Benefits of Good PFI Contract Management for Expiry
- Steve Lawley Director of Estates and Facilities - The Dudley Foundation Group of Hospitals
Transformation is placed at the heart of the UK government's drive to improve productivity, increase efficiency, and improve outcomes across the NHS. This is reflected in the New Hospitals Programme in England, which represents a significant investment in the NHS estate and infrastructure, aimed at enabling delivery of new service models.
Healthcare providers need to understand the impact of service transformation on the scale and scope of services that will be needed in the future, to ensure that new hospital facilities are 'right-sized'. Capital investment needs to reflect the wider strategic objective of delivering care in the most appropriate location at the right time.
As an example, the James Paget University Hospitals (JPUH) Change Framework provides a programmatic approach to collating and evaluating the impact of system-wide transformation programmes and prioritising programmes that are required to deliver local and system objectives. The approach provides assurance that the new models of care and activity assumptions driving the scope, scale and size of capital investment plans are supported by operational plans. It also supports understanding of the achievability of other objectives that are delivered as part of wider programmes of work - digitalisation, net zero carbon, improved working environment, etc.
The benefits of the programmatic approach include:
- Operationalising local and system strategic goals
- Quantifying and measuring the impact of programmes on strategic objectives and providing assurance on deliverability of plans
- Enabling system-wide coordination and implementation of transformation programmes
- Strengthening system-wide governance, accountability and integration
- Facilitating a whole system approach to data analysis and population health management
- Identifying interdependencies to maximise use of resources across the system
This presentation will describe the progress JPUH (supported by Currie & Brown) has made, the challenges we have faced and the opportunities identified through taking a programmatic approach to system-wide transformation.
Panellists in this session are:
Steve Lawley, Director of Estates and Facilities, The Dudley Group NHS Foundation Trust
Martin Clark, Senior Director and UK Head of Healthcare, Currie & Brown
Jade Metcalfe, Senior Consultant, Healthcare Advisory Team, Currie & Brown
Will Brown, Assistant Director of Strategy and Transformation, James Paget University Hospitals NHS Trust
James Hackett, Programme Director, James Paget University Hospitals NHS Trust
The Procure Partnerships Framework is a compliant and flexible framework that has supported 65 NHS Foundation Trusts in the past year.
We propose to discuss estates and facilities' ability to meet the required Diagnostic capacity, Elective Recovery, Mental Health initiatives, and Net Zero targets.
We will present the Framework's expertise of best value delivering healthcare schemes with contributions by both Camden and Islington NHS Foundation Trust and South Warwickshire University NHS Foundation Trust.
Evidencing live projects in delivery under PPF that demonstrate best-in-class processes to meet the Integrated Health and Social Care System's future strategic planning requirements.
1.Framework versus Open Tender
Discussing the Framework approach versus an open tender.
o PAS91 compliant contractors and processes
o Fixed contractor rates
o Faster procurement
• Open Tender
o Unlimited pool of contractors
o Not time-limited
2.Early Decision Making
Discussing the benefits of early contractor involvement.
The following projects will frame this discussion, Highgate Mental Health Centre for Camden and Islington NHS FT and South Warwickshire University NHS FT Elective Hub.
o Contractor Engagement
o Guarantees successful procurement
o Alleviates market fluctuations
o What are the requirements?
o When in the RIBA plan of work to engage the contractor market.
3.Sustainable Development in the NHS
Discussing sustainable development across the NHS Estate?
• Net Zero
o The NHS aims to reach net zero by 2040; the ambition is to reach an 80% reduction by 2032.
o What can estates and facilities do to meet the targets?
o How can Public Sector Decarbonisation Fund monies/ grants be accessed?
• Social Value
o Requirements set out in Social Value Act 2012.
o How can the NHS implement these ideals and measures?
o What is the PPF's experience of supporting NHS Trusts in meeting Social Value targets?
Robbie Blackhurst, Framework Director, ProCure Partnerships Framework
Paul Harris, Director, Harris Associates Ltd
Health & Social Planning is at the forefront of the public's mind, brought about by the crisis over December and into the winter months as we continually saw more and more ambulances parked outside the front of A & E.
The problem is generally understood, in that we need to unblock circa 15% of beds blocked by, primarily, older people, thereby allowing the improved flow of patients through the hospital
As the government announces plans to deliver 5,000 new beds as part of wider £ 1 Billion investment strategy, we want to offer an alternative reaction to potentially the health system doing as they have always done within the context of what they already know
Our presentation builds on the conversation from the IHEEM 2020 conference presentation 'Homes in the Park' in which we shared our thoughts on how understanding the funding of housing and flexible design can unlock a multiple of opportunities in the NHS.
In essence, funding from Homes England can be used to unlock old hospital estate, reduce backlog maintenance, whilst adding value to the patient experience as we build adjacent or on a hospital site. Fundamental to the plan is the patient wellbeing and the need to address the concerns of clinicians who might resist discharge due to poor quality accommodation in the wrong location.
Critically we discuss the supply of funding in partnership with private investor partners, who then partner with housing associations to underwrite their new build projects, thereby addressing the limitations associated with CDEL
In refreshing our ideas, we are confident, that if adopted, we can and will influence the delivery of the Integrated Health & Social Care System's future strategic planning requirements.
The NHS currently faces complex challenges in its ability to deliver current and long-term service demand. These challenges come in several forms from vacancies, growing waiting lists, aging buildings, and infrastructure at its capacity limits.
Estate infrastructure poses a serious concern to many NHS trusts, with backlogs for building repair mounting, proposed new infrastructure to drive down waiting lists, as well as the ability to maintain or replace infrastructure severely hampered due to a legacy of under-investment.
In this environment, the governance and investment decisions for NHS Trusts need to be strategically targeted to align clinical & system priorities, estate risk & safety standards, as well as estate infrastructure capacity and alignment to long-term Net Zero targets.
Governance of capital investment is critical in providing clear organisational structure, effective decision‐making, and control processes ensuring viable and affordable investments. These processes face competing investment priorities; however, these processes can be problematic, with risk to infrastructure not prioritised against new or expanded services. Estates' risk may not be acknowledged or considered within developments, or risks may be reduced for political purposes, with subsequent impacts on the viability and affordability of the capital investments. These sorts of failures of governance extended into planning for Net Zero targets, where investment in new green technologies may fail to acknowledge the required infrastructure to support them.
Governance has a significant influence on investment decisions, NHS Trusts need a coordinated governance structure to reduce risks, ensuring viability and affordability, particularly in large complex investments.
NHS trusts need to ensure they are appropriately prioritising estate investment, ensuring risks are understood across the organisation's governance, the investments required to support service expansion & delivery are factored into the business cases as well as ensuring PFI providers are meeting their requirements in terms of estate investment.
Harindar Dhaliwal, Managing Director, Step Places
Raymond Mcfee, Associate Director, WT Partnership
Mark Page, ICS Associate Director for Estates and Net Zero, Norfolk and Waveney ICB
The healthcare sector is a major contributor to the UK's carbon footprint, with the NHS alone creating around 4-5% of the country's carbon emissions. As a result, science-based Net Zero targets are informing UK energy policymaking and driving the thinking behind organisational climate target setting.
Given public support, political and scientific consensus on the need to achieve Net Zero by 2050, it makes commercial and social sense for organisations to develop and implement high-integrity decarbonisation strategies. Without effective action, climate change will, crucially, have profound implications for the health and wellbeing of the UK's population; the smooth delivery of our health and social care services; and the management of critical infrastructure.
In this presentation, we will review the ways in which investing in sustainability will improve capability, capacity and efficiency across healthcare estates:
• Ageing and inefficient energy estates cause wastage. Avoidable spending can be eliminated in order to enable more investment in improving patient healthcare. Focusing on sustainability can improve operational efficiency, reduce energy costs and meet regulation requirements.
• More time and money can be invested in staff, equipment and machines. As a result, more resources will be available for locum staff and the budget for staff satisfaction, lifting the pressure and strain on the workforce. Estates could also purchase automated equipment to ensure the efficiency of operations.
• A modern, compliant and robust energy strategy will reduce exposure to grid failures. This ensures effective management of energy estates and is critical to protecting patient care and health workers.
• The right partner can accelerate your efficiency goals, ensuring resilience, continuity and cost savings.
• Overall, reducing the carbon footprint of healthcare estates accelerates the UK-wide journey to net zero.
A changing world demands a new approach to energy, to both protect the future, and to improve the present.
Learning through a safety lens – The presentation will share how the Healthcare Safety Investigation Branch approaches and analyses evidence during an investigation to support generation of safety recommendations which aim to improve patient safety at a national level. The presentation will utilise a case study where equipment was procured with additional functionality that hadn’t been fully understood or considered with dire consequences.
Panellists in this session are:
Phil Bryant, Head of Public Sector - Sales, Centrica Business Solutions
Scott Hislop, Principal National Investigator, Healthcare Safety Investigation Branch