1.8 The review confirmed that the BHR Trust has identified and acted on a number of opportunities to reduce the costs of the PFI project. There are many examples of good practice in the BHR Trust's contract management that provide useful models for other Trusts and PFI procuring authorities for optimising the management of existing PFI contracts. Examples include:
• Effective management of existing cost/gain share provisions in relation to insurance;
• Seeking to reduce energy consumption, for example through increasing energy use awareness;
• Regular reviews of soft services specification against service requirement;
• Aligning market testing dates between sites with the same soft services provider; and
• Accessing agency energy purchasing discounts (via Buying Solutions).
1.9 The capacity of the hospital is larger than the BHR Trust's current requirements. The BHR Trust has taken action (through accepted or planned variations to the project) to minimise the marginal costs of surplus capacity, including through subletting a surplus ward to a private healthcare provider, with related usage agreements for clinical and non-clinical services. The BHR Trust is also reviewing opportunities for temporary mothballing of contingent ward space.
1.10 In addition, the BHR Trust has taken or is considering opportunities to extract savings or improve value for money from changes to the project specification, whilst maintaining the operational performance. Examples are standardising the ward housekeeping specification across its PFI and non PFI hospitals and reviewing and adjusting response times and shift patterns for portering and security services. In addition, the Trust has introduced changes to specification of replacement equipment under the medical equipment contract, to reflect the longer lifecycle of some medical equipment, in order to optimise the use of the contract budget.