Repeatable Mental Health Bedrooms Hilton City Hotel, Leeds€¦ · Repeatable Mental Health...
Transcript of Repeatable Mental Health Bedrooms Hilton City Hotel, Leeds€¦ · Repeatable Mental Health...
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Repeatable Mental Health BedroomsHilton City Hotel, Leeds25th June 2015
www.procure21plus.nhs.uk
Delivering Cost Reduction through StandardisationRoll-Out of Repeatable Rooms and Standard Components
25th June 2015
www.procure21plus.nhs.uk
Introduction and Welcome
David KershawPSCP Programme Director
Agenda
• Introduction and Welcome• DH Opening Address• Cost Reduction Journey• Repeatable Room: Functional MH Bedroom• Repeatable Room: Organic MH Bedroom• Standard Components• Target Cost Savings• 11:30 Break and Exhibition
Agenda
• Supplier Presentations and Q&A– Bedhead Service Trunking– Mental Health Windows– Soft and Hard Flooring– Lighting
• 13:00 Lunch and Exhibition• Supplier Presentations and Q&A
– Doors– Sanitary Ware– Patient Hoists
Agenda
• 15:00 Break and Exhibition• Supplier Presentations and Q&A
– Privacy Screens– Paint
• Final Q&A• Summary• 16:00 Close
Housekeeping
• Breaks• Facilities• Fire/Emergency• Phones
Delivering value with P21+
DH – Leading the nation’s health and care
Ray StephensonProCure21+ National Framework Programme LeadFinance and NHS Directorate25.06.15
99 DH – Leading the nation’s health and care
Government Construction StrategyDH and the Principal Supply Chain Partners
• Introduced May 2011
• To deliver up to 20% cost efficiency savings for NHS CapitalProjects
• Challenged the PSCPs
• PSCPs responded with repeatable rooms, standard materials andcomponents and discount/bulk buying
• Benchmarking Targets
1010 DH – Leading the nation’s health and care
• All delivered within 2 years
• Consulting with the NHS
• 95% Buy-in
• Repeatable Rooms acute sector - Delivered
• Standardisation/Priced Components - Delivered
1111 DH – Leading the nation’s health and care
Your Challenge
• Opportunity to change the way capital projects are delivered
• Get involved, engage early
• Invite your PSCP to talk to you about this initiative for your scheme
• Support information sharing
1212 DH – Leading the nation’s health and care
The Future
• This is the start of a wider push for efficiency in NHS Estates andFacilities Management
• We will be collaborating with the Industry to identify and deliverfurther savings both Cap Ex and Op Ex
• This framework is providing a model of engagement for the future,including sharing designs more widely in the healthcare sector
• Supported by Central Government as part of wider efficiency agenda
1313 DH – Leading the nation’s health and care
Beyond 2016
• Health Minister has agreed to a new Framework when P21+ ends –P22
• Development work already started
• Engagement with the NHS about your requirements
• Embedding standardisation and developing the Repeatable Roomsand Standard Components within P22 framework
1414 DH – Leading the nation’s health and care
Today
A lot of work has gone into this day
• Engage with us
• Tell us what you think
• Talk to your PSCP
• Go and see for yourself
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ANY QUESTIONS
DH – Leading the nation’s health and care
www.procure21plus.nhs.uk
Cost Reduction Journey
Lewis Parker/Omar JomeenPSCP Leads – Kier/Galliford Try
The Challenge
• GovernmentConstructionStrategy
• Efficiency Agenda
Our Response• Cost reduction
programme
• Repeatablesolutions
• Standard materials& Components
• National Events
Cost Manager
LEADERSHIP
Programme Manager
OurCommittedResponse
All 6 PSCPsWorking
together withDH, Supply Chain
and Industry
Core Teams
RepeatableRoomDesign
RoomSpecification
OperatingPolicy
Literature/ResearchReview
EvidenceMatrix
PatientFocusGroup
PreviousSchemeDesigns
PeerReview
In-UseReview
PostProject
Evaluation
SupplierDevelopment
Development Process
Specification
Operational Policy
Literature Review
Evidence Matrix
Patient Group
Design Assessments
Peer Review
Applies to all Rooms& Designs
Design
Published WorkP21+ Club website
Guidance
Development WorkReports
Literature reviewsAssessment Schedules
Updated & NewFrameworkDocuments
CharterWorks Information
Procurement StrategyGuidance Note 19 & 20
NHS England & TDABusiness Case
checklists
Published Work
P21+ Club websiteStandard Share
Standard Materials &Components:
Soft & Hard FlooringSuspended Ceilings
Doors & IronmongeryLighting
Sanitary WareFire & Smoke Dampers
Bedhead ServicesRadiant PanelsCeiling Hoists
PaintWindows
What have weachieved
14 Standard RoomsDeveloped &
Validated:
Acute• 3 Single Bedrooms• 3 4Bed MBB
Primary/Acute• 5 Consult/Exam Rooms
Mental Health• Functional Bedroom• 2 Organic Bedrooms
iPad App
What we aredoing now and
in the future
EmergencyDepartment Rooms:
• Fixed acuity• Acuity-adaptable• Chair-centric
Review Feasibility &Benefits for :
• 8 Bed Cluster
Standard Components• To suit rooms
Sharing information innovation – schemes rolling out
26
How you willbenefit
COMMERCIALTECHNICAL
Off the shelfsolutions-ready for
use
Off the shelfsolutions-ready for
use
Compliant designs andproducts
Compliant designs andproducts
Endorsed byDepartment of Health
Endorsed byDepartment of Health
Quicker design periodQuicker design period
Significant savingson HBN Bespoke
Designs
Significant savingson HBN Bespoke
Designs
Benchmarked CostsBenchmarked Costs
Supporting theGovernment
Construction Strategy
Supporting theGovernment
Construction Strategy
Helps you deliver realsavings
Helps you deliver realsavings
Use on New build andrefurbished projects
Use on New build andrefurbished projects
Value for MoneyValue for Money
Helping youachieve your
savingstargets
&improve your
businessCan youafford
not to?
Terry Moore, TED 3 Minute Talks, 2005
Terry Moore, TED 3 Minute Talks, 2010
Terry Moore, TED 3 Minute Talks, 2010
Thoughts for today
• Listen to what’s on offer• £1.3M saved in £4.7M of Orders• Why are you not benefiting from using
Standard Components• Easy to access benefits, via StandardShare
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Repeatable Mental Health Bedrooms
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Functional Mental Health Bedroom
Pat Pemberton/Rosemary Jenssen
What are the repeatablemental health bedrooms?What they are:
For two care groups:
•adults with functional mental illness
•adults with organic mental illness
What they are not:
• children or adolescents
• disabled patients
• patients with intensephysical nursing needs
• patients with specificbariatric requirements
Literature Review
• Evidence baseddesign
• MARU (MedicalArchitectureResearch Unit)
• Over 50 studies
• Evidence Tables
Evidence Based Matrix
Pers
onal
isat
ion
Uni
tSiz
e
Day
Ligh
ting
Pers
onal
Sto
rage
Artif
ical
Ligh
ting
Artw
ork
Reduce Violence & Aggression ü üü ü ü ü ü üReduce Stress & Agitation ü ü ü ü ü ü üIncrease Patient Safety ü ü üü ü ü ü üIncrease Patient Satisfaction ü ü ü ü üIncrease Patient Control ü ü üü üü ü ü ü ü
Increase Social Support ü
Increase Staff Observation ü
Increase Staff Satisfaction ü ü ü
Ther
apeu
ticE
nviro
nmen
t
Ope
nnes
s&
Sigh
tLin
es
Pers
onal
Spa
ce&
Priv
acy
Anti-
ligat
ure
Mea
sure
s
Patie
ntEx
perie
nce
Staf
fEx
perie
nce
Fixtures & Fittings
Loca
tion
ofth
ebe
droo
m
Res
iden
tialC
hara
cter
Win
dow
Spec
ificat
ion
Doo
r&H
andl
eS
peci
ficat
ion
Tem
pera
ture
Vent
ilatio
n
Acou
stic
s
EnvironmentalComfort
Out
look
Design Principles
Mental Health Survey
Patient Workshop: Mental Fight Club
• February 2014
• Personalisation and identity
• Bright with a connection to outdoors
• Open and spacious
• Storage
compliant design features:-•15.0 sqm combined bedroom and en-suite•Sight-line from door•daylight and views out•en-suite HBN00-02 and 03 compliant•Rooms paired to share services•Anti-ligature•1800mm corridor widthrecommendations:-•Bed relative to window•Personalisation•Acoustic consideration•Furniture detail•Ceiling height min 2700mm (‘break the box’)•Recognise function of corridor + threshold•Carpet in part of the room
MH functional single bedroom en-suite – key drivers
En-suitesh/wc
En-suitesh/wc
Sleep/rest
Sleep/rest
Work/play
storagestorage
support recovery
entryentry
MH functional single bedroom – layout parameters
Bedroom design incl staff / therapeutic features En-suite design featuresN
etro
omar
ea(s
qm)
Cle
arw
idth
Cle
arde
pth
Bed
posit
ion
Sight
-line
from
door
Wor
ksp
ace
Stor
age
prov
ision
Perso
nalis
atio
n/
artw
ork
Tech
nolo
gy
Cei
ling
heig
ht
Win
dow
size
+op
erat
ion
Doo
rtyp
e
Doo
rsiz
e+
oper
atio
n
Net
room
area
(sqm
)
Duc
tare
a(s
qm)
Loca
tion
rela
tive
tobe
droo
m
Con
stru
ctio
nin
-situ
/pod
Doo
rtyp
e
door
size,
oper
atio
n+
lock
-ba
ck
MH Functional bedroom assessments
MH functional bedroom en-suite – 2 arrangementsIn-board with sight-line splay
Parallel/nested
• En-suite comfortable, not over or under sized• Sight-line, move into room, impact of f,f+e• Bed position impact on the ‘sense of space’
MH functional bedroom in-board en-suite – room testing
features:-100% sight-line, more bed positions, efficient footprint, tested observation recess depth
MH functional bedroom en-suite – model test
Technical Workshop
• Detailed design:– Support for work on
storage– En-suite arrangement:
• Solid stub wall• Pocket door
• Broader principles:
– Standard brief
• What is an acceptablelevel of risk?
• Definition of anti-ligatureand testing
• Expectations – infectioncontrol
– Flexibility: baseline forforensic bedroom?
MH functional bedroom en-suite – 2 arrangementsIn-board with sight-line splay Parallel/nested
enhanced design features:-Weight sensitive door, sliding or pocket doors to en-suite, higher ceiling, window seat,fitted furniture, artwork, opportunity for personalisation
features:-100% sight-line, 2 bed positions, efficient footprint, reduced corridor length
MH functional bedroom en-suite – in-board
En-suitesh/wc
En-suitesh/wc
Sleep/rest
Sleep/rest
Work/play
storagestorage
support recovery
entryentry
bedroom, 11.8sqmen-suite, 3.1 sqmduct, 0.4sqm
MH functional bedroom mock up@ Thorlux show room, 30:10:14
MH functional bedroom mock up@ Thorlux show room, 30:10:14
MH functional bedroom mock up@ Thorlux show room, 30:10:14
10. C-Sheets
10. Federated BIM Model
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Furniture Arrangements
• Padded waistcoat• Waterproof top• shoes• trainers• boots• 4 pairs of trousers• 2 tracksuit bottoms• shorts• 7 t-shirts• 3 rugby tops• 3 jumpers• 7 boxers• 7 socks• Baseball cap• (2 bath towels)• (2 hooded tops)
MH bedroom storage test - triangular
MH bedroom storage test – rectangular high level
• Padded waistcoat• 2 Waterproof tops• shoes• trainers• boots• 8 pairs of trousers• 2 tracksuit bottoms• shorts• 10 t-shirts• 6 rugby tops• 6 jumpers• 7 boxers• 7 socks• Baseball cap• 2 bath towels• 4 hooded tops
MH bedroom storage test – rectangular low level
• Padded waistcoat• Waterproof top• shoes• trainers• boots• 4 pairs of trousers• 2 tracksuit bottoms• shorts• 7 t-shirts• 3 rugby tops• 3 jumpers• 7 boxers• 7 socks• Baseball cap• 2 bath towels• 2 hooded tops
Patient Workshop: Mental Fight Club
• September 2014
• What does this space say to me?
• What does this space expect of me?
– Bed position
– Furniture
– Storage
– Colour
features:-Modular options, single fixed room design, 4 bed positions
MH functional bedroom – modularised fitted furniture
MH functional bedroom - Aerial viewRectangular furniture option with peninsula bed
MH functional bedroom - perspective view from windowRectangular furniture option peninsula bed
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Organic Mental Health Bedroom
Pat Pemberton/Rosemary Jenssen
HBN compliance- HBN 35Size: Bedrooms with en-suites- but no showers 17m2
5.46 Single rooms, with en-suite WC and washing facilities arerequired. The wash basin will need to be at a height suitable for aperson sitting on a chair. The en-suite facilities will need to havewheelchair access.
5.47 The bedroom may be furnished with a variable height bed andgeneral type bed head services but piped oxygen and suction arenot required. An emergency call system is required. The room willalso require a bedside locker, a chair of appropriate height andstorage for clothes.
What are the needs?
• Nursing care – continuation of care that has been provided at
home
• Interventions to encourage activities of daily living
• Safety – falls prevention and harm relating to falls
• Rest and relaxation
• Security and observation
Literature Review and Workshops
• Literature Review
• Mental Health Survey
• The Kings Fund
• South Essex CarersGroup
• Innovate Dementia
compliant design features:-•17.0 sqm -19.0sqm combined bedroom and en-suite•Sight-line from door•daylight and views out•en-suite HBN00-02 and 03 compliant•Rooms paired to share services•Anti-ligaturerecommendations:-•Familiarity ‘v’ ligature•Accommodate more interventions•Memory box•Sight-line to wc•Fitted furniture detail•Ceiling height min 2700mm•Recognise function of corridor + threshold•Seamless floor finish
MH organic single bedroom en-suite – key drivers
En-suitesh/wc
En-suitesh/wc
Sleep/rest
Sleep/rest
Work/play
storagestorage
support recovery
entryentry
Bedroom design incl therapeutic/nursing features En-suite design featuresN
etro
omar
ea(s
qm)
Cle
arw
idth
Cle
arde
pth
Bed
posit
ion
Sight
-line
from
door
Wor
ksp
ace
Stor
age
prov
ision
Perso
nalis
atio
n/
mem
ory
box
artw
ork
Cei
ling
heig
ht
Win
dow
size
+op
erat
ion
Doo
rtyp
e
Doo
rsiz
e+
oper
atio
n
Net
room
area
(sqm
)
Duc
tare
a(s
qm)
Loca
tion
rela
tive
tobe
droo
m
Sight
-line
bed
tow
c
Con
stru
ctio
nin
-situ
/pod
,gr
abra
ils
Doo
rtyp
e
door
size,
oper
atio
n+
lock
-ba
ck
MH Older Adult/Organic bedroom assessments
• En-suite comfortable, not over or under sized• Bed type and size• Option peninsula or against the wall
MH organic bedroom in-board en-suite – room testing
Technical Workshop• Detailed design:
– Size of the en-suite inrelation to assistance
– Single leaf entrance door
• Broader principles:– Standard brief
• What is an acceptable levelof risk?
• What level of assistance arewe designing for?
– Flexibility: baseline forforensic bedroom?
Organic in-board en-suite
Increased lengthby 275mm
Increased depthby 200mm
whb
showerchair
1010mm s.o.doorset
assistance on and off wc, with two staff1. 2. 3.
adjustments made to organic en-suite post technical workshop
layout pre and post workshop
features:-100% sight-line, efficient footprint, four bed positions, sight-line to wc
MH organic bedroom in-board en-suite
En-suitesh/wc
En-suitesh/wc
Sleep/rest
Sleep/rest
Work/play
storagestorage
support recovery
entryentry
bedroom, 14.3sqmen-suite, 3.8 sqmduct, 0.4sqm
bay, 0.6 sqm
10. C-Sheets
Organic nested en-suite
whbshower
chair
1010mm s.o.doorset
assistance on and off wc, with two staff1. 2.
New layout nested en-suite post technical workshop
features:-Shallower plan depth, two bed positions, seating area within corridor
MH organic bedroom nested en-suite
En-suitesh/wc
En-suitesh/wc
Sleep/rest
Sleep/rest
Work/play
storagestorage
support recovery
entryentry
bedroom, 13.8sqmen-suite, 3.8 sqmduct, 1.3 sqm
bay, 0.6 sqm
10. C-Sheets
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Furniture Arrangements
features:-100% sight-line, efficient footprint, four bed positions, sight-line to wc
MH organic bedroom – modularised furniture
MH organic inboard en-suite bedroom - Aerial viewTallboyfurniture option with peninsula bed
MH organic inboard en-suite bedroom – perspective viewTallboy furniture option with peninsula bed
features:-100% sight-line, shallower plan depth, longer corridor, two bed positions, sight-line to wc
MH organic bedroom – modularised furniture
MH organic nested en-suite bedroom - Aerial viewTallboy furniture option with peninsula bed
MH organic nested en-suite bedroom - perspective viewTallboy furniture option with peninsula bed
www.procure21plus.nhs.uk
Standard Components
David KershawPSCP Programme Director
Standard Components
Standard Component Catalogue
Technical Papers
• AHU• Chillers• Pipework• Partitions
Benefits – Potential Savings• Total potential saving:
£31m, or c5.17%(against typical market rates, and based on £600m total spend pa)
• Flooring: £4.20m• Doors: £3.84m• Lighting: £2.52m• Ceilings: £2.46m• Bedhead Services: £1.98m• Ceiling Hoists: £1.20m• Sanitary Ware: £0.54m• Radiant Panels: £0.48m• Paint: £0.18m• Windows: £0.76m
• Partitions: £4.5m• Pipework: £3.54m• Chillers: £2.64m• AHUs: £2.16m
This image cannot currently be displayed.
9 Month Savings
• Total: £1,307k
• Lighting: £512K (20%)
• Sanitary Ware: £494k (91%)
• Ceilings: £186k (8%)
• Flooring: £103k (2%)
• Doors: £10k (.3%)
• Fire Dampers: £2k
AiredaleBuckland and Dover
CroydonDarlington Memorial
HillingdonLeighton
New CrossNottingham University
RotherhamRoyal Stoke University
ScarboroughSouthampton General
St BernardsStepping Hill
The Walton CentreWorcester Royal
Queen Elizabeth, Gateshead
Accessing StandardShare
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Target Cost Savings
Richard VenablesInterserve
The ChallengeGovernment Construction Strategy – Efficiency Agenda
Sharing goodpractice/
standardisation
Innovation,changing
culture, BIM,Govt softlandings
Incentivisingsupply chain
collaboration toprovide value/
bulk buying
Controlling scope& understanding
what costsmoney
Challengingtime-scales
Managingexpectations
Reviewingperformance
Publishingcost
analyses
20% savingsrequired
14.1% savingsproposed
Target Cost SavingsRoom sizes?• Inboard en-suite – both
organic and functionalsimilar to HBN
• Nested en-suite minimalsaving against HBN
Efficiencies?• Right solution first time• Quality time• Component savings
Focus onpatient care
RepeatableRoomDesign
RoomSpecification
OperatingPolicy
Literature/ResearchReview
EvidenceMatrix
PatientFocusGroup
PreviousSchemeDesigns
PeerReview
In-UseReview
PostProject
Evaluation
SupplierDevelopment
Development Process
Specification
Operational Policy
Literature Review
Evidence Matrix
Patient Group
Design Assessments
Peer Review
Applies to all Rooms& Designs
Right solution first time
All rooms
All designs
Consistent
Thorough
üü
Evidencebased
Quality Time!
Design / Consultation• Detailed analysis – once• Consistent details• Improved Patient Experience
Construction• Early Involvement of the right supply
chain• Quality install
• More off site• Better co-ordination• Familiarity
• Certainty and knowledge• Speed to market
£1,425 cost saving for PSCP / PSCM teamper room
If take into account Trust (clinical andmanagement) time this saving will more
than double.
Components – benefits andsavings
93
Up to 37%savings
ManufacturersFixed price duration,extended warranties, UKmanufactured
Wholesalers Up to40%savings
National, efficient call-off,any size scheme, Fixedprice 2016
Guidance Up to30%savings
Specification clarity,understanding cost,technical design review
Specification Up to32%savings
Rationalise door sets (15)
Lessons learnt
Investment
Aggregatespendprofile
Collaborationwith keysuppliers
Focussedresources
Speed tomarket
Understandthe market
Design led– ensurecompliant
specification
Benchmarkand review
Best pricenot bestdiscount
Trustedrelationships
Communicateand market
Innovatetogether
Client BenefitsPSCP
Investment
Baselinefor localbranding
andadaption
HBMcompliantdesigns
Evidencebased
Quickerdelivery,right first
time
New NHSspecific
products
Free researchand
development
Efficientcapitalspend
Reduceddevelopment
time
Removal ofwaste
Realistic androbust
Integratedworkinginnovatetogether
The end result
96
Standardisedcomponents &
designüIncreased
certainty oftime, cost,
quality
Whole life costchoices
üü
Target Costsaving > 5%ü
Ben
efit
Standardisation
Up to 5% targetcost saving:Area/DesignBetter buying
Road to Savings
GCS 14.1%target
20%+Potential with:StakeholderengagementStafffamiliaritySupplierresponseLifecycle
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Break, Exhibition and Video
Return 12:00