The Design Development Protocol for PFI Schemes - Epos
The Design Development Protocol for PFI Schemes - Epos
The Design Development Protocol for PFI Schemes - Epos
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<strong>The</strong> <strong>Design</strong> <strong>Development</strong><br />
<strong>Protocol</strong> <strong>for</strong> <strong>PFI</strong> <strong>Schemes</strong><br />
Revision 1<br />
August 2004
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Title<br />
Public Private Partnerships in the NHS: <strong>The</strong> <strong>Design</strong> <strong>Development</strong><br />
<strong>Protocol</strong> <strong>for</strong> <strong>PFI</strong> <strong>Schemes</strong> - Revision 1 - August 2004<br />
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For Recipient's Use<br />
DH and NHS Estates<br />
31st August 2004<br />
Trusts undertaking <strong>PFI</strong> schemes and bidding Consortia<br />
#VALUE!<br />
First published in 2001, this version has been updated in the light of<br />
revised <strong>PFI</strong> procurement process guidance. It continues to represent<br />
an agreed approach to the design development process and focuses<br />
on the in<strong>for</strong>mation that is required to be generated, shared and<br />
finalised between the Trust and bidders at each stage of the <strong>PFI</strong><br />
process up until Financial Close.<br />
N/A<br />
0<br />
<strong>Design</strong> <strong>Development</strong> <strong>Protocol</strong> <strong>for</strong> <strong>PFI</strong> <strong>Schemes</strong> - January 2001<br />
0<br />
<strong>Protocol</strong> to be observed by <strong>PFI</strong> schemes at pre ITN stage<br />
0<br />
Implementation from date of publication<br />
Stephen Purden RIBA<br />
NHS Estates<br />
1, Trevelyan Square<br />
Boar Lane, Leeds<br />
LS1 6AE<br />
0113 2547238<br />
steve.purden@dh.gsi.gov.uk<br />
0
Public Private Partnerships<br />
in the NHS –<br />
<strong>The</strong> <strong>Design</strong> <strong>Development</strong><br />
<strong>Protocol</strong> <strong>for</strong> <strong>PFI</strong> schemes<br />
Revision 1 – August 2004
<strong>The</strong> <strong>Design</strong> <strong>Development</strong> <strong>Protocol</strong> <strong>for</strong> <strong>PFI</strong> schemes<br />
© Crown copyright 2004<br />
2
Revision 1 – August 2004<br />
Contents Page<br />
1 Introduction 4<br />
Summary of the <strong>Design</strong> <strong>Development</strong> Process<br />
2 Invitation to Negotiate (ITN) – in<strong>for</strong>mation to be provided by the trust 6<br />
Output specification – whole development statement<br />
Output specification – clinical/departmental policies<br />
Output specification – architectural – design exemplar solution<br />
Output specification – engineering, structural and civil<br />
Output specification – non-clinical services<br />
Output specification – equipment schedules and scope<br />
Supporting in<strong>for</strong>mation to be supplied by the trust<br />
3 In<strong>for</strong>mation to be supplied by Bidders at PITN 15<br />
4 In<strong>for</strong>mation to be supplied by Bidders at FITN 16<br />
Health planning and architecture<br />
Engineering services<br />
Other in<strong>for</strong>mation<br />
5 <strong>Design</strong> sign-off – pre-Financial Close 21<br />
Trust review of design data<br />
Review <strong>for</strong> clinical functionality<br />
Appendices 23<br />
APPENDIX A – Standards and guidelines relevant to design and construction<br />
APPENDIX B – NHS equipment group classifications<br />
APPENDIX C – PITN pricing pro-<strong>for</strong>ma<br />
APPENDIX D – Capital cost model FITN<br />
APPENDIX E – Capital and developmental costs cash flow FITN<br />
APPENDIX F – Life-cycle costs FITN<br />
3
<strong>The</strong> <strong>Design</strong> <strong>Development</strong> <strong>Protocol</strong> <strong>for</strong> <strong>PFI</strong> schemes<br />
1. Introduction<br />
1.1 <strong>The</strong> <strong>Design</strong> <strong>Development</strong> <strong>Protocol</strong> (“the <strong>Protocol</strong>”),<br />
was first published in January 2001. This updated version<br />
has been developed through a series of discussions between<br />
the Department of Health, NHS Estates, NHS<br />
trusts, the Health and Safety Executive, the Royal<br />
Institute of British Architects and the Major Contractors<br />
Group (“MCG”). It represents an agreed approach to the<br />
design development process as it moves through the<br />
stages of bidding, selection of preferred bidder and<br />
ultimate acceptance of the selected bidder’s design.<br />
1.2 <strong>The</strong> <strong>Protocol</strong> supports the revised procurement<br />
process detailed in the Department of Health’s Private<br />
Finance Initiative (“<strong>PFI</strong>”) guidance documents: “Improving<br />
the <strong>PFI</strong> Process”; “New Standard Preliminary Invitation to<br />
Negotiate”; “New Standard Pre-Qualification Questionnaire”;<br />
“New Standard Output Specifications”; “<strong>The</strong> Standard<br />
Form of Project Agreement”; “<strong>The</strong> New Standard<br />
Payment Mechanism”. <strong>The</strong>se are published on the<br />
Department’s website at http://www.dh.gov.uk/<br />
ProcurementAndProposals/PublicPrivatePartnership/<br />
PrivateFinanceinitiative.<br />
1.3 <strong>The</strong> <strong>Protocol</strong> should be observed by all NHS organisations<br />
undertaking a <strong>PFI</strong> scheme; this applies equally to<br />
NHS Foundation Trusts who wish to obtain a “Deed of<br />
Safeguard” from the Secretary of State <strong>for</strong> Health. (An<br />
NHS trust is used as the example throughout this<br />
document, referred to simply as “the trust”.) <strong>The</strong><br />
exceptions are those schemes whose Invitation to<br />
Negotiate (“ITN”) was issued prior to publication of this<br />
<strong>Protocol</strong>. <strong>The</strong>se schemes may adopt the <strong>Protocol</strong> at their<br />
discretion or otherwise continue with the process set out<br />
in the ITN.<br />
1.4 Private Sector Bidders should also be required to<br />
comply with the <strong>Protocol</strong> as part of their bid.<br />
1.5 <strong>The</strong> <strong>Protocol</strong> relates to the design development<br />
process only.<br />
1.6 <strong>The</strong> objectives of the design development process<br />
are:<br />
1.6.1 to ensure that the process results in a clearly<br />
understood set of proposals that address the<br />
trust’s need, <strong>for</strong>m a robust basis <strong>for</strong> selection of<br />
Preferred Bidder and define the level of detail<br />
required by all parties in order to enter into contractual<br />
commitments;<br />
4<br />
1.6.2 to ensure that the process does not impose unnecessary<br />
burdens, in terms of time and cost, on<br />
either the trust or the bidders;<br />
1.6.3 to avoid un<strong>for</strong>eseen changes after the selection of<br />
a Preferred Bidder in the project proposals and/or<br />
the capital cost due to:<br />
• any misunderstandings regarding the nature,<br />
quality or methodology of the scheme proposed;<br />
• the proposals not being coherent and deliverable;<br />
or<br />
• the trust changing or refining its requirements;<br />
and<br />
“<br />
<strong>The</strong> <strong>Protocol</strong> does not,<br />
is not intended to and (by<br />
definition) cannot allocate<br />
or transfer risks which as a<br />
matter of law cannot be<br />
transferred<br />
”<br />
• to establish clearly the trust’s rights of sign off<br />
on design and the consequent allocation of<br />
design risk.<br />
1.7 <strong>The</strong> <strong>Protocol</strong> does not, is not intended to and (by<br />
definition) cannot allocate or transfer risks which as a<br />
matter of law cannot be transferred. For example, trusts<br />
retain certain health and safety obligations in relation to<br />
the Health and Safety at Work etc Act.<br />
1.8 It is essential that trusts recognise and comply with<br />
Office of Government Commerce (OGC) Construction<br />
Procurement Guidance No 10 “Achieving Excellence<br />
through Health and Safety” published at http://www.ogc.<br />
gov.uk. <strong>The</strong> Government’s Procurement Policy is that all<br />
public procurement is to be based on Value <strong>for</strong> Money.<br />
Value <strong>for</strong> Money is the optimum combination of whole-life<br />
cost and quality to meet the users’ requirements. Trusts’<br />
actions have a direct impact in contributing to the<br />
achievement of this policy and they must demand that<br />
the health, safety and welfare of those who work in the<br />
construction industry are given the highest priority from<br />
the very beginning of the project.
1.9 Trusts must also recognise their duties as clients as<br />
defined in the Construction (<strong>Design</strong> and Management)<br />
Regulations 1994 (CDM). <strong>The</strong>se duties commence at the<br />
outset of the project be<strong>for</strong>e ITN. Trusts should seek advice<br />
on the detailed application of the regulations.<br />
Summary of the design development process<br />
1.10 <strong>The</strong> focus of the <strong>Protocol</strong> is the in<strong>for</strong>mation that is<br />
required to be generated, shared and finalised between<br />
the trust and bidders at each stage in the process up until<br />
Financial Close. Typically, the process will consist of the<br />
following stages:<br />
1.10.1 the submission of bidders’ responses to the Preliminary<br />
Invitation to Negotiate (“PITN”) followed<br />
by an evaluation of the responses and<br />
subsequent selection of shortlisted bidders;<br />
1.10.2 the submission of responses by shortlisted bidders<br />
to the Final Invitation to Negotiate (“FITN”)<br />
and subsequent refinement of those responses<br />
up to selection of a Preferred Bidder; and<br />
1.10.3 the development of the design by the Preferred<br />
Bidder and acceptance, or “sign off”, by the trust<br />
prior to Financial Close.<br />
1.11 <strong>The</strong> <strong>Protocol</strong> is set out in accordance with these<br />
three main stages (although <strong>for</strong> post-contract purposes<br />
Revision 1 – August 2004<br />
the trust and preferred bidder must still agree Revisable<br />
<strong>Design</strong> Data in accordance with the Standard Form<br />
Contract).<br />
1.12 For trusts wishing to follow the 3:1 procurement<br />
process, the PITN and FITN combine as a single ITN.<br />
1.13 In order to enable the bidders to prepare their<br />
proposals within the allocated time periods <strong>for</strong> both PITN<br />
and FITN, trusts should ensure that the design brief<br />
issued at the start of each stage is robust and has clinical<br />
sign-off. Changes to the brief should not be made in the<br />
middle of any stage unless there are exceptional circumstances.<br />
It is important <strong>for</strong> trusts to ensure that there is a<br />
clear methodology <strong>for</strong> costing potential changes once a<br />
Preferred Bidder is appointed.<br />
1.14 Prior to the selection of the Preferred Bidder the<br />
trust will require that the bidder provide written confirmation<br />
of the fixed price that it submitted in response to<br />
the FITN, and that only those issues as specified in the<br />
preferred bidder letter are open to further negotiations.<br />
1.15 This document was last updated in July 2004 and<br />
will continue to be reviewed periodically and updated as<br />
necessary.<br />
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<strong>The</strong> <strong>Design</strong> <strong>Development</strong> <strong>Protocol</strong> <strong>for</strong> <strong>PFI</strong> schemes<br />
2. Invitation to negotiate<br />
2.1 In advance of committing a scheme to the market,<br />
Trusts should have developed a robust set of proposals<br />
that makes up the Public Sector Comparator (“PSC”).<br />
<strong>The</strong>se proposals will have <strong>for</strong>med the basis of the<br />
approved Outline Business Case (“OBC”). <strong>The</strong> level of<br />
technical and design content of the PSC should be<br />
agreed with NHS Estates in advance of the OBC<br />
development. Guidance on the design and estates<br />
aspects of the PSC is being developed by an NHS<br />
Estates working group. In <strong>for</strong>mulating the PSC, trusts<br />
should appoint technical advisors, including healthcare<br />
planners, who would be responsible <strong>for</strong> developing a<br />
robust brief that meets clinical and service needs. This<br />
should entail direct engagement with trust clinical staff<br />
who should take ownership of the scheme from initiation<br />
throughout the process. Trusts will be required to<br />
demonstrate clinical and user involvement in the design<br />
development process<br />
2.2 When the process adopts a staged ITN, the PITN<br />
will be a draft or abbreviated <strong>for</strong>m of the FITN document.<br />
(Section 2 of “Public–Private Partnerships in the NHS:<br />
<strong>The</strong> Private Finance Initiative”; paragraph 5.56).<br />
2.3 Technical advisers should be able to demonstrate<br />
real experience in scheme delivery. A traditional design<br />
team, comprising architects, engineers and quantity<br />
surveyors, may produce more benefits than a firm of<br />
“generic” technical advisors. <strong>The</strong> technical advisors<br />
should be responsible <strong>for</strong> taking the clinical brief and<br />
developing a design exemplar which is af<strong>for</strong>dable,<br />
deliverable, and reflects the design quality now expected<br />
of Public Buildings (ref. “Better Public Buildings”, October<br />
6<br />
Preferred bidder artist’s impression, Southern Derbyshire<br />
“<br />
a traditional design<br />
team, comprising<br />
architects, engineers and<br />
quantity surveyors, may<br />
produce more benefits than<br />
a firm of ‘generic’ technical<br />
advisors<br />
”<br />
2000). <strong>The</strong> advisors should provide architectural, structural<br />
and building engineering output specifications and<br />
an indication of the trust’s aspirations in regard to, <strong>for</strong><br />
example, architectural treatment, landscaping, internal<br />
spatial quality, response to urban context; and should<br />
include consideration of the Achieving Excellence in<br />
<strong>Design</strong> Evaluation Toolkit agenda.<br />
2.4 In accordance with the CDM Regulations 1994,<br />
trusts should appoint a Planning Supervisor at or be<strong>for</strong>e<br />
the start of initial design work. <strong>The</strong> Planning Supervisor’s<br />
main responsibility is to ensure that all those who are<br />
carrying out preliminary design work on the project collaborate<br />
and pay attention to the need to reduce risk<br />
wherever possible. <strong>The</strong> Planning Supervisor should have<br />
a thorough knowledge of the design process and sufficient<br />
experience in the size and complexity of the specific<br />
project. <strong>The</strong> Planning Supervisor should notify HSE of the<br />
project once appointed.
In<strong>for</strong>mation to be provided by trusts<br />
2.5 <strong>The</strong> in<strong>for</strong>mation provided by the trust in the ITN<br />
must be sufficiently well progressed to enable the private<br />
sector to rapidly develop their proposals. <strong>The</strong>re<strong>for</strong>e the<br />
in<strong>for</strong>mation provided should be sufficiently robust to allow<br />
bidders to provide a response that will enable the trust to<br />
evaluate and select the shortlisted bidders. At the ITN<br />
(PITN) stage the trust should provide the in<strong>for</strong>mation<br />
detailed below:<br />
2.5.1 the trust’s healthcare philosophy;<br />
2.5.2 output specifications in the following areas:<br />
• whole development statement;<br />
• clinical output specifications including Whole<br />
Hospital and Departmental Clinical Operational<br />
Policies;<br />
• functional content and schedules of accommodation;<br />
• architectural output specifications including a<br />
<strong>Design</strong> Exemplar Solution;<br />
• civil, structural and engineering services<br />
output specifications;<br />
• non-clinical output specifications (<strong>for</strong> example<br />
FM services etc);<br />
• details of existing supply contracts and their<br />
effect on the design;<br />
• equipment output specification including IM&T<br />
and proposed procurement path; and<br />
Preferred bidder artist’s impression, Southern Derbyshire<br />
• statement of intent with respect to ecologically<br />
sustainable design.<br />
2.6 <strong>The</strong> trust should provide details of the design<br />
evaluation criteria such as AEDET (Achieving Excellence<br />
<strong>Design</strong> Evaluation Toolkit) and NEAT (NHS Environmental<br />
Assessment Toolkit) – see Appendix A.<br />
Output specification – whole development<br />
statement<br />
2.7 <strong>The</strong> whole development statement will contain<br />
comprehensive requirements <strong>for</strong> the project. It should<br />
include, where relevant, the following:<br />
2.7.1 site constraints;<br />
2.7.2 design vision statement;<br />
2.7.3 essential departmental and clinical dependencies<br />
and relationships;<br />
2.7.4 desired departmental and clinical dependencies<br />
and relationships;<br />
2.7.5 town planning issues. <strong>The</strong>se might include,<br />
among other matters:<br />
• car parking provision;<br />
Revision 1 – August 2004<br />
• vehicular and pedestrian movement; and<br />
• environmental issues (the outcome of any<br />
Environmental Impact Analysis the trust has<br />
been required to carry out);<br />
2.7.6 key policy statements developed from the Controls<br />
Assurance standards and other sources.<br />
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<strong>The</strong> <strong>Design</strong> <strong>Development</strong> <strong>Protocol</strong> <strong>for</strong> <strong>PFI</strong> schemes<br />
2. Invitation to negotiate<br />
Output specification – clinical departmental<br />
policies<br />
2.8 A clinical output specification should be prepared<br />
<strong>for</strong> each clinical area of the project. As far as possible<br />
these specifications should be completed in a consistent<br />
<strong>for</strong>mat. A guide template is presented below:<br />
Architectural output specification – design<br />
exemplar solution<br />
2.9 <strong>The</strong> design exemplar is intended to represent a<br />
quality benchmark against which the bidders’ proposals<br />
will be measured. <strong>The</strong> exemplar will demonstrate the<br />
aspirations of the trust in terms of graphical and technical<br />
TEMPLATE FOR CLINICAL SERVICE/DEPARTMENTAL SPECIFICATIONS<br />
HEADING INFORMATION COVERED<br />
Scope of Service • Description of Service;<br />
• Catchment Population;<br />
• Exclusions from Services covered<br />
8<br />
representations of the PSC. It is not intended to constrict<br />
the bidders’ proposals to a particular solution. <strong>The</strong><br />
intention is to provide an advanced level of briefing that<br />
will enable the bidders’ response to be more advanced in<br />
terms of understanding than would normally be the case.<br />
<strong>The</strong> trust may wish to issue more detailed scheme<br />
layouts and proposals or, alternatively, specific studies of<br />
key critical areas depending on the nature of the scheme<br />
and the trust’s particular requirements. Such briefing<br />
in<strong>for</strong>mation acts as a guide and may include:<br />
2.9.1 options considered in terms of functional relationships<br />
expressed as a diagrammatic analysis;<br />
2.9.2 <strong>Development</strong> Control Plan at 1:1000 scale;<br />
Activity Indicators • Current Service Activity (eg FCEs/OPD attends/treatments per annum);<br />
• Models of Care;<br />
• Work patterns – noting seasonal/gender/timing patterns of service delivery;<br />
• Service Trends;<br />
• Projected Activity<br />
Functional Content • Size of Department (eg beds/consulting/exam rooms/number of theatres etc);<br />
• Details of IM&T service requirements<br />
Functional Relationships • Key departmental adjacencies noting whether they are essential, important, desirable<br />
or not desirable<br />
Operational Policies • Hours of Operation;<br />
• Staff Numbers;<br />
• Operational Processes/Workflow Patterns;<br />
• Occupancy Pressures;<br />
• Reference to other specifications<br />
Supporting Services • Interrelationship of department/ service with other clinical services (eg Pharmacy/<br />
Rehabilitation/Medical Physics/Labs etc);<br />
• Interrelationship of department/service with other non-clinical services (eg Catering/<br />
On-call/Linen/Supplies/Disposal/Portering/Cleaning etc);<br />
• Arrangements <strong>for</strong> staff (eg education, beverage breaks/ meals, staff change etc).<br />
Facility Requirements • List of the facility requirements needed to undertake the service;<br />
• Schedule of areas;<br />
• Note of the key equipment requirements needed<br />
Description of Accommodation • Description of the function and relationship between key rooms within the department;<br />
• Note of main and significant equipment<br />
Environmental and Service Requirements • Key building and engineering requirements eg levels of sterility, medical gases, natural<br />
light and ventilation requirements telephones/ call systems etc<br />
Specific <strong>Design</strong> Guidance • Reference to any key design guidance eg Ionising Radiation Protection Regulations<br />
1999 etc
2.9.3 block departmental relationship plan at 1:500<br />
scale;<br />
2.9.4 urban design principles, including:<br />
• approach to wider context beyond the site<br />
boundary;<br />
• transport issues;<br />
• hard and soft landscaping strategy;<br />
• approach to car parking and access;<br />
2.9.5 typical ward layout at 1:200 showing critical<br />
dimensions and/or studies of key critical areas;<br />
2.9.6 key entrance and public space at 1:200;<br />
2.9.7 perspective sketches showing key entrance and<br />
public spaces where prepared as part of the PSC;<br />
2.9.8 principal elevations of the building;<br />
2.9.9 draft room data sheets and a selection of generic<br />
room layouts to illustrate critical clinical dimensions.<br />
2.10 A schedule of general architectural and design<br />
quality requirements should be provided, dealing with<br />
more subjective aspects of design and construction.<br />
<strong>The</strong>se could include:<br />
2.10.1 flexibility of design and specific known changes<br />
in use that must be provided <strong>for</strong>;<br />
2.10.2 proportion and scale;<br />
2.10.3 requirements <strong>for</strong> the internal environment,<br />
including natural daylight;<br />
2.10.4 desired orientation;<br />
2.10.5 car parking and desired proximity to access<br />
points;<br />
2.10.6 an aesthetic statement;<br />
2.10.7 phasing issues;<br />
2.10.8 non-mandatory requirements with regard, <strong>for</strong><br />
example, to materials;<br />
2.10.9 provision of social spaces;<br />
2.10.10 urban and social integration;<br />
2.10.11 human dignity.<br />
2.11 Trusts should feel free to provide in pictorial <strong>for</strong>m<br />
the standards of finish and internal and external design<br />
features that they require. For example, if maternity LDRP<br />
rooms are to be of a hotel standard, with concealed services<br />
and soft furnishings, images of other schemes will<br />
assist bidders in understanding the trust’s requirements.<br />
<strong>The</strong> standards should, however, be consistent with the<br />
costs included in the trust’s PSC.<br />
2.12 Appendix A lists the documents which are typically<br />
sources of standards <strong>for</strong> design and construction<br />
and which should be considered when drawing up the<br />
architectural specification.<br />
2.13 <strong>The</strong> architectural per<strong>for</strong>mance standards are<br />
measures of the per<strong>for</strong>mance of the buildings and of the<br />
“hard” facilities management function, and will <strong>for</strong>m part<br />
of the ongoing per<strong>for</strong>mance and payment mechanism.<br />
<strong>The</strong>y should be fully disclosed in the architectural output<br />
specification. To a certain extent, the adoption of statutes,<br />
British Standards, Health Building Notes (“HBNs”)<br />
and Health Technical Memoranda (“HTMs”) etc will set<br />
per<strong>for</strong>mance standards <strong>for</strong> the building and, where these<br />
are to be incorporated as part of the payment mechanism,<br />
this should be made explicit. Additionally, there may<br />
be a need to set out further per<strong>for</strong>mance standards<br />
where these are not incorporated in design and construction<br />
standards.<br />
2.14 Typical per<strong>for</strong>mance standards relate to:<br />
2.14.1 energy use and/or insulation;<br />
2.14.2 acoustic requirements;<br />
2.14.3 humidity;<br />
2.14.4 ventilation and cooling;<br />
2.14.5 water and sewage; and<br />
2.14.6 security.<br />
Revision 1 – August 2004<br />
“<br />
the standards should<br />
. . . be consistent with the<br />
costs included in the trust’s<br />
PSC<br />
”<br />
2.15 <strong>The</strong> trust, in consultation with its technical advisors,<br />
should take into account the site-specific environmental<br />
conditions and constraints when setting per<strong>for</strong>mance<br />
standards <strong>for</strong> the project. <strong>The</strong> standards should be<br />
achievable and realistic as an interdependent set of<br />
requirements.<br />
9
<strong>The</strong> <strong>Design</strong> <strong>Development</strong> <strong>Protocol</strong> <strong>for</strong> <strong>PFI</strong> schemes<br />
2. Invitation to negotiate<br />
Leicester General Hospital – Trust design exemplar<br />
Proposed site plan<br />
Current layout<br />
10
2.16 When setting standards, trusts should consider<br />
how they would be used in the ongoing contract. As<br />
mentioned above, some will <strong>for</strong>m part of the per<strong>for</strong>mance<br />
and payment mechanism. Others may only be checked<br />
once as having been satisfied either during construction<br />
or on commissioning of the building. It is important when<br />
setting standards to think through the methods <strong>for</strong><br />
monitoring them and the implications of the standard not<br />
being maintained through the contract.<br />
2.17 <strong>The</strong> standards set should reflect the per<strong>for</strong>mance<br />
required under the trust’s PSC solution so that a fair<br />
comparison can be made. Response times etc should<br />
provide value <strong>for</strong> money.<br />
2.18 A schedule of design-life expectancies <strong>for</strong> the<br />
major elements of construction should be provided.<br />
<strong>The</strong>se will <strong>for</strong>m part of the Trust’s Construction Requirements<br />
as set out in the Standard Form Project Agreement.<br />
<strong>The</strong> Trust should look to strike a fair balance between<br />
establishing what is required <strong>for</strong> the hand-back<br />
provisions in the Standard Form Project Agreement and<br />
limiting the ability of the bidder to provide innovative solutions<br />
in the delivery of the service. <strong>The</strong> major structural<br />
elements should include, <strong>for</strong> example:<br />
2.18.1 the structural envelope – <strong>for</strong> example frame,<br />
walls, floors;<br />
2.18.2 the waterproofing elements;<br />
2.18.3 the internal fabric and finishes;<br />
2.18.4 plant and equipment.<br />
Engineering output specification – engineering,<br />
structural and civil<br />
2.19 A similar approach should be adopted <strong>for</strong> this part<br />
of the output specification to that <strong>for</strong> the architectural<br />
specification. Additional standards and regulations will be<br />
applicable to engineering and structural specifications,<br />
including:<br />
2.19.1 Institution of Electrical Engineers (“IEE”) regulations;<br />
2.19.2 Health and Safety at Work etc Act 1974 and<br />
associated regulations;<br />
2.19.3 Construction (<strong>Design</strong> and Management) Regulations<br />
1994;<br />
2.19.4 Health and Safety Executive Guidance;<br />
2.19.5 Gas Safety Regulations;<br />
2.19.6 Water Research Centre Codes;<br />
2.19.7 Chartered Institute of Building Services Engineers<br />
(CIBSE) codes and guides;<br />
2.19.8 fire precautions.<br />
Revision 1 – August 2004<br />
2.20 <strong>The</strong> Trust should recognise that it is likely that<br />
many of the per<strong>for</strong>mance standards <strong>for</strong> engineering services<br />
will feed into the ongoing per<strong>for</strong>mance and payment<br />
mechanism.<br />
2.21 In<strong>for</strong>mation and Communications Technology<br />
(“ICT”) requirements should be set out in this section of<br />
the output specification. This should include any special<br />
requirements to support specialist diagnostic or surgical<br />
techniques or teaching requirements.<br />
Output specification – non-clinical<br />
2.22 An output specification should also be prepared in<br />
a consistent manner <strong>for</strong> all non-clinical areas and services<br />
of the project. This should particularly focus on the facilities<br />
management interface with clinical and clinical support<br />
functions. A guide template is presented below:<br />
Output specification – equipment schedules<br />
2.23 <strong>The</strong> trust should advise bidders at this stage on<br />
the scope of the trust’s equipment requirements having<br />
carefully considered the impact of different approaches<br />
on patient care. In <strong>for</strong>mulating the output specification <strong>for</strong><br />
the equipping solution the trust should:<br />
2.23.1 explore its existing schedules in order to establish<br />
more accurately the level and quantity of<br />
equipment that will need to be replaced be<strong>for</strong>e<br />
the project comes on stream;<br />
“<br />
per<strong>for</strong>mance standards<br />
<strong>for</strong> the project . . . should<br />
be achievable and realistic<br />
as an interdependent set of<br />
requirements<br />
”<br />
11
<strong>The</strong> <strong>Design</strong> <strong>Development</strong> <strong>Protocol</strong> <strong>for</strong> <strong>PFI</strong> schemes<br />
2. Invitation to negotiate<br />
TEMPLATE FOR NON-CLINICAL SERVICES/DEPARTMENTAL SPECIFICATIONS<br />
HEADING INFORMATION COVERED<br />
Scope of Service • Description of Service;<br />
• Customer/Consumer base (eg catering requirements);<br />
• Exclusions from Services covered<br />
Activity Indicators • Current Service Activity;<br />
• Work patterns – noting seasonal/gender/timing patterns of service delivery;<br />
• Service Trends;<br />
• Projected Activity.<br />
Functional Content • Size of Department (eg area plus storage);<br />
• IM&T service requirements<br />
Functional Relationships • Key departmental adjacencies noting whether they are essential, important, desirable or<br />
not desirable<br />
Operational Policies • Hours of Operation;<br />
• Staff Numbers;<br />
• Operational Processes/Workflow Patterns;<br />
• Communication/transportation (eg service corridors);<br />
• Reference to other specifications.<br />
Supporting Services • Interrelationship of department/service with other clinical services (eg <strong>The</strong>atres/A&E/<br />
Pharmacy/Rehabilitation/Medical Physics/Labs);<br />
• Interrelationship of department/service with other non-clinical services;<br />
• Arrangements <strong>for</strong> staff (eg education, beverage breaks/meals, staff change etc)<br />
Facility Requirements • List of the facility requirements needed to undertake the service;<br />
• Note of the key equipment requirements (include IM&T)<br />
Description of Accommodation • Description of the function and relationship between key rooms/services within the<br />
department;<br />
• Note of main and significant equipment<br />
Environmental and Service Requirements • Key Building and Engineering requirements eg levels of sterility, medical gases, natural<br />
light and ventilation requirements, telephones/ call systems etc<br />
Specific <strong>Design</strong> Guidance • Reference to any key design guidance eg waste management.<br />
2.23.2 determine the level of investment available within<br />
its block capital programme and review its revenue<br />
budgets to indicate clearly any implications<br />
with regard to the transfer of risk;<br />
2.23.3 ensure that the assumptions made in its PSC are<br />
appropriate, as the bidders may wish to use this<br />
in<strong>for</strong>mation as an indication of the trust’s requirements;<br />
2.23.4 ensure that a true comparator has been satisfactorily<br />
established and that the trust’s per<strong>for</strong>mance<br />
standard is clearly stated <strong>for</strong> the provision<br />
and maintenance of the equipment;<br />
2.23.5 detail the extent to which any existing equipment<br />
will be transferred to the Private Sector Partner;<br />
2.23.6 consider the implications of writing off the existing<br />
equipment;<br />
12<br />
2.23.7 consider the impact on af<strong>for</strong>dability and VFM;<br />
2.23.8 determine the output and per<strong>for</strong>mance specification,<br />
particularly <strong>for</strong> clinical and diagnostic<br />
equipment;<br />
2.23.9 consider the adequacy of definition <strong>for</strong> minor<br />
items like dispensers, trolleys, illuminators etc;<br />
2.23.10 consider the life-cycle replacement, maintenance<br />
and cost;<br />
2.23.11 assess compatibility with existing equipment;<br />
2.23.12 define the interface with clinical equipment such<br />
as patient monitoring equipment and the controls<br />
software;<br />
2.23.13 identify the inclusion or exclusion of some<br />
group 3 equipment such as free-standing mobile<br />
suction units.
Equipment scope<br />
2.24 <strong>The</strong> recommended minimum scope in respect of<br />
equipment <strong>for</strong> all <strong>PFI</strong> projects is as follows.<br />
Initial supply and installation of Group 1 & 2 items<br />
2.25 <strong>The</strong> initial supply and installation of Group 1 and<br />
installation only of Group 2 fixtures and fittings/equipment<br />
will be provided under the design and construction contract<br />
in accordance with the room data sheets to be<br />
agreed with the trust.<br />
Maintenance and replacement of Group 1 & 2 items<br />
2.26 Upon completion of the design and construction<br />
contract, the <strong>PFI</strong> contractor will be responsible <strong>for</strong> the<br />
maintenance and replacement of all Group 1 and maintenance<br />
of Group 2 fixtures and fittings/equipment <strong>for</strong> the<br />
whole of the concession period. For both groups, this will<br />
include any making good/modifications/damage to the<br />
building fabric and/or engineering services during equipment<br />
decommissioning and replacement. When Group 2<br />
equipment ceases to be maintainable, the Trust will be<br />
responsible <strong>for</strong> the supply costs only of life-cycle replacement<br />
items of Group 2 equipment over the concession<br />
period and the <strong>PFI</strong> contractor will be responsible <strong>for</strong><br />
installation and maintenance thereafter. <strong>The</strong> disposal of<br />
replaced Group 2 equipment will be the contractor’s<br />
responsibility, unless the trust elects otherwise.<br />
Group 3 and 4 FM equipment and furniture<br />
2.27 <strong>The</strong> trust should consider the transfer of all FM<br />
Group 3 and 4 equipment, furniture, spare parts, tools<br />
and consumables relating to all services to be provided<br />
under the FM contract, to the Private Sector Partner at<br />
the commencement of service delivery. <strong>The</strong> Private Sector<br />
Partner would then be responsible <strong>for</strong> the maintenance<br />
and replacement of all items transferred and the<br />
initial supply, maintenance and replacement of all other<br />
equipment, furniture, spare parts, tools and consumables<br />
as may be necessary <strong>for</strong> the FM services provided under<br />
the contract.<br />
Group 3 and 4 items used by the trust<br />
2.28 Unless subject to a full equipping service, Group<br />
3 and 4 items used by the trust will be supplied, maintained<br />
and replaced by the trust.<br />
Extended scope<br />
2.29 Each trust should review in detail whether the<br />
minimum level of equipment provision outlined above<br />
would meet the clinical needs <strong>for</strong> the duration of the<br />
contract. In the event that a full equipping and/or managed<br />
technology service is considered preferable, full<br />
output specifications should be provided.<br />
Equipment specification<br />
Dryburn Hospital, opened April 2001 – pathology laboratory<br />
Revision 1 – August 2004<br />
2.30 At the FITN Stage (where the 4:2:1 process is<br />
used) or at ITN (where the 3:1 process is used), the trust<br />
should issue all bidders with indicative equipment data<br />
sheets (or alternatively, a project-based consolidated<br />
room component schedule) of all Groups 1 to 3 equipment<br />
<strong>for</strong> all trust clinical and clinical support functions of<br />
the project. This should be based on the PSC equipment<br />
provision and ensure a level playing field <strong>for</strong> bidder’s bid<br />
pricing.<br />
13
<strong>The</strong> <strong>Design</strong> <strong>Development</strong> <strong>Protocol</strong> <strong>for</strong> <strong>PFI</strong> schemes<br />
2. Invitation to negotiate<br />
Supporting documentation to be supplied by<br />
the trust<br />
2.31 <strong>The</strong> following in<strong>for</strong>mation should be made available<br />
to bidders, together with any other documentation<br />
that the trust or its advisers believe is necessary <strong>for</strong><br />
bidders to <strong>for</strong>mulate priced proposals:<br />
2.31.1 trust’s Outline Business Case. This should<br />
include the schedules of accommodation,<br />
including room areas and plant and communications<br />
space allowances, prepared by the trust,<br />
and should be used to develop the PSC. This<br />
should not be held to constitute any part of the<br />
specification, but to act as a guide to the trust’s<br />
approach to the project;<br />
2.31.2 planning documentation including outline consent,<br />
planning agreements and overall plans <strong>for</strong><br />
the local area;<br />
2.31.3 statement of other consents that will be required,<br />
to the extent known by the trust, such as listed<br />
building consent;<br />
2.31.4 in<strong>for</strong>mation on property title and tenure of the<br />
site;<br />
2.31.5 where the OBC proposes the retention of existing<br />
buildings on the site, 1:200 loaded drawings<br />
<strong>for</strong> these buildings or, if not available, the nearest<br />
alternative;<br />
2.31.6 where existing buildings are to be transferred to<br />
the project company as part of the project, the<br />
trust should ensure, if it appoints third-party consultants<br />
to carry out surveys, appraisals or condition<br />
statements, that:<br />
14<br />
• the third-party consultants agree to undertake<br />
the work on the basis that their reports<br />
will be shared with the bidders, and the<br />
benefit of the surveys and any associated<br />
warranties will be assigned to the selected<br />
bidder,<br />
• the trust discloses the contents of such surveys,<br />
appraisals or condition statements to<br />
bidders and, if possible, assigns the benefit<br />
of them (whether completely or on a shared<br />
basis) to the selected bidder;<br />
• the relevant report, appraisal or survey is upto-date<br />
(or as up-to-date as is practicable)<br />
and addresses the issues likely to be of particular<br />
concern to bidders and financiers<br />
generally;<br />
Dryburn Hospital, opened April 2001 – coronary care nurses’<br />
station<br />
2.31.7 where it is proposed that suitable surveys are to<br />
be jointly commissioned by bidders and the trust<br />
prior to selection of a Preferred Bidder, the arrangement<br />
and proposed cost sharing mechanism<br />
should be set out in the ITN;<br />
2.31.8 if the trust has undertaken ground condition and<br />
other surveys on the proposed site the in<strong>for</strong>mation<br />
may be included in the ITN documentation<br />
sent to the bidders. It is likely that this in<strong>for</strong>mation<br />
will need to contain arrangements to<br />
allow the benefit of the surveys to be assigned to<br />
the eventual Preferred Bidder. Similarly, a costsharing<br />
mechanism will also need to be considered.<br />
Where a trust elects to carry out a ground<br />
condition survey and include it in the ITN, this will<br />
not alter the allocation of a ground condition risk<br />
in the Standard Form Project Agreement;<br />
2.31.9 a copy of the outline health and safety plan prepared<br />
by the Planning Supervisor. <strong>The</strong> plan<br />
should include the in<strong>for</strong>mation co-ordinated by<br />
the Planning Supervisor, including the location of<br />
existing services, the results of asbestos and<br />
contaminated land surveys, the storage location<br />
of any hazardous materials, and details of the<br />
safety hazards involving adjacent land use, site<br />
boundaries and site access. If the current in<strong>for</strong>mation<br />
available is inaccurate, the trust should<br />
seek the advice of the Planning Supervisor as to<br />
whether more accurate in<strong>for</strong>mation is required to<br />
meet its obligations.
3. In<strong>for</strong>mation to be provided by bidders at PITN<br />
3.1 In the past it has been the case that trusts have<br />
required responses to the in<strong>for</strong>mation they have provided<br />
in a variety of <strong>for</strong>mats and to varying levels of detail.<br />
Following lengthy consultation with trusts, their advisers<br />
and companies involved in the <strong>PFI</strong> market, guidance<br />
standardising responses from bidders was first published<br />
by the Department of Health’s Private Finance Unit (PFU)<br />
in June 2002; an amended version was published in<br />
February 2003 and is available on the website.<br />
3.2 Under the standard PITN guidance the in<strong>for</strong>mation<br />
required from bidders is divided into five sections, one of<br />
which is ‘Approach to <strong>Design</strong> and Construction’, which<br />
has a mandatory weighting of 25–35%. <strong>The</strong> aim of the<br />
Halifax General Hospital – opened April 2000<br />
Revision 1 – August 2004<br />
PITN stage is primarily about selecting bidders to go<br />
through to the shortlist as judged against a range of<br />
qualitative factors, and again the standard guidance <strong>for</strong><br />
the first time sets a prescriptive methodology <strong>for</strong> scoring<br />
the responses to each of the five sections in terms of<br />
approach, deliverables, innovation and compliance. However,<br />
trusts must be satisfied that the proposals they<br />
receive are also likely to be af<strong>for</strong>dable, and to this end the<br />
section ‘Financial Responses’ in the standard PITN contains<br />
a prescriptive list of costing questions <strong>for</strong> bidders’<br />
proposals. <strong>The</strong>se have been further refined with the production<br />
of a separate (Capital and Service elements) PITN<br />
pricing pro-<strong>for</strong>ma document which can be found in<br />
Appendix C of this document.<br />
15
<strong>The</strong> <strong>Design</strong> <strong>Development</strong> <strong>Protocol</strong> <strong>for</strong> <strong>PFI</strong> schemes<br />
4. In<strong>for</strong>mation to be submitted by bidders at FITN<br />
4.1 This section details the in<strong>for</strong>mation to be provided<br />
in response to the FITN. It covers Health Planning and<br />
Architecture, Engineering Services and other in<strong>for</strong>mation.<br />
Health planning and architecture<br />
4.2 Bidders will be expected to provide the following<br />
in<strong>for</strong>mation to trusts. It represents a minimum requirement:<br />
4.2.1 the 1:1000 <strong>Development</strong> Control Plan. Typically<br />
such a plan will include the following in<strong>for</strong>mation<br />
(this list is not exhaustive, as additional in<strong>for</strong>mation<br />
may be required to demonstrate the viability of the<br />
proposals):<br />
• communications routes into and out of the<br />
hospital <strong>for</strong> vehicles, pedestrians and cyclists;<br />
• planning restrictions affecting the development<br />
and modifications to highways, response to<br />
specific local authority planning requirements;<br />
• orientation of the building and its relationship<br />
to other buildings and infrastructure on the<br />
site;<br />
• landscape strategy;<br />
• main access points to the building;<br />
• major service routes;<br />
• response to the surrounding and wider urban<br />
context;<br />
4.2.2 a 1:500 scale outline design indicating functional<br />
relationships and area schedules;<br />
4.2.3 site traffic analysis <strong>for</strong> vehicular and pedestrian<br />
movement. This may take the <strong>for</strong>m of a desktop<br />
study and include concept drawings;<br />
4.2.4 landscape concept. A general statement should<br />
be prepared, supported by high-level concept<br />
drawings of the landscape type required <strong>for</strong> planning<br />
consent;<br />
4.2.5 construction phasing – outline proposals <strong>for</strong> the<br />
construction decanting, including diagrammatic<br />
description, should be supplied;<br />
4.2.6 1:200 scale architectural drawings should be<br />
provided, in plan and section, indicating room<br />
adjacencies, circulation layouts, corridor widths<br />
and floor-to-ceiling heights. <strong>The</strong>se should be provided<br />
<strong>for</strong> all areas of the hospital. <strong>The</strong>se plans<br />
16<br />
should be adequately prepared to scale, allowing<br />
circulation and communications routes/wayfinding<br />
strategies, entrances and egresses to be clearly<br />
highlighted;<br />
4.2.7 trusts should recognise that at this stage 1:200<br />
scale drawings are to be provided to ensure that<br />
all the scheduled rooms can be accommodated<br />
within the proposed footprint of the building and<br />
that room adjacencies accord with the key operational<br />
principles declared in the clinical output<br />
specifications. <strong>The</strong>y should also demonstrate that<br />
patient environment matters, such as natural daylight<br />
and views, have been addressed. It is unlikely,<br />
however, that bidders’ architects will achieve<br />
the final layout without a full and <strong>for</strong>mal<br />
consultation with trust clinicians and staff. It is<br />
recommended that, at this stage, consultation<br />
involves the trust’s project team and key clinical<br />
and operational staff representatives. Following<br />
the appointment of a Preferred Bidder, it is anticipated<br />
that the Preferred Bidder and the trust will<br />
commence detailed consultation and design<br />
development with end-user groups to achieve the<br />
completion of 1:200 plans prior to the <strong>for</strong>mulation<br />
of selected 1:50 loaded room layouts and wall<br />
elevations complete with schedules and room<br />
data specifications prior to financial close;<br />
4.2.8 the in<strong>for</strong>mation requirements at the selection of<br />
Preferred Bidder must be sufficiently developed to<br />
give price certainty and com<strong>for</strong>t on the ultimate<br />
achievement of clinical functionality. <strong>The</strong> trust’s<br />
project director and technical advisors should be<br />
able to <strong>for</strong>m a judgement as to the benefits and<br />
dis-benefits of respective schemes from the 1:200<br />
scale drawings produced;<br />
4.2.9 1:50 scale equipment layout drawings and wall<br />
elevations <strong>for</strong> key rooms in the development<br />
should be provided. Typical rooms which should<br />
be provided are:<br />
• multi-bed rooms (en-suite at trust’s discretion);<br />
• single-bed rooms (must now be en-suite);<br />
• operating theatre;<br />
• anaesthetic room;<br />
• typical radiodiagnostic room;<br />
• ITU bay;
Wycombe General Hospital – opened April 2000<br />
Revision 1 – August 2004<br />
17
<strong>The</strong> <strong>Design</strong> <strong>Development</strong> <strong>Protocol</strong> <strong>for</strong> <strong>PFI</strong> schemes<br />
4. In<strong>for</strong>mation to be submitted by bidders at FITN<br />
• CCU room;<br />
• LDRP room;<br />
• typical treatment room;<br />
• typical clean utility room;<br />
• typical dirty utility room; and<br />
• assisted WC;<br />
4.2.10 draft room data sheets and project-wide draft<br />
equipment component schedules should be<br />
provided, based on the in<strong>for</strong>mation provided by<br />
the trust;<br />
4.2.11 details of functional content, summarised by department,<br />
should be given. <strong>The</strong>se should integrate<br />
the functional content in the trust’s output<br />
specifications with bidders’ proposals;<br />
4.2.12 schedules of accommodation with key operating<br />
assumptions should be provided. <strong>The</strong>se will<br />
have to be agreed with the trust at the end of the<br />
ITN stage if a fixed price is to be given be<strong>for</strong>e<br />
selection of the Preferred Bidder;<br />
4.2.13 bidders should provide strategic 1:200 plans<br />
and compartmentation plans, highlighting evacuation<br />
strategies and staff implications in the<br />
event of fire;<br />
4.2.14 bidders should submit typical 1:200 scale elevation<br />
drawings which are sufficient to demonstrate<br />
what the building would look like and the<br />
materials which would be used;<br />
4.2.15 bidders should indicate their interior design concepts<br />
<strong>for</strong> public and patient areas. Bidders<br />
should also indicate external landscaping proposals;<br />
4.21.6 full wayfinding strategy;<br />
4.2.17 design flexibility concepts should highlight the<br />
development areas and soft spaces contained in<br />
the design;<br />
4.2.18 a structural grid at 1:200 scale should be<br />
submitted;<br />
4.2.19 proposals <strong>for</strong> supplies, storage, distribution (with<br />
specific reference to laundry and linen) and<br />
waste management should be provided;<br />
4.2.20 proposals of how decontamination and control<br />
of infection are to be achieved should be provided;<br />
18<br />
4.2.21 a statement of the strategies with respect to<br />
ecologically responsible design and building<br />
management should be provided;<br />
4.2.22 design programme. Bidders should supply their<br />
envisaged programme to Financial Close and<br />
thereafter to design completion. This should<br />
show the proposed programme <strong>for</strong> the development<br />
of the 1:200 and 1:50 scale drawings.<br />
Proposals <strong>for</strong> achieving clinical sign-off should<br />
also be included.<br />
Engineering services<br />
4.3 In relation to engineering services, bidders should<br />
provide the following in their FITN submissions:<br />
4.3.1 engineering philosophy, including outline system<br />
selections;<br />
4.3.2 defined plant areas and zones;<br />
4.3.3 schematic and written proposals <strong>for</strong> major plant<br />
provision;<br />
4.3.4 explanations of expansion capabilities and<br />
standby facilities;<br />
4.3.5 a draft environmental impact statement;<br />
4.3.6 major plant life-cycle statement. This should include<br />
an explanation of the bidder’s life-cycle<br />
philosophy and an elemental breakdown of capital<br />
costs. This will allow the trust’s technical advisers<br />
to confirm that life-cycle assumptions are<br />
reasonable and deliverable when set against the<br />
proposed capital spend;<br />
4.3.7 lift usage and materials traffic assessment;<br />
4.3.8 engineering 1:200 scale line drawings that provide<br />
sufficient detail of the service risers, ducts<br />
and service routes to indicate the strategic distribution<br />
of the engineering services;<br />
4.3.9 evidence that the services support the trust’s<br />
business and life-critical services under supply<br />
failure scenarios;<br />
4.3.10 external services. This should include detail of<br />
the main routes, intakes and off-site reliance of<br />
the services;<br />
4.3.11 energy strategy;<br />
4.3.12 outline method statements <strong>for</strong> commissioning<br />
and decommissioning of the engineering services;
4.3.13 an aesthetic statement detailing the lighting to<br />
be provided both internally and externally;<br />
4.3.14 the number and location of IT communications<br />
rooms and any other ICT equipment that has<br />
space implications;<br />
4.3.15 generic room data sheets should be provided <strong>for</strong><br />
typical rooms indicating temperatures, ventilation<br />
rates, lighting levels, acoustic per<strong>for</strong>mance and<br />
general levels of service provision. Typical rooms<br />
should include:<br />
• in-patient rooms;<br />
• treatment rooms;<br />
• offices;<br />
• radiodiagnostic rooms;<br />
• utility rooms;<br />
• consulting rooms;<br />
• operating theatre suites;<br />
• ITU patient rooms;<br />
• CCU patient rooms; and<br />
• HDU patient rooms.<br />
Other in<strong>for</strong>mation<br />
4.4 Other in<strong>for</strong>mation to be provided in the submission<br />
to the FITN is detailed in the following paragraphs:<br />
4.4.1 project management arrangements during the design,<br />
construction and service stages of the project<br />
should be outlined; in particular the management<br />
arrangements <strong>for</strong> partnering with the trust to<br />
deliver the project;<br />
4.4.2 quality management arrangements during the design,<br />
construction and service stages of the project<br />
should be outlined;<br />
4.4.3 evidence of planning support. <strong>The</strong> trust will have<br />
obtained outline planning consent. However, bidders<br />
would be expected to provide evidence that<br />
the 1:500 and elevation drawings meet the requirements<br />
of the local planning authority. Proposals<br />
<strong>for</strong> other buildings that <strong>for</strong>m part of the<br />
commercial proposal (<strong>for</strong> example private patients<br />
and retail facilities) should also have the demonstrable<br />
support of the local planning authority;<br />
4.4.4 external and internal access routes including a<br />
security statement;<br />
4.4.5 building areas. A gross area and room areas<br />
scheduled by department should be included;<br />
4.4.6 capital cost breakdown. <strong>The</strong> pro-<strong>for</strong>mas in<br />
Appendices D and E should be completed to<br />
provide in<strong>for</strong>mation on:<br />
• mobilisation proposals and outline of cost;<br />
• cost plan and cashflow <strong>for</strong>ecast;<br />
• elemental breakdown of equipment costs;<br />
• inflation assumptions;<br />
• preliminary costs and overhead/profit;<br />
• design fees;<br />
Revision 1 – August 2004<br />
• risk contingencies included in the price <strong>for</strong><br />
areas arising from, <strong>for</strong> example, need <strong>for</strong><br />
greater clarity of content, and site in<strong>for</strong>mation;<br />
4.4.7 outline specification of main elements against the<br />
headings listed in the capital and life-cycle cost<br />
schedules (completion of the pro-<strong>for</strong>mas in Appendices<br />
D and F). Note this is particularly im-<br />
Norfolk and Norwich Hospital – opened September 2001<br />
19
<strong>The</strong> <strong>Design</strong> <strong>Development</strong> <strong>Protocol</strong> <strong>for</strong> <strong>PFI</strong> schemes<br />
4. In<strong>for</strong>mation to be submitted by bidders at FITN<br />
portant when considering value <strong>for</strong> money and<br />
life-cycle costs; and<br />
4.4.8 a schedule of design life proposals and summary<br />
cashflow <strong>for</strong> the agreed elements as detailed in<br />
Appendix F (pro-<strong>for</strong>ma and definitions).<br />
4.5 <strong>The</strong> above in<strong>for</strong>mation should be comprehensive <strong>for</strong><br />
the whole development and be consistent with bidders’<br />
service proposals.<br />
4.6 Bidders should provide details of their Outline<br />
Construction Phase Health and Safety Plan together with<br />
their proposals to comply with the CDM Regulations<br />
when the planning supervisor duty is transferred at<br />
Financial Close.<br />
20
5. <strong>Design</strong> sign-off – pre-Financial Close<br />
5.1 After selection of a Preferred Bidder, the design<br />
development process will continue up to financial close,<br />
with some detailed working-up completed thereafter.<br />
During contract negotiations, the trust and Preferred Bidder<br />
will continue working on the design and, additionally,<br />
on the process <strong>for</strong> developing or amending the design<br />
post-Financial Close.<br />
5.2 This section of the protocol sets out the scope and<br />
purpose of the trust’s review of design data and the<br />
resulting allocation of design risk which takes place<br />
during the period between the selection of Preferred<br />
Bidder and Financial Close. <strong>The</strong> Standard Form Project<br />
Agreement sets out the design sign-off process and<br />
responsibilities post-Financial Close.<br />
5.3 <strong>The</strong> trust and Preferred Bidder should take into<br />
account the Strategic Health Authority’s responsibilities in<br />
terms of Full Business Case (“FBC”) approval and allow<br />
adequate time in the programme <strong>for</strong> consultations and<br />
feedback. Complementary to this, and as part of the central<br />
approval process, it is a mandatory requirement that<br />
NHS Estates review designs.<br />
Trust review of design data be<strong>for</strong>e Financial<br />
Close<br />
5.4 <strong>The</strong> trust is entitled to review data produced at each<br />
stage of the design process. It has the right to object and<br />
withhold approval where:<br />
5.4.1 it believes the design would not meet its requirements,<br />
as set out in the output specification(s) or<br />
ITN; or<br />
5.4.2 the design does not achieve clinical functionality.<br />
5.5 <strong>The</strong> fact that the trust has a right to review and<br />
object does not imply acceptance of any design responsibility<br />
on the part of the trust. <strong>The</strong> broad principle is that<br />
it is the responsibility of the trust to ensure that it can<br />
carry out its clinical functions in the hospital. It is the<br />
consortium’s responsibility to ensure that the detailed<br />
development of its design brief and the detailed development<br />
of the hospital design enable the trust to carry out<br />
its clinical functions. <strong>The</strong> trust’s sign-off and acceptance<br />
of risk thus relates purely to clinical functionality. What<br />
clinical functionality means in practice is set out in section<br />
5.6 below.<br />
5.6 Areas where the trust will not take design risk include,<br />
inter alia, the following:<br />
5.6.1 compliance of design with statute, regulations, fire<br />
strategy;<br />
5.6.2 safety aspects of the design;<br />
Revision 1 – August 2004<br />
5.6.3 that the design will achieve satisfactory planning<br />
consent;<br />
5.6.4 consistency of design with the project as a whole<br />
or consistency of various design documents with<br />
each other;<br />
5.6.5 engineering and structural aspects of design;<br />
5.6.6 materials, workmanship and technical per<strong>for</strong>mance<br />
of the building;<br />
5.6.7 the impact of design on the contractor’s ability to<br />
meet the project requirements; and<br />
5.6.8 design layout of areas to be used by the contractor.<br />
“<br />
the broad principle is<br />
that it is the responsibility<br />
of the trust to ensure that<br />
it can carry out its clinical<br />
functions in the hospital<br />
”<br />
5.7 Clinical functionality refers, and refers only, to the<br />
project’s capacity <strong>for</strong> use by the trust or its staff <strong>for</strong><br />
carrying out the trust’s clinical functions and non-clinical<br />
functions. <strong>The</strong> trust’s non-clinical functions are deemed<br />
to include all hard and soft facilities management services<br />
retained by the trust that are outwith the bidder’s<br />
responsibility.<br />
5.8 In assessing clinical functionality the trust will review<br />
all design data including, in particular, fully loaded 1:50<br />
scale drawings. In approving the design it will be signing<br />
off conclusively on clinical functionality as indicated by the<br />
in<strong>for</strong>mation presented. Any subsequent changes after<br />
Financial Close made at the request of the trust to<br />
achieve clinical functionality will be at the trust’s risk and<br />
will be treated as trust changes. <strong>The</strong>se trust changes will<br />
be priced, and any resulting change in the cost will feed<br />
21
<strong>The</strong> <strong>Design</strong> <strong>Development</strong> <strong>Protocol</strong> <strong>for</strong> <strong>PFI</strong> schemes<br />
5. <strong>Design</strong> sign-off – pre-Financial Close<br />
into a revised unitary charge in accordance with the<br />
change mechanism.<br />
5.9 <strong>The</strong> approval process will not impinge upon the<br />
contractor’s responsibility to achieve the per<strong>for</strong>mance<br />
standards and, where appropriate, availability standards<br />
established in the trust’s output specifications. Achievement<br />
of these per<strong>for</strong>mance and availability standards will<br />
remain the contractor’s risk, and this will be reflected in<br />
the payment mechanism.<br />
Review <strong>for</strong> clinical functionality<br />
5.10 This section of the protocol is intended to identify<br />
the specific areas over which the trust will carry out its<br />
review <strong>for</strong> clinical functionality.<br />
5.11 <strong>The</strong> trust’s review <strong>for</strong> clinical functionality will<br />
include:<br />
5.11.1 positioning of roads, footpaths and car parks at<br />
a scale of 1:1000;<br />
5.11.2 departmental relationships and adjacencies at a<br />
scale of 1:500 macro level;<br />
5.11.3 departmental layouts and room adjacencies at a<br />
scale of 1:200 micro level;<br />
Atrium, Halifax General Hospital<br />
22<br />
5.11.4 fully loaded room layouts detailed in 1:50 drawings.<br />
This review will cover the clinical functionality<br />
of:<br />
• room size and usable floor space;<br />
• room shape and compliance with ergonomic<br />
data and minimum critical dimensions;<br />
• room elevations;<br />
• access points/location of doors and windows;<br />
• location of utilities, engineering and specialist<br />
services;<br />
• location of equipment including IM&T provisions;<br />
• floor areas;<br />
• departmental floor areas; and<br />
• overall building footprint.<br />
5.12 <strong>The</strong> trust should make it clear that the following<br />
items are not covered:<br />
5.12.1 sufficiency of non-departmental corridor and<br />
communications space;<br />
5.12.2 ceiling heights; and<br />
5.12.3 environmental aspects of design, <strong>for</strong> example<br />
temperature, lighting and humidity.
Appendix A: Standards and guidance relevant to design and construction<br />
1 <strong>The</strong> following documents are sources of standards <strong>for</strong><br />
design and construction and should be considered when<br />
drawing up the architectural output specification.<br />
Statutory requirements<br />
2 Bidders should be required to comply with the statutory<br />
requirements applicable to the project, which will<br />
include the building regulations, water bylaws, the Health<br />
and Safety at Work etc Act and the requirements of the<br />
Fire Authority. <strong>The</strong> trust needs to ensure compliance with<br />
“Guidelines <strong>for</strong> Implementing Controls Assurance in the<br />
NHS” and HSC 1999/123.<br />
British Standards and British Standard Codes<br />
of Practice<br />
3 “Catch-all” obligations requiring bidders to comply with<br />
all British Standards and all British Standard Codes of<br />
Practice should be avoided as they cover a very extensive<br />
range of documents, only some of which will be directly<br />
applicable to the project, and which contain inconsistencies<br />
and contradictions. Trusts’ technical advisers, in referring<br />
to British Standards or Codes of Practice, should<br />
be specific, and it should be made clear whether they are<br />
mandatory or simply to be treated as guidance.<br />
Health Technical Memoranda (“HTMs”)<br />
4 HTMs give comprehensive advice and guidance on the<br />
design, installation and operation of specialised building<br />
and engineering technology used in the delivery of healthcare.<br />
<strong>The</strong>y include Firecode, which sets standards <strong>for</strong> the<br />
layout, design, construction and fire safety management<br />
of hospitals and other healthcare premises. <strong>The</strong> Secretary<br />
of State <strong>for</strong> Health has retained powers of direction under<br />
the NHS Community Care Act 1990, which requires NHS<br />
healthcare premises (including trust premises) to comply<br />
with Firecode, and the Chief Executive and General Managers<br />
of the trust are responsible <strong>for</strong> ensuring that this is<br />
implemented. <strong>The</strong>re have been instances in the past<br />
where Firecode has been in conflict with the requirements<br />
of building control officers, and the output specification<br />
should make it clear to bidders which set of requirements<br />
is to take precedence in the event of such a conflict.<br />
5 Other HTMs should be reviewed, and it should be<br />
stated explicitly, in the output specification by the trust,<br />
which will be regarded as mandatory and which are desir-<br />
able. Bidders will not be required to have regard <strong>for</strong> HTMs<br />
not listed in the output specification.<br />
Health Building Notes (“HBNs”)<br />
6 <strong>The</strong> HBN series is intended to give advice on the<br />
briefing and design implications of Departmental policies.<br />
<strong>The</strong>y are supplemented by Health Guidance Notes<br />
(“HGNs”), which highlight new legislation and respond to<br />
changes in departmental policy or reflect changing NHS<br />
operational requirements.<br />
7 In drafting the output specification, trusts should give<br />
particular consideration to how they wish to deal with the<br />
four HBN volumes dealing with common activity spaces.<br />
<strong>The</strong>se provide detailed ergonomic data and specify critical<br />
dimensions <strong>for</strong> the efficient functioning of an activity.<br />
Because of its cost implications, this is often an area of<br />
considerable debate during the bidding process, so<br />
trusts may wish to expressly require bidders to comply<br />
with or exceed the preferred minimum dimensions set out<br />
in these HBNs, or to require bidders to in<strong>for</strong>m the trust<br />
where they do not so comply.<br />
Health Facility Notes (“HFNs”)<br />
8 HFNs contain no <strong>for</strong>mal policy input from the Department<br />
of Health, but they do provide guidance on certain<br />
key issues. Trusts should review these <strong>for</strong> applicability as<br />
requirements or guidance, and disclose those which<br />
should be used either way. An example is the HFN<br />
‘<strong>Design</strong> against crime: a strategic approach to hospital<br />
planning’, which deals with the impact of space on crime<br />
and security and how design can be used in the prevention<br />
of crime.<br />
Encode guidance<br />
9 This guidance can assist in the planning of energysaving<br />
proposals. Again, it should be reviewed <strong>for</strong> its applicability<br />
as mandatory or as guidance, and fully disclosed<br />
in either case.<br />
Other NHS Estates guidance<br />
10 Health notices produced by NHS Estates relating to<br />
hazards and safety can also be useful, as they have been<br />
drafted as a result of experience in the field. <strong>The</strong> Patients’<br />
Charter also establishes minimum standards to be<br />
achieved in specific areas, including the provision of<br />
23
Appendix A: Standards and guidance relevant to design and construction<br />
single-sex wards, privacy, and access <strong>for</strong> the physically<br />
impaired. Where the NHS have required trusts to achieve<br />
certain standards in respect of these requirements, those<br />
standards should be made clear as mandatory in the<br />
trust’s output specification.<br />
11 In addition to clarifying the status of the standards<br />
and guidance, trusts should also take account of the fact<br />
that, in some instances, documents to which they have<br />
referred may not be consistent with current legislation or<br />
good practice due to the time that has elapsed since the<br />
guidance was written. Where the trust’s technical advisers<br />
are aware that this is the case, they should make it<br />
clear that these aspects of the documents should be<br />
ignored. Trusts could also require bidders to highlight any<br />
further areas of documents with which compliance is<br />
mandatory which do not comply with either current<br />
legislation or current good practice, as adherence with<br />
legislation and good practice should remain the contractor’s<br />
risk.<br />
Achieving Excellence in <strong>Design</strong> Evaluation Toolkit<br />
(“AEDET”)<br />
12 <strong>The</strong> pursuit of high design quality <strong>for</strong> public buildings<br />
is Government policy and high on the agenda, and as a<br />
result Trusts are required to state how they intend to<br />
achieve and monitor high design quality. To support this<br />
directive NHS Estates have produced a design appraisal<br />
procedure (“AEDET”) that will provide the basis of a<br />
Trust’s appraisal of bidders’ design submissions. <strong>The</strong><br />
toolkit is intended to be used at various key stages in the<br />
design development process and to support the nonfinancial<br />
assessments of the various bids. Consortia will<br />
be expected to work with trusts to develop Achieving<br />
Excellence in <strong>Design</strong> Evaluation Toolkit assessments of<br />
relevant designs.<br />
NHS Environmental Assessment Tool (“NEAT”)<br />
13 <strong>The</strong> Government is committed to tackling pollution<br />
and improving the environment, and to support this policy<br />
and help the NHS deliver its targets NHS Estates have<br />
produced an NHS Environmental Assessment Tool<br />
(“NEAT”) that will provide a holistic approach to the<br />
environmental assessment <strong>for</strong> the NHS. <strong>Schemes</strong> will be<br />
evaluated by NHS trusts using this toolkit.<br />
24
Appendix B: NHS equipment group classifications<br />
1 Equipment <strong>for</strong> hospitals is categorised into four<br />
groups, as follows, and generic listings of equipment and<br />
their grouping <strong>for</strong> model departments are defined within<br />
the NHS Estates Activity DataBase:<br />
1.1 Group 1 equipment: items (including engineering<br />
terminal outlets ) supplied and within the terms of<br />
the building contract.<br />
• This means equipment that is normally fixed to the<br />
building fabric and/or attached to, or <strong>for</strong>ming part<br />
of, the building services. This may have an impact<br />
on space and/or building services to be provided,<br />
and will normally be supplied and fitted by the<br />
contractor (<strong>for</strong> example worktops, autoclaves,<br />
sanitary fittings, bedhead units, theatre lights, terminal<br />
outlets).<br />
• If the trust has any particular requirements in<br />
respect of Group 1 equipment, these should be<br />
specified. <strong>The</strong>re are a number of areas that have<br />
given problems in the past. <strong>The</strong>se include the provision<br />
of socket-outlets in acute care and theatre<br />
areas, where clinicians often wish to see more<br />
sockets provided than are specified in the NHS<br />
guidance. <strong>The</strong>atre lights and pendants are another<br />
area where clinical requirements are very specific<br />
and should be established in the output and<br />
per<strong>for</strong>mance specifications. <strong>The</strong> trust there<strong>for</strong>e<br />
needs to establish what its requirements will be<br />
relative to the guidance levels and to set these out<br />
in the output and per<strong>for</strong>mance specification.<br />
1.2 Group 2 equipment: items which have space<br />
and/or building construction and/or engineering<br />
service requirements and are fixed within the<br />
terms of the building contract but supplied under<br />
arrangements separate from the building contract.<br />
• This means equipment included in the final room<br />
data sheets as Group 2 which is normally fixed to<br />
the building fabric and/or attached to the building<br />
services and which will normally be fitted by the<br />
contractor but supplied under arrangements<br />
separate from the <strong>PFI</strong> contract. Where trusts<br />
require items ordinarily categorised as Group 2 to<br />
be supplied by the Private Sector Partner, these<br />
items should be categorised as Group 1 equipment.<br />
In general, these items tend to be relatively<br />
minor compared with Group 1 items (<strong>for</strong> example<br />
paper towel/glove dispensers, key cupboards, pin<br />
boards etc). <strong>The</strong>y could also include major diagnostic<br />
imaging and radiotherapy “big ticket” items<br />
which, like Group 1 items, may have an impact on<br />
space and/or building services to be provided.<br />
<strong>The</strong> trust should compile an accurate and complete<br />
list of its requirements <strong>for</strong> Group 2 equipment,<br />
in terms of procurement, quantity, engineering<br />
services, environmental and quality standards.<br />
Bidders should be expected to establish the<br />
necessary service, space and environmental<br />
requirements <strong>for</strong> such equipment and include it in<br />
their bids.<br />
• Certain major items of equipment, such as major<br />
diagnostic imaging equipment or linear accelerators<br />
etc, will require particular attention. In a <strong>PFI</strong><br />
contract the trust will need to consider the risk,<br />
potential delay, cost and implication <strong>for</strong> life-cycle<br />
replacement and maintenance of not including it<br />
within the contract. <strong>The</strong> trust will also need to<br />
consider that this type of equipment has implications<br />
in terms of space, access, shape of rooms,<br />
environmental requirements, engineering services<br />
and commissioning. <strong>The</strong> inclusion will have to be<br />
considered against the clinical needs and changing<br />
technology.<br />
1.3 Group 3 equipment: as Group 2 but supplied<br />
and fixed (or placed in position) under arrangements<br />
separate from the building contract.<br />
• This means those items included in the final room<br />
data sheets as Group 3 items which are freestanding<br />
and/or mobile and/or “plug-in” items,<br />
which will normally be provided by the trust (<strong>for</strong><br />
example beds, clinical furniture, ECG machines,<br />
vacuum pumps etc). Where trusts require items<br />
ordinarily categorised as Group 3 to be supplied<br />
by the contractor, these items should be categorised<br />
as Group 1 equipment. <strong>The</strong> exception to this<br />
are Group 3 items required <strong>for</strong> services to be<br />
provided by the Private Sector Partner, which<br />
would normally be provided by the Private Sector<br />
Partner. <strong>The</strong> service, space and environmental<br />
requirements <strong>for</strong> items other than those provided<br />
by the Private Sector Partner, many of which may<br />
be crucial to the healthcare requirements of the<br />
trust and expensive to provide, should be specified<br />
by the trust. Certain items of mobile equipment<br />
(<strong>for</strong> example mobile radiological equipment)<br />
will require careful consideration in terms of space,<br />
environmental and service requirements. <strong>The</strong> trust<br />
should also specify any constraints about location,<br />
access and storage.<br />
25
Appendix B: NHS equipment group classifications<br />
• It is also important <strong>for</strong> the trust to highlight the<br />
extent to which any existing Group 3 equipment<br />
will transfer to the Private Sector Partner.<br />
1.4 Group 4 equipment: items supplied under arrangements<br />
separate from the building contract,<br />
possibly with storage implications but otherwise<br />
having no effect on space or engineering service<br />
requirements.<br />
• This means those items that are not included on<br />
the final room data sheets that, apart from storage<br />
implications, have no effect on the requirements<br />
<strong>for</strong> space or engineering services. <strong>The</strong>se items are<br />
normally provided by the trust (<strong>for</strong> example surgical<br />
instruments, telephone handsets etc). <strong>The</strong> only<br />
exception to this are the Group 4 items required<br />
<strong>for</strong> services to be provided by the Private Sector<br />
Partner, which would normally be provided by the<br />
Private Sector Partner.<br />
2 In summary, the more detail the trust is able to provide<br />
regarding the equipment required, the greater the level of<br />
price certainty obtained. Where sufficient detail has been<br />
provided, the risks of failing to meet the trust’s equipment<br />
specification will rest with bidders. However, given the<br />
potential <strong>for</strong> uncertainty in this area and the costs involved,<br />
trusts are advised to ensure that their technical<br />
advisers comment on whether the bids they receive are<br />
sufficiently robust in respect of equipment.<br />
In<strong>for</strong>mation to Bidders<br />
3 <strong>The</strong> trust is to provide in<strong>for</strong>mation on the assumptions<br />
made <strong>for</strong> the provision of equipment in the PSC. This<br />
Category A – Supplied, installed,<br />
commissioned, maintained and<br />
replaced by project company<br />
Category B – Supplied by the trust<br />
– installed, commissioned and<br />
maintained by project company.<br />
Replaced by the trust<br />
Category C – Supplied, installed<br />
and replaced by the trust –<br />
maintained by project company<br />
Category D – Supplied, installed,<br />
commissioned, maintained and<br />
replaced by the trust<br />
26<br />
should be developed from estate, equipment and capital<br />
databases to reflect their expectations <strong>for</strong> the <strong>PFI</strong><br />
scheme. It will not be sufficient to rely on NHS standard<br />
equipment groupings alone, but these should be considered<br />
as follows.<br />
• Category A: equipment which is supplied, installed,<br />
commissioned, maintained and replaced<br />
by the project company and is essential and integral<br />
to the building;<br />
• Category B: equipment which is supplied by the<br />
trust. It is installed, commissioned, and maintained<br />
by the project company but replaced by the<br />
trust;<br />
• Category C: equipment which is supplied, installed<br />
and replaced by the trust and maintained<br />
by the project company;<br />
• Category D: equipment which is supplied,<br />
installed, commissioned, maintained and replaced<br />
by the trust.<br />
3.1 <strong>The</strong> trust may have assumed that some categories<br />
of equipment will need to be transferred<br />
from the existing hospital, and this equipment and<br />
quantity should be identified against the above<br />
categories. It should also be carefully assessed as<br />
being useable at the anticipated time of transfer,<br />
and the decommissioning, transfer, re-installation<br />
and insurance costs and responsibilities should be<br />
established.<br />
3.2 Facilities management equipment is classified as<br />
Category A unless the services are not being<br />
transferred to the project company.<br />
Group 1 Group 2 Group 3 Group 4 Notes<br />
Example<br />
Included FM and capital<br />
cost of equipment by<br />
project company<br />
Trust to identify<br />
transferable equipment<br />
This must be a fully itemised list under categories A–D plus full details of what if anything will be included in a Managed Equipment Service.<br />
Note it is essential that decommissioning ,insurance and re-commissioning costs are included in the trust PSC,so that true comparisons can be made.
Appendix C: PITN capital cost<br />
Functional Content Area by Department<br />
New<br />
Refurbishment<br />
Adaptation<br />
Gross Area including communication and public spaces<br />
New<br />
Refurbishment<br />
Adaptation<br />
Capital Cost £<br />
Equipment Cost £<br />
External Works and Infrastructure capital cost £<br />
Fees, overheads and profit £<br />
Gross capital cost (including fees, profit, overheads etc) £<br />
Service elements<br />
Service type Rate<br />
Hard FM Services (£/m 2 per annum) – life-cycle risk<br />
Portering (£/m 2 per annum)<br />
Linen (£ per 1000 articles)<br />
Cleaning (£/m 2 per annum)<br />
Catering (£ per 1000 meals)<br />
Security (£/m 2 per annum)<br />
Reactive maintenance (£/m 2 per annum) – no life-cycle risk<br />
Life-cycle element<br />
Concession period<br />
New build (£/m 2 per annum)<br />
Refurbished estate (£/m 2 per annum)<br />
Project Co costs (£/m 2 per annum)<br />
Equipment (£ per annum)<br />
Mean<br />
rate pa<br />
m 2<br />
m 2<br />
m 2<br />
m 2<br />
m 2<br />
1. 2. 3. 4. 5. 6. 7.<br />
27
Appendix C: PITN capital cost<br />
Concession period 8. 9. 10. 11. 12. 13. 14. 15.<br />
New build (£/m 2 per annum)<br />
Refurbished estate (£/m 2 per annum)<br />
Project Co costs (£/m 2 per annum)<br />
Equipment (£ per annum)<br />
Concession period 16. 17. 18. 19. 20. 21. 22. 23.<br />
New build (£/m 2 per annum)<br />
Refurbished estate (£/m 2 per annum)<br />
Project Co costs (£/m 2 per annum)<br />
Equipment (£ per annum)<br />
Concession period 24. 25. 26. 27. 28. 29. 30.<br />
New build (£/m 2 per annum)<br />
Refurbished estate (£/m 2 per annum)<br />
Project Co costs (£/m 2 per annum)<br />
Equipment (£ per annum)<br />
Notes <strong>for</strong> the completion of the data capture<br />
<strong>for</strong>m<br />
• Functional content – should differentiate between:<br />
N (new build); A (adaptations of existing<br />
buildings <strong>for</strong> alternative use); or C (refurbishing<br />
existing buildings <strong>for</strong> current use). <strong>The</strong> trust’s<br />
estate should be assumed to be at Condition B,<br />
unless the trust has provided in<strong>for</strong>mation to the<br />
contrary. Where the project comprises existing<br />
estate and new build, the bidder should only<br />
report as capital those areas <strong>for</strong> which life-cycle<br />
risk will be accepted.<br />
• Floor area – estimates must be provided <strong>for</strong> the<br />
floor area contributed by each department or area<br />
into the project, irrespective of whether they are<br />
the result of new build or the usage of existing<br />
estate. Again, these estimates relate only to those<br />
elements of the project <strong>for</strong> which the bidder<br />
accepts life-cycle risk.<br />
• Equipment costs – these are to be expressed as<br />
capital values <strong>for</strong> the project and should assume<br />
at least the inclusions of Categories 1 and 2<br />
equipment (and other categories as advised by<br />
28<br />
the trust and to the extent detailed by the trust).<br />
Major items must be as specified by the trust at<br />
prices quoted by the trust.<br />
• External works and site infrastructure – should<br />
be expressed as one capital value and should only<br />
include those works to be paid <strong>for</strong> by the trust<br />
through the unitary charge. Other works which<br />
may be required by other organisations (such as<br />
the local council) and are funded from other<br />
sources should be excluded.<br />
• Advisory fees – should include an estimate of<br />
advisory fees to Financial Close (<strong>for</strong> example<br />
architects, corporate finance, legal). <strong>The</strong>reafter,<br />
other administrative charges (which may include<br />
advisory fees of one <strong>for</strong>m or another) should be<br />
included within the annual estimate of Project<br />
Company running costs.<br />
• Service elements – all rates should use the units<br />
specified. Bidders should assume that the services<br />
are configured in such a way as to deliver<br />
against the trust’s output and service specifications.
Appendix C: PITN capital cost<br />
• Life-cycle costs – should be estimated and profiled<br />
across the life of the concession period. No<br />
adjustment should be made <strong>for</strong> asbestos removal<br />
unless the trust has indicated otherwise. Hard FM<br />
is assumed to relate to services delivered to existing<br />
estate and new build <strong>for</strong> which the project<br />
company will take life-cycle risk. Where a limited<br />
maintenance service (commonly termed a “toolbox”<br />
service) is to be provided to existing estate,<br />
which does not constitute acceptance of life-cycle<br />
risk, this rate per square metre should be set out<br />
under “Reactive Maintenance”.<br />
• Assumptions – <strong>for</strong> ease of comparison, bidders<br />
should ensure that their pricing data are provided<br />
according to the following bases:<br />
– capital costs should be expressed at the MIPS<br />
level specified by the trust;<br />
– Bidders should indicate (if they have not already<br />
done so in their submission) the expected<br />
start date <strong>for</strong> the construction phase and<br />
its duration;<br />
– capital and life-cycle costs should be consistent<br />
with the trust’s decanting proposals;<br />
– lump sum figures <strong>for</strong> decanting costs will be<br />
<strong>for</strong> the private-sector scheme and not directly<br />
comparable with the PSC;<br />
– Bidders should assume that IM&T infrastructure<br />
is included within equipment and life-cycle<br />
costs. If the project is to include a significant<br />
IM&T procurement (<strong>for</strong> example a PACS system)<br />
which is to be funded through the same<br />
unitary charge as the build scheme, the capital<br />
and life-cycle implications should be identified<br />
separately in a <strong>for</strong>mat (and using assumptions)<br />
consistent with those <strong>for</strong> the build scheme;<br />
– Bidders should not adjust services or life-cycle<br />
costs <strong>for</strong> inflation. Trusts’ financial advisers will<br />
wish to apply a common set of financial conditions<br />
to the submissions to assist comparability;<br />
– unit costs should be presented on a gross<br />
basis, without any allowance <strong>for</strong> any offset<br />
owing to third-party income.<br />
It should be acknowledged that detailed discussions with<br />
users will not have taken place at PITN stage.<br />
29
Appendix D: Capital cost model FITN<br />
Bidders are required to submit a Full Financial Model<br />
setting out costs, financing etc. <strong>The</strong> Model should describe<br />
the basis on which the capital costs have been<br />
developed and clearly identify any exclusions.<br />
Separate elemental breakdowns (items 1a to 5n only)<br />
should be provided <strong>for</strong> each part of the construction<br />
30<br />
works (that is, <strong>for</strong> each phase and/or <strong>for</strong> each separate<br />
building). A separate breakdown should also be submitted<br />
<strong>for</strong> alteration/refurbishment works.<br />
Building description: ______________________________<br />
Gross floor area: _____________________ m 2<br />
Element<br />
Building & Engineering<br />
Cost £<br />
* 1a Substructure<br />
* 2a Frame<br />
* 2b Upper Floors<br />
* 2c Roof<br />
* 2d Stairs<br />
* 2e External Walls<br />
* 2f Windows & External Doors<br />
* 2g Internal Walls & Partitions<br />
* 2h Internal Doors<br />
* 3a Wall Finishes<br />
* 3b Floor Finishes<br />
* 3c Ceiling Finishes<br />
§ 4a Furniture & Fittings (group 1)<br />
§ 4b Workshop & other FM equipment (group 1)<br />
* 5a Sanitary Appliances<br />
§ 5b Medical Equipment (group 1)<br />
§ 5c Kitchen & Catering Equipment (group 1)<br />
§ 5d Other Services Equipment (group 1)<br />
* 5e Disposal Installations<br />
* 5f Mechanical Installations (†)<br />
* 5g Electrical Installations (†)<br />
* 5h IT & Communications (†)<br />
* 5i Pneumatic Tube Conveyor<br />
* 5j Medical Gases, Compressed Air & Vacuum Systems<br />
* 5k Building Management System<br />
* 5l Renal Dialysis Water Supplies<br />
* 5m Lifts<br />
* 5n Builders work in connection with Engineering Services<br />
Total Building and Engineering (a)
Appendix D: Capital cost model FITN<br />
Element Cost £<br />
External Works<br />
* 6a Site Clearance and Demolition<br />
* 6b Preparatory Earthworks<br />
* 6ca Site Access Roads and Parking<br />
* 6cb Multi-storey Car parks<br />
* 6d Paths and Paved Areas<br />
* 6e Soft Landscaping<br />
* 6f Fencing and Site Fittings<br />
* 6g Other Site Works (retaining walls etc)<br />
* 6h Drainage<br />
* 6i External Services<br />
* 6j External Lighting<br />
* 6k Buildings work in connection with External Services (including Service Tunnels etc)<br />
* 6l Minor Building Works<br />
Total External Works (b)<br />
Alteration Works<br />
* 7a Alteration Works<br />
* 7b Temporary Structures and Other Enabling Works<br />
Total Alterations etc (c)<br />
Preliminaries<br />
* On-site staff<br />
* Sundry costs<br />
* On-site labour<br />
* Materials and goods<br />
* Plant, consumables, stores and services<br />
* Insurances<br />
Total Preliminaries (d)<br />
Contingency<br />
‡ <strong>Design</strong> Reserve<br />
‡ Construction Contingency<br />
Total Contingency (e)<br />
TOTAL CONSTRUCTION COSTS (at Base Date) (a+b+c+d+e) sub total (f)<br />
31
Appendix D: Capital cost model FITN<br />
• Bidders should provide a detailed and fully quantified<br />
cost plan which arithmetically supports the<br />
figures (as marked by an asterisk *) inserted within<br />
the above capital cost breakdown. <strong>The</strong> cost plan<br />
must be presented in sufficient detail to identify<br />
the specification, quantity and rate <strong>for</strong> all major<br />
materials and components adopted <strong>for</strong> both the<br />
builder’s work and the engineering installations.<br />
• Elements 4b and 5c may be included in the service<br />
providers’ charges and not available as a<br />
lump sum.<br />
32<br />
Element Cost £<br />
Contractors’ Fees<br />
Contractors’ pre-construction fee<br />
Contractors’ overheads and profit<br />
* Contractors’ costs (specify)<br />
Total Contractors’ Fees (g)<br />
<strong>Design</strong> & Technical Fees<br />
Architects’ Fee<br />
Structural/Civil Engineers’ Fee<br />
Services Engineers’ Fee<br />
Quantity Surveyors’ Fee<br />
Planning Supervisors’ Fee<br />
Healthcare Planners’ Fee<br />
On-site Supervision<br />
Other Fees (specify)<br />
Total <strong>Design</strong> & Technical Fees (h)<br />
Non-works Costs<br />
Planning Fees<br />
Building Regulations<br />
Other Statutory or Local Authority Charges (specify)<br />
Site Surveys & Investigations<br />
Other fees or non-works costs (specify)<br />
Total Non-works Costs (j)<br />
Risk Allowance<br />
‡ Risk Allowance<br />
Total Risk Allowance (k)<br />
* Any other Capital Costs not identified above<br />
Total Other Costs (m)<br />
¿ Inflation on construction costs etc (n)<br />
TOTAL CAPITAL COSTS (out-turn) (f+g+h+j+k+m+n)<br />
• For clarification, Bidders may include with their<br />
cost plan a detailed and fully quantified breakdown<br />
of preliminaries, which arithmetically supports<br />
the figures, split into the six categories<br />
identified above (that is, provide schedules which<br />
identify and cost numbers of staff in terms of man<br />
days, confirm provision <strong>for</strong> site accommodation,<br />
crane age, scaffolding, skips etc).<br />
• Bidders may provide details to support the Contingency/Risk<br />
Allowance (marked ‡ above).<br />
• For clarification, Inflation (¿) should be shown<br />
against construction cost items. Figures inserted
Appendix D: Capital cost model FITN<br />
against Contractors’ Fees, <strong>Design</strong> & Technical<br />
Fees, Non-works Costs, Risk Allowance and<br />
Other Costs are assumed to be fixed and inclusive<br />
of inflation.<br />
• Bidders should provide the engineering elements<br />
(marked † above) broken down as follows:<br />
Services Engineering Elements<br />
Mechanical Services: (5f) Heat source and Prime Movers<br />
Steam distribution<br />
Condensate return<br />
Cold water services<br />
Domestic hot water services<br />
Heating<br />
Electrical Services: (5g) HV Services<br />
Ventilation and air conditioning<br />
Chilled water installations<br />
Internal fire protection installations<br />
Standby Generators & UPS<br />
LV Distribution, Main and Sub-Main Cabling<br />
Internal Lighting Installation & Luminaires<br />
Emergency Lighting<br />
Small Power Services<br />
Patient/Nurse Call Systems & Other Call Systems<br />
Fire Detection and Alarm Systems<br />
Alarm and Security Systems and CCTV<br />
Radio Sound Distribution Systems & TV Aerial Amplifiers & Wiring<br />
Wiring to Mechanical Services and BMS<br />
Containment <strong>for</strong> use by others<br />
Lightning Protection System<br />
Earthing Systems<br />
IT & Communications: (5h) Structured Cabling Systems<br />
LAN Active Equipment<br />
Telephone Handsets and Payphones<br />
33
Appendix D: Capital cost model FITN<br />
Equipment<br />
• Bidders should provide the equipment elements<br />
(marked § above) broken down, as a minimum, as<br />
follows:<br />
Equipment Cost Analysis<br />
Furniture & Fittings (4a) Based on generic RDS’s or bidder’s scheme details<br />
Workshop & Other FM Equipment (4b) May be included in the service providers charges and not available as a lump sum<br />
Kitchen & Catering Equipment (5c) May be included in the service providers charges and not available as a lump sum<br />
Medical Equipment(5b) Based on unsigned off accommodation and bidder’s selection of provider.<br />
• For the avoidance of doubt, medical equipment<br />
should include theatre lights and pendants, fume<br />
cupboards and laboratory tables, post-mortem<br />
tables, body stores, patient hoists and autoclaves<br />
and washers.<br />
• Bidders should provide, as a minimum, a detailed<br />
and fully quantified and costed schedule of equipment<br />
which arithmetically supports the allowances<br />
against each of the above sub-categories of medical<br />
equipment (with the exception of “other”).<br />
Bidders should state their assumptions against all other<br />
figures (that is, <strong>for</strong> equipment other than medical equipment)<br />
where no schedule is provided (<strong>for</strong> example if “nil”,<br />
whether allowed <strong>for</strong> outside the Capital Costs).<br />
Capital cost summary <strong>for</strong> FITN<br />
From the in<strong>for</strong>mation set out above, the Bidders should<br />
summarise the capital costs in the <strong>for</strong>m prescribed below;<br />
the summary must cover and identify separately the<br />
whole of the anticipated capital expenditure on the project,<br />
including:<br />
• building and engineering costs, broken down into<br />
individual phases or buildings;<br />
• external works and alterations;<br />
• preliminaries and contingencies;<br />
• contractors’ and design and technical fees;<br />
• non-works costs and risk;<br />
• other capital costs.<br />
<strong>The</strong> alphabetical references are to the subtotals in the<br />
capital cost model <strong>for</strong> each block.<br />
34
Appendix D: Capital cost model FITN<br />
Capital and development costs summary<br />
Element Phase or<br />
Building<br />
Building & Engineering (a)<br />
External Works (b)<br />
Alterations (c)<br />
Preliminaries (d)<br />
Contingencies (e)<br />
TOTAL CONSTRUCTION<br />
COSTS (Base Date) (f)<br />
Contractors Fee (g)<br />
<strong>Design</strong> & Technical Fees (h)<br />
Non Works Costs (j)<br />
Risk (k)<br />
Other Capital Costs (m)<br />
Inflation (n)<br />
TOTAL CAPITAL COSTS<br />
(Out-turn)<br />
Phase or<br />
Building<br />
Phase or<br />
Building<br />
Phase or<br />
Building<br />
Phase or<br />
Building<br />
Phase or<br />
Building<br />
Phase or<br />
Building<br />
35
Appendix E: Capital and development costs cash flow FITN<br />
<strong>The</strong> purpose of this return is to enable the trust to quickly<br />
be assured that the funding and cash flow is in place to<br />
support the level of costings in the pro-<strong>for</strong>mas and that<br />
the bidder has created a risk reserve.<br />
Bidders should provide the extract of their financial model<br />
cash flow statement which covers the capital costs, that<br />
is, the “<strong>Development</strong>”, “Construction” and “Lifecycle”<br />
costs. This is the cash flow used to cover all the build<br />
elements and life-cycle activities/costs in the pro-<strong>for</strong>mas<br />
in Appendices D and F. Bidders, in addition, are to clearly<br />
state if any of the categories and elements in the pro<strong>for</strong>mas<br />
are not included in these figures.<br />
Bidders should also confirm that they have Debt Service<br />
Reserve (DSR) and Life-cycle/Maintenance Reserve<br />
arrangements in place, although figures are not required<br />
here.<br />
36
Appendix F: Life-cycle costs FITN<br />
<strong>The</strong> summary cash flow of projected life-cycle expenditure<br />
should be submitted on the pro-<strong>for</strong>ma overleaf on a<br />
year-by-year basis. In each instance the Bidder should<br />
highlight design life and assumed replacement cycles.<br />
<strong>The</strong> detailed elemental components to build up the lifecycle<br />
costs are shown in the supporting table which<br />
follows the pro-<strong>for</strong>ma.<br />
Separate breakdowns should be provided <strong>for</strong> each part<br />
of the construction works (that is, <strong>for</strong> each phase and/or<br />
<strong>for</strong> each separate building) and <strong>for</strong> each of the identified<br />
facilities. Works of statutory and condition B compliance<br />
in relation to the identified facilities should be shown separately.<br />
37
Appendix F: Life-cycle costs FITN<br />
Life-cycle cost summary FITN pro-<strong>for</strong>ma<br />
<strong>The</strong> Bidder should provide a summary cash flow of projected<br />
life-cycle expenditure (on a year-by-year basis) in<br />
the following <strong>for</strong>mat:<br />
Element<br />
38<br />
Replacement Cycle<br />
(Years)<br />
Structure & Fabric<br />
Structure (frame, upper floors, stairs)<br />
Roofs<br />
External walls<br />
Windows & external doors<br />
Internal walls & partitions<br />
Internal walls & partitions<br />
Internal Finishes<br />
Floor Finishes<br />
Ceiling Finishes<br />
Decorations<br />
External Decoration<br />
Internal Decoration<br />
Fittings & Furniture<br />
Furniture & Fittings<br />
Medical Equipment<br />
Kitchen & Catering Equipment<br />
Workshop & Other FM Equipment<br />
Maintenance of Equipment<br />
Services<br />
Sanitary<br />
Water<br />
Heating<br />
Cooling<br />
Ventilation & Air-conditioning<br />
Lifts and Escalators<br />
Electric Power<br />
Lighting<br />
IM&T & Communications<br />
Other M&E Services<br />
External Works<br />
Roads etc<br />
External Services<br />
Backlog<br />
Management Costs<br />
TOTAL LIFE-CYCLE COSTS (Base Date)<br />
Inflation<br />
TOTAL LIFE-CYCLE COSTS (Out-turn)<br />
£’000<br />
Annual Periods<br />
£’000 £’000
Appendix F: Life-cycle costs FITN<br />
All above cash flow figures to be inclusive of all “add-on<br />
costs”, <strong>for</strong> example access costs, preliminaries, overheads,<br />
profit, contingencies, disturbance and making<br />
good etc.<br />
• Bidders should submit a detailed and fully quantified<br />
equipment schedule which arithmetically supports<br />
the allowances <strong>for</strong> the repairs to/replacement<br />
of equipment included above. <strong>The</strong> equipment<br />
schedule should itemise equipment in the<br />
elements listed above.<br />
• For clarity, life-cycle costs <strong>for</strong> equipment within the<br />
identified facilities should include Category 1 and<br />
2 (installation and maintenance) equipment and<br />
the maintenance of Category 1, 2 and 3 equipment.<br />
Bidders should assume equipment to have<br />
Life-cycle costs: list of headings to build up life-cycle costs<br />
(This list is not exhaustive, and the bidder should add additional items as appropriate)<br />
Column A<br />
Element/Component<br />
Structure and Fabric<br />
been new, with no subsequent replacement<br />
(either to date or within the period leading up to<br />
the Bidder taking life-cycle responsibility).<br />
• Bidders should submit a detailed schedule clearly<br />
identifying life-cycle works assumed to be undertaken<br />
by the trust within identified facilities in order<br />
to sustain the current condition standard up to the<br />
date of handover of the identified facilities.<br />
• For clarity, life-cycle costs <strong>for</strong> IM&T within the<br />
identified facilities should include the replacement<br />
of cabling and active components. Bidders should<br />
allow <strong>for</strong> re-provision of all cabling and active<br />
components within the identified facilities prior to<br />
final opening of the new facilities.<br />
Column B<br />
Element Definitions<br />
Structure (frame, upper floors, stairs) ducts<br />
frames<br />
stairs<br />
balustrades<br />
protection rails<br />
gantry rails<br />
fire escapes<br />
floor structures<br />
Roofs repairs to/replacement flat roofs<br />
pitched roofs<br />
roof lights<br />
External walls external structure walls<br />
curtain walls<br />
cladding<br />
glazed screens<br />
Windows & external doors external doors and windows<br />
Internal walls & partitions internal walls and partitions<br />
Internal doors internal doors<br />
ironmongery<br />
borrowed lights<br />
Internal Finishes<br />
Floor finishes: repairs to/replacement vinyl flooring<br />
fitted carpets<br />
carpet tiling<br />
ceramic tiling<br />
Wall finishes: repairs to/replacement plaster<br />
ceramic tiling<br />
Ceiling finishes: repairs to/replacement suspended ceilings<br />
plasterboard ceilings<br />
39
Appendix F: Life-cycle costs FITN<br />
Column A<br />
Element/Component<br />
Column B<br />
Element Definitions<br />
Decoration<br />
External Decoration (including cleaning external surfaces)<br />
Internal Decoration walls<br />
ceilings<br />
doors<br />
other<br />
Equipment<br />
Furniture & Fittings: repairs to/replacement: Category A (shelves, cupboards, worktops, curtain rails etc)<br />
Category B<br />
Medical Equipment: repairs to/replacement: Category A (theatre lights, pendants, sterilizers, washers etc)<br />
Category B<br />
Kitchen & Catering Equipment: repairs to/replacement Category A (fridges, cookers, dishwashers etc)<br />
Category B<br />
Workshop & Other FM Equipment: repairs to/replacement Category A (workbenches etc)<br />
Category B<br />
Maintenance of Equipment Category A<br />
Category B<br />
Category C<br />
Services<br />
Sanitary installation; repairs, replacement and servicing to: sanitaryware<br />
taps<br />
valves<br />
waste, soil, overflow and vent pipes<br />
Water installation: repairs, replacement and servicing to: boosted cold water<br />
CWS pipework<br />
DHWS calorifiers and plant<br />
DHWS pipework<br />
water storage tanks<br />
Heating installation: repairs, replacement and servicing to: steam and HTHW shell and tube boilers<br />
medium & low pressure steel boilers<br />
combustion controls<br />
feed pumps<br />
feed treatment plant<br />
firing equipment<br />
fans<br />
instrumentation<br />
calorifiers and heat exchangers<br />
control equipment<br />
pipework installations<br />
pumps<br />
radiators – cast iron<br />
radiators – steel<br />
suspended ceiling heaters<br />
tanks<br />
valves<br />
Cooling installation: repairs, replacement and servicing to: refrigeration plant<br />
cooling coils<br />
pipework installations<br />
pumps<br />
valves<br />
40
Appendix F: Life-cycle costs FITN<br />
Column A<br />
Element/Component<br />
Services (continued)<br />
Column B<br />
Element Definitions<br />
Ventilation/Air-conditioning: repairs, replacement and servicing to: refrigeration plant, medium and large, compression and<br />
absorption<br />
distribution systems (pipework, ducts)<br />
terminal units<br />
cooler batteries<br />
fans and washers<br />
heater batteries<br />
heat rejection equipment<br />
package air handling equipment<br />
automatic temperature controls<br />
fire dampers<br />
Lifts and Escalators: repairs, replacement and servicing to: lifts<br />
escalators<br />
Electric power and lighting: repairs, replacement and servicing to: mains cabling<br />
electrical switchgear and distribution equipment<br />
final circuits and outlets<br />
electrical motors<br />
generators<br />
prime movers, reciprocating engines<br />
prime movers, turbine, gas and steam<br />
standby prime movers, diesel<br />
lighting<br />
Lighting: repairs, replacement and servicing to: lighting installations<br />
emergency lighting<br />
batteries, lead acid, sealed<br />
batteries, nickel alkaline, vented<br />
luminaires – bulbs and tubes<br />
luminaires – fittings<br />
Protection: repairs, replacement and servicing to: fire alarm systems<br />
intruder alarms<br />
CCTVs<br />
lightning protection<br />
IM&T and Communications cabling<br />
active components<br />
call systems<br />
clock systems<br />
Other M&E services: repairs, replacement and servicing to other<br />
services that are part of the building:<br />
building management system<br />
gas installations<br />
medical gases – pipework<br />
medical gases – outlets, valves and fittings<br />
medical vacuum and compressed air systems<br />
pneumatic conveyor<br />
smoke vents<br />
steel chimneys<br />
incinerators<br />
laundry plant, washing machines<br />
wet risers<br />
41
Appendix F: Life-cycle costs FITN<br />
Column A<br />
Element/Component<br />
External works<br />
42<br />
Column B<br />
Element Definitions<br />
Roads etc: repairs, replacement and services to: roads and paving<br />
hard landscaping<br />
fencing<br />
signage<br />
furniture<br />
External Services drainage<br />
water<br />
electric<br />
gas<br />
Backlog<br />
Management costs management costs associated with the above
Picture Credits:<br />
Page Front cover Anshen Dyer Architects (Proposed <strong>PFI</strong> scheme at Central<br />
Manchester and Manchester Children’s University Hospitals NHS<br />
Trust)<br />
Back cover Anshen Dyer Architects (Proposed <strong>PFI</strong> scheme at Central<br />
Manchester and Manchester Children’s University Hospitals NHS<br />
Trust)<br />
6 Capita Percy Thomas (<strong>PFI</strong> scheme at Derby Hospitals NHS<br />
Foundation Trust)<br />
7 Capita Percy Thomas (<strong>PFI</strong> scheme at Derby Hospitals NHS<br />
Foundation Trust)<br />
10 Swantre Hayden Connell Architects (Proposed <strong>PFI</strong> scheme at<br />
University Hospitals of Leicester NHS Trust)<br />
13 <strong>PFI</strong> scheme at County Durham and Darlington Acute Hospitals<br />
NHS Trust<br />
14 <strong>PFI</strong> scheme at County Durham and Darlington Acute Hospitals<br />
NHS Trust<br />
15 <strong>PFI</strong> scheme at Calderdale and Huddersfield NHS Trust<br />
17 <strong>PFI</strong> scheme at Buckinghamshire Hospitals NHS Trust<br />
19 <strong>PFI</strong> scheme at Norfolk and Norwich University Hospitals NHS Trust<br />
22 <strong>PFI</strong> scheme at Calderdale and Huddersfield NHS Trust<br />
Adult’s Concourse Children’s High Level<br />
Preferred bidder artist’s impression <strong>for</strong> Central Manchester