We’re pleased to welcome Graham Jamieson to the blog, to find out more about his role in developing the new St Luke’s Medical Centre in Duston, Northampton.
Graham is Managing Partner for Dr Astbury and Partners at St Lukes Medical Centre. Having worked in banking for much of his career, in 2003 Graham joined the practice becoming a partner a couple of years later. The practice recently relocated to a new purpose built medical centre on a new development in Duston.
Tell us a bit about the project
Theres been a medical practice covering the Duston and St James areas of Northampton for over 100 years. Prior to the move to St Lukes, the practice handled approximately 21,000 patients, split evenly across two different locations: Duston Medical Centre and the Harlestone Road Surgery.
In 2005, we were approached by the Northamptonshire PCT, who advised that some Section 106 land was available for a new health facility on the former British Timken site in Duston and asked whether wed be interested. The land the developers had in mind was a rather odd shaped plot which actually wasnt going to be quite big enough. So with Neil Masons help, we negotiated with the developers to purchase more land, resulting in a larger more even-shaped plot.
Not having had any direct, recent experience of building a medical centre of this size, we looked at various design/development companies, eventually choosing Ashley House.
We were very closely involved with the design of the building and as part of our design process, I visited a number of similar medical centres around the country. In discussion with their practice managers, it became apparent that we would need a surveyor who could manage the project on our behalf. Enter Phil Weston, from Neil Mason Associates.
One of the best decisions we made was to involve Phil. I can honestly say that without him, I dont think wed have made it to the end of the project. Hes worked tirelessly to keep things on track and has been completely committed to the project. Im sure hes saved us thousands of pounds by double checking the plans and project schedules, and being completely on top of the detailed spec. Its those small things that actually add up: when you realise that your new room has to have a further four sockets retro fitted to make it usable.
The build itself took 12 months: Sept 2011 to October 2012 and then a month or so of fit out.
Did you encounter any problems along the way?
No project of this size is ever straightforward! The first significant problem was that the land needed to be remediated. Toxins had leached into the ground and the groundwater supply so there was a substantial delay while that was rectified.
There was a long and drawn-out process for getting planning permission for the medical centre. It actually lasted a couple of years including, at the death, the planners announcing that there werent enough parking spaces. This necessitated a further negotiation with the developer to purchase more land, only for the planners to complain that there were now too many spaces! In the end, the extra space has been laid to grass and landscaping and will allow us to extend the building in the future should we need to.
Initially we had lots of difficulties getting the finance case signed off with the PCT. Our turning point with the PCT came when their Head of Finance realised that our new building would have space to accommodate a further 7,000 patients which meant a PCT planned development elsewhere in Northampton suddenly wasnt required, saving them money.
What are your top tips for other practices looking at a new build?
- Go and see as many comparable surgeries as you can.
- If you want to be able to say This is what we want, go away and build it and give us the keys when youre finished, then you need a design and build specialist. But if youre more prepared for a detailed hands on approach, find an experienced building surveyor early on to project manage the process and employ your architect and builders directly. Be aware though that if you do this, you need a good support team. There arent enough hours in the day to manage the project and do your day job.
- Talk to the PCT (or its successor) from an early stage to establish early on whether they are fully behind the project. Get them completely onside because otherwise it will be an uphill struggle
- Consider the finances carefully. Is the partnership going to pay for it outright? Will the bank actually lend you the money you need? Are you expecting the PCT to fully fund it? Are you looking at PFI or LIFT? Or are you planning to involve a specialist property investment company and lease the property from them?Whichever route you choose, you need explore all the options at a very early stage. We initially worked with a bank who were happy to lend us the money, but as the project progressed and the economy took a nose dive, the bank started to add more and more conditions, to the point where in the end they made it too difficult for us to go ahead. We ended up borrowing from Aviva, which turned out to be a lucky stroke for us – the team there has been excellent.
- Think through the actual move itself to ensure it runs smoothly. We set up a small team internally with specific responsibilities and they were absolutely great.
- Negotiate on everything! We found we could make vast savings because we were buying in bulk.
- Dont underestimate how long the project will last or how much of your time it will take up!
So, what would you do differently next time?
If I had my time again, I wouldnt got down the design/development route. I would probably employ Phil and do it direct. We needed Ashley Houses experience and knowledge, but knowing what I know now, Id be more willing to take direct control of the job myself.
Id also plan the purchasing of the equipment earlier. It seems a relatively easy job to purchase IT, phones, clinical equipment and furniture but I underestimated the time and effort needed to get suppliers to tender. Sorting the equipment earlier on would have taken a lot of pressure off.
Whats the feedback from patients and colleagues been like?
By and large the feedback has been very positive although the new location has made it harder for some patients who are now faced with a longer walk or a bus journey. The biggest criticism we have had is that there arent childrens toys in the waiting room, although this was a decision I took when we were thinking about cleanliness and CQC requirements. My colleagues all agree that the building works really well. You can plan the buildings design to your hearts content but until you actually get in and start using it, you can never be entirely sure.