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Walsgrave Hospital

Category: Hospitals

"The opportunity we have here is staggering. It is an unparalleled investment for the Coventry and Warwickshire area. We will have a state of the art facility maintained and equipped for 35 years. As a result we are attracting some top class doctors who are keen to work in this modern environment. I believe we wouldn't have been as bold under conventional funding."

David Roberts, Chief Executive of University Hospitals Coventry and Warwickshire

November, 2004

The PPP Forum interviewed David Roberts, Chief Executive of University Hospitals Coventry and Warwickshire.

Walsgrave PFI hospital is a design, construction and hard FM contract worth over £400 million for a 1212 bed acute hospital and a clinical sciences teaching facility. It is the first ever PFI scheme to involve two NHS trusts; University Hospitals Coventry and Warwickshire NHS Trust and Coventry Primary Care Trust.

Walsgrave Hospital is due to be completed in 2006; the Clinical Sciences Building and the new Sterile Services Department have already been completed and handed over to the Trust. This interview represents the first of a series to be undertaken as more of the hospital is completed.

Walsgrave Hospital is the third PFI hospital that David has been engaged in. Previously, he worked on a new district general PFI hospital in Swindon as well as an ambulatory centre.

The contract was two months away from being signed when you joined the Trust, how did this impact on your experience?

"It wasn't easy as the drawing up of the contracts was already well underway and PFI contracts are complicated. You have to rely on the professional advice given to you from your legal team that the contracts are worthy of signature. However, I was aware of this when I started the post and it adds to the challenge!"

What has been your experience of the parts that have been handed over so far?

"Firstly, before the contract was signed, Skanska had already committed £40 million to the project in order to deliver the Clinical Sciences building in time for the new academic year. That was a big commitment of funds on their part and meant we had a very grand building ready for the new intake. That doesn't mean to say it doesn't come with its own problems as all the dates are shifted six months earlier.

Overall, there have been no major problems, Skanska have been pretty responsive to our issues. For example, they will be replacing the floor for the third time. This problem could have occurred anyway, but with the PFI, it has been pretty painless in terms of Skanska acceptance when things aren't quite right.

In terms of standards, the Centre of Reproductive Medicine has been adequate but the CSSB has turned out to be a very good environment, higher than we would have expected under conventional procurement. The ambience is good and that bodes well, a very positive experience."

The project is a huge undertaking, especially alongside a working hospital. How has the relationship been between you and the contractor been during this phase?

"There are of course some tensions. There's not one part of the site that isn't being touched. The disruption is major and not only that, we are growing as an organisation. With the building work, we have over 2,000 construction workers per day, doubling the daily attendance at the site.

However, Skanska are very professional and in my opinion, a competent builder. They keep the roads clean and there aren't articulated vehicles coming in and out all the time; they've been considerate to the fact that we are an operating hospital. We've never had the power/water supply cut off by accident or anything like that! When you consider the size of construction, you expect some of those things to happen."

How has the relationship been with the contractors?

"The relationship has changed as the process has gone on. After the contract was signed there was a feeling of elation amongst all parties but then you get down to the nitty gritty of getting the hospital built, things change. The relationship has never been an aggressive one but that isn't to say it hasn't been fraught at times! I think now, we are where we should be but it will change again once the hospital built and we turn to the business of running one."

How does your experience with a PFI hospital differ to a conventionally procured hospital?

"Well, everything is set out in the contract, the quality of build, the performance expected etc. There are two sides to that, on the one hand, it's difficult to get something changed and for that reason, it's important to get things right in the first place as the contracts are geared to deliver what has been set out. On the other hand, we can now be more demanding and expect a certain level of standards. There is real accountability to the money we spend."

Walsgrave PFI hospital was the first to be signed incorporating the new Retention of Employment model. How did your staff feel about it?

"They reacted stunningly. They have been responsible about it and progressive. I could not have wanted a better situation. They have real confidence with the model. It has so far been a non-issue, and when you consider that it affected over 1,000 employees, that is quite impressive."

How do you think your job will change once the hospital is completed?

"The management of the estate should be easier. With the clear contractual requirements, we will have a hospital that is kept in good condition 24 hours a day, seven days a week. Also, whereas before the maintenance budget would be raided for any shortfalls elsewhere, which often happened, the money is ring-fenced and ensures that we will maintain standards of cleanliness and the upkeep of the building.

My role will become more about performance management of the contractors. This can be complicated and we will need to develop these skills as it is a new way of working. We will become custodians of public money in a different way and we need to get the right people involved who can manage these contracts and ensure that we get the most out of the project. Eventually, I believe with the PFI, we should be in a more powerful position than we have been previously to enable us to deliver better public services."

How do you see the future of Walsgrave?

"The opportunity we have here is staggering. It is an unparalleled investment for the Coventry and Warwickshire area. We will have a state of the art facility maintained and equipped for 35 years. As a result, we are attracting some top class doctors who are keen to work in this modern environment. I believe we wouldn't have been as bold under conventional funding."