Capital expenditure in the NHS amounted to approximately ?3.5 billion in 2007/2008. With a line of accountability that stretches from local community and patient groups to government targets, Primary Care Trusts and NHS managers are pressured from all sides to see that money well spent. So how can individual contractors help the PCTs meet those demands?



Any contractor who has worked within the health sector will know that it presents specific challenges regardless of the type of service being provided. Arguably, the construction industry faces more challenges than most due to the nature of its work. Successful companies ? and those which win repeat business ? have learnt how to predict and tackle potential problems whilst working within the constraints of the clinical environment.

Fast track refurbishment is a speciality that is of particular interest to many PCTs as they strive to meet objectives and cut down the length of time contractors spend on site. Working at speed must not, however, lead to corners being cut or quality being compromised. This is more easily achieved where the workforce consists of employed staff and trusted subcontractors, but one of the key roles in pulling the job together is that of the project manager. It is imperative to take account of all foreseeable factors that may have a bearing on satisfactory project completion, and this is best done during the crucial planning stage. PCTs will want to see a demonstration of the contractor's ability to bring in the project within set timescales and budgets as well as a detailed risk assessment. Resources spent on planning at this stage are more than repaid during the project's implementation.

On many construction sites the client is a visitor rather than a resident, but with the health sector this is far from the case. Successful contractors have more than one client: the PCT plus the staff and patients at the site in question. In many instances, contractors will be required to work whilst routine services continue uninterrupted. This presents a number of issues, such as limiting noise levels, gaining access, site tidiness and, not least, health and safety. A phased approach to the work can help overcome these problems as can segregating each working area to avoid noise and dust contamination.

Such challenges are compounded when working at mental health facilities, where it is vital to ensure that patients are not able to gain access to the construction areas and that the ongoing work does not compromise on site security.

In many commercial projects circumstances dictate that construction or refurbishment takes place whilst the client's normal business carries on. Naturally, this is very much the case with health services but it would be inappropriate to compare the ?normal business? of a hospital or health centre to that of the commercial sector. Working in close proximity to patients requires understanding of the stress and strain that they are likely to be experiencing through illness, surgery or medical investigation. Full consideration should be given of the impact the project will have on staff, patients, visitors and other services that need regular access to the site. A courteous, sensitive workforce will be an asset, as will membership of a Consideration Contractors Scheme.