Drivers for whole life performance

Buildings for the Health Service

Health Building Note 1 Buildings for the Health Service 1998 (published by NHS Estates) gives guidance to those planning, briefing and designing hospitals. Clause 2.18 states:

'The design and specification should be worked out in close collaboration with the operational and maintenance staff ... to obviate the short-sighted approach of designing for cheapest initial cost, which results in ever-worsening maintenance costs, premature obsolescence, and adversely affects staff morale and the service they provide. Instead whole life costs of all building and engineering components and systems should be the basis of design decisions.'

Briefing advice

In 2002, the Design Brief Working Group was commissioned by the National Health Service Estates to produce an advice note to Trusts considering or commissioning health buildings. It states:

'... the building or facility must allow resources to be applied and managed in a creative, balanced and effective manner, over a life cycle upwards of 50/60 years.'

and notes that:

'Changing procurement methods such as PFI have directed greater attention to a whole life-cycle approach ...'.

Sustainability

The NHS guide on sustainable development (2001) was to assist those involved in providing, managing and using NHS healthcare facilities work towards sustainability. Whole life costing and performance concepts run through the document:

'... the use of whole life thinking in planning, designing, building and maintaining estate can bring long-term efficiencies and performance improvement.'

NHS ProCure 21 was a new method by which the NHS will carry out capital procurement. The Best Client Manual (2002) details the process. Key elements include:

'The incorporation of whole life costs and sustainable environmental objectives apply to the complete facility.'

'In practical terms, the best client role means ensuring that:

- Whole life costs are calculated and not just the costs of initial construction.'

Best client attributes include embracing:

'best value solutions that take account of whole life cycle costs rather than the lowest price'.