the changing landscape in nhs construction programmes - professor duane passman
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The University of SalfordVisiting Professor Series
10 November 2011
The Changing NHS
Duane Passman Director of 3Ts, Estates & Facilities,
Brighton & Sussex University Hospitals NHS Trust
Visiting Professor, University of Salford
Duane Passman – Major Projects
• The Current NHS;• The Future NHS;• Future Challenges;• The 3Ts Programme.
Overview
The Current NHS (1)Department of Health
•Policy & Direction;•Standards & Resources;•Choice
Strategic Health Authorities
•Performance Management;•Strategic Capital;•Developing local strategies
Primary Care Trusts
•Commissioning Services;•Delivery of Primary and Community Services;•Improving Health
NHS Trusts and FTs
•Delivery of Acute and MH Services
Monitor
•FT Authorisation;
•Independent Regulator
• One DH (sometimes);• 4 SHA Clusters (10 legal bodies);• Circa 50 Primary Care Trust Clusters
(151 legal bodies);• Circa 240 NHS Trusts (inc FTs);
– 140 FTs (41 mental health and 3 Ambulance);
– Still broadly 100 to become FTs;
– Mergers expected.
The Current NHS (2)
• 10 SHAs: – Overall strategy and leadership;– Overview of health system and developing
market;– High quality commissioning of services;– PCT Performance Management;– Developing strategic alliances;– Governance & corporate responsibility;– Capability and capacity building.
The Current NHS (3)
• 151 PCTs: – Guarantee access and choice;– Health promotion and protection (links to
Local Authorities);– Support and reinforce patient-led NHS
• Market information;• Public engagement;• Local target setting;
– Performance management of providers.
The Current NHS (4)
The Future NHS (1)
DH
NHS Commissioning
Board
ClinicalCommissioning
Groups
Monitor
FTsNHS
Trusts
SenatesHealth &
Well-BeingBoards
OtherProviders
• More FTs;• Increased Shared Services:
• Finance;
• Back-office.
• Greater plurality – independent sector, local authorities, third sector;
• Greater role for GPs and Local Authorities.
The Future NHS (2)
• One national framework – accountability for outcomes;
• Five domains – of responsibility:– Preventing people dying prematurely;
– Enhancing quality for life for people with LTCs;
– Recover from ill-health or injury;
– Positive experience;
– Safe environment.
The Future NHS (3)
• Ten overarching indicators;• 31 improvement areas;• 51 indicators to measure improvement
(in development).
The Future NHS (3)
• Cost:– National tariff – to be set by Monitor as
economic regulator;
– Same payment for same procedure to encourage efficiency;
– Local variance.
The Future NHS (4)
• Economic Climate:– More for less – 5% (at least) CIPs;
– Less public capital available;
– Poor liquidity in private markets (for larger schemes);
– Sustainability;
– Continuous improvement.
(same slide as 2009!)
The Future NHS (5)
Royal Sussex County Hospital CampusProposed Redevelopment Area (red boundary)
Barry & Jubilee Buildings
Barry & Jubilee Buildings
• £420m project, 91,000 m2
• Design using integrated BIM;• Examining in-use energy and water
(with Matthew Bacon);• Occupancy analytics;• BIM and Operational Facilities
Management;• Benefits realisation.
3Ts in Brighton
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