Abstract
AMA Research will shortly publish the 3rd Edition of its overview of
Healthcare Construction Market in the UK, focusing on key market trends,
structure and change within the NHS, major healthcare providers and companies,
contractors and procurement issues. This report reviews key forms of
procurement in healthcare construction including Procure21 and NHS LIFT, with
£ 21 billion to be spent in the next 3 years.
Key areas in the report:
- An overall review of both primary and acute healthcare in the public and
private setting
- Analysis of public sector funding for NHS acute and primary care
facilities - LIFT, Procure 21 etc.
- Review of key procurement processes, key construction consortia etc.
- Detailed analysis of the Government' s targets for capital spending as
outlined in the 2007 Comprehensive Spending Review, an update of construction
progress and an assessment of contractors output of work in the healthcare
market - £ 21 billion in next 3 years.
Areas of particular interest:
- Review of the progress of the new Express LIFT initiative and the
Procure21+ framework which is being re-branded from 2010 onwards at a cost of
around £ 2.9bn
- Expansion of the private sector in primary care provision and an increase
in partnerships with the NHS - the role of corporate providers and
healthcare chains, concerns that current reforms will lead to increasing
fragmentation of provision in the healthcare sector
- Update of construction progress and an assessment of contractors output -
including an analysis of PFI, Procure21 and NHS LIFT. Almost £ 7 billion
to be spent in 2009-10.
- Anticipated opportunities for healthcare work over the next few years in
the light of the current economic downturn
- More than 100 hospitals have been built under the 2000 NHS Plan. Although
the programme is due to end in 2010, substantial funding increases for the
healthcare sector are planned, with over £ 21bn being spent on
healthcare projects over the next 3 years
Companies and Consortia included:
Balfour Beatty, Consort Healthcare, Bovis, Catalyst Healthcare Consortium,
Carillion, Clinicenta, Lodestone Patient Care, Galliford Try,HBG (BAM
Construct UK), Interserve Project Services, Pyramid Healthcare
Consortium,Summit Healthcare, Kier Health, Prospect Healthcare, John Laing,
Morgan Sindall, Willmott Dixon, Building Better Health Consortium, Primary
Asset.
Key areas of coverage in the report include:-
PUBLIC SECTOR HEALTHCARE IN THE UK
- Overview & Structure of the NHS and healthcare sector in England, Wales
and Scotland.
- Legislative Drivers and Policy Issues shaping the way in which care is
being delivered.
- Overview of the Primary Care Sector, including primary care trusts,
provision of GP surgeries, polyclinics, treatment centres, walk-in centres,
dental provision.
- An overview of the Secondary/Acute care sector, including foundation
hospitals and plans to increase the provision of community hospitals and in
the UK.
- Healthcare spending in the UK, including total spending, NHS budgets and
primary care spending.
THE PRIVATE ACUTE HEALTHCARE SECTOR IN THE UK
- Structure and size of the private acute healthcare sector in the UK.
- Increasing partnership of the private sector with the NHS.
- Acute Hospital provision & leading independent providers.
CONSTRUCTION OUTPUT IN THE HEALTHCARE SECTOR
- Value of construction new work output and construction output by sector in
2008.
- Construction output in 2009 and Beyond - £ 6.8 billion in 2009-10.
- Analysis of contractors output in the public healthcare sector.
- Outlook for Healthcare Construction Work over the next few years in the
light of the current economic downturn - £ 21 billion to be spent in
next 3 years.
- Capital Expenditure in the NHS in England, Scotland, Wales & N. Ireland.
- Impact of the ' Credit Crunch' on Healthcare Infrastructure - PFI
projects.
- Healthcare Work Output - Government Targets & Progress to Date.
PROCUREMENT OF HEALTHCARE CONSTRUCTION WORK
- Overview of principal procurement routes used in the NHS.
- The Private Finance Initiative - background, market size, progress to
date, leading contractors.
- NHS LIFT - background, investment, scheme update & progress, principal
consortia, new framework members, future of NHS LIFT and Express LIFT, LIFT in
other regions.
- Procure 21 - background, investment, scheme update & progress, P21 in
Wales, Frameworks Scotland, future of P21 and P21+. Restructuring of
programme, £ 2.9 billion in next 4 years, new opportunities.
CONTRACTOR PROFILES
- Structure and size of the contracting industry.
- Key construction companies and contractors.
- Private sector consortia in healthcare.
- Contractor profiles - key contractors operating in the healthcare market.
- Healthcare developers - companies specialising in GP and primary care
premises investment and development.
Table of Contents
1. INTRODUCTION 6
2. EXECUTIVE SUMMARY AND FUTURE PROSPECTS 7
3. PUBLIC SECTOR HEALTHCARE IN THE UK 13
- 3.1 OVERVIEW & STRUCTURE OF THE NHS 13
- 3.1.1 Scotland 13
- 3.1.2 Wales 13
- 3.1.3 Legislative Drivers & Governmental Reforms 13
- 3.2 THE PRIMARY CARE MARKET 14
- 3.2.1 Overview & Primary Care Trusts 14
- 3.2.2 GP Surgeries & Health Centres 15
- 3.2.3 Polyclinics 16
- 3.2.4 Treatment Centres 18
- 3.2.5 Walk in Centres 19
- 3.2.6 Dental Provision 20
- 3.3 SECONDARY/ACUTE CARE MARKET 20
- 3.3.1 Overview & Structure 20
- 3.3.2 Types of Hospital 21
- 3.4 HEALTHCARE SPENDING IN THE UK 23
- 3.4.1 Total Healthcare Spending 23
- 3.4.2 NHS Spending 23
- 3.4.3 Primary Care Spending 26
4. HE PRIVATE ACUTE HEALTHCARE SECTOR IN THE UK 28
- 4.1 OVERVIEW AND SIZE 28
- 4.2 PARTNERSHIP WITH THE NHS 30
- 4.3 ACUTE HOSPITAL PROVISION & LEADING PROVIDERS 30
- 4.3.1 Private Healthcare Companies 32
- 4.4 PRIVATE DENTAL CARE 33
5. CONTRACTORS OUTPUT IN THE UK HEALTHCARE SECTOR 36
- 5.1 TOTAL CONSTRUCTION OUTPUT 36
- 5.1.1 Value of Output - Construction New Work 36
- 5.2 CONSTRUCTION OUTPUT BY SECTOR 37
- 5.3 CONSTRUCTION OUTPUT IN 2009 AND BEYOND 38
- 5.4 CONTRACTORS OUTPUT IN THE HEALTHCARE SECTOR 40
- 5.4.1 Outlook for Healthcare Construction Work 41
- 5.5 CAPITAL EXPENDITURE IN THE NHS 42
- 5.5.1 England 42
- 5.5.2 Wales 43
- 5.5.3 Scotland 43
- 5.5.4 Northern Ireland 44
- 5.5.5 Impact of the ' Credit Crunch' on Healthcare Infrastructure 44
- 5.6 HEALTHCARE WORK OUTPUT - GOVERNMENT TARGETS & PROGRESS TO DATE 45
6. PROCUREMENT OF HEALTHCARE CONSTRUCTION WORK 48
- 6.1 OVERVIEW 48
- 6.2 THE PRIVATE FINANCE INITIATIVE 49
- 6.2.1 Size of PFI Healthcare Market and Progress to Date 50
- 6.2.2 Leading Players in the PFI Healthcare Market 53
- 6.3 NHS LOCAL IMPROVEMENT FINANCE TRUST (LIFT) 54
- 6.3.1 Background & Overview 54
- 6.3.2 Investment in NHS LIFT 54
- 6.3.3 Scheme Update and Progress to Date 55
- 6.3.4 Principal Consortia and LIFT Partners 56
- 6.3.5 Express LIFT - The Future of NHS LIFT 59
- 6.3.6 LIFT in other Regions 60
- 6.4 PROCURE21 61
- 6.4.1 Background & Overview 61
- 6.4.2 Scheme Update and Investment in Procure21 61
- 6.4.3. Procure 21 in Wales 62
- 6.4.4 Frameworks Scotland 64
- 6.4.5 Procure21+ (The Future of Procure21) 64
7. CONTRACTOR PROFILES 66
- 7.1 STRUCTURE AND SIZE OF THE CONTRACTING INDUSTRY 66
- 7.2 KEY CONSTRUCTION COMPANIES AND CONTACTORS 67
- 7.3 PRIVATE SECTOR CONSORTIA IN THE HEALTHCARE SECTOR 69
- 7.4 KEY HEALTHCARE CONTRACTOR PROFILES 71
- 7.5 HEALTHCARE DEVELOPERS 75
TABLES AND CHARTS
- TABLE 1 SUMMARY OF MAJOR CAPITAL SPENDING PROGRAMMES IN THE HEALTHCARE
SECTOR BUDGETS BY PROGRAMME 2006-2011 8
- TABLE 2 UK-WIDE PLANS FOR POLYCLINICS (AS AT MAY 2009) NO. OF CLINICS BY
AREA 17
- TABLE 3 CURRENT STATUS OF THE INDEPENDENT SECTOR TREATMENT CENTRE
PROGRAMME (AS AT MAY 2009) - KEY PROVIDERS / FACILITIES 19
- TABLE 4 COMMUNITY HOSPITAL PROJECTS APPROVED (AS AT MAY 2009) CAPITAL
VALUES AND APPROVAL DATES 22
- CHART 5 VALUE OF UK NHS EXPENDITURE 2005-2011 (£ BILLION) 24
- TABLE 6 UK NHS PRIMARY CARE TRUST SPENDING ALLOCATIONS 2006-2011 (£
BN) 26
- TABLE 7 UK TOP 20 PRIMARY CARE TRUSTS BY SIZE OF OPERATIONAL CAPITAL
BUDGET 2009-10 27
- CHART 8 PRIVATE ACUTE HEALTHCARE MARKET - % BY SECTOR (£ BILLION)
2007-2008 29
- TABLE 9 LEADING UK PRIVATE HOSPITAL PROVIDERS 31
- TABLE 10 TOP 18 PRIVATE HEALTHCARE COMPANIES BY NUMBER OF SURGERIES RUN 33
- TABLE 11 MAJOR DENTAL COMPANIES IN THE UK BY NUMBER OF PRACTICES - 2007
AND 2009 34
- CHART 12 VALUE OF CONSTRUCTION OUTPUT NEW WORK 2002-2013 (£
BILLION) 36
- CHART 13 VALUE OF CONSTRUCTION OUTPUT NEW WORK BY SECTOR - % BY VALUE 2008
38
- TABLE 14 CONTRACTORS OUTPUT OF HEALTHCARE SECTOR WORK (PUBLIC/PRIVATE)
1998-2008 (£ M) 40
- TABLE 15 NHS CAPITAL SPENDING - 2007-2011 (£ BN) 42
- TABLE 16 HEALTHCARE CAPITAL EXPENDITURE IN WALES 2009-10 ALLOCATION BY
TRUST 43
- TABLE 17 CONSTRUCTION ACTIVITY IN THE UK HEALTHCARE SECTOR - PROGRESS TO
DATE MAY 2009 47
- TABLE 18 PFI HOSPITAL SCHEMES - BY STAGE OF DEVELOPMENT AND CAPITAL
VALUE (AS AT DECEMBER 2008) 51
- TABLE 19 PFI HOSPITALS CUT FROM THE DH HOSPITALS PFI PROGRAMME IN
2007-2009: 52
- TABLE 20 LEADING PFI CONTRACTORS BY TOTAL PFI HEALTHCARE WORK WON (£
M) - TO DECEMBER 2008 53
- TABLE 21 INVESTMENT IN NHS LIFT - WAVES 1-4 (AS AT DECEMBER 2008) 55
- TABLE 22 PROGRESS OF SCHEMES IN WAVES 1-4 OF NHS LIFT (AS AT DECEMBER
2008) 56
- TABLE 23 MAJOR NHS LIFT PREFERRED BIDDERS/CONSORTIA (MEMBERS & SCHEMES)TO
DATE 57
- TABLE 24 DESIGNED FOR LIFE: BUILDING FOR WALES - COMPOSITION OF SUPPLY
CHAIN PARTNERS 63
- TABLE 25 MAIN PRIVATE CONTRACTORS - BY NUMBER OF EMPLOYEES 2007 66
- TABLE 26 UK' S TOP 20 CONTRACTORS BY GROUP TURNOVER 2007-2008 68
- TABLE 27 TOP 10 CONTRACTORS IN THE HEALTH SECTOR 70
- TABLE 28 PRIMARY HEALTHCARE DEVELOPERS BY NUMBER OF SURGERIES DEVELOPED 77
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