Shoring up the Foundations: Can Private Public Partnership (PPP) Healthcare Schemes be Better by Design?

Since the 80’s public-private partnership (PPP) procurement models emerged as the dominant form of procurement for large National Health Service projects. However, the funding model has come at a cost. It is estimated that PPP hospitals currently cost the NHS around £2 billion every year in maintenance and operational costs, which equates to more than £3,700 every minute.

Much of this onerous legacy is the result of an approach that has prioritised commercial considerations in the design and construction of the built asset, resulting in poor performance of the building and correspondingly high costs during the operational phase. Meanwhile the operational contract – typically over 25-35 years – has seemingly involved no accurate forecasting, and no cap on profits. Unitary charges are high and profit from any revenue streams, such as rental from retail units, has gone back into the PFI vehicle, rather than providing an income for the trust.

The question posed is: Can PPP Healthcare schemes be better by design?

As transformative new PPP models emerge in the UK, like the mutual investment model launched in Wales and the Scotland wide hub initiative replacing its non-profit distribution (NPD) model, significant technological advances have been made in the way design consultants develop, manage and document building design. Using case studies of healthcare facilities completed in the UK and currently ongoing in NA under the PPP procurement model, I will present how PPP healthcare schemes can be better by design.

Presentation content:

• How Design Consultants can better PPP Healthcare schemes in the UK – Case Studies: Tunbridge Wells Hospital at Pembury, South West Acute Hospital
• How Design Consultants currently better PPP Healthcare schemes in NA – Case Studies: MVH Cancer Center, Centre for Addiction and Mental Health in Canada
• What can we learn from NA for future PPP Healthcare schemes in the UK
• How BIM can transform the design and delivery of PPP Healthcare schemes