Healthcare Estates Welsh Conference and Exhibition … Howard Alex Beedle.pdf · Alex Beedle Pre construction Manager ... • Overview of the current service for inpatient CAMHS

Healthcare EstatesWelsh Conference and Exhibition

Friday 24th April 2009

North Wales Adolescent UnitChild and Adolescent Mental Health Service

(CAMHS)

North Wales Adolescent UnitPresenters

Ian HowardProject Owner - North Wales NHS Trust

Alex BeedlePre construction Manager - Laing O’Rourke

North Wales Adolescent Unit This Presentation Covers

• Overview of the current service for inpatient CAMHS • Vision for the future service• Project structure• Key Challenges• Design• Programme• Business Case• Health and Safety• Framework benefits• Current status of the project

North Wales Adolescent Unit The Service

• Meets the mental health needs of vulnerable young people aged13-18 –e.g.– Eating disorders– Self Harm– Anxiety

• An inpatient service, with a length of stay 6 months on average

North Wales Adolescent Unit Limitations of Current North Wales CAMHS [1]

North Wales Adolescent Unit Limitations of Current North Wales CAMHS [2]

• Cedar Court is a 12-bedded unit in a housing estate

• Physical environment not fit for purpose:No emergency service Unable to admit patients with behavioural

disturbanceUnable to admit under the Mental Health Act

North Wales Adolescent Unit Limitations of Current North Wales CAMHS

• Insufficient planned treatment beds• Not a 24/7 service

• Results of these limitations Frequent placements out of North Wales Inappropriate admissions to Adult Mental

Health and Paediatric wards

The vision is for a new, purpose built, adolescent psychiatric inpatient facility

providing a centre of excellence for the young people and families of North Wales

North Wales Adolescent UnitVision for the future of Vision for the future of North Wales CAMHSNorth Wales CAMHS

North Wales Adolescent Unit The new high quality service…

An accessible purpose built unit comprising:• 6 bed acute care/emergency admission ward• 12 bed planned treatment ward • Therapeutic & support accommodation• Educational accommodation• Forensic Adolescent Consultation and

Treatment Service FACTS (outpatients)– Outpatient clinic for assessment and

treatment of local young people with mental health problems.

• Recreational facilities and gardens

North Wales Adolescent UnitStructure

Owner / Project teamIan Howard Andy WilliamsTrevor Hartley WilliamsDarren Smith

StakeholdersClinical TeamEducationCateringSecurityFacilities

PlanningDesign & Construct

Public RelationsOperational Policies

EquipmentIM&T

Human Resource

Management Alex BeedleColin Chong

Design TeamDesign Buro - Architect

Health Planning - SercoWSP - Services

RVW - Structural CHT Specialist Services

Welsh Health Estates

Welsh Assembly Government

Project Manager / CostGleeds

North Wales NHS Trust

Supply Chain Laing O’Rourke

Project Board, Task Groups

North Wales Adolescent Unit Structure

• Clinical leadership and engagement

• Creation of a team early in the process

• Size of the Project Board

North Wales Adolescent Unit 5 Key Challenges

1. Timescales – expiry of the lease2. No NHS building standards for

CAMHS3. Affordability4. Site selection5. Consultations & planning

North Wales Adolescent Unit Key Challenge 1 (Timescales)

• Expiry of the lease• Increased the risk• Benefits of early engagement of the supply

chain– Hard-headed look at the timescales, resulting

in 1 extension to the lease– The quality of the OBC and FBC

North Wales Adolescent Unit Key Challenges 2 & 3

2. No NHS building standards for CAMHS – No Departmental Cost Allowance Guidance– Made value-for-money harder to establish

3. Affordability– Meeting our aspirations within the resources

available (capital and revenue)– Value engineering

North Wales Adolescent Unit Key Challenge 4. (Site Selection)

Site Issues - Background– Conwy/Denbighshire location – Within 15 minutes of the A55– A minimum of 2 1/2 - 3 acres of usable site area– Discrete– Not isolated– Natural screening

North Wales Adolescent Unit Methods Used provide an Objective Evaluation

• 21 sites to 5 to 3• Formal evaluation by the project board

- buildability; planning; deliverability• Preferred option Abergele hospital site

– Ease of access across North Wales– Semi rural location– Expansion potential– Trust ownership

• Clinical risk (bridge)

North Wales Adolescent Unit Site Selection Abergele Hospital

North Wales Adolescent Unit

• Consultation and Planning• Design• Programme• Business Case• Health and Safety• Benefits of the Framework• Current status of the project

North Wales Adolescent Unit Key Challenge 5 (Consultations & Planning)

Take the “politics” out of planning

• Communication Group– HCW, CHC, Trust, Clinicians, SCP, Architect

• Consultation Events – Inform and Educate

• Local stakeholders• Local media

– e.g. to publicise news

• Information is available in public places• Place information on relevant websites e.g.

– Feedback included with planning submission


Abergele Hospital Site

North Wales Location

Local Features


Site Photos

Existing Unit

Adjacent Ward

Boiler House

Main Building

Adjacent Green Lane

Bridge

Bridge


Functional Relationships


Proposed Building Massing

Departmental Relationships


FF Plan

GF PlanSite Plan

Bedroom Plan

Block plans


Bridge Protection

Initial appearance


Imaging

Holistic low energy approach

• “Easy wins”– Naturally ventilated– Roof lights / windows “safe vent”– Eaves overhang increased – reduces solar

gains – Optimised plant locations & service routes

• Thermal modelling accurate performance • Ground source heat pump• Under floor heating & cooling

• Excellent NEAT rating / ADEAT score

North Wales Adolescent UnitSustainability and Services

North Wales Adolescent UnitProgramme - Overview

• OBC• FBC• Construction

2006 2007 2008 2009

Existing lease expires

North Wales Adolescent UnitProgramme - OBC

• OBC• Site Selection• Hibernation• Design & Price• Consultations• Planning• Approval

2006 2007

• Site Selection ratification

• Elections & consultations

• Planning

• OBC

• Affordability

• VE opportunities best value

North Wales Adolescent UnitProgramme - FBC

• OBC• FBC• Design 1:50s• Design RDs• Target

2006 2007 2008 2009

Trust Programme Risk

FBC Activities in OBC

North Wales Adolescent UnitProgramme - Construction

• OBC• FBC• Construction

– Enabling– Timber Frame– Services– Finishes– Commission– Handover

2006 2007 2008 2009

OBC / FBC / Construction

Overall programme 35 months

less 7 month hibernation

= 28 months

Lean delivery

2 ½ years

Project Item Data

Gross Internal Area 3,174m2

Works Cost (Excluding VAT)

£8,853,591.00

Project out turn cost £13,712,635

Business Case MIPS 490


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£1,000

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Adjusted £/m2


Construction (Design & Management) Regs 2007

Clinical Risk (clinical risk document)Bridge with ravine

Robust materials

Self harm potential of service users

Maintaining security of unit both internally and externally

Our SolutionMethodical consultation with Clinicians, Fire Officer & Security

Stand alone facility separate from existing hospital

Consideration for anti-ligature / anti climb components

Site screening, gardens to rear allow for privacy and dignity

Maintenance to be undertaken away from patient areas

North Wales Adolescent UnitHealth and Safety

Some Key Construction Considerations

Timber Frame solution

Off site / Speed

Mock ups and sample room

Role of Supervisor

Planning conditions

Infrastructure

Early engagement

Phasing sequential build


Community Benefits

North Wales Adolescent UnitBenefits of the framework

•Framework KPI local Welsh workforce in excess of 60% of project value. •Promoting training and career development•Partnerships with local colleges. •Yale College at Wrexham where Apprentices study for NVQs with practical experience at Abergele

Apprentice Darryl Lodwick, 17, said,“I’m fire boarding and plaster boarding. It’s my first job and I’m loving it.”

North Wales Adolescent Unit Framework benefits

People

Scope

Time

Best practice design Extensive & robust OBC/Contract

2 ½ years lean deliveryNEC Contract Early Warnings

H&S Executive – why can’t all sites be like this?

Extensive Consultations

Clinicians talking to suppliers

Facilities talking to installers

North Wales Adolescent Unit Where we are now

• We haven’t finished• We are on track – time, cost, quality• Will deliver on the vision for the service – a

centre of excellence

Thank you


Documents

Healthcare Estates Welsh Conference and Exhibition … Howard Alex Beedle.pdf · Alex Beedle Pre construction Manager ... • Overview of the current service for inpatient CAMHS