Our community, we care, you matter...... New Hospital & Healthcare Facilities 14 th August 2014

Our community, we care, you matter ......

New Hospital & Healthcare Facilities

14th August 2014

Working in partnership to transform healthcare in Orkney

Cathie Cowan

Chief Executive


Our Project

• This is not a routine contract / build. This is a legacy project that will profoundly influence healthcare in Orkney for the next 60 years plus

• The quality of our solution will directly influence the safety of our most vulnerable people and the perception of their experience. This will be the most significant capital project the Board will undertake this century

• We are a small Board with limited numbers of senior managers and senior clinical leaders. We’ve taken the decision to dedicate some of the very best of these to this project. It is therefore an outstanding team


Our Project

• Throughout this process we will be assisted by Scottish Government, Scottish Futures Trust, Health Facilities Scotland and external professional advisors. We will also work with our local partners notably Orkney Islands Council and Voluntary Action Orkney

• We will want to work with a ‘bidder’ that fully understands our requirements and can demonstrate exceptional standards of innovation, engagement and delivery

• Orkney has a tradition for outstanding architecture, many people over the centuries have come to Orkney and left their legacies – now our heritage, we want you to make the same impression


Our Outline Business Case

• Sets out our vision for reshaping and investing in health services as part of whole system health and care redesign

• The underlying impetus driving this investment is three-fold:

– Improving and redesigning clinical services

– Benefits for our patients, our staff and our communities

– Replacement of buildings

• Articulates our clinical service delivery model and proposals for the replacement of our Rural General Hospital and related healthcare facilities within a landmark building


Our Strategic Context


Our Local Context

• The new hospital and healthcare facilities will provide the functions both of a Rural General Hospital (RGH) for Orkney as well as two primary care practices with their own entity and sense of place. Public Dental Services, Scottish Ambulance Service and NHS24 will be co-located on site

• Kirkwall Hospital is the only acute health care facility in Orkney and as such must manage all acute presentations. Unlike most mainland Boards, irrespective of demand it cannot close to admissions which reflects the need to have operational capacity both in terms of physical resources (beds) and workforce

• Innovation to support health care delivery is vital to the success of this project


Our Local Context

• Our geography, our transport links and the need for our staff to respond to every emergency presents situations and opportunities to think and do things differently

• NHS Orkney relies significantly on visiting Consultants to support specialist ambulatory care and outpatient activity. Scheduling appointments, admission and discharge time is dependent on air and ferry schedules. Some patient groups (e.g. maternity) may have a longer length of stay due to where they live and/or fixed travel timetables

Our community, we care, you matter ...... Our community, we care, you matter ......

Our Key Investment Objectives

• To improve capacity and access to health care services – ensuring the health needs of the population are met

• To provide facilities/services that are Fit for purpose Support safe and effective clinical working Improve clinical and functional relationships Enable the provision of modern NHS care Provide sufficient flexibility for future changes to service provision

• To ensure that the hospital and services are developed in such a way as to maximise performance and efficiency

• To maximise benefits of shared facilities

• To enable innovative ways of working

• To develop an effective solution within an affordable financial envelope having regard to the cost and time taken to procure NHS premises


Our expectations• A partner who shares our values

• A partner who is just as passionate about providing innovative health service solutions as us

• A partner who understands the importance of physical layouts and interior ambience and how that impacts on our patients, our staff and our visitors

• A partner who respects and grasps our remote and rural context

• A partner who acknowledges the importance of this Project and what it means for our communities

• Our record shows we are a Board that aims high and achieves. As our partner, convince us that you share our ambition and demonstrate an ability to deliver a solution – that will become a memorable and outstanding legacy


Deputy Director Scottish Government Health & Social Care Directorates


Mike Baxter

Importance of this project

• Future proofing and providing sustainable services

• Supports a clinical service model that has SG support

• Utilising investment to maximise efficiency and value for money

• Generational opportunity which must be maximised

NPD In Context

• Supplements our capital budget • New South Glasgow Hospitals completion &

Legal Commitments• Remaining net capital budget directed towards

maintenance/ equipment• State of the NHSScotland Asset and Facilities

Report 2013• Additional Investment supported by RDEL to

CDEL Transfers of up to circa £100m per annum

Delivering the NPD programme

• Tried and tested standard processes and governance

• SG, SFT and Boards working together to develop and deliver pipeline

• Parameters already set out by Scottish Government – Letter to NHS Boards of 22 March 2011 http://www.pfcu.scot.nhs.uk

• Focus on development of proposals with robust outline business cases– Defined scope– Affordability well developed– Delivery confidence essential

Our Involvement in the Project

• Explicit Support for Orkney project as part of Infrastructure Investment Plan published in December 2011

• Project Board

• Capital Investment Group - Approval

• Independent Assurance -Key Stage Review

• Approve Funding Conditions


Kerry Alexander

NPD Programme Director

www.scottishfuturestrust.org.uk

A programme perspective

Kerry AlexanderNPD Programme Director


18 July 2014


Major NPD projects statusAugust 2014

Project Status Procurement Construction Financial Close

Inverness College Financial Close √ May 2013

City of Glasgow College Financial Close √ August 2013

M8/M74/M73 Financial Close √ February 2014

Ayrshire College Financial Close √ May 2014

NHS Ayrshire & ArranAcute Mental Health and NACH

Financial Close √ June 2014

SNBTS National Centre Preferred Bidder √ August 2014

NHS Lothian RHSC/DCN Preferred Bidder √ October 2014

Aberdeen Western Peripheral Route

Preferred Bidder √ October 2014

NHS D&G Acute Services Redevelopment Project

Final Tender √ January 2015

NHS Orkney New Healthcare Facilities

OJEU √ Spring 2016


What makes this project different


Drawing on lessons learned

• Design - being clear what works and what can be improved on

• Preparation and clarity on dialogue approach

• Well resourced project team and bidder team

• Agile and pragmatic decision making

• Good stakeholder management


Scottish Futures Trust


Expectations of bidders

• Addressing the need for great quality, highly sustainable facilities, delivered with maximum benefit to local communities

• Consideration of the NPD principles and risk profile

• Pragmatic approach to dialogue and standard contract

• Appropriate rate of return for risks taken


Gerry O’ Brien

Deputy Chief Executive/Director of Finance

Your opportunity

• Development must: – recognise the financial realities of the NPD

programme

– affordable and be delivered within cost cap

– avoid unnecessary embellishment and unproductive space

– provides space for needs not wants


Reference Design

• 12,900 m2 for hospital and primary care facilities• Plus 1,500m2 for Clinical Support Facilities in separate on-

site building • Clinical Support facilities are office type accommodation

that we believe are more efficiently provided in a separate on-site building

• We wish to explore the optimum solution for the Clinical Support accommodation

• Circa 300 car parking spaces and extensive landscaping


Reference Design

• Reference design:– prepared to RIBA stage 2 we seek solutions to enhance

and improve this

– made available to bidders along with our internal assessment using final bid evaluation criteria

• We want bidders to be bring their own ideas, innovation and improvement, therefore limited mandating


Mandated Elements

• All inpatient beds to be on one level to achieve co-located inpatient areas to facilitate the ability to flex beds and staffing when there are peaks and troughs of inpatient numbers across the separate units, without moving or boarding patients

• In-patient rooms to be designed with interlocking en-suite rooms• Clinical adjacencies to be compliant with the 1:500 adjacency matrix• Macmillan unit to have a dedicated entrance at ground level with

direct access to an external garden area• The Schedule of Accommodation reflects the minimum space

requirements


Facilities Management

• Standard form NPD Project Agreement provision of hard FM and lifecycle maintenance

• No TUPE transfers envisaged

• NHSO is open to dialogue with bidders to optimise FM delivery


Energy

• We will adopt the standard NPD Project Agreement position on energy provision

• Bidders will be aware of significant renewable energy generation in Orkney which should provide opportunities for achievement of low carbon facility

• Invite energy solutions that maximise operational energy efficiencies

• BREEAM “excellent” rating against 2011 scheme


Equipment and IT

• Project Co to be responsible for provision of group 1 equipment and installation of group 2

• Some group 1 may be specified by NHSO• IT infrastructure must recognise that links to mainland

hospitals outwith Orkney and outlying islands are crucial• Infrastructure to allow NHSO to be at the forefront of

telehealth developments• Telehealth and IT decision making support is everyday

business



Stephen KempRegional Chair

Scottish Builders Federation

New Hospital & Healthcare Facilities

Orkney Supply Chain

All groundworks, drainage, road installation Cranage and haulage Concrete and associated formwork & steelwork Steel erection and cladding Blockwork, render, roughcast Windows & Ext doors Insulation and sealants Dry lining and internal finishing joiner trades Ames Taping Decoration Electrical, mechanical and plumbing Ground source including boreholes (MCS) Solar thermal & PV (MCS) Surfacing, paving, road marking Landscaping Full FM support


Ann McCarlie

Project Director

PQQ Timetable

Stage Date

PQQ Return Date 12 noon, Friday 5th September 2014

Number of Copies Required - 7 CD ROMs plus 3 Hard Copies

Shortlist Announced Tuesday 28th October 2014

Debrief Reports Issued to Unsuccessful Candidates

Monday 17th November 2014


PQQ QuestionsCommunity Benefits (A19)

• We want to contribute to sustaining and developing the wider Orkney community – opportunities for training, employment and education

for the full term of the contract

• This will be a landmark public building and we want the people of Orkney to identify with the development– the community should feel a sense of ownership of the

design and of any artwork and the landscaping


PQQ Questions

Comparable Experience (B4, B5 and B6)

• Covers PPP, Non PPP and remote and rural projects in last 5 years

• 3 examples of PPP projects

• 3 examples of non PPP projects

• 2 examples of remote and rural projects


PQQ Evaluation

• Appendix 1 of the PQQ provides the proforma for completion in respect of each case study submitted by candidates

• The evaluation methodology is set out in Appendix 2

• Appendix 3 details the sections within the PQQ and who should respond

• Appendix 4 gives the scoring for questions B8 and C8

Short-listing

• The Board only intends to shortlist three candidates

• The Board will shortlist those achieving the highest scores following the detailed evaluation

• The shortlisted Candidates will each receive the Invitation to Participate in Dialogue which will confirm the arrangements for next stage of the procurement process and the award criteria


Competitive DialogueTimetable

Submission Meeting Scope Location

Dialogue Session 1 w/c 17 Nov 2014 w/c 24 Nov 2014Technical & Design Orkney

Legal & Financial Edinburgh

Dialogue Session 2 w/c 15 Dec 2014 w/c 05 Jan 2015Technical & Design Orkney


Dialogue Session 3 w/c 26 Jan 2015 w/c 02 Feb 2015Technical & Design Edinburgh


Interim Submission w/c 02 March 2015 Feedback w/c 30 March 2015 Edinburgh

Competitive DialogueTimetable

Submission Meeting Scope Location

Dialogue Session 4 w/c 13 April 2015 w/c 20 April 2015Technical & Design Edinburgh


Dialogue Session 5 w/c 11 May 2015 w/c 18 May 2015Technical & Design Edinburgh


Dialogue Session 6 w/c 08 June 2015 w/c 15 June 2015Technical & Design Orkney

Legal & Design Edinburgh

Final Submissions Submission Event Date Location

Draft Final Submissionw/c 29 June 2015

Presentation w/c 06 July 2015 Orkney

Feedback Meeting w/c 13 July 2015 Edinburgh

Final Report w/c 27 July 2015 Edinburgh or via VC

Final Submission w/c 31 Aug 2015

Preferred Bidder Selected/Notified w/c 19 Oct 2015

NHSO Project Team

Project Director Ann McCarlie

Project Admin Support

Sharon Smith + A N Other

Project Manager Bruce Barron T&T

John Ord T&T

Commercial & Financial

Albert Tait Carla Tannous

Equipment Jim Taylor

Clinical & Operational Rhoda Walker

Marthinus Roos John Trainor

Sally Riddoch

Estates Lead Gary Mortimer NHS Grampian

FM Lead Malcolm

Colquhoun

IT Lead Tom Gilmour

External Advisors

Legal Technical Financial

HC Planner

Peter Henderson HFS

Duncan Blue HFS

M&E Alan Scott

NHSO Competitive Dialogue NHS Orkney Competitive Dialogue Team

November 2014 to July 2015

NHSO Project Team

To Be Consulted

Community Benefits OIC

Others to be identified Design

A+D Scotland

Technical Standards

HFS

Advisors

Technical Sweett Group

Hulley & Kirkwood,

Blythe & Blythe Archial

Legal McRoberts

Financial Caledonia Economics

with QMPF

Healthcare Planners Buchan & Associates

Equipment HFS

Insurance Willis

Additional NHS Input in CD Period

Infection Control

Clinical Teams

HR & OD

TCS Team

Communications and Public Patient

Involvement

GP & Community

Services

SAS Staff Side

Project Overview and Summary

Cathie Cowan

Chief Executive


Project Overview

• This NPD project will include a Hospital and Healthcare facilities under one roof

• This NPD project is very different to other Hospital Projects, it looks to deliver a Rural General Hospital

• This is very different from a District General Hospital in that its main elective workload is ‘low’ risk, paradoxically its emergency care activity is as potentially acute as any tertiary care hospital


Some of Our Unique Factors • The most significant and unique factor of this project is that

whatever the circumstances the hospital cannot close to admissions

• There are occasions when patients cannot be transferred off the island due to bad weather and acutely ill adults and children have to be cared for until transfer is possible

• The scheduling of appointments, admission and discharge time is dependent on air and ferry schedules

• Inter-island and mainland tele-medicine / video conferencing links are central to day-to-day clinical operations and must be robust and resilient


The Challenge

• To provide this unique facility within the cost cap

• To build a facility that:– patients will feel at ease in– staff will enjoy working in– visitors will comment on its ambience– helps support the delivery of 21st century healthcare– the community will be proud of

• The community should feel a sense of ownership of

the design and it should utilise materials that look at home in Orkney and that are suitable for our distinct climate


The Opportunity• In short, we want a partner that can acknowledge that this is a

legacy project that will profoundly influence healthcare in Orkney for the next 60 years plus

• We in return will promise a competent dialogue process that is open, flexible and works to timetable

• We need you to recognise Orkney is special, people and communities matter to us, because we care

• As a Board we aim high and achieve. As our partner convince us that you share our ambition and together let’s deliver a solution – that will become a memorable and outstanding legacy


Thank You

Documents

Our community, we care, you matter...... New Hospital & Healthcare Facilities 14 th August 2014