The challenges of delivering multiple PPP projects IAIN F GRAHAM

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1 The challenges of delivering multiple PPP projects IAIN F GRAHAM Director of Capital Planning & Projects NHS Lothian iain.graham@nhslothian.scot.nhs.uk Scottish health & social care facilities conference 2017 Day 2 Friday 3 rd November 2017

2 The journey The projects Timelines Preparing Enabling Contracting Other lessons along the way Q&A / video time

3 The context THE PROJECTS

4 Lothian Partnership Centre bundle Three new Partnership Centres to replace a number of NHS and local authority premises. Allemuir Partnership Centre 7.3 million Interesting info Operational October 2017 Blackburn Partnership Centre 8.2 million Interesting info Operational October 2017 Pennywell All Care Centre 12.1 million Interesting info Operational December 2017

5 Royal Edinburgh Hospital Campus redevelopment phase 1 48 million phase one included: Robert Fergusson National Brain Injury Unit a specialist clinic for the treatment of patients from across Scotland, suffering psychiatric or behavioural problems after a head injury was set up to create somewhere suitable for this specialist care. Royal Edinburgh Building A new facility providing services for the adult acute mental health inpatient service, older people s mental health assessment unit, Intensive Psychiatric Care Service (IPCU).

6 Royal Hospital for Children & Young People and Department of Clinical Neurosciences October 2017 Artist impression 150 million programme Over 60 departments moving during 2018

7 East Lothian Community Hospital 70 million programme Modern and purpose-built hospital developed on the existing Roodlands site in Haddington, helping improve the quality of care for people in East Lothian. New outpatients building will be occupied by patients from February 2018.

8 Dovetailed pipeline of work; resources spread across the projects TIMELINES

9 Multiple PPP Projects Construction Lothian bundle Blackburn IA OBC approval Construction starts complete Operational IA Pennywell All Care Centre IA Allemuir East Lothian Community Hospital IA OBC approval Construction starts Construction Complete (phase 1) Royal Edinburgh Campus Phase 1 IA OBC approval Construction starts handover Operational Operational Royal Hospital for Children & Young People and Department of Clinical Neurosciences OBC approval Construction starts Additional works Construction complete

10 Understanding, learning, testing, governing, procuring. PREPARING

11 Standing Financial Instructions.not commercial LOTHIAN HEALTH BOARD FINANCE AND RESOURCES COMMITTEE PRESENT [ ] (in the Chair) [ ] IN ATTENDANCE [ ] Extract of Minutes of a Meeting of the Finance and Resources Committee (the Board ) held in Edinburgh on 20 th January 2016 at 9 am QUORUM Pursuant to paragraph 5.5 (Quorum) of the NHS Lothian Standing Orders for the proceedings and business of Lothian Health Board and its Committees dated 2 April 2014, the Chairman noted that a quorum was present. Accordingly the Chairman declared the meeting duly convened. APOLOGIES [ ] DECLARATION OF INTERESTS No declaration(s) of interest(s) were raised in relation to any of the matters to be discussed. PARTNERSHIP CENTRE BUNDLE (the Project ) There was submitted by the Chief Executive of the Board the Partnership Centre Bundle Approval Submission dated October 2014 outlining the hub project to be entered into by the Board prior to 31 March 2016 (or such other date as may subsequently be approved by those persons identified in paragraph 5

12 Our requirements Balanced needs There may be alternative approaches Mandatory Indicative Operational Functionality Architectural Expression Interface Circulation Space Drawings + Specs Engineering Town Planning Hard FM

13 I thought it would be square

14 Understanding the pricing Standard form Actual scoring PRICE PRICE Linear Non-linear

15 De risking or. ENABLING

16 Project enabling Reinstatement + Use of neighbouring premises Utilities Service Strip Construction + Operational Access Rights Site Compound Reconfiguring Roads + Landscaping Drainage Connections

17 Let s make this easy.. Procurement route and structure of contracts Business cases Land acquisitions Enabling works derisk Demolitions and evictions

18 Land buying from partners..

19 Enabling Demolitions Examples include: Hospital buildings Bowling green and orchard Nursery Petrol filling station Public convenience (was not moved in the end.) Pub, dentist s and shopping centre (part of a regeneration)

20 Regeneration Clearing a site Changing architectural styles

21 The joy of revenue funded projects, simple.. CONTRACTING

22 Teamwork The home team away Our partners

23 Where do I (you) sign? Give the NHS a corner.. Partners.or election candidates

24 FC - Deal rooms London style (pre Brexit) Edinburgh style (Post Indy Ref )

25 Who do we work with?

26 Where does the money go?

27 Road bumps and OTHER LESSONS

28 Let s do something different... But the change process is the same as the last PPP? Isn't it?

29 Road bumps Clear guidance provided eventually ESA 2010 August 2014 Eurostat revised technical interpretation of ESA 2010, November 2014 SFT alert public bodies with projects nearing financial close of risk. November 2015 Hub Partnership Centre Bundle in first tranche of projects to be taken to FC Early 2016 Partnership Centre Bundle Financial Close PS (April 2017). NPD schemes confirmed as on balance REH 1 contract amended retrospectively. ELCH on revised hub model

30 Lessons NHS team uniforms Testing anti ligature fittings

31 What it is all about.building a healthier future Happy to take questions while we run a couple of video clips

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