News - June 2019
Revolutionising healthcare delivery
The NHS in England is renowned for taking a rather-siloed approach to everything from the procurement of goods and services to the delivery of new buildings.
But, thinking only on a local scale in this way, and failing to see the bigger picture, can result in a system that is doomed to failure and almost impossible to adapt if, and when, needs change in the future.
However, North of the border, there are signs of a new way of thinking, and this was outlined at the first-ever healthcare buildings forum Scotland, held in Edinburgh last month.
The event provided a crucial opportunity for healthcare product and service suppliers to meet key decision-makers involved in the design and development of health and social care facilities across the country.
And, over the one-and-a-half days of meetings and networking opportunities,
three speaker sessions were also held, where experts provided an overview of the opportunities and challenges facing the sector.
Since 2007, over £5billion has been invested in health infrastructure in Scotland, and the aim, moving forward, is to create a new generation of joined-up health and care facilities which focus on wellbeing and independence rather than reactive healthcare.
This fresh approach will take pressure off hospitals and bring care services into communities and primary care settings, resulting in a demand for new infrastructure.
The first speaker, Alan Morrison, head of capital investment for the Scottish Government, told delegates: “The NHS has just celebrated its 70th year and it is important to recognise the contribution infrastructure plays in the effective delivery of health and care services.
“Much of the estate has world-leading facilities. However, some parts are old and some are significantly older than the NHS itself and won’t meet modern demands even if upgraded.
“We need to put in place estates plans that support service strategies and set out a clear vision for the future.”
Look to the future
He added: “The NHS has complex infrastructure that is used on a daily basis and, as such, it needs to be kept at its most productive for as long as is practical. This will require a continuous programme of planned preventive maintenance and replacement.”
He was unable to put a figure on the level of ongoing investment in health and care buildings, as this is currently impacted by the ongoing Brexit negotiations and the future funding levels Scotland will receive from the English government.
But he said an investment strategy for all sectors was currently being drafted, adding that he wanted this to look at a ‘more-sustainable and long-term capital investment programme’.
Due to the switch from reactive care delivered in major acute hospitals to pro-active, pre-emptive care delivered in communities, many of the new buildings will be within the primary care sector – most likely smaller-budget projects, but many more in number.
These will largely be delivered through Scotland’s five ‘hubs’, each with a private-sector development partner.
Known as ‘hubCos’, these take a long-term planning approach to identifying the buildings needed to support the delivery of improved community services, not just healthcare buildings, but also other key community facilities such as schools and libraries.
Collectively, these organisations are developing and delivering a diverse pipeline of best-value, award-winning community infrastructure, currently valued at more than £2billion and anticipated to grow to over £3billion in the coming years.
In the right place
Morrison said: “Hospitals are really expensive to replace and the balance between spending £500m on a hospital or £20m-£30m for primary and community care facilities is the current challenge. But our strategy is to shift that care and we need to have the infrastructure there, in the right places, to be able to do that.”
This autumn the Scottish Government is also poised to launch Framework Scotland 3, the latest iteration of its national procurement programme which provides a wide variety of construction-related services for both new-build and refurbishment projects.
Like the current programme there will be five Principal Supply Chain Partners (PSCPs) appointed to the framework, plus, this time, an additional reserve.
This is likely to fund new capital investment to the tune of more than £120m a year over the next five years, predominately upgrading existing plant and infrastructure and refurbishing wards to improve the environment for staff and patients.
John McDonald of Kier Construction, which is on the current and new framework, attended the forum and said there was a wealth of opportunities within the health sector in Scotland moving forward.
Kier itself is working on a number of projects collectively worth in excess of £45m and the company has an overall turnover in Scotland of more than £170m as a business.
McDonald said the key to breaking into the Scottish market was having previous experience delivering healthcare projects, and a local presence.
He advises: “A lot of boards want to pick up the phone and have you in front of them quickly.
“It’s about having a satellite office and building that relationship. You need to prove you can respond to everything, and do that quickly.
“It’s a difficult barrier to break down, but when you do the opportunities are there.”
Several of the health boards that deliver medical services in Scotland were also represented at the forum, including NHS Lothian.
Its director of operations for facilities, George Curley, said: “We have a very-big programme of infrastructure investment planned over the next 5-10 years, worth close to £1billion.
“Through this innovative programme of modernisation we are developing into a single integrated health system.”
Among several case studies delivered during the speaker sessions was an overview of the ground-breaking Stirling Care Village.
Designed with an emphasis on being dementia-friendly, the project is seen as a forerunner for the planned new approach to the delivery of integrated services, encompassing a range of health and social care services including a care hub for older people and health services such as primary and urgent care, X-ray and diagnostics, minor injuries, and out-of-hours services.
Speaking at the forum, Henry McKeown of JM Architects, the designers behind the project, said: “It’s about remodelling the estate and working together to deliver more-integrated care.
“In Scotland there is evidence of these new models of care, but they are small in scale and not widespread, so this is likely where future investment will be concentrated.
“You never get a second chance to make a good impression and it’s about getting it right first time.”
Commenting about his experience of this year’s forum, supplier delegate, Steven Hadden of Harrison Thompson, said: “This is very well-organised event which attracts the right delegates, offering very-good business and networking opportunities.”
Keith Redford of ARM added: “After exhibiting at traditional events for many years, the forum was a refreshing way to speak to people.”
And project delegate, McDonald, said: “Coming to an event like this and being able to meet face-to-face with suppliers is really useful.
“It’s a great way to network compared to the traditional channels as people you meet here know things that are happening in the market that you don’t know about.
“For us it’s about being able to build and then maintain a relationship and to find out what’s in the pipeline.”