Business Case for a Replacement Health Centre, London Borough of Southwark

The commission for this work began in December 2007 and work is currently continuing (the commission is due to complete during Spring 2010).

Acton Shapiro was commissioned by the lead GP Practice in the current health centre (with funding for assignment underwritten by the developer of the replacement health centre).  The principal aim of the project was to meet the PCT’s requirement for a detailed and costed justification of rationale for relocation and to provide specialist support to all aspects of the preliminary planning work.

A key aspect of this project (as with many Business Cases) is to ensure clear communications and control of the overall project in the various stages leading up to formal approvals and legal/financial close.  A series of regular, minuted Steering Group meetings was instigated and chaired by Acton Shapiro.  These enabled the PCT, the Practice, the District Valuer, the Architect and the Developer (and its agents) to co-ordinate planning actions.  Tight timescales for delivery were also facilitated.  The Steering Group also enabled all parties to manage the complex and lengthy process of obtaining statutory planning consents, which involved a Section 106 Planning Agreement.

An essential ingredient of any Business Case is to place this firmly in the context of the PCT’s requirements for:

  • improving services for patients and the public
  • meeting current local and national policy requirements (such as improving access, rationalising the primary care estate, improving service integration, etc.)
  • providing a sustainable and “value for money” premises solution.
Acton Shapiro thus spent considerable time working with the Practice and the PCT to arrive at a solution that met these parameters.  The Business Case document itself reflected these issues.  It also specified clearly the rationale for the proposed relocation, its costs, the PCT’s funding required, the service benefits and the estate/design implications.

In addition to preparing the actual business document, Acton Shapiro was able to help with:
  • preparing the Practice’s specifications for the developer (“Tenants' Requirements”)
  • supporting the Practice in respect of the statutory planning process
  • acting as “honest brokers” for issues of contention as they arose between the various involved parties as the planning for the scheme progressed
  • liaising with the Practice’s legal representatives – thus saving on legal costs
  • negotiations with the District Valuer
  • focusing on meeting of deadlines
  • inputting experiences gained from other similar schemes elsewhere
  • facilitating Practice “time-outs” to ensure full Partner involvement throughout the process.

Important learning points from this project were:

  • to acknowledge the time needed to work up detailed – and agreed – designs and plans
  • to focus on rigorous and consistent communication between all the various parties to identify clearly the aspirations and expectations of key players – in particular, the PCT, the Practice and the Developer
  • to recognise that the Business Case needs to be underpinned as much by service improvements and patient benefit as by merely addressing physical shortfalls with the current buildings.