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Norfolk and Norwich Case Study

Category: Hospitals

We would never have achieved a brand new hospital in Norwich, if it wasn’t for PFI. We offer our patients a fantastic facility.

Anna Dugdale, the Chief Executive of Norfolk and Norwich Hospital.

June, 2010

The £245 million Norfolk and Norwich Hospital PFI scheme is to design, build, finance and operate a 950 – bed acute general hospital. Reaching financial close in January 1998 it was the second large scale PFI hospital scheme in the UK to be signed. Norfolk and Norwich achieved construction completion in August 2001 and won Best Designed Hospital Project in the Building Better Healthcare Awards in 2002.

The new hospital is situated 4 miles from the centre of Norwich and has brought together staff and services from the Norfolk and Norwich and the West Norwich hospitals. The Norfolk and Norwich University Hospital NHS Foundation Trust has 5,700 staff who every year treat more than 700,000 people from Norfolk, neighbouring counties and from further afield. The Trust provides a full range of acute clinical services, including specialist services such as oncology, orthopaedics, plastic surgery, and paediatric medicine and surgery. The Trust also plays an important role in the teaching and training of a wide range of health professionals, in partnership with the University of East Anglia, City College Norwich and University Campus Suffolk.

The PPP Forum recently interviewed Anna Dugdale, the Chief Executive of the hospital. This is the PPP Forum’s second interview with a representative from the hospital, the first was in 2002 with Malcolm Stamp when he was Chief Executive.

Seven years into the project, what are your thoughts on the design?

“The building is incredibly impressive and creates quite an impact although the design is quite simple. The wards are situated on one side of the building, diagnostics are in the centre and the outpatients area is located on the opposite side."

What is your relationship with the project company like?

“The project company has been brilliant. Their team has remained pretty stable and we have a good relationship with them. We are lucky to have had broadly the same team since from before the hospital was even built and this has been a huge advantage. The team is now changing, but they are being very flexible to accommodate all our needs.” 

In terms of the day to day operations, how are the contractors doing?

“Serco have been great partners. They are very responsive and customer focussed and the local team are understanding of our strategic expectations.”

Are they quick to respond to problems?

“Absolutely! We recently had some visitors from Adelaide University Hospital. They said that Norfolk and Norwich is the best PFI hospital they have seen and it’s in the best condition.

I set high standards, and personally led the relationship with Serco. It took a lot of time and hard work to reach a shared understanding of what quality means. Patients always remark on our cleanliness and this is due to hard work, being clear about standards and making sure they are enforced.”

How do you characterise your contractual relationship?

“Very collaborative and very strong and we leave the contract on the shelf for as long as we can. We have a performance report which we share with Serco monthly and which exceeds the contractual performance report. We worked with Serco to tell them what we wanted to see in the report, we developed it together and go through it as a team.”

What sort of feedback do you receive from the patients?

“Really really positive. Patients are choosing to come here from other areas; we frequently receive letters of gratitude, praising our facilities often from visitors to Norfolk who comment on how favourably they compare.”

How have the local residents’ attitudes changed towards the PFI hospital?

“In 2002, there was huge anti-PFI feeling but the mood has definitely swung the other way as increasing numbers of our local population have first hand experience of the hospital.”

In 2002, I understand there was a low staff morale, is this still the case?

“I think that was mainly due to the big changes caused by the PFI scheme. We have now moved on from there.

We run our hospital hot and there is little headroom, so when there is an unpredicted surge of activity, it can be challenging. For example in November 2009 we had 20% more medical admissions compared with the previous November. But we get through it.                                               

What are your views on PFI projects?

“We would never have achieved a brand new hospital in Norwich, if it wasn’t for PFI. We offer our patients a fantastic facility.PFI is more expensive than your traditional NHS hospital, but you get what you pay for.

We have over 700,000 patients a year who all benefit from a building that looks even better than it did when it opened. No one would know that we have already been opened for seven years!”