Build to serve with service design
Gary Sturgess, August 2007
Infrastructure Partnerships Australia

Debate about the merits of public private partnerships usually focuses on front-end gains such as value-for-money savings and on-time, on-budget delivery. By and large, PPPs have delivered these benefits, and they have come from a contracting model that is highly effective at transferring risk to the provider, and the development of solutions in a competitive environment. 

But there is a great deal more to public private partnerships than this. If they are well designed, PPPs bring together the designers and operators of public services and the designers and the builders of the physical assets into a partnership that is obliged to work closely together in order to succeed, financially and operationally.

And where service design is placed at the heart of building design - where the facility is the physical manifestation of an innovative new service solution - then the opportunity exists to transform the way in which public services are delivered.

It is generally understood that a step change occurred in the early stages of the PPP prisons market, where the companies that would be responsible for the operation of the prisons came up with design innovations that enabled them to reduce staff/prisoner ratios.

What is not so widely understood is that improvement in both service and building design has continued, as companies have continued to search for new sources of efficiency for different kinds of prisons on different sites.

A recently-signed hospital contract in Scotland demonstrates particularly well how government clients can take advantage of service-led PPPs. At Forth Valley, the client was looking to transform the way in which the hospital functioned. They asked the bidders to put forward solutions that segregated the movement of patients, visitors, supplies and waste, with a view to improving patient dignity and better preventing the spread of infection.

The winning consortium - led by the service company, Serco Group plc - separated the movement of people and goods into different pathways, and segregated patients from visitors, so that they will no longer have to share the same lifts and corridors.

In partitioning the movement of people and goods into separate corridors, the provider was able to offer a solution based on the use of robotics. Robots guided by magnetic strips - similar to those used in modern car plants - will move along these pathways delivering food and linen, and taking away waste and other materials.

Chutes have been installed for the immediate removal of non-clinical waste and soiled linen, which will assist in keeping wards clear and odour-free. Clinical waste is required by law to be stored in bins and these will be removed by the robots, helping to prevent needle-stick injuries.

An additional benefit of separating the people flow in the building is that the hospital porters who normally spend part of their time moving the goods trolleys, are now free to focus on moving patients. The company is now able to invest in training to help develop their people skills - which is good for the patients and the staff.

There have also been efficiency benefits. The use of robots to move trolleys down through separate corridors and lifts means that these movements can be carried out, twenty-four hours a day. This reduces congestion and optimises the use of staff time.

Forth Valley is one of the most innovative new hospital developments in the United Kingdom, and it has been possible because a client that refused to impose traditional constraints on the competing consortia, and by a consortium that was prepared to place service design at the heart of building design.