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Andrew McLeman -  Apparently  now the number 1 authority on the cost implications of single bed hospital wards!!!!

 

In June 2008 just after the Scottish Government announced that any new hospital build would, to help combat MRSA and the like, only in the future have single bed rooms and no multi bed wards, a "Scotland on Sunday" newspaper journalist phoned me late afternoon on a Friday (was I the only QS still at my desk at that time?) for a comment from a Professional Construction Cost Consultant on the cost implications of this decision was likely to have.

 

Coming at it cold I however In a ten minute conversation considered various items such as the extra circulation requirements, the extra sanitary appliances etc, and the more inefficient shape - e.g. narrower wings to achieve single room outside windows, and so a greater external floor to wall ratio and more land required to build.

 

I discussed also that designers would have to be as ingenious as the could be to make it work, but that retrofitting, if that was the next stage , would be considerably more problematical. I thought on the whole it would be a good idea, and any extra building costs would be recouped fairly quickly in savings in less disease control. 

 

I was put on the spot to say how much extra this was likely to be, and acknowledging that wards/rooms are only part of any ward equation, and that efficiencies would be found, I came up with a figure I thought was realistic of 10%.extra.

 

Of course this 10% is what the Scotland on Sunday (front page!) article homed in on, and repeated almost verbatim in the next days Daily Mail including my quote. I even thought my "well considered initial " figure might be shot down in flames, or raised a discussion somewhere? -  but no ...it seems that it was accepted by everyone without any dissention!

 

Then as a result of this initial interview, I was approached by the magazine "Public Service Review" to include 200 words  for their April 2009 issue on various aspects of single bed versus  four or more bed wards, repeated below. As now I appear to be the primary "expert" on this subject, it is presumably only a matter of time till I get my TV break  

 

Single rooms only to beat NHS superbugs

Published Date: 29 June 2008

By Kate Foster


ALL new hospitals in Scotland are to be built with private rooms for every patient in a bid to halt the spread of deadly superbugs.

Traditional wards will be phased out to reduce the risks of patients catching potentially fatal hospital-acquired infections such as MRSA and Clostridium difficile.


The move follows an outbreak of C diff that caused the deaths of nine patients at the Vale of Leven Hospital and contributed to the deaths of nine more, while five babies in a special care unit in Paisley have tested positive for MRSA.

But experts warned last night that the single-room policy would increase the cost of building hospitals by around 10%, as well as raising running costs. There is also a debate over whether private rooms will significantly cut infection rates.

The new building for the Southern General Hospital in Glasgow, which has more than 1,000 beds and is due to open in 2014, will contain private rooms only. Health Secretary Nicola Sturgeon told Scotland on Sunday: "We are very keen to move to single wards."

Charles Saunders, chairman of the BMA's Scottish consultants committee, said: "Single-bed rooms are better for infection control, for patient privacy and (recovery]."

But Professor Allyson Pollock, head of the Centre for International Public Health Policy at the University of Edinburgh, said: "There is no strong research evidence that moving to single rooms is conducive to health and better outcomes or reducing the infection rate. Single rooms do not deal with hospital hygiene measures."

Andrew McLeman, a surveyor who has overseen large building projects, said a hospital with single rooms would cost around 10% more to build.

"It would be a less efficient use of space, would need more land and more circulation room," he said.

 

Public Service Review Article  - April 09  

 

A Ward 1950's Style

 

"There are a number of cost implications in designing for single room over four or larger bed wards. The first pressure on costs for a single bed is on floor area as the shared circulation space in a four bed ward has to be provided exclusively in a single room, plus the extra area for an ensuite toilet rather than a shared facility.

As bed spaces are only part of the equation in hospital wards designers are likely with ingenuity by adjusting ancillary areas to be able to achieve this within or close to existing area allowances. It is the other influences on costs such as extra doors, sanitary equipment and services provision that will however inevitably put substantial pressure on achieving this within the existing cost allowances.

 

The requirement to have windows in each single room will also mean that a narrower plan shape will be required resulting in a less efficient and therefore more expensive greater external wall to floor ratio, plus a larger footprint and more site area.  

 

The savings on costs due to reduced Healthcare associated infections, additional flexibility, easier access and shorter patient stays should however provide lifetime benefits well in excess of these fairly minor additional building costs."

  

Andrew McLeman FRICS RMaPS

Chartered Quantity Surveyor

McLeman QS Network

 

 

 

   
 

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The Royal Household have recently commisioned us for a third CDM-C project at the Palace of Holyroodhouse. The latest is for a quick refurb ot the Queen's Gallery

Belhaven Hill School at Dunbar has recently appointed us as CDM-C for a conversion of their staff accommodation.

We are pleased to be ithe QS on a 650K conversion to a listed building in Elie for a private client.

Co-iincidentally we have four  CDM-C projects in Merchiston. The first is the conversion of the North Merchiston Club, the second is the new tennis courts for  Merchiston Bowling and Tennis Club , the other two are  projects at Merchiston campus of Edinburgh Napier University one being a new entrance canopy and the other the third phase of their re-roofing programme.. 

About to start on site is a fire damage reinstatement of a tenement property in Bellshill where we are QS and CDM-C for the joint owners.

At Milnathort we are both QS and CDM-C for a development for Ross Country Homes, where we are also undertaking the bank monitoring role.

The Bourse in Leith is a commercial development where we are CDM-C and QS for a stone fabric repair.

After 12 years as a Sole Trader we have now incorporated as a Limited Company Registered in Scotland Nr SC396395.  McLeman QS Network Ltd.

"By Royal Appointment"!- 
It may only be a fairly small project at the cafe at Holyrood House in Edinburgh, however we are very honoured to have secured a CDM-C commission from  "The Royal Household."

We are now well into our CDM-C Framework commission which runs till late 2012 with West Lothian Council Construction Services. We have already undertaken a new 1m visitor Centre at Beecraigs, a number of demolition projects, a War Memorial, plus the more usual housing and schools projects.

Weslo Housing Management  appointed us for a third  year for both QS and CDM service to take forward their 2011-12 maintenance programme, which include 9 projects with a value of  1.25m. 

Andrew McLeman quoted in the Scotsman and then asked to pen an article for a Health Publication on the cost implications of having only single bed rooms in future Scottish hospitals - see the articles here

Recently completed  are two 1m house extensions/
refurbishments  The first  near Loch Lomond and the second one in East Lothian

The Benjamin Tindall designed Luffness Castle extension is now complete and the Z1 Youth Bar for Girvan Youth Trust has recently opened to rave reviews.

Our CDM Co-ordination Division has new projects for Clients including  Adelphi Distillery, Linlithgow Golf Club, Energy Tech Centre, Paragon Inks,   West Lothian Council; The Duke of Argyle Estates,  St Peters Church, PGL Travel, Mayfield Salisbury Church,  NHS Lothian:  Forth Valley College and  Cigna Ltd.

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