Royal National Orthopaedic Hospital NHS Trust
Bolsover Street Redevelopment Project
Design development
Since the previous board report (May 2007) the Trust Project Team together with
HOK International (Architects) have completed design development on the reduced
scheme. This has included completion of the 1:200 department layouts; completion
of the 1:50 room layouts; completion of the room data sheets and equipment
loadings (the basis of which have enabled the final costs to be identified); and
completion of the interior design.
The current design enables opportunities to improve the patient experience and is
flexible to account for future changes in healthcare delivery. The work has been done
in the context that the OPD of 2020 and beyond ( our lease will take us to 2035) may
be a very different place to the OPD of today and that the majority of patients using
this facility are not sick, supporting the principle that it is only clinical when it needs to
be.
The ground floor is primarily outpatient consult and examination rooms efficiently
designed to ensure effective staff and patient flows. The staff have a ‘working space’
or ‘back office’ which links all of the clinic rooms and will allow clinicians to flow
between rooms to consult with colleagues and perhaps log on to a workstation to
dictate notes or review diagnostics. The patient is welcomed into the building,
greeted by a hotel styled reception with coffee lounge in a double height atrium and
glass walls looking out onto the streetscape. As they travel further into the building
they continue to benefit from the glass walls in the sub waiting areas.
The lower ground floor has three functions: Imaging and Orthotics departments
supported by a large waiting area with a glass ceiling and a large, interactive
children’s play area; and the staff facilities combined to create a staff rest room,
kitchen and large teaching space, all within a contained and patient free area plus
staff changing and showering facilities.
The first floor is the floor where patients will receive interventions such as
physiotherapy, occupational therapy including splint making, plasters, preassessment, ultrasound examinations. However the consult exam rooms can still be
used for general OPD activity if capacity demands it or even private patient activity
when scheduling allows.
The proposed plans have been developed with input from staff to ensure that the
proposed build solution can work clinically and each dept lead has signed off the
equipment loadings for their areas. I do ask the Board to note that the service
improvement work needed to develop the model of care and to support depts
such as physiotherapy in establishing the type of activity they can undertake in
the reduced scheme will require focus and support during 2008.
The interior design has been developed with the support of the HOK designers
whose track record in developing 21st century hospitals with strong interior design
was a key factor in their selection as preferred partner. The project team for this
Stephanie Williamson, Project Manager
November 2007
Page 1
element included: Dr Fred Middleton and Dr Saroj Patel, a ward manager from the
Children’s unit, the customer care manager and a Bolsover St member of staff. The
team also included a patient user of Bolsover St who is also an artist who uses her
experience of spinal fracture and subsequent surgery as inspiration for her works and
had responded to the call for patient involvement. She has offered to create an
installation for the new building and ideas are currently being developed. In addition
for the visioning workshop we were joined by a child and an adolescent.
Demolition
The demolition of 41-44 Bolsover St and part of the old administration block, which
was a Trust responsibility and part of the sale agreement was completed in early
November 2007 without incident and on plan. Staff reported very little impact on
operational activity and close communication between contractor and Trust was
maintained at all times. The vacated site is now ready for commencement of phase
1. Car parking for key users has been maintained at neighbouring Howard House.
The number of spaces available mirrors the number available within the basement
car park of the new scheme and has proven to work well over the last 4 months. It is
being managed through a booking system based on the RNOH Web (intranet).
Planning
As previously reported planning consent was achieved from Westminster CC in
January 2007. Some additional section 106 costs were identified and agreed and will
be deducted from the land sale receipt. The outstanding rights of light issues took
some time to resolve with neighbours and a second planning application for a
reduced scheme was prepared with the Trusts’ consent to submit to WCC. In the
event the rights of light were then agreed, within the indicative financial envelope in
October 2007.
Financial Update
The design solution, as previously reported, reduces the accommodation from
23,246sqft to 16,652sqft (a reduction of 6,594sqft or just over 28%) which in turn
reduces the annual rent from £813,610 to £580,820 ex VAT, insurance, rates and
services charge (a saving from the original proposal of £232,790).
The reduced scheme had an impact on the land sale receipt which has been set out
by Bolsover St Ltd (the developer) and verified by both Drivers Jonas and Nisbets
(Trust advisors). The costs arise from a combination of reduced land value (as the
largest percentage of area we withdrew from was lower ground floor) and increased
build cost per sqm (for example façade costs remain very similar). The cost amounts
to £1,109,271 and is deducted from the RNOH portion of the land sale receipt.
The land sale receipt has been calculated as £17,845,996, which is above the
minimum that was set at £17,300,000. Once the cost of the reduced scheme has
been deducted the Trust sale receipt will be £10,090,000. The Board are asked
to note that this has been verified by Drivers Jonas, our property consultants.
The expected capital receipt is 30th November 2007.
An equipment schedule is being developed following completion of the room data
information. It is anticipated that there will be a capital / revenue consequences for
the Trust to support the acquisition of the clinical equipment. It is proposed to ask the
Stephanie Williamson, Project Manager
November 2007
Page 2
Special Trustees to fund the non clinical equipment and art strategy with whom we
have already had some initial communications and a schedule is being developed to
present to them early 2008.
Programme
Completion is expected to be 30th November (+ 5 working days). The Board is
asked to recommend completion.
Following completion the following represents the high level project plan:
 Temporary lease commences 30th November (+ 5 working days)
 Start on site 2nd January 2008
 Phase 1 construction is 21 months
 Handover of new facility October 2009
 Commissioning of new facility November 2009
 Vacation of old facility and commencement of new lease December 2009
The Executive and Board members are asked to note the progress report, with any
questions to be directed to the Project Director.
Stephanie Williamson, Project Manager
November 2007
Page 3