Contractors eye up mini-hospital PFIs

NHS Estates is to launch a controversial new scheme this month that will see private sector consortia directly employing clinical staff at 10 new privately financed diagnostic and treatment centres (DTCs).

The pilot schemes are expected to be announced over the Christmas period. They will call for private consortia with the skills to not only design, construct, manage and maintain the units, but also to provide and manage all clinical staff.

The pilot scheme is part of a government programme to build more than 30 DTCs in an attempt to radically reduce NHS waiting lists.

The DTCs will provide a new form of cottage hospital, which will take the pressure off the district and general hospitals by performing minor operations such as hip replacements, knee repairs and cataract surgery.

The total programme is worth £3bn in construction work and requires £2bn per year of medical and support services work.

Construction firms are preparing to bid for the work. Jarvis Projects has built a pilot diagnostic and treatment centre in Birmingham, while Carillion recently set up a joint venture with Nestor Healthcare, aimed specifically at this market.

The DTCs will be designed, built, refurbished, maintained, and run by the private sector and staffed by international teams of clinicians, to avoid draining the NHS of existing staff.

But the pilots are also seen as controversial. One healthcare consultant said: "This is seen as a way to introduce new working practices for clinical staff, with operations performed during the weekend and in the evenings and the training of skilled nursing staff to do simple key-hole surgery.

"Launching it so near to the Christmas holidays is probably an attempt to bury bad news."

Smaller units will be traditionally procured under partnering agreements, with larger-scale units expected to be privately financed.

The first tranche of units will be sited where waiting lists are longest, mainly in the South East, and will consist of refurbishment rather than new build, in a bid to deliver the units as quickly as possible. But more complex and larger projects will follow.

A first tranche of DTCs will be advertised in the OJEC next month.