Does the idea of working with any one of 600 NHS trusts, all with varying levels of construction experience, make your heart stop? fret not – an antidote has been found …

One of the main objectives of ProCure21 is to enable the NHS to be a better client. This is not an easy task, mainly because of the sheer size and complexity of the organisation. There are some 600 different NHS trusts located around the country – and this excludes other NHS organisations such as the National Blood Service. Many can be classified as one-off or occasional clients. NHS bodies are highly effective and skilled in the management and delivery of healthcare, which is their role. As a result, only a few trusts have the necessary expertise to deliver capital projects. So how has this problem been addressed? NHS Estates has worked with trusts to help them acquire the skills to be an effective – and demanding –partner.

Rethinking Construction by Sir John Egan challenged clients and the construction industry to achieve annual reductions of 10% in construction costs and time with increased predictability without reductions in quality, while also improving health and safety. A key recommendation in the report was that public-sector clients were to take the lead in making sure this happened. It was a tall order: traditional construction practices in the NHS had resulted in an average 10% time and cost overrun.

An NHS Estates spokesperson says: “If Egan’s targets are to be achieved, radical changes are needed to the processes and the culture within the NHS. Evidence exists shows client-led projects are making dramatic improvements in construction. However, these don’t just happen and client training and education is required to deliver the real benefits that we are all looking to achieve. Training is helping trusts achieve what they want.”

In recent years, there has been little investment in the training and development of the NHS client, which has resulted in a reduction in the skills and experience available to deliver its projects. The NHS has recognised that to deliver successful projects consistently, it needs to educate project directors that are conversant with planning and construction processes, knowledgeable about the health service, understand and manage relationships associated within a project and within the NHS, and can manage the relationship with suppliers. This new breed of professional is viewed as key to delivering NHS projects that are not only efficient and effective, but also fit for purpose.

Through a structured training and development programme, the NHS is aiming to provide tuition in technical areas, such as the use of the NEC Contract under ProCure21 and issues of lean construction, benchmarking, and so on. Softer areas, such as team building and management of diverse teams, are also included.

Improvements don’t just happen – client training is required to deliver benefits

NHS Estates

Through courses (one has been established at London South Bank, Lancaster and Portsmouth universities and links forged with the Association of Project Managers) and sessions by industry experts, ProCure21 hopes to enhance the skills of project directors and teams to ensure that they have the tools and techniques to manage projects effectively and achieve goals.

To assist clients in improving their performance, NHS Estates has published The Best Client Guide: Good practice briefing and design manual, and a website-based toolkit called BOP (Building on partnering) that offers guidance and support to enable NHS project directors, as well as their suppliers, to improve their performance.

Raising the profile and education of project directors will eventually create a pool of knowledge that can be used to share best practice for the benefit of the NHS as a whole. Peter Woolliscroft, head of construction at NHS Estates, says: “We want those with the skills to keep on using them, bringing their expertise to new schemes. We don't want those skills to be lost to the NHS.”