Memorandum by The Leeds Teaching Hospitals
NHS Trust (PS 43)
1. BACKGROUND
The Leeds Teaching Hospitals NHS Trust
(i) The Trust consists of six hospital sites:
St James's, The Leeds General Infirmary, Seacroft, Chapel Allerton,
Wharfedale and Cookridge Hospitals. The annual Trust budget is
approximately £500 million. We employ approximately 15,000
staff and have approximately 3,000 beds.
(ii) The Trust was formed as a result of the
merger of the two former acute trusts in Leeds (The St James's
and Seacroft NHS Hospital Trust and The United Leeds Teaching
Hospitals NHS Trust). The decision to create the Trust was based
on the findings of a review of clinical services in Leeds which
identified a need to reconfigure and centralise clinical services
across Leeds. Following the merger and creation of the Trust in
1998 a plan was constructed to rationalise the Trust's clinical
services (the Trust Reconfiguration Strategy, TRS). Phase I—the
construction of an Oncology facility currently provided at Cookridge
Hospital, at St James's Hospital and the reprovision of Wharfedale
Hospital in the north of Leeds have received outline business
case approval and will be delivered through PFI.
2. NON-CLINICAL
SERVICES (ANCILLIARY
AND ESTATES
SERVICES)
(i) All non-clinical support services (ancilliary,
estate and industrial services) are managed by the Division of
Property and Support Services, one of eight divisions of the Trust.
The Division employs 2,700 staff and has an annual budget of £50
million. Services are provided on all Trust sites.
(ii) In common with many trusts the configuration
and operation of non-clinical support services has remained unchanged
for a considerable period. There is much scope for modernisation
and change with respect to the introduction of more flexible and
innovative working practices and reward frameworks. Recruitment
and retention of support service staff at current rates of pay
and terms and conditions, particularly within a buoyant employment
market such as Leeds, is a major problem.
3. PRIVATE SECTOR
INVOLVEMENT/CATERING
SERVICES
(i) Patient Catering Services—The Trust
has recently entered into a partnership arrangement with Tillery
Valley Foods South Wales, to provide frozen patient meals which
will be supplemented by a range of in-house products and regenerated
at ward level by ward based Trust staff. The contract value is
approximately £20 million over 10 years and includes the
construction of a receipt and distribution unit within the Trust.
Patient Catering Services have historically been provided from
traditional in-house production facilities which were expensive
to maintain. Also excessive transportation distance from production
point to the patient at ward level often resulted in poor food
quality. The decision to adopt a hybrid public/private system
in this case is based on quality and patient satisfaction with
cost being revenue neutral.
(ii) Staff Catering Services—The Trust
will shortly be reviewing current staff and visitor catering and
retail facilities provision and exploring methods of future provision.
Staff/visitor facilities at the Leeds General Infirmary are provided
by Medirest. The Trust is currently working with Medirest to rationalise
and improve the quality of service provided to staff and visitors.
With the exception of the Leeds General Infirmary all staff/visitor
services are provided in-house. An assessment of the nature of
service required, which will include a high level of staff involvement
and consultation, versus the expertise and capital necessary to
provide the required service will be made which will inform the
method of provision.
4. PRIVATE SECTOR
INVOLVEMENT—NON-CATERING
(i) Non-core Hotel Services
A range of "non-core" (non-ward/clinically
based) support services were market tested at Seacroft Hospital
several years ago. The services are provided through Initial Healthcare/Rentokil.
There is a high degree of user satisfaction with the arrangement,
which was entered into on the basis of quality as a primary concern.
Technology and expertise not available at the time of contract
award within the NHS locally was successfully made available via
the contractor.
(ii) Estates/Maintenance
Peaks and troughs in demand in building of engineering
maintenance are managed successfully by the sue of a range of
private sector contracts and contractors to supplement the in-house
estate/maintenance workforce.
5. PFI/THE TRUST
RECONFIGURATION STRATEGY
(TRS)
Phase I of the TRS, the reprovision of Oncology
Services at St James's (capital value circa £160m) and the
reprovision of Wharfedale Hospital in the North of Leeds will
be provided through PFI. Following consultation with the staff
and staff-side organisations, the Trust has decided to include
hard FM (estate services) only in this phase. This creates the
opportunity to examine current working practices and value for
money across remaining estate services and soft FM services (catering,
housekeeping, portering, transport, etc). This does not preclude
the creation of more innovative public/private partnership in
all or parts of the Trust's non-clinical support services in future.
A key issue in our future success will be the willingness of staff-side
organisations to participate in true partnership to achieve best
value for support services in supporting the Trust's core business.
November 2001
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