Select Committee on Treasury Minutes of Evidence



Annex

 

CHART OF "CENTRAL" IM&T BUSINESS CASES

FBC Approved:

 

Project

Status

Value (Whole Life Costs- million)

Project Connect

FBC approved 11-00

340 approx

NHS CDSS

FBC approved 9-00

NPC 18

NHS Number for Babies

FBC approved 10-00

1

Project Connect clinical messaging

FBC approved 01-01

41

Shared Services pilots

HMT approval imminent

21

Microsoft deal

FBC approved 10-01

139

HR/Payroll (now renamed "Electronic Staff Record")

Contract signed 5-12-01

325

Rationalisation of NHS arrangements for procurement from Novell

FBC approved 3-02

10

Online System for Comparative Analysis and Reporting (OSCAR)

FBC approved 3-02

2

Total

 

897

Scheme still in procurement/approval process

 

Project

Status

Value (Whole Life Costs- million)

National Ambulance Radio Project—digitising all NHS ambulance radio

OBC due shortly

134

Booked Admissions

OBC approved 12-01, FBC next.

468

Dental Practice Board

OBC approved 1-02, FBC next

45

Digital TV

Pilots, OBC next

100 for national rollout [ballpark figure]

EDI Electronic Prescribing

Pilots, OBC next

88 for national rollout [ballpark figure]

Financial Systems and e-procurement [part of Shared Services]

OBC expected soon

450

Shared Services call centres

OBC awaited

220 approx

General Ophthalmic Services centralisation

OBC awaited

20 broad figure

Infrastructure: emails and directory services OBC

OBC approved 10-01, FBC next

148 NPC, no funding requirement [to be met from existing budgets]

National electronic Library for Health

OBC received and under consideration

40 approx

NHS Direct intelligent phones

FBC received and under consideration

24

European Computer Driving Licence

OBC approved 1-02, FBC next

10 central costs, 46 NHS costs

National Breast Screening System Redevelopment Project

FBC received and under consideration

2

Total

 

1,795

 

  Information in support of several of the answers given by Mr Douglas, can best be given by supplying the attached tables, listing:

    —  One table listing the major PFI schemes by financial close and operational dates;

    —  Three tables listing all PFI schemes, banded between 1-10 million, to 10-25 million and over 25 million. These tables show the value of each project and, where information is held centrally, the anticipated or actual dates for FBC approval, financial close, first operational day for the new hospital and the date the contract expires. If available, the annual unitary payment is also disclosed. [11]

    (i)   These tables show that the NHS currently has in progress the following numbers and value of PFI projects:

Value of schemes

No

Total value m

1-10 million

80

342

10-25 million

39+

599

Over 25 million

64+

7,494

Total:      

183

8,435

 

        +  The reason for the slight variation between the two tables and the detail provided by Richard Douglas is that one of the announced major schemes is below 25 million (Hull, actual value 22 million) and one scheme (Hexham) originally estimated to cost less than 25 million has risen to 29.7 million.

    (ii)   The total capital spend in the NHS in the period 1997-98—2001-02 is estimated to be 10,644 million in cash terms. In the same period, PFI projects with a total capital value of 4,933 million reached financial close. PFI projects signed therefore represents 31.6 per cent of total capital and PFI investment spend in this period.

    (iii)  The table shows that the date the last major contract was signed was Dudley, in May 2001. However, contracts at Gloucester, Blackburn, Barking and Havering, Walsgrave and Central Manchester should all sign in the next six to seven months.

      Schemes at Bromley, Barnet and Chase Farm, Worcester, Hereford, South Durham, South Tees, Swindon and Marlborough, Kings, Leeds Community, Brighton, St Georges, UCLH, Hull, West Middlesex, Berkshire Healthcare, Dudley, Gloucester, Blackburn, Avon and Wilts Mental Health and NW London will all be operational by the end of June 2005. Thus, four schemes which have yet to sign should be operational by June 2005.

Major PFI Schemes by financial and operational (defined as first patient day) date

 

Region

NHS Trust

Financial Close date

  Operational   Date

South E

Dartford and Gravesham

30-07-97

11-09-00

N and Y

Carlisle Hospitals

03-11-97

29-05-00

South E

South Buckinghamshire

14-12-97

17-10-00

Eastern

Norfolk and Norwich Health

09-01-98

21-09-01

N and Y

North Durham Health Care

31-03-98

02-04-01

North W

South Manchester University

08-06-98

25-07-01

London

Greenwich Healthcare

01-07-98

01-03-01

N and Y

Calderdale Healthcare

31-07-98

08-04-01

London

Bromley Hospitals

19-11-98

30-04-03

London

Barnet and Chase Farm

01-02-99

19-04-02

West Mids

Worcestershire Acute

18-03-99

01-04-02

West Mids

Hereford Hospitals

31-03-99

01-03-02

N and Y

South Durham Health Care

28-05-99

01-07-02

N and Y

South Tees Acute Hospitals

16-08-99

01-04-03

South W

Swindon and Marlborough

05-10-99

15-01-03

London

King's Healthcare

06-12-99

31-01-03

N and Y

Leeds Community and Mental

01-03-00

01-12-02

London

St George's Healthcare

17-03-00

01-04-03

London

University College London

12-07-00

01-04-05

N and Y

Hull and East Yorkshire hospitals

08-12-00

30-01-03

London

West Middlesex University

30-01-01

01-04-03

South E

Berkshire Healthcare

01-04-01

09-03-03

West Mids

Dudley Group of Hospitals

08-05-01

01-06-04 #

South W

Gloucestershire Royal

01-03-02

01-09-04

North W

Blackburn Hyndburn and Ribble Valley

01-03-02

01-09-04

London

Barking Havering and Redbridge Hospitals

01-03-02

30-09-05

West Mids

University Hospitals Coventry and Warwickshire*

01-06-02

01-03-06#

Trent

Southern Derbyshire Acute

01-06-02

01-12-07#

North W

Central Manchester Healthcare*

01-09-02

30-06-06#

N and Y

Newcastle upon Tyne

01-02-03

01-10-05

South E

Portsmouth Hospitals

15-02-03

15-10-06

South E

Oxford Radcliffe Hospitals

15-03-03

30-01-07#

London

North West London Hospitals

01-05-03

01-05-05#

South E

East Kent Hospitals

01-06-03

01-07-06#

South W

United Bristol Healthcare

01-06-03

01-01-07

London

Barts and the London

01-06-03

01-09-13#

N and Y

Hull and East Yorkshire Hospitals

01-08-03

01-10-05

South E

Maidstone and Tunbridge Wells*

01-08-03

01-09-06#

N and Y

Leeds Teaching Hospitals

01-08-03

01-02-07#

London

St Mary's (Paddington Basin)

14-08-03

16-04-08

London

North Middlesex Hospitals

01-09-03

01-01-07#

Eastern

Peterborough Hospitals

01-09-03

01-03-07#

West Mids

University Hospital Birmingham*

01-09-03

01-07-08#

West Mids

Walsall Hospitals*

01-10-03

01-03-06#

North W

Salford Royal Hospitals

01-10-03

01-12-06#

South W

Avon and Western Wiltshire Mental Health

01-12-03

01-06-05

Eastern

Mid Essex Hospitals

01-12-03

01-10-06

South E

Brighton Health Care

01-12-03

01-04-05/

North W

St Helens and Knowlsey Hospitals

01-12-03

01-07-08#

London

Barnet and Chase Farm Hospitals

01-01-04

15-06-05#

London

Whipps Cross Hospitals

01-02-04

15-06-07#

South E

Oxford Radcliffe Hospitals

01-03-04

01-11-06#

N and Y

Bradford Hospitals

01-03-04

01-07-07#

West Mids

Royal Wolverhampton Hospitals

01-03-04

01-05-08#

Trent

Sherwood Forest Hospitals

01-03-04

01-01-10#

London

Lewisham Hospital

01-04-04

01-12-05

Eastern

Essex Rivers Healthcare

01-04-04

01-12-06#

N and Y

Pinderfield and Pontefract Hospitals*

01-04-04

01-04-07#

South W

Plymouth Hospitals

01-04-04

01-09-07#

West Mids

North Staffordshire Hospital

01-04-04

01-03-08#

South W

South Devon Healthcare

01-08-04

01-01-06#

North W

Tameside and Glossop Acute Services

01-09-04

01-07-07#

South E

Southampton University Hospitals

01-06-05

01-06-07#

Trent

University Hospitals of Leicester

01-06-05

01-07-10

 

Total

   

Public Schemes

 

Region

NHS Trust

Tender Award date

  Operational   Date

North W

Rochdale Healthcare

14-08-98

01-08-00

Trent

Central Sheffield University Hospitals

19-09-98

01-02-01

South E

Royal Berkshire and Battle Hospital

08-01-97

2002

London

Guys and St.Thomas

19-09-98

2004

 

Total

   
 

Total PFI and Public

   

#wave 4-6 scheme

* scheme progressing with more than one lead trust

GATEWAYS AND THE NHS CAPITAL INVESTMENT PROGRAMME

Background

  Procedures for Capital Investment Projects in the NHS have for some years encompassed both a series of mandatory approval gateways at various stages of the life cycle of a Capital Investment Project eg Strategic Outline Case, Outline Business Cases, Full Business Case etc together with requirements for Post Project Evaluation. NHS capital Investment procedures are contained within the Capital Investment Manual (CIM) which is currently being reviewed to take account of current best procurement practice and this includes the continuous review of the performance of projects to identify lessons learned and ensure the NHS benefits from them both on the project under consideration and future projects which is the objective of the Gershon Gateway Reviews.

Current Situation

  The current situation in respect of evaluating Capital Investment Projects in the NHS and applying learning lessons to the NHS Capital Investment Programme is based on Post Project Evaluation and the dissemination of feedback to the NHS.

  NHS Estates have established is a Capital Project Evaluation Section on the NHS Estates website—this provides an opportunity for NHS Trusts to provide feedback and the dissemination of lessons learned to the whole NHS and other bodies who access the website. Information on the key lessons learned from this are included in Appendix 1 of this response.

  Both the implementation of NHS ProCure 21 and the review of the Capital Investment Manual will address the above together with recommendations that have been made in any National Audit Office (NAO) Reports on NHS projects for example, recommendations from the report on Guys Hospital Phase III Development are also identified in Appendix 1 of this minute.

  Steps have already been taken in some cases in respect of addressing the lessons learned that are identified in Appendix 1, for example, the establishment of the Diploma in Project Leadership Course at Lancaster University to provide skilled Project Directors. Also we already have approval gateways to ensure appropriate funding is available for projects before they progress ie SOC, OBC, FBC.

The Future—NHS ProCure 21 and Review of NHS Capital Investment Manual

  The key objective of the Gershon Gateway review process is to review projects at various gateways to identify areas were improvements have been achieved or are required and disseminate the lessons learned to all. NHS Estates will address this objective through the implementation of NHS ProCure 21 and the review of NHS Capital Investment Manual.

  NHS ProCure 21 is the Department Health response to implementing "Achieving Excellence", HM Treasury's policy response to the Egan Report (Rethinking Construction by Sir John Egan). It comprises the following key elements:

    —  Partnering—establishing long term relationships with carefully selected suppliers and applying supply chain management techniques to achieve continuous improvements in value for money;

    —  Best Client—this is based upon the establishment of proper client briefing and the accreditation of Project Directors;

    Design Quality—this is based upon the requirement to create the best environment for visitors, patients and staff;

    —  Benchmarking and Cost Intelligence—this enables us to demonstrate progress, manage performance, identify lessons learned and deliver continuous improvements.

  Under NHS ProCure 21 there is a requirement for Project Directors to review the performance of projects against a set of Key Performance Indicators (KPI's) at the Approval Gateways identified in the Capital Investment Manual, and more frequently if the project team requires it on specific projects. This will enable the identification and dissemination of lessons learned through the identification of improved or poor performance. The KPI's being used as part of NHS ProCure 21 have been established as a result of NHS Estates leadership of the OGC Benchmarking Action Group and will be applied to all public sector projects in the future.

  The NHS Capital Investment Manual (CIM) is currently being reviewed and will incorporate requirements for the continuous review of projects against KPI's at Approval Gateways as required for under NHS ProCure 21 (see above).

  If a project requires an external peer review then a Project Director not involved in the scheme would be selected from the Register of Accredited Project Directors to provide this.

Application of Gershon Gateway Review "Process" to all NHS projects

  As stated earlier there is already a mandatory requirement for Post Project Evaluation on all NHS projects and information from this is available on the NHS Estates website. The implementation of NHS ProCure 21 and the review of the Capital Investment Manual will ensure that all capital investment projects within the NHS will be reviewed at the Approval Gateways identified in the NHS Capital Investment Manual. The establishment of a register of accredited Project Directors provides us with a readily available and highly qualified resource to provide peer reviews of projects when needed.

 


11 Not printed. A copy has been placed in the Library.Back

 
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