Essentia - Cost Management

EMERGENCY CARE PATHWAYS, ST THOMAS’ HOSPITAL Case Studies

The Programme

The Outcome

A multi-phased programme to improve and increase the A&E department at St Thomas’s hospital capacity to 140,000 patients a year, whilst remaining business as usual.

Having established an early and agreed cost model which had been informed by the risk management process in terms of contingency provision, our approach is on the pro-active management of cost. We have implemented a rigorous and robust change control procedure which includes a “real time” dashboard reporting being provided on a weekly basis so that at any given time the client has a clear and concise picture of commercial movement including the variations being considered and requiring approval, the level of remaining contingency, the risk profile, likely expenditure across the remaining works, mitigation strategies. We also continue to work closely with the Client and the wider project team to ensure that the lessons learnt from the Phase 1 Contract are integrated into Phases 2 - 5.

Our Unique Approach

The Cost Management team provided Scheme cost management services on this project, tracking affordability and forecasting across not only the construction costs, but also professional fees, non-works, equipment and information technology. This project came with challenges in obtaining detailed tender and construction status due to missing or inaccurate or restriction of access and backlog maintenance problems along with working restriction of a live clinical environment. Our approach was therefore to manage all of these issues within a strong and robust risk management process and that was fully informed by lessons learnt from other Trust projects, both the good and not so good. Having identified the risks, we ensured that the tender and contract documentation was robustly drafted to deal with the risks.

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