Queen Elizabeth University Hospital Independent Review - report recommendations: Scottish Government response

Response to Recommendations from Chapter 2 – Building a Hospital in the 21st Century

Recommendation 1

1. Altering or upgrading facilities in response to changes in demand, or developments in clinical practice needs a flexible approach to healthcare design taking account of the full range of considerations including infection prevention and control.

Scottish Government's Response

We recognise the need for healthcare facilities to be flexible to accommodate changes in demand or clinical practice. NHS Scotland's Achieving Excellence Design Evaluation Toolkit (AEDET) rates designs according to a number of standards including, "The design is sufficiently flexible to respond to clinical change and to enable expansion" and "Where possible spaces are standardized and flexible in use patterns". The use of a Design Quality Indicator Tool such as AEDET is a mandatory requirement of the NHSScotland Design Assessment Process (NDAP) under NHS CEL 19 (2010) "A Policy on Design Quality for NHSScotland".

The National Centre for Reducing Risk in the Healthcare Built Environment's ("the National Centre") remit will cover the full lifecycle of all relevant builds, from strategic assessment through to building operations and ongoing maintenance to decommissioning. It will also cover major refurbishments as well as new builds and it will monitor compliance with guidance relating to water, ventilation, drainage, fire safety, electrical and medical gases as they relate to the built environment, and infection prevention.

Recommendation 2

2. Success criteria for healthcare construction projects need to reflect a broader and clinically-relevant range of parameters.

Scottish Government's Response

The Scottish Government agrees that the success criteria for healthcare construction projects need to reflect a broad and clinically-relevant range of parameters. The Scottish Capital Investment Manual (SCIM) provides guidance on the processes and techniques to be applied in the development of all infrastructure and investment programmes and projects within NHS Scotland. It includes a broad range of clinically-relevant objectives for projects and indicators of success. These include the objective of improving safety in the healthcare environment and one of its associated indicators of reducing healthcare associated infections.

Recommendation 3

3. Infrastructure policy makers, construction professionals, budget specialists and engineers should join with people who bridge clinical and facilities disciplines to support work under the auspices of the new National Centre for Reducing Risk in the Healthcare Built Environment to design criteria for successful project management in healthcare construction and capital investment.

Scottish Government's Response

The National Centre will have increased capability to develop and maintain guidance and standards by which compliance within the healthcare built environment is measured and assurance can be provided.

Recommendations 4 and 5

4. We call for much higher profile for evidence generation and use in policy making and practice relating to health, healthcare, infection prevention and control in the built environment.

5. There needs to be continuing investment in evidence based guidance to give design teams clear expectations of good design, build and commissioning practice.

Scottish Government's Response

The National Centre will research and share best practice and changes in standards/models for the built environment across the world to inform guidance and capital projects.

The National Centre is also expected to share developments in research, guidance and intelligence with boards, targeting specific boards where the updates are pertinent to existing projects.