A new way to care – and a new way to build

The guiding principle of NKS, Stockholm's new world-leading university hospital, is 'The Patient in Focus.' Highly specialised and specialised healthcare, research and education will be integrated in this 320,000 m² state-of-the-art building. The hospital will be funded, built and administered as a PPP (public-private partnership).

NKS, the world's largest PPP hospital, will be located in Solna, near Stockholm, Sweden, where construction started just a few weeks ago; the hospital will be fully complete by autumn 2017. This demanding schedule has a high rate of production, with a workplace demanding extensive logistics to avoid disrupting ongoing activities or the surrounding infrastructure. In addition, NKS will be built and operated with the minimum possible environmental impact. The objective is a sustainable, climate-neutral university hospital. This represents a major challenge for project manager Swedish Hospital Partners, builder Skanska Healthcare and FM provider Coor, who have been assigned to design, build, manage and operate the new hospital until 2040.

Mats Abrahamsson, Technical Manager of NKS, sees clear benefits in outsourcing the hospital's construction and operation:
"The incentive lies in building a robust hospital that lasts. Because the project manager (who will be arranging funding and implementation) is taking responsibility and assuming all the risk for this hospital for a 30-year period, it has to think intelligently and sustainably right back in the project management phase. It also has thorough knowledge of this."

The reference project the Greater Stockholm health authority (SLL) set up for NKS had some residual problems with its logistics solution.
"The private partners resolved this problem for us. Coor produced a complex solution based on its experience and specialist competence."

When NKS is under construction, infrastructure will be built in to facilitate interaction between healthcare, research and education. This will bring new know-how and medical advances into use faster, benefiting the most severely ill patients. This sets challenges for new, unconventional solutions for the future university hospital's organisational resources, logistics and physical environment.

"NKS sets high standards on flexibility and interchangeability. The hospital and its premises must be easily realigned from one activity to another," comments Mats.

For patients and their relatives, this means safe environments with a human touch. Overnight patients will get private rooms with a shower and toilet, and a space for their relatives. Single rooms improve patient integrity and safety through reduced infection risk. The hospital will be divided between public and professional zones so patients avoid being transported in beds in lifts and corridors, where there may be a lot of personal traffic.

Here at SLL, it's important that we ensure that all our functional requirements are satisfied. There have been several hundred people with different competencies involved from our side right from the start, especially in healthcare, construction and management. We also brought in consultants from the UK, where PPPs are a common way of funding and building, who supported this long tendering procedure," added Mats.

Because this is a PPP project, the health authority will be purchasing a functional hospital with all its FM services—providing everything works as agreed.

"We've set high functional standards and acceptance criteria, but basically, we won't pay for anything we can't use. This is one way of ensuring we get a robust hospital and that the desired level of service is delivered right through the contract term."

NKS - key facts

• The hospital will be providing highly specialised and specialised healthcare focusing on effective patient flows, high patient safety and single rooms for overnight patients' plus more interaction between healthcare, research and education.
• 9-10 floors, helicopter pad and 2 to 3 sub-surface levels with staff parking and goods reception.
• A total of 600 beds, of which 130 intensive care and intermediary care beds and 75 post-op beds. An additional 100 outpatient beds and 100 overnight beds in a patient hotel.
• 180 consulting rooms.
• 1,600-1,800 patient visits a day, of which 10-20% are emergencies.
• 6,000 employees plus some 1,000 researchers and students.
• Construction cost of SEK 14.5 bn, excluding operational equipment.
• NKS was tendered in a PPP, with a project manager, Swedish Hospital Partners (a 50:50 joint venture between Skanska and Innisfree) project managing, building, funding, maintaining and running the building for 30 years.