A model framework of output specifications for hospital PPP/PFI projects

Purpose: Social infrastructure projects such as hospitals are increasingly being procured through public private partnerships (PPP). Due to their complex nature and very high operational requirements, these healthcare projects need special attention in developing robust output specifications at the early procurement stage. The purpose of this paper is to present a model framework of output specifications for adoption by public sector clients in jurisdictions planning to develop hospital PPP/PFI (Private Finance Initiative) projects. Design/methodology/approach: The research is based on an in-depth analysis of best practices from standard and sample project output specification documents used in Australia and the UK for completed hospital projects, reinforced by interviews with key stakeholders in the two countries. Findings: Drafting output specifications for hospital PPP projects is perceived to be a difficult and challenging task due to the complexity and changing needs brought about by evolving health policy, technology and medical advancement. The overarching target of preparing good output specification is to achieve value for money, innovation, risk transfer (including catering for changes), whole life asset performance and establishing performance criteria to link up with the payment mechanism. Practical/implications: The proposed framework is built up from public sector requirements on the physical asset, operational services provided by the private sector, with links to payment mechanism and performance evaluation. It also addresses change mechanism as well as conditions upon hand-over back to the public sector. Originality/value: Unlike traditional projects which are procured using prescriptive specifications, PPP/PFI projects are procured using performance based output specifications. This paper provides the foundation and a model framework for preparing comprehensive output specifications based on best practices in Australia and the UK, using hospital as the contextual background.