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Our community, we care, you matter ......

New Hospital & Healthcare Facilities 14 th August 2014. Our community, we care, you matter. Working in partnership to transform healthcare in Orkney. Cathie Cowan Chief Executive. Our community, we care, you matter. Our Project.

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Our community, we care, you matter ......

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  1. New Hospital & Healthcare Facilities 14th August 2014 Our community, we care, you matter ......

  2. Working in partnership to transform healthcare in Orkney CathieCowan Chief Executive Our community, we care, you matter ......

  3. Our Project • This is not a routine contract / build. This is a legacy project that will profoundly influence healthcare in Orkney for the next 60 years plus • The quality of our solution will directly influence the safety of our most vulnerable people and the perception of their experience. This will be the most significant capital project the Board will undertake this century • We are a small Board with limited numbers of senior managers and senior clinical leaders. We’ve taken the decision to dedicate some of the very best of these to this project. It is therefore an outstanding team Our community, we care, you matter ......

  4. Our Project • Throughout this process we will be assisted by Scottish Government, Scottish Futures Trust, Health Facilities Scotland and external professional advisors. We will also work with our local partners notably Orkney Islands Council and Voluntary Action Orkney • We will want to work with a ‘bidder’ that fully understands our requirements and can demonstrate exceptional standards of innovation, engagement and delivery • Orkney has a tradition for outstanding architecture, many people over the centuries have come to Orkney and left their legacies – now our heritage, we want you to make the same impression Our community, we care, you matter ......

  5. Our Outline Business Case • Sets out our vision for reshaping and investing in health services as part of whole system health and care redesign • The underlying impetus driving this investment is three-fold: • Improving and redesigning clinical services • Benefits for our patients, our staff and our communities • Replacement of buildings • Articulates our clinical service delivery model and proposals for the replacement of our Rural General Hospital and related healthcare facilities within a landmark building Our community, we care, you matter ......

  6. Our Strategic Context Our community, we care, you matter ......

  7. Our Local Context • The new hospital and healthcare facilities will provide the functions both of a Rural General Hospital (RGH) for Orkney as well as two primary care practices with their own entity and sense of place. Public Dental Services, Scottish Ambulance Service and NHS24 will be co-located on site • Kirkwall Hospital is the only acute health care facility in Orkney and as such must manage all acute presentations. Unlike most mainland Boards, irrespective of demand it cannot close to admissions which reflects the need to have operational capacity both in terms of physical resources (beds) and workforce • Innovation to support health care delivery is vital to the success of this project Our community, we care, you matter ......

  8. Our Local Context • Our geography, our transport links and the need for our staff to respond to every emergency presents situations and opportunities to think and do things differently • NHS Orkney relies significantly on visiting Consultants to support specialist ambulatory care and outpatient activity. Scheduling appointments, admission and discharge time is dependent on air and ferry schedules. Some patient groups (e.g. maternity) may have a longer length of stay due to where they live and/or fixed travel timetables Our community, we care, you matter ...... Our community, we care, you matter ......

  9. Our Key Investment Objectives • To improve capacity and access to health care services – ensuring the health needs of the population are met • To provide facilities/services that are • Fit for purpose • Support safe and effective clinical working • Improve clinical and functional relationships • Enable the provision of modern NHS care • Provide sufficient flexibility for future changes to service provision • To ensure that the hospital and services are developed in such a way as to maximise performance and efficiency • To maximise benefits of shared facilities • To enable innovative ways of working • To develop an effective solution within an affordable financial envelope having regard to the cost and time taken to procure NHS premises Our community, we care, you matter ......

  10. Our expectations • A partner who shares our values • A partner who is just as passionate about providing innovative health service solutions as us • A partner who understands the importance of physical layouts and interior ambience and how that impacts on our patients, our staff and our visitors • A partner who respects and grasps our remote and rural context • A partner who acknowledges the importance of this Project and what it means for our communities • Our record shows we are a Board that aims high and achieves. As our partner, convince us that you share our ambition and demonstrate an ability to deliver a solution – that will become a memorable and outstanding legacy Our community, we care, you matter ......

  11. Deputy Director Scottish Government Health & Social Care Directorates Mike Baxter Our community, we care, you matter ......

  12. Importance of this project • Future proofing and providing sustainable services • Supports a clinical service model that has SG support • Utilising investment to maximise efficiency and value for money • Generational opportunity which must be maximised

  13. NPD In Context • Supplements our capital budget • New South Glasgow Hospitals completion & Legal Commitments • Remaining net capital budget directed towards maintenance/ equipment • State of the NHSScotland Asset and Facilities Report 2013 • Additional Investment supported by RDEL to CDEL Transfers of up to circa £100m per annum

  14. Delivering the NPD programme • Tried and tested standard processes and governance • SG, SFT and Boards working together to develop and deliver pipeline • Parameters already set out by Scottish Government – Letter to NHS Boards of 22 March 2011 http://www.pfcu.scot.nhs.uk • Focus on development of proposals with robust outline business cases • Defined scope • Affordability well developed • Delivery confidence essential

  15. Our Involvement in the Project • Explicit Support for Orkney project as part of Infrastructure Investment Plan published in December 2011 • Project Board • Capital Investment Group - Approval • Independent Assurance -Key Stage Review • Approve Funding Conditions

  16. Kerry Alexander NPD Programme Director Our community, we care, you matter ......

  17. A programme perspective Kerry Alexander NPD Programme Director

  18. 18 July 2014

  19. Major NPD projects status August 2014

  20. What makes this project different

  21. Drawing on lessons learned • Design - being clear what works and what can be improved on • Preparation and clarity on dialogue approach • Well resourced project team and bidder team • Agile and pragmatic decision making • Good stakeholder management

  22. Scottish Futures Trust

  23. Expectations of bidders • Addressing the need for great quality, highly sustainable facilities, delivered with maximum benefit to local communities • Consideration of the NPD principles and risk profile • Pragmatic approach to dialogue and standard contract • Appropriate rate of return for risks taken

  24. Gerry O’ Brien Deputy Chief Executive/ Director of Finance Our community, we care, you matter ......

  25. Your opportunity • Development must: • recognise the financial realities of the NPD programme • affordable and be delivered within cost cap • avoid unnecessary embellishment and unproductive space • provides space for needs not wants Our community, we care, you matter ......

  26. Reference Design • 12,900 m2 for hospital and primary care facilities • Plus 1,500m2 for Clinical Support Facilities in separate on-site building • Clinical Support facilities are office type accommodation that we believe are more efficiently provided in a separate on-site building • We wish to explore the optimum solution for the Clinical Support accommodation • Circa 300 car parking spaces and extensive landscaping Our community, we care, you matter ......

  27. Reference Design • Reference design: • prepared to RIBA stage 2 we seek solutions to enhance and improve this • made available to bidders along with our internal assessment using final bid evaluation criteria • We want bidders to be bring their own ideas, innovation and improvement, therefore limited mandating Our community, we care, you matter ......

  28. Mandated Elements • All inpatient beds to be on one level to achieve  co-located inpatient areas to facilitate the ability to flex beds and staffing when there are peaks and troughs of inpatient numbers across the separate units, without moving  or boarding patients • In-patient rooms to be designed with interlocking en-suite rooms • Clinical adjacencies to be compliant with the 1:500 adjacency matrix • Macmillan unit to have a dedicated entrance at ground level with direct access to an external garden area • The Schedule of Accommodation reflects the minimum space requirements Our community, we care, you matter ......

  29. Facilities Management • Standard form NPD Project Agreement provision of hard FM and lifecycle maintenance • No TUPE transfers envisaged • NHSO is open to dialogue with bidders to optimise FM delivery Our community, we care, you matter ......

  30. Energy • We will adopt the standard NPD Project Agreement position on energy provision • Bidders will be aware of significant renewable energy generation in Orkney which should provide opportunities for achievement of low carbon facility • Invite energy solutions that maximise operational energy efficiencies • BREEAM “excellent” rating against 2011 scheme Our community, we care, you matter ......

  31. Equipment and IT • Project Co to be responsible for provision of group 1 equipment and installation of group 2 • Some group 1 may be specified by NHSO • IT infrastructure must recognise that links to mainland hospitals outwith Orkney and outlying islands are crucial • Infrastructure to allow NHSO to be at the forefront of telehealth developments • Telehealth and IT decision making support is everyday business Our community, we care, you matter ......

  32. Stephen Kemp Regional Chair Scottish Builders Federation Our community, we care, you matter ......

  33. New Hospital & Healthcare Facilities Orkney Supply Chain

  34. All groundworks, drainage, road installation • Cranage and haulage • Concrete and associated formwork & steelwork • Steel erection and cladding • Blockwork, render, roughcast • Windows & Ext doors • Insulation and sealants • Dry lining and internal finishing joiner trades • Ames Taping • Decoration • Electrical, mechanical and plumbing • Ground source including boreholes (MCS) • Solar thermal & PV (MCS) • Surfacing, paving, road marking • Landscaping • Full FM support

  35. Ann McCarlie Project Director Our community, we care, you matter ......

  36. PQQ Timetable Our community, we care, you matter ......

  37. PQQ Questions Community Benefits (A19) • We want to contribute to sustaining and developing the wider Orkney community • opportunities for training, employment and education for the full term of the contract • This will be a landmark public building and we want the people of Orkney to identify with the development • the community should feel a sense of ownership of the design and of any artwork and the landscaping Our community, we care, you matter ......

  38. PQQ Questions Comparable Experience (B4, B5 and B6) • Covers PPP, Non PPP and remote and rural projects in last 5 years • 3 examples of PPP projects • 3 examples of non PPP projects • 2 examples of remote and rural projects Our community, we care, you matter ......

  39. PQQ Evaluation • Appendix 1 of the PQQ provides the proforma for completion in respect of each case study submitted by candidates • The evaluation methodology is set out in Appendix 2 • Appendix 3 details the sections within the PQQ and who should respond • Appendix 4 gives the scoring for questions B8 and C8

  40. Short-listing • The Board only intends to shortlist three candidates • The Board will shortlist those achieving the highest scores following the detailed evaluation • The shortlisted Candidates will each receive the Invitation to Participate in Dialogue which will confirm the arrangements for next stage of the procurement process and the award criteria Our community, we care, you matter ......

  41. Competitive DialogueTimetable

  42. Competitive DialogueTimetable

  43. NHSO Project Team

  44. NHSO Competitive Dialogue

  45. Project Overview and Summary Cathie Cowan Chief Executive Our community, we care, you matter ......

  46. Project Overview • This NPD project will include a Hospital and Healthcare facilities under one roof • This NPD project is very different to other Hospital Projects, it looks to deliver a Rural General Hospital • This is very different from a District General Hospital in that its main elective workload is ‘low’ risk, paradoxically its emergency care activity is as potentially acute as any tertiary care hospital Our community, we care, you matter ......

  47. Some of Our Unique Factors • The most significant and unique factor of this project is that whatever the circumstances the hospital cannot close to admissions • There are occasions when patients cannot be transferred off the island due to bad weather and acutely ill adults and children have to be cared for until transfer is possible • The scheduling of appointments, admission and discharge time is dependent on air and ferry schedules • Inter-island and mainland tele-medicine / video conferencing links are central to day-to-day clinical operations and must be robust and resilient Our community, we care, you matter ......

  48. The Challenge • To provide this unique facility within the cost cap • To build a facility that: • patients will feel at ease in • staff will enjoy working in • visitors will comment on its ambience • helps support the delivery of 21stcentury healthcare • the community will be proud of • The community should feel a sense of ownership of the design and it should utilise materials that look at home in Orkney and that are suitable for our distinct climate Our community, we care, you matter ......

  49. The Opportunity • In short, we want a partner that can acknowledge that this is a legacy project that will profoundly influence healthcare in Orkney for the next 60 years plus • We in return will promise a competent dialogue process that is open, flexible and works to timetable • We need you to recognise Orkney is special, people and communities matter to us, because we care • As a Board we aim high and achieve. As our partner convince us that you share our ambition and together let’s deliver a solution – that will become a memorable and outstanding legacy   Our community, we care, you matter ......

  50. Thank You

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