Private Finance Initiative

PFI is the public building procurement policy introduced by the Government in 1993. Private companies have always built NHS Hospitals, however, under PFI, a private consortia (funder, building contractor, architect and facilities management company) finance, build and then service and maintain a new hospital in return for an agreed annual charge from the NHS for both the use of the building and the provision of non-clinical services over a period of 25 years or more.

The challenge for the NHS is to use this extensive building programme to raise the quality of healthcare design and architecture. It is a challenge widely supported by a number of key organisations: The Department of Health, NHS Estates, The Modernization Agency, The NHS Confederation, The Medical Architecture Research Unit, The Commission for Architecture and The Built Environment, The Construction Industry Council, The Royal Institute of British Architects, The Kings Fund and The Nuffield Trust among others.

There are strong arguments for incorporating commissioned artworks into PFI schemes. Achieving Excellence Design Evaluation Toolkit (AEDET) developed by The Centre for Healthcare Design, recommends that design be evaluated under three basic headings: Functionality, Excellence and Impact. The arts have a significant contribution to make in creating impact. In particular, the arts can be used to:

Create local distinctiveness
Ensure that the built environment reflects individual human scale
Meet the spiritual and emotional needs of patients and staff
Support and improve wayfinding, for example by creating landmarks at entrances and in key public spaces
Enhance landscaping and interior design through creative use of materials and finishes
Enhance the prestige and reputation of the NHS Trust during the redevelopment process

Extract from The Art of Good Health: A Practical Handbook by Jane Willis, Published by NHS Estates