The new Royal Adelaide Hospital March 2012 Drivers for Change - - PowerPoint PPT Presentation

The new Royal Adelaide Hospital

March 2012

The new Royal Adelaide Hospital

Drivers for Change

> Changing demographics

• Ageing population
• Prevalence of chronic disease

> Increasing demand

• Community expectations
• Technological improvements

> Workforce shortages

• Ageing of the workforce
• Decreasing numbers entering the workforce

> Increasing cost

The new Royal Adelaide Hospital

SA Health Care Plan 2007-16

> Launched by the Premier and Minister for Health in June 2007 > Sets the framework for

> Service redistribution > Demand management > Clinical engagement > Workforce development > Infrastructure investment

The new Royal Adelaide Hospital

Key Challenges

In summary, there are two key challenges underpinning The SA Health Care Plan

• Enabling the hospital system to respond more

adequately to the rise in demand

• Developing out of hospital services to reduce

the rate of growth in demand

The new Royal Adelaide Hospital GP, Private, NGO, Commonwealth and Community Sector

Major Hospitals

General Hospitals – Country & Metro

GP Plus Health Care Services–Metro & Country

Community & individual capacity for own health and wellbeing

System Architecture

Clinical Networks & Statewide Plans

The new Royal Adelaide Hospital

The new Royal Adelaide Hospital

The new Royal Adelaide Hospital

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SA Health and Medical Research Institute

• $200 million Commonwealth funded
• To be co-located with the new RAH
• Will house 675 researchers

The new Royal Adelaide Hospital

Vision

> High quality health services in a modern setting. > Exciting health, research, education and service delivery precinct playing a part in the revitalisation of the west end of the city > Leader in innovation and health reform > Healing environment and advanced technology together with high quality medical care. > Patient centred care embedded in the

• verall design

> High quality environment for staff.

The new Royal Adelaide Hospital

Model of Care: Key Components

> Provision of safe care > Avoid duplication > Reduce waiting > Critical clinical decision making points > Reduced flow / volume through ED > Distributed imaging > Multiple access points > Fast tracked admissions

The new Royal Adelaide Hospital

Design Objectives

> Create the next generation hospital

• Manage greatly increased activity
• Better functionality & Improved

productivity

• ”Smart” - High level of ICT & automation
• Flexibility & adaptability
• Healing environment - Green Spaces
• Environmentally sustainable – energy

efficient

• Disaster capable
• Good for patients: good for staff

The new Royal Adelaide Hospital

NRAH – approach to space

• Emergency
• Inpatient
• Tech Suites
• Outpatients
• Day Areas
• Hyperbaric

Clinical Areas

+

• Med Imaging
• Nuclear Med.
• CSSD
• Pathology
• Pharmacy
• Biomed
• Allied health

Clinical Support

+

• FM
• Building/Eng
• Waste
• Linen
• Food Services
• IT
• Stores

Non Clinical Support

+

• Workspaces
• Multi-purpose
• Education
• Teaching
• Staff Amenities
• Public

Amenities

Blue Space +

• Therapeutic
• Support
• Central
• Interface

Green Space

OVERALL SPACE DISTRIBTION

GLOBAL

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Application of the ‘Village’ concept

Blue Space

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Bigger Hospital for ALL South Australians

RAH NEW RAH INCREASE OVERNIGHT BEDS 650 700 50 ICU BEDS (included in

• vernight beds)

42 60 18 DAY BEDS 30 100 70

TOTAL BEDS 680 800 120

RECOVERY SPACES 74 181 107 TREATMENT SPACES (ED) 63 78 15 RESUSCITATION (ED) 4 8 4

TOTAL SPACES 821 1067 246 (30%)

TREATMENT SPACES

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Bigger hospital for ALL South Australians

RAH NEW RAH INCREASE OPERATING THEATRES 35 1 at 65m2 40 All at 65m2 5 CT CAPACITY 3 7 4 MRI CAPACITY 2 5 3 LINEAR ACCELERATOR CAPACITY 5 6 1 PET CAPACITY 1 2 1

MEDICAL SERVICES

The new Royal Adelaide Hospital

Our Partner

> SA Health Partnership

• Macquarie Bank
• Leighton Contractors
• Hansen Yuncken
• Spotless
• Hewlett Packard

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Roles in the new RAH PPP

> SA Health Partnership (SAHP) will, under a 35- year contract:

• Design and build the new RAH
• Maintain the new RAH as new
• Provide non-clinical support services

> State Government will:

• Provide all clinical services
• Provide clinical staffing, teaching, training, research

> Operation of the hospital will revert to the State in 2046 in as new condition

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Total capital cost

Design and construction (SAHP) $1.85 billion State works / medical equipment $244.7 million CAPITAL COST $2.09 BILLION

SAHP’s cost of $1.85b is a fixed price to design and build the new RAH to meet the State’s service specifications

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Capital cost comparison

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Nominal $m SAHP’s proposal State’s estimate Difference PPP works 1,849.8 1,782.7

• 236.1

Risk valuation (included above) 303.2 State works 244.7 244.7 — TOTAL ESTIMATE 2,094.5 2,330.6

• 236.1

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PPP Service Payments

> Average full year service payment is $397m, varying slightly with lifecycle costs (this also covers the capital cost) > This is less than 9% of SA Health’s annual budget for 2010-11, and declines as a percentage of the budget over the life of the PPP > This will be partly offset by the cost of running the existing RAH

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Value for money

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Net Present Cost ($million) based on discount rate range Low Mid High Risk-adjusted PSC 3,298.0 3,298.0 3,298.0 SAHP’s Proposal 3,217.6 3,160.6 3,109.5 Value for money benefit 80.4 137.4 188.5

> SAHP’s proposal is $137 million (4.2%) better value for money than the State’s Public Sector Comparator (PSC)

The new Royal Adelaide Hospital

The Process

> The business case (2006/7) > Developing the specification (2008/9) > Expression of interest (2009) > Bid phase (2009/10) > Preferred Bidder (Dec 2010) > Final negotiations (2010/11) > Financial close (June2011) > Hospital opens (April 2016)

The new Royal Adelaide Hospital

The Experience

> State Government > SA Health > The Clinicians

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