1.21 The NHS has experienced numerous changes in strategic thinking and direction over the past 10 to 15 years with the National Beds Inquiry and the NHS Plan being the latest drivers in health strategy. The Department currently advises that bed occupancy should not exceed 85 per cent. Prior to the redevelopment West Middlesex had a rate of some 89.5 per cent or higher, following the redevelopment West Middlesex is expected to be up to 85 per cent.
1.22 The difficulty in establishing consistent strategic direction in the NHS over time is a factor that affects all hospitals whether procured conventionally or through PFI. Given the long duration of a PFI deal, there is more need for flexibility to be incorporated in the design and contractual arrangements.