European Health Property Network

1. European Health Property Network Brian Gilroy National Director of Estates Brian.gilroy@hse.ie European Health Property Network Conference April 2008

2. European Health Property Network • Health Infrastructure: - what is it? • Current Health Estate • Estates Structure • Fact and Figures • Recent and Current work • Investment priorities & patterns • Realising Potential • Future Health Estate. European Health Property Network Conference April 2008

3. European Health Property Network • National Director of Estates • “Corporate” Estates functions: • Capital; Property/Office; Environment & Standards; Commercial & VFM; Architecture and Planning. • Regional Assistant National Directors • Delivery & Implementation. • Multi – disciplinary expertise • Restructuring in progress • Role of Hospitals, Institutions & Voluntary Bodies. European Health Property Network Conference April 2008

4. European Health Property Network Health Facilities – What are they? Include buildings, land, plant and equipment. Role they play: Clinical Economic Social Psychological Environmental European Health Property Network Conference April 2008

5. European Health Property Network Current Health Estate Illustrated: • Old - e.g. Dr.Steevens, Rotunda - Changing uses/urban & cultural importance • 19th Century – e.g. Workhouses - Accessibility • 1930’s - Type & standard of construction • 1950’s: Sanatoria - Building plans & Configuration • Late 20th Century: changing needs - Space standards & capacity • Into the 21st Century…….. European Health Property Network Conference April 2008

6. European Health Property Network Current Estate: Some facts and figures: • Acute Beds: 11,660 Public 4,400 Private • Co- Located project to deliver approximately 1,000 beds • Mental Health Beds: 4,000 • Long Stay Dependent Elderly: 8,205 Public 17,500 Private - (20-25% in buildings 150+ years) • 50+ Acute Hospitals Nationwide • Specialist facilities • Care Programmes: Primary Care; Acute Hospital, Childcare, Elderly, Mental Health, Disability. European Health Property Network Conference April 2008

7. European Health Property Network Drivers for Change: HSE Mission – “Easy Access, Public Confidence, Staff Pride” • Improved patient outcomes • Changing Models of Care • Integration of Primary and Secondary Care • In-Patient to day case shift • Aligning facilities with service needs • Inherited Historical Deficits • Changing demographics • Patient and staff expectations • Control of infections • Technical advances European Health Property Network Conference April 2008

8. European Health Property Network Drivers for Change (cont.): • Risk Management • Higher environmental & space standards • Safe Care • In-Patient to day case shift • Privacy and dignity • “Patient Focus” • “Healing environment” - Space, light, views, noise, colour, etc • Value for Money • Staff recruitment and retention European Health Property Network Conference April 2008

9. European Health Property Network Recent achievements: New and enhanced facilities, supporting improved clinical delivery, in more appropriate environments • St.Vincents University Hospital (awards…) • Cork Maternity Hospital • Tullamore • Thurles CNU (Community Nursing Units) • IBTS – Irish Blood Transfusion Service • Dublin Dental Hospital –International exemplars/world class European Health Property Network Conference April 2008

10. European Health Property Network In Design & being procured: • NRH – National Rehabilitation Hospital • Mater Adult • NPH – National Paediatric Hospital • Marymount Hospice • CNU’s (Community Nursing Units) • Primary Care Units • CMH (Central Mental Hospital) • Grangegorman European Health Property Network Conference April 2008

11. European Health Property Network Investment Priorities • Investment to support service reconfiguration and clinical priorities: Revenue consequences of capital investment • Improved delivery of projects • Efficiency and affordability whole life cost: - General ratio 1 (construction) : 10 (running) : 200+ (staff) over lifetime - (0.1 design) • Increasing complexity (NPH) (National Paediatric Hospital) European Health Property Network Conference April 2008

12. European Health Property Network Investment Patterns: NDP: 2007-2113 - €4.5bn Health: NHO: €2bn PCCC: €2.1bn NPRO:€415M (PPP) Minor Capital: €80m per annum ICT:€409m Total HSE 2008 Vote: €14.9bn 2008 Capital: €540m • Oversubscribed plan • Other funding sources: - Private (Co-Located); Revenue Stream ; Voluntary; Altruistic; Cross- Sectoral; Sale of surplus European Health Property Network Conference April 2008

13. European Health Property Network • Criteria for selection/tender list: • Answer questions • Health and Safety • Speedy Delivery • Understanding of Health Environment & Client requirements • Quality of design, construction, performance. European Health Property Network Conference April 2008

14. European Health Property Network Maximise Potential of Health Estate & New Capital Investment. • VFM • Learn lessons • Support innovation : - ICT - Model of care - Design - Construction process • International trends and practices • Recognise that not all significant clinical improvements will necessarily need significant capital investment. European Health Property Network Conference April 2008

15. European Health Property Network The future: • Better patient outcomes • Flexible and adaptable estate • Fit for purpose • Support service needs & priorities • Realistic lifespans • Planned programmes of investment • Healing and quality environments • Facilities a measure of worth of Health Service, those using the service, and those delivering care. European Health Property Network Conference April 2008