Or, how an NHS trust in ormskirk decided to twist, not stick, by embracing a procurement method it had never used before. And boy, did it win hands down …

If Southport & Ormskirk NHS Trust had gone down the conventional procurement route, a new treatment, obstetric and paediatric centre at its Ormskirk hospital site would not have been up and running until April 2005. That the new £12.4m centre opened its doors to patients at the beginning of October is down to the trust’s foresight in selecting the ProCure21 route rather than tried-and-tested traditional tendering.

The trust project director Steve Taylor asserts: “The impact on the health of the local community of finishing ahead of programme will be massive.”

At the back end of 2002 when the decision was taken to use ProCure21, Taylor says he wasn’t so sure how things would pan out. “I admit, I did have reservations. It was a new framework. We’ve all been through the various conflict scenarios with contractors in the past and I think everyone here wasn’t entirely sure how it would work.”

But work it did. Not only that, the project notched up some notable successes:

  • Ten weeks were trimmed off the original construction programme of 94 weeks.
  • Out-turn costs were slashed 7%, but not at the expense of the finishes, which are usually the first to suffer when costs are trimmed. Instead, enhanced flooring, lighting, fixtures and finishes have been incorporated.
  • Not a single claim was received from the specialist contractors.
  • A measure of the collaborative working between the trust and principal supply chain partner ACM’s contractor Costain and their understanding of each other’s business needs can be gleaned from client satisfaction reports and best client reports, which were consistently recorded as “good”.
When ACM was appointed, a fair amount of the design work had already been undertaken by multidisciplinary practice Mersey Design Group, services engineer Terry & Partners and structural engineer Smith Associates. There then followed three months of intense debate on finalising the design and cost in value-engineering sessions, which involved other members of the supply chain, until the guaranteed maximum price was agreed.

the impact on the health of the local community in finishing ahead of programme will be massive

Steve Taylor, project director

Simon Dolan, Costain’s contracts manager, says the sessions resulted in a number of ideas and techniques being tried (see “Constructive ideas”, below and overleaf). Dolan cites, as a typical example, the proposal by mechanical and electrical contractor

NG Bailey to use prefabricated pipework. He remarks: “The pipework was delivered to site in 6 m long modules, fully fitted, insulated and ready to go. They came in cradles and it was just a case of lifting them to the ceilings of the corridors and bolting them into place. It saved us considerable time, perhaps six to eight weeks, particularly when commissioning.”

Steelwork fabrication times were also shaved by involving the supply chain. Dolan says fabricator Killelea agreed all the steelwork connections with consultant Smith Associates prior to the design being finalised. “As soon as the final design left the engineer’s CAD system and had been emailed to Killelea, fabrication could start. It meant manufacturing started virtually the day after the GMP had been agreed.

There was not the 15 to 17 weeks’ lead time that you’d normally get.”

As soon as the final design left the engineer’s CAD system and had been emailed, fabrication could start

Simon Dolan

The partnering ethic also led to the decision not to have clerks of works overseeing construction. In their place, Costain selected six of its own senior craftsmen to control quality and ensure things were right first time, thereby reducing the dreaded snagging list. No mean feat, considering there are some 560 rooms in the new centre.

At the start of the job, Denis O’Brien, Costain’s managing surveyor, had similar concerns to project director Taylor on using ProCure21. He remarks: “I was slightly suspicious. I had just finished a development in Salford Quays for Peel that had run along similar lines and I knew it could work, but only if we could build a team.”

Now he says: “I know it sounds corny, but it was a real team effort. On normal contracts, you are lucky if you get past the first week without falling out with the M&E contractor. Here we are over 80 weeks later and we still haven’t had a row.”

By way of a bonus, ACM and Costain are now gearing up for more work worth about £23m with the trust.

Taylor adds: “We have had our spats – that’s inevitable. But the relationship is strong. They know that if I’ve got a cost pressure, they have also and we have got to resolve it together. Here, the cost per metre was £1750 and you only have to look around to see the high quality we have achieved for that.”

Constructive ideas

In addition to the modular pipework, a number of other practical ideas have been incorporated at Ormskirk …

1. The hospital’s maintenance staff were invited to a workshop to discuss ways of easing future repair and maintenance operations. This led to adopting flexible pipework to sinks so that replacement taps didn’t need to be an exact match of the original fittings.

2. More valves and isolators were incorporated to negate the need for switching off the services to an entire hospital wing when carrying out alterations or repairs to a single room.

3. Soil and vent systems were designed with dedicated pipes running to dedicated manholes. Again, this negates the need to put sections of the new building out of action when dealing with an isolated problem.

4. Plants rooms were fitted with drains so that staff wouldn’t need mops and buckets to clean up after routine maintenance.

5. Photographs were taken of every room to show where valves, fire dampers, control switches and so on were located before the false ceilings were installed. The maintenance team has been given a CD containing all these photographs so that the valves can be located without having to take down lots of ceiling tiles.

6. No floor screed was specified. Instead, the concrete floor was power-floated to give a level surface with concrete grinders used afterwards to remove any minor irregularities.

7. The painting and decorating regime was altered so that, initially, only the mist and first coat were applied before the fittings and fixtures were added. Therefore any overspraying wasn’t an issue. After all the fixings and fixtures were in place, the decorators returned for the final brush coat. Costain’s contracts manager Simon Dolan remarks: “Normally, you have to come back during snagging to repaint the final coat because of knocks, scraps and finger marks. After we applied the first couple of coats, the whole place looked a lot more finished and gave everyone a lift. And people treated it with a lot more respect.”

8. During earthworks, thousands of pounds were saved by not having to install wheelwashers to clean vehicles that had crossed the muddy site before using public roads. Costain adopted a policy of segregating plant that operated on site from roadgoing vehicles. The policy also saved thousands by reducing the amount of hardcore required for temporary roadways for such vehicles.

9. Only two types of partitioning were specified – one for dry areas, the other for wet zones like bathrooms. Dolan remarks: “By limiting it to two types, we achieved a massive gain in productivity and eliminated the chances of the wrong board being installed. We just put paint marks on the floor to show which type of board was required.”

The vitals: ormskirk

 Obstetrics and paediatric centre, Ormskirk
Southport and Ormskirk NHS Trust
November 2002 to October 2004
Principal supply chain partner
ACM (Amec, Costain and Mowlem consortium)
Architect and client’s cost adviser
Mersey Design Group
Structural engineer
Smith Associates
Services engineer
Terry & Partners
Quantity surveyor
(GMP) Davis Langdon
Specialist contractors M&E:
NG Bailey; structural steelwork: Killelea; joinery: Nationwide Joinery; windows: Royal Extrusions; groundworks: Hayhurst; roofing and cladding: Speedwell Roofing; flooring: John Abbott