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What are the roles of design and designers in the LIFT programme?

Chris Shaw, Director, MAAP Ltd

Context of Local Improvement Finance Trust: Talk of restructuring primary care has been around for a long time. Primary care has many sub-standard facilities. In London an audit found that 75 per cent of primary care facilities were inaccessible. Structure of primary care in many areas involves many single-handed GPs.

Issues for designers advising the NHS: Language is a problem - understanding what is meant by particular terms, eg primary care, walk in centre and so on.

Who you are advising is sometimes unclear. There may be more than one PCT, and there are other stakeholders such as local authorities, mental health trusts and others.

There is a need to understand the existing primary care estate. Some PCTs have good records, but not all.

The Strategic Services Development Plan (SSDP) is forming as the work is underway - PCTs are new organisations still developing.

In selecting schemes, what makes a good LIFT phase 1 scheme?

• Looking for a proof on concept around the SSDP.
• Looking for good geographical distribution of the schemes
• Test the bid schemes - is there enough variety and complexity and a good mix of refurbishment and new build
• Is the value of the scheme enough to attract bidders
• How many samples are there?

There is a need to package up the data as part of the initial bid. Debate around whether schedules of accommodation need be part of the package (probably not because you are testing the team's ability as to whether they can assess and discuss the functional content). Have to check that the selection of sites and content match. Increasingly there is a move towards looking for outline planning consent at an early stage.

Evaluating design proposals involves:

• establishing the criteria; the capability and resource of partners, can they comply technically, can they deliver
• process; is it clear and understandable
• the product; is it any good?

Issues for designers with the bidding team: Many of the designers help set up consortium bid teams. Designers are an important part of the 'persona' of the consortia. Designers need to understand the amount of commitment needed to the bid; how much time and resources the work will involve.

It is also important to have view of what the future role might be; through the tranches of the bid, in the supply chain and in partnering services.

Designers as part of the bidding consortium need to liaise with PCTs and need to establish early on what the 'product' is - are you going to treat everything as a bespoke design or have product that is customised (designs have to be produced very quickly). Also need to interpret the brief, question the function and content and come up with a design strategy.

In the larger projects there may be more than one team of architects involved.

The package needs to be evaluated by the design team. Check that it is consistent with the SSDP, whether the costs are sensible and will it 'fit'.

User consultation: This is very important. It is a chance to understand the key movers and personalities involved and a chance to demonstrate you are the kind of person they can work with.

Designing for the bid: This is a challenge. There is a tight programme which is resource hungry. The briefing process is unsatisfactory from the designer's point of view - more like product design than 'normal architecture'. The questions in the brief must be answered as these will be what you are evaluated against.

Post bid clarification: This isn't usually costed for at the start of a project, but it can be resource hungry and time consuming. Some re-design may be necessary.

Getting to closure: Again, this is resource hungry. However, briefing gets better - more honest. GPs start to get involved at this stage.

The Liftco role: Once Liftco is established designers can feed more into strategy and maintenance and development of the Liftco estate. They will also be involved in evaluation of subsequent phases and the next SSDP.

Other roles for designers: The designer is part of the supply chain, giving them closer link to construction and delivery. There is also a role in partnering services: auditing of the estate; feasibility studies; post project evaluation.

Other points

• Expensive to bid
• Very little benchmarking
• Very little feedback on how designers are doing

Christopher Shaw is an architect who has spent most of his career working on health and social care projects. A decade ago he became a founding director of MAAP architects, specialising exclusively in healthcare work. After years of working quietly in this niche he is now surprised to find himself rather busy.
Whilst remaining closely involved with the administration and development of the practice, principal areas of his expertise lie in facility evaluation and auditing, as well as the design and planning of primary care premises. Christopher's recent projects include completion of three PFI Mental Health hospitals. He has worked on several LIFT projects as both NHS Trust advisors and for a participating consortium. He is currently writing the new HBN 36 for NHS Estates.

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