| 1. |
INTRODUCTION |
6 |
| 2. |
SUMMARY AND FUTURE PROSPECTS |
7 |
| 3. |
PUBLIC SECTOR HEALTHCARE IN THE UK |
12 |
| 3.1 | OVERVIEW AND STRUCTURE OF THE NHS |
12 |
| 3.1.1 | Scotland |
12 |
| 3.1.2 | Wales |
13 |
| 3.1.3 | Legislative Drivers and Governmental Reforms |
13 |
| 3.1.4 | The NHS Estate |
15 |
| 3.2 | PRIMARY HEALTHCARE MARKET |
16 |
| 3.2.1 | Overview & Primary Care Trusts |
16 |
| 3.2.2 | GP Surgeries & Health Centres |
20 |
| 3.2.3 | Polyclinics |
21 |
| 3.2.4 | Treatment Centres |
22 |
| 3.2.5 | Dental Provision |
23 |
| 3.3. | SECONDARY/ACUTE CARE MARKET |
23 |
| 3.3.1 | Overview & Structure |
23 |
| 3.3.2 | Types of Hospital |
23 |
| 3.4 | HEALTHCARE SPENDING IN THE UK |
26 |
| 3.4.1 | NHS Spending |
26 |
| 3.4.2 | Impact of the 2010 Comprehensive Spending Review |
27 |
| 3.4.3 | NHS Funding in Scotland |
31 |
| 3.4.4 | NHS Funding in Wales |
31 |
| 3.4.5 | Primary Care Spending |
32 |
| 4. |
PRIVATE ACUTE HEALTHCARE SECTOR IN THE UK |
34 |
| 4.1 | PARTNERSHIP WITH THE NHS |
35 |
| 4.2 | ACUTE HOSPITAL PROVISION & LEADING PROVIDERS |
36 |
| 4.2.1 | The H5 Private Hospitals Alliance |
37 |
| 4.2.2 | Private Healthcare Companies |
38 |
| 4.3 | PRIVATE DENTAL CARE |
42 |
| 5. |
CONTRACTORS OUTPUT IN THE HEALTHCARE SECTOR |
44 |
| 5.1 | TOTAL CONSTRUCTION OUTPUT |
44 |
| 5.1.1 | Value of Total Output – Construction New Work |
44 |
| 5.1.2 | Output by Sector |
45 |
| 5.2 | OUTPUT FOR 2011 AND BEYOND |
47 |
| 5.3 | CONSTRUCTION OUTPUT IN THE HEALTHCARE SECTOR |
49 |
| 5.3.1 | Outlook for Healthcare Construction Work |
50 |
| 5.4 | CAPITAL EXPENDITURE IN THE NHS |
51 |
| 5.4.1 | England |
51 |
| 5.4.2 | Scotland |
52 |
| 5.4.3 | Wales |
53 |
| 5.4.4 | Northern Ireland |
53 |
| 6. |
PROCUREMENT OF HEALTHCARE CONSTRUCTION WORK |
55 |
| 6.1 | OVERVIEW OF PFI |
55 |
| 6.2 | SIZE OF THE PFI HEALTHCARE MARKET AND PROGRESS TO DATE |
56 |
| 6.2.1 | Overview |
56 |
| 6.3 | FUTURE OF HEALTHCARE PFI UNDER THE COALITION GOVERNMENT |
58 |
| 6.3.1 | Alternative Models to PFI in Healthcare |
59 |
| 6.3.2 | Leading Players in the PFI Healthcare Market |
60 |
| 6.4 | LOCAL IMPROVEMENT FINANCE TRUST (LIFT) |
61 |
| 6.4.1 | Overview of NHS LIFT |
61 |
| 6.4.2 | Investment in LIFT |
62 |
| 6.4.3 | Scheme Update |
63 |
| 6.4.4 | Principal Consortia & LIFT Partners |
66 |
| 6.4.5 | The Future of LIFT under the Coalition Government |
67 |
| 6.4.6 | Express LIFT |
67 |
| 6.5 | PROCURE21 |
68 |
| 6.5.1 | Procure 21 Programme |
68 |
| 6.5.2 | Procure 21+ Programme |
69 |
| 6.5.3 | Procure 21 in Wales |
70 |
| 6.5.4 | Frameworks Scotland |
72 |
| 7. |
CONSTRUCTION SUPPLY IN THE HEALTHCARE SECTOR |
74 |
| 7.1 | OVERVIEW |
74 |
| 7.2 | KEY CONSTRUCTION COMPANIES AND CONTRACTORS IN HEALTHCARE |
74 |
| 7.3 | PRIVATE CONSORTIA IN THE HEALTHCARE SECTOR |
76 |
| 7.4 | KEY HEALTHCARE CONTRACTOR PROFILES |
78 |
| 7.4.1. | Balfour Beatty |
78 |
| 7.4.2 | BAM |
79 |
| 7.4.3 | Carillion |
80 |
| 7.4.4 | Galliford Try |
80 |
| 7.4.5 | Interserve |
81 |
| 7.4.6 | John Laing |
81 |
| 7.4.7 | Kier |
82 |
| 7.4.8 | Laing O’Rourke |
82 |
| 7.4.9 | Morgan Sindall |
83 |
| 7.4.10 | Willmott Dixon |
84 |
| 7.5 | HEALTHCARE DEVELOPERS AND INVESTORS |
84 |
| TABLES AND CHARTS |
| TABLE 1 | SUMMARY OF HEALTHCARE SECTOR BUDGETS AND MAJOR CAPITAL SPENDING PROGRAMMES 2010-2015 |
7 |
| TABLE 2 | TOTAL SIZE OF NHS ESTATE BY FUNCTION (SQ. M.) 2009-10 – PCTS, ACUTE TRUSTS, MENTAL HEALTH & CARE TRUSTS |
15 |
| TABLE 3 | GP CONSORTIA (PATHFINDERS) BY STRATEGIC HEALTH AUTHORITY REGION |
19 |
| TABLE 4 | GP COMMISSIONING TRANSITION TIMETABLE. 2011-2013 |
20 |
| TABLE 5 | COMMUNITY HOSPITALS – NOTIONAL ALLOCATIONS TO EACH SCHEME (£M) |
25 |
| CHART 6 | VALUE OF UK NHS EXPENDITURE 2005 – 2015 (£BILLION) |
27 |
| TABLE 7 | CSR 2010 –OVERVIEW OF CAPITAL BUDGETS BY GOVT. DEPT 2010-2015 |
29 |
| TABLE 8 | TOTAL HEALTHCARE SPENDING SCOTLAND 2011-12 (£M) – CAPITAL AND RESOURCE BUDGETS |
31 |
| TABLE 9 | UK NHS PRIMARY CARE TRUST SPENDING ALLOCATIONS 2006-2012 (£BN) |
32 |
| TABLE 10 | UK TOP 20 PRIMARY CARE TRUSTS BY SIZE OF OPERATIONAL CAPITAL BUDGET 2011-12 |
33 |
| CHART 11 | PRIVATE ACUTE HEALTHCARE MARKET - % BY SECTOR (£BN) 2009-2010 |
34 |
| TABLE 12 | LEADING UK PRIVATE HOSPITAL PROVIDERS – MARKET SHARE BY NO. OF HOSPITALS / BEDS |
36 |
| TABLE 13 | LEADING PRIMARY HEALTHCARE PROVIDERS BY NUMBER OF SURGERIES OWNED |
41 |
| TABLE 14 | MAJOR DENTAL COMPANIES IN THE UK BY NUMBER OF PRACTICES IN 2009 AND 2010 |
42 |
| TABLE 15 | UK CONSTRUCTION OUTPUT 2004 – Q3 2010 (£ BILLION AT CURRENT PRICES) |
44 |
| CHART 16 | VALUE OF CONSTRUCTION OUTPUT NEW WORK BY SECTOR - % BY VALUE Q3 2010 |
47 |
| CHART 17 | NON-DOMESTIC CONSTRUCTION OUTPUT (UK) 2004 TO 2014 - BY VALUE (£ BILLION AT CURRENT PRICES) |
48 |
| TABLE 18 | CONTRACTORS OUTPUT - HEALTHCARE SECTOR WORK (PUBLIC/PRIVATE) 2004-2010 (£M) |
49 |
| CHART 19 | FORECAST HEALTHCARE CONSTRUCTION OUTPUT (PUBLIC/PRIVATE) 2010-2014 (£M) - BY VALUE (£ BILLION AT CURRENT PRICES) |
50 |
| TABLE 20 | NHS CAPITAL SPENDING – 2007-2015 (£BN) |
52 |
| TABLE 21 | HEALTHCARE CAPITAL SPENDING SCOTLAND 2011-12 (£M) |
53 |
| TABLE 22 | HEALTHCARE CAPITAL SPENDING WALES 2010-14 (£M) |
53 |
| TABLE 23 | HEALTHCARE CAPITAL SPENDING NORTHERN IRELAND 2010-15 (£M) |
54 |
| TABLE 24 | PFI INVESTMENTS TO DATE (BY SECTOR) |
55 |
| TABLE 25 | MAJOR PFI HOSPITAL SCHEMES – BY STAGE OF DEVELOPMENT AND CAPITAL VALUE (AS AT NOVEMBER 2010) |
57 |
| CHART 26 | CAPITAL INVESTMENT IN NHS LIFT 2003-2011 BY VALUE (£M AT CURRENT PRICES) |
62 |
| TABLE 27 | NHS LIFT SCHEMES BY WAVE & NO. OF SCHEMES OPERATIONAL AND UNDER CONSTRUCTION -VALUE AND PRIVATE PARTNER |
64 |
| TABLE 28 | MAJOR NHS LIFT PRIVATE SECTOR PARTNERS & CONSORTIA |
66 |
| TABLE 29 | LEADING CONTRACTORS IN THE HEALTHCARE SECTOR – GROUP TURNOVER (£000) |
75 |
| TABLE 30 | TOP 10 CONTRACTORS IN THE HEALTH SECTOR – OVERVIEW OF INVOLVEMENT IN PFI, LIFT AND P21 |
77 |
| TABLE 31 | PRIMARY HEALTHCARE DEVELOPERS & INVESTORS BY NUMBER OF PRIMARY CARE PREMISES OWNED |
85 |
