Infrastructure
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Carillion
investors brings an additional rigor. A key aspect of this approach is gaining an understanding of key financial drivers of long-term value. This includes balancing initial capital costs with replacement cycles; balancing maintenance costs with extending asset replacement cycles; recognising that managing the total area to be constructed and managed has an order of magnitude benefit over striving to reduce construction rates by a few percentage points; recognising that faster construction programmes not only allow the hospital to open sooner, but also has significant financial benefits. Having established the infrastructure financial
plan, the new facility needs to be designed and constructed, and the impact of the built environment on the patient experience needs to be a central theme. However all too often this is not the case. The design of a new hospital needs to consider: l How the construction is achieved in a manner that is safe for the workforce, both during construction and for the teams that will maintain the facility l Control of infection needs to be considered from separation of flows of patients and visitors, through to construction methods that protect from the introduction of infection hazards l The delivery of hotel services needs careful consideration, as it is these services that have a significant impact on patients’ perception of their hospital experience l The impact on clinical staff efficiency of adjacencies of clinical departments l The flexibility to accommodate fast-evolving clinical equipment and technologies l Recognising the impact that routine fixtures and fittings can have on different patient groups Each element of a new hospital has experts who
can provide advice and best practice. Success is when all of these work in harmony, and achieving this requires complex programme management skills.
Southmead Hospital, Bristol
construction, difficult handovers from construction to occupation, higher than predicted operational costs and insufficient budgets for maintaining and servicing the new facility. Reducing these risks requires dedicated executive level, broad programme management skills, from inception of a new hospital project, through to the steady state operational phase.
Financial planning At the heart of a successful new hospital is a long-term business plan, including the strategic case for the new hospital within the health system, and the implications for providing a clinical workforce to provide care in the new facility. From an infrastructure perspective, the business plan manifests itself in a long-term infrastructure financial model. Testing of this model by lenders and
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Further information
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Southmead Hospital, Bristol Issue 01 | Global Opportunity Healthcare 2015 69
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