Taking the pulse with PPE | Archive Titles

Case study 1: lessons learned from a large PFI Acute Hospital
Key lessons learned	Practical application
Time input
SPV underestimated amount of management time and resources to plan and deliver the project	As technical advisors to Trusts, we probe bidders’ resource plans during the evaluation stage and highlight when resources look light
Turnover of key players
Turnover of project team staff caused disruption to the development process as new team members were brought on board	We advise that project teams should log key decisionson the development of the brief and project and undertake formal recorded handovers between old and new team members
Involve the right people
Involvement in negotiations of key people involved in making the Project Agreement work on the ground proved successful	We encourage the participation of staff involved in service provision in the process and encourage bidders to do likewise so that agreed solutions are based on fact, not supposition
Check/challenge assumptions
Lack of focus and challenge of perceived design constraints within existing buildings due for refurbishment proved to be a shortcoming	Ensure assumptions and perceived constraints are thoroughly explored and challenged at an early stage by the project team
Get into the building as it is being built
Trust enjoyed largely unrestricted access to the building during construction, enabling problems to be spotted early and rectified	Encourage the contractor to provide access to Trust project teams in a controlled and safe but open basis
Be open about problems
Service transfer dates were threatened by delays in completing the building and poor communication of status of building completion issues	Contractual terms and working relationships to be developed to encourage openness on status of the construction project so that mutually acceptable joint solutions can be agreed
Involve your in-house experts
Involvement of infection control team on furniture selection proved to be of great benefit	We encourage the involvement of infection control nurses in all aspects of design, equipping, commissioning and move planning to benefit from their knowledge and advice
Responsibility for commissioning
Ultimate responsibility for the commissioning process lay with people with a responsibility for service This enabled commissioning plans to more easily accommodate and reflect the Trust’s operational requirements and aspirations rather than be seen merely as the end of a building project planning rather than people with estates backgrounds.	We advise Trusts we are supporting on their hospital commissioning projects to invest ultimate responsibility for the commissioning process with senior staff with a background in clinical service delivery and some responsibility for operational services
Be ready for the steady state phase
The transition into the operational phase proved difficult as knowledge and expertise on PFI contract administration was needed outside the project delivery in areas such as the finance department	We advise Trusts to ensure that responsibility for administering the contract and payment mechanism are in place and are bedded down ready for the steady state phase. This means identifying and training people in the finance and FM departments to reduce reliance on their project technical advisors

Case study 2: lessons learned from a small PFI Acute Hospital
Key lessons learned	Practical application
Builder’s interfaces with operational requirements Builders did not always fix fittings with a view to the users’ needs. For example, mirrors and towel rails in disabled WCs and paediatric accommodation were fitted at the wrong heights and the TV brackets clash with cubicle curtain rails.	We advise that dummy ward areas are created wherever possible so that issues such as these, which often do not become apparent until rooms are constructed, can be caught early and resolved before too much abortive work is carried out.
M&E interfaces with operational requirements
There was no override to the automatic lighting system provided in open plan offices, so making powerpoint presentations was difficult. There was a similar issue with ward corridor lights, which could not be turned off – even at night. In other areas, inhabitants had to walk in a counter- intuitive direction to turn the movement sensitive lights on in a department. Until the issue was resolved, patient call bells could not be heard in other bedrooms in the ward. Also one had to be at the staff base to be able to find out where the alarm was coming from.	We advise far greater interface between the design team’s M&E consultants and users involved in planning facilities so that all implications of the M&E installation on working practice can be assessed and discussed.