This 35-year deal meets expected local needs with some flexibility to address inherent uncertainties in wider long-term NHS plans

4  As many of the buildings were over 100 years old and dilapidated, the Trust, the local Health Authorities and the NHS London Regional Office (LRO) all considered that a redevelopment of the West Middlesex hospital site was essential to meet local needs for modern, high quality healthcare2. In accordance with procedures introduced since the planning of the earlier Dartford and Gravesham PFI project they agreed a strategic outline case for this redevelopment.

5  Long-term planning is difficult in the health service because healthcare is changing over time and the local demography may also change. This may affect the optimum type and location of facilities that are required. This exposes the Trust to the risk that it may become locked into a long-term contract for buildings and services that are no longer needed. This issue is not limited to PFI hospitals, but the long-term service contract of a PFI deal makes termination likely to be more expensive. In the West Middlesex deal there is some flexibility to accommodate these uncertainties. Up to six additional wards can be provided or alternatively bed numbers could be decreased. The Trust believes the contract provides sufficient flexibility to address future uncertainties in long-term healthcare.

___________________________________________________________________________

2  The local health authorities were Ealing, Hammersmith and Hounslow (EHH) Health Authority and Kingston and Richmond (K&R) Health Authority.