Repeatable Mental Health Bedrooms Hilton City Hotel, Leeds€¦ · Repeatable Mental Health Bedrooms Hilton City Hotel, Leeds 25th June 2015

www.procure21plus.nhs.uk

Repeatable Mental Health BedroomsHilton City Hotel, Leeds25th June 2015


Delivering Cost Reduction through StandardisationRoll-Out of Repeatable Rooms and Standard Components

25th June 2015


Introduction and Welcome

David KershawPSCP Programme Director

Agenda

• Introduction and Welcome• DH Opening Address• Cost Reduction Journey• Repeatable Room: Functional MH Bedroom• Repeatable Room: Organic MH Bedroom• Standard Components• Target Cost Savings• 11:30 Break and Exhibition

Agenda

• Supplier Presentations and Q&A– Bedhead Service Trunking– Mental Health Windows– Soft and Hard Flooring– Lighting

• 13:00 Lunch and Exhibition• Supplier Presentations and Q&A

– Doors– Sanitary Ware– Patient Hoists

Agenda

• 15:00 Break and Exhibition• Supplier Presentations and Q&A

– Privacy Screens– Paint

• Final Q&A• Summary• 16:00 Close

Housekeeping

• Breaks• Facilities• Fire/Emergency• Phones

Delivering value with P21+

DH – Leading the nation’s health and care

Ray StephensonProCure21+ National Framework Programme LeadFinance and NHS Directorate25.06.15

99 DH – Leading the nation’s health and care

Government Construction StrategyDH and the Principal Supply Chain Partners

• Introduced May 2011

• To deliver up to 20% cost efficiency savings for NHS CapitalProjects

• Challenged the PSCPs

• PSCPs responded with repeatable rooms, standard materials andcomponents and discount/bulk buying

• Benchmarking Targets


• All delivered within 2 years

• Consulting with the NHS

• 95% Buy-in

• Repeatable Rooms acute sector - Delivered

• Standardisation/Priced Components - Delivered


Your Challenge

• Opportunity to change the way capital projects are delivered

• Get involved, engage early

• Invite your PSCP to talk to you about this initiative for your scheme

• Support information sharing


The Future

• This is the start of a wider push for efficiency in NHS Estates andFacilities Management

• We will be collaborating with the Industry to identify and deliverfurther savings both Cap Ex and Op Ex

• This framework is providing a model of engagement for the future,including sharing designs more widely in the healthcare sector

• Supported by Central Government as part of wider efficiency agenda


Beyond 2016

• Health Minister has agreed to a new Framework when P21+ ends –P22

• Development work already started

• Engagement with the NHS about your requirements

• Embedding standardisation and developing the Repeatable Roomsand Standard Components within P22 framework


Today

A lot of work has gone into this day

• Engage with us

• Tell us what you think

• Talk to your PSCP

• Go and see for yourself

www.procure21plus.nhs.uk/club

ANY QUESTIONS

DH – Leading the nation’s health and care


Cost Reduction Journey

Lewis Parker/Omar JomeenPSCP Leads – Kier/Galliford Try

The Challenge

• GovernmentConstructionStrategy

• Efficiency Agenda

Our Response• Cost reduction

programme

• Repeatablesolutions

• Standard materials& Components

• National Events

Cost Manager

LEADERSHIP

Programme Manager

OurCommittedResponse

All 6 PSCPsWorking

together withDH, Supply Chain

and Industry

Core Teams

RepeatableRoomDesign

RoomSpecification

OperatingPolicy

Literature/ResearchReview

EvidenceMatrix

PatientFocusGroup

PreviousSchemeDesigns

PeerReview

In-UseReview

PostProject

Evaluation

SupplierDevelopment

Development Process

Specification

Operational Policy

Literature Review

Evidence Matrix

Patient Group

Design Assessments

Peer Review

Applies to all Rooms& Designs

Design

Published WorkP21+ Club website

Guidance

Development WorkReports

Literature reviewsAssessment Schedules

Updated & NewFrameworkDocuments

CharterWorks Information

Procurement StrategyGuidance Note 19 & 20

NHS England & TDABusiness Case

checklists

Published Work

P21+ Club websiteStandard Share

Standard Materials &Components:

Soft & Hard FlooringSuspended Ceilings

Doors & IronmongeryLighting

Sanitary WareFire & Smoke Dampers

Bedhead ServicesRadiant PanelsCeiling Hoists

PaintWindows

What have weachieved

14 Standard RoomsDeveloped &

Validated:

Acute• 3 Single Bedrooms• 3 4Bed MBB

Primary/Acute• 5 Consult/Exam Rooms

Mental Health• Functional Bedroom• 2 Organic Bedrooms

iPad App

What we aredoing now and

in the future

EmergencyDepartment Rooms:

• Fixed acuity• Acuity-adaptable• Chair-centric

Review Feasibility &Benefits for :

• 8 Bed Cluster

Standard Components• To suit rooms

Sharing information innovation – schemes rolling out

26

How you willbenefit

COMMERCIALTECHNICAL

Off the shelfsolutions-ready for

use

Off the shelfsolutions-ready for

use

Compliant designs andproducts

Compliant designs andproducts

Endorsed byDepartment of Health

Endorsed byDepartment of Health

Quicker design periodQuicker design period

Significant savingson HBN Bespoke

Designs

Significant savingson HBN Bespoke

Designs

Benchmarked CostsBenchmarked Costs

Supporting theGovernment

Construction Strategy

Supporting theGovernment

Construction Strategy

Helps you deliver realsavings

Helps you deliver realsavings

Use on New build andrefurbished projects

Use on New build andrefurbished projects

Value for MoneyValue for Money

Helping youachieve your

savingstargets

&improve your

businessCan youafford

not to?

Terry Moore, TED 3 Minute Talks, 2005



Thoughts for today

• Listen to what’s on offer• £1.3M saved in £4.7M of Orders• Why are you not benefiting from using

Standard Components• Easy to access benefits, via StandardShare


Repeatable Mental Health Bedrooms


Functional Mental Health Bedroom

Pat Pemberton/Rosemary Jenssen

What are the repeatablemental health bedrooms?What they are:

For two care groups:

•adults with functional mental illness

•adults with organic mental illness

What they are not:

• children or adolescents

• disabled patients

• patients with intensephysical nursing needs

• patients with specificbariatric requirements

Literature Review

• Evidence baseddesign

• MARU (MedicalArchitectureResearch Unit)

• Over 50 studies

• Evidence Tables

Evidence Based Matrix

Pers

onal

isat

ion

Uni

tSiz

e

Day

Ligh

ting

Pers

onal

Sto

rage

Artif

ical

Ligh

ting

Artw

ork

Reduce Violence & Aggression ü üü ü ü ü ü üReduce Stress & Agitation ü ü ü ü ü ü üIncrease Patient Safety ü ü üü ü ü ü üIncrease Patient Satisfaction ü ü ü ü üIncrease Patient Control ü ü üü üü ü ü ü ü

Increase Social Support ü

Increase Staff Observation ü

Increase Staff Satisfaction ü ü ü

Ther

apeu

ticE

nviro

nmen

t

Ope

nnes

s&

Sigh

tLin

es

Pers

onal

Spa

ce&

Priv

acy

Anti-

ligat

ure

Mea

sure

s

Patie

ntEx

perie

nce

Staf

fEx

perie

nce

Fixtures & Fittings

Loca

tion

ofth

ebe

droo

m

Res

iden

tialC

hara

cter

Win

dow

Spec

ificat

ion

Doo

r&H

andl

eS

peci

ficat

ion

Tem

pera

ture

Vent

ilatio

n

Acou

stic

s

EnvironmentalComfort

Out

look

Design Principles

Mental Health Survey

Patient Workshop: Mental Fight Club

• February 2014

• Personalisation and identity

• Bright with a connection to outdoors

• Open and spacious

• Storage

compliant design features:-•15.0 sqm combined bedroom and en-suite•Sight-line from door•daylight and views out•en-suite HBN00-02 and 03 compliant•Rooms paired to share services•Anti-ligature•1800mm corridor widthrecommendations:-•Bed relative to window•Personalisation•Acoustic consideration•Furniture detail•Ceiling height min 2700mm (‘break the box’)•Recognise function of corridor + threshold•Carpet in part of the room

MH functional single bedroom en-suite – key drivers

En-suitesh/wc

En-suitesh/wc

Sleep/rest

Sleep/rest

Work/play

storagestorage

support recovery

entryentry

MH functional single bedroom – layout parameters

Bedroom design incl staff / therapeutic features En-suite design featuresN

etro

omar

ea(s

qm)

Cle

arw

idth

Cle

arde

pth

Bed

posit

ion

Sight

-line

from

door

Wor

ksp

ace

Stor

age

prov

ision

Perso

nalis

atio

n/

artw

ork

Tech

nolo

gy

Cei

ling

heig

ht

Win

dow

size

+op

erat

ion

Doo

rtyp

e

Doo

rsiz

e+

oper

atio

n

Net

room

area

(sqm

)

Duc

tare

a(s

qm)

Loca

tion

rela

tive

tobe

droo

m

Con

stru

ctio

nin

-situ

/pod

Doo

rtyp

e

door

size,

oper

atio

n+

lock

-ba

ck

MH Functional bedroom assessments

MH functional bedroom en-suite – 2 arrangementsIn-board with sight-line splay

Parallel/nested

• En-suite comfortable, not over or under sized• Sight-line, move into room, impact of f,f+e• Bed position impact on the ‘sense of space’

MH functional bedroom in-board en-suite – room testing

features:-100% sight-line, more bed positions, efficient footprint, tested observation recess depth

MH functional bedroom en-suite – model test

Technical Workshop

• Detailed design:– Support for work on

storage– En-suite arrangement:

• Solid stub wall• Pocket door

• Broader principles:

– Standard brief

• What is an acceptablelevel of risk?

• Definition of anti-ligatureand testing

• Expectations – infectioncontrol

– Flexibility: baseline forforensic bedroom?

MH functional bedroom en-suite – 2 arrangementsIn-board with sight-line splay Parallel/nested

enhanced design features:-Weight sensitive door, sliding or pocket doors to en-suite, higher ceiling, window seat,fitted furniture, artwork, opportunity for personalisation

features:-100% sight-line, 2 bed positions, efficient footprint, reduced corridor length

MH functional bedroom en-suite – in-board

En-suitesh/wc

En-suitesh/wc

Sleep/rest

Sleep/rest

Work/play

storagestorage

support recovery

entryentry

bedroom, 11.8sqmen-suite, 3.1 sqmduct, 0.4sqm

MH functional bedroom mock up@ Thorlux show room, 30:10:14



10. C-Sheets

10. Federated BIM Model


Furniture Arrangements

• Padded waistcoat• Waterproof top• shoes• trainers• boots• 4 pairs of trousers• 2 tracksuit bottoms• shorts• 7 t-shirts• 3 rugby tops• 3 jumpers• 7 boxers• 7 socks• Baseball cap• (2 bath towels)• (2 hooded tops)

MH bedroom storage test - triangular

MH bedroom storage test – rectangular high level

• Padded waistcoat• 2 Waterproof tops• shoes• trainers• boots• 8 pairs of trousers• 2 tracksuit bottoms• shorts• 10 t-shirts• 6 rugby tops• 6 jumpers• 7 boxers• 7 socks• Baseball cap• 2 bath towels• 4 hooded tops

MH bedroom storage test – rectangular low level

• Padded waistcoat• Waterproof top• shoes• trainers• boots• 4 pairs of trousers• 2 tracksuit bottoms• shorts• 7 t-shirts• 3 rugby tops• 3 jumpers• 7 boxers• 7 socks• Baseball cap• 2 bath towels• 2 hooded tops

Patient Workshop: Mental Fight Club

• September 2014

• What does this space say to me?

• What does this space expect of me?

– Bed position

– Furniture

– Storage

– Colour

features:-Modular options, single fixed room design, 4 bed positions

MH functional bedroom – modularised fitted furniture

MH functional bedroom - Aerial viewRectangular furniture option with peninsula bed

MH functional bedroom - perspective view from windowRectangular furniture option peninsula bed


Organic Mental Health Bedroom

Pat Pemberton/Rosemary Jenssen

HBN compliance- HBN 35Size: Bedrooms with en-suites- but no showers 17m2

5.46 Single rooms, with en-suite WC and washing facilities arerequired. The wash basin will need to be at a height suitable for aperson sitting on a chair. The en-suite facilities will need to havewheelchair access.

5.47 The bedroom may be furnished with a variable height bed andgeneral type bed head services but piped oxygen and suction arenot required. An emergency call system is required. The room willalso require a bedside locker, a chair of appropriate height andstorage for clothes.

What are the needs?

• Nursing care – continuation of care that has been provided at

home

• Interventions to encourage activities of daily living

• Safety – falls prevention and harm relating to falls

• Rest and relaxation

• Security and observation

Literature Review and Workshops

• Literature Review

• Mental Health Survey

• The Kings Fund

• South Essex CarersGroup

• Innovate Dementia

compliant design features:-•17.0 sqm -19.0sqm combined bedroom and en-suite•Sight-line from door•daylight and views out•en-suite HBN00-02 and 03 compliant•Rooms paired to share services•Anti-ligaturerecommendations:-•Familiarity ‘v’ ligature•Accommodate more interventions•Memory box•Sight-line to wc•Fitted furniture detail•Ceiling height min 2700mm•Recognise function of corridor + threshold•Seamless floor finish

MH organic single bedroom en-suite – key drivers

En-suitesh/wc

En-suitesh/wc

Sleep/rest

Sleep/rest

Work/play

storagestorage

support recovery

entryentry

Bedroom design incl therapeutic/nursing features En-suite design featuresN

etro

omar

ea(s

qm)

Cle

arw

idth

Cle

arde

pth

Bed

posit

ion

Sight

-line

from

door

Wor

ksp

ace

Stor

age

prov

ision

Perso

nalis

atio

n/

mem

ory

box

artw

ork

Cei

ling

heig

ht

Win

dow

size

+op

erat

ion

Doo

rtyp

e

Doo

rsiz

e+

oper

atio

n

Net

room

area

(sqm

)

Duc

tare

a(s

qm)

Loca

tion

rela

tive

tobe

droo

m

Sight

-line

bed

tow

c

Con

stru

ctio

nin

-situ

/pod

,gr

abra

ils

Doo

rtyp

e

door

size,

oper

atio

n+

lock

-ba

ck

MH Older Adult/Organic bedroom assessments

• En-suite comfortable, not over or under sized• Bed type and size• Option peninsula or against the wall

MH organic bedroom in-board en-suite – room testing

Technical Workshop• Detailed design:

– Size of the en-suite inrelation to assistance

– Single leaf entrance door

• Broader principles:– Standard brief

• What is an acceptable levelof risk?

• What level of assistance arewe designing for?

– Flexibility: baseline forforensic bedroom?

Organic in-board en-suite

Increased lengthby 275mm

Increased depthby 200mm

whb

showerchair

1010mm s.o.doorset

assistance on and off wc, with two staff1. 2. 3.

adjustments made to organic en-suite post technical workshop

layout pre and post workshop

features:-100% sight-line, efficient footprint, four bed positions, sight-line to wc

MH organic bedroom in-board en-suite

En-suitesh/wc

En-suitesh/wc

Sleep/rest

Sleep/rest

Work/play

storagestorage

support recovery

entryentry

bedroom, 14.3sqmen-suite, 3.8 sqmduct, 0.4sqm

bay, 0.6 sqm

10. C-Sheets

Organic nested en-suite

whbshower

chair

1010mm s.o.doorset

assistance on and off wc, with two staff1. 2.

New layout nested en-suite post technical workshop

features:-Shallower plan depth, two bed positions, seating area within corridor

MH organic bedroom nested en-suite

En-suitesh/wc

En-suitesh/wc

Sleep/rest

Sleep/rest

Work/play

storagestorage

support recovery

entryentry

bedroom, 13.8sqmen-suite, 3.8 sqmduct, 1.3 sqm

bay, 0.6 sqm

10. C-Sheets


Furniture Arrangements

features:-100% sight-line, efficient footprint, four bed positions, sight-line to wc

MH organic bedroom – modularised furniture

MH organic inboard en-suite bedroom - Aerial viewTallboyfurniture option with peninsula bed

MH organic inboard en-suite bedroom – perspective viewTallboy furniture option with peninsula bed

features:-100% sight-line, shallower plan depth, longer corridor, two bed positions, sight-line to wc

MH organic bedroom – modularised furniture

MH organic nested en-suite bedroom - Aerial viewTallboy furniture option with peninsula bed

MH organic nested en-suite bedroom - perspective viewTallboy furniture option with peninsula bed


Standard Components

David KershawPSCP Programme Director

Standard Components

Standard Component Catalogue

Technical Papers

• AHU• Chillers• Pipework• Partitions

Benefits – Potential Savings• Total potential saving:

£31m, or c5.17%(against typical market rates, and based on £600m total spend pa)

• Flooring: £4.20m• Doors: £3.84m• Lighting: £2.52m• Ceilings: £2.46m• Bedhead Services: £1.98m• Ceiling Hoists: £1.20m• Sanitary Ware: £0.54m• Radiant Panels: £0.48m• Paint: £0.18m• Windows: £0.76m

• Partitions: £4.5m• Pipework: £3.54m• Chillers: £2.64m• AHUs: £2.16m

This image cannot currently be displayed.

9 Month Savings

• Total: £1,307k

• Lighting: £512K (20%)

• Sanitary Ware: £494k (91%)

• Ceilings: £186k (8%)

• Flooring: £103k (2%)

• Doors: £10k (.3%)

• Fire Dampers: £2k

AiredaleBuckland and Dover

CroydonDarlington Memorial

HillingdonLeighton

New CrossNottingham University

RotherhamRoyal Stoke University

ScarboroughSouthampton General

St BernardsStepping Hill

The Walton CentreWorcester Royal

Queen Elizabeth, Gateshead

Accessing StandardShare

www.procure21plus.nhs.uk/club/


Target Cost Savings

Richard VenablesInterserve

The ChallengeGovernment Construction Strategy – Efficiency Agenda

Sharing goodpractice/

standardisation

Innovation,changing

culture, BIM,Govt softlandings

Incentivisingsupply chain

collaboration toprovide value/

bulk buying

Controlling scope& understanding

what costsmoney

Challengingtime-scales

Managingexpectations

Reviewingperformance

Publishingcost

analyses

20% savingsrequired

14.1% savingsproposed

Target Cost SavingsRoom sizes?• Inboard en-suite – both

organic and functionalsimilar to HBN

• Nested en-suite minimalsaving against HBN

Efficiencies?• Right solution first time• Quality time• Component savings

Focus onpatient care

RepeatableRoomDesign

RoomSpecification

OperatingPolicy

Literature/ResearchReview

EvidenceMatrix

PatientFocusGroup

PreviousSchemeDesigns

PeerReview

In-UseReview

PostProject

Evaluation

SupplierDevelopment

Development Process

Specification

Operational Policy

Literature Review

Evidence Matrix

Patient Group

Design Assessments

Peer Review

Applies to all Rooms& Designs

Right solution first time

All rooms

All designs

Consistent

Thorough

üü

Evidencebased

Quality Time!

Design / Consultation• Detailed analysis – once• Consistent details• Improved Patient Experience

Construction• Early Involvement of the right supply

chain• Quality install

• More off site• Better co-ordination• Familiarity

• Certainty and knowledge• Speed to market

£1,425 cost saving for PSCP / PSCM teamper room

If take into account Trust (clinical andmanagement) time this saving will more

than double.

Components – benefits andsavings

93

Up to 37%savings

ManufacturersFixed price duration,extended warranties, UKmanufactured

Wholesalers Up to40%savings

National, efficient call-off,any size scheme, Fixedprice 2016

Guidance Up to30%savings

Specification clarity,understanding cost,technical design review

Specification Up to32%savings

Rationalise door sets (15)

Lessons learnt

Investment

Aggregatespendprofile

Collaborationwith keysuppliers

Focussedresources

Speed tomarket

Understandthe market

Design led– ensurecompliant

specification

Benchmarkand review

Best pricenot bestdiscount

Trustedrelationships

Communicateand market

Innovatetogether

Client BenefitsPSCP

Investment

Baselinefor localbranding

andadaption

HBMcompliantdesigns

Evidencebased

Quickerdelivery,right first

time

New NHSspecific

products

Free researchand

development

Efficientcapitalspend

Reduceddevelopment

time

Removal ofwaste

Realistic androbust

Integratedworkinginnovatetogether

The end result

96

Standardisedcomponents &

designüIncreased

certainty oftime, cost,

quality

Whole life costchoices

üü

Target Costsaving > 5%ü

Ben

efit

Standardisation

Up to 5% targetcost saving:Area/DesignBetter buying

Road to Savings

GCS 14.1%target

20%+Potential with:StakeholderengagementStafffamiliaritySupplierresponseLifecycle


Break, Exhibition and Video

Return 12:00