International benchmarking demonstrates the competitiveness of the construction costs of the project
Dublin, April 26th, 2017, The National Paediatric Development Board (NPHDB) and the Children’s Hospital Group Board (CHGB) today warmly welcomed the announcement by the Minister for Health Simon Harris TD that Government has approved the construction investment decision for the building of the new children’s hospital and the two associated Paediatric Outpatients and Urgent Care Centres at Connolly and Tallaght Hospitals.
This decision paves the way for the laying of foundations at the new children’s hospital project on a campus shared with St James’s Hospital and the new facilities at Connolly and Tallaght Hospitals.
The NPHDB, appointed by the Government in 2013 to design, build and equip the new children’s hospital, has overseen an immense programme of work over the past three years which has seen the completion of a beautiful design for this state-of-the-art children’s hospital and the two Paediatric Outpatients and Urgent Care Centres. This work has been carried out on behalf of the Children’s Hospital Group which, together with the Boards, executives, clinicians and staff of the three Dublin children’s hospitals, as well as, current and former patients and their families, has helped to inform all aspects of the design to ensure that it meets the current and future clinical needs of Ireland’s sickest children and young people and the local needs of the greater Dublin area.
Full planning permission for the hospital, the two Paediatric Outpatients and Urgent Care Centres, a Children’s Research and Innovation Centre and a 53-unit family accommodation centre was granted by An Bord Pleanála in April last year. A comprehensive tendering process was completed recently to select a construction company to complete the build of the hospital and the two Paediatric Outpatients and Urgent Care Centres. The 12-acre site on the St James’s Hospital campus has been fully cleared and is now ready for the laying of foundations of what will be one of the biggest buildings in Ireland. The size of Dundrum Shopping Centre and the length of Grafton Street, the new hospital will include over 6,150 rooms, 4 acres of outdoor gardens and external space and 380 individual inpatient rooms each having their own en-suite and a bed for parents to sleep near their sick child.
Parent and long-time campaigner for a new children’s hospital in Ireland Louis Roden, Chairman of the New Crumlin Hospital Group, said: “This is a great day, another critical milestone in helping us realise the vision and dream of ensuring that the sickest children of Ireland are treated in a modern world class facility, one that is fit for purpose. Staff, parents but most importantly the children of Ireland have had to put up with a lot of sub-standard facilities for far too long. It is fantastic that we finally have the green light and will soon see walls being built. This day has come too late for my children as they will have moved into the adult system by the time the hospital is open along with countless others who endured the endless delays. Nonetheless I take great joy in knowing that soon, other parents and children will get the facilities they deserve. We now need to ensure that the hospital opens without any further delay. The opening day can’t come quickly enough.”
Professor Owen Smith CBE, Consultant Paediatric HaematologistatOur Lady’s Children’s Hospital, Crumlin said: “It is hard to put into words the positive impact that this new children’s hospital will have on the health outcomes and overall welfare of children and young people. My clinical colleagues across the three children’s hospitals and I, together with the Children’s Hospital Group team have spent many hours with the project and design team helping to inform the planning of the clinical spaces in what will be one of the finest hospitals in the world. The ability to work across all specialities within the paediatric community under one roof while also sharing knowledge, skills and resources with our colleagues in St. James’s will have a phenomenal impact on how children and young people are treated and clinical outcomes can only improve.”
John Pollock, Project Director, NPHDB said: “The Board and staff of the NPHDB, together with the international design team, are delighted that we now have the green light to move ahead to the next critical phase of the project. We have completed the first part of our three-pronged remit – we have a beautiful design and are ready now to proceed to the build phase. We have selected a preferred construction partner and are ready now to sign contracts. Cost experts, Linesight have conducted international benchmarking exercises and they have demonstrated that the construction cost of the hospital compares favourably with hospitals recently built in the UK, the US and in the Middle East. Our core objective is to build and equip a modern, state of the art hospital that delivers value for the people of Ireland but which importantly is designed, built and equipped in a manner which will enable clinicians and staff, who have informed the design, to do their jobs to the best of their ability.”
Eilísh Hardiman, Chief Executive, Children’s Hospital Group: “While today, the focus is on the three new buildings – what we are really celebrating today is that the capital investment required to support the development of a single children’s hospital central to a clinical network of services which represents a significant leap forward in paediatric healthcare in Ireland. Over the past three and a half years we have been working closely with boards, management and staff at Our Lady’s Children’s Hospital, Crumlin, Temple Street Children’s University Hospital and the National Children’s Hospital at Tallaght Hospital to drive forward with our plans on how the three hospitals can come together as a single organisation in a way that will improve the experience and outcomes for children and their families, and make it better for our staff. This challenging work continues to make progress with plans in development for a digital hospital that will act as the first implementation of the national electronic healthcare record. This work will be given further focus as we start to see bricks being laid. We are on the cusp of changing how paediatric services are delivered in Ireland. It is a time of real and significant change for all of us involved in caring for children, young people and their families and we are delighted for patients, their families and our staff.”
The Youth Advisory Committee is a group of young people – users of the Dublin children’s hospitals - who have fed into the design and delivery of services at the new children’s hospital for the past number of years. In a joint statement today, they said; “As current and former users of hospital services we have spent many hours talking to the team who are designing the new children’s hospital. We have told them what we thought would help children and their families who stay in hospital for long periods of time. Important things such as a bed for parents or guardians to stay in the same room as their child, the ability to choose your own food, open spaces and places where teenagers can gather together with their friends were all high on our list and have been included in the design. We are extremely happy that the funding has been secured and we look forward to the opening of the new children’s hospital.”
In a joint statement Helen Shortt, CEO of Our Lady's Children's Hospital, Crumlin, Mona Baker, Temple Street Children’s University Hospital, and David Slevin, CEO of Tallaght Hospital; said; “On behalf of the Boards and the staff of the three children’s hospitals we welcome the announcement today that the construction investment for the new children’s hospital and two OPD & Urgent Care Centres (planned for Connolly and Tallaght Hospitals) has been approved. The Children’s Hospital Group and the National Paediatric Development Board have brought the project to this significant point bringing it to closer to seeing bricks laid at the site of the planned new children’s hospital. These facilities will be a big improvement for children, young people, families and staff. The design and the range of facilities that will be available under one roof will be exceptional. The hospitals are looking forward to the opening of the new hospital and to seeing continuing improvements in clinical care and outcomes for the children and young people in our care.”
Dr Sharon Sheehan, Master / CEO, Coombe Women & Infants University Hospital; said “Today’s decision brings us another step closer to tri-location of adult, paediatric and maternity services on the one hospital campus. A proposed site for the Coombe Women & Infants University hospital has been identified in the Site Master Plan for the St James's campus, and the new children's hospital design has incorporated the required operational links with both maternity and adult hospitals which will facilitate the move by the Coombe to this shared campus. We look forward to bringing the full breadth and depth of women and infant services that operate in the Coombe Women and Infants University Hospital onto the St. James's Hospital campus site to tri-locate with St. James's Hospital and the new children's hospital. Our women and infants deserve no less”.
Editors’ Notes:
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About the new children’s hospital project:
- The St. James’s Hospital Campus is approx. 50 acres – equivalent to 25 soccer pitches with 12 acres dedicated to the new children’s hospital - equivalent to 6 soccer pitches
- It will be the size of Dundrum Town Shopping Centre with an internal street the length of Grafton Street.
- The new children’s hospital will be tri-located with Adult and Maternity hospitals on a shared campus. It is planned that the Coombe Women and Infants University Hospital is also relocating to the same campus.
- The new children’s hospital will be 7 storeys at its highest, comprising of approx. 160,000m2 of accommodation including the car park.
- 6150 rooms in total
- 380 individual inpatient rooms, each with an en-suite and bed for parent to sleep near their child
- 93 Day Beds
- 22 operating theatres and procedure rooms
- 48,000 Lights & 36,000 ICT Points
- 39 Lifts
- 1,000 underground car parking spaces (675 of these for families which can be pre-booked and 31 Emergency spaces outside ED supported by a concierge)
- The size of Dundrum Town Centre, with an internal street the length of Grafton Street
- 4 acres of outdoor areas & gardens
- 14 gardens and internal courtyards – including the Rainbow Garden which is the length of Croke Park
- No hospital campus in Ireland is better served by public transport - 6 bus routes passing through the Campus; 3 Red Line Luas Stops serving the Campus; and 3 Dublin bike stations. Heuston Station is also in close proximity.
- 2 new paediatric Outpatients and Urgent Care Centres at Tallaght Hospital and Connolly Hospital
- A new Children’s Research and Innovation Centre
- A 53-Unit family accommodation unit (Ronald McDonald House Charity)
Tender Process
The recently concluded tendering process for the main construction works for the new children’s hospital, and for the Paediatric Outpatients and Urgent Care centres at Tallaght and Connolly Hospitals determined the actual market cost of the construction elements of the project, which were included in the Final Project Brief. Local and international companies participated in the highly competitive tender process undertaken by National Paediatric Hospital Development Board (NPHDB). More than 35 people participated in review panels for the tenders. The tenders were reviewed and measured against a number of technical and financial criteria and were independently peer-reviewed by construction experts with extensive experience of projects of this size and complexity. The preferred, and most competitive, contractor for construction of the new children’s hospital is BAM Building Ltd., has been selected.
Final Project Brief
Under the NPHDB establishing legislation (SI 246 of 2007), the statutory approval process for constructing the hospital requires the NPHDB to submit a Project Brief to the Minister for his consent prior to the HSE giving approval. Accordingly, with the Children’s Hospital Group, it prepared a Definitive Business Case which sets out a detailed analysis of the costs of the new children's hospital and satellite centres and the associated benefits. The Final Project Brief, which includes the Definitive Business Case, was submitted to Minister.
The Final Project Brief sets out the costs and funding proposals for the construction of the core hospital and satellite centres, including equipment, VAT provision, risk provision, all fees, decant, external works, enabling costs, project management costs, commercial spaces (underground car park and retail space), and higher education facilities. It also provides details on two options for the procurement of equipment for the hospital.
On foot of today’s Government decision, the Minister will officially consent to the Final Project Brief and this will be followed by HSE approval of the Brief.
Award of Contracts
Today’s decision by Government means that the NPHDB can now proceed to award the contracts to the successful bidder BAM Building Ltd. The contracts are being awarded for the building of the new children’s hospital and 2 Paediatric Outpatients and Urgent Care Centres, third level education facilities, hospital school, car park and retail space. The NPHDB is finalising the contract arrangements and contract award details are commercially sensitive.
Capital costs
The total capital cost for the delivery of the project at St. James’s Hospital and the 2 Paediatric Outpatients and Urgent Care Centres is € 1.07bn, of which €1.004bn is Exchequer related, made up of €916m Exchequer capital and €88m Exchequer ICT capital as set out in the table below. Car park and retail facilities are not intended to be Government funded on the basis that they are commercially viable businesses which can be commercially funded. The project will be managed and delivered within these parameters.
Cost Comparisons
HSE capital funding of €650m was approved in 2014 following an initial cost estimate of the construction aspects of the project. This covered core (new children’s hospital and 2 Paediatric Outpatients and Urgent Care Centres) elements of the hospital construction only. The €650m funding did not include equipment, educational facilities or commercial elements such as retail and car parking. Alternative funding sources were identified for these elements, estimated to cost €140m. This brought the NPHDB 2014 cost estimate to €790m. In 2015, additional shared services for the campus were included in the project (energy centre, clinical decontamination, facilities management) bringing the overall budget to €800m.
Since the cost estimates were completed in 2014/15, the final cost of the design, build and equip programme for which the NPHDB is responsible has increased.
There are three factors that have driven this increase - these are:
- Increase in projected construction inflation over the project duration 2014 to 2021 – at the time of the cost estimate in 2014, inflation was running at 3% per annum and it is now running at over 9% per annum.
- the extended programme timeframe (longer than anticipated planning, procurement and approvals processes)
- market costs of the tenders came in higher than forecast.
These three factors bring the cost from €800m to €983m.
An internationally recognised design team supported by an experienced Board and Project Team are in place to drive the project to develop the new children’s hospital and focus on delivering the project in accordance with national policy to optimal design and value for money. They have followed best international design, planning and procurement processes at each stage of the project. The final construction elements of the project compare favourably when benchmarked against the costs of international projects of a similar size and scale.
In an international benchmarking exercise, the construction cost of the hospital compares favourably with hospitals recently built in the UK, the US and in other parts of Europe. The standard measure of cost evaluation is a cost per square foot – when this measure applies, the hospital is one of the least expensive when compared with others built in the past five years.
The NPHDB will continue to carry out value engineering processes with the construction team to manage and reduce costs where possible and will work with a Construction Management Services advisor to monitor costs and to ensure everything is delivered safely, on time and on budget.
Scheduled opening of the new children’s hospital and two Paediatric Outpatients and Urgent Care Centres
Clearance and enabling works are nearly complete on the campus shared with St James’s Hospital campus, making way for construction to begin on site within the next few weeks. It is anticipated that the new children’s hospital will open its doors in Q3 2021. The Paediatric Outpatients and Urgent Care Centres at Connolly Hospital and Tallaght Hospital, which will provide Urgent Care and Outpatient Care to children in the Greater Dublin Area, including Dublin City and County, Wicklow, Meath and Kildare, will open before the main hospital, in late 2018 (Connolly) and Q1 2019 (Tallaght).
Capacity and accommodation
The buildings have been designed to ensure that children and young people are treated in the best organised and most clinically suitable setting. In the main hospital at St James’s, there will be 380 single rooms all with en-suite bathrooms and a parent’s bed. There will be 93 daycare bays, 18 operating theatres and 122 consulting rooms in total. The rooftop rainbow garden is a central feature of the design and it will provide a secure and sheltered environment adjacent to the wards. The planned accommodation will include facilities for inpatients, day care patients, outpatients, operating theatres and emergency care. The elements of the hospital will include:
- Outpatients, daycare, theatre, emergency department and critical care units
- Laboratory, medical imaging and diagnostic services
- Specialist therapy and play facilities
- Age-appropriate facilities for children and young people
- Hospital school
- Reception, concourse and public realm including retail spaces in the main atrium
- Operational communication links into the adult hospital and maternity hospital
- Education, training, research and innovation facilities
- Underground car parking
Inpatient accommodation (all single rooms, en-suite, in-room parent accommodation)
- 300 generic inpatient rooms
- 60 critical care inpatient rooms incorporating paediatric intensive care/high dependency and neonatology intensive care/high dependency
- 20 child and adolescent mental health beds (incorporating eating disorders and acute
Child and Adolescent Mental Health Services (CAMHS))
Day care facilities
- 61 general medical and surgical day care bays
- 4 nephrology/urology day care bays
- 22 haematology/oncology day care bays
- 6 cardiology day care bays
Operating theatres
- 12 general theatres
- 6 specialist theatres
- 1 PIR suite
- 2 endoscopy rooms
- 1 catheterisation laboratory
Outpatients
- 110 outpatient consulting/examination rooms at the main hospital
- 12 outpatient consulting/examination rooms at the satellite centres (six in each)
Emergency Facilities
ED and urgent care facilities will be provided at the main hospital, with urgent care facilities at the Paediatric Outpatients and Urgent Care Centres also. There will be 24 short stay observation beds across the hospital and outpatients and urgent care centres (6 in each outpatients and urgent care centres and 12 in the main hospital), and 56 assessment bays (10 in each Paediatric Outpatients and Urgent Care Centre, and 36 in the main hospital).
Paediatric outpatients and urgent care centresat Tallaght and Connolly Hospitals
The outpatients and urgent care centres will improve geographic access to urgent care for children in the Greater Dublin Area. Consultant-led urgent care, with 4-6 hour observation beds, appropriate diagnostics and secondary outpatient services including rapid access general paediatric clinics as well as child sexual abuse unit examination, observation and therapy rooms will be provided in the satellite centres. The centre at Connolly will also include two HSE paediatric care primary care dental services operating theatres.
Integration Programme
The capital project to build the new children’s hospital and outpatients and urgent care centres will only provide buildings. The overall programme to deliver the new children’s hospital will entail both a complex merger of three different voluntary hospitals and a new build (in addition to a major ICT programme and co-location with an adult and the tri-located maternity hospital). Integration of the three existing children’s hospitals, the opening of the Paediatric Outpatients and Urgent Care Centres and the transfer of services to the new hospital facilities while maintaining existing services, patient safety and quality at three existing sites until transition is complete represent a highly complex project in its own right. The major programme of work of clinical integration, people and change management and commissioning required to achieve a successful transition to the new facilities is already underway. Revenue funding of €15m has been made available in 2017 for this work.
Legislation
It is the Minister’s intention to shortly bring to Government Heads of a Bill to establish a single entity to integrate the services currently provided by the three Dublin children’s hospitals, prepare for the transition to the new facilities and ultimately to run the children’s hospital paediatric outpatients and urgent care centres and when they open.
Children’s Research and Innovation Centre
More than a hospital, the new children’s hospital and outpatients and urgent care centres will be a research-intensive academic healthcare institution. Excellence in modern paediatric practice cannot be achieved without an embedded culture of, and focus on, research, education and innovation. To deliver this vision, the main facilities for research and innovation will be located at the Children’s Research and Innovation Centre (CRIC) on the St. James’s campus, which has a rich history in clinical research. Clinical management and research staff at the new children’s hospital will be able to study, evaluate, and improve the healthcare services provided to children and young people in Ireland. The CRIC on the campus will be non-Exchequer funded and will be built using separately-raised philanthropic funds.
Economic and social benefits
There are significant economic and social benefits to be gained from the new children’s hospital development for the Dublin 8 community, both during the construction phase, and afterwards when the hospital is operational. The An Bord Pleanála Inspector’s Report 2016 concluded that there was no doubt in relation to the significant urban regeneration potential arising from the development and the Inspector noted the NPHDB’s commitment to community gain.
