1.3 The West Middlesex site is large and unwieldy. The layout of interdependent services such as Accident and Emergency (A&E), operating theatres, and rehabilitation units is inefficient and in some instances compromises patients' recovery, as they can spend up to 15 minutes in an electric ambulance being moved around the site. Some essential services, such as X-ray, are provided several times at different locations, leading to inefficient staffing and additional costs.
1.4 Much of the dilapidated building stock on the site is over 100 years old and in recent inspections the site as a whole has failed to meet its statutory fire and health and safety obligations. The layout and conditions therefore make the site unsuitable for modern, high quality healthcare.
1.5 Plans to improve the site have been circulated since the 1970s and the project was originally intended to be part of the proposed first wave of PFI deals in the mid-1990s. The PFI procurement, which was well advanced, was stopped in 1997 when the Department decided to prioritise the schemes that would be completed. West Middlesex Hospital was 14th on a list of urgent projects, the first 13 of which went ahead. The project was included in the next wave of PFI hospital projects taken forward in 1998. London Regional Office (LRO) indicated that the project remained a priority and would have been taken forward through conventional procurement if a PFI solution was not deemed appropriate.