… That said, Peter Woolliscroft, NHS Estates head of construction, thinks the year-old ProCure21 still has a long way to go. Here he talks about supply and demand, water meters and what the future holds

For someone who had just spent more than four hours updating the National Audit Office on every detail of the progress of ProCure21, Peter Woolliscroft, NHS Estates' head of construction, seemed remarkably unfazed. He is also remarkably upbeat about the future of ProCure21, despite the fact that NHS Estates is being abolished.

“The message we want to get across is that it’s business as usual for ProCure21,” he asserts. His confidence about the future has been boosted by the NAO describing the construction process as “an exemplar of collaborative working” even though it has only been in existence for a year.

ProCure21 was born out of Sir John Egan’s Rethinking Construction report and developed by NHS Estates to meet the massive rebuilding programme announced by the government in 2000. The 10-year plan envisages the creation of 100 hospitals, 20 new-generation diagnostic and treatment centres, 500 one-stop primary care centres, and up to 3000 family doctors’ premises either substantially refurbished or replaced.

ProCure21 is intended to be used on any publicly funded scheme of more than £1m and the programme is estimated to be worth between £1.2bn and £1.4bn a year. The value of work in the current programme, including a six-month pilot study that preceded the national roll-out, is put at £1.75bn over 160 projects.

All the work is undertaken on a partnering basis with integrated supply chains led by 12 principal supply chain partners (PSCPs), operating nationwide. The initiative aims to give hospital, mental health and primary care trusts certainty in cost and programme timetable, high quality design and true value for money, thereby ending the days when many projects failed to deliver on one or more of these criteria. It also provides a simple construction mechanism for NHS trusts, many of which are new or infrequent clients.

Just over one year into the programme and Woolliscroft is generally satisfied with progress so far. “What we have done is go a long way towards creating a real sea-change in the construction process within the NHS. We’ve also had a high level of success helping clients change culture from the old way of doing things to the new.

“We are working closely with trusts and PSCPs to ensure that the approach works properly and to make any changes that are needed. We recognise that we are still at an early stage but the benefits are already clear – schemes on time, on cost, delivered to a high standard and offering predictability.

This has been borne out in testaments received from the administrative and clinical sides of the trusts. Woolliscroft reports: “They have said that whenever they have been involved in a construction project in the past, it has been tortuous, adversarial and aggressive. Now, they are saying it has been a dream to work with teams that want to understand what we need and will strive to give us what we need.

“Capital investment in the NHS has shot up and with hundreds of schemes, large and small, the NHS needed a new approach to get the best for the public money. Good as the results are so far, we believe there is much more to come. It is no longer good enough for the construction industry to produce a scheme at the price it has always produced a scheme: it should be demonstrating how efficiently it is doing the work. The benchmark, if there is one, is quite old fashioned in the way it has been established. The industry has only to get just below that benchmark to get under the cost limits.”

My challenge to people in the supply industry is to prove how efficiently you are using what you have

He uses an analogy to explain his thoughts on inefficiency. “If you have a water meter that is using, say, 500 units and suddenly that jumps up to 600, people will look where the extra 100 units have gone. What we are saying is that people should have first evaluated the 500 units because they might have had a water leak for years. We need to apply this sort of logic to construction.”

Woolliscroft, who has some 30 years’ experience in the health sector from estates management to FM, confesses: “How you measure efficiency is becoming a bit of a passion for me.”

He continues: “You hear a lot in the trade press about supply and demand. The industry says demand is such that there are not enough carpenters and bricklayers. My challenge to people in the supply industry is to prove how efficiently you are using what you have now. Tell me that you are 80% efficient in your construction process and I will accept that we need to start looking at a better way of dealing with supply and demand. But the suspicion of most of the world is that you are no better than 30% efficient. You will argue that is because the client hasn’t got its act together. OK, so what are you doing to help the client get its act together, and what are you doing to explain to clients what your pinch points are?”

His chiding doesn’t stop with construction. He wants the NHS to achieve “best client” status and that can only be met if individual trusts improve their own performance. “We have been able to support trusts in doing things differently, especially where the client thinks that the contractor is on the opposite side of the fence.

“By and large, clients need to understand the amount of effort that’s needed on their part to make the project a success. It is not a part-time job any more. The construction industry is very sophisticated when it needs to be and the client needs to reflect that. More importantly, the client needs to devote enough of its time up front.

“The thing that the client has got, which nobody else has, is the knowledge about how that particular hospital site works and how it will all fit together in the future. We want to help trusts articulate that.

“Clients have got to spend enough time thinking about that and relaying that in a language that the construction industry understands. This inability to speak the same language is the biggest barrier to success.”

Becoming the best

One of the biggest obstacles in the NHS’s quest to achieve “best client” status is that each trust has a different level of experience in construction procurement. This is being tackled in a four-pronged attack:

  • a series of training courses that are designed to address particular areas critical to delivering a P21 scheme;
  • a project directors’ training course has been established at Lancaster, South Bank and Portsmouth universities and links forged with the Association of Project Managers;
  • publication of The Best Client Guide: Good practice briefing and design manual;
  • a website-based toolkit, Building on Partnering, that offers guidance and support to NHS project directors.

In addition, NHS Estates offers a wealth of other material, guidance, toolkits and best practice.

Further details can be obtained from www.nhs-procure21.gov.uk