Contact: Martha Fowler-Dixon, Strategic Commissioning Director (Learning Disabilities).[email protected] 01962 847257

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 Southampton City and Hampshire Primary Care Trusts and their District Councils be welcomed.

1.2 That participation in the South West Hampshire NHS 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, namely Christine Buckett and Kevin Gardner, appointed by the Head of Corporate and Legal services are authorised to sign the Strategic Partnering Agreement.

1.5 That Richard Ellis, Assistant Director, Commissioning, Partnerships and Provisions is the named representative on the Strategic Partnering Board who reserves the right to nominate a deputy

2. Background

2.1 This report follows the report called "Participation in Southwest Hampshire Local Improvement Finance Trust" (to the Executive Member for Social Services of 28 October 2005) which set out the early processes necessary to set up the LIFT company. The following decisions were made: -

2.1.1 That Hampshire County Council become a partner in Southwest Hampshire LIFT at level 2 without exclusivity, and is listed as such in the Official Journal of the European Union ("OJEU")which will invite private sector partners to tender for Southwest LIFTco.

2.1.2 That the draft Memorandum of Information and the OJEU notice be approved

2.1.3 That the Director of Adults Services be given delegated authority to agree and approve any amendments to the final version of the OJEU and Memorandum of Information subsequent to the date of this decision day.

2.1.4 That the South West LIFT Strategic Services Delivery Plan (SSDP) version 4.1 be approved and that authority is delegated to the Director of Adult Services to agree and approve any amendments to the final version subsequent to this decision day.

2.1.5 That approval is given to the procurement regime as outlined in this report

2.1.6 That the South West Hampshire LIFT Scheme of Delegation and Project Board Terms of Reference are approved.

3. Reason

3.1 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. A LIFT company has been formed and will create a 20-25 year partnering agreement. Phase One schemes include development of a Primary Care delivery centre (Walk-in Centre, Out of Hours service, GP Services, Community Services, Muscular-skeletal services, Chronic disease management, Direct access basic X-ray and diagnostics, mobile diagnostics and pharmacy and the SCPCT Headquarters) and an Adult Mental Health In-patient Unit at the Royal South Hants Hospital in Southampton (50 acute beds, 10 intensive care beds, ECT, therapy).

3.2 Participation in the LIFT company will enable the County Council to progress initiatives that support the Corporate Strategy to maximise well-being through the delivery of high quality healthcare facilities, in partnership with NHS Colleagues and private sector partners.

3.3 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.

4. Other options considered and rejected.

4.1 No involvement

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

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

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

5.1 None

6. Dispensation granted by the Standards Committee

6.1 None

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

7.1 Financial closure is sought by 8 February 2008.

Approved by: Date of decision: 18 January 2008

Councillor Felicity Hindson

Executive Member for Adult Social Care

Contact: Martha Fowler-Dixon, Strategic Commissioning Director (Learning Disabilities) [email protected] 01962 847257

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 Southampton City and Hampshire Primary Care Trusts and their District Councils be welcomed.

1.2 That participation in the South West Hampshire NHS 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, namely Christine Buckett and Kevin Gardner, appointed by the Head of Corporate and Legal services are authorised to sign the Strategic Partnering Agreement.

1.5 That Richard Ellis, Assistant Director, Commissioning, Partnerships and Provisions is the named representative on the Strategic Partnering Board who reserves the right to nominate a deputy

2. Background

2.1 Southampton City and Hampshire Primary Care Trusts were awarded LIFT status in 2005. These means that they have approval to form a company with a private sector partner to enable the building of high quality healthcare facilities.

2.2 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. It is the only source of new capital available to these Primary Care Trusts

2.3 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.

2.4 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

2.5 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.

2.6 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. This fund has been utilised to enable the first schemes to progress.

2.7 NHS Estates are also involved with LIFT and provide project support to the production of a Strategic Service Delivery Plan (SSDP) which is the first stage of the LIFT process. Work on the SSDP has resulted in development of the two schemes below.

3. Schemes to be built by the LIFT company

3.1 West Southampton Primary Care Delivery Centre (WPCDC).

Scheme includes:

· Walk-in centre

· Out of hours services

· GP and enhanced services

· Community services

· Muscular-skeletal services

· Chronic disease management

· Direct access basic x-ray and diagnostics

· Mobile diagnostic facilities

· Pharmacy

· SCPCT Headquarters

3.2 Adult Mental Health In-patient Unit

Scheme includes:

· 50 acute mental health beds (two wards of 15

· beds and two areas of 10 beds)

· One 10-bed psychiatric intensive care unit

· A place of safety

· An ECT suite

· Central therapy areas

· Internal and external recreation areas

· Individual ward gardens

· Improved staff facilities

· Modern catering arrangements

· Guest accommodation

· Home Treatment Service

4. Local progress to date

4.1 Since the approval of LIFT status, a LIFT Project Board has been established, led by Southampton City and Hampshire PCT's with representation from Hampshire County Council, South Central Ambulance NHS Trust, Southampton University Hospitals Trust, Winchester and Eastleigh Healthcare NHS Trust, Southampton City Council, Eastleigh Borough Council, Winchester City Council, Basingstoke and Deane Borough Council, Hampshire Partnership Trust. This group has overseen all aspects of the development of the LIFTco

4.2 A Strategic Service Development Plan has been produced and signed off by all the partners.

4.3 The next phase is to prepare the Strategic Partnering Agreement which has to be signed by all the partners. Approval of this report will provide the evidence and audit trail to confirm the level of County Council involvement in this LIFT company and authorises two officers appointed by the Head of Corporate and Legal services to sign the strategic partnering agreement.

5. Issues for HCC and Local People

5.1 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 west Hampshire.

5.2 The new primary care delivery centre will provide a range of modern health care facilities. Improved local diagnostic facilities will support provision of care closer to home and will shorten the patient pathway for some procedures.

5.3 Current mental health facilities are old and out of date. The new facility will significantly improve the quality of in patient care. This reprovision also supports remodelling of services. This will strengthen assertive outreach teams and increasing the availability of community-based perinatal mental health staff; and establish early intervention in psychosis services. These changes will improve the treatment and support that service users receive. This will not only benefit the service user but also primary care as it will provide appropriate treatment out of the hospital environment and closer to the patient's home. Crisis resolution and home treatment services will lead to a reduction in the number of admissions to acute psychiatric hospitals and also reduce length of stay for those admitted due to provision of intensive levels of support once people are discharged.

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

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

5.5.1 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.

5.5.2 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 does not require accommodation in any of the early schemes.

5.5.3 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. This approach has already been adopted by the County Council in formal agreement with the Southeast Hampshire LIFTco.

5.5.4 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.

5.5.5 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 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 Southampton City and Hampshire Primary Care Trusts be welcomed.

6.2 That participation in the Southampton City and Hampshire 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

NONE