1 The NAO report examined whether the PFI contract was likely to deliver the services the Trust wanted and how the contract payments would be funded; whether the Trust secured a good deal; how the Trust managed the procurement and their advisers; and what steps the NHS were taking to act on lessons learned from this project.
2 The NAO found that:
a The contract is likely to deliver the services the Trust wanted, but additional financial support was being provided to meet the costs of the new hospital. In determining the services to be provided the then Regional Health Authority told the Trust that the new hospital should not have more than 400 in-patient beds. Given the expected demand on the hospital, 400 beds was broadly consistent with the plans for bed capacity in new hospitals which the NHS was then pursuing. In taking forward the plans for the new hospital the Trust provided for more day-case and out-patient treatments, with in-patient care backed up by a range of high technology and treatment departments.
b The PFI deal was expected to deliver additional non-financial benefits compared with traditional procurement but there is uncertainty as to the level of savings, if any, that would be achieved.
c The procurement was not fully competitive but the Trust benchmarked most of the costs.
3 The NAO's recommendations included:
a Funding limits for PFI health projects should be agreed at the outset with confirmation that the project will contribute to the best use of NHS funds within the plans for local health services.
b Key decisions on whether a project represents value for money should be based on careful calculations of the likely costs and benefits which should be subject to rigorous review.
c The data for cost overruns on past traditional hospital procurements should be refined.
d Trusts should maximise competitive tension in the bidding process including checking whether bidders feel able to comply with the bidding requirements.
e The NHS may wish to consider whether it should commission certain advice centrally on PFI issues.