Prepare schedules of accommodation

The number of generic, specialist and public spaces to be included in a primary and social care building will be determined by discussions during the briefing process and will be recorded on an accommodation schedule. This should be seen as an evolving tool that helps to:

• explain emerging ideas with stakeholders
• check that space is provided to accommodate required activities
• prepare costs for the project
• test the site's capacity for buildings and car parking
• inform potential stakeholders of their capital and revenue commitments

The schedule should be prepared using spreadsheet software, for which a simple method of version control must be devised.

Decisions on the number and size of rooms should be recorded on an accommodation schedule.

Room numbers will usually be determined by an analysis of existing activity patterns and an understanding of local pressures for service developments in particular disciplines. Other factors that will influence room numbers are changes in population and shifts in the local health economy, brought about by closures of primary care premises or policy implementation. The bext way to ensure that sufficient clinical rooms have been provided is to prepare a model timetable for the new facility, charting room numbers against activity, for each session during the week and month. It is also possible to undertake a tabletop analysis, based on a 'greenfield' scenario, or to check that site-specific assumptions are broadly within expected parameters. The accommodation schedule will go through many revisions, as part of an iterative process, before it is finalised. At key stages in the briefing and design process it will be used to:

• explain emerging ideas with stakeholders
• check activities against those recorded in organisational briefing documents
• prepare costs for the project
• test the site's capacity for buildings and car parking
• inform potential stakeholders of their capital and revenue commitments

Discussions about the content of the schedule will usually be led by the project manager, who will be responsible for drawing together and managing the process. As part of the briefing process, while putting together the accommodation schedule, a number of questions should be considered:

• How do existing premises cope with current throughput, and what is the quality of the patient experience?
• How will work practices alter in the new premises, and how will this affect waiting times and length of appointments?
• How do current standards compare with national guidelines? (The national target of one GP per 1800 patients, for example, may exceed current provision but it may be appropriate to design facilities to meet this level of service in the future.)
• How many of the different room types are required? (See also 'Generic, specialist and public spaces, and how to size them'.)
• What is the pattern of use for treatment rooms? (See also sections on 'Clinical activity spaces'.)
• How many WCs are required and how many people should waiting areas accommodate? (See also sections on 'Public spaces'.)

It is strongly recommended that the schedule is prepared using Microsoft Excel or similar, so that the bottom line implications of any decisions made can be easily assessed. The following points should be considered:

1. The accommodation schedule should be organised to reflect the clustering of the accommodation into public, clinical and staff spaces, with shared use of generic spaces wherever possible.
2. Rooms should be grouped in clusters of similar accommodation, and a numbering system used to identify each room and the cluster it sits within.
3. The name of each room should be entered, along with its size and the number of such rooms in each particular cluster.
4. The formula in the spreadsheet should be used to aggregate the total of these spaces (net area) on a separate sub-total line under each cluster.
5. An allowance should be made for circulation, internal walls, space for services, etc. This is typically 28%, although it may rise to 35% in clusters where patients are regularly moved on trolleys. This allowance should be expressed in a separate column, against each of the cluster sub-totals, to give GIAs.
6. The GIA for each cluster can be automatically added together, to give a GIA for the building.
7. The schedule should include the project name, date and revision number.

Typical accommodation for a building with three, six and nine consult/exam rooms are provided (see attachment). For each example, the accommodation is presented in distinct clusters ('essential dedicated', 'essential shared' and 'optional'). These clusters are split into public, clinical and staff spaces.