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Health board estate in need of maintenance

THE NORTH Wales health board is to write to Welsh Government to make clear the need for support in bringing its ageing buildings, including Wrexham Maelor Hospital, up to standard.

Betsi Cadwaladr University Health Board members were given a presentation on the authority’s Estates Strategy at their by-monthly meeting, by interim executive director of finance Stephen Webster.

Concerns were highlighted that parts of the estate are not meeting fire safety standards and other statutory requirements.

According to 2021-22 data in the report, 62 per cent of the health authority’s buildings are sound, operationally safe and exhibiting only minor deterioration, against an average of 78 per cent across Wales as a whole. The authority is aiming for 90 per cent.

Figures in the report show the authority’s buildings are lower than the national average and 90 per cent target for statutory compliance, fire safety compliance, and functional suitability.

The strategy, which has been updated for the first time since 2019 states: “On average, physical condition and statutory compliance of the estate has got worse since the 2019 Estate Strategy.

“In particular, the Abergele Hospital, Maelor Hospital, Royal Alexandra Hospital, and Ysbyty Gwynedd sites are in poor condition with low levels of compliance.”

It adds: “In particular, Bryn-Y-Neuadd, Abergele and Wrexham Maelor estate all have low levels of functional suitability.”

Wrexham Maelor Hospital

The health board’s estate has a total backlog maintenance cost of £348m with approximately 73 per cent of the total backlog attributed to its three acute hospitals, which includes the Maelor in Wrexham.

The strategy report adds: “Total backlog costs have increased significantly since the 2019 Estate Strategy (from £142m to £348m).

“Maintenance Backlog is the cost to bring estate assets that are below acceptable standards (either physical condition or compliance with mandatory fire safety requirements and statutory safety legislation) up to an acceptable condition.”

The report states that Wrexham Maelor Hospital has the second highest backlog maintenance in the health board’s estate and that the age and resilience of the engineering infrastructure is a concern.

High percentages of its occupied floor area are not compliant with statutory requirements, and are not functionally suitable. The design and layout of the Maelor also presents infection prevention and control risks, and does not comply with current guidance or support efficient working and new models of care.

But there are plans for investment with the Wrexham Maelor Hospital Continuity Programme, currently at full business case stage on the health board’s Capital Programme, which aims to address key infrastructure issues.

In supporting the strategy, chair of the health board Mark Polin called for colleagues to make the starkness of the situation clear to Welsh Government.

Cllr Mark Polin

He said: “Are we confident that we, the board, have adequately laid out to Welsh Government the scale of the challenge we are facing in terms of, if nothing else, our inability to meet statutory requirements, fire safety requirements, which expose us to risks that should be properly set out to Welsh Government and shared?

“I think we need to start briefing stakeholders in terms of the scale of the challenge we face in this regard because as the report identifies, at the outermost limit, the maintenance backlog is now £350m and our reliance on revenue to offset the decline in capital and address the risks is increasing significantly.”

He added: “We are now facing a very toxic situation for want of a better description which will lead to some very difficult decisions being made.”

The health board’s interim chief executive Gill Harris said the Welsh Government had been made aware of individual parts of the estate in need of upgrading, but that this was an opportunity to present the overall picture.

She added: “It is now an opportunity for us to set those out in a letter, correspondence to Welsh Government articulating the risks we have across the health board.

“Clearly we have had conversations with them about individual elements of this plan, I think this now offers an opportunity to put it in the round.”

This proposal was supported by board members, along with the Estates Strategy.