. The user

group is currently undergoing review to raise the profile of the EFPMS within Trusts and to redress the

balance of membership for estates and facilities staff, with the aim of improving the quality of facilities

management (FM) data submitted. The re-formed group is likely to develop into a ‘benchmarking club’

responsible for developing suitable performance indicators (PIs) with appropriate data definitions that

will serve to improve standards and performance across Wales.

1.1.5 WHC (2003) 120 and WHC (2004) 047 described the programme of work to develop and implement

the performance framework for NHS Wales and the introduction of the Balanced Scorecard. WHC

(2005) 72, The Balanced Scorecard for NHS Wales 2005-06, issued in August 2005, builds on these

initial steps and introduces the second Balanced Scorecard for NHS Wales for use in 2005-06. Future

balanced scorecards will be linked to the recently published strategy for NHS Wales, Designed for Life

and the National Leadership and Innovations Agency for Healthcare’s modernisation assessment

referred to in that strategy.

1.1.6 It is envisaged that Facilities Performance Reports will evolve over time as the ability of the Service to

provide robust data improves and additional PIs are identified for benchmarking purposes. The All

Wales Facilities Forum (AWFF), set up in 2004 to drive forward the FM agenda and move towards a

balanced scorecard performance approach, will also oversee developments in FM.

1.1.7 Responsibility for the management of hospital sites within the former Powys Health Care NHS Trust

has been transferred to the Powys Local Health Board and, for the purposes of this report and to

enable a consistent approach to be taken with regard to PIs and targets, this particular Local Health

WELSH HEALTH ESTATES - Facilities Performance Report 2004/05 5

1 INTRODUCTION

Board is deemed to have the same status as the other Welsh Trusts. Due to its uniqueness amongst

Trusts, the Welsh Ambulance Services Trust has not been included.

1.2 The 2004-05 Facilities Performance Report

1.2.1 The 2004-05 Facilities Performance Report complements the 2004-05 Estate Condition and

Performance Report and focuses on a range of FM services that support clinical care. The Executive

Summary (Section 2) is followed by an overview of FM services (Section 3). The nature of the available

data has determined, to a great extent, its applicability and scope. Where appropriate, it has been

applied on a Trust-wide basis (Section 4), or limited to individual NHS acute hospitals (Section 5).

Analyses of the data for individual Trusts have been included in Appendices I – XIV.

1.2.2 This report is the second to be produced for the NHS in Wales and is based on EFPMS returns

submitted for 2004-05. Following the issue of the 2003-04 Facilities Report questionnaires were sent

to Chief Executives and Line Managers requesting feedback. Comments were generally favourable in

terms of the format and layout of the report, which was seen as a positive step in taking FM services

forward. However, in the context of the PIs used, there was concern about the underlying weaknesses

with regard to the comparability of data submitted and the ability of Trusts to provide that data in

accordance with the EFPMS definitions. These aspects will be addressed by WHE as part of an on-

going process of refinement of the EFPMS and with additional guidance and support for Trusts where

required. However, it is also recognised that EFPMS representatives in some Trusts will need to make

a far more concerted effort with FM service providers and mobilise all contributors of the required

data in order to report accurately and on time.

1.2.3 It should be noted that, in the main, this report is based on the analysis of the financial costs of carrying

out the facilities functions in the NHS in Wales and, therefore, the PIs do not take into account the quality

aspects of these services and, in particular, the way they impact on the patient experience in the NHS.

A number of PIs have been used including, where possible, those that are patient-orientated and it is

anticipated that more patient-focused PIs will feature in future reports.

1.2.4 This year, once again, the quality, consistency and, in some cases, the lack of data submitted by Trusts

has been disappointing, reinforcing a view that there is an absence of a robust management-led data

verification process within many Trusts. Whilst WHE has not carried out a comprehensive validation of

all the data, every effort has been made to identify and address significant anomalies.

1.2.5 Responsibility for the accuracy of the data submitted to WHE, in particular its provision in accordance

with the stated data definitions, and the effect this may have on PIs used in this report, rests ultimately

with the Trusts. Only one Trust of the three responsible for managing Private Finance Initiative (PFI)

hospitals apparently continues to have difficulty in obtaining data from its PFI operator.

1.2.6 The acute hospitals included for detailed analysis in this report are listed in Figure 1 along with the

Trust and Region to which they belong.

INTRODUCTION

6 WELSH HEALTH ESTATES - Facilities Performance Report 2004/05

1.3 Facilities functions

1.3.1 With reference to paragraph 1.2.1 above, the report analyses the facilities data either Trust-wide or on

the basis of 16 major acute hospital sites.

Trust-wide information

1.3.2 Comments on the data submitted for the following Trust-wide facilities functions are included in

Section 4 of this report:

❖ Telecommunications

❖ Car parking

❖ Cleaning services

❖ Catering services

❖ Laundry and linen services

❖ Security services

❖ Portering services

❖ Postal services

❖ Outsourced services

INTRODUCTION


REGION TRUST TRUST TYPE HOSPITAL

Conwy & Denbighshire Large multi-service Ysbyty Glan Clwyd

North Wales North West Wales Large multi-service Ysbyty Gwynedd

North East Wales Large multi-service Ysbyty Maelor

Bro Morgannwg Large multi-service Princess of Wales

Carmarthenshire Medium acute Prince Philip

Carmarthenshire Medium acute West Wales General

Mid & West Wales Ceredigion & Mid-Wales Small multi-service Bronglais General

Pembrokeshire & Derwen Medium multi-service Withybush General

Swansea Large multi-service Morriston

Swansea Large multi-service Singleton

Cardiff and Vale Acute teaching Llandough

Cardiff and Vale Acute teaching University Hospital of Wales

South East Wales Gwent Healthcare Large multi-service Nevill Hall

Gwent Healthcare Large multi-service Royal Gwent

North Glamorgan Medium multi-service Prince Charles

Pontypridd & Rhondda Large multi-service Royal Glamorgan

Figure 1: Acute hospitals included in the report

Hospital-specific information

1.3.3 Comments on the data submitted for the following hospital-specific facilities functions are included

in section 5 of this report:

❖ Car parking

❖ Cleaning services

❖ Catering services

❖ Laundry and linen services

❖ Security services

❖ Portering services

❖ Postal services

1.4 Good practice

1.4.1 A key objective of this report is to provide data and information that will enable FM stakeholders to

share good practice and, in doing so, contribute to the process of continuous improvement in the

provision of FM services within Trusts. Benchmarking is a fundamental tool in sharing good practice.

1.4.2 It is apparent that, to varying degrees, Trusts already monitor themselves against internally-set targets

and some use other FM benchmarking tools, although the full extent of this is not known. For this

reason the AWFF is currently looking at how Trusts may further avail themselves of good practice

sharing opportunities, and at ways in which WHE may provide the necessary support.

1.4.3 In view of the on-going development of the Performance Improvement Framework and the PIs that

will feature in balanced scorecards, it is not possible to be specific about Trust indicators and the

setting of appropriate targets. However, throughout this report the available data has been analysed

and used not only to inform but, wherever possible, to stimulate thought and discussion both at a

national/strategic and local/operational level and to assist the development of appropriate PIs.

1.4.4 WHE has organised one workshop so far in 2005 for Trusts to participate in the process of refining the

data definitions and PIs for Catering, Cleaning and Portering. Further workshops to cover the full range

of FM services are anticipated.

1.4.5 The above process has highlighted instances of significant variations in performance against the

indicators used. Indeed, there are some cases of alarmingly wide variations which are unlikely to be

accounted for by differences in service provision and, therefore, more likely to be due to management

effectiveness. These have been highlighted in the report and all present opportunities for Trusts to

consider areas for improvement. Cross-reference to Appendices I–XIV is intended to enable

benchmarking and may be particularly helpful in this respect.

1.4.6 Increasingly, as PIs are refined and adopted in Trust balanced scorecards, opportunities to benchmark

against these will arise. The only suitable FM indicator at the present time is the audited score against

the National Standards of Cleanliness and, as more Trusts participate fully, this will be an increasingly

valuable indicator for the ongoing sharing of good practice.

INTRODUCTION


2.1 Context of the report

This report examines the performance of facilities management related services and functions in the

NHS in Wales for the period 2004-05. It includes data and information on a Trust-wide basis and,

where appropriate, on a hospital-specific basis, which this year is, as with the report for 2003-04,

limited to 16 major acute hospital sites.

The report, compiled by Welsh Health Estates (WHE), complements the 2004-05 Estate Condition and

Performance Report, and is the second of its type to be based on the Estates and Facilities Performance

Management System (EFPMS) data, submitted by 13 NHS Trusts and Powys Local Health Board. Due to

its uniqueness amongst Trusts, the Welsh Ambulance Services Trust has not been included.

This is the third year that the submission of the majority of the EFPMS facilities data has been

mandatory and, once again, the quality, consistency and, in some cases, the lack of data submitted by

Trusts has been disappointing, suggesting the ongoing absence of a robust management-led data

verification process within many Trusts. Whilst it has not been possible for WHE to carry out a

comprehensive validation check of the data, every effort has been made to identify and address

anomalies. Responsibility for the accuracy of the data submitted to WHE, however, rests ultimately

with the Trusts.

The unreliability of the data has, once again, limited the scope for analysis and hindered the

establishment of trends. The effectiveness of the EFPMS is largely dependent upon the reliability and

consistency of its data. These issues, therefore, continue to be a priority matter for WHE and efforts

are being made to address deficiencies through Data Quality Assessments carried out with each Trust.

It continues to be a matter of concern that there appears to be an underlying difficulty for some Trusts

to provide what is considered to be essential management information.

The performance indicators (PIs) included in this report are a combination of financial indicators

widely used for audit studies and benchmarking and, wherever possible, indicators that relate directly

to the patient/visitor experience. The patient/visitor-related indicators are seen as a step towards the

‘harmonisation’ of key PIs for the NHS-wide and Trust-specific balanced scorecards that, in due course,

will inform the Assembly’s Performance Framework.

WHC (2003) 120 and WHC (2004) 047 described the programme of work to develop and implement

the performance framework for NHS Wales and the introduction of the Balanced Scorecard. WHC

(2005) 72, The Balanced Scorecard for NHS Wales 2005-06, issued in August 2005, builds on these

initial steps and introduces the second Balanced Scorecard for NHS Wales for use in 2005-06. Future

balanced scorecards will be linked to the recently published strategy for NHS Wales, Designed for Life

and the National Leadership and Innovations Agency for Healthcare’s modernisation assessment

referred to in that strategy.

Wherever possible, the opportunity has been taken to compare expenditure between Trusts and to

give a breakdown of overall expenditure for the services in the NHS in Wales. The provision of this data


2 EXECUTIVE SUMMARY

is seen to be useful for performance management purposes and for future investigations into possible

correlations with patient/visitor-related PIs and the findings from Hospital Patient Environment (HPE)

external assessments.

The analysis of data in this report also enables Trusts to identify where they may be under-performing

against the all-Wales averages. It also indicates where examples of good practice are adopted by

similar Trusts with an improved performance. The All Wales Facilities Forum is now established as an

advisory committee to drive forward facilities related issues within the NHS in Wales. It will oversee

developments in FM and work towards a Balanced Scorecard way of comparing performance.

2.2 Facilities performance

2.2.1 Organisational issues

FM services are commonly split between estates and hotel services, and organisational structures

within Trusts continue to evolve to reflect the increasing importance being placed on FM in supporting

the delivery of clinical services. The nutrition and catering standards issued in 2002 and the cleaning

standards issued in 2003, for example, require that Trusts nominate a board member with

responsibility for those services.

At director level, however, there is evidence of significantly different corporate approaches to the

assignment of responsibilities for FM services. In the majority of Trusts responsibility is shared

between estates, facilities, commercial and operational directorates. In some Trusts, however,

responsibility for one or more of the services falls outside these directorates.

Structures below director level are generally similar, with departmental line managers, supported by

their own departmental structure, reporting to their director and being responsible for their specific

FM service.

2.2.2 Expenditure

Overall

An analysis of figures reported for 2004-05 shows that expenditure on facilities (hotel services) costs

totalled £133.7 million across Wales. This is an increase of £2 million on the costs reported for 2003-

04 and represents approximately 5.3% of the Trusts’ income.

The current all-Wales breakdown of the percentage expenditure on facilities services is shown in

Figure 3 on page 17.

With increasing attention being paid to the importance of the patient experience, it is anticipated that

the profile of facilities services will continue to rise and that the monitoring of the level of expenditure

on such services will be considered important.

Observations for Trusts

Observations on the expenditure reported by individual Trusts have been included in

Appendices I - XIV.

EXECUTIVE SUMMARY



It is appreciated that expenditure on facilities services alone does not present the complete picture

for the performance of the service delivery, and the All Wales Facilities Forum is now taking forward

the development of a range of appropriate indicators. However, it is often a very helpful indicator

when used to compare similar organisations, in order to draw attention to potential savings and to the

allocation of resources for optimum performance. Hence, the available EFPMS data has been used and

observations made where appropriate. A consolidated table giving a breakdown of expenditure for

the facilities services of each Trust, including the all-Wales average values, is illustrated in Figure 4 on

page 18.

2.2.3 Hotel services

Telecommunications

No clear indication of performance is currently available for telecommunication services. The only PI

adopted as a benchmark is the costs per occupied floor area, ranging between £4 and over £10 per

unit area. A factor in this variation is the increasing use of mobile phones, with approximately 25% of

all calls being made to a mobile phone and accounting for as much as 35% of the telephony call spend.

This financial indicator needs refinement to include aspects of service quality. One particular aspect is

telephone answering response times, although there is currently no national NHS standard in place.

The ‘average’ response times data currently available is seen as inadequate to give a true reflection of

the service provided and will need to be refined to be of benefit.

It is apparent that bedside communication and entertainment systems are increasingly being adopted

by Trusts, although the full extent is not known. The facilities these systems can provide, both for

patients and Trusts, are potentially beneficial. However, contractual arrangements need to be

considered carefully and the costs incurred by users must be taken into account.

Car parking

It is evident that Trusts are experiencing increasing problems in meeting the demand for parking

spaces at healthcare facilities. The findings of the Hospital Patient Environment (HPE) Annual Reports

have identified the capacity of car parks at many of the sites visited as inadequate. In addition, there

are problems with access by public transport.

Data submitted by Trusts shows that, on the basis of spaces provided/100m2 of occupied floor area,

the range is substantial, varying from 1.5 to 2.7 spaces between Trusts, which may well correlate with

some sites having worse parking problems than others.

Since 2003-04 there has been an increase of over 3,200 parking spaces across all Trusts. Of these, over

300 have been allocated to disabled users resulting in an increase of 27% in disabled spaces. As a result,

there has been an improvement in the number of Trusts meeting the local authority guidelines for the

provision of disabled spaces in a new car park.

According to the data submitted, nine of the fourteen Trusts have introduced a charging regime at one

or more of their hospitals. Of the nine Trusts, three generated income from both staff and visitors, two

from staff only and four from visitors only. The reported income from staff and patients/visitors for

2004-05 stands at £940,000 and £1,455,000 respectively.

EXECUTIVE SUMMARY

Cleaning

The National Standards of Cleanliness for NHS Trusts in Wales, 2003 provided a toolkit for auditing and

assessing the performance of the Service measured against specific cleaning outcome requirements.

EFPMS data for 2003-04 included the results submitted for 89 hospitals and aggregated sites.

The data for 2004-05 shows a higher number of hospital audit scores being submitted and all Trusts

returned an audit score against the National Standards of Cleanliness for some, if not all, of their

hospitals. Trusts that failed to provide externally verified scores for all of their hospitals have reported

that their Trust Cleaning Plans are to take any remaining hospitals into account in future, and this will

be monitored closely. Results for 93 hospitals and aggregated sites were submitted, with audit scores

that ranged from 31% to 100%. The extreme cases were isolated and most scores for major hospitals

ranged from 60% to 95%. The audit scores will clearly be a factor in demonstrating continuous

improvement in the provision of an acceptable standard of cleanliness in hospitals.

At Trust level the indicator of cost per m2 of occupied floor area has been used for comparison

purposes. With the exception of Velindre NHS Trust which reported a cost of £11.28/m2, cleaning costs

ranged from less than £20/m2 to almost £30/m2. Similarly, costs reported for the major acute hospitals

ranged from £17/m2 to over £33/m2.

Welsh Risk Management Standard 40: Cleanliness was introduced in April 2005 to ensure that the

Trusts meet the requirements of the National Standards. It is expected that the requirement for self-

assessment from April 2006 will identify areas in which improvements can be made to the quality of

cleaning ‘action plans’. This requirement will also provide further data that will allow for the in-depth

comparison of performance between the Trusts.

Catering

According to Trust data, almost £49,460,000 overall was spent on catering operations (including non-

patient activity) in 2004-05, which is just over £2 million more than reported for 2003-04, and

represents 13% of the total expenditure on FM services by Trusts and just under 2% of Trust income

for 2004-05.

The indicator of ‘cost of patient meals/inpatient day’ used in the 2003-04 report can no longer be

developed from the data provided and will not be pursued. However, a ‘patient meal day’ cost

indicator has been introduced to the EFPMS for 2004-05 that reflects the “cost of feeding one patient

per day”, including all meals and beverages, on a site basis.

It is clear from the data reported that, in general, Trusts have experienced difficulties in providing

robust information regarding the ‘patient meal day’. According to the data submitted, it is found that

there is a significant and unrealistic variance for individual sites. Management and operational aspects

of service delivery are likely to be playing a considerable part in contributing to such wide variations,

rather than issues of quality of the meals alone.

However, despite these difficulties, the overall average ‘patient meal day’ cost for Trusts of around £7

is considered to provide a useful baseline indicator for future refinement. A consistent relationship

EXECUTIVE SUMMARY


between this indicator and one of gross cost per patient meal requested, which has averaged at

approximately £3.50, has also been observed for a number of Trusts. Hence the value of using both

indicators, either independently or together as a tool for the verification of the ‘patient meal day’ cost,

will be further explored.

The above data returns have highlighted the difficulty that some Trusts have had, once again, in

providing the required data, highlighting the need for further refinement of the data definitions.

Food wastage is another factor affecting cost. Ward wastage survey data available for NHS Trusts

(no data was reported from Powys LHB), suggests the total number of untouched patient meals in

2004-05 was 1,205,000, which represents almost 10% of the total patients meals produced.

Accordingly, the percentage of meals remaining untouched is alarmingly high, ranging between 10%

and 20% for most sites, although several sites reported figures in excess of 20%. As an indication of

costs it can be shown that a reduction in untouched meals of only 1% would achieve an overall saving

of over £300,000 for the 16 acute hospitals alone.

As well as the ‘overproduction’ of meals and instances where patients are away having treatment while

meals are served, it is acknowledged that food wastage also occurs for a variety of other reasons.

These may include the unsuitability of the menu and food quality. Hospital management should be

particularly concerned whether patient recovery and early discharge could be affected by these

factors.

Figures show that 68% of patient meals were produced by conventional cooking methods, with an

even split between plated and bulk delivery. 20% of meals were produced by cook chill method, with

an 11.5% and 8.5% split between plated and bulk delivery respectively. The remaining 12% were

produced using cook chill services, with an even split between plated and bulk delivery.

Linen and laundry

All Trusts in Wales have contracts or service level agreements with the five Welsh NHS Trust laundries

for the provision of their linen and laundry services, with the exception of one Trust that contracts out

its requirement to a commercial company.

Using these laundries across Wales, Trusts reported that during 2004-05 a total of almost 28 million

items were laundered at a cost of almost £10 million, resulting in an average cost/item of 35.4p. The

cost per item varies significantly between Trusts, ranging from 27p to 57p. The reasons for such a wide

variation need to be explored with the Trusts and may include the need to clarify the EFPMS data

definitions.

When comparing the cost of linen and laundry per occupied bed day the variation for twelve of the

fourteen Trusts is within the range of £2.02 and £2.83. In most cases this bears out the differences

accounted for by the cost/item, although there are some inconsistencies that do not appear to be

correlated with the demands of differing organisation types.

Security

According to the Trust data, the NHS in Wales spent £2,579,726 on security services in 2004-05, which

represents approximately 2% of the total expenditure on FM services. It is apparent from the data

EXECUTIVE SUMMARY


submitted that there is a wide variation in the proportion of expenditure on security services by Trusts.

Analysis shows that figures range from 0.1% to over 11%. It follows that expressing costs as a rate per

m2 has also shown an alarmingly wide variation, ranging between £0.12/m2 and £4.81/m2.

Although the nature, location and usage of the premises covered will have an influence on the

demand for security services, the extremes and accompanying wide variations suggest that the data

cannot be used for performance management. They do, however, draw attention to the apparent

inability of many Trusts to account accurately for the costs of this important service, which is clearly

a matter of concern. Similarly, the quality of data submitted for the number of security incidents is

inconsistent, preventing meaningful analysis.

In August 2005, the Welsh Assembly Government issued the Security Management Framework for

NHS Trusts in Wales. This was produced by the all-Wales Security Task and Finish Group under the

auspices of the AWFF. The purpose of the framework is to introduce the revised security standards for

NHS Wales and provide guidance on their implementation. The central part of the document is the

requirement for a revised Welsh Risk Management Standard 33: Security Management.

The Community Health Councils (CHCs) carried out the second round of HPE assessments in Autumn

2004, and once again security was rated as one of the most disappointing aspects of external areas in

the Welsh hospitals visited. There is a recommendation that Trusts identify the shortfalls in their

security arrangements and rectify them as soon as possible.

Portering

Total expenditure on portering services for 2004-05 was just over £19 million, which is an increase of

10.7% on expenditure in 2003-04. Almost 1,150 whole time equivalent (WTE) porters are employed

across Wales. The number of porters employed by individual Trusts varied between over 170 WTE to

less than 20 WTE.

The number of WTE staff per 10,000m2 of occupied floor area has been used as a PI, resulting in a

range of between four and nine porters.

Postal services

The reported expenditure on postal services for 2004-05 was £3,366,455. In general, postal costs are

directly linked to the size of Trust, activity, type of service provided and the topography of the sites

within each Trust. Due to the significant variations in these factors, even between Trusts of a similar

type, it is difficult to make observations or comparisons of value.

Outsourced services

It was hoped that the data submitted would allow comparisons to be made between Trusts regarding

the services they outsource. However, due to errors in the data submitted and the failure of one Trust

to submit any data, this has not been possible and the information presented under section 4.10.1 is

included for information purposes only.

EXECUTIVE SUMMARY



3.1 Overview of facilities management services

Grouping of services into estates and hotel services

3.1.1 This report complements the 2004-05 Estates Condition and Performance Report by providing

information on the range of support services that underpin clinical care such as cleaning, catering and

portering and, therefore, are not featured in estate-focused reports.

3.1.2 Facilities management (FM) services provided by NHS Trusts are often grouped into ‘hard’ services

covering estate management and maintenance, and ‘soft’ services covering hotel services, such as

catering, portering, cleaning and laundry. For the purposes of this report and in line with the EFPMS

definitions, hotel services include cleaning, catering, laundry & linen, security, portering, postal

services, telecommunications and car parking.

3.1.3 While FM services are split into estates and hotel services, it is recognised that at a board, managerial

and operational level, responsibilities for these services within Trusts are assigned across a variety of

disciplines and departments. Frequently, for example, nursing directorates have lead responsibility for

catering while personnel directorates may have lead responsibility for security indicating that, at

board level, the range of services are not exclusively covered by Estates and/or Facilities or

Commercial/Operational Service directorates.

Management structures

3.1.4 The concept of a Facilities Directorate within Trusts in Wales is relatively new, having been introduced

within the last 10 years. Since the Directorates were set up, facilities management structures have

evolved following a variety of models, illustrated by the fact that 75% of Trusts have a single director

with responsibility for estates and facilities functions while the remainder have opted for separately

managed functions.

3.1.5 Structures below director level are similar, with departmental line managers, supported by their own

departmental structure, reporting directly to a director and being responsible for their specific FM

service.

Outsourcing

3.1.6 Many Trusts outsource some of their hotel services, which are generally non-core or specialist.

Interestingly, Swansea continues to be the only Trust to outsource portering and domestic services,

both of which are provided by the same company. It is understood that this arrangement works well

for the Trust, in conjunction with a software package to assist the in-house monitoring team with

performance management.

3.2 Performance management and the balanced scorecard approach

3.2.1 The National Estates Strategic Framework, published by the WAG in October 2002, was specifically

written to provide an overarching framework for the future development and management of the

healthcare estate. The framework included a commitment to promote the use and continued

3 FACILITIES MANAGEMENT PROFILE

FACILITIES MANAGEMENT PROFILE


development of the EFPMS as a performance management tool, supported by the Estates

Development Panel (EDP) set up in 2003 primarily to drive forward the estates agenda.

3.2.2 More recently, the AWFF was set up in 2004 to complement and work alongside the EDP in order to

drive forward the facilities-related issues within the NHS in Wales. The development of the

performance management of facilities services using the balanced scorecard approach at National and

Trust level is an issue to be taken forward by the AWFF.

3.2.3 A range of Trust-specific and national PIs are required for incorporation into the Trust scorecard,

which will ultimately inform the Performance Improvement Framework (PIF) for NHS Wales. In general

the intention is that decision-making should take account of patient experience related PIs as well as

financial considerations. Currently patient experience PIs are not available as part of the EFPMS and

will require careful development to ensure data can be gathered in a consistent manner.

3.2.4 It is anticipated that a number of PIs with associated targets will feature in the Trust and national

balanced scorecards as part of the PIF. In the absence of the nationally agreed PIs, the measures used

in this report are, in general, a combination of ‘industry standard’ PIs and measures that WHE has

developed in consultation with the Service. However, the only facilities-related national PI used for the

Balanced Scorecard and included in the EFPMS continues to be the externally verified cleaning score

measured against the National Standards of Cleanliness for NHS Trusts in Wales.


4.1 Expenditure on NHS facilities services

4.1.1 The EFPMS holds information on a range of facilities services (hotel services) costs, which are listed

on an all-Wales basis in Figure 2. It can be seen that the overall figure is almost £134 million, which is

£2 million more than for 2003-04, and represents approximately 5.3% of the total Trusts’ income for

2004-05, reported to be almost £2,543 million.

(It should be noted that cost data for the PFI Chepstow Community Hospital has not been made

available for inclusion in this analysis.)

4.1.2 The all-Wales percentage breakdown of facilities expenditure is illustrated in Figure 3.

Comparison with the breakdown of facilities expenditure for 2003-04 shows little variation overall. The

percentage expenditure for 2004-05 of 37% for catering, 14% for portering and 2% for security has

remained unchanged, whilst there has been a 1% shift away from laundry and linen and

telecommunications, to cleaning and postal services.

Facility (Hotel Services) Function Gross Cost

(£)

Telecommunications 11,717,386

Catering services 49,458,405

Cleaning services 37,473,992

Laundry and linen services 9,766,209

Portering services 19,358,719

Security services 2,579,726

Postal services 3,366,455

Total 133,720,892

Figure 2: All-Wales costs by facility services

Cleaning28%

Postal3%

Telecoms9%

Security2%

Portering14%

Catering37%

Linen and Laundry7%

Figure 3: All-Wales breakdown of the percentage expenditure on facilities services

4 ANALYSIS OF TRUST-WIDE DATA

ANALYSIS OF TRUST-WIDE DATA


4.1.3 The cost for each service as a percentage of the overall facilities budget within each Trust is illustrated

in Figure 4.

In general, the apparent stability of the all-Wales percentage breakdown for 2004-05 in comparison

with 2003-04 is a reflection of the consistency of the expenditure profile for facilities services for

most individual Trusts, with shifts of one or two percentage points (at most) between the services

being reported in the majority of cases.

Otherwise, with the exception of the special case of Velindre, where there has been a major shift away

from telecommunications, there are isolated instances of significant variations. These include the

reported budgets for 2004-05 at Cardiff and Vale, which allocated +5% to cleaning and -6% to laundry

& linen services along with Pontypridd and Rhondda, which allocated +7% for catering services. In

these cases the shifts are understood to be due to inaccuracy of the data rather than a reflection of

a shift in budget allocation.

Facility Function

Trust Tel

eco

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s

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(%) (%) (%) (%) (%) (%) (%)

Bro Morgannwg NHS Trust 11 25 34 10 2 16 3

Cardiff and Vale NHS Trust 6 33 36 6 5 11 3

Carmarthenshire NHS Trust 7 25 41 7 1 15 3

Ceredigion & Mid Wales NHS Trust 9 27 41 8 <1 13 2

Conwy & Denbighshire NHS Trust 7 32 34 5 1 19 1

Gwent Healthcare NHS Trust 12 27 39 7 1 13 2

North East Wales NHS Trust 8 24 33 9 2 21 3

North Glamorgan NHS Trust 7 31 32 8 3 18 <1

North West Wales NHS Trust 12 22 45 7 <1 11 3

Pembrokeshire & Derwen NHS Trust 9 34 31 11 1 13 1

Pontypridd & Rhondda NHS Trust 5 28 41 7 2 15 2

Powys LHB 10 32 37 8 <1 10 2

Swansea NHS Trust 9 28 37 7 1 16 3

Velindre NHS Trust 13 20 24 4 8 18 13

All-Wales average 9 28 37 7 2 14 3

Figure 4: Percentage breakdown of the reported expenditure allocated tofacilities services in each Trust



4.1.4 Comparison of Trust expenditure on facilities services, as a percentage of the overall Trust budget, is

illustrated in Figure 5. Velindre NHS Trust, with a figure of 2% is the lowest. Figures for the other Trusts

range from 4.2% to 6.5%, resulting in an all-Wales average of 5.3%. It is interesting to note that the

figure reported by Velindre has reduced significantly from that of 3.4% for 2003-04. This will, to a large

extent, reflect the significant drop in reported telecommunications costs and draws attention to the

specialist nature of the Trust.

It should be noted that the costs for on-site collection and handling of waste, non-patient

transportation and car parking are included in the overall facilities costs, but are not assigned to these

individual services.

4.1.5 Information relating to operating costs for individual Trusts and observations made on that

information has been included in Appendices I–XIV.

4.1.6 Occupancy costs for acute, minor acute, community and psychiatric hospitals are contained in

Appendix XV.

4.1.7 Figure 6 illustrates the overall FM cost/m2 for each Trust calculated from the submitted data for

2003-04 and 2004-05.

4.1.8 Appendix XVI provides a breakdown of costs for individual FM services at each Trust to enable

comparison with all-Wales calculated estimates.

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% of Trust budget All-Wales average

Figure 5: Facilities service costs expressed as a percentage of the overall Trust budget



4.2 Telecommunications

General information

4.2.1 Impressions of a Trust are often formed by how quickly, politely and efficiently an initial telephone call

is handled. The ‘front of house’ service is not only having to embrace new and rapidly changing

technology but has to develop staff skills to ensure the service becomes more customer-focused and

able to respond as a focal point for general information.

4.2.2 Although no national NHS standard has been set for hospital telephone response times, other public

sector organisations have set four rings, or approximately ten seconds, as their target. When using

‘average’ response times to compare performance it is clear that the data does not give a true

reflection of the service provided, since substantial delays occur at peak times that are offset by

long periods of low activity at night and weekends.

Switchboard response times have been somewhat devolved by the introduction of auto-attendant,

giving callers options to wait for an operator, or press a certain number for a department, or even to

call back later. However, while these are used commonly in administration offices, they are not

generally used in larger hospitals.

In view of the above, graphical representation of this data has not been produced. In due course it is

anticipated that balanced scorecards for Trusts will be able to provide peak time response data in

order to assess performance.

Trust Name Organisation Type Calculated FM cost

from submitted data

(£/m²) Bro Morgannwg NHS Trust Large Multi Service 86.59

Cardiff and Vale NHS Trust Acute Teaching Outside London 67.74

Carmarthenshire NHS Trust Medium Acute Outside London 107.25

Ceredigion & Mid Wales NHS Trust Small Multi-Service 107.19

Conwy & Denbighshire NHS Trust Large Multi Service 76.05

Gwent Healthcare NHS Trust Large Multi Service 88.11

North East Wales NHS Trust Large Multi Service 74.25

North Glamorgan NHS Trust Medium Multi-Service 83.26

North West Wales NHS Trust Large Multi Service 80.58

Pembrokeshire & Derwen NHS Trust Medium Multi-Service 81.92

Pontypridd & Rhondda NHS Trust Large Multi Service 104.90

Powys LHB Medium Community with Mental Health 68.21

Swansea NHS Trust Large Acute Outside London 81.14

Velindre NHS Trust Acute Specialist 56.70

Estimated all-Wales average 81.53

Figure 6: Comparison of overall cost/m2 for FM services



4.2.3 The Telecommunications Act 1984 introduced deregulation that allowed companies to apply for

licenses to provide certain telephony services. Conventional call traffic, once carried exclusively by

British Telecom, was such a service and a number of competing companies have emerged as major

players. This change has given Trusts the opportunity to transfer calls to an alternative carrier and

benefit from lower charges. Many Trusts have now made the change and are apparently reaping the

rewards.

4.2.4 The need for immediate contact with patients and suppliers over the last decade has seen a rapid

growth in the use of mobile telephony. Major call carriers confirm that approximately 25% of calls are

now made to a mobile phone and, although call charges are being driven down by competition, they

can account for as much as 35% of Trusts’ telephony call spend. This is an area that Trusts should

continue to closely monitor and manage accordingly.

4.2.5 A document on the use of mobile communication systems within hospitals was issued by the MHRA

in August 2004, supplementing the previously published advice contained in MRHA Device Bulletins

DB9702 and DB 1999 (02). These documents recognise the difficulty in enforcing an effective ‘total

ban’ policy and encourage a balanced approach to ensure that the benefits of mobile wireless

technology can be made available to healthcare organisations. Overly restrictive polices may act as

obstacles to beneficial technology and may not address the growing need for personal

communication for patients, visitors and workforce. The removal of a total ban policy will present new

challenges for Trusts if mobile phone ‘friendly’ areas are permitted, as the risk to and effect on medical

devices from the electro-magnetic waves transmitted by the mobile phones will still need to be

considered.

4.2.6 Bedside communication and entertainment systems, described in England as Patient Power, are fully

managed bedside services that allow patients to keep in touch with friends and relatives by phone.

They also allow personal access to a wide range of television channels, films and information systems

that can include e-mail and high-speed Internet access. The second-generation systems for utilising

digital technology are being further developed to provide electronic patient records (EPR) and

digitised diagnostic images at the bedside by integration into the hospital’s IT network.

4.2.7 Bedside communication systems may be used for patient surveys in order to collect data on patient

satisfaction. The data can be used to complement PIs introduced into a balanced scorecard without

the need for distributing and collecting hard copy questionnaires.

4.2.8 In addition to the benefits already mentioned, the system allows nurses to concentrate on patient

care because of fewer telephone calls made to the nurse station. It also offers special facilities for the

elderly, the disabled and children. It may alleviate patient boredom, can be developed to allow patients

to select meals using an on-line menu ordering system and reduces the telephone traffic through the

hospital’s switchboard.

4.2.9 In line with the agreed model concession agreement developed by NHS Estates for England, bedside

communication systems are installed at no cost to Trusts. NHS Estates set up a national licensing

system that allows those suppliers, who have demonstrated that they have the capacity to install and

effectively manage a bedside communication and entertainment system, to provide the service in



NHS Hospitals. In 2003-04 four companies had been awarded full licences. However, this figure has

now been reduced to three, as one company is reported to have withdrawn.

4.2.10 Some of the benefits listed above, however, do not come free to the patient. Whilst outgoing

telephone calls are charged at standard call box rates, incoming calls are charged at premium rates.

Some television channels and children’s channels are provided free but the cost of entertainment

packages depends upon selection and usage. The license holders in England have indicated that, from

their experience, patients who fully utilise the system could expect to spend about £2.50 to £3.50 per

day for the services used. This figure has increased from the estimated cost of £2/day reported for

2003-04.

Analysis of Trust Telecommunication data

4.2.11 The average telephone response times reported for 2004-05 ranged from 7 seconds at Ceredigion to

25 seconds at Bro Morgannwg. When using ‘average’ response times to compare performance it is

clear that the data does not give an accurate reflection of the service provided, since substantial

variations in activity occur at peak times. Graphical representation of this data, therefore, has not been

produced.

4.2.12 The overall expenditure on the telecommunications services in 2004-05 was £11,717,386.

Unfortunately, as Carmarthenshire did not submit data in 2003-04, and the data from Velindre was

considered to be unrepresentative and, therefore, excluded, it is not possible to provide accurate

comparisons for the overall expenditure year-on-year.

4.2.13 Due to the limited data collected for telecommunications, the analysis has been restricted to a

comparison of costs/occupied floor area expressed as £/m2. The results for 2004-05 are illustrated in

Figure 7 and show that costs range from £4.10/m2 at Cardiff and Vale to £10.21/m2 at Gwent

Healthcare, which represents 43% less and 30% more than the calculated all-Wales average of

£7.14/m2, respectively.

Figure 7: Telecommunications cost/m2 of occupied area

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Trust cost / occupied floor area All-Wales average



4.2.14 Cardiff and Vale reported the lowest cost/m2 of all of the Trusts for the second consecutive year.

Developments with telecommunications

4.2.15 The National Patient Safety Agency (NPSA) conducted a survey of acute hospitals in England and

Wales to determine what numbers staff dial in an emergency. They found that several numbers were

used, 222, 2222, 3333, 999, 100, etc. It was a concern to staff moving between sites that an

emergency number they were familiar with might not be used at their new location. On completion of

the survey the NPSA instructed that all hospital staff should dial 2222 for Cardiac Arrest. This has now

been implemented.

4.2.16 Some Trusts have converged their data and voice systems by adopting Voice over IP (VoIP)

technology, which basically means using one network to send and receive, both voice and data traffic.

There is no requirement for a separate telephone and computer socket. The telephone plugs into the

PC and the PC plugs into the data socket as normal. The ‘old’ telephone sockets and miles of internal

telephone cable become redundant. VoIP calls transit the Internet and are generally free of charge;

the customer pays revenue for the network lines and can send as many calls as the size of their

connections will allow.

4.2.17 Video conferencing is now being used extensively across NHS Wales. HSW Telecomm Services is the

management centre for the videoconference network. It is also the test bed for video conferencing

and the technical support centre for the network known as the Welsh Health Video Services (WHVS).

All Trusts in Wales and some Local Health Boards, have installed video conferencing, which has enabled

them to conduct meetings and present statistics and graphs, etc. across the network from their

meeting rooms and in some cases from their desks, without the need to travel for meetings. It is

intended that the service will extend to GPs in the near future. Video conferencing calls are not

restricted to the network, and enable users to contact or be contacted from practically any country in

the world with the facility.

4.3 Car parking

General information

4.3.1 The provision of adequate and easily accessible car parking is critical to patients, staff and visitors. In

practice this is rarely achieved on hospital sites and few cater for peak demand. It is not uncommon

to see cars parked on every available grass verge with visitors vainly searching for a space.

4.3.2 Hospital Patient Environment (HPE) Annual Reports have also identified the capacity of car parking

facilities at hospital sites across Wales as inadequate, especially regarding designated spaces for

disabled users. In addition, they highlight a general lack of support staff to manage and direct traffic

flow where necessary, and that parking at most sites is considered stressful for both staff, patients and

visitors. This problem is reported as part of a wider issue connected with the provision of public

transport alternatives, and urging the Welsh Assembly Government to ensure that transport plans are

inclusive of the needs of patients and the NHS, with partnership working between the NHS and Local

Authorities, remains a priority.



4.3.3 HPE assessments have also found that, in general, the charges levied for car parking are considered

‘good’ across Wales, although some concern has been expressed over Pay & Display meters as a

number of these do not give change, which results in overcharging.

4.3.4 There are no easy solutions to these problems but it is anticipated that the comparators used in the

following figures, in conjunction with public transport considerations and healthy travel initiatives, will

assist Trusts in the development of Transport Plans for their hospitals. It is also envisaged that

developments with EFPMS data and Trust balanced scorecards will, in future, refine the PIs on parking

provision.

Analysis of Trust car parking data

4.3.5 The total number of car parking spaces available for use within Trust grounds for 2004-05 was 32,814,

which is over 3,200 more than the previous year and represents an increase of almost 11%. Of these,

1,498 were allocated for disabled staff and visitors, which is over 300 more than the previous year and

represents an increase of 27%. These increases indicate that, overall, the proportion of car parking

spaces allocated for disabled staff and visitors has risen from just under 4% for 2003-04 to over 4.5%

for 2004-05.

4.3.6 The variation for parking spaces provided by Trusts compared with the occupied floor area of their

properties for both 2003-04 and 2004-05 is illustrated in Figure 8. It can be seen that for 2004-05 the

range varies between about 1.5 spaces/100m2 at Gwent Healthcare and Ceredigion & Mid Wales, and

just over 2.7 at Bro Morgannwg. The graph also illustrates that there is a 50/50 split across the fourteen

Trusts between those reporting an increase and those reporting a reduction in the rate. However, the

overall average has remained about the same and increased only slightly, from 1.8 to 2. The marked

change for Gwent Healthcare is due to omissions in the number reported for 2003-04.

Figure 8: Number of parking spaces/100m2 of occupied floor area

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2003-04 2004-05



Figure 9: Disabled car parking allocation

4.3.7 The percentage of spaces allocated for disabled parking as a percentage of total spaces for each Trust

is illustrated in Figure 9. It can be seen from the figures for 2004-05 that there has been an

improvement in nearly all Trusts, and that the rates range between just under 3% at Carmarthenshire

and Gwent Healthcare, and 7.9% at Powys LHB which has, once again, reported by far the highest rate.

4.3.8 Trusts have adopted a variety of policies and contractual arrangements in respect of car parking

charges. According to the data submitted for 2004-05 only nine Trusts generate income from car

parking, which is an increase on the six reported for 2003-04. Of the nine Trusts, three generated

income from both staff and visitors, two from staff only, and four from visitors only.

For the five Trusts that generated income from staff, this ranged from just over £4,500 to almost

£300,000, whereas the income generated from visitor parking from seven Trusts ranged from just

under £10,000 to almost £800,000. The totals from the participating Trusts for staff and visitors were

approximately £940,000 and £1,455,000 respectively. This shows an increase from the figures

reported for 2003-04 of approximately £638,000 and £1,289,000 respectively, and demonstrates

more growth in the income generated from staff.

It should be noted that the absence of income generation reported does not in all cases imply that

no parking charges are levied for staff or patients and visitors. This is due to the current data

definitions requiring Trusts to report income generated from parking spaces within the organisation’s

grounds, whereas contractual arrangements for car parking spaces may apply to remote and/or

adjoining land not owned by the Trust. Furthermore, the financial aspects of the contractual

arrangements may not provide Trusts with what can be regarded as an income.

In an effort to provide Trusts with more meaningful information on car parking charges across hospital

sites in Wales, it is anticipated that the data required by the EFPMS will be reviewed and data

definitions clarified by WHE and the Service.

Additional analysis of car parking on acute hospital sites is included in Section 5.2.

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4.4 Cleaning services

General information

4.4.1 The National Standards of Cleanliness for NHS Trusts in Wales were launched in June 2003 and issued

under cover of WHC (2003) 59. They introduced a risk-based approach to the development of

cleaning specifications for all Trusts to adopt and set out clear requirements for cleaning, along with

a system for ongoing audits to assist with continuous improvement.

4.4.2 At the same time as the National Standards were issued to the service, the Auditor General for Wales’

report The Management and Delivery of Hospital Cleaning Services in Wales was published. This made

a number of recommendations, one of which was concerned with the setting of cleaning budgets to

meet risk-based cleaning standards. This process requires budgeting for cleaning specifications that

take into account the time needed to achieve the required cleaning outcomes, rather than setting

cleaning budgets based on historical financial allocation. This could significantly affect the cleaning

budget necessary to meet the required cleaning specifications and achieve an acceptable audit score

against the National Standards.

4.4.3 A performance assessment toolkit that accompanies the National Standards provides an audit

methodology to generate a score for the EFPMS. However, there were initial problems for many Trusts

in setting up the required internal audits and, along with the need for external verification of the

scores for the EFPMS, many Trusts were unable to submit any results. The returns for the scores for

2003–04 were therefore patchy, which restricted the opportunities for analysis.

4.4.4 The data for 2004-05 shows a higher number of hospital audit scores being submitted, and all Trusts

returned an audit score against the National Standards of Cleanliness for some, if not all, of their

hospitals. However, only the following Trusts provided scores for all of their hospitals:

❖ Cardiff and Vale;

❖ Ceredigion & Mid Wales;

❖ North East Wales;

❖ North Glamorgan;

❖ North West Wales;

❖ Swansea and

❖ Velindre.

Most of the Trusts that failed to provide externally verified scores for all of their hospitals have reported

that their Trust Cleaning Plans will be taking any remaining hospitals into account in future. This will

need to be monitored closely. It is interesting to note, that the type and size of a Trust appears to have

little bearing on the ability of that Trust to comply with this requirement, and that some Trusts appear

to be having far more difficulty than others in providing this data for all of their sites.

The continued collection of this data will allow for the demonstration of improvement in the provision

of an acceptable standard of cleanliness to be monitored. It is anticipated that, as Trusts progress with



the implementation of the standards, they will be in a much better position to determine their current

performance and be able to demonstrate continuous improvements as required by the Welsh

Assembly Government.

4.4.5 The introduction of the Welsh Risk Management Standard 40: Cleanliness in April 2005, was to ‘ensure

that NHS Trusts meet the requirements of the National Standards of Cleanliness for NHS Trusts in

Wales, and to demonstrate improvement in reducing risks associated with environmental cleanliness

in all NHS Trust premises in which patient services are delivered’.

The areas for assessment include requirements to ensure the provision of:

❖ Clear management arrangements linked to clinical and corporate governance;

❖ A consistently high standard of cleanliness, where patient views are incorporated into the planning,

implementation and monitoring processes;

❖ The utilisation of the most appropriate cleaning methods and frequencies to maintain Trust

buildings and fixtures to an acceptable standard;

❖ Staff training appropriate for them to undertake their duties;

❖ Key performance indicators capable of showing improvements in environmental cleanliness; and

❖ Assessment of the cleanliness of the healthcare environment by both internal and external

audit.

The requirement for self-assessment under Welsh Risk Management Standard 40: Cleanliness

commences from April 2006. This will allow for more in-depth analysis of reported data in future

reports in terms of cost effectiveness and quality control.

Analysis of Trust cleaning data

4.4.6 Overall the cost for cleaning was almost £37.5 million, an increase from the £36 million reported for

2003-04, which equates to 1.5% of the overall Trust income and 25.8% of the overall facilities budget.

As indicated above, cleaning budgets are now required to support cleaning specifications that achieve

acceptable output requirements in accordance with the National Standards.

4.4.7 Excluding the PFI hospitals at Port Talbot, Cardiff and Chepstow, approximately 6,500 staff, working in

excess of 4,000,000 hours, were recorded as providing the service, of which almost all were reported

to be working on a part-time basis.

4.4.8 A comparison of the existing cleaning service costs, reported as a percentage of the Trusts’ income, is

shown in Figure 10. According to the submitted data, the all-Wales average of Trust income spent on

cleaning has reduced from 1.7% in 2003-04 to 1.5% for 2004-05. At almost 2.1%, it appears that Powys

Local Health Board has spent the greatest percentage of income on cleaning for 2004-05. It is

interesting to note here that, whilst the proportion of the Trusts’ income spent on cleaning has

decreased, the overall cost of cleaning has increased.



4.4.9 The cost of cleaning services per occupied floor area is shown in Figure 11. Although historically the

cost/m2 PI has been a nationally used one, it should not be viewed in isolation from local conditions.

For example, the age profile of properties is understood to have a significant impact upon cleaning

costs. It is also difficult to quantify the effect that changes in design standards, building functionality

and quality of finishes has on the cost/m2 but these must all be borne in mind when making

comparisons.

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Trust All-Wales average

Figure 11: Cost of cleaning services/m2 of occupied floor area

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udge

t as

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Inco

me


Figure 10: Cost of cleaning services as a percentage of Trust income

* Cleaning costs for Chepstow hospital were not submitted.



In addition, all components of cost need to be considered carefully when comparing the overall cost

figures that are currently provided. For example, there is uncertainty as to whether all Trusts are

apportioning the staff time where necessary. It follows that until more sophisticated accounting

systems are adopted, which take into account where staff time should be apportioned to disparate

tasks (as with generic workers and the time spent on cleaning duties), there may be doubt as to

whether this factor is always being accounted for manually.

The total cost for cleaning services for 2004-05 was £37,473,992, an increase of £1,480,140 on the

cost reported for 2003-04. It can be seen from Figure 11 that the all-Wales average for the cost of

cleaning/m2 is £22.85, an increase of almost £1 on the 2003/04 figure.

4.4.10 Cleaning audit scores were submitted for 93 hospitals and aggregate sites that ranged from 31% to

100%. These extremes are isolated cases and most scores for the major hospitals ranged between 60%

and 95%. In general, there has been an improvement on the scores reported for 2003-04.

Additional analysis in respect of cleaning at the acute hospital sites is detailed in Section 5.3.

4.5 Catering services

General information

4.5.1 A Nutritional and Catering Framework drawn up in May 2002 was issued to Trusts for implementation

as part of the Welsh Assembly Governments’ initiative Improving Health in Wales – A Plan for the NHS

with its partners. Produced by the All-Wales Catering/Nutrition Group for the Welsh Assembly

Government, the framework recognises the importance of good nutritional management, its impact

on the speed with which patients recover and its contribution to an early discharge from hospital.

4.5.2 To support the framework, Welsh Risk Management Standard 23: Nutrition and Catering was reviewed

to ensure that the catering management, food handling and NHS premises in which food is stored,

prepared or served, comply with current food legislation and good practice, and provide for the

dietary and nutritional requirements of the patient. (Information on nutrition has not been included

as it is outside the scope of this report).

It is anticipated that WRMS 23 will be reviewed in 2006 and the requirements amended for

continuous improvement in the quality of service in this area. Along with a review of the requirements,

an element of external assessment is also under consideration by the Welsh Risk Pool for the future.

Should this be introduced, it is seen as adding value to the process of performance management to

ensure that each Trust remains compliant with the Standard and assist with benchmarking against PIs.

4.5.3 Welsh Risk Management Standard 23 stipulates the use of a number of PIs to assist Trusts with

measuring improvements in their catering services, including patient surveys. Although data

associated with these PIs is not included in the EFPMS, it is envisaged that they will feature alongside

EFPMS PIs in both National and Trust balanced scorecards to inform the Performance Framework. This

will give opportunities to introduce issues relating to quality into this report.

4.5.4 The Facilities Performance Report for 2003-04 highlighted the difficulties some Trusts had in providing

the required data. These difficulties included:

❖ Segregating the time allocated to the preparation of patients/other meals from other duties;

❖ Interpreting the data definitions such as apportioning managers’ time and

❖ Apportioning staff costs at the point of service to the patient, for example, where Trusts utilise

domestic staff to fulfil this role.

Whilst it is evident that there has been an improvement in the quality of the catering services data

provided, it is also apparent that the above difficulties still apply. Therefore, once again, where there

have been anomalies with the data submitted and it has not been possible to verify the accuracy of

the data, it has not been used in this report for comparison purposes. Trusts that are still experiencing

such difficulties will need to resolve them in order to achieve maximum benefit from the EFPMS.

Analysis of Trust catering data

4.5.5 According to Trust data, almost £49,460,000 overall was spent on catering operations (which include

non-patient activities) in 2004-05, which is just over £2 million more than reported for 2003-04, and

represents 13% of the total expenditure on FM services by Trusts and just under 2% of Trust income

for 2004-05.

4.5.6 A comparison of staff costs, expressed as a percentage of the gross cost of catering operations, is

illustrated in Figure 12. It can be observed that the all-Wales average is 52%, which is a reduction of

3.5% against the figures for 2003-04. Seven Trusts have spent less on staff costs as a percentage of

the gross cost of catering operations than in 2003-04. It is interesting to note that about half of the

£2 million increase in the overall cost of catering operations has been attributed to staff costs.

4.5.7 Patients often see meal times as an important aspect of their recovery and one where they have some

measure of control. In addition to the requirement of the Welsh Risk Management Standard 23 for

meal times to be uninterrupted, wherever possible, the designation of protected meal times may also

be considered by Trusts.



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%

Trust All-Wales Average

Figure 12: Staff costs as a percentage of gross cost

(%)



Eight Trusts report having introduced protected meal times but it is only Conwy & Denbighshire

NHS Trust and Powys LHB that have introduced them to a high degree. Conwy & Denbighshire NHS

Trust report having protected meal times at all of their hospital sites, with 100% patient

mealtimes covered at all hospitals except Ysbyty Glan Clwyd (45%). Powys LHB report having all

mealtimes covered at all of their hospitals. The introduction of protected meal times within the

acute hospitals is limited to two of the sixteen hospitals: Ysbyty Glan Clwydd (45%) and

Withybush (60%).

4.5.8 The indicator of ‘cost of patient meals/ inpatient day’ developed for comparisons in the 2003-04

report can no longer be developed from the data provided and will not be pursued.

4.5.9 A ‘patient meal day’ cost indicator has been introduced to the EFPMS for 2004-05 that reflects the

“cost of feeding one patient per day”, including all meals and beverages, on a site basis.

It is clear from the data reported that, in general, Trusts have experienced difficulties in providing

robust information regarding the ‘patient meal day’. According to the data submitted, it is found that

there is a significant, and unrealistic, variance for individual sites, and with averaged costs for Trusts

ranging from £2.31 at Carmarthen to £12.37 at Powys LHB.

However, despite these difficulties, the overall average ‘patient meal day’ cost for Trusts of around

£7 is considered to provide a useful baseline indicator for future refinement. A consistent relationship

between this indicator and one of gross cost per patient meal requested, which has averaged at

approximately £3.50, has also been observed for a number of Trusts. Hence the value of using both

indicators, either independently or together as a tool for the verification of the ‘patient meal day’ cost,

will be further explored.

4.5.10 It is apparent that more needs to be done in an effort to refine the data definitions so that more

robust data may be reported in the future. A series of workshops is proposed to provide further

guidance to service providers, aimed at improving the quality of the data and enabling more

meaningful comparisons to be made from PIs.

4.5.11 Food wastage is another factor to be considered. Ward Food Wastage Survey returns suggest that a

total of 1,205,000 patient meals produced in 2004-05 were untouched, which represents 9.5% of the

associated total patients meals produced (no data was reported from Powys LHB). It is of concern that

the percentage of food waste for many hospitals is in the 10% to 20% range along with several in

excess of 20%. There is also an apparent increase from the 8.3% reported for last year, which is

disappointing. Clearly more will need to be done in an effort to reverse this trend.

It should be noted that the full methodology for calculating the percentage of food waste (calculated

on a sample basis and in terms of untouched meals) is set out in the Ward Food Wastage Survey

section of the EFPMS Data Definitions and Completion Notes.

4.5.12 A breakdown in the reported number of patient meals requested according to the type of service

employed indicated that 68% were from conventional means with an even split for plated and bulk

delivery. At 20%, cook freeze was the next most widespread method employed, and this had an 11.5%

to 8.5% split for plated and bulk respectively. The remaining 12% were produced by cook chill service

with an even split for plated and bulk delivery.

An analysis relating type of service delivery to cost and the amount of food wastage did not produce

any meaningful comparisons. However, it is clear, when comparing similar types of service, that some

sites produce meals at low cost with little waste while others do not, thus, presenting opportunities to

identify and share best practice in implementation. Issues concerning aspects of quality of the meals

produced have not been considered as they are currently outside of the scope of this report.

Additional information on catering at the acute hospital sites is detailed in Section 5.4.

4.6 Laundry and linen services

General information

4.6.1 The Health Service Guidelines HSG (95) 18, issued in April 1995, covered the arrangements for

processing used and infected linen at hospital laundries. They set out the recommended procedures

to help Trusts meet their obligations under the Health and Safety at Work Act 1974, taking reasonable

steps to prevent the risk of infection to staff when handling and laundering linen. They also dealt with

the potential for harm to staff and damage to linen by the failure to separate ‘sharps’ from dirty linen

before they are placed in laundry bags. Workshops are to be organised by The Society of Hospital

Linen Services and Laundry Managers to look at the implications of the new guidelines for NHS

laundry standards, which are expected to be issued soon.

Laundries have to comply with this guidance and the services they provide to Trusts are audited using

the NHS Estates Process Assessment Toolkit 21 (PAT 21). The toolkit is designed to address specific

issues relating to processes or practices that allow organisations to classify their adherence to the

relevant guidance. Audits carried out by WHE in 2004 identified that some laundries did not comply

fully with the guidance, which resulted in some Trusts having to reconsider how their theatre linen

should be provided.

4.6.2 The Medical Devices Directive (93/42/EEC), published in 1993, became compulsory in June 1998 and

required all medical devices, including surgical packs complete with linen, to be CE marked when

placed on the European market. With regards to Sterile Service facilities provided by Trusts in Wales,

this CE mark requirement has to be observed whenever such ‘medical devices’ are supplied to any

other healthcare organisation within the EC, including other Trusts in Wales.

4.6.3 The European Standard EN 13795, issued in 2002, defined the performance of fabrics used in

theatres, that is, theatre gowns and drapes. Materials should comply with stringent new requirements

such as microbial penetration (wet and dry), fluid penetration, low linting and adequate strength for

their use. While there is no legal requirement to comply with EC standards, meeting the EN 13795

standard is the easiest way to demonstrate compliance with the requirements of the Medical Devices

Directive 93/42/EEC.

4.6.4 The Society of Hospital Linen Services and Laundry Managers are currently developing a Linen Service

Code of Practice that will target the different approaches to dealing with laundry issues, such as a bed-

changing policy, to assist the service. Research is also being conducted in Scotland to address the

implications for the spread of MRSA by current practices with the laundering of uniforms and

changing facilities for healthcare workers that come into close contact with patients.





All Trusts in Wales have contracts or service level agreements with the five Welsh NHS Trust laundries

for the provision of their linen and laundry services. Pembrokeshire and Derwen NHS Trust, however,

contract out their requirements to a local company.

The five Welsh NHS laundries are managed by:

❖ Gwent Healthcare NHS Trust

❖ Conwy & Denbighshire NHS Trust

❖ Carmarthenshire NHS Trust

❖ Swansea NHS Trust

❖ Pontypridd & Rhondda NHS Trust

Analysis of Trust laundry and linen data

4.6.5 This year laundry and linen data was submitted by all Trusts and it was reported that 27,572,325

laundry and linen pieces were used/processed in 2004-05 at a total cost of £9,766,209. When

compared with the figures for 2003-04, this is a relatively modest increase of just over £732,000 for

the 4.6 million additional items processes in 2004-05, and actually resulted in the average cost/item

being reduced by 4p from 39.4p to 35.4p.

However, as illustrated in Figure 13 it can be seen that the cost/item was reduced for only two

individual Trusts but the reduction at Cardiff and Vale NHS Trust, from 63.09p to 29.5p for over

4 million items used, was so large that it has had a major impact overall. There remains uncertainty

regarding the interpretation of the data definitions in connection with the dramatic reduction in cost

reported by Cardiff and Vale.

Figure 13 also shows that Carmarthenshire has reduced its cost/item from 36.5p to 33.4p, and that

the remainder of the Trusts were between 27.4p for Pembrokeshire & Derwen, and 57.6p for Bro

Morgannwg. These rates are higher than those for 2003-04 ranging from 0.82p to 16.65p in the case

of Pembrokeshire and Derwen.

Figure 13: Cost/item of laundry and linen

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(p)

2003/04 2004/05

4.6.6 Following the use of the ‘cost of laundry and linen per occupied bed day’ used in the 2003-04 report,

Figure 14 shows that the 2004-05 figures present a similar picture with the cost for 12 Trusts ranging

between £2.02 and £2.83. Extremes of £1.81 and £3.66 were reported for Cardiff and Vale and

Velindre respectively, with the associated number of laundry and linen items contributing to this cost

calculated at 6.15 and 11.4 in each case.

Additional analysis of laundry and linen services at the acute hospital sites is detailed in Section 5.5.

4.7 Security services

General information

4.7.1 In August 2005, the Security Management Framework for NHS Trusts in Wales was issued. This was

produced by the all-Wales Security Task and Finish Group for the Welsh Assembly Government, under

the auspices of the AWFF. The purpose of the framework was to introduce revised security standards

for NHS Wales and provide guidance on their implementation. The central part of the document is the

requirements of a revised Welsh Risk Management Standard 33: Security Management.

Under Area for Assessment 11 for WRMS 33, it is a requirement for Trusts to use key indicators

capable of showing improvements in security management at all levels, including the Board, and that

the efficacy and usefulness of the indicators are reviewed regularly in association with the Trusts’ Risk

Management Committee. EFPMS data for security services features in the compulsory indicators for

implementation of this standard.

As stated in the Security Framework, “the value in recording appropriate data that is clearly defined

cannot be overstated, as it provides for better-informed planning for crime reduction and the

improvement to security services across the Trust’s healthcare premises”.



Figure 14: Cost of linen and laundry/occupied bed day

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Trust Cost All-Wales average cost

A variety of reporting systems are currently being implemented in Wales having disparate data coding

and methods of reporting, and all largely dependent upon staff self-reporting. As with 2003-04, it is

apparent from the data on security service incidents made available for submission to the EFPMS for

2004-05 that some of the systems are failing to report accurately. A group of Risk Managers in South

East Wales are currently gathering data from the systems in use and looking at developing a suitable

all-Wales coding methodology, to enable common methods of reporting and comparability for

analysis.

4.7.2 The Community Health Councils (CHCs) carried out the second round of HPE assessments in Autumn

2004, and once again security was rated as one of the most disappointing aspects of external areas

in the Welsh hospitals visited.

Eight of the eighteen hospitals visited received a poor rating for levels of security staffing with only

slightly better results for lighting and CCTV. The report considered that these aspects of security were

important for the reassurance of both staff and patients and hoped that the situation would be

remedied as a preventative rather than a reactive measure.

The recommendation was that Trusts identify the shortfalls in their security arrangements and rectify

them as soon as possible.

Analysis of Trust security services data

4.7.3 The provision of an environment in which patients, staff and visitors can feel secure should be a high

priority for Trusts. As with the last report, it is disappointing to have to report again that much of the

data submitted for 2004-05 is considered to be unreliable.

Regrettably, there are still instances of definite reporting errors, for example, the omission of data,

along with instances where data submitted in accordance with specific definitions for a Trust vary by

too great a margin to be robust. For example, the total number of security incidents reported for the

Large Multi Service Trusts varied widely, from a minimum of 184 for North West Wales, to just

over 3,000 for Gwent Healthcare. Similarly with data reported for the number of assaults on staff, for

the Large Multi Service Trusts the numbers range from 14 for North West Wales to 673 for

Bro Morgannwg.

Much of the data submitted in respect of security service costs also indicates that it is unreliable, and

suggests an on-going difficulty for many Trusts to account for monies spent on FM services generally,

and in particular when attempting to identify costs for individual service areas such as security.

Where data has clearly been inaccurate, and it has not been possible to obtain clarification, the data

has been disregarded in any of the following analyses.

4.7.4 According to Trust data, the NHS spent nearly £2.6 million on security services in 2004-05, which is

significantly less than the amount of nearly £3 million for 2003-04, and represents just under 1.3% of

the total expenditure on FM services by Trusts in 2004-05.



Figure 15 expresses this cost for Trusts as a percentage of their overall FM service expenditure.

However, discussion with the Trusts that have submitted very low costs has revealed that they have

been unable to identify the full costs for security services, and so, as this service is relatively less

expensive than most of the other FM services, it can be said that this percentage of total reported

expenditure is appreciably less than the true figure.

From what are considered to be the more reliable security service costs submitted it can be shown

that the percentage of the total FM costs for individual Trusts ranges between around 0.5% at

Pembrokeshire & Derwen, and almost 3.5% at Cardiff and Vale. Excluding the data for the four Trusts

reporting to be outside of this range, an average of 1.75% is obtained.

The higher figures for both Cardiff and Vale NHS Trust and Velindre NHS Trust may well reflect the

increased demand on security services due to the nature, location and usage of the particular hospitals

and premises involved. In general, there appears to be no correlation between security costs as a

percentage of overall Trust expenditure and organisation type.

4.7.5 Security services costs as a rate/m2 are expressed in Figure 16. The chart illustrates the wide variation

in rates, apparently without correlation to organisation type.

As with the earlier analysis involving security service costs, and similarly with the data for 2003-04, it

would appear that Ceredigion & Mid Wales NHS Trust, North West Wales NHS Trust and Powys Local

Health Board have supplied unreliable data. With the data relating to these Trusts and Powys Local

Health Board excluded, the variation ranges between £0.80/m2 and £3.00/m2.

It is noted that Velindre NHS Trust has a significantly higher figure at £4.81/m2, and this is believed to

reflect the specialist nature of the Trust.

Additional analysis of security services at the acute hospital sites is detailed in Section 5.6.



Figure 15: Security cost as a percentage of overall Trust expenditure

on facilities services

0.00%

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(%)

4.8 Portering services

General information

4.8.1 The range of duties carried out by portering staff is wide and varied and not always allied to the

provision of patient care. Generally, management structures across Wales are similar, usually with a

Portering Manager responsible for the service and accountable to the Hotel Services/Operational

Manager. Operationally, porters are usually attached to departments such as pharmacy, accident and

emergency, theatres and kitchens, while a team of pool porters, managed by a charge hand, supports

wards and other departments.

4.8.2 The following analyses look at expenditure and the number of porters employed. However, these

statistics do not necessarily provide a measure of the quality and efficiency of the service. Good

appearance, politeness, helpfulness and a caring approach are all attributes expected by patients from

a hospital porter. The introduction of a balanced scorecard approach in future years should allow for

these essential characteristics to be included in performance reviews.

Analysis of Trust portering data

4.8.3 Total expenditure on portering services for 2004-05 is just over £19 million, an increase of 10.7% on

the 2003-04 figure.

4.8.4 The number of porters employed across Wales is almost 1,144 whole time equivalent (WTE) staff for

2004-05 which is an increase of 67 on the number reported for 2003-04. The number of porters

employed by individual Trusts varies between 173 WTE for Gwent Healthcare to less than 17 WTE at

Ceredigion & Mid Wales and Velindre NHS Trusts.

4.8.5 The cost of portering services calculated for 2004-05 ranges between £7.42/m2 at Cardiff and Vale and

£16.35/m2 at Carmarthenshire, with the all-Wales average being £11.80/m2. This average figure has

increased by 11% from the 2003-04 figure.



Figure 16: Security service costs/m2

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(£ /

m²)

4.8.6 Using the data reported for portering service costs (including pay and non-pay) and WTE the

cost/WTE varies considerably by between about £15,000, as in the cases of Bro Morgannwg and North

West Wales, and over £20,000, as with Ceredigion & Mid Wales, North Glamorgan and Velindre.

4.8.7 The number of porters employed by the Trusts in terms of WTE/10,000m2 of occupied floor area is

shown in Figure 17. From the data for 2004-05, the all-Wales average for number of porters on this

basis of floor area is 7, an increase of just over 6% on the figure calculated for 2003-04. According to

the available data Bro Morgannwg, Carmarthenshire, Conwy & Denbighshire and Pontypridd &

Rhonnda NHS Trusts employ the highest number of porters on the basis of floor area, all exceeding

9 WTE, which is approximately 33% above the all-Wales average. Cardiff and Vale, Powys LHB and

Velindre NHS Trusts employ the least on this basis, all less than 5 WTE, which is approximately 33%

below the average.

Additional analysis of portering services at the acute hospital sites is detailed in section 5.7.

4.9 Postal services

General information

4.9.1 In general, postal costs are directly linked to the size of the Trust, activity, type of service provided and

the topography of the sites within each Trust. Due to the significant variations in these factors, even

between Trusts of a similar size, it is considered that no useful comparisons can be made for this

service area and restricted the analysis of data to making the following observations.

Analysis of postal services data

4.9.2 Total expenditure on postal services for 2004-05 was £3,366,455, representing an increase of 7% on

the figure for 2003-04, and equating to 3% of the total facilities budget.



Figure 17: WTE Staff/10,000m2 occupied floor area

0.00

2.00

4.00

6.00

8.00

10.00

12.00

Bro

Mor

gann

wg

NH

S T

rust

Car

diff

and

Val

e N

HS

Tru

st

Car

mar

then

shire

NH

S T

rust

Cer

edig

ion

& M

id W

ales

NH

S T

rust

Con

wy

& D

enbi

ghsh

ire N

HS

Tru

st

Gw

ent H

ealth

care

NH

S T

rust

Nor

th E

ast W

ales

NH

S T

rust

Nor

th G

lam

orga

n N

HS

Tru

st

Nor

th W

est W

ales

NH

S T

rust

Pem

brok

eshi

re &

Der

wen

NH

S T

rust

Pon

typr

idd

& R

hond

da N

HS

Tru

st

Pow

ys L

HB

Sw

anse

a N

HS

Tru

st

Vel

indr

e N

HS

Tru

stPo

rter

s / 1

0,00

0m²

of

occ

up

ied

flo

or

area


4.9.3 A total of almost 62 WTE staff is reported for 2004-05 to be employed to undertake postal work,

representing an increase of approximately 11 WTE staff (just over 20%) on last year’s figures. The

number of WTE staff undertaking postal work for each Trust ranged from almost 13 WTE at Bro

Morgannwg NHS Trust, to none at North Glamorgan NHS Trust.

4.10 Outsourced services

General information

4.10.1 As with last year’s report, due to errors in the data submitted for 2004-05 and the failure of Gwent

Trust to submit any data on this area, it has not been possible to make any valued comparisons or

observations on outsourced services. For example, there are many instances of a service being 100%

outsourced, but with the cost of the contract(s) not corresponding to the expenditure reported by the

Trust for that service. However, this is considered to be an area where more detailed monitoring and

analysis is warranted in order to provide important information. Accordingly, the data for 2004-05 is

considered of on-going value and is reproduced in Figure 18 for reference.



Figure 18: Contract status within Trusts expressed as percentage of total cost of theparticular service

* indicates that the data reported is considered to be unreliable

Facility Function

Trust Car

par

king

Cat

erin

g

Cou

rier

ser

vice

s

Dom

estic

ser

vice

s

Gro

unds

and

gar

dens

mai

nten

ance

Laun

dry

Non

-em

erge

ncy

patie

nt tr

ansp

ort

Pes

t con

trol

Por

teri

ng

Pos

tal s

ervi

ces

Res

iden

tial a

ccom

mod

atio

n

Man

ned

secu

rity

Tele

com

mun

icat

ions

Bro Morgannwg NHS Trust 100 50 90 80 100 100

Cardiff and Vale NHS Trust 57 5 100 3 100 100 100 2 4 10 9

Carmarthenshire NHS Trust 100 100 50 1 100

Ceredigion & Mid Wales NHS Trust 100 * 100

Conwy & Denbighshire NHS Trust 100 50 100 100 80 100

Gwent Healthcare NHS Trust NO DATA SUBMITTED

North East Wales NHS Trust 20 95 100 100

North Glamorgan NHS Trust * 100 100 100 *

North West Wales NHS Trust 100 75 100 100

Pembrokeshire & Derwen NHS Trust 100 100 100

Pontypridd & Rhondda NHS Trust 100 100

Powys LHB * 100 95 *

Swansea NHS Trust 78 100 100 100 100 100 19

Velindre NHS Trust 85 * * 100 100 * *

5.1 Overall analysis

5.1.1 The overall cost for the facility functions carried out within the 16 major acute hospitals in Wales

during 2004-05 was £73,745,938 and Figure 19 shows a breakdown of these costs by function.

5.1.2 The breakdown of facility function costs within the 16 major acute hospitals, expressed as a

percentage of the total FM costs, is shown in Figure 20. It can be seen that catering and cleaning

together account for 69% of the hotel services costs.


5 ANALYSIS OF MAJOR ACUTE HOSPITAL DATA

Facility Function Gross Cost

(£)

Car Parking Information not available

Cleaning services 20,880,666

Catering services 29,923,851

Laundry & linen services 6,646,203

Security services 1,582,439

Portering services 12,318,501

Postal services 2,394,278

Totals 73,745,938

Figure 19: Facility costs by function in 16 major acute hospitals

Laundry & Linen9%

Security2%

Postal3%

Cleaning28%

Portering17%

Catering41%

Figure 20: Average cost for facility functions as a percentage of total FM cost

for the 16 major acute hospitals

5.2 Car parking

Analysis of acute hospital car parking data.

5.2.1 According to the data for the sixteen major acute hospitals almost 21,000 parking spaces were

provided in total, which is about 2,000 more spaces than last year. Most of the hospitals either

increased capacity or maintained the same number, with the exception of Llandough Hospital, which

reported 10% fewer spaces.

5.2.2 The total available parking spaces allocated for disabled staff and visitors was between about 2% and

6%. Figure 21 compares this provision against that expected by local authorities for new car parks

whereby those with up to 200 spaces are to have 6% allocated for the disabled and those above 200

are to have 4% plus 4.

Figure 21 also illustrates the fact that, if these guidelines were applied to acute hospitals, seven of the

hospitals complied in 2004-05, which adds the University Hospital of Wales (UHW) and Royal

Glamorgan Hospital to the list of hospitals reported last year. Morriston Hospital and UHW reported

the greatest increases of 57 and 45 disabled parking spaces respectively.

ANALYSIS OF MAJOR ACUTE HOSPITAL DATA


0 20 40 60 80 100 120 140 160

Bronglais General Hospital

Llandough Hospital

Morriston Hospital

Nevill Hall Hospital

Prince Charles Hospital

Prince Philip Hospital

Princess of Wales Hospital

Royal Glamorgan Hospital

Royal Gwent Hospital

Singleton Hospital

University Hospital of Wales

West Wales General Hospital

Withybush General Hospital

Ysbyty Glan Clwyd

Ysbyty Gwynedd

Ysbyty Maelor

Existing Disabled Spaces Current Standard for a New Car Park

Figure 21: Number of disabled car parking spaces

5.2.3 From the data submitted on charging for parking, it appears that only three of the sixteen hospitals did

not charge patients/visitors, these being Ysbyty Glan Clwyd, Ysbyty Maelor and Prince Charles. For the

rest of the hospitals included, the average charge per hour levied on patients and visitors (based on a

three hour period) ranged from 25p to £1.19, with an average of 54p. The gross income from parking

charges totalled almost £1.5 million in 2004-05, which is over £470,000 more than in the previous year.

Staff parking charges were reported for seven of the hospitals, this being two more than last year.

Income generated from staff parking applied to five of these, which totalled nearly £895,000 and

ranged from £80,000 to £290,000 for the hospitals concerned.

5.3 Cleaning services

Analysis of acute hospital cleaning data

5.3.1 The cost of cleaning/m2 calculated for the 16 major acute hospitals is illustrated in Figure 22. The data

for 2004-05 shows that the average cost/m2 has increased from £22.69 to £23.30. The 2003-04 report

noted that the three main North Wales hospitals were achieving lower costs than the majority of their

southern counterparts. This would still appear to be the case, with Ysbyty Gwynedd spending the

least on cleaning/m2 .

5.3.2 The Performance Assessment (Toolkit), which accompanied the National Standards of Cleanliness, set

out the detailed methodology for the calculation and verification of an audit score. The reported

scores are an important indicator of the adequacy, or otherwise, of the cleaning specifications

currently in operation. With full implementation of the National Standards of Cleanliness, involving



0.00

5.00

10.00

15.00

20.00

25.00

30.00

35.00

Ysb

yty

Gw

yned

d

Prin

cess

of W

ales

Hos

pita

l

Ysb

yty

Mae

lor

Uni

vers

ity H

ospi

tal o

fW

ales

Nev

ill H

all H

ospi

tal

Sin

glet

on H

ospi

tal

Prin

ce C

harle

s H

ospi

tal

Wes

t Wal

es G

ener

alH

ospi

tal

Ysb

yty

Gla

n C

lwyd

Roy

al G

wen

t Hos

pita

l

Mor

risto

n H

ospi

tal

With

ybus

h G

ener

alH

ospi

tal

Roy

al G

lam

orga

n H

ospi

tal

Bro

ngla

is G

ener

al H

ospi

tal

Llan

doug

h H

ospi

tal

Prin

ce P

hilip

Hos

pita

l

(£/m

²)

Acute Hospital Acute Hospital Average

Figure 22: Cleaning costs/m2



audit trails that assist in the prioritisation of remedial measures, the scores become an important

indicator for Trusts to demonstrate continuous improvement in standards at their hospitals.

In conjunction with financial and quality indicators, the scores could also provide an indication as to

whether or not a Trust is obtaining ‘best value’ from the cleaning budget. At the present time there

appears to be no correlation between the cost of cleaning and the audit score received for

compliance with the National Standards.

5.3.3 The externally verified whole hospital audit scores for major acute hospitals against the Standards for

2004–05 are illustrated in Figure 23. It can be seen that Nevill Hall Hospital is the only hospital without

a score. Gwent Healthcare NHS Trust has advised that its Cleanliness Strategy will include the provision

of a score later this year, but not in time for the submission of EFPMS data.

Reported scores now range from 61% to 95%, which shows a narrower spread than the 50% to 97%

range reported last year. This is a welcome development as it indicates a general refinement in

following the methodology for the calculation and verification of the score, and adds confidence in

the reliability of the results.

In addition, it is welcome to see that the average score in 2003-04, which was just over 71%, has now

increased to almost 74%. However, there is considerable room for improvement, particularly for the

seven hospitals below this figure.

Figure 23 also shows that only four hospital scores show improvement on last year’s figures, three

ostensibly remain the same, and in five hospitals standards have apparently deteriorated. Where

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50.00

60.00

70.00

80.00

90.00

100.00

Bro

ngla

is G

ener

al H

ospi

tal

Llan

doug

h H

ospi

tal

Mor

risto

n H

ospi

tal

Nev

ill H

all H

ospi

tal

Prin

ce C

harle

s H

ospi

tal

Prin

ce P

hilip

Hos

pita

l

Prin

cess

of W

ales

Hos

pita

l

Roy

al G

lam

orga

n H

ospi

tal

Roy

al G

wen

t Hos

pita

l

Sin

glet

on H

ospi

tal

Uni

vers

ity H

ospi

tal o

fW

ales

Wes

t Wal

es G

ener

alH

ospi

tal

With

ybus

h G

ener

alH

ospi

tal

Ysb

yty

Gla

n C

lwyd

Ysb

yty

Gw

yned

d

Ysb

yty

Mae

lor

(%)

Audit Score

No

scor

e pr

ovid

ed

Figure 23: Audit score against cleaning standards

standards appear to have dropped, the Trusts concerned now have the audit trails to identify and

address the problems, and employ their internal auditing function to the full in this process. In

addition, assessment against the Welsh Risk Management Standard 40: Cleaning, introduced in 2005,

will provide further indications of where improvements may be made in the action plans for the

cleaning service provided.

5.4 Catering services

Analysis of acute hospital catering data

5.4.1 From the results of Ward Food Wastage Surveys, the percentages calculated for hospital meals that go

untouched by patients is illustrated in Figure 24, and are intended to reflect the proportion of “over

production” of meals to what is actually required. The average percentage of untouched meals for the

sixteen acute hospitals has increased from 8.3% in 2003-04 to 9.9% in 2004-05. Clearly more will need

to be done in an effort to reverse this general trend.

However, it is important to note that the figure resulting from the Ward Food Wastage Survey

conducted at Morriston Hospital was 31%, but the next highest percentage was 14.8% at Ysbyty Glan

Clwydd, suggesting that the Morriston figure is an isolated instance, and the extrapolated figure of

nearly 220,000 meals wasted has impacted disproportionately upon the average. This point has been

reinforced by the fact that 6 of the 16 acute hospitals indicate a reduction in food wastage and 3 have

remained constant. If the data from Morriston Hospital is omitted, the acute hospital average would

be 7.9%.

Although there will inevitably be some food wastage, the benefit of a significant reduction in over

production should not be underestimated. A reduction in untouched meals of only 1% may achieve

an overall cost saving at these acute hospitals of around £300,000.



0.00

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25.00

30.00

35.00

Bro

ngla

is G

ener

alH

ospi

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doug

h H

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risto

n H

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Nev

ill H

all H

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Prin

ce C

harle

sH

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Prin

ce P

hilip

Hos

pita

l

Prin

cess

of W

ales

Hos

pita

l

Roy

al G

lam

orga

nH

ospi

tal

Roy

al G

wen

t Hos

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l

Sin

glet

on H

ospi

tal

Uni

vers

ity H

ospi

tal o

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t Wal

es G

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ospi

tal

With

ybus

h G

ener

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tal

Ysb

yty

Gla

n C

lwyd

Ysb

yty

Gw

yned

d

Ysb

yty

Mae

lor

(%)

Acute Hospital All Wales Average

Figure 24: Percentage food waste (untouched meals)

5.5 Laundry and linen services

Analysis of acute hospital laundry and linen data

5.5.1 The cost of laundry per occupied hospital bed is compared over a two-year period in Figure 25. Apart

from the extreme changes at UHW, Llandough and Withybush, which are considered to be unreliable,

the figures indicate that seven hospitals have increased their costs and three have reduced them.

Figure 25 also shows that the range of costs for 2004-05 is between £735 and £1104. This results in

an average of £968, which exceeds the all-Wales average marginally by £13.

5.6 Security services

Analysis of acute hospital security data

5.6.1 The cost of providing security services at the 16 acute hospital sites, measured against the number of

assaults on staff reported for those hospitals in 2004-05, is illustrated in Figure 26.

The data provided for these individual hospitals has improved from last year, although no cost was

reported for Nevill Hall, Singleton and Withybush. Furthermore, Bronglais and Ysbyty Gwynedd are

considered to be too low to be reliable. Excluding data from these hospitals it can be seen that the

variation in terms of cost/m2 has been reduced greatly, ranging between £1.50/m2 and £3.50/m2.



0

200

400

600

800

1,000

1,200

1,400

1,600

Bro

ngla

is G

ener

alH

ospi

tal

Llan

doug

h H

ospi

tal

Mor

risto

n H

ospi

tal

Nev

ill H

all H

ospi

tal

Prin

ce C

harle

s H

ospi

tal

Prin

ce P

hilip

Hos

pita

l

Prin

cess

of W

ales

Hos

pita

l

Roy

al G

lam

orga

n H

ospi

tal

Roy

al G

wen

t Hos

pita

l

Sin

glet

on H

ospi

tal

Uni

vers

ity H

ospi

tal o

fW

ales

Wes

t Wal

es G

ener

alH

ospi

tal

With

ybus

h G

ener

alH

ospi

tal

Ysb

yty

Gla

n C

lwyd

Ysb

yty

Gw

yned

d

Ysb

yty

Mae

lor

(£)

2003-04 2004-05

Figure 25: Cost of laundry/bed

No

cost

dat

a su

bmitt

ed

No

cost

dat

a su

bmitt

ed

Once again, disregarding omissions and likely errors in reporting, notable changes in the number of

assaults reported in 2004-05 from these hospitals when compared with 2003-04 are as follows:

❖ A reduction at Ysbyty Maelor from 735 to 153.

❖ A reduction at Ysbyty Glan Clwyd from 296 to 155.

❖ A reduction at Princess of Wales from 161 to 100.

❖ An increase at Llandough Hospital from 284 to 469.

❖ An increase at the University Hospital of Wales from 423 to 580.

There is no apparent correlation between the above changes and the amount spent on security

services at these hospitals when compared with the previous year’s figures.

5.6.2 As indicated above, there has been some improvement in data quality in 2004-05 but significant

inconsistencies and weaknesses in reporting procedures for some Trusts remain, which need to be

addressed before further data analysis is undertaken.

5.7 Portering services

It is widely acknowledged that the location, site layout and the type of service provided profoundly

affects the cost of portering services at all hospitals. However, this should not discourage local

management from reviewing their service against similar hospitals, whenever possible, when assessing

their own performance.

Analysis of acute hospital portering data

5.7.1 The all-Wales average cost/occupied floor area derived from the data for 2004-05 is £14.5/m2, which

represents a 6.3% increase compared with 2003-04. The cost/m2 calculated for individual hospitals

ranged from £6.5/m2 to £19.8/m2, with the University Hospital of Wales spending the least per m2 for

portering services for the second consecutive year.



Figure 26: Cost/m2 for the provision of security services comparedwith number of assaults on staff

0.00

0.50

1.00

1.50

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2.50

3.00

3.50

4.00

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n H

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ill H

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ce C

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s H

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hilip

Hos

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Prin

cess

of W

ales

Hos

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Roy

al G

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n H

ospi

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Roy

al G

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t Hos

pita

l

Sin

glet

on H

ospi

tal

Uni

vers

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ospi

tal o

f Wal

es

Wes

t Wal

es G

ener

al H

ospi

tal

With

ybus

h G

ener

al H

ospi

tal

Ysb

yty

Gla

n C

lwyd

Ysb

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Gw

yned

d

Ysb

yty

Mae

lor

(£/m

²)

0

100

200

300

400

500

600

700

(No

)

Cost/m² Assaults on Staff

No

cost

dat

a

No

cost

dat

a

No

cost

dat

a

5.7.2 A comparison of the number of porters WTE per m2 of occupied floor area for 2003-04 and 2004-05

is illustrated in Figure 27. Costs have risen in 10 cases, with the largest increase of £4.2/m2 (30.6%) at

Prince Philip Hospital, and fallen in only 5 of the hospitals, with the greatest reduction of £2.9/m2

(14.6%) at the Royal Glamorgan Hospital. (N.B. The reduction at the Royal Glamorgan Hospital is in

conjunction with a 4,155m2 increase in occupied floor area).

5.7.3 A comparison of the number of porters WTE per 100 beds is illustrated in Figure 28. This shows the

average number of porters/100 beds for 2004-05 is 11.2, which is an increase of 0.88 (8%) on figures



0.00

5.00

10.00

15.00

20.00

25.00

Bro

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is G

ener

alH

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Llan

doug

h H

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Mor

risto

n H

ospi

tal

Nev

ill H

all H

ospi

tal

Prin

ce C

harle

sH

ospi

tal

Prin

ce P

hilip

Hos

pita

l

Prin

cess

of W

ales

Hos

pita

l

Roy

al G

lam

orga

nH

ospi

tal

Roy

al G

wen

tH

ospi

tal

Sin

glet

on H

ospi

tal

Uni

vers

ity H

ospi

tal

of W

ales

Wes

t Wal

es G

ener

alH

ospi

tal

With

ybus

h G

ener

alH

ospi

tal

Ysb

yty

Gla

n C

lwyd

Ysb

yty

Gw

yned

d

Ysb

yty

Mae

lor

(£/m

²)

2003-04 2004-05

Figure 27: Cost of portering/m2

0.00

2.00

4.00

6.00

8.00

10.00

12.00

14.00

16.00

18.00

20.00

Nu

mb

er o

f p

ort

ers/

100

bed

s

Acute Hospital Acute Hospital Average

Figure 28: Number of porters/100 beds

Ysb

yty

Gw

yned

d

Prin

ce C

harle

sH

ospi

tal

With

ybus

h G

ener

alH

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Wes

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Prin

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of W

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Roy

al G

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orga

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tal

Prin

ce P

hilip

Hos

pita

l

Roy

al G

wen

tH

ospi

tal

Ysb

yty

Mae

lor

Ysb

yty

Gla

n C

lwyd

Mor

risto

n H

ospi

tal

Uni

vers

ity H

ospi

tal

of W

ales

Bro

ngla

is G

ener

alH

ospi

tal

Nev

ill H

all H

ospi

tal

Llan

doug

h H

ospi

tal



calculated for 2003-04. The number of porters/100 beds calculated for 2004-05 ranges between 7 at

Ysbyty Gwynedd and 18 at Ysbyty Glan Clwyd.

5.8 Postal services

Due to the wide variation in factors that influence the cost of the service, such as size and topography

of the site, and type of hospital and activity, no analyses have been made for the data reported.

However, the data is available electronically in the supplementary data spreadsheet provided on CD-

Rom or on the WHE website.

APPENDIX I

Observations on FM-related Operating Costs

BRO MORGANNWG NHS TRUST



APPENDIX I

1.0 Introduction

1.1 The level of expenditure on facilities services alone does not reflect the performance of service

delivery. However, it is a helpful indicator when used to compare the expenditure of similar

organisations and draw attention to potential savings and the allocation of resources for optimum

performance. Hence, observations have been made on the available EFPMS data and the information

has been presented to enable benchmarking and, wherever possible, the sharing of good practice.

It should be noted that until suitable qualitative service PIs are developed for use in conjunction with

financial PIs to provide a balanced view, the system of colour coding performance used by the Welsh

Assembly Government’s balanced scorecard, as adopted for the Facilities Performance Report 2003 –

2004, will not be applied.

2.0 Breakdown of Trust facility services expenditure

2.1 A breakdown of the total reported costs associated with FM for the Trust is set out in Figure 1. Also

shown is the breakdown expressed as a cost/m2 compared with the all-Wales average. (N.B. due to the

omission of some data from Trusts, estimates have been incorporated to produce this average).

The total FM operating cost reported by Bro Morgannwg for 2004-05 has increased by £303,667

compared with 2003-04. This has resulted in an overall facilities cost of £86.59/m2, an increase of 15%

on last year’s figure and now significantly higher than the all-Wales average of £81.53/m2. This may, in

part, be due to the closure of Hensol Hospital and the subsequent opening of Llwyneryr Hospital at a

time when data was not available for inclusion for 2004-05.

Due to the small number of similar hospital types within the Trust it is not easy to make valued

comparisons. Future reports will include costs compared with the all-Wales average for each hospital

type. Telecommunications costs have been included on a Trust basis and not allocated to individual

sites.

2.2 Figure 2 shows the cost of the main FM functions expressed as a percentage of the total FM reported

costs.

Compared with the chart produced for Bro Morgannwg for 2003-04, the most notable change is a

3% reduction in allocation for cleaning services. There are apparently no major differences from the

all-Wales average profile, with above average allocations for telecommunications (2%), laundry &

linen (3%) and portering services (2%) and below average allocations for cleaning (3%) and catering

services (3%).

Telecomsservice

Cleaningservices

Cateringservices

Laundry

& Linen

services

Securityservices

Porteringservices

Postalservices

Totals

FM Costs (£) 1,158,000 2,596,685 3,638,661 1,044,080 178,613 1,665,379 315,599 10,597,017

Trust cost (£/m²) 9.46 21.22 29.73 8.53 1.46 13.61 2.58 86.59

All-Wales cost (£/m²) 7.14 22.85 30.16 5.95 1.57 11.80 2.05 81.53

Figure 1: Trust facilities information

APPENDIX I


3.0 Breakdown of facilities services costs for individual sites

3.1 Sites included for the 2004-05 EFPMS were as follows:

❖ 9 Individual hospital sites

❖ Aggregate 1 – Freehold, diagnostic & treatment centres, health centres

❖ Aggregate 2 – Freehold, all other sites

❖ Aggregate 5 - Leased and part serviced by NHS Trust/landlord

3.2 Details of all the available individual Trust facility functions costs on a site-by-site basis are shown in

Figure 3.

3.3 Observations on the data contained in Figure 3 are as follows:

1. As with the data returns for 2003-04, some of the costs for Maesgwyn, Cimla, Groeswen and

Glanrhyd Hospitals were originally included in the submissions for other hospitals. These have since

been apportioned for these sites by the Trust so that a more accurate picture of the costs for the

individual hospitals can be obtained.

2. Catering costs at the Princess of Wales Hospital are over £290,000 lower than reported for 2003-04

and are the only service area for this hospital reported to have decreased. This reduction, in

conjunction with an increase in occupied floor area of almost 4,000m2, has contributed to the

cost/m2 reducing by £16.30, a drop of almost 18%.

3. This year far more FM data for Neath Port Talbot Hospital has been returned and the overall FM cost

of occupancy is calculated at £107.46/m2. A more detailed analysis shows that this apparent high

cost reflects the component occupancy costs of cleaning at £34.29/m2, catering at £44.40/m2,

laundry and linen at £12.79/m2 and portering at £12.85/m2.

4. Security costs for the Trust appear to be low, with only the dedicated security at Princess of Wales

Hospital being reported, with no further information provided.

5. No data for Llwyneryr Hospital has been included in data returns for 2004-05.

Telecoms11%

Cleaning25%

Catering33%

Security2%

Portering16%

Postal3%

Linen and Laundry10%

Figure 2: Facilities expenditure % by function

APPENDIX I


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9

APPENDIX II


CARDIFF and VALE NHS TRUST


1.0 Introduction














The total FM operating cost reported by Cardiff and Vale for 2004-05 has decreased by £1,062,000

compared with 2003-04. This has resulted in an overall facilities cost of £67.74/m2, which is

significantly lower than the all-Wales average of £81.53/m2.

From the data available, the Trust appears to have out-performed the all-Wales average for all FM

services with the exception of security, although there is uncertainty regarding the returns for laundry

and linen costs as they are reported to have dropped dramatically from 2003-04.

The Trust spends £3.05/m2 on security services, nearly twice the all-Wales average, and reports

expenditure for security at all hospital sites. The Trust statistic for employing WTE staff is 52.31, which

is more than double the number for Gwent Healthcare NHS Trust, which is the second highest

employer of WTE staff in this area.




sites.

APPENDIX II


Telecomsservice

Cleaningservices

Cateringservices

Laundry

& Linen

services

Securityservices

Porteringservices

Postalservices

Totals

FM Costs (£) 1,288,775 7,069,244 7,734,913 1,288,457 959,985 2,333,638 632,395 21,307,407

Trust cost (£/m²) 4.10 22.48 24.59 4.10 3.05 7.42 2.01 67.74

All-Wales cost (£/m²) 7.14 22.85 30.16 5.95 1.57 11.80 2.05 81.53



costs.

Compared with the chart produced for Cardiff and Vale for 2003-04, the most notable changes are

with cleaning and laundry & linen services, which indicate a 5% higher and 6% lower allocation,

respectively. For 2004-05, the Trust reports spending significantly more of its FM expenditure than the

all-Wales averages for cleaning (5%) and security (3%), and less on telecommunications (3%) and

portering (3%).






❖ Aggregate 3 - Leased and fully serviced by the NHS Trust

❖ Aggregate 4 - Leased and fully serviced by the Landlord


3.2 Details of all the individual facility functions costs on a site-by-site basis for the Trust are shown in

Figure 3.


1. The difference between the FM cost/m2 for Llandough Hospital and the University Hospital of

Wales has decreased slightly but is still considerable at £93.87/m2 and £55.91/m2 respectively. The

reduction is accounted for mainly by Llandough Hospital having decreased costs by approximately

£1,000,000, reflecting large reductions in costs for security, catering and laundry and linen.

APPENDIX II


Cleaning33%

Telecoms6%

Postal3%

Linen and Laundry6%

Catering36%

Portering11%Security

5%


2. The apparent anomaly on portering costs raised in the 2003-04 data for Barry Community Hospital,

that has about half the occupied floor area and beddage of the PFI St David’s Hospital, arises again

for 2004-05. The costs of portering services at Barry of £18.01/m2 are almost five times those for

St David’s at £4.00/m2.

3. Although the figure for Trust cleaning service costs is very close to the all-Wales average of

£22.85/m2, individual hospital rates vary significantly and are as high as £43.72/m2 at St David’s

Hospital. However, the higher rates are balanced by the rate of £18.70/m2 for the University Hospital

of Wales that accounts for almost 54% of the reported occupied floor area for the Trust.

4. A major reduction in overall costs has been reported for Llandough Hospital, along with 4 fewer

WTE security staff, which has resulted in the FM cost for security services dropping dramatically

from £9.45/m2 in 2003-04 to £3.26/m2.

5. There has been a significant reduction of over £1,400,000 in the total laundry & linen costs reported

this year compared with those reported in 2003-04. At the time of issue of this report WHE has

been unable to ascertain what factors have influenced this reduction.

APPENDIX II


Figu

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4

APPENDIX II


APPENDIX III


CARMARTHENSHIRE NHS TRUST


APPENDIX III


1.0 Introduction














The total FM operating cost reported by Carmarthenshire for 2004-05 has increased by £776,020

(12%) compared with 2003-04. In terms of cost/m2, the increase is 6% from £94.30/m2 to £99.73/m2

for 2004-05. Significantly, this includes an increase in postal service costs of over £207,000 to a more

realistic cost of £239,042 and represents 3% of the overall FM expenditure. (N.B. As the cost of

telecom services was not reported with last year’s data, the telecom services cost for 2004-05 has

been omitted from the above comparisons.)

Taking telecom service costs into account the Trust’s overall FM cost/m2 is £107.25/m2, which is

£25.72/m2 more than the all-Wales average and is the highest of all the Trusts in 2004-05. It appears

that all individual service costs have exceeded the all-Wales average, with the exception of security,

which at £1.38/m2 is £0.19/m2 below.

As with data for 2003-04, it appears that the high catering costs reported are contributing significantly

to the Trust exceeding the all-Wales average. Although cost/m2 is a poor PI for catering services, it is

worth noting that the Trust is also reported to spend 2.7% of its total income on catering, which is the

highest proportion reported for any Trust in 2004-05. Similarly, portering costs at £16.35/m2 are the

highest for Trusts in 2004-05. Furthermore, the portering cost/occupied bed PI exceeds £3,200, which

is far higher than all other non-specialist Trusts.

Telecomsservice

Cleaningservices

Cateringservices

Laundry

& Linen

services

Securityservices

Porteringservices

Postalservices

Totals

FM Costs (£) 554,629 1,966,967 3,252,899 586,679 101,682 1,205,487 239,042 7,907,385

Trust cost (£/m²) 7.52 26.68 44.12 7.96 1.38 16.35 3.24 107.25

All-Wales cost (£/m²) 7.14 22.85 30.16 5.95 1.57 11.80 2.05 81.53





sites.


costs.

Compared with the chart produced for Carmarthenshire NHS Trust for 2003-04, the most notable

changes are that postal and cleaning services have increased by 3% and 2% respectively, whereas

catering services show a reduction of 4%. Compared with the all-Wales average profile, the only

significant differences are with catering services, where the Trust exhibits a 4% higher allocation and

with cleaning and telecommunications services, which are 3% and 2% respectively less than the

calculated average.






3.2 Details of all the individual Trust facility functions costs on a site-by-site basis are shown in Figure 3.


1. It was apparent from the data initially submitted by the Trust that costs for certain services needed

to be apportioned to appropriate hospital sites. The subsequent verification of such data has

resulted in improved accuracy and has allowed a more meaningful analysis to be made.

APPENDIX III


Cleaning25%

Telecoms7%

Postal3%Security

1%

Portering15%

Catering42%

Linen and Laundry7%


2. The low total FM cost for Bryntirion Hospital is understood to reflect the fact that no patients

receive treatment there, and that it is the location of a central catering unit.

3. As with the cleaning costs submitted for Prince Philip Hospital (PPH) and West Wales General

Hospital (WWGH) for 2003-04, a significant difference of over £7/m2 is apparent, and at £33.13/m2

and £25.23/m2 respectively, they are both above the all-Wales average for acute hospitals for

2004-05.

4. Security costs have been provided for five of the six hospitals. The total security costs for the Trust

of £101,682 are more than double the £47,681 reported for PPH and WWG for 2003-04.

5. The total cost of £1,205,487 for portering services in 2004-05 represents a 10% increase from 2003-

04 but this includes a significant reallocation of costs to PPH, resulting in an increase at this site of

30% from £302,242 to £429,231.

6. As with the data reported in 2003-04, the total Trust cost for postal services are divided between

PPH and WWGH. The overall cost of postal services has increased for 2004-05 by 87% to a more

realistic £239,042.

APPENDIX III


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APPENDIX III


APPENDIX IV


CEREDIGION & MID-WALES NHS TRUST


1.0 Introduction














The total FM operating cost reported by Ceredigion & Mid Wales for 2004-05 has increased by a

relatively modest £179,498 (7%) compared with 2003-04. In terms of facilities cost/m2, these have

increased by 8% from £99.61/m2 to £107.19/m2 for 2004-05, which is considerably higher than the

all-Wales average of £81.53/m2.

With the exception of telecom services cost/m2 that is reported to have decreased by 19%, the overall

increase for 2004-05 appears to have resulted from higher costs for all other services that now exceed

their respective all-Wales average by between 18% and 31%. Cleaning, catering and portering costs/m2

for the Trust are approaching the highest recorded for 2004-05.




sites.

2.2 Figure 2 shows the cost of the main FM functions expressed as a percentage of the total FM

reported costs.

APPENDIX IV


Telecomsservice

Cleaningservices

Cateringservices

Laundry

& Linen

services

Securityservices

Porteringservices

Postalservices

Totals

FM Costs (£) 227,642 722,192 1,072,085 202,286 2,956 356,309 61,407 2,644,877

Trust cost (£/m²) 9.23 29.27 43.45 8.20 0.12 14.44 2.49 107.19

All-Wales cost (£/m²) 7.14 22.85 30.16 5.95 1.57 11.80 2.05 81.53


The chart is very similar to that produced for Ceredigion & Mid Wales for 2003-04. Compared with the

all-Wales average profile, the most notable difference concerns catering services, where the Trust

exhibits a 4% higher allocation than the all-Wales average.








1. The cost of cleaning services at Bronglais General Hospital for 2004-05 is £579,164, which is

£60,382 more than for 2003-04 and represents an increase of 12%. In terms of cost/m2 this

represents an increase of £3.29/m2, up to £30.11/m2, which is considerably higher than the all-Wales

average for acute hospitals for 2004-05 of £23.30/m2. Despite this extra expenditure the reported

audit score against the National Standards of Cleanliness has not improved for 2004-05, remaining

at 62%.

2. The Trust is reported to spend only approximately 0.1% of its FM budget on security services. It is

noted that there has been a reduction in the total number of security incidents reported for the

Trust, from 170 in 2003-04 to 98 in 2004-05, a reduction of over 40%.

APPENDIX IV


Telecoms9%

Cleaning27%

Postal2%

Linen and Laundry8%

Catering41%

Portering13%

Security0%


APPENDIX IV


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APPENDIX V


CONWY & DENBIGHSHIRE NHS TRUST


1.0 Introduction














The total FM operating cost reported by Conwy & Denbighshire for 2004-05 has increased by

£707,882 (8%) compared with 2003-04. This has resulted in an overall facilities cost of £76.05/m2, an

increase of 6% on last year’s figure.

The total FM cost/m2 is among the lowest recorded for 2004-05 and, for the second consecutive year,

is significantly less than the all-Wales average. In 2003-04 the Trust costs were calculated at 10% less

than the all-Wales average, and in 2004-05 the figure is 7%.

Although the cost/m2 for cleaning and portering exceeds the all-Wales average by 6% and 19%

respectively, the comparatively low cost/m2 calculated for the Trust is due to all the other FM services

ranging between 15% and 46% below the all-Wales average.

Expenditure on portering services as a percentage of the overall Trust budget is calculated to be 19%

and this is the highest reported for 2004-05.

Laundry and linen service costs for 2004-05 are reported to have increased significantly by £72,933

(18%) from 2003-04 but remain the lowest reported for a non-specialist Trust both in terms of cost/m2

and average cost/piece.

APPENDIX V


Telecomsservice

Cleaningservices

Cateringservices

Laundry

& Linen

services

Securityservices

Porteringservices

Postalservices

Totals

FM Costs (£) 663,584 2,886,385 3,043,085 487,227 114,328 1,742,829 130,638 9,068,076

Trust cost (£/m²) 5.57 24.21 25.52 4.09 0.96 14.62 1.10 76.05

All-Wales cost (£/m²) 7.14 22.85 30.16 5.95 1.57 11.80 2.05 81.53





sites.


costs.

The chart is very similar to that produced for Conwy and Denbighshire for 2003-04. Compared with

the all-Wales average profile, the most notable differences concern portering and cleaning services,

where the Trust exhibits a 5% and 4% higher allocation respectively, and with catering services, which

is 2% less than the calculated average.

2.2 A breakdown of the total reported costs, expressed as percentages by facilities function, is

presented in Figure 2.









1. Portering cost/m2 for Ysbyty Glan Clwyd is calculated to be £19.61/m2 and is almost the highest

reported for an acute hospital in 2004-05, and significantly higher than the all-Wales average for

acute hospitals of £14.50/m2.

2. The FM cost/m2 of £40.16 for H M Stanley Hospital in 2004-05 is slightly higher than in 2003-04 but

remains disproportionately low compared with other community hospitals. This may be due to a

APPENDIX V


Telecoms7%

Cleaning32%

Postal1%

Linen and Laundry5%

Catering35%

Portering19%

Security1%


relatively large occupied floor area that is unrelated to the service costs associated with the

delivery of healthcare.

3. With the exception of the aggregate sites, the costs for security services for 2004-05 mirror the

data reported for 2003-04 exactly.

4. As reported for 2003-04, catering costs once again have not been apportioned in some cases and,

therefore, contribute to the distortion of the cost for the sites involved.

APPENDIX V


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APPENDIX V


APPENDIX VI


GWENT HEALTHCARE NHS TRUST


1.0 Introduction














The total FM operating cost reported by Gwent Healthcare for 2004-05 has increased by £5,189,234

compared with 2003-04. However, this increase is largely accounted for by the inclusion of costs for

FM services that were absent from the 2003-04 submissions, notably the Trust laundry and linen costs

and the true cost of portering for the Royal Gwent Hospital. These two items alone account for

approximately £2,915,000 of the overall increase.

The overall FM cost/m2 for the Trust is £88.11/m2, which is 7% greater than the all-Wales average. It

should be noted that although the occupied floor area for Chepstow Hospital is included, only laundry

& linen services costs have been submitted. With the laundry & linen costs and occupied floor area for

Chepstow Hospital removed from the calculation the more realistic figure of £99.60/m2 is derived for

comparison.

It is disappointing that the Trust has been unable to obtain all of the required data for Chepstow

Hospital for 2004-05, as was also the case for 2003-04. It is understood that the PFI contract is due

for re-tender and the difficulty in accessing the information required will be taken into consideration.

However, the data submitted for 2004-05 appears to have improved considerably, the only service

area appearing to be incorrect being security services, where the calculated cost/m2 is unrealistically

low. It is also understood that the Trust plans to centralise its Facilities and Support Services by April

2006, which should overcome many of the problems encountered in providing the necessary data.

APPENDIX VI


Telecomsservice

Cleaningservices

Cateringservices

Laundry

& Linen

services

Securityservices

Porteringservices

Postalservices

Totals

FM Costs (£) 2,590,605 5,939,259 8,676,735 1,636,081 242,120 2,834,798 441,294 22,360,892

Trust cost (£/m²) 10.21 23.40 34.19 6.45 0.95 11.17 1.74 88.11

All-Wales cost (£/m²) 7.14 22.85 30.16 5.95 1.57 11.80 2.05 81.53


APPENDIX VI





sites.


costs.

The chart is very similar to that produced for Gwent Healthcare for 2003-04. Compared with the all-

Wales average profile, the only significant differences concern telecommunications services, where

the Trust exhibits a 3% higher allocation than the all-Wales average and with catering services, which

is 2% more than the calculated average.







1. Only laundry & linen costs were provided for Chepstow Community Hospital. It is understood that

discussions are to take place with the service provider at this PFI hospital to enable the necessary

data to be provided for future reports.

2. The cleaning costs for Caerphilly Miners Hospital result in an extremely high cost/m2 of £54.43 in

2004-05, an increase of £6.37/m2 from 2003-04.

Telecoms12%

Cleaning27%

Postal2%

Security1% Portering

13%

Catering38%

Linen and Laundry7%


APPENDIX VI


3. Although there has been an improvement in the robustness of the data for 2004-05, the data set is

still incomplete and there is a need for apportionment of costs for some hospitals. This, together

with the incomplete data set for 2003-04, does not allow for meaningful comparisons to be made

for either the core FM services or between hospital types.

APPENDIX VI


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APPENDIX VII


NORTH EAST WALES NHS TRUST


1.0 Introduction














The total FM operating cost reported by North East Wales for 2004-05 has increased by £446,221 (6%)

compared with 2003-04. In conjunction with a net increase of over 1,100m2 in occupied floor area,

this has resulted in a facilities cost of £74.25m2. This is a reduction of £3.76/m2 (5%) on the 2003-04

figures, and puts the Trust further below the all-Wales average for 2004-05 of £81.53/m2.

Most service costs appear less than the all-Wales average, notably cleaning and catering, at 23% and

19% respectively. The services that exceeded the averages for all-Wales were laundry & linen, portering

and postal services, being 9%, 34% and 11% respectively.



type. Telecommunications costs have been included on a Trust basis and not allocated to individual sites.


costs.

The chart is very similar to that produced for North East Wales for 2003-04. Compared with the all-

Wales average profile, the only major difference concerns portering services, where the Trust exhibits

a 7% higher allocation than the all-Wales average. The two notable areas where expenditure is lower

are cleaning and catering services, both at 4% less than the calculated average.

APPENDIX VII


Telecomsservice

Cleaningservices

Cateringservices

Laundry

& Linen

services

Securityservices

Porteringservices

Postalservices

Totals

FM Costs (£) 654,053 1,997,539 2,759,924 731,789 195,703 1,775,689 256,767 8,371,464

Trust cost (£/m²) 5.80 17.72 24.48 6.49 1.74 15.75 2.28 74.25

All-Wales cost (£/m²) 7.14 22.85 30.16 5.95 1.57 11.80 2.05 81.53


APPENDIX VII








❖ Aggregate 5 - Leased and part serviced by the NHS Trust/Landlord



1. As with the data for 2003-04, security service costs are only reported for Ysbyty Maelor. The Trust

has confirmed that security is provided to the other sites on an ad-hoc basis. Of the 1473 reported

security incidents 96% occurred at Ysbyty Maelor.

2. FM costs at Penley Hospital are £168.49/m2, which are significantly higher than any other site within

the Trust. This appears to reflect the high facilities cost for running a very small hospital.

3. Portering service costs at Ysbyty Maelor have increased by £205,203 (16%) for 2004-05 when

compared with 2003-04. With an increased occupied floor area of 14,756m2 being reported for the

site, the FM cost of £19.52/m2 for 2004-05 is £1.33/m2 lower than the cost of £20.85/m2 for 2003-

04. However, this reduced FM cost remains far higher than the £14.50/m2 average for major acute

hospitals in 2004-05.

Telecoms8%

Cleaning24%

Postal3%Security

2%

Portering21%

Catering33%

Linen and Laundry9%


APPENDIX VII


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APPENDIX VIII


NORTH GLAMORGAN NHS TRUST


APPENDIX VIII


1.0 Introduction














The total FM operating cost reported for North Glamorgan for 2004-05 has increased by £270,186

(4%) compared with 2003-04.

The Trust’s overall FM cost of £83.26/m2 is marginally higher than the all-Wales average for 2004-05

of £81.53/m2. This is closer than for 2003-04 when the Trust was 13% above the all-Wales average.

Only the cost for telecoms, catering and postal services are below the all-Wales average. However,

there is some doubt as to the accuracy of the reported data for postal services as this service is

fragmented across various departments.

Cleaning costs of £26.80/m2 are 15% higher than the all-Wales average. However, this figure shows a

reduction in costs from 2003-04 of £29.35/m2, whilst the audit scores against the National Standards

of Cleanliness for all hospitals are unchanged.




sites.

Telecomsservice

Cleaningservices

Cateringservices

Laundry

& Linen

services

Securityservices

Porteringservices

Postalservices

Totals

FM Costs (£) 483,911 2,096,814 2,137,434 562,109 215,836 1,173,676 3,408 6,673,188

Trust cost (£/m²) 6.19 26.80 27.32 7.19 2.76 15.00 0.04 83.26

All-Wales cost (£/m²) 7.14 22.85 30.16 5.95 1.57 11.80 2.05 81.53


APPENDIX VIII



costs.

The chart is very similar to that produced for North Glamorgan for 2003-04. Compared with the

average profile for expenditure in 2004-05, the only significant changes are concerned with

expenditure on catering, which is 5% lower and portering and clearning services at 4% and 3% higher,

respectively.







1. The FM cost for Prince Charles Hospital has decreased significantly from £91.06/m2 in 2003-04 to

£76.01/m2. The total FM costs have increased by just over £80,000 but the reduction is due to the

occupied floor area increasing by 8,892m2.

2. The relatively high security service cost of £8.42/m2 at Mountain Ash General Hospital is consistent

with the findings for 2003-04.

3. Portering costs at St Tydfil’s Hospital are £29.62/m2, which is extremely high and a significant

increase on the figure for 2003-04. This is, in part, attributable to a reduction in occupied floor area

of 1,179m2.

Cleaning31%

Linen and Laundry8%

Catering33%

Portering18%

Security3%

Telecoms7%Postal

0%


APPENDIX VIII


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.26

APPENDIX IX


NORTH WEST WALES NHS TRUST


APPENDIX IX


1.0 Introduction














The total FM operating cost reported by North West Wales for 2004-05 has increased by £565,506

(5%) compared with 2003-04. The cost/m2 has increased by 6% to £80.58/m2, with no significant

change in occupied floor area, making it marginally less than the all-Wales average.

As with the data supplied for 2003-04, only £15,000 has been reported for the Trust expenditure on

security services. This figure, which was allocated to Ysbyty Gwynedd, was queried with the Trust, and

is considered to be unreliable. It is reported that only 120 security incidents occurred at Ysbyty

Gwynedd, and of these only 7 were assaults against staff. There were no security incidents reported

for 5 other hospitals and 64 incidents reported for the remaining 7 hospitals.




sites.


costs.

The chart is very similar to that produced for North West Wales for 2003-04, the most notable change

being a 2% increase in the allocation for catering services. Compared with the average profile for

Telecomsservice

Cleaningservices

Cateringservices

Laundry

& Linen

services

Securityservices

Porteringservices

Postalservices

Totals

FM Costs (£) 1,167,922 2,241,830 4,486,772 712,000 15,000 1,145,038 284,260 10,052,822

Trust cost (£/m²) 9.36 17.97 35.96 5.71 0.12 9.18 2.28 80.58

All-Wales cost (£/m²) 7.14 22.85 30.16 5.95 1.57 11.80 2.05 81.53


expenditure in 2004-05, the allocation for cleaning services and portering services are 6% and 3%

lower respectively, with 8% and 3% more being spent respectively on catering and

telecommunications services.







❖ Aggregate 4 - Leased and fully serviced by the Landlord




1. Comparisons of the costs for each hospital show that Ffestiniog Memorial Hospital has FM costs of

£160.05/m2, higher than the other hospitals within the Trust.

2. The cleaning cost of £2,245,830 is almost identical to that reported in 2003-04 of £2,241,836.

However, it would appear that there was an error with the 2003-04 data for at least one of the sites,

which has impacted upon the accuracy of the data.

3. Portering service costs of £9.11/m2 calculated for Ysbyty Gwynedd are the second lowest in Wales

for an acute hospital and, as with the report for 2003-04, second only to the University Hospital of

Wales.

4. Cleaning costs for Ysbyty Glan Clwyd are £33,993 less than for 2003-04, representing a cleaning cost

of £16.35/m2 that is the lowest calculated for 2004-05.

APPENDIX IX


Cleaning22%

Postal3% Telecoms

12%Security

0%

Portering11%

Catering45%

Linen and Laundry7%


APPENDIX IX


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APPENDIX X


PEMBROKESHIRE & DERWEN NHS TRUST

1.0 Introduction














The total FM operating cost reported by Pembrokeshire & Derwen for 2004-05 has decreased by

£442,025 (9%) compared with 2003-04. However, in conjunction with a considerable reduction in

reported occupied floor area of 11,920m2 (17%), there has been an increase in cost/m2 to £81.92/m2,

bringing it very close to the all-Wales average for 2004-05.

The FM cost of cleaning services has increased by 17%. This significant increase has caused it to rise

further above the all-Wales average for 2004-05. There has also been a considerable increase in FM

cost for laundry & linen services. The rise of 31% takes the cost from below the all-Wales average for

2003-04 to above the all-Wales average for 2004-05.




sites.


costs.

Compared with the chart produced for Pembrokeshire & Derwen for 2003-04, the most notable

differences are that catering services account for 2% less and laundry & linen 3% more of the budget.

APPENDIX X


Telecomsservice

Cleaningservices

Cateringservices

Laundry

& Linen

services

Securityservices

Porteringservices

Postalservices

Totals

FM Costs (£) 445,136 1,576,541 1,438,298 493,675 46,000 623,479 62,600 4,685,729

Trust cost (£/m²) 7.78 27.56 25.15 8.63 0.80 10.90 1.09 81.92

All-Wales cost (£/m²) 7.14 22.85 30.16 5.95 1.57 11.80 2.05 81.53


APPENDIX X


Compared with the average profile for expenditure in 2004-05, the allocation for cleaning services and

laundry & linen services are 6% and 4% higher respectively, with 6% less being spent on catering

services.





❖ Aggregate 3 – Leased and fully serviced by the NHS Trust



1. The major development of the South Pembrokeshire Hospital is reported to have prevented the

submission of any data for the site for the period 2004-05.

2. The cost of laundry and linen services for Withybush General Hospital has increased by £99,671

from the figure reported for 2003-04. This sharp increase, together with slight increases in costs for

catering and portering services, has counteracted the significant reduction in cleaning and postal

services and has raised the FM cost for the hospital marginally from the rate for 2003-04. The FM

costs of the new Psychiatric MI Units are reported to be included with the data for Withybush

General Hospital, preventing meaningful comparisons.

3. The overall cost of FM services at St David’s Hospital is £346.63/m2, more than three times that

calculated for 2003-04. Although total FM costs have decreased slightly, this disproportionately

high rate reflects a major reduction in the reported occupied floor area of 14,080m2 (70%), and

clearly raises concerns about the applicability and/or accuracy of the data provided.

4. Only St David’s Hospital is reported to have a dedicated security service, with other hospitals having

security tasks included with the porters duties.

Cleaning34%

Linen and Laundry11%

Catering31%

Portering13%

Security1% Telecoms

9%

Postal1%


APPENDIX X


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APPENDIX XI


PONTYPRIDD & RHONDDA NHS TRUST

APPENDIX XI


1.0 Introduction














The total FM operating cost reported by Pontypridd & Rhondda for 2004-05 has increased by

£442,025 (6%) compared with 2003-04. In conjunction with a slight reduction in occupied floor area

of 2,083m2, these changes have marginally increased the cost/m2, which is now £23.37/m2 above the

all-Wales average for 2004-05.

The only service area where the calculated FM cost is less than the all-Wales average for 2004-05 is

telecommunications. As with the figures for 2003-04, all other FM service costs have exceeded the

respective all-Wales average. Most significantly, the costs for cleaning and portering both exceeded

the all-Wales averages by almost 23%.



type. Telecommunications costs have been included on a Trust basis and not allocated to individual sites.


costs.

Compared with the chart produced for Pontypridd and Rhondda for 2003-04, the most notable

changes are the reduction in expenditure on telecommunication services of 7%, and the increase of

Telecomsservice

Cleaningservices

Cateringservices

Laundry

& Linen

services

Securityservices

Porteringservices

Postalservices

Totals

FM Costs (£) 471,357 2,484,755 3,618,108 637,490 141,901 1,287,913 192,738 8,834,262

Trust cost (£/m²) 5.60 29.50 42.96 7.57 1.68 15.29 2.29 104.90

All-Wales cost (£/m²) 7.14 22.85 30.16 5.95 1.57 11.80 2.05 81.53


5% and 3% for cleaning and portering services respectively. Compared with the average profile for

expenditure in 2004-05, the allocation for catering services is 4% higher, whereas it is 4% less for



3.1 Sites included for the 2004-05 EFPMS were as follows::



❖ Aggregate 2 – Freehold, all other properties




1. All service area costs reported for Ysbyty George Thomas have increased considerably and, in

conjunction with a slight reduction in occupied floor area of 248m2 (5%), have contributed to the

very high total FM cost of £185.31/m2.

2. Apart from the cleaning cost of £18.44/m2 for Pontypridd and District Hospital, all other hospitals

are well in excess of the all-Wales average, ranging from £26.14/m2 at Dewi Sant to the extremely

high figure of £76.19/m2 at Ysbyty George Thomas. The Royal Glamorgan Hospital figure of

£29.96/m2 remains one of the highest for acute hospitals in 2004-05. Concerns have been raised

with the Trust regarding the applicability and/or accuracy of the available data.

3. Portering costs for 2004-05 vary considerably, from the extremely low figure of £4.71/m2 at

Pontypridd and District Hospital to a high figure of £21.88/m2 at Llwynypia Hospital. However,

Llwynypia Hospital delivers its services from nine separate buildings and this, along with additional

office accommodation, is understood to contribute to the relatively high costs of a range of

services provided.

APPENDIX XI


Cleaning28%

Postal2% Telecoms

5%

Security2%

Portering15%

Catering41%Linen and Laundry

7%


APPENDIX XI


4. Catering costs of £44.46/m2 at Royal Glamorgan Hospital are 32% higher than the all-Wales average

for 2004-05 and contribute to the overall FM cost for the hospital of £106/m2, one of the highest

of the acute hospitals in 2004-05.

5. The East Glamorgan site has been sold by the Trust, and no data was provided for the 2004-05

report.

APPENDIX XI


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APPENDIX XII


POWYS LOCAL HEALTH BOARD

1.0 Introduction











2.1 A breakdown of the total reported costs associated with FM for the LHB is set out in Figure 1. Also



The Local Health Board, treated as a Trust within this report, has an advantage over the other Trusts

because it operates ten similar sites thus allowing it to compare their individual performance.

The total FM operating cost reported by Powys LHB for 2004-05 has increased by £91,070 (3%)

compared with 2003-04. In conjunction with a sizable increase in occupied floor area of 5,963m2,

these changes have resulted in a considerable reduction in the total FM cost/m2 rate. This is now

£68.21/m2, which is £16.96/m2 less than last year’s figure and considerably less than the all-Wales

average of £81.53/m2.

The LHB cleaning cost has dropped by £57,847 compared with 2003-04. This results in a cleaning FM

cost of £24.58/m2, that is 8% above the all-Wales average for 2004-05, whereas portering service cost

at £7.96/m2 is 33% below the all-Wales average.

Security costs for 2004-05 have been provided for only 4 sites and total £1,006. This figure is less than

reported for 2003-04 and appears to be unrealistically low but, following a data check, was confirmed

by the LHB as accurate. The number of security incidents has also decreased from those reported in

2003-04, from 75 incidents to 55.

Telecommunications costs have been included on a Board-wide basis and not allocated to individual

sites.

APPENDIX XII


Telecomsservice

Cleaningservices

Cateringservices

Laundry

& Linen

services

Securityservices

Porteringservices

Postalservices

Totals

FM Costs (£) 371,975 1,143,042 1,325,173 267,517 1,006 370,226 65,367 3,544,306

Trust cost (£/m²) 8.00 24.58 28.49 5.75 0.02 7.96 1.41 68.21

All-Wales cost (£/m²) 7.14 22.85 30.16 5.95 1.57 11.80 2.05 81.53

Figure 1: LHB facilities information

APPENDIX XII



costs.

Compared with the chart produced for Powys LHB for 2003-04, the most notable differences are that

cleaning services account for 3% less and laundry & linen 2% more of the budget. Compared with the

average profile for expenditure in 2004-05, the allocation for cleaning services is now 4% higher,

whereas 4% less was spent on portering services.





3.2 Details of all the individual LHB facility functions costs on a site-by-site basis are shown in Figure 3.


1. Overall FM costs at Victoria Memorial Hospital of £127.86/m2 are high in comparison with the other

hospitals within the Board.

2. The cleaning costs calculated vary between hospital sites from a high £57.60/m2 at Montgomery

County Infirmary to a very low £7.50/m2 at Bronllys Hospital. Bronllys Hospital was calculated at

£12.16/m2 for 2003-04 but a reported drop in costs of £57,847, in conjunction with an increase in

occupied floor area of 2,965m2, has contributed to the unrealistically low rate for 2004-05.

3. The overall low portering service FM cost of £7.96/m2 is developed from rates that vary between

£6.18/m2 at Broddyfi Community Hospital and £15.46/m2 at Llanidloes and District Hospital.

4. Postal costs of £23,584, submitted for Brecon War Memorial Hospital, equate to 36% of the Board’s

total reported postal cost and, as with the data submitted for 2003-04, appear to be

disproportionately high.

Cleaning32%

Linen and Laundry8%

Catering38%

Portering10%

Security0%

Telecoms10%

Postal2%


APPENDIX XII


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001,

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6.00

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67.0

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0046

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68.2

1


APPENDIX XIII


SWANSEA NHS TRUST

APPENDIX XIII


1.0 Introduction














The total FM operating cost reported by Swansea for 2004-05 has increased by £400,954 compared

with 2003-04. This makes the facilities cost of £81.14/m2, for the Trust, £1.56/m2 higher than last year

but once again very close to the all-Wales average.

Portering services at £12.88/m2 continue to be the only core service area where cost significantly

exceeds the all-Wales average, whilst the costs for other service areas are very close to their respective

all-Wales average.

The increase in laundry and linen service costs of almost 19% is reported to be due largely to a

significant increase in patient/hospital activity.




sites.


costs.

Telecomsservice

Cleaningservices

Cateringservices

Laundry

& Linen

services

Securityservices

Porteringservices

Postalservices

Totals

FM Costs (£) 1,382,429 4,368,808 5,818,239 1,040,682 200,805 2,499,373 434,137 15,744,473

Trust cost (£/m²) 7.12 22.52 29.99 5.36 1.03 12.88 2.24 81.14

All-Wales cost (£/m²) 7.14 22.85 30.16 5.95 1.57 11.80 2.05 81.53


APPENDIX XIII


The cost breakdown for the Trust is very close to the all-Wales average profile for 2004-05, with the

largest difference being a 2% above average allocation for portering services. There appear to be no

major differences with the chart produced for Swansea for 2003-04, other than a 2% reduction for






❖ Aggregate 2 – Freehold, all other properties



1. The significant difference between the portering costs at Singleton Hospital and Morriston Hospital

reported for 2003-04 is repeated this year. The rates are £12.27/m2 and £19.76/m2 respectively.

2. Singleton Hospital continues to be the only major acute hospital site in Wales for which there is no

account of a formal security service being provided.

Cleaning28%

Postal3%

Telecoms9%

Security1%

Portering16%

Catering36%

Linen and Laundry7%


APPENDIX XIII


Figu

re 3

: Fac

iliti

es e

xpen

ditu

re

Sit

eN

ame

Ho

spit

alT

ype

Tel

eco

ms

(Tru

st-w

ide)

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(£)

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²)

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81.1

4

APPENDIX XIV


VELINDRE NHS TRUST


APPENDIX XIV


1.0 Introduction














There has been a reduction of over £1m in total FM costs reported by Velindre, from almost £2.8m to

just over £1.9m, due almost entirely to a reduction in telecommunication service costs. The FM cost

for 2004-05 is £56.70/m2, which is over 30% less that the all-Wales average.

Compared with the data for 2003-04, every FM service cost average has increased, with the exception

of telecommunications and postal services. However, these services still remain well below the

respective all-Wales average. This is of general interest only, as the specialist nature of the Trust is

understood to account for the considerable departure from the national averages for most of the

services, making cost comparisons with other Trusts inappropriate.

Telecommunications costs have been included on a Trust basis and not allocated to individual sites.


costs.

The large reduction in the telecommunications component of the FM breakdown for Velindre NHS

Trust, from 48% in 2003-04 to 13% for 2004-05, has radically altered the chart. Due to the specialist

nature of the Trust, the comparison is expected to be only of on-going interest for this Trust.

Telecomsservice

Cleaningservices

Cateringservices

Laundry

& Linen

services

Securityservices

Porteringservices

Postalservices

Totals

FM Costs (£) 257,368 383,931 456,079 76,137 163,791 344,885 246,803 1,928,994

Trust cost (£/m²) 7.56 11.28 13.41 2.24 4.81 10.14 7.25 56.70

All-Wales cost (£/m²) 7.14 22.85 30.16 5.95 1.57 11.80 2.05 81.53




❖ 1 Individual hospital site


❖ Aggregate 2 - Freehold, all other properties




1. The anomaly encountered last year with the extraordinarily high telecommunication services cost

for the Trust appears to have been resolved, as the figure of £7.56/m2 for this year comes out only

slightly above the estimated all-Wales average of £7.14/m2.

2. The Trust expenditure for cleaning services in 2004-05 has increased by over £100k for a similar

occupied floor area as 2003-04. This is understood to be due to the cleaning costs associated with

Health Solutions Wales, which are now part of the Trust, along with an increase in costs for Velindre

Hospital. The cleaning audit score submitted for Velindre Hospital in 2004-05 remained at 92%.

3. With postal service costs approaching £200k for 2004-05, they continue to feature as a highly

significant proportion of the total FM expenditure.

APPENDIX XIV


Cleaning20%

Linen and Laundry4%

Catering24%

Portering18%

Security8%

Telecoms13%

Postal13%


APPENDIX XIV


Figu

re 3

: Fac

iliti

es e

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ditu

re

Sit

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ame

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spit

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(Tru

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(£)

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APPENDIX XV

Occupancy costs for different hospital types

APPENDIX XV


Fixed Costs £/m² rate Cost of Occupancy £/m² rate

Capital Charges Unknown Fixed Asset Costs 0.52

Taxes Unknown

Leases (Cost) 2.12

Leases (Income) 1.59 Operational Costs 51.48

Fixed Asset Cost 0.52 Annual Cost 52.00

Variable Costs 1

Electricity 5.57

Prime Energy 6.35

Water/Sewage 4.21

Telephone 7.54

Waste Disposal 2.86

Sub-Total 26.53

Engineering & Building 24.45

Ground & Gardens 0.51

Operational Cost 51.48

Variable Costs 2

Cleaning 26.04

Catering 35.03

Portering 16.07

Laundry 8.20 Cost Serviced Space £/m² rate

Security 1.54

Postal 2.86 Cost of Occupancy 52.00

Sterile Services 5.96

EBME 5.87 Service Costs 101.56

Sub-Total 101.56 Annual Cost 153.56

ACUTE HOSPITALSFixed Assets, Operational Costs & Cost of Occupancy Summary

(Based on the 2004-05 EFPMS Returns)

APPENDIX XV




Taxes Unknown

Leases (Cost) 2.12



Variable Costs 1

Electricity 4.05

Prime Energy 9.36

Water/Sewage 4.76

Telephone 7.54

Waste Disposal 2.26

Sub-Total 27.98




Variable Costs 2

Cleaning 30.98

Catering 40.42

Portering 12.90


Security 2.05





MINOR ACUTE HOSPITALSFixed Assets, Operational Costs & Cost of Occupancy Summary


APPENDIX XV




Taxes Unknown

Leases (Cost) 2.12



Variable Costs 1

Electricity 4.33

Prime Energy 8.38

Water/Sewage 2.37

Telephone 7.54

Waste Disposal 2.21

Sub-Total 24.83




Variable Costs 2

Cleaning 31.40

Catering 44.56

Portering 12.51


Security 0.99





COMMUNITY HOSPITALSFixed Assets, Operational Costs & Cost of Occupancy Summary


APPENDIX XV




Taxes Unknown

Leases (Cost) 2.12



Variable Costs 1

Electricity 3.41

Prime Energy 6.50

Water/Sewage 2.37

Telephone 7.54

Waste Disposal 1.85

Sub-Total 21.68




Variable Costs 2

Cleaning 31.24

Catering 38.58

Portering 7.40


Security 1.66





PSYCHIATRIC HOSPITALSFixed Assets, Operational Costs & Cost of Occupancy Summary


APPENDIX XVI

Cost comparison of individual FM services


APPENDIX XVI


Tru

stN

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a

(£/m

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(£/m

²)(£

/m²)

(£/m

²)(£

/m²)

(£/m

²)(£

/m²)

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The

leve

l of

exp

endi

ture

on

faci

litie

s se

rvic

es a

lone

doe

s no

t re

flect

the

per

form

ance

of

serv

ice

deliv

ery.

How

ever

, it

is a

hel

pful

ind

icat

or w

hen

used

to

com

pare

the

exp

endi

ture

of

sim

ilar

orga

nisa

tions

and

dra

w a

tten

tion

to p

oten

tial s

avin

gs a

nd t

he a

lloca

tion

of r

esou

rces

for

opt

imum

perf

orm

ance

. Hen

ce, o

bser

vatio

ns h

ave

been

mad

e on

the

avai

labl

e EF

PMS

data

and

the

info

rmat

ion

has

been

pre

sent

ed t

o en

able

ben

chm

arki

ng a

nd, w

here

ver

poss

ible

, the

sha

ring

of g

ood

prac

tice.

A s

umm

ary

of t

he c

alcu

late

d co

sts

for

each

FM

ser

vice

is p

rovi

ded

belo

w t

o al

low

com

paris

on w

ith

all-W

ales

ave

rage

s de

rived

fro

m t

he r

epor

ted

data

for

200

4-05

.

© Copyright Welsh Health Estates 2005

All Rights Reserved. No part of this publication may be

reproduced, stored in a retrieval system, or transmitted, in any

form or by any means, electronic, mechanical, photocopying,

recording or otherwise without the prior permission of the

copyright owner.

Cover photographs by Welsh Health Estates.

Designed by Keith James Design Associates.

Printed by Integrated Graphics Ltd., Barry

Front Cover photographs:

1, St. Cadoc’s Hospital, Caerleon

2, Reproduced with kind permission of

North Glamorgan NHS Trust

3, Royal Glamorgan Hospital, Llantrisant

4, Royal Glamorgan Hospital, Llantrisant

Back Cover photographs:

5, Cancer Treatment Centre –

Ysbyty Glan Clwyd

6, Welshpool Community Hospital

PO Box 182,

Bevan House, 24-30 Lambourne Crescent, Llanishen

Cardiff CF14 5GS

PO Box 182,

Ty Bevan, 24-30 Cilgant Lambourne, Llanisien

Caerdydd CF14 5GS

1

2 3

5 6

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the nhs estate in wales

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