Developing a framework for whole of life costing in the national health service estate

The NHS represents a major industry sector, employing well over one million people and incurring gross expenditure of some £33.4bn. It is estimated that 20% of this is apportioned to management of the estate (NHS 1999). The demands for increased accountability and value for money are some of the fundamental reasons why NHS Trusts should move towards a more holistic view of investment appraisal and this paper reports on a research project that it aiming to address the major issues. In collaboration with the Royal Liverpool University NHS Trust, this research aims to develop a robust and accurate method of collating, analysing and disseminating vital WLC information. Central to the research is considering the estate in its holistic nature and not just the systematic consideration of conventional costs-in-use. The research aims to relate all the features of the estate, quantitative as well as qualitative, with the aim of developing a set of key performance indicators and risk assessment profiles to facilitate effective investment appraisal. The paper reports on the current stage of the research and the how it will be developed over the next year.