INTRODUCTION and OVERVIEW
AMA Research are pleased to announce the publication of the 6th edition of its overview of the Healthcare Construction Market in the UK, focusing on key market trends and major structural change within the NHS and private sectors, which should be of particular interest to healthcare providers and construction professionals involved in the healthcare sector.
The report reviews recent changes and provides insight on forward plans, including capital spending in the healthcare sector, key issues for the construction industry and anticipated opportunities for healthcare construction work over the next few years.
Key issues analysed include:
- Government reform of the NHS and implications of the Health & Social Care Act for the construction industry.
- New providers and clients under the new NHS Structure.
- Analysis of Capital Funding to 2016 and capital funding arrangements under new NHS Structure.
- Major contractors, consortia, developers and investors involved in the healthcare sector - construction pipelines, budgets, key schemes and players.
Particular areas of insight include:
- Potential impact of the government's 'NHS: Five Year Forward View', which outlines what needs to be done between 2015 and 2020 to improve the NHS - a 'blueprint' for the party that wins the 2015 general election, which sets out new models of care and could have significant implications for the NHS and its estate.
- Review of primary healthcare and GP estate and government funding to upgrade premises - GPs now firmly at the core of the NHS.
- Review of future of main procurement routes and construction programmes - PFI and Private Finance 2 (PF2), LIFT and ExpressLIFT; Hub Initiative in Scotland; Procure21+; Designed for Life: Building for Wales and Frameworks Scotland - construction pipelines, budgets, key schemes and players.
- Shift away from major new build hospital schemes towards local and primary health facilities and refurbishment schemes. ExpressLIFT and P21+ construction pipeline.
- Review of growing involvement of private sector and commercial providers in NHS primary care provision.
Some of the companies included:
Apollo Capital Projects, Assura, Balfour Beatty, Bam Construction, Bouygues, BMI Healthcare, Boots, Brookfield Multiplex, Care UK, Carillion, GPI, GTD (Go To Doc), HCA International, Integrated Dental Holdings Ltd, Interserve, IntraHealth, John Laing, Kier, Laing O'Rourke, Lend Lease, Malling Health, MedicX Fund, Nuffield Health, Octopus Investments, Primary Health Properties, Ramsay Healthcare, Robertson Construction, Ryhurst, Sainsbury's, Sir Robert McAlpine, Skanska UK, Spire Healthcare, SSP Health, Carlyle Group, Vinci, Virgin Care, Wates, Willmott Dixon.
Key areas covered in the report:
PUBLIC SECTOR HEALTHCARE IN THE UK
- Overview and new Structure of the NHS - England, Scotland, Wales - government reforms of the NHS and implications of new Health & Social Care Act.
- New Providers and Clients under new NHS Structure - CCGs, Foundation Trusts, NHSCB.
- Size and condition of the NHS Estate in England, Wales and Scotland - impact of NHS reforms on NHS estate rationalisation and upkeep.
- Overview of the Primary Healthcare Estate - Future of GP premises and primary healthcare services under the new Health Act and the 'NHS Five Year Forward View'.
- Healthcare Spending and Investment in the UK - primary care spending, NHS funding in Wales, Scotland and Northern Ireland, 2014 Autumn Statement, forecasts 2014-2016.
PRIVATE ACUTE HEALTHCARE SECTOR IN THE UK
- Private partnership with the NHS and analysis of private and corporate providers in the NHS.
- Acute private hospital provision and leading providers - number of facilities, key contracts.
- Private healthcare companies - key players, market size, including major groups; retail outlets moving into primary healthcare; private healthcare groups and property/ investment companies specialising in GP and primary care premises investment and development.
- Private dental care - major dental companies/practices.
CONTRACTORS OUTPUT IN THE HEALTHCARE SECTOR
- Analysis of Total New Work Construction Output - output by sector and for 2015 and beyond.
- Construction output in the healthcare sector - 2009-2019 - factors influencing forecasts.
- Healthcare construction work pipeline - key funding streams (PFI/PPP P21, P21+), programme budgets to 2017 and beyond, number of schemes, capital values.
- Capital expenditure in NHS - England, Scotland, Wales and N. Ireland - key developments.
PROCUREMENT OF HEALTHCARE CONSTRUCTION WORK
- Size/value of the PFI healthcare market and progress of schemes to date.
- Future of Healthcare PFI (Private Finance 2) - key schemes, values.
- Overview of NHS LIFT/ExpressLIFT/Hub Initiative Scotland/Procure21 & Procure21+/ Designed for Life: Building for Wales Framework/Frameworks Scotland - budgets, construction pipelines, progress to date, forecasts.
- NHS LIFTExpress and P21+ construction pipelines 2014-20 - values, schemes, status, players etc.
- Other finance and procurement options for NHS clients - LABVs, Joint Ventures, Surplus Land - open up the market considerably to smaller firms and suppliers.
CONSTRUCTION SUPPLY IN THE HEALTHCARE SECTOR
- Key construction companies in the healthcare sector - recent projects.
- Key consortia in healthcare sector - key players.
- Healthcare developers and investors.
- Current construction opportunities and tenders in the healthcare sector.
Health Sector Construction Output - 2010-2016 by Value
Table of Contents
2. SUMMARY AND FUTURE PROSPECTS
3. PUBLIC SECTOR HEALTHCARE IN THE UK
- 3.1. OVERVIEW AND STRUCTURE OF THE NHS
- 3.1.1. Health & Social Care Act 2012
- 3.1.2. Providers and Clients under the Reformed NHS Structure
- 3.2. THE NHS IN AN AGE OF AUSTERITY - ESTATE RATIONALISATION
- 3.2.1. England
- 3.2.2. Scotland
- 3.2.3. Wales
- 3.2.4. Northern Ireland
- 3.2.5. Future of the NHS and NHS Estate
- 3.2.6. GP Premises
- 3.3. HEALTHCARE SPENDING IN THE UK
- 3.3.1. NHS Funding - England
- 3.3.2. NHS Funding - Scotland
- 3.3.3. NHS Funding - Wales
4. PRIVATE ACUTE HEALTHCARE SECTOR IN THE UK
- 4.1. OVERVIEW AND SIZE
- 4.1.1. Partnership with the NHS
- 4.2. LEADING PRIVATE HEALTHCARE PROVIDERS
- 4.2.1. Private Healthcare Companies
- 4.2.2. Private Dental Care
5. CONTRACTORS OUTPUT IN THE HEALTHCARE SECTOR
- 5.1. TOTAL CONSTRUCTION OUTPUT
- 5.1.1. Construction New Work - Value of Non-Domestic Output to 2019
- 5.1.2. Output by Sector
- 5.2. CONSTRUCTION OUTPUT IN THE HEALTHCARE SECTOR
- 5.2.1. Outlook for Healthcare Construction Work
- 5.2.2. Healthcare Construction Pipeline
- 5.3. CAPITAL EXPENDITURE IN THE NHS
- 5.3.1. England
- 5.3.2. Scotland
- 5.3.3. Wales
- 5.3.4. Northern Ireland
6. PROCUREMENT OF HEALTHCARE CONSTRUCTION WORK
- 6.1. PFI
- 6.1.1. Overview & Size of the PFI Healthcare Market
- 6.1.2. Future of Healthcare PFI
- 6.1.3. Alternative Models to PFI in Healthcare
- 6.2. PROCUREMENT ROUTES FOR GPS AND CCGS
- 6.2.1. Future of Healthcare Procurement
- 6.2.2. NHS LIFT
- 6.2.3. Express LIFT
- 6.2.4. Hub Initiative Scotland
- 6.2.5. Procure21/Procure21+
- 6.2.6. Designed for Life - Building for Wales (P21 in Wales)
- 6.2.7. Frameworks Scotland
- 6.2.8. Other Finance and Procurement Options for NHS Clients
7. CONSTRUCTION SUPPLY IN THE HEALTHCARE SECTOR
- 7.1. OVERVIEW
- 7.2. KEY CONSTRUCTION COMPANIES AND CONTRACTORS IN HEALTHCARE
- 7.3. KEY CONSTRUCTION CONSORTIA IN THE HEALTHCARE SECTOR
- 7.4. HEALTHCARE DEVELOPERS AND INVESTORS
- 7.5. OPPORTUNITIES/TENDERS
TABLES AND CHARTS
- TABLE 1: SUMMARY OF HEALTHCARE SECTOR BUDGETS & MAJOR CAPITAL SPENDING PROGRAMMES 2013-2016 - EXPRESS LIFT, P21, FRAMEWORKS SCOTLAND, BUILDING FOR WALES ETC.
- CHART 2: STRUCTURE OF THE NEW NHS (NHS ENGLAND)
- TABLE 3: TOTAL SIZE OF NHS ESTATE BY FUNCTION - GIFA, LAND AREA, UNUTILISED SPACE, CAP EXP, BACKLOG MAINTENANCE - 2012-13 - 2013-14
- TABLE 4: NHS SCOTLAND ESTATE - ACUTE SERVICES BY TYPE OF FACILITY, AREA (SQ. M) AND PROPERTY & FM COSTS (£M) - 2013-14
- CHART 5: NHS SCOTLAND ESTATE - AGE OF PROPERTY 2013-14 (%)
- CHART 6: VALUE OF UK NHS EXPENDITURE 2006 - 2016 (£BN)
- TABLE 7: NHS ENGLAND BUDGET 2015-16 - ALLOCATION OF RESOURCES - ANALYSIS BY SECTOR AND PROGRAMME (CCG, PRIMARY CARE, MENTAL HEALTH, PUBLIC HEALTH ETC)
- TABLE 8: TOTAL HEALTHCARE SPENDING SCOTLAND 2010-16 (£M)
- CHART 9: PRIVATE ACUTE HEALTHCARE MARKET SIZE - % BY SECTOR (ACUTE HOSPITALS, NHS COMMISSIONING, MENTAL HEALTH - (£BN) 2013-14
- TABLE 10: MAJOR NHS HEALTHCARE CONTRACTS AWARDED TO THE PRIVATE SECTOR SINCE APRIL 2013
- TABLE 11: LEADING UK PRIVATE HOSPITAL PROVIDERS 2014 - MARKET SHARES, NO. OF ACUTE , HOSPITALS, BEDS
- TABLE 12: TOP 25 PRIMARY HEALTHCARE PROVIDERS BY NUMBER OF SURGERIES & OTHER FACILITIES OWNED - 2015
- TABLE 13: MAJOR DENTAL COMPANIES IN THE UK BY NUMBER OF PRACTICES IN 2012 AND 2015
- CHART 14: VALUE OF NON-DOMESTIC CONSTRUCTION OUTPUT 2009 - 2019 BY VALUE (£BN AT CURRENT PRICES)
- CHART 15: VALUE OF CONSTRUCTION OUTPUT NEW WORK BY SECTOR - % BY VALUE 2014
- TABLE 16: CONTRACTORS OUTPUT OF HEALTHCARE SECTOR WORK (PUBLIC/PRIVATE) 2008-2014 (£M)
- CHART 17: HEALTH CONSTRUCTION OUTPUT FORECASTS 2009 TO 2019 - BY VALUE (£BN AT CURRENT PRICES)
- TABLE 18: HEALTHCARE PROJECTS - FORWARD CONSTRUCTION PIPELINE 2014-2020 AND BEYOND - NO. OF SCHEMES, PROCUREMENT PROGRAMME, CAP EXPENDITURE, START/COMPLETION, SCHEME STATUS ETC
- TABLE 19: NHS CAPITAL SPENDING - 2007-2016 (£BN)
- TABLE 20: TOTAL HEALTHCARE SPENDING SCOTLAND 2010-16 (£M)
- TABLE 21: HEALTHCARE CAPITAL SPENDING WALES 2010-16 (£M)
- TABLE 22: HEALTHCARE CAPITAL SPENDING NORTHERN IRELAND 2010-16 (£M)
- TABLE 23: CURRENT PFI INVESTMENTS (BY GOVERNMENT DEPARTMENT) - NO. OF PROJECTS, CAPITAL COSTS
- CHART 24: CAPITAL INVESTMENT IN NHS LIFT 2004-2016 BY VALUE (£M AT CURRENT PRICES)
- TABLE 25: NHS LIFT - FORWARD CONSTRUCTION PIPELINE 2014-2016 (SCHEMES, STATUS, CAPITAL VALUES, COMPLETIONS ETC)
- TABLE 26: HUB INITIATIVE SCOTLAND - HUBCOS (AREA, CAPITAL VALUES, TIER 1 SUPPLY CHAIN PARTNERS ETC)
- TABLE 27: HUB INITIATIVE SCOTLAND - HEALTHCARE PROJECTS IN DEVELOPMENT - CAPITAL VALUES, STATUS AND COMPLETION DATES
- CHART 28: P21/P21+CAPITAL VALUE OF SCHEMES IN DEVELOPMENT 2011-2020
- TABLE 29: PROCURE21 - FORWARD CONSTRUCTION PIPELINE 2014-2020 (NUMBER & VALUE OF SCHEMES, STATUS) BY REGION
- TABLE 30: PROCURE21+ - FORWARD CONSTRUCTION PIPELINE 2014-2020 (NUMBER & VALUE OF SCHEMES, STATUS) BY REGION
- TABLE 31: DESIGNED FOR LIFE - BUILDING FOR WALES2 - FRAMEWORK PARTNERS
- TABLE 32: FRAMEWORKS SCOTLAND - REGISTERED HEALTHCARE PROJECTS (NO. AND VALUES OF SCHEMES, STATUS) - BY HEALTH BOARD
- TABLE 33: LEADING CONTRACTORS IN THE HEALTHCARE SECTOR BY GROUP TURNOVER AND VALUE OF HEALTHCARE PROJECTS WON 2014 (£M)
- TABLE 34: MAJOR CONSORTIA AND SUPPLY CHAIN/FRAMEWORK PARTNERS IN THE HEALTH SECTOR
- TABLE 35: PRIMARY HEALTHCARE DEVELOPERS & INVESTORS BY NUMBER OF PRIMARY CARE PREMISES OWNED
- TABLE 36: HEALTHCARE PROJECTS IN PIPELINE 2015 - CAPITAL VALUES & STATUS