Partnerships for health

Mike Douglas and Amrit Naru say that partnerships are flourishing within the ProCure 21 method of procuring health facilities.

The issues surrounding healthcare procurement continue to be, for many, fairly complex. Given that the NHS has the largest and most multifaceted property portfolio in Europe, underlying concerns about successful project delivery are hardly surprising.

Along with the 2000 NHS Plan, which set out the Government's strategy for investment across the UK's health service, came ProCure 21. which to a large extent vastly improves the way in which schemes are delivered. Peter Woolliscroft, ProCure21's programme director, has stated that up to 4% savings in procurement costs are achievable. The success of pilot projects in the north west and the Midlands led to plans for a nationwide roll-out Since its introduction, ProCure 21 has played a major part in fostering partnering between the public sector and the construction industry, laying the foundations for future working practices by encouraging a transparent approach to project delivery. This has made a significant contribution to establishing relationships built on trust, mutual respect and a real desire for teamwork.

With the announcement of the abolition of NHS Estates this September, the future of ProCure 21 appeared to be in jeopardy, but thankfully Under-secretary of State for the Department of Health. Lord Warner, is understood to support its continuance. Given that the cost of establishing the ProCure 21 framework has been relatively high, not just for the NHS but for Principal Supply Chain Partners (PSCPs) and second-tier level organisations (although it is important to view these costs within the wider context of potential savings), this is good news indeed.

Waring and Netts. one of the north's largest firms of architects with nearly 90 staff, has been successfully delivering healthcare projects since the 1960s. Currently the practice is working as part of the Laing O'Rourke design team as part of the Equion consortium to deliver Newcastle upon Tyne Hospitals NHS Trust's C430m PFI scheme, at the city's Royal Victoria Infirmary and Freeman Hospital.

Waring and Netts first had the opportunity to substantially develop its partnering skills as architect on the £15m Blyth Community College in Northumberland in 2001, which was recognised as an example of best practice by CABE (the Commission for British Architecture and the Environment). We went on to hone our partnering skills on a number of other schemes both in the education and health sectors before winning a place on the Laing O'Rourke, Interserve, Medicinq and Kier supply chains for ProCure 21.

Waring and Netts is an enthusiastic promoter of partnering and believes that many benefits accrue - not just for the trust but also for contractor and designer. As a result, further refining the art is at the top of our agenda.

To assess the many benefits of partnering and analyse what partnering actually means in a live NHS project, it is worth reflecting upon the problems faced by the NHS before the dawn of partnering as a real concept. Typically projects involved contractors selected on the basis of the most competitive price, striving to increase profitability by raising claims arising from design changes and design errors. Often organisations had little or no understanding of the end user client's needs or aspirations, whether in the healthcare, education or commercial sector.

Like any other construction project, this initial lack of focus on the client and their needs gave rise to problems of poor quality schemes, late delivery and design errors. In turn, this resulted in a frustrated client as well as a frustrated contractor, leading to acrimony and adversarial attitudes throughout the industry. From our experience, it is evident that partnering is about culture and the way in which the participants view and manage a project. It centres on establishing good relationships based on collaboration, openness and trust, thereby reducing the scope for conflict.

It is also about providing feedback on performance and benchmarking progress to create the framework for achieving continuous improvement. It is evident that it can only be successful if all participants are of the same 'partnering' mindset. By adopting a partnered approach through the vehicle of ProCure 21 set within the context of healthcare provision, there is an ideal synergy.

However, as a practice with extensive partnering experience we sense that experiencing the process for the first time as part of a supply chain can sometimes create feelings of uncertainty and even suspicion amongst supply chain members. 'Open book' and transparent methods of dealing with issues can be quite intimidating.

At times like these, the support and guidance of a strong and knowledgeable supply chain leader cannot be underestimated as a means of educating all the partners about the process and gaining alignment on the objectives of the project, so that any initial uncertainties or grey areas can be ironed out at the outset.