The new Royal Adelaide Hospital March 2012
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
System Architecture Major Hospitals Clinical Networks & Statewide Plans General Hospitals – Country & Metro GP Plus Health Care Services–Metro & Country GP, Private, NGO, Commonwealth and Community Sector Community & individual capacity for own health and wellbeing The new Royal Adelaide Hospital
The new Royal Adelaide Hospital The new Royal Adelaide Hospital
The new Royal Adelaide Hospital
The new Royal Adelaide Hospital
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 9
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 overall 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 GLOBAL OVERALL SPACE DISTRIBTION Clinical Non Clinical Clinical Areas + + + Blue Space + Green Space Support Support • Med Imaging • Emergency • FM • Workspaces • Therapeutic • Nuclear Med. • Inpatient • Building/Eng • Multi-purpose • Support • CSSD • Tech Suites • Waste • Education • Central • Pathology • Outpatients • Linen • Teaching • Interface • Pharmacy • Day Areas • Food Services • Staff Amenities • Biomed • Hyperbaric • IT • Public • Allied health Amenities • Stores The new Royal Adelaide Hospital
Application of the ‘Village’ concept Blue Space The new Royal Adelaide Hospital
Bigger Hospital for ALL South Australians TREATMENT SPACES RAH NEW RAH INCREASE OVERNIGHT BEDS 650 700 50 ICU BEDS (included in 42 60 18 overnight beds) DAY BEDS 30 100 70 TOTAL BEDS 680 800 120 RECOVERY 74 181 107 SPACES TREATMENT 63 78 15 SPACES (ED) RESUSCITATION 4 8 4 (ED) 246 TOTAL SPACES 821 1067 (30%) The new Royal Adelaide Hospital 15
Bigger hospital for ALL South Australians MEDICAL SERVICES RAH NEW RAH INCREASE 35 40 OPERATING 5 THEATRES 1 at 65m 2 All at 65m 2 CT CAPACITY 3 7 4 MRI CAPACITY 2 5 3 LINEAR ACCELERATOR 5 6 1 CAPACITY PET CAPACITY 1 2 1 The new Royal Adelaide Hospital 16
Our Partner > SA Health Partnership • Macquarie Bank • Leighton Contractors • Hansen Yuncken • Spotless • Hewlett Packard The new Royal Adelaide Hospital
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 18 The new Royal Adelaide Hospital 18
Total capital cost Design and construction $1.85 billion (SAHP) State works / medical $244.7 million equipment 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 19 The new Royal Adelaide Hospital 19
Capital cost comparison Nominal $m SAHP’s State’s proposal estimate Difference PPP works 1,849.8 1,782.7 -236.1 Risk valuation (included 303.2 above) State works 244.7 244.7 — TOTAL ESTIMATE 2,094.5 2,330.6 - 236.1 20 The new Royal Adelaide Hospital 20
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 21 The new Royal Adelaide Hospital 21
Value for money > SAHP’s proposal is $137 million (4.2%) better value for money than the State’s Public Sector Comparator (PSC) Net Present Cost ($million) based on discount rate range Low Mid High 3,298.0 3,298.0 3,298.0 Risk-adjusted PSC 3,217.6 3,160.6 3,109.5 SAHP’s Proposal 80.4 137.4 188.5 Value for money benefit 22 The new Royal Adelaide Hospital 22
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 The new Royal Adelaide Hospital
The new Royal Adelaide Hospital
The new Royal Adelaide Hospital
The new Royal Adelaide Hospital
The new Royal Adelaide Hospital
The new Royal Adelaide Hospital
The new Royal Adelaide Hospital
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