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Hairmyres Hospital

Category: Hospitals

“So when PFI came along that was a solution for us, because it was money over the long-term rather than in a lump sum upfront. So that was one of the biggest benefits we saw from providing this as a PFI: we got a new hospital that I think we may not otherwise have had, or if we were going to get it, it may have been a smaller development, or it may have been a long time in coming."

Dr Barry Vallance, Associate Medical Director, Hairmyres Hospital

May, 2007

The original Hairmyres was an old military style hospital occupying multiple sites that was created for wounded soldiers coming back from the Second World War.

A PFI project to redevelop the site was signed in 1998 and the new £68 million Hairmyres Hospital opened its doors to patients in March 2001.

The innovative design allows for the hospital to adapt to the changing needs of primary healthcare for the future and its groundbreaking modular construction allows flexibility for future extension and adaptation – which is already proving its worth.

In June 2004 Hairmyres Hospital won the Public Private Finance Award for “Best Operational Hospital”.

The PPP Forum interviewed Dr Barry Vallance, the Associate Medical Director at Hairmyres Hospital and the Consultant Physician and Cardiologist in the Acute Care and Emergency Division.

It was old and not fit for purpose. At one point the patients in the Gynae theatre used to have to go outside to the street on a trolley to go to and from theatre. It was completely inadequate. There was clearly a need for a brand new building. It meant that we all moved on to the one site that was fit for purpose and purpose built.”

The original plan put forward by the Lanarkshire Health Board was only to part rebuild Hairmyres, and to have linked corridors between the old and the new building. This was because the Board could not afford the capital cost of a whole new rebuild.

“So when PFI came along that was a solution for us, because it was money over the long-term rather than in a lump sum upfront. So that was one of the biggest benefits we saw from providing this as a PFI: we got a new hospital that I think we may not otherwise have had, or if we were going to get it, it may have been a smaller development, or it may have been a long time in coming.

I think PFI is a quick answer, it’s a quick way of getting a building. Certainly we were impressed by the speed that it was designed and built. It was built ahead of time rather than behind time.”

The design specification evolved during the planning phase to ensure the new hospital fulfilled all clinical requirements. The architect’s design was to have the spine of the hospital at the back and chevrons for the wards coming off the length of that spine.

“I was really intrigued by that concept which I hadn’t seen before.”

This innovative design separated the patient/ward areas from the busy spine of the hospital. This meant there was no need to take everything through the wards to get to service them and that all the servicing aspects of the wards were at one end, where they hinge to the spine. The design also means that specialties can be relocated whenever required as the wards were created identical to each other.

The design process resulted in different specialties being placed together and the relationships between them were extensively examined during that process. Every speciality was involved in the detailed planning stages – technical, nursing and medical. All the acute patients have been positioned at one end of the hospital and the non- acute patients at the other end. This means that there are vertical relationships as well as horizontal ones in the new hospital.

“The modular design of the ward areas – the continuation from one ward to the next – was and continues to be a very useful concept for us. Certainly the architects we dealt with were very receptive to our requests and I would be happy to compliment them on that. They did that very well – they very much took on board what was being suggested. They would just go away and come back with another redesign, and eventually I think we got most of it just about right. So they were very responsive.”

A full risk management exercise was undertaken before the actual move to the new hospital. This was a major exercise that required careful planning.

“I was very impressed by the removal company – they planned it extremely well. They had very large numbers of staff present to deal with the move and that allowed us to continue with our activities in the old hospital right up until the very last day. Fortunately on the day I don’t think anything went wrong. Everything worked.”

NHS Lanarkshire is being redeveloped through ‘A Picture of Health’ which will entail major changes to the hospital. Around 150 beds will be added, the theatre and coronary care complexes extended. It is also likely that a completely new A&E and medical receiving area will be built as well. This is to accommodate the move from three acute sites in Lanarkshire to two, requiring increased bed capacity on the two remaining sites.

“We will go back through the same process again and I have no concerns that it’s going to be PFI.”

Has the PFI changed your job?

Not at all. I come to work in a very attractive facility that is maintained by someone else, and if something breaks they have to fix it and we have no expense to incur, so it makes no difference in terms of coming to work. Clinicians don’t see any difficulty. I think we don’t know we’re in a PFI build – we just come to Hairmyres hospital!

Does the long-term contract help with management and budgeting?

We know what it’s going to cost us and there aren’t any unforeseen costs if something breaks – so say if there’s a storm and the roof blows off we don’t have that risk. There is the transfer of risk; I don’t think that transfer of risk comes cheaply, but it means that we don’t have any unforeseen expenses. We know that there’s a fixed price that we pay.

How would you describe your relationship with the private sector provider?

As a clinician I don’t have a relationship – I don’t see them, I don’t need to. And therefore it’s seamless in the background, which is the way it should be. I don’t see any problem at all. I come into a building that’s fully serviced and seems to be well maintained. People comment that when they come into the hospital it looks as fresh as the day it was built. There are one or two areas which could do with a little bit here or there but in the main it’s well maintained and looks fresh. It was a fresh design to begin with – it’s bright, airy and colourful and I think it looks very similar now to what it was like when it opened.”

Has the new hospital helped with recruiting and retaining staff?

Yes. The environment has been very important. It has turned around our recruitment abilities. Obviously you can’t say that’s just because of PFI, it’s because of the new hospital. But certainly the fact that it happened quickly and we had a complete rebuild rather than a partial rebuild because of PFI did help.”

Is there any advice you would give to someone else about to embark on a PFI project?

To be absolutely sure that you have your specifications agreed on both sides – the actual design, the technical specifications and the outputs. My advice would be to make sure you get the design that you really want, and don’t let someone else put upon you what they think is the correct design. And perhaps the PFI project - as we went through it - was more responsive than a conventionally procured project would have been. I can’t definitely compare as I haven’t been through both processes but certainly from our point of view the design was very reactive to our concerns and our desires.”

What are your final thoughts about the Hairmyres PFI project?

I’m proud of it – the first hospital to open in Scotland of that scale – I see no problem in saying that. I’m proud of the facility that we have. People who’ve not visited don’t know what we’re talking about, and we perhaps don’t blow our own trumpet enough, but those who do come and visit – medical staff who come to a conference, who examine here for postgraduate exams – they get their eyes opened and say that they had no idea it was like this, what a beautiful facility it is. And they’re coming from other so called centres of excellence!