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HBG takes the drama out of the hospital crisis

PROCURE

Former construction minister Nigel Griffiths once described ProCure 21, the Government's hospital building programme, as a fine example of how the industry should work. But now it faces an uncertain future.

After visiting one flagship site, Alasdair Reisner asks: why?

LET'S tick some boxes. For years the construction industry has been told by its clients, including the Government, that it needs to reform and bring itself into the 21st centu ry. You must work in par tnerships.

You must form long - term relationships. You must innovate. You must be involved in projects earlier.

You must build on time. You must build on budget.

So what happens when all of these boxes are ticked?

Since it was launched nationwide in September 2003, the Department of Health's ProCure 21 hospital building framework has seen more than 200 projects, together worth more than £2 billion, enter its programme. But it is not the budget that makes ProCure 21 stand out from the crowd. If you are looking for a signpost for the way in which the construction industry should be moving then ProCure 21 is pointing in the right direction.

Partnerships and long-term working relationships run through ProCure 21 like the words through a stick of rock. NHS trusts looking to build can call upon a panel of 11 contractors or Principal Supply Chain Partners chosen for their formidable abilities in the health sector.

The trust then chooses one of these firms with which to work in partnership to develop the scheme from the drawing board right through to construction.

By bringing the PSCPs on board early, the trust can take advantage of all the experience the contractor and its supply chain bring to the table. The hope is that, once a PSCP has been chosen, the trust will then return to it each time it has a new project, developing long-term relations that work in both sides' favour.

So you would think its future must be looking rosy as a mode of procurement. But the sorry fact is that, since the demise of parent organisation, NHS Estates, in July 2004, ProCure 21 has wandered about like a lost child in search of a home.

This has created uncertainty among both contractors and NHS trusts, resulting in claims that work loads are d rying up as people wait for news, good or bad. Consultants drafted in by the Department of Health to determine the future of the programme have now reported back, leading to ProCure 21 being shifted to the department's estates and facilities division.

But there still seems little certainty that expected workloads will materialise. The programme remains mired in controversy, a situation which worsened since the resignation before Christmas of ProCu re 21 boss Peter Woolliscrof t.

It must be frustrating for Adrian Padley and Paul Clem inson. As regional implementat ion manager and ProCure 21 contracts manager respectively for cont ractor HBG, the pair have overseen some of the best evidence that the programme works when it is given the opportunity to f lourish. HBG is now working on eight projects for Sheffield Teaching Hospitals NHS Foundation Trust.

This represents more repeat work for a single trust than any other PSCP under ProCure 21.

'The proof is in the pudding with ProCure 21, ' says Mr Padley. 'With it, a contractor is looking at a scheme from the start. It is really looking at how the scheme will be built and that reduces the risk. Sheffield is a great example of that.

The team here is working with the end user in order to get the right results.' This no empty boast. The evidence is there to back up these claims. So far the one project that HBG's team has completed for the trust ? a theatre admissions unit to create extra bed space ? was completed significantly under-budget and the 12-week programme was finished in 10.

Other projects are running on time, to budget and demonstrating innovation that you would not have seen had the works been tendered traditionally.

Mr Padley explains why: 'In the old method of tendering you would have had a bid team based at you r head off ice with a little bit of input from a site manager advising on a bid tendered against bill of quantities and some drawings. When the job was won you arrived on site and had to deal with all of the issues you had not thought of.' The difference with ProCure 21 is that, because contractors are chosen from the panel of PSCPs using a very short interview process rather than a long-winded tender that could drag on for months or years, they have far more time to invest in the preparation and development of schemes.

'We are now getting involved in the strategic outline case for projects, right at the start, ' says Mr Cleminson. 'That means we can inf luence and advise on the project while it is still being developed.

Trusts used to rush the development period and have too many risks on the table. That would manifest itself as delays and increased cost on site. We have told them that we can still maintain their start and finish dates but that we are better off spending more time developing the project, building up a robust guaranteed maximum pr ice. By doing that we can reduce the risk and deliver it more quickly.' Whereas in the past the trust would have just had a couple of workers trying to scrape together a scheme to a point where it could be approved, HBG can open development of the project up to its entire supply chain and trust stakeholders, bringing in both construction and operations expertise to work out any risks and how they can be dealt with to produce the best scheme.

As the firm increases the number of jobs it has running with the trust, it builds up both relationships with its client and knowledge of the site. Mr Padley gives a simple example of the benefits this offers both sides.

'As we are developing we are learning about the hospital. We are building up a picture of the levels of the site. Each time we are using the same contractor to undertake a levels su rvey, so as we work we are developing the whole picture for the trust. Existing records are just not there; some of these buildings date back years.

'Now we have these surveys, we know where everything is and it minimises the risk in developing projects.' The ongoing relationship with the trust also means HBG can get better value from its supply chain. Mr Padley says: 'We can now look to some of the larger steelwork firms. Although the bulk is not there in terms of the size of projects, if you add up all the works we are doing it is not short of £50 million. The larger firms are now interested in working with us because they know they are going to get continuity of work.' And it is not just the Sheffield trust that benefits from HBG's work. The firm is also working for an array of other trusts nationwide and the flow of information between project teams is an advantage to everyone.

'We have monthly meetings with all our ProCure 21 team leaders where we sit down and discuss our schemes, ' says Mr Padley. 'We tell each other what we are learning on our schemes and everyone can take that knowledge back to enhance their own projects.

Th is is further enhanced by the fact that some of our supply chain partners work with other PSCPs, so we are learning lessons from their schemes.' An example of this is the innovat ion seen in the spread of off-site manufacture on ProCu re 21 projects.

'If you go onto a ProCure 21 site you are going to see modularisation, ' says Mr Padley. 'It's fast. The healthcare market changes so quickly. How long should we be designing a building for? Are you right to use bricks and mortar or a modular unit that can be removed or modified? We can build with flexibility.' Sheffield Teaching Hospitals NHS Foundation Trust project director Mark Hattersley confirms the benef its of the ProCu re 21 approach f rom the client's perspective.

'The PSCP doesn't drive things or take over, ' he says. 'They are there as a partner to us in a longterm relationship. They build using information from all their previous jobs and they are happy to tell us where they have made mistakes and how our projects could be done better.

'It is this that enables them to push the envelope in terms of service and delivery of facilities, not just for today but for the future.' So a happy client, a happy contractor and buildings that are well built to both budget and on time. You have to ask why ProCure 21 has been treated so badly over the past couple of years.

Only time will tell whether this uncertainty will continue. HBG must surely hope that it does not.