TRAINING AND DEVELOPMENT Advisory Platform a professionals’ toolkit which will aim to


provide a range of guidance to anyone who has that lightbulb moment.


Revenue and capital or


revenue v capital The pie chart shows emphatically that by far the greater cost over the lifetime of a building is in the running costs – the revenue costs. In the public sector (with some small


‘Vision - the lightbulb moment’, page 26, Creating Excellent Buildings, CABE


Why have we chosen


these initial topics? A large part of our work looks at the very early stages of projects when experience shows that problems can quickly mount soon after the ‘light bulb’ moment if the full extent of what a project needs is not taken into account. Once a new project has gone down the


wrong path, even for a short period, it can be near impossible to recover. The pie chart (right) is a stark reminder of


a number of relevant but often overlooked characteristics of projects over their lifetime. The relatively small percentage of overall


cost related to ‘design’ includes the entire design process, including detailed and site design. The percentage of that design component


dedicated to the creative process will be comparatively tiny. The earliest elements including strategy, optioneering, and initiation – which should all happen before a brief is written and a drawing drawn - attract so small a percentage that they are invisible. But it is in these post ‘big bang’ moments


that the project emerges from the imagination to the page - where early errors and omissions can lead to practical failures in the long-term. Hence the work within SEMAP to develop


October 2023 Health Estate Journal 9


exceptions) capital and revenue costs are kept utterly separate. It is usual within business cases to set out the revenue implications of any new capital project, but little if any work is undertaken to explore whether there might be more beneficial approaches to the watertight relationship between these two sources of cash. Small changes in concept, patient pathways, and design, can produce enormous patient and staff benefit, as well as improving efficiency and reducing revenue over a facility’s lifetime: there is often little incentive to carry out option modelling based on best practice; nor is post-occupancy evaluation often conducted. Once the project ball is rolling, everything needs to be done quickly


– timescales for early stages are


compressed: time and capital cost become the key twin objectives.


Initial steps for any


capital project Having had the lightbulb moment, and in the initial excitement, it is all too easy to get off on the wrong foot. There will be expectations around cost and programme which, if prescribed too early, can constrain and potentially derail the proposal. There are many other possible pitfalls, and most can be avoided by seeking the right close client team members as soon as possible. Which professionals will be best suited


will depend on the specific project, but almost always, it is highly beneficial to appoint a healthcare planner to shape the proposal across a range of healthcare agendas. Equally, there is much value for larger schemes in appointing an external client advisor. SEMAP has begun to look closely at the


roles and skills available from healthcare planners, and that work is described in more detail below. We may explore the role of client advisor in further work.


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