CONSTRUCTION
at the whole project programme to determine where the pinch points were – was incredible. In these situations it’s important to understand how informed the client is, and to have commercial conversations about what level of risk is acceptable. For example, if you’re dealing with the design of a nuclear installation, do you design for the potential impact of a significant 1000-year seismic event with the consequential costs of construction, or for a 100- year event, which might reduce the construction cost, but increase risk? It’s all about the acceptable level of risk, and you can never completely eliminate all risk. Clearly in the health sector you’re not looking at that level of risk, but can we learn from some of those other sectors, and can we cascade that into this sector? It’s something to consider?” Steve Batson said: “I also think there may be lessons from how the private sector is engaging with this.”
Modelling and data differences Steris’s Andrew Varley said: “We talk about modelling, and things like that. There are quite a lot of PFIs out there. It’s OK when it is the NHS building it, because it has control of its own budget, will overspend it, and plough the money in. However, with a private client, usually the NHS is not putting capital in, but rather paying over a period of time, as a service charge – which depends on the capital spend the private company is investing. For example, if we are building, we will do the scans and the modelling. We have a 3D model, but that effectively sits within our company, because we’re not contracted as the builder, but as a service-provider. We’re leasing that building, and the NHS has many leased buildings as well, which probably do have all this information in that format, as private industry tends to run it that way. We will, for example, say we want a model and COBie data, because we’re looking at it from an FM standpoint. How much it costs the NHS monthly as fees depends on capital spend. Now, when you’re in charge of that capital spend, you can make those changes as you go along, saying: ‘I’m sorry; we’ve overspent, we need another £X million’, or whatever. However, it’s a bit different when your monthly fees are going to rise because you’ve got to depreciate over the next 10-15 years. That’s the challenge with service contracts involving construction; the monthly fee creeps up, because you’re discovering things. When NHS Estates is in charge of procurement, that’s fine, as these areas can be explored and they understand. However, they are generally nothing to do with the procurement. It’s a totally different department, purchasing a service, and not concerned about the Building Safety Act – because they’re passing it all on to the service-provider undertaking the construction and alterations. “So,” Andrew Varley continued: “I don’t think
Procurement really understands all that consideration of the Act’s impact. When they say they want a price back, at a fixed cost, you’re paying for a lot of added risk, whereas realistically the procurement method must change to allow for two stages. You don’t know what you’re pricing until you look at it and ‘open the can’; otherwise you pay for the risk and effectively the NHS is going to overpay, because there’d lots of risk, so somebody’s going to catch cold. It’s either the NHS or the private sector; the latter doesn’t really want to do that, so you end up with the NHS overpaying. We’ve seen that with PFIs.” He added: “I think when Estates look after it, they can
control it. Procuring services, where companies are leasing buildings or functionality, means they’ve got to interact or refurbish areas as part of that service, and this is where the challenge lies, because you’ve still got to comply, and this may increase the scope of the original works.” Steve Batson said: “There are two really key interesting
Dean Payton said: “It seems to me that Trusts might create a new role, to oversee the client duties for minor works, instead of employing an independent BRPD to dispense the client duties…”
points there. The first is the private sector PFI – because a lot of PFIs funded 20-25 years ago are nearing their end, and so with that sizeable part of the estate, there’s a whole debate about compliance to standards, and the surrounding evidence, when the PFI facilities are handed over. “The second point relates to the Building Safety Act. If
the NHS was the owner of a residential block, the client isn’t a multifaceted client per se, because you’re selling a flat in a high-rise building and taking your money for it. With the NHS, however, it’s so complicated and fragmented, but ultimately it’s the client who’s responsible for the activity and safety. So, even though it’s different departments and silos, surely it’s still the client who has a legal responsibility?”
A universal responsibility Clarion’s Phil Morrison responded: “The Building Safety Act is quite cute on that, because it charges everyone with responsibility – whether you’re the landlord, leaseholder, developer, or the freehold proprietor, you have responsibilities, and must ensure everything is dealt with appropriately. This will be challenging for NHS Trusts, because so frequently, the NHS doesn’t know if it owns or leases a building, or it could own a building, lease it back to itself, and then lease it out to another part of the NHS. The service simply doesn’t have the necessary records in place to be effectively doing any of that kind of stuff.” Steve Batson said: “The Integrated Care Boards are ultimately top of the tree in terms of responsibility for the local health economy, but whether it’s the Estates or clinical teams under that Board, they’re all equally responsible under the Act – because the provider, who may just be clinical, paying for that service, can’t take some share of responsibility upstream.” Phil Morrison said: “I don’t think the Building Safety Act would go to the level of the integrated healthcare provider. You’d start at the NHS Foundation Trust level, and then you’re looking at the Chief Executive, the Board, and your Estates team. You’re then looking through the contract, in terms of who has a legal interest, all the way through to the
Phil Morrison: “We can trace the DNA of the Act back to the Grenfell disaster, Dame Hackitt’s enquiry, and her subsequent report.”
October 2024 Health Estate Journal 27
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