P3 Project for New Brampton Hospital: William Osler Health Centre

William Osler Health Centre's new hospital in Brampton will be the first Private-Public-Partnership (P3) hospital project in Ontario and the largest in Canada. Agnew Peckham has played a key and ongoing role in developing this project. We:

• helped develop the strategy to secure a P3 partner
• created the clinical output specification document for the project to set the functional criteria to which the new building would be planned
• continue to provide ongoing advice as a member of the Hospital's project compliance team monitoring the planning and design of the new facility

The new hospital will be a 608-bed regional hospital of about 1.2 million square feet. It will provide new and enhanced acute, rehabilitation, and mental health services in a state-of-the-art facility, including surgical suite and day surgery unit, cardiac procedures suite, regional dialysis, Level II NICU, high risk obstetrics, psychogeratric services, and others.

The William Osler Health Centre was formed when Ontario's Health Services Restructuring Commission amalgamated three community hospitals serving Brampton, Georgetown and Etobicoke. Plans to accommodate the new directions include the new P3 project hospital for Brampton, renovation of the current Brampton hospital for complex continuing care beds and ambulatory care services, and renovation of Etobicoke and Georgetown hospital campuses. In addition to providing a range of services within 1,300 beds (acute, mental health, rehabilitation and complex continuing care), William Osler Health Centre provides specialized regional services and an extensive list of outpatient services on all four sites.

Value to Client

The decision to procure the new Brampton Hospital through a pilot alternative finance model ensured that a new facility of this scale could be built. We worked closely with the MOHLTC and SuperBuild to ensure that the model we developed for the P3 project would:

• be supported by the MOHLTC and would be approved for implementation within very challenging timelines
• protect the quality of the clinical and functional environment, yet enable the Hospital to benefit from the potential innovations proposed by its private-sector partner

Our earlier assessment work enabled WOHC to

• evaluate the viability of its current Brampton facilities and the options to accommodate the future health service requirements of the community
• to make a well-informed decision to pursue a new hospital rather than redeveloping its current facility
• secure MOHLTC understanding of the longer-term advantages of developing a replacement new facility and securing its support for the project

Relevance for Other Planning

Our study of the redevelopment options for William Osler and the multi-year financial analysis furthered Agnew Peckham's appreciation of the value of business-case analysis in longer-term planning and the significance of the current gap between operations and capital in traditional planning.

The project also provided Agnew Peckham with a unique opportunity to gain valuable insight into alternative financing strategies (of which P3 is only one) and their impact on capital planning. Many Canadian hospitals require significant redevelopment to adapt effectively for different methods of delivery of care and technology. With a national shortfall in capital funds for infrastructure investment, alternative financing strategies offer creative solutions for hospitals.

Other Ongoing Assistance for William Osler Health Centre

Agnew Peckham has provided a range of services for all four WOHC sites, including:

• a clinical strategic plan
• master programs and master plans for all four sites
• functional programs for the new hospital and redevelopment at the other three sites
• leading the consulting team to develop a 25-year detailed financial analysis to provide the rationale for a new hospital for Brampton, including an extensive review of the existing facilities, and operating and capital implications for redevelopment
• detailed planning layouts for several departments at each site to assist in maintaining operations while the redevelopment plans are implemented
• strategic support and facilitation of working committees charged with the implementation of new care models, infectious diseases protocols, and proposals for new services and business partnerships.

These recent projects demonstrate Agnew Peckham's various areas of expertise. A more extensive summary of our experience is demonstrated in our projects completed since 1999.

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