The NHS’ largest ever building programme is in full swing, addressing demand for radical improvements in healthcare delivery in the acute and primary healthcare sectors. Recent research, published by the Nuffield Trust, shows that the NHS has the capacity to improve and that foundations are in place for long-term progress. The principal objectives of the NHS Plan, which is driving the current investment and which runs until 2010, are:

• To reduce waiting times
• To provide universal access to high quality healthcare
• To increase the capacity of diagnostic and preventative medicine
• To take advantage of methods of service delivery provided by new technologies, innovative ways of working or alternative sources such as the private sector.

The implications for a capital build programme are significant. Under a spend programme worth more than £11bn, 100 large hospital schemes are should be open by 2010, together with a new generation of Diagnostic and Treatment Centres. The NHS Plan also involves the private sector in the provision of DTCs contracted specifically to provide elective surgery to reduce waiting lists.

With the introduction of a partnering approach to procuring capital works worth £1-25m, Procure 21, the NHS’ management of medium-scale capital projects is also being overhauled. As a supplement to previous articles on the PFI, DLE focuses in this cost model on smaller-scale hospital development.