1. European Health Property Network Brian Gilroy National Director of Estates Brian.gilroy@hse.ie European Health Property Network Conference April 2008

2.  Health Infrastructure: - what is it?  Current Health Estate  Estates Structure  Fact and Figures  Recent and Current work  Investment priorities & patterns  Realising Potential  Future Health Estate. European Health Property Network European Health Property Network Conference April 2008

3. European Health Property Network  National Director of Estates  “Corporate” Estates functions: Capital; Property/Office; Environment & Standards; Commercial & VFM; Architecture and Planning. Capital; Property/Office; Environment & Standards; Commercial & VFM; Architecture and Planning.  Regional Assistant National Directors Delivery & Implementation. Delivery & Implementation.  Multi – disciplinary expertise  Restructuring in progress  Role of Hospitals, Institutions & Voluntary Bodies. European Health Property Network Conference April 2008

4. European Health Property Network Health Facilities –  What are they?  Include buildings, land, plant and equipment.  Role they play: Clinical Clinical Economic Economic Social Social Psychological Psychological Environmental Environmental European Health Property Network Conference April 2008

5. Current Health Estate Illustrated:  Old - e.g. Dr.Steevens, Rotunda - Changing uses/urban & cultural importance  19 th Century – e.g. Workhouses - Accessibility  1930’s - Type & standard of construction  1950’s: Sanatoria - Building plans & Configuration  Late 20 th Century: changing needs - Space standards & capacity  Into the 21 st Century…….. European Health Property Network Conference April 2008 European Health Property Network

6. Current Estate: Some facts and figures:  Acute Beds: 11,660 Public 4,400 Private  Co- Located project to deliver approximately 1,000 beds  Mental Health Beds: 4,000  Long Stay Dependent Elderly: 8,205 Public 17,500 Private - (20-25% in buildings 150+ years)  50+ Acute Hospitals Nationwide  Specialist facilities  Care Programmes: Primary Care; Acute Hospital, Childcare, Elderly, Mental Health, Disability. European Health Property Network Conference April 2008 European Health Property Network

7. Drivers for Change: HSE Mission – “Easy Access, Public Confidence, Staff Pride”  Improved patient outcomes  Changing Models of Care  Integration of Primary and Secondary Care  In-Patient to day case shift  Aligning facilities with service needs  Inherited Historical Deficits  Changing demographics  Patient and staff expectations  Control of infections  Technical advances European Health Property Network Conference April 2008 European Health Property Network

8. Drivers for Change (cont.):  Risk Management  Higher environmental & space standards  Safe Care  In-Patient to day case shift  Privacy and dignity  “Patient Focus”  “Healing environment” - Space, light, views, noise, colour, etc  Value for Money  Staff recruitment and retention European Health Property Network European Health Property Network Conference April 2008

9. Recent achievements: New and enhanced facilities, supporting improved clinical delivery, in more appropriate environments  St.Vincents University Hospital (awards…)  Cork Maternity Hospital  Tullamore  Thurles CNU (Community Nursing Units)  IBTS – Irish Blood Transfusion Service  Dublin Dental Hospital –International exemplars/world class European Health Property Network European Health Property Network Conference April 2008

10. European Health Property Network In Design & being procured:  NRH – National Rehabilitation Hospital  Mater Adult  NPH – National Paediatric Hospital  Marymount Hospice  CNU’s (Community Nursing Units)  Primary Care Units  CMH (Central Mental Hospital)  Grangegorman European Health Property Network Conference April 2008

11. Investment Priorities  Investment to support service reconfiguration and clinical priorities: Revenue consequences of capital investment  Improved delivery of projects  Efficiency and affordability whole life cost: - General ratio 1 (construction) : 10 (running) : 200+ (staff) over lifetime - General ratio 1 (construction) : 10 (running) : 200+ (staff) over lifetime - (0.1 design)  Increasing complexity (NPH) (National Paediatric Hospital) European Health Property Network European Health Property Network Conference April 2008

12. Investment Patterns: NDP: 2007-2113 - €4.5bn Health: NHO: €2bn PCCC: €2.1bn PCCC: €2.1bn NPRO:€415M (PPP) Minor Capital: €80m per annum Minor Capital: €80m per annum ICT:€409m ICT:€409m Total HSE 2008 Vote: €14.9bn 2008 Capital: €540m 2008 Capital: €540m  Oversubscribed plan  Other funding sources: - Private (Co-Located); Revenue Stream ; Voluntary; Altruistic; Cross- Sectoral; Sale of surplus European Health Property Network European Health Property Network Conference April 2008

13. European Health Property Network  Criteria for selection/tender list: Answer questions Answer questions Health and Safety Health and Safety Speedy Delivery Speedy Delivery Understanding of Health Environment & Client requirements Understanding of Health Environment & Client requirements Quality of design, construction, performance. Quality of design, construction, performance. European Health Property Network Conference April 2008

14. Maximise Potential of Health Estate & New Capital Investment.  VFM  Learn lessons  Support innovation : - ICT - Model of care - Model of care - Design - Design - Construction process - Construction process  International trends and practices  Recognise that not all significant clinical improvements will necessarily need significant capital investment. European Health Property Network European Health Property Network Conference April 2008

15. The future:  Better patient outcomes  Flexible and adaptable estate  Fit for purpose  Support service needs & priorities  Realistic lifespans  Planned programmes of investment  Healing and quality environments  Facilities a measure of worth of Health Service, those using the service, and those delivering care. European Health Property Network Conference April 2008 European Health Property Network