A framework for achieving whole life value of healthcare facilities through briefing and optioneering

Since its inauguration in 1948, the National Health Service (NHS) has been providing “free at the point of delivery” healthcare to all UK citizens. However, lately, there has been unprecedented concern over the capability of most NHS hospitals to demonstrate best value in providing non-clinical service to NHS Trust customers. Demonstrating value is particularly important because of the current multi-billion pound expenditure towards modernising the healthcare service estate. Consequently, the present research aimed to respond to the need to demonstrate satisfactory Whole Life Value (WLV) delivery of healthcare facilities. This has been achieved by focusing on the improvement of front-end processes of construction briefing and optioneering, where most value can be embedded before progressing onto design and construction. The study reviewed extant literature in an attempt to construct a theoretical linkage between the three concepts of WLV, strategic briefing and optioneering. In addition, through a qualitative empirical study comprising interviews, workshops observations and a detailed case study, the same concepts were investigated within the context of NHS healthcare facilities. Key findings indicated that having a specific project strategy is vital to WLV delivery; and that selecting the right project and design options is dependent on first agreeing and clarifying a clinical service model/plan with clinicians. It was also found that improved construction briefing and optioneering involves adequately defining a customised whole life solution informed through purposeful communication and engagement with relevant stakeholders in contributing towards issues that directly affect how they use a healthcare facility. Another key finding was that WLV of healthcare facilities is defined through a whole life solution which is directly linked to its usefulness or utility value realisable by service users in achieving expected clinical outcomes over the facility’s design life. Therefore, through briefing and optioneering, a healthcare facility’s project strategy must be directly linked with specific needs and requirements (among other things) in order to reflect exactly what the stakeholders and end-users value in a healthcare built environment in the long term. These research findings were applied to inform the formulation of a better briefing and optioneering guidance framework applicable during project definition for satisfactory WLV delivery of healthcare schemes.