House of Commons - Health

Select Committee on Health Memoranda

5. Capital Expenditure And Investment (continued)

2. FISC, the DoH finance sub-committee chaired by Richard Douglas, the Director of Finance, provided a ruling regarding revenue support for PFI projects. With effect from April 2003, no central budgets were to be maintained to provide revenue subsidies for PFI projects. These were for smoothing money; support for deferred assets/residual interest and for on balance sheet PFI projects.

3. Following further consultation it was decided to withdraw central support after a transitional phase. This and the sums were agreed and notification circulated in Spring this year.

4. Support for deferred assets/residual interest and on balance sheet schemes is to be phased out by 2005-06.

5. Support for Smoothing money is to be phased out by 2007-08.

5.3.4 Could the Department provide an update of Tables 5.3.4? [5.3.4]

1. The information requested is provided in Table 5.3.4.

Table 5.3.4

INCREASES TO THE CAPITAL COST OF PFI SCHEMES


A	B	C	D	E	F
North	Capital Cost at OBC Stage	Capital Cost Reported Last Year	Capital Value This Year	% Increase Since OBC Stage	% Increase Since Last Year
	£m	£m	£m

Leeds Teaching Hospitals	125.0	174.0	221.0	76.8%	27.0%
Newcastle upon Tyne Hospitals	129.5	220.1	256.2	97.8%	16.4%
Mid Yorkshire Hospitals	164.1	211.0	256.0	56.0%	21.3%
Hull and East Yorkshire Hospitals (Oncology)	37.6	56.0	60.4	60.6%	7.9%
Newcastle, North Tyneside—Morpeth	21.3	25.0	31.8	49.3%	27.2%
Northgate and Prudhoe PCT	14.0	14.0	24.0	71.4%	71.4%
Sheffield Teaching Hospitals	30.0	30.0	31.2	4.0%	4.0%
Central Manchester and Manchester Children's	199.0	420.0	414.7	108.4%	-1.3%
East Lancashire Hospitals—Burnley	13.7	30.1	31.5	130.8%	4.7%
St Helens and Knowsley	211.0	229.0	257.8	22.2%	12.6%
Salford Royal Hospitals	114.0	196.3	186.2	63.3%	-5.1%
Tameside and Glossop	41.0	84.2	84.2	105.4%	0.0%
Doncaster and South Humber	11.3	12.1	15.0	32.7%	24.0%
Selby and York PCT	23.6	N/A	24.2	2.5%	N/A
East Lincolnshire PCT	24.0	N/A	24.0	0.0%	N/A
North Kirklees PCT	25.0	N/A	27.0	8.0%	N/A
TOTAL NORTH	1,184.1	1,701.8	1,945.2

COMMENT ON ANY INCREASES OVER 10%


Leeds Teaching Hospitals

Initial OBC cost	125
Increased Multi-storey car park requirement	21
Increased building size requirements including incorporation of elements of "improving the patient experience"	25
Detailed review of fixture and fittings	3
Development of M & E services	5
Inclusion of PACS	2
Other equipment changes	2
Specification developments and reviews including linnear accelerator shielding requirements and service requirements	20
MIPS uplift	26
Reduction to enabling schemes	-8
Current Capital cost	221

Newcastle Upon Tyne Hospitals	% increase
Inflation	30.27
Extended scope to contain Children's wing	29.13
Improving the patient environment	15.32
Service developments	8.59
Design implications at RVI	6.73
Roof Top Helipad for A&E (Revised CAA guidance will no longer allow a ground level landing pad)	1.09
Inclusion of items previously recorded as Charitably Funded (to align costs with PFI bids). NB: the trust will still pursue charitable funding for these elements (Cystic Fibrosis, relocation of Doulton Tiles).	2.76
A larger multi-storey car park at the Freeman Hospital (City Council planning requirement.)	3.98
Total % increase since OBC	97.87
Mid Yorkshire Hospitals—Wakefield
Capital cost at SOC stage	164.1
Increase relating to the NHS Estates Departmental Cost—Allowance Guides (DCAGs) taking into account the new principles in order to produce a better patient environment.	23.6
Changes in functional content	12
Additional scope and space requirements	17
Non works cost changes	2
Additional contingency	2
Other	0.3
Increase to latest MIPS level	32
Increased use of Public funds to advance the scheme as part of the OBC approvals process	3
Current Capital value	256
Hull and East Yorks
Capital cost at SOC stage	37.6
Improving the patient environment	2.9
Increased linnear accelerators (3 to 6)	6.1
Inflation	5.8
Undergraduate teaching accomodation	1.2
Reprovision of boiler house	1.5
Other functional and infrastructure changes	0.9
MIPS increases	4.4
	60.4
Newcastle, North Tyneside—Morpeth
Improving the patient environment
Design development
Refined on-costs following geo-technical survey
Inflation (Mips 310 to FP 395)
Central Manchester & Manchester Children's
Original OBC figure	199
MIPS increase	12.6
Adult NBI growth & children's Burns & Cleft Lip	23.2
Energy targets, building regs & Health and safety	7.75
Mental Health reprovision	7.75
Final OBC figure	250.3
Early Delivery of Children's facilities	26.9
Modernisation
Adults NBI growth	12.8
Equipment consequences	7.9
Cardiac services	1.7
Obstetrics new model of care	1.5
Improving the Patient Experience	30.8
New Guidance (Health & Safety, building regs etc)	12
Service Developments—Nationally/Regionally Driven	10.4
Service Developments—Trusts driven	5
Service Developments University Driven	1
Other	9.6
Capital Costs as per FBC	369.9
FBC Inflation	50.2
reduction	-7.1
FBC Cost	413
East Lancashire Hospitals—Burnley
Increase from £13.7 to £31.5m:
—NBI and NHS Plan
—Renal Dialysis Unit
—MIPs increases to MIPS 408
—Clarifications PSC
St Helens & Knowsley Hospitals
OBC costs	229.8
Service changes/consumerism
Whiston
wards consumerism	3.7
Critical care new HBN 27	1.7
Whiston out-patients	1.5
Pathology body storage	0.2
relocate A & E, burns review	1.2
CT & MRI link to A & E	0.6
St Helens
In-patient facility at St Helens	1.1
Nuclear medicine and CT suite	1.1
Functional content changes
Whiston
General changes in content, offices etc.	2
Additional on-costs, circulation	2
Temporary accommodation	2.1
Remodelling of retained accommodation	4.5
St Helens
Hamill day assessment	1.5
Clinical psychology	1.1
Clinical measurement	1.1
Additional on/costs, circulation	1.6
Additional on/costs, drainage, piling	0.8
Enabling, R & D reprovision	0.2
Revised PSC costs	257.8
Salford Royal
SOC cost	114
Building Inflation	12
Improving the patient experience	10
Estates standard	9
A&E	4.1
shift to HDU beds	3.8
Post acute bed	2.5
Neonatal	0.6
Children's	1.6
On costs	18.3
Ceiling limits	1.5
Deacked car park	4
Equipment	4.6
Contingency	3.9
Reduction in VAT free costs	3.1
Increase in Health & Social Care centre costs.	3.3
Total	196.3
This figure represents the capital costs of both the Hospital PFI scheme and the four Health and Social Care Centres, these have now been grouped together to reflect the scope and content of the OBC. However, the HSCCs are being procured under Lift and therefore not part of the PFI procurement. The capital costs below show the costs of the Hope Hospital PFI scheme only:
Withdrawal of HSCCs from scheme costs	-19.4
Reconciliation	-3.2
Reduction of new build following review in 2003	-3.6
Increase in MIPs for Hope Hospital from 360 to 395	16.1
	186.2
Tameside & Glossop
SOC cost	41.0
Improving the Patient Experience/modernisation	18.3
Equipment	3.5
Renal	1.0
MRI	1.6
Opthamology	4.2
NBI growth	4.5
EMI	10.1
Total OBC	84.2
Doncaster & South Humber
Initial OBC cost	11.3
Inflation to initial FBC date	0.8
	12.1
Inclusion of Equipment in construction costs	0.9
Additional costs re dealing with floodplane	0.2
MIPS increases to delayed financial close	1.8
	15.0

Table 5.3.4

INCREASES TO THE CAPITAL COST OF PFI SCHEMES


A	B	C	D	E	F
London	Capital Cost at OBC Stage	Capital Cost Reported Last Year	Capital Value This Year	% Increase Since OBC Stage	% Increase Since Last Year
	£m	£m	£m

Barking, Havering and Redbridge	145.6	181.5	232.4	59.6%	28.0%
Barts and The London	620.0	1,052.0	1,052.0	69.7%	0.0%
The Whittington Hospital	23.0	23.0	29.4	27.8%	27.8%
Wandsworth PCT	20.5	42.9	57.4	180.0%	33.8%
Newham Healthcare	21.3	42.4	54.8	157.3%	29.2%
Kingston Hospital	22.1	27.6	32.8	48.4%	18.8%
Paddington Basin	327.0	800.0	800.0	144.6%	0.0%
North West London Hospitals	55.0	69.3	68.6	24.7%	-1.0%
Lewisham Hospital	44.0	47.0	73.0	65.9%	55.3%
North Middlesex	73.0	74.0	100.8	38.1%	36.2%
Barnet and Chase Farm	41.0	N/A	79.8	94.6%	N/A
Whipps Cross	184.0	N/A	329.7	79.2%	N/A
LONDON TOTAL	1,576.5	2,359.7	2,910.7

COMMENT ON ANY INCREASES OVER 10%

Barking, Havering and Redbridge Hospitals

Building cost Inflation (MIPS)

Indexation

The location factor—the premium experienced for building in Outer London has increased

Design fee allowance and Contingency allowance

Additional 60 beds and clinical accommodation.

The project achieved financial close on 15 January 2004. The final capital cost shown is the actual at financial close and is the cost to the private sector plus the cost of land. The cost quoted includes the costs of land, construction, equipment and professional fees but excludes VAT, rolled up interest and financing costs such as bank arrangement fees, bank due diligance fees, banks' lawyers fees and third party equity costs. The cost of the land (£26 million) was borne by the public sector and is therefore excluded from the analysis for question 5.3.3.

Barts and the London

The Barts and The London OBC was approved at a cost of £462 million. The figure reported previously (£620 million) included an estimate for building cost inflation, due to the complexity and duration of the scheme. The increase to the current forecast outturn is explained as follows:


	£m

OBC approved capital cost (MIP295)	462
Changes in scope of project (MIP295)	237
Building cost inflation	353
Current forecast outturn cost (equivalent to MIPS 460)	1,052

The OBC was submitted in November 1999 and used the then current MIPS index of 295 giving a base date for inflation calculation of 1997.

The changes in scope include an additional 125 beds and other supporting facilities, improvements to the patient environment in line with the NHS Plan, and the removal of ICT systems (to be procured separately) from the scheme. All changes have been agreed with the Trust's commissioners.

The current forecast outturn assumes construction takes place between 2005 and 2013. The £353 million building cost inflation equates to an increase of 51%. Building cost inflation, as measured by the NHS Estates MIPS index, has increased by 33% since 1997.

Building cost inflation is estimated to be rising at approximately 3% to 5% per annum (this needs to be treated with caution as the predictive accuracy of the MIPS index is not strong and building costs can be volatile, particularly in London). The current forecast outturn includes an estimate of inflation up to the completion of the majority of the new build in the scheme in 2009.

It should be noted that the increase from £620 million to £1,052 million is the cumulative increase over the last four years since the OBC was approved. All these figures relate to the Trust's Public Sector Comparator that has been updated periodically throughout the last four years to reflect the changing content of the scheme. A full review of the of the PSC was carried out during summer 2002 and more recently building cost inflation assumptions were updated in the light information available to the Trust from its bid development process.

The Whittington Hospital

As previously reported, the increase from OBC at MIPS 310 is largely due to inflation, combined with the excercising by the Trust of an Option in the Project Agreement to fit-out an additional floor with 40 beds. Inflation accounts for the bulk of the increase (MIPS 310 to MIPS 380 at financial close). The Trust has also opted to let the retail fit-out works as a separate contract, leading to a slightly reduced capital cost figure.

Wandsworth PCT

The building price index (MIPS) has increased the base capital cost by £13.170 million. The location factor has increased from 12% to 23% as Wandsworth is deemed an Inner London Borough. This has increased costs by a further £2.551 million. Gross inflationary increases are £15.721 million. The SHA took a decision to include Mental Health (69 beds, Day Hospital and CMHT bases) and Shell Space to allow for future service provision in Summer 2002 amounting to a furhter cost of £19.236 million. Additional costs of equipment, lifecycle costs and revisions to programme resulted in an extra cost of £2.036 million.

Newham Healthcare

Increases in inflation since OBC account for £6.8 million. Increase in location factor from 9% to 16% accounts for a further £2.2 million. Hence £9 million of the £21 million increase relates to inflationary pressures. Changes in Building Regulations and Landfill Costs have added a further £2.8 million. Actual changes in specifications, additional equipment etc account for £3 million. The requirement for other unforeseen works on site—decanting, upgrading of kitchen facilities and construction traffic access from the A13 have added £4 million. The final £3.8 million relates to increased risk allowance for working within existing buildings and near to occupied patient areas.

Increase since last year due to: change in MIPS index, an increase in the location factor adjustment and the finalisation of all details of the scheme up to financial close in January 2004.

Kingston

OBC capital cost was £22.1 million based on a MIPS index of 310. The FBC capital cost is £32.7 million based on a MIPS index of 422. The movement due to inflation is £8.1 million. The movement due to changes in specification is £2.5 million which is 11% of the OBC cost.

Paddington Basin

The capital cost at OBC was at MIPS 310 and the current costings are at MIPS 360, giving an inflation increase of 16% or £50 million. The Imperial College NHLI building is now included within the project scope. This was to have been procured seperately. The requirements to improve the patient experience have been worked into a more detailed design solution. The proportion of critical care beds has also increased with a consequent increase in the space required. The overall campus will have an increase of 26 beds, giving a current total of 1,088. Buildings to be retained (QEQM and Clarence Memorial) will now be completely refurbished as part of the project. Underground construction work has been priced more realistically and an appropriate contingency now allowed—there are several tube lines close to the surface of the site.

The Paddington Basin Health Campus project is in the process of submitting a new Outline Business Case for the project. The likely capital cost is £800 million which is the same as reported last year.

North West London Hospitals

The increase from the OBC is due to:

Increase in the price base from MIPS 325 to MIPS 360—£5.8 million

Increase in the outer London location adjustment—£0.5 million

In line with plans developed by Park Royal Partnership for the regeneration of Park Royal, the footprint for BECaD has been moved. This has lead to significant costs in providing temporary accommodation for departments that will be displaced. Additional costs of £2 million will be covered by a grant from the London Development Agency.

A multi storey car park has been added to the FBC at a cost of £2.4 million. This contributes to the potential for land development which the new footprint allows.

A planned extension to ACAD as part of the overall change in the delivery of services at Central Middlesex Hospital has been increased in size at a cost of £0.7 million. This is partly to provide temporary accommodation for displaced departments during BECAD construction and partly to allow for increased capacity in the long term.

There has been few changes in the content of the BECAD building. Changes that have been made include:

Two additional radiology film rooms to improve throughput reducing waiting times and length of stay £1.5 million

A sterile services department 0.7 million

The balance is due to general increases in department areas and specifications in line with NHS Estates guidelines to improve the patient experience. All the above costs exclude VAT as this is not a cost within the overall public accounts. The capital value this year is at the approval MIPS level of 360.

Lewisham Hospital

The capital cost at OBC was at MIPS 310 and the current costings are at MIPS 422, giving an inflation increase of £11 million. The increase in the inner London location adjustment from 21% to 23% accounts for a further £1 million. General increases in department areas and specifications in line with NHS Estates guidelines to "improve the patient environment" have increased costs by £5 million. Changes in Building Regulations added £2 million and additional equipment to meet health and safety requirements has added £2 million. Changes in the scope of the scheme included an additional floor to accomodate beds for elderly patients, increasing the number of beds reprovided in the scheme from 284 to 419. The total cost of changes in scope and functional content was £5 million. All changes have been agreed with the Trust's commissioners.

North Middlesex Hospital NHS Trust

The main reason for the increase is the 18% increase in out-turn inflation of £13.2 million due to upwards revision of MIPS indices since OBC. A number of pressures on accommodation requirements, including the issue of new HBNs has resulted in an increase in functional content of £4.8 million, or 4.6%. The active switching element of IT—£1.2 million—was excluded from the OBC capital cost as it was assumed this would be funded directly by the Trust, however there is insufficient block capital funding available. The OBC cost forms relied on ECAGs and the equipment costs were subsequently revised to take account of the Trust's manual handling policy and include the cost of digital imaging technology. Additionally the OBC contained aggressive assumptions about transfers, which, following an in-depth consideration of individual equipment items, are not reflected in the equipment schedules provided to bidders in the ITN. The overall increase in the net cost of equipment is £3.7 million.

Finally the scheme now includes Ophthalmology—£1.7 million, which was excluded from the OBC, but which the PCTs have now asked to be included, and approximately 2,200 sq m of shell space—£3 million, which will provide flexibility to respond to a number of current issues and strategic changes across the sector.

Barnet and Chase Farm Hospitals NHS Trust

The functional content of the project has been revised to include an additional two theatres and an additional endoscopy suite. An additional 17 beds are also to be provided. The capital costs have also increased in line with the increase in MIPS and the consequent increases generated by this in fees, contingencies etc.

Whipp Cross University Hospital NHS Trust

The OBC was approved in principle in July 2003 and finally approved by the SHA in January 2004. The scheme cost has increased due to: changes in the MIPS index, change in location factor and the consequent increases in associated costs (fees, contingencies etc). The project has also responded in full to improving the patient experience and the revised space standards. The approved OBC sum was £328 million (with the SOC being £184 million). A schedule of decanting and enabling works has been developed to assist the future PFI provider in clearing the site. One of these early schemes is the creation of a new energy centre on the site which woudlj have been necessary in any event. An uplift was agreed to the cost of this (due to building price inflation) which added a further net £1.7 million to the project control total. The current control total is £329.7 million.

Table 5.3.4

INCREASES TO THE CAPITAL COST OF PFI SCHEMES


A	B	C	D	E	F
South	Capital Cost at OBC Stage	Capital Cost Reported Last Year	Capital Value This Year	% Increase Since OBC Stage	% Increase Since Last Year
	£m	£m	£m

Avon and Western Wiltshire MH Partnerships	68.0	83.0	83.0	22.1%	0.0%
Salisbury Healthcare	15.6	22.0	24.1	54.5%	9.5%
Taunton and Somerset Cancer Unit	16.0	18.0	18.0	12.5%	0.0%
Portsmouth Hospitals	127.7	192.0	192.0	50.4%	0.0%
Oxford Radcliffe Hospitals—Relocation	95.0	134.0	137.0	44.2%	2.2%
Buckinghamshire Hospitals— Stoke Mandeville	23.7	47.7	46.6	96.6%	-2.3%
Brighton Healthcare—Children's scheme	30.9	43.0	37.1	20.1%	-13.7%
Oxford Radcliffe Hospitals—Cancer	60.0	93.0	99.7	66.2%	7.2%
Plymouth Hospitals	101.0	274.4	348.7	245.2%	27.1%
New Forest PCT—Lymington	36.0	36.0	36.0	0.0%	0.0%
South Devon	65.0	N/A	250.0	284.6%	N/A
Southampton	52.0	N/A	80.0	53.8%	N/A
Maidstone & Tunbridge Wells	175.0	N/A	290.0	65.7%	N/A
TOTAL SOUTH	865.9	943.1	1,642.2

COMMENT ON ANY INCREASES OVER 10%

Avon and Western Wiltshire

Projected increase up to financial close from MIPS 325 to MIPS 398.

Projects transferred from PFI to other procurement packages (treasury funded and LIFT)

Design and development—improving the patient experience

Uplift in on-costs for Secure Services

Salisbury Healthcare

Addition of Laundry and increase from MIPS 325 to MIPS 360.

Taunton and Somerset

Increase from MIPS 325 to MIPS 360

Portsmouth Hospitals

Impact of change from MIPs 378 to MIPs 415

Improving the patient environment

Additional 20 Maternity beds

Impact of building regulations


Oxford—Relocation Scheme Change to MIPS	27.3

Adjustment to price level to correct for location factor	5.0
Impact of Building Regulations Part L	3.5
Impact of "improving the patient environment"	6.0
"Real" changes in design/functional content	0.2
	42.0
Stoke Mandeville
Cost at OBC	23.7
New Mortuary	0.7
Improving the patient environment	3.0
Intermediate Care ward (22 beds)	1.6
Pharmacy and Cook-chill reprovision	1.8
Additional Acute Medical beds/Stroke Unit (44 beds)	3.4
Trust Admin	0.9
Uplift from MIPS 310 to MIPS 394	11.5
Cost this year at MIPS 394	46.6
Brighton

For the 2003-04 Return, the outurn capital cost figure was quoted as opposed to current MIPS rate	30.9
Oxford—Cancer Centre Scheme

Capital cost at MIPS 325	60.0
Uplift from MIPS level at previous report to MIPS as at 1 April 2002 (MIPS 325 to MIPS 361)	6.4
Elderly care scheme added	27.2
Value reported last year	93.6
Elderly scheme removed	-27.2
Uplift from MIPS 361 to 438	14.2
Addition of variant proposals: Private patients, Theatres, PET/MRI build.	19.1
Current capital cost	99.7
Plymouth Hospitals
Capital Cost Reported "Last Year" to "Capital Cost at OBC Stage" variance: The figure of £101 million was the estimated cost at the SOC stage in 2000-01. Following the SOC, a detailed review has resulted in the original scheme being combined with a rehabilitation SOC for the Plymouth Health Communiy. This has a benefit for patient services in creating a more integrated solution and for the PFI process as a combined scheme. In addition, further improvements in the patient environment and associated costs for VAT and inflation have resulted in a new scheme design and cost. The revised total cost includes the following amendments:
Post SOC inclusion of an Intensive Rehabilitation Capital project previosuly managed by Plymouth Community Trust.	45

Improvements to the patient environment—the original refurbishment of the Hospital Building within the SOC only included the reconfiguration/relocation of services. As further work was conducted it became evident that a significant part of the buildings infrastructure needed replacement to meet modern standards, hence, additional costs were included to cover the replacement of lifts, electricity infrastructure and other infrastructure items.	65
Additional VAT costs not included within the original SOC	40
Uplift for inflation from SOC to OBC stage	23
Total increase since SOC	173
Capital Value "This Year" to "Capital Cost Reported Last Year" variance: The capital value last year showed the uninflated figure (MIPS VOP345), this has now been inflated using NHS Estates guidelines to the relevant inflation figures for each year which results in an additional £77.6 million for inflation up until 2010. The MIPS increase has been offset by minor savings of £3 million on the scheme.
Total Increase since last Year	74.4
South Devon Healthcare
The figure of £65 million was the anticipated cost at the SOC stage. The SOC of Torbay was based on a scheme, which was focused on an improvement in Surgical Services and A&E only and the refurbishment of 15,600m2 of existing buildings. Following the SOC and as a consequence of a review of the Torbay site conducted by external advisers to the NHS Estates Design Panel, it was recognised that a cogent solution to this requirement was impossible to achieve given the fragmented nature of previous developments on this site. Consequently a wider review of the services provided on the site was undertaken which resulted in the recognition of the need for a more comprehensive development at Torbay, which reflected the objectives of the NHS Plan.	130
In carrying out this further evaluation it was also possible to include many of the items included in "Improvements to the Patient Environment" agenda, which had not been reflected in the original review.	42
The SOC at Newton Abbot had an allowance for the purchase of industrial land at a cost of £0.9 million which was subsequently rezoned and re-valued at £2.5 million.	1.6
Additionally, with the review of the services at Torbay it was recognised that a number of these services would be more appropriately located at Newton Abbot.	11.4
Total Increase since SOC	185
Southampton
Change to scope of scheme as SOC is updated.
Maidstone and Tumbridge Wells
MIPS

Table 5.3.4

INCREASES TO THE CAPITAL COST OF PFI SCHEMES


A	B	C	D	E	F
Midlands and Eastern	Capital Cost at OBC Stage	Capital Cost Reported Last Year	Capital Value This Year	% Increase Since OBC Stage	% Increase Since Last Year
	£m	£m	£m

North Staffordshire	224.0	269.0	308.0	37.5%	14.5%
University Hospitals Birmingham	291.0	379.3	440.1	51.2%	16.0%
Peterborough Hospitals	135.0	293.0	293.0	117.0%	0.0%
Addenbrookes	30.0	76.0	76.0	153.3%	0.0%
Mid Essex hospitals—Chelmsford	80.0	110.0	121.0	51.3%	10.0%
Essex Rivers Healthcare—Colchester	79.0	127.0	139.0	75.9%	9.4%
Sherwood Forest Hospitals	66.0	125.0	147.4	123.3%	17.9%
Southern Derbyshire Acute Hospitals	177.0	312.2	312.2	76.4%	0.0%
Nottinghamshire Healthcare	13.9	18.7	19.4	39.6%	3.7%
University Hospitals of Leicester	286.0	403.0	447.0	56.3%	10.9%
Daventry & South Northants PCT	19.5	23.7	28.2	44.6%	19.0%
Northampton PCT	19.5	28.9	31.2	60.0%	8.0%
South Holland Community Hospitals	24.2	N/A	25.0	3.3%	N/A
Ipswich Hospital	24.9	N/A	26.0	4.4%	N/A
Brentwood, Billericay & Wickford PCT	20.0	N/A	20.0	0.0%	N/A
South Essex Mental Health & Community	17.0	N/A	17.0	0.0%	N/A
Mid Essex hospitals—Chelmsford	16.8	N/A	16.8	0.0%	N/A
Epping Forest PCT	10.0	N/A	13.4	34.0%	N/A
Derbyshire Mental Health	31.6	N/A	31.6	0.0%	N/A
Witham & Braintree	8.0	N/A	12.7	58.8%	N/A
Royal Wolverhampton	110.0	N/A	312.0	183.6%	N/A
Walsall Hospitals	43.0	N/A	127.0	195.3%	N/A
TOTAL MIDLANDS & EASTERN	1,726.4	2,165.8	2,964.0

COMMENT ON ANY INCREASES OVER 10%

North Staffordshire Hospitals

Uplift from MIPS 345 to MIPS 385

Inclusion of expansion and education space.

University Hospitals Birmingham

Inclusion of new DCAGs for "improving the patient environment agenda". Inclusion of 64 new beds and associated support.

Accommodation related to growth identified through the capacity planning exercise.

Increase from MIPS 310 to MIPS 385

Addenbrookes

Inclusion of a genetics centre—capital cost £9 million. This was originally a separate scheme but has now been merged with the larger scheme. Inclusion of new DCAGs for "improving the patient environment". Inclusion of an integrated capital development to be funded by the University of Cambridge and the MRC (c£20 million)

Mid Essex Hospital

Inclusion of new DCAGs for "improving the patient environment"; 70 extra beds and two additional theatres; removal of staff accommodation element.

Peterborough

Inclusion of new DCAGs for "improving the patient environment". Expansion of cancer, renal and neo-natal intensive care services. Inclusion of £23.8 million Mental Health scheme.

Essex Rivers

Inclusion of new DCAGs for "improving patient experience", indexation and incorporation of NHS Plan targets and revised activity figures.

Sherwood Forest Hospitals

Inclusion of "improving the patient experience" standards; expansion of services, including emergency care and pathology; indexation.

Southern Derbyshire Acute

Inclusion of "improving the patient experience" standards; inclusion of a new Medical School; modernisation of maternity and gynae services; indexation.

Nottinghamshire Healthcare

Improvement of ICU facilities; additional office space; indexation.

Leicester

UHL Pathway project has increased by 56.3% since SOC approval. This is due to a number of factors: the application of "improving the patient environment" standards, inflation and the inclusion of the reprovision of academic space due to be replaced within the PFI.

Daventry and South Northants

Increase in capital cost due to inclusion of VAT, recalculation of inflation allowance and additional costs related to Local Authority planning requirements.

Northampton Healthcare

Revised models of care and "improving the patient environment. Trust currently working with commissioners to reduce the impact of changes to the original proposal.

Epping Forest

Inclusion of improving the patient experience.

Additional ward,outpatient/physiotherapy, free standing cafeteria, creation of expansion space.

Whitham and Braintree

Inclusion of "improving the patient experience", indexation and the inclusion of additional community services.

Wolverhampton

Return not received from SHA.

Walsall Hospitals

Increase to MIPS 385.

5.3.5 Could the Department provide an update of Tables 5.3.5, showing, for major projects (those greater than £25 million in value), a comparison between the PFI price and the publicly financed option. The publicly financed comparator's costings should be broken down as follows:

Basic construction contract, broken down between pre-implementation and post implementation costs;

The value of risk adjustment, again broken down between pre-implementation and post implementation costs, in both pounds and percentage terms, and

The final total real full life cost of both options. [5.3.5]

1. The information requested is provided in the attached tables.