Contact: Nicky Pendleton Partnership manager (South East)01329 82 4121

1 Summary The following decisions are sought:-

1.1 That the opportunity to become a partner in the formation of an NHS LIFT company with East Hants and Fareham and Gosport Primary Care Trusts and their District Councils be welcomed.

1.2 That participation in the East Hampshire and Fareham and Gosport LIFT (Local Improvement Finance Trust) at level 2- which is to Agree to be a Participant in the Strategic Partnering Agreement (SPA) (without exclusivity) be formally agreed.

1.3 That the County Council works in partnership with the Primary Care Trusts (PCT's), local District councils and others to implement phase one schemes and to develop proposals for future schemes.

1.4 That the two officers appointed by the Head of Corporate and Legal services are authorised to sign the Strategic Partnering Agreement.

2 Reason

The NHS LIFT process has been introduced to stimulate investment in local primary and social care facilities, and to ensure delivery of the NHS plan targets for modernising primary care through capital development. The East Hants and Fareham and Gosport PCT's are the first in Hampshire to be awarded LIFT status as one of 24 schemes approved nationally in the third wave approved in August 2002. A LIFT company is being formed and will create a 20-25 year partnering agreement. Phase One schemes include development of a community health campus in Havant (with up to 140 beds, out of hours and minor injury services, diagnostic and treatment facilities.) and primary care centres at Havant, Cowplain and Rowner where integrated primary and social care services are planned.

Participation by the County Council in the Strategic Partnering Agreement gives the right to include future arrangements for social care premises in the LIFT but without an obligation to do so.

Sign up to the Strategic Partnering Agreement means that the County Council is named as a Contracting Authority in the OJEC (Official Journal of European Communities) notice which provides a stronger commercial offering to private sector partners so making the LIFT more attractive to high quality private partners

3. Other options considered and rejected.

3.1 No involvement

3.2 Taking a lease plus agreement in respect of individual premises without signing the Strategic Partnering Agreement

3.3 Taking up shares in joint venture company (Liftco) to be establishes to take the East Hants and Fareham and Gosport LIFT forward.

4. Conflicts of Interest declared by the decision-maker or a Member or Officer consulted

4.1 None

3 Dispensation granted by the Standards Committee

5.1 None

4 Reason(s) for the matter being dealt with if urgent

Not applicable

Approved by: Date of decision:

Councillor Felicity Hindson

Contact: Nicky Pendleton Partnership manager (South East Hants) 01329 824121

Purpose of the Report

To agree Hampshire County Council participation in the NHS LIFT in South East Hampshire

1 Background

East Hampshire and Fareham and Gosport Primary Care Trust have recently been awarded LIFT status as one of 24 schemes approved in a third wave nationally this August..

The NHS LIFT process has been introduced to stimulate investment in local primary and social care facilities, and to ensure delivery of the NHS plan targets for modernising primary care through capital development. (£1b investment in Primary Care/3,000 GP premises/500 new One-Stop Centres) It is the only source of new capital available to these Primary Care Trusts

LIFT is a mechanism for grouping together a number of primary and social care developments to make them attractive for public private partnerships. A LIFT company (Liftco) is formed as the Public Private Partnership vehicle for delivering the schemes.

Equity stakes in LIFTco are shared between Partners as follows,

20% Local Partners, (PCT's District and County Councils, GP's etc)

60%, Private Partners

20% Partnerships for Health

Partnerships for Health (PfH) has been established by the NHS to help deliver the LIFT process. PfH is 75% publicly owned. It has a mandate to manage the procurement process, e.g. legal and financial advice; to introduce standard templates across all schemes; and ensure schemes are commercially viable. PfH will have a 20% stake in each of the LIFT companies across the country, and provides project management support. Each LIFT is led by a Project Director, and these are nationally networked through PfP to ensure shared learning and support. Acting arrangements are in place and recruitment is underway.

PfH work closely with the NHS Private Finance Unit which holds an "enabling fund" that can be bid against to progress local schemes, for example it can be used for advanced land purchase. A local bid for approximately £4 million is being prepared by the south east LIFT.

NHS Estates are also involved with LIFT and provide project support to the production of a Strategic Service Delivery Plan which is the first stage of the LIFT process.

3. Schemes under development by the PCT's

3.1 East Hampshire schemes

Phase 1

· Oak Park Site in Havant proposals include-out of hours service, minor injury unit, child development centre, rehabilitation team base, re-provision of day assessment unit, a range of up to 140 beds for GP admissions and older people.

· Cowplain Primary Care Centre.

Phase 1A

· Havant Primary Centre

· Dunsbury Way Primary Care Centre

· Emsworth Primary Care Centre

Phase 2

Future schemes include development of Primary Care Centres to support West Waterlooville and Liss housing developments and could include facilities for a multi-agency, multi-disciplinary service for children with special needs.

3.2 Fareham and Gosport schemes

Phase 1

· Rowner primary care centre

Phase 2

· Under development, to include development of a Community Hospital on the Coldeast site and other primary care centres including Fareham where the county council has an area office.

4. Local progress to date

Since the approval of LIFT status in August there has been rapid progress. A LIFT Project Board has being established, led by East Hants PCT with senior representation from both PCT's, Hampshire County Council, the Hampshire and Isle of Wight Strategic Health Authority, Fareham, Gosport, Havant and East Hants District Councils, GP's and potentially other professional groups (dentists, pharmacists, therapists etc.) This group will oversee all aspects of the development of the LIFTco

A LIFT Project Group has been established to ensure the milestones are achieved, which includes production of the strategic service delivery plan, briefing of partner authorities, staff and the public.

Other individual project groups have been established to progress each scheme. Representatives of the social services department are participating in these groups. These have focused on developing the vision for primary care teams including care management, district nurses, therapists, podiatrists dentists and others.

A challenging timetable has been established to ensure Phase 1 schemes commence construction by December 2003.

The first milestones are that by December 2002 a Strategic Service Development Plan will have been produced and signed off by all the partners and that the Strategic Partnering Agreement will be signed by all the partners.

5. Issues for the County Council

This is an exciting opportunity for the County Council to work jointly with health colleagues and others to develop and build new facilities for the population of south east Hampshire. A modern primary care centre will provide services which will include general practitioner services enhanced and modernised to include a range of locally based integrated specialist clinics, for example pain management, dermatology; sports injuries. Provision of modern diagnostic facilities and IT links to acute hospital specialists will mean that patients consulting the primary care team can have their problem investigated, diagnosed and treatment commenced in one place. Patients will be able to book appointments requiring a consultant opinion at a time convenient to themselves, or obtain relevant health information to through IT links from the primary care centre. The centre could also provide a pharmacy with the opportunity for expert review of medication, facilities for the multi disciplinary rehabilitation or enablement team including care managers, district nurses and therapists, timely access to equipment and advise; podiatry and community dental services, and nurse and therapy led clinics. Accommodation could also be provided for other relevant services such as citizens advice, the pensions agency, a carers centre and so on.

Whilst many of the initial schemes are predominantly primary care facilities, the emerging concept is of a unified multi agency multi disciplinary team providing integrated services from local centres. LIFT provides the means to provide our staff with the high quality, serviced accommodation in modern facilities. As LIFT unfolds over the next ten years more health and social care schemes can be developed to take forward the integration and partnership agenda.

All the partnering documents have been reviewed by the County Council Legal department.

A range of options for involvement by local authorities are available, these are;-

5.1 No involvement at all. This has been rejected as there potentially many schemes likely to emerge over the life of the LIFT partnership which could last at least 20 years and other options offer involvement without financial risk or commitment.

5.2 To take up a lease plus agreement in respect of individual premises without signing the Strategic Partnering Agreement. This option offers a traditional lease plus flexible serviced accommodation, normally for 20 years. This option has been rejected at this stage since the County Council is not requiring significant accommodation in any of the early schemes.

5.3 To agree to be a participant in the Strategic Partnering Agreement (SPA) without exclusivity) This option is recommended because the County Council would be largely reserving its position, giving itself the right to include future arrangements for social care within the LIFT but without an obligation to do so. The Strategic Partnering Agreement sets out a framework for the long term relationship with the Liftco. This relationship includes committing to participation in the Strategic Partnering Board and reserving a right to require Liftco to enter into lease plus arrangements, without a commitment to do so. It does not require the County Council to make any financial commitment.

5.4 To be a participant in the Strategic Partnering Agreement with exclusivity.

This option is not recommended because the County Council would be obliged to put new schemes to LIFT through the life of the Strategic Partnering Agreement.

5.5 To take up shares in the joint venture Liftco

This is not recommended because the County Council would be required to become a shareholder in the Liftco and would be a an associate member of the board that has influence over the companies operations and planning of future requirements but within the context of a private sector controlled company. It would be expected to transfer assets to the company (at a best consideration value), the excess value could be taken in cash or other forms of investment in the company.

6. Recommendations

6.1 That the opportunity to become a partner in the formation of an NHS LIFT company in East Hants and Fareham and Gosport Primary Care Trusts be welcomed.

6.2 That participation in the East Hampshire and Fareham and Gosport LIFT (Local Improvement Finance Trust) at level 2- which is to Agree to be a Participant in the Strategic Partnering Agreement (SPA) (without exclusivity) be formally agreed.

6.3 That the County Council works in partnership with the Primary Care Trusts (PCT's), local District councils and others to produce the Strategic Service Delivery Plan, to implement phase one schemes and to develop proposals for future schemes.

6.4 That the County Council authorise two officers appointed by the Head of Corporate and Legal services to sign the strategic partnering agreement.

Section 100 D - Local Government Act 1972 - Background Documents

The following documents disclose facts or matters on which this report, or an important part of it, is based and has been relied upon to a material extent in the preparation of this report.

NB the list excludes:

1. Published works

2. Documents which disclose exempt or confidential information as defined in the Act