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25 May 2022

Hilton Metropole, Birmingham


NHS Orkney

WINNER – Infrastructure or Capital Project of the Year, GO Awards Scotland 2019/20

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NHS Orkney recently oversaw the creation of The Balfour, the Orkney Islands’ new-build integrated healthcare facility providing a 49 bedded Rural General Hospital together with Primary  Care and Community services within one building. As winners at the GO Awards Scotland, NHS Orkney have achieved automatic nomination for the National GO Awards. Here, Project Director Ann McCarlie explains the scale of the project, and how its benefits extend well beyond providing healthcare to Orkney residents. 

The Project

The smallest health board in Scotland, NHS Orkney serves a population of approximately 21,000 people and employs nearly 600 staff with a wide range of general and specialist skills.

This project covered the procurement, design and delivery of the new integrated hospital and healthcare facility on a greenfield site in Kirkwall, the capital of Orkney. The project aimed to deliver a fit-for-purpose healthcare facility for the benefit of NHS Orkney’s patients, carers, staff and the wider community, ensuring the health needs of the population are met within facilities that are efficient, resilient and sustainable and which allows the delivery of integrated hospital and primary healthcare services.

Widening involvement

In the initial stages of the project, the project team undertook extensive consultation with a wide range of stakeholders to produce the Clinical Strategy for overall service provision. Further detailed consultation, informed by the Clinical Strategy, covered the range from the required size and adjacencies for each room to details such as the position of each socket in a room, to ensure the facilities function as intended. The consultations included meetings with patient and community groups, staff team meetings, reviews with healthcare planners and workshops to develop output specifications for each service. From this consultation process a reference design was developed which informed the overall design requirements of the building.

An important role for the Project Team was to record the agreed specifications for mechanical and electrical services, Information and Communications Technology and equipment, to ensure these were properly reflected in the procurement documentation and delivered in the eventual design and building.  The building specification was not changed or deviated from once agreed. This was in large part due to the extensive and detailed nature of the consultation process and the diligence of the project team.

Balfour Hospital Orkney entrance

The completed Balfour Hospital

To ensure that local trades, firms and people were involved in the delivery of the project at every stage, NHS Orkney specified that bidders for the project should demonstrate how local SMEs could have the opportunity to participate in and benefit from the overall project. The successful contractor demonstrated an interactive programme to engage with and develop local enterprises. This included offering apprenticeships jointly with local small contractors, working with the local Education Authority and SMEs to ensure that the apprentices would be able to complete their training either locally or on the mainland of Scotland. Local SMEs successfully bid to provide site start up services, scaffolding services, crane services, specialist stonework and joinery for the project.

Sharing skills

During the various stages of the project the small core Project Team was supplemented by a multidisciplinary in-house Extended Project Team of NHS Orkney staff from a variety of  backgrounds, including clinical, technical, IT, financial, operational, procurement and estates and facilities. The core and extended team met weekly, with monthly Risk Group Meetings also held. Over a period of approximately five years each member of the Extended Project Team brought their unique skill sets and experience to the project and developed a variety of project skills as the project progressed towards its successful delivery, which reduced reliance on external advisors, so reducing costs.

Each member of the Extended Project Team now has a set of skills and experience which they can   take back to their ‘day job.’ In the process project disciplines have been developed and enhanced throughout the organisation. Several team members were successful in obtaining promoted posts within NHS Orkney, based on the skills and experience gained within the project team.

In addition, the project team recruited admin staff from NHS Orkney’s Modern Apprentice scheme who were supported in developing project management skills. This approach proved very successful with the first such recruit being appointed to a substantive role in Primary Care Services and another, having completed their Modern Apprenticeship, now embarking on a degree course.

Efficiency and sustainability

The new building, its technology and equipment has been deigned to be as flexible and ‘future-proof’ as possible so that the building itself, its systems, NHS Orkney and its staff can develop and adapt to meeting the changing needs of the people and communities of Orkney as these develop.

Future benefits include, for example, the use of technology to support and develop telemedicine, remote consultations and virtual clinics. This will reduce, as far as possible, the need for patients to travel outwith Orkney for the majority of routine care, and support communication with and for patients in remote locations to reduce the requirement to travel to the Orkney Mainland.

In line with Orkney’s development as a hub for renewable energy solutions, bidders were challenged to design a low carbon energy solution, with this criterion forming part of the overall evaluation process. The solution designed by the preferred bidder and installed in the building has electricity as the primary power source and the main plant is twin air-to-water heat pumps. These pumps are externally mounted, extracting heat from the air to heat circulating water via electrical heat pump technology. In addition, solar panels on the roof supplement the building’s electricity supply from the main grid.

This design innovation, delivering a low carbon solution, should be viewed in the context of the delivery of a complex acute healthcare project, compounded by Orkney’s remote island location. To ensure the design was robust, deliverable and sustainable, specific attention was paid to resilience across the design of the building, how it was equipped and the design and installation of mechanical and engineering systems. This was so that the building and its life-critical systems can be maintained for extended periods in the event of failure of primary and secondary systems and/or extended periods when travel to and from Orkney is disrupted, for example due to severe weather.

Additionally, the car park is equipped with charging points for electric vehicles and all internal and external lighting has been designed to be as energy efficient as possible.

The GO Awards Experience

The team wanted to showcase the variety of ways the project has benefited Orkney, and in particular how a small public sector organisation can deliver a multi-million pound capital project utilising the skills and experience across its workforce to meet some very specific and in some cases unique requirements. Entering the GO Awards has been a positive experience and we would encourage others to enter.