Keith Terry’s take on large PFI hospital developments

You have worked as Technical Advisor on some large PFI hospital developments. What would you say is the main disadvantage of PFI procurement?
It can be poor value for money. With PFI, it is more important than ever to have developed a clear and detailed brief from which to conduct a robust dialogue and negotiation process. Ongoing design reviews and installation checking is also critical if there are to be “no surprises” in the final product.
What other aspects are particularly challenging?
On such large schemes it is challenging, and exciting, to champion the aspect of genuine sustainability. This is more than just achieving a good BREEAM score and bolting on some local energy generation. We lead negotiations towards incorporating the very best “passive engineering” design methodologies from other sectors and countries.
Can that be achieved given the constraints on public sector costs?
There may be a cost penalty in the short term, but if sustainability is considered at the outset as an intrinsic part of the design then this can be minimised. Then by careful, considered choices we can engineer significant long term benefits.Brand new, complex, technology is often found to be less effective than anticipated, whereas there are some simple solutions from other sectors that have been proved to be effective.
Can you give any examples?
We have done a great deal of work over the years in the education sector to promote the benefits of heavyweight construction and night time air purging to control summer time overheating. This is not complex technology, yet the effect is definite and marked. We are encouraging the use of this approach in appropriate departments at a large PFI hospital development in Liverpool at the moment to reduce the need for cooling and improve the internal environment.
Do certain issues come up regularly in hospital design?
Yes – the quality of the internal environment. This can have such a positive effect on healthcare outcomes yet the value of good lighting, air quality, summer time thermal comfort and user control are often treated as secondary to more “functional” aspects.
What do you see as your main role when providing advice to the public sector?
It is always nice to work with clients to de-mystify engineering issues so that they are fully engaged with the choices made. This is particularly satisfying when it comes to so called “green” technology such as renewable energy and the like, because there is a lot of “misinformation” on this subject. Through workshops, seminars and visits to actual installations to look at energy generated in the real world, we have been able to contribute to informed choices based on a clear long term strategy.
Presumably there are fewer opportunities to improve the environment on smaller schemes, such as refurbishment of old estate?
The opportunities are certainly different. However the potential for carbon reduction is immense, given how poor the existing building fabric can often be. We have also found when undertaking site infrastructure and energy surveys that the biggest cause of wasted energy is the set up, or lack of flexibility, in the existing control systems, which can be very easy to fix.

Information correct at date of publish: June 2010