Royal Hospital for Children and Young People: independent assessment of governance arrangements

Footnotes

1 To design, build, finance and maintain a new facility to re-provide services from the Royal Hospital for Sick Children, Child and Adult Mental Health Service and the Department of Clinical Neurosciences in a single building adjoining the Royal Infirmary of Edinburgh at Little France (Source: Project Agreement, dated 13 February 2015, page 5)

2 It was agreed that KPMG would not undertake a technical review in this respect but confirm whether the SHTM standards were included within the design specifications.

3 As defined in paragraph 2.2.1

4 The Cabinet Secretary announced this decision following communication with the NHSL chief executive regarding the identification of the ventilation system issues.

5 The NHSL Board delegated responsibility for oversight of the Project to the Financial & Resources Committee which established the Programme Board and a smaller team (the “Project Team”)

6 Being Integrated Health Services Lothian Limited and Macquarie Capital, along with the following contractors: Brookfield Multiplex, Bouygues Energies and Services and HCP Management Services Limited. Collectively for the purposes of this Report referred to as “Project Co”

7 The Project Agreement being an agreement with IHSL for the design, build, finance and maintenance of the Project on 13 February 2015

8 IPTD: Volume 3 Board’s Construction Requirements, Rev C, Subsection B, B (page 9) 9 IPTD: Volume 3 Board’s Construction Requirements, Rev C, Subsection C, Section 8 (page 102)

10 IPTD, Volume 1, Revision A, Appendix A (ii), Submission Requirements, Point C8.3 (page 105)

11 IPTD, Volume 1, Revision A, Appendix A (ii), Submission Requirements, Point C8.3 (page 106)

12 Reference Design Envisaged Solution – RHSC / DCN Environmental Matrix version third issue, dated 19 September 2012 (page 5)

13 Being the date when the conditions of the financial agreement are fulfilled, prior to the funds being made available (“Financial Close”)

14 Document reference (tender version): Reference Design Envisaged Solution – RHSC / DCN Environmental Matrix version third issue, dated 19 September 2012 (page 2, note 15)). Document reference (Project Agreement version): WW-XX-XX-DC-001. Page 2, Note 15. Contained within Schedule Part 6, Construction Matters, Part 6 of the Project Agreement

15 Full wording read: “10ac/hr Supply for isolation cubicles” in a version of the EM dated 26 November 2015

16 We understand from Mott MacDonald that the ‘Board’ in this context refers to both themselves and the Project Team and not the ultimate NHSL Board.

17 Email from Mott MacDonald to Multiplex, among other recipients, on 17 October 2016 (document reference: 161017 MM-GC-002084). We understand from Mott MacDonald that the ‘Board’ in this context refers to both themselves and the Project Team and not the ultimate NHSL Board.

18 The party that NHSL Board entered into a project agreement with for the design, build, finance and maintenance of the Project and who formed part of the Project Co

19 Document: 10.11.4 31-01-19 IHSL.NHSL Plant Rooms Ventilation Systems

20 Document: 10.11.4 31-01-19 IHSL.NHSL Plant Rooms Ventilation Systems

21 As referred to a paragraphs 4.4.6 and 4.4.7

22 We understand from Mott MacDonald that the ‘Board’ in this context refers to both themselves and the Project Team and not the ultimate NHSL Board

23 REV 07 ww-xx-xx-dc-xxx-001 - signed copy. Environmental Matrix comments, Second Batch, NHSL reference 7 (page 4)

24 REV 07 ww-xx-xx-dc-xxx-001 - signed copy. Environmental Matrix comments, Second Batch, NHSL reference 7 (page 4)

25 Being the date of approval of the document ‘Multi Bed - Ventilation Amendment Proposal to Achieve Room Balance’

26 Multi Bed - Ventilation Amendment Proposal to Achieve Room Balance

27 Settlement Agreement, Schedule 1, Part 1, Technical Schedule, Item 7 (page 30) 28 Attached to an email from Mott MacDonald to Multiplex, among others, dated 14 October 2019. (Document reference: 141014 MM-GC-000399)

29 Document reference: 141013 Environmental Matrix Comments

30 Comment 7. Document reference: 141013 Environmental Matrix Comments

31 Referred to in the NHSL Annual Audit Report dated June 2019 (https://www.audit-scotland.gov.uk/report/nhs-lothian-annual-audit-report-201819)

32 A form of public-private partnership procurement programme

33 Initially referred to along with IHSL as Project Co

34 The SHTM standards

35 EC Harris was initially instructed, which was later acquired by Arcadis NV

36 In relation to four-bedded rooms

37 Per SHTM 03-01, Appendix 1, Critical Care areas of a hospital require 10 ac/hr

38 The Settlement Agreement contains a table with 81 items, however eight of these stated ‘NOT USED’

39 Settlement Agreement, Schedule 1, Part 1, Technical Schedule, Item 7 (page 30)

40 Commissioning activities were in effect the preparation for receiving patients into the Hospital e.g. ensuring the equipment and relevant supplies were in place, that staff were familiar with the layout and that the Hospital was cleaned

41 SHTM 03-01, Part A, February 2014, Section 8.65

42 The requirements are set out in SHTM 03-01, Part A, February 2014, Section 8.64 to 8.65

43 H&V Commissioning Services Limited

44 SHTM 03-01, Part A, February 2014, Appendix 1: Recommended air-change rates

45 Version 2 dated February 2014

46 Within Appendix 1: Recommended air-change rates

47 SHTM 03-01, Version 2 dated February 2014, page 82

48 SHTM 03-01 V2 Part A paragraph 2.60

49 October 2011 was the date of the first publication of SHTM 03-01

50 ITPD Volume 1, section 2.5.3 ‘Room Data Sheets’

51 On the basis that the EM index refers to the department code for Critical Care being ‘B1’ and none of the 11 room references detailed in section 2.5.2 of the IPTD have the prefix B1

52 ITPD: Volume 3, Board’s Construction Requirements, Rev C, August 2013

53 ITPD: Volume 3, Board’s Construction Requirements, Rev C, August 2013, Section 2.3

(page 22)

54 ITPD: Volume 3, Board’s Construction Requirements, Rev C, August 2013, Section 2.3, part v. (page 24)

55 ITPD: Volume 3, Board’s Construction Requirements, Rev C, August 2013

56 ITPD: Volume 3, Board’s Construction Requirements, Rev C, August 2013, Subsection C, Section 5.2 (page 68)

57 ITPD: Volume 3, Board’s Construction Requirements, Rev C, August 2013, Subsection C, Section 8.1 (page 104)

58 ITPD: Volume 3, Board’s Construction Requirements, Rev C, August 2013, Subsection C, Section 8.5.3 (page 104)

59 ITPD: Volume 3, Board’s Construction Requirements, Rev C, August 2013, Subsection C, Section 8.7.8 (page 119)

60 ITPD: Volume 3, Board’s Construction Requirements, Rev C, August 2013, Subsection C, Section 8.7.22 (Ventilation and Air Conditioning of Isolation Rooms) (page 124)

61 B1 Critical Care, Clinical Output Based Specifications, dated January 2013 62 Section 1.9 Design Guidance, page 15 of the B1 Critical Care, Output Based Specifications, dated January 2013

63 IPTD: Volume 3 Board’s Construction Requirements, Rev C, Subsection B, B (page 9) 64 IPTD: Volume 3 Board’s Construction Requirements, Rev C, Subsection C, Section 8 (page 102)

65 Entitled the ‘Reference Design Envisaged Solution – RHSC / DCN RDS Environmental Matrix’

66 Appendix A (ii) Submission Requirements, Section C8.3 (page 105)

67 The ITPD EM, entitled ‘Reference Design Envisaged Solution – RHSC / DCN RDS Environmental Matrix’ version third issue, dated 19 September 2012 (page 2, note 15)) (Document reference: 20120919 Environment Matrix (ITPD))

68 Reference Design Envisaged Solution – RHSC / DCN RDS Environmental Matrix version third issue, dated 19 September 2012 (page 5)

69 The ITPD EM

70 Document reference: RHSC RDS Environmental Matrix Sept 2010_iss1_rev-

71 Document reference: Reference Design Envisaged Solution – RHSC / DCN RDS Environmental Matrix version third issue, dated 19 September 2012

72 Reference Design Envisaged Solution – RHSC / DCN RDS Environmental Matrix version third issue, dated 19 September 2012

73 Document reference: RHSC RDS Environmental Matrix Sept 2010_iss1_rev-. Dated 9 September 2010

74 Document reference: 7.1.13 Preferred Bidder Status Letter dated 5 March 2014

75 Section 4.4 of Schedule Part 1 - Terms of Preferred Bidder Appointment (Document reference: 7.1.13 Preferred Bidder Status Letter dated 5 March 2014)

76 Section 4.4 of Schedule Part 1 - Terms of Preferred Bidder Appointment (Document reference: 7.1.13 Preferred Bidder Status Letter dated 5 March 2014)

77 Attached to an email from Mott MacDonald to Multiplex, among others, dated 14 October 2019. (Document reference: 141014 MM-GC-000399)

78 Document reference: 141013 Environmental Matrix Comments

79 Comment 7. Document reference: 141013 Environmental Matrix Comments

80 Document reference: 141013 Environmental Matrix Comments

81 Document reference: 20141027 Environmental Matrix Comments

82 Document reference: 20141111 RE Environmental Matrix NHSL Comments Feedback 3

83 Document reference: 111114 RDD Part 4 Enviro Matrix comments

84 Bullet point 4. Document reference: 111114 RDD Part 4 Enviro Matrix comments

85 Document reference: 150129 MM-GC-000432

86 RHSC – DCN Edinburgh. Air Movement Report For Single Bedrooms (Draft). Document reference: 13.01.15 20141127 air movement

87 Document reference: 150129 MM-GC-000432

88 Project Agreement, Schedule Part 6 (Construction Matters), Section 3 (Board’s Construction Requirements), Revision I

89 Project Agreement, Schedule Part 6 (Construction Matters), Section 3 (Board’s Construction Requirements). Document reference: RHSC DCN BCRs A B C Rev I clean 230115

90 Project Agreement, Schedule Part 8, Review Procedure, Appendix 1 (page 241)

91 As detailed in Schedule Part 6 (Construction Matters), Part 5, Reviewable Design Data (page 27)

92 Project Agreement, Schedule Part 8, Review Procedure, Appendix 1 (page 241)

93 Contained within Schedule Part 6, Construction Matters, Part 6 of the Project Agreement. Document reference: WW-XX-XX-DC-001

94 Document reference: WW-XX-XX-DC-001. Page 2, Note 15. Contained within Schedule Part 6, Construction Matters, Part 6 of the Project Agreement.

95 Document reference: WW-XX-XX-DC-001. Section B1 – page 5

96 Document reference: WW-XX-XX-DC-001. Page 2, Note 15. Contained within Schedule Part 6, Construction Matters, Part 6 of the Project Agreement

97 Document reference: WW-XX-XX-DC-XXX-001 (rev 1)

98 Bullet point 4. Document reference: 111114 RDD Part 4 Enviro Matrix comments 99 An email from Mott MacDonald to Multiplex, among others, dated 14 October 2019. (Document reference: 141014 MM-GC-000399)

100 The document itself was undated but the Project Agreement was dated 12 and 13 February 2015

101 We understand from NHSL that the version included within the Settlement Agreement was version 11 which is dated 25 October 2017

102 Schedule 1, Part 1, Technical Schedule of the Project Agreement (Pages 26 to 54)

103 Schedule 1, Part 1, Technical Schedule of the Project Agreement (Page 30)

104 We understand from NHSL that the details of this agreed resolution were those contained within Project Co notice of change dated 14 May 2018

105 Project Co notice of change dated 14 May 2018, Section 1.0. Document reference: 180522 Schedule 16 Project Co Change Notice No 051

106 Project Agreement, Schedule Part 16, Change Protocol, Section1, Definitions (page 389)

107 Contained within Schedule Part 16: Change Protocol Section 5: Project Co Changes

108 Project Agreement, Schedule Part 16, Change Protocol, Section 5, Project Co Changes (page 418)

109 Project Agreement, Schedule Part 13 ‘Independent Tester Contract’, Appendix 1 ‘Scope of Services – Independent Tester Contact

110 Scope item 1.1

111 Scope item 1.3

112 Scope item 1.2

113 Scope item 1.9

114 Scope item 3.2

115 Contained within Schedule Part 10, Outline Commissioning Programme, Appendix B – Completion Criteria

116 Chartered Institute of Building Services Engineers

117 The Royal Hospital for Children and Young People Edinburgh Key Issues Report No. 37, April 2018, Appendix D Compliance Issues Outstanding (reference nr 212, page 26)

118 The Royal Hospital for Children and Young People Edinburgh Key Issues Report No. 42, September 2018, Appendix D Compliance Issues Outstanding (reference nr 212, page 25)

119 Document reference: 10.11.4 31-01-19 IHSL.NHSL Plant Rooms.Ventilation Systems

120 Document reference: 10.11.4 31-01-19 IHSL.NHSL Plant Rooms.Ventilation Systems

121 Document reference (tender version): Reference Design Envisaged Solution – RHSC / DCN Environmental Matrix version third issue, dated 19 September 2012 (page 2, note 15)). Document reference (Project Agreement version): WW-XX-XX-DC-001. Page 2, Note 15. Contained within Schedule Part 6, Construction Matters, Part 6 of the Project Agreement

122 Full wording read: “10ac/hr Supply for isolation cubicles” in a version of the EM dated 26 November 2015. Document reference: WW-XX-XX-DC-XXX-001 (rev 1).

123 We understand Ernst and Young provided financial advisory support to the Project. We have not commented on their involvement in the Project further in this Section as they were not involved in providing technical advice

124 Document: Mott MacDonald and NHSL Board contract

125 Required to be performed before construction could commence (prior to IPTD stage)

126 Drafted in 2015

127 NHS Lothian – RHSC + DCN, Post Financial Close Support Services Proposal.

128 Operational functionality being as described at paragraph 4.4.7

129 We understand that both MM and the Project Team reviewed the EM and provided their collective comments to Project Co.

130 Document reference: 20141027 Environmental Matrix Comments

131 Document reference: 20141027 Environmental Matrix Comments. Comment 7

132 Document reference: 161017 MM-GC-002084

133 Document reference: REV 07 ww-xx-xx-dc-xxx-001 - signed copy from C to D

134 Document reference: REV 07 ww-xx-xx-dc-xxx-001 - signed copy from C to D. Environmental Matrix comments, Second Batch, NHSL reference 7 (page 4)

135 Document reference: REV 07 ww-xx-xx-dc-xxx-001 - signed copy from C to D. Environmental Matrix comments, Second Batch, NHSL reference 7 (page 4)

136 Document reference: 161107 MM-GC-002155

137 Page 5

138 Document reference: 20171117 MM-GC-003531

139 Document reference: NEW 170619 R.A.M-GC-000285 Bedroom Ventilation. Contained within email trail.

140 Schedule 1, Part 1, Technical Schedule of the Project Agreement (Page 30)

141 We understand from NHSL that the details of this agreed resolution were those contained within Project Co notice of change dated 14 May 2018

142 Project Co notice of change dated 14 May 2018, Section 1.0. Document reference: 180522 Schedule 16 Project Co Change Notice No 051

143 We understand from Mott MacDonald that the ‘Board’ in this context refers to both themselves and the Project Team and not the ultimate NHSL Board.

144 Document reference (WW014): 03.06.16 Copy of 20160525 Derogation Deliverables - WW014. Document reference (WW015): 26.07.16 Derogation Deliverables - WW015-1

145 We understand from Mott MacDonald that the ‘Board’ in this context refers to both themselves and the Project Team and not the ultimate NHSL Board.

146 Document reference:160922 MM-GC-002006 - Boards rejection of WW014 and WW015

147 “4 bedded room 1-L1-100”. Document reference:160922 MM-GC-002006 - Boards rejection of WW014 and WW015.

148 The terminology ‘multi-bedded rooms’ and ‘four-bedded rooms’ is used interchangeably

149 Parties involved are set out in an email dated 6th July 2017 ‘RE: Risk Assessment re 4 bedded room Ventilation’

150 Document reference: Compliance Issues and Commissioning Delay 240717 FINAL

151 Point 5.2. Document reference: Compliance Issues and Commissioning Delay 240717 FINAL

152 Point 5.4. Document reference: Compliance Issues and Commissioning Delay 240717 FINAL

153 Record of General Risk Assessment, dated 28 January 2018. 13 rooms consisting of 7 for which it was “essential” to change, and 6 for which it was “desirable” to change.

154 We understand from NHSL that one additional room was included in the Settlement Agreement, compared to the 13 rooms listed in the risk assessment

155 Settlement Agreement, Schedule 1, Part 1, Technical Schedule, Item 7 page 30

156 Document reference: WW-SZ-XX-DC-XXX-010 Rev 7 Status A

157 Signed by NHSL and Project Co on 26 July and 27 July 2018 respectively

158 RDD process – in accordance with the levels as set out in the Project Agreement, Schedule Part 8 (Review Procedure), Clause 4.3 (page 239): Level A: No Comment, Level B: Proceed subject to Amendment as noted, Level C: Subject to amendment as noted, Level D: Rejected

159 As defined in Section 2.2.1

160 Rating methodology: “Red, Amber, Green”

161 Part of SG’s Capital Investment team within the Health and Social Care Directorate