Healthcare Estates Welsh Conference and Exhibition Friday 24th April 2009 North Wales Adolescent Unit Child and Adolescent Mental Health Service (CAMHS)
Presenters Ian Howard Project Owner - North Wales NHS Trust Alex Beedle Pre construction Manager - Laing O Rourke
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
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
Limitations of Current North Wales CAMHS [1]
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 disturbance Unable to admit under the Mental Health Act
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
Vision for the future of North Wales CAMHS 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
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
Structure Welsh Assembly Government Welsh Health Estates North Wales NHS Trust Owner / Project team Ian Howard Andy Williams Trevor Hartley Williams Darren Smith Stakeholders Clinical Team Education Catering Security Facilities Project Manager / Cost Gleeds Project Board, Task Groups Planning Design & Construct Public Relations Operational Policies Equipment IM&T Human Resource Supply Chain Laing O Rourke Management Alex Beedle Colin Chong Design Team Design Buro - Architect Health Planning - Serco WSP - Services RVW - Structural CHT Specialist Services
Structure Clinical leadership and engagement Creation of a team early in the process Size of the Project Board
5 Key Challenges 1. Timescales expiry of the lease 2. No NHS building standards for CAMHS 3. Affordability 4. Site selection 5. Consultations & planning
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
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
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
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)
Site Selection Abergele Hospital
Consultation and Planning Design Programme Business Case Health and Safety Benefits of the Framework Current status of the project
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
North Wales Location Abergele Hospital Site Local Features
Adjacent Ward Adjacent Green Lane Existing Unit Boiler House Bridge Site Photos Main Building Bridge
Functional Relationships North Wales Adolescent Unit
Departmental Relationships Proposed Building Massing
GF Plan Block plans Site Plan FF Plan Bedroom Plan
Initial appearance Bridge Protection
Imaging North Wales Adolescent Unit
Sustainability and Services 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
Programme - Overview 2006 2007 2008 2009 OBC FBC Construction Existing lease expires
Programme - OBC 2006 2007 OBC Site Selection Hibernation Design & Price Consultations Planning Approval Site Selection ratification Elections & consultations Affordability VE opportunities best value Planning OBC
Programme - FBC 2006 2007 2008 2009 OBC FBC Design 1:50s Design RDs Target Trust Programme Risk FBC Activities in OBC
Programme - Construction 2006 2007 2008 2009 OBC FBC Construction Enabling Timber Frame Services Finishes Commission Handover OBC / FBC / Construction Overall programme 35 months less 7 month hibernation = 28 months Lean delivery 2 ½ years
Business Case MIPS 490 Project Item Data Gross Internal Area 3,174m 2 Works Cost (Excluding 8,853,591.00 VAT) Project out turn cost 13,712,635
Benchmark Ardenleigh CAMHS Newcastle CAMHS Hampshire Adolescent Secure Psychiatric Unit East Sussex CAMHS North Wales CAMHS 3,000 2,500 2,000 1,500 1,000 500 0 North Wales Adolescent Unit Adjusted /m2 1
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 Solution North Wales Adolescent Unit Health and Safety Methodical 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
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
Benefits of the framework Community Benefits 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.
Framework benefits Extensive Consultations Clinicians talking to suppliers People Facilities talking to installers Scope Best practice design Extensive & robust OBC/Contract Time 2 ½ years lean delivery NEC Contract Early Warnings H&S Executive why can t all sites be like this?
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