Hospitals are failing to capitalise on the potential of the framework for delivering their capital projects.

That’s a bold statement, isn’t it, but as BAM is a contractor building and managing hospital facilities, we know there is far more we can offer our friends in the NHS under their Procure22 (P22) capital framework. And we want them to take advantage.

The framework has been running since 2003 and it is already transforming how major healthcare projects are delivered. Time and cost overruns have been virtually eliminated.

But we have been building hospitals in the UK for 150 years so we know a thing or two about the collaborative approach sitting at the heart of the NEC3 contract that is responsible for this change.

Remarkably, though, although it is collaboration that unlocks long-term progressive estate management and development, and provides the antidote to the traditional adversarial relationships associated with construction, some still view it with suspicion.

They should not. Because to extract the full benefits of this successful framework, the NHS needs to take the next step in collaboration.

Bradford Royal Infirmary
That means recognising contractors like BAM, and our supply chain, as valuable partners who bring expertise not readily available in today’s NHS. It means us becoming involved across the whole health economy.

The mind-set must change from seeing us as principally builders appointed for a single building or a group of buildings to seeing us as long-term partners helping deliver service improvement and organisational changes through well-designed, flexible and efficient facilities across multiple sites and providers.

It is that step which will really unlock the untapped potential for innovation and efficiency.

Our partnership with the NHS under the P22 Framework has already resulted in a range of standard room designs, standard assemblies and standard components, free P22 training, a suite of guidance documents covering the use of BIM, pre- and post-occupancy evaluation and Government Soft Landings (GSL). Millions of pounds of project savings prove that this behind-the-scenes work delivers.

Engaging us earlier would accelerate the scale of these benefits.

We know how to design, cost and construct healthcare facilities. Involving us from the very start would only add further value and reduce abortive work.

Trusts should embed their construction partner and our supply chains post-SOC (strategic outline case) into their project teams. We would provide valuable early advice on construction risk, sequencing and buildability, modern methods of construction and cost information based on actual outturn costs.

Trusts would have greater cost certainty, with open book accounting and more innovative solutions, plus closer alignment with their clinical requirements, and more realistic and productive programmes.

Working together in a spirit of mutual trust and co-operation to understand what is affordable at an early stage is surely better than discovering too late stage that a project is unaffordable?

Within the construction industry the end user benefits of early involvement have long been recognised.

Aintree Hospital
We add value most at preconstruction – in design, planning and organising the project. But we are not involved early enough to influence the front end.

There is a precedent. At the Erasmus Medisch Centrum in Rotterdam, the operator is reducing operating costs with help from asset data supplied by us as the contractor. We can do the same for an NHS trust here.

Data is another under-exploited estate asset waiting for Trusts to take advantage of it. The benefit of BIM incorporated at the start means the facility and assets become a living database: a mine of valuable information that have the potential to reduce future operating costs during management.

There is nothing stopping our friends and colleagues in the NHS from doing what I am suggesting, right now. I encourage them to do so and am certain that some of them will open that door before long.

About the author

Jonathan Ainley

Framework Manager

Jonathan Ainley qualified as an architect in Manchester and has spent his career as a specialist in healthcare design and strategic estate planning. He spent 10 years as an NHS programme director before becoming involved in strategic estate planning. In that time he has designed new hospitals, developed estate strategies, preparing business cases, and developing clinical design briefs for new hospitals. He joined BAM as frameworks manager in 2018.

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