ABSTRACT
The constant restructuring has an impact on the financial planning for development, which creates problems for both the healthcare provider and architects wanting to work within it. Apart from the Care Quality Commission, more pressure on hospital to improve their physical environments comes from the Patient-Led Assessments of the Care Environment scores. The work that needs to be done in order to revive healthcare estates is significant and complex. Each hospital has its own vagaries of estate-related costs. The most significant constraint on capital expenditure is the overall capital departmental expenditure limit on healthcare trusts. Allyson Pollock, Director of the Institute of Health and Society at Newcastle University, believes that there are no winners in private finance initiative (PFI) for the healthcare providers or the people, except the bankers and shareholders. CABE has pointed out that ideally a ‘good’ PFI contract could create an incentive for good design and construction, because the building must be maintained for a long time.
