The National Health Service (NHS) is recognised as the largest public sector
institution in Europe. This presents significant challenges in regards to
operation and maintenance of the diverse built estate, and the ever-evolving
clinical models of care. The economic downturn, and strict policy of austerity
in the UK, presents limitations and challenges in capital investment. The
majority of healthcare facilities which will be used throughout the 21st
century, have already been built. This demands that solutions be found in the
areas of asset maintenance and refurbishment. These challenges are
complicated further, by the institutional and statutory requirements of the
NHS to meet demanding sustainability targets. This in turn, is underpinned
by exacting assessment methodologies and rating systems, and critically, an
institutional ‘duty’ to pursue and evidence that ‘Value for Money’ has been
achieved as far as reasonably practicable. The existing estate management
tools were assessed by a process of triangulation, and the relevant decisionmakers
and stakeholders from both the NHS and the Design Teams and
Constructors were identified. The original contribution demonstrates the
development of a novel decision support prototype which facilitates and
improves the current decision making process. The prototype allows the
integrated team to consider, evaluate, and agree, best-fit options in a
measured, recordable, and replicable manner. Key to this process, is the
ability to compare and rank often competing criteria, and to test the nonfinancial,
and financial preferences by means of sensitivity analysis
techniques. The research and the developed working prototype, were then
tested and validated against an expert panel, on a broad scope of issues,
ranging from Graphical User Interface aesthetics and usability, to
functionality and applicability to the current standard business case process.
The results of the testing and validation excercises were overwhelmingly
positive