Department of Health: The Paddington Health Campus Scheme

appendix two7 It was the view of the Independent Review Panelthat failing to address adequately the concerns of theGateway Review in a timely manner had a substantiveimpact on the scheme.The 2004 Joint Review promptedthe production of a smaller, moreaffordable OBC8 The escalation of projected costs since OBCapproval, from £360 million to over £800 million by2003, led to an expression of concern from the Treasury.A Member of Parliament also requested an investigationfrom the National Audit Office. This led to the creationof a Steering Group. The Group, which consisted ofrepresentatives from the Department of Health, Treasuryand the National Audit Office, was tasked with:nnreviewing the change in the scheme’s costs sinceOBC approval; andreviewing the process which led to this situation.9 The Group’s findings, published in September 2004,highlighted concerns in two main areas: project governanceand management and affordability. It concluded that unlessthe identified weaknesses were addressed, it was unlikelythat the required investment in the NHS in west Londonwould achieve its objectives. The review recommended:abcdThe Strategic Health Authority should lead a processidentifying options for investment in the NHS inwest London for heart and lung, paediatrics, tertiaryservices and St Mary’s infrastructure;Primary Care Trusts should lead the development ofappropriate models of care;Responsibilities for projects should be clearly set outand there should be a single client who takes fullresponsibility for the cost and funding implicationsof design changes;Recent Gateway recommendations for the PaddingtonHealth Campus should be implemented for themanagement of any new investment scheme andappropriate project resources should be provided forany project team by Primary Care Trusts in line withnational guidance and the revised scale of investment.The 2005 Independent Review Panelidentified ‘lessons learnt’ from thecollapsed Campus scheme10 Following the decision in May 2005 not to proceedwith the Paddington Health Campus, the North WestLondon Strategic Health Authority commissioned anIndependent Review of the scheme. The aim of the reviewwas to identify the ‘lessons learnt’, which could improve thequality of future similar PFI projects throughout the NHS.11 The Panel concluded, in September 2005, that thescheme was unable to simultaneously and adequatelyfulfil all the basic parameters for success – specifiedclinical activity, land procurement commitments or spacewith Outline Planning Resolution (or later a Masterplan)and robust income streams. The review also noted thatthe project was allowed to continue for as long as it diddue to the absence of reliable processes responsiblefor sponsoring, managing and delivering the projectthroughout the management chain.12 The Independent Review Panel also made43 recommendations, covering:abcdefgGovernment and Department of Health leadershipand policy;Department of Health’s supporting frameworkand tools;Area-based capacity and performance management;Sponsorship of programmes;Programme governance and delivery;Management of land and planning dependencies; andContext for re-use of Paddington HealthCampus assets.the Paddington Health Campus scheme 45