3.11 Changes to central health policy or the demand for particular services from the local community could result in the Trust needing building changes. The Trust has already commissioned additional building work since the PFI contract was let at an expected capital cost of around £15 million (Figure 20) with the Accident and Emergency improvements having been completed. The work is being carried out by Carillion, partly under the PFI deal through a bond variation and partly through conventional NHS funding. The Trust has taken steps to test that Carillion's pricing of the additional building works are reasonable by either competitively tendering the work or benchmarking Carillion's prices. The Trust may also need a change of use of existing facilities. This occurred when the Trust converted a children's ward into an adult ward.
3.12 Two of the additional building projects, the mental health assessment centre for older people and the renal dialysis unit, will be paid for by the NHS out of public capital by the West Kent NHS and Social Care Trust and Kings' College Hospital NHS Trust who are the relevant service providers.23 Under the terms of the PFI deal the Trust was required to be contractually liable to THC Dartford for the cost of this work by way of a variation to the PFI contract as this was work being carried out on the Trust's site. The Trust will recover the cost from the two service provider NHS Trusts. Any facilities management services that the two NHS Trusts using the facilities may require will also be initially charged to the Trust under the PFI contract. The Trust's liabilities arising from these services for the two other Trusts are, however, being underwritten by the Dartford, Gravesham and Swanley Primary Care Trust.
20 | The Additional Buildings Projects |
Building | What it will provide | Who is doing the work | How much will it cost | How will it be contracted for and financed | Construction start date | Completion date |
Treatment Centre | 40 beds and the ability to treat 3,400 extra patients a year. | Medical provision by the Trust. Construction and facilities management by Carillion through THC Dartford (following independent surveyors reports that the costs were reasonable). | Estimated capital cost £8 million. The Trust's annual PFI charges will increase by £900,000. | As a PFI contract variation. Funded by THC Dartford from variation bonds raised as part of the refinancing. | March 2004 | June 2005 |
A & E improvements | Improvements to current A&E to help the Trust deal with higher than expected usage. | Carillion (following competitive testing of their proposed price). | £600,000- £700,000 | Separate building contract. Funded conventionally by the NHS. | March 2004 | Completed |
Mental Health Assessment Centre and Renal Dialysis unit | Facilities for use by West Kent NHS & Social Care Trust & King's College Hospital NHS Trust. | Carillion (following competitive testing). | Estimated capital cost £5 million. The Trust's annual PFI charges will not increase since the work is being funded by other Trusts | As a PFI contract variation with the cost to be borne by the two other NHS Trusts who will use the facilities.1 | March 2004 | February 2005 |
Total Estimated Cost approximately £15 million | ||||||
NOTE 1 The Trust will recover the cost from the two service provider NHS Trusts: the West Kent NHS and Social Care Trust and King's College Hospital NHS Trust. To pay for this, these Trusts will draw on conventional funding. | ||||||
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23 If West Kent NHS and Social Care Trust should withdraw from the project, then the Trust has an agreement in place whereby Dartford, Gravesham and Swanley Primary Care Trust will underwrite their contribution.