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POSITIVE OUTCOMES New market realities and how clients are responding 2010 | Volume # 02 In this volume Page 02 - Improve your business margins - An immediate approach Page 05 - Life after Lehmans: Joint ventures can work Page 08 - Could your supply chain be your secret weapon? Page 10 - The big utilities challenge Page 13 - Silver Linings: Corporate property, I.T and the cloud Page 15 - Medical makeover: 10 steps to a new kind of healthcare

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Page 1: Positive Outcomes 2

POSITIVE OUTCOMES New market realities and how clients are responding

2010 | Volume #02

In this volume

Page 02 - Improve your business margins - An immediate approachPage 05 - Life after Lehmans: Joint ventures can workPage 08 - Could your supply chain be your secret weapon? Page 10 - The big utilities challenge Page 13 - Silver Linings: Corporate property, I.T and the cloudPage 15 - Medical makeover: 10 steps to a new kind of healthcare

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Positive Outcomes: New market realities and how clients are responding

01

Welcome to POSITIVE OUTCOMES #02

New rules are written, replacing the old ones at speed but with an added expectation that new solutions will not only serve key project objectives, but also drive business and organisationalgrowth. They are seeking to improve and deliver the best possible outcomefrom investment expenditure.

For us, it is delivering these outcomes that drives our efforts: the achievement of clearly defined and desired results that our clients demand from their expenditure on built assets. We are experiencing an extraordinary increase in demand for help from clients who are seeking to improve what they do and beat the market.

In this second issue of Positive Outcomes, we take a close look at some of these challenges and the steps we’ve been taking to help our clients meet them. We’ve gathered experiences from a selection of sectors to offer you tested and measurably effective examples of how companies are facing up to new market challenges.

‘New market realities and how clients are responding’ also brings together the views of our industry - leading sector specialists on issues of real and pressing relevance to global business, as well as ongoing learnings from some 4,000 commissions we’re engaged on worldwide.

I hope you find the articles thought provoking, and would invite you to share your feedback with us by registering atecharris.com/positiveoutcomes, or bycontacting our sector specialists directlyusing the contact details at the end ofeach article.

Wishing you every success in thesechallenging times.

David Sparrow

Board Member - Client Solutions

‘The old rules no longer apply’ is a common enough phrase during times of change and we all appreciate that doing thesame thing will achieve the same result at best. However, in the aftermath of unprecedented market turbulence, it is abrave business that doesn’t work hard to understand how they must respond in order to survive and then succeed.

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Positive Outcomes: Improve your business margins - An immediate approach

IMPROVE YOUR BUSINESS MARGINS - AN IMMEDIATE APPROACH.

02

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Getting operational costs down:The aimIf you think about the aspects of your business - things like asset management and equipment maintenance - it’s easy to find a huge number of places where inefficient processes could have developed. And if you leave one inefficient system in place, the knock-on effect can lead to slower production, more labour hours for staff, and huge amounts of money being wasted on unnecessary activities.

Although these areas might seem too far down the system to make much of a difference, they can be crucial in helping you optimise your operational expenditure, the combination of lower quantum, higher efficiency and a reduction in rates. When assets are large and complicated, this balance can be difficult to achieve. Get it right, and you could cut your OPEX costs by up to 30%.

03

With oil barrel prices fluctuating and profits down, oil, gas andchemical companies need their assets to be as efficient and productive as they can be. But it’s not always the big business changes that make the most immediate difference. In fact, moreand more companies are finding that the best opportunities torapidly improve their business margins lie within identifying and‘cashing in’ the low hanging opportunities found withinoperational and business processes at the work place.

A good start; do you knowwhere you stand?A short diagnostic review using a qualitative and quantitative ‘3 cost pillar`study is where most companies begin.It tells you where you could make easy,practical improvements to your siteprocesses and how much money you’relikely to save.

In order to visualise the areas of potential improvement, the next step would be touse a gap analysis to acknowledge whereyou are in terms of your asset, business and peer group and identifying opportunitiesfor improvement.

Of course, to make the most of these opportunities, you need to put long-term changes in place. But by highlighting andimplementing these ‘quick-fix’ solutionscompanies have made immediatesubstantial savings - some of over$50 million on OPEX costs. Mostly, savings can be achieved by improvingsite maintenance approaches - fromplanning and scheduling all the waythrough to execution.

Depending on the size of the asset a1% increase in the productivity levelcould represent a saving of over$1 million a year. Mark Howard

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Positive Outcomes: Improve your business margins - An immediate approach

Cost pillar scores are normalised to a best practice score of 5

Illustrates the gap betweenas-is and to-be for each of the3 pillars of cost

TO

BE

4.5

4.0

3.5

3.0

2.5

2.0

1.5

1.0

0.5

0Quantum Efficiency Rate

BE

STP

RA

CT

ICE

AS

IS

‘Time on Tool’ - the smart method There are a number of techniques which can be implemented. A simple wayto identify inefficiency is a ‘wastewalk’ - literally walking a site, notinganything that doesn’t seem as efficient as it could be.

A more advanced technique is a system and methodology developed to assess productivity called the `Time on Tool` method. It measures achieved work against planned work, to see where efficiency is falling short. By using this technique, companies can identify where work processes aren’t running smoothly - particularly between the planning and implementation stages.

Putting the theory into practiceOnce you’ve seen where systems and processes are inefficient, the next stage is to re-engineer them to increase productivity. It can also be a good chance to see where a lack of communication between departments is causing inefficiency - andto put new systems in place to encourageyour planners to talk to the people onthe ground.

Some companies take the Time on Toolmethod one step further, setting productivity targets for individual areas, like mechanical pipe work, scaffolding, insulation, electrical, instrumentation, static and rotating equipment. Using Time on Tool shows what should be possible.It’s then up to managers to set incentives for suppliers and contractors to make sure they reach those levels of efficiency.

For more information on how to improvebusiness margins please contact:

Mark HowardHead of Oil, Gas & Chemicals

e [email protected]

Or visit our website:

echarris.com/oilandgas

04

Help’s at handMost businesses that turn to us for help in these areas are running cost efficiency rates of 30 - 40%. And they’re not unusual. We can help your business identify where it’s losing money, then find real, practical solutions to improve your margins.

Depending on the size of the asset a 1%increase in the productivity level couldrepresent a saving of over $1 millionper year.

In the past, we’ve helped with assets of allsizes, and in all areas - from oil and gas tomanufacturing, utilities to the aviation sectors and we’ve set ‘best in class’ productivity levels for Europe, the Far East, USA and Middle East.

30%Get it right and you could cut OPEX costs by up to:

Cost Pillar Overview

Illustrates the gap between as-is andto-be for each of the 3 pillars of cost.

Cost pillar scores are normalised to abest practice score of 5.

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Positive Outcomes: Life after Lehmans: Joint ventures can work

LIFE AFTER LEHMANS: JOINT VENTURES CAN WORK.

05

Just a few short years ago, real estate joint ventures inhigh-growth markets looked like the holy grail for gettingaccess to market and high returns, fast. Speed to marketwas everything - all too often, at the expense ofdue diligence...

Then Lehman Brothers collapsed and turned the financial world on its head. The impact on the JV partnerships meant disagreements about contributing equityagainst a now flawed business plan.This meant the international fundswere not able to deliver the high capitalreturns anticipated. According to ourresearch, 75% of the real estate investor JV partnerships in the pre-Lehmaninvestor days, did not deliver the promisedreturns - and it’s a similar story for otherasset classes.

Despite that, JVs will remain critical for different reasons. They are a key route to sourcing assets for investors and for developing new market growth for enterprises ( just ask the international real estate funds sourcing deals in China!). Despite the evidence of their previous failings, we believe JVs can still deliver the necessary returns. This is by focusing on the assets during critical steps at every phase of the process.

Page 8: Positive Outcomes 2

The three phasesYou can split the process up into three distinct phases: asset planning, asset development and asset management. In each phase, the chances of success go up if the partners can agree on a number of key steps. In fact, our research suggests that almost half of JVs that fail, do so because one of these stages is overlooked.

Phase one: asset planning

Phase one is about laying the right foundations; from picking the right partner, market and asset class, to agreeing on a business plan, deciding on accepted levels of risk and ultimately - signing on the dotted line. These are some of the most important activities, particularly when it comes to analysing the sensitivity of your revenue streams and management strategies. Our advice is that this ought to be done by someone, without a financial or emotional investment in the venture.

The risk is that overly long deliberations may see you missing out on the mostexceptional returns. Today, taking anymore than 6 months to get your partnership off the ground is too long.

Phase two: asset development

The second phase is all about making sure that your assets are delivered inline with your business plan and risk levels, a process that involves setting procurement strategies and milestones,to the agreement of project control and sales plans. It’s also about making sure both partners’ needs are beingmet, and resolving any potential conflictsor stumbling blocks.

Phase three: asset management

As the returns start to come in, you’ll needto agree on either an exit or hold strategy to make sure you get the most value fromyour partnership. Both partners will needto agree on criteria to know the right time to move on from the outset.

Positive Outcomes: Life after Lehmans: Joint ventures can work

06

In each phase, the overall chances of success go up if the partners can agree on a number of key steps.

PHASE TWO - ASSET DEVELOPMENT

Asset Expertise

Project Controls

IRR Target

TeamAsset Return Business Plan

Market Solutions

Asset Type PoliticalFit

Key Assumptions

Finance Source

JV Partner Remuneration

Share Structure of JV

Sensitivity of Revenue Streams

Operations Model

Exit Plan Restructure Capital

Constructor Guarantees

Delivery Plan

Procurement Strategy

Tenant/BuyerNeeds

Capability Gap Review

Defined Milestones

Target Partner

PHASE ONE - ASSET PLAN

FUND INVESTMENT RETURN NEED

PHASE THREE - ASSET MANAGEMENT

JV AGREEMENT

EXPECTED RETURNS

Sales Plan

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07

To discuss how to maximise jointventures please contact:

Matthew CuttsHead of Lenders & Investors

e [email protected]

Or visit our website:

echarris.com/lendersandinvestors

Putting theory into practiceOne of our investment bank clients recently acquired a developer in an emerging Central Eastern European (CEE) market. Their goal was to transform it from a politically well-connected but immature local player to a ‘best in class’ regional developer in 18 months.

We started by determining the ideal outcome and working our way backwards through each stage. We looked at the bestperforming developers in the CEE market -their team, structure and performance. Then we used those benchmarks to workout the fine details of the JV agreement.After the agreement was signed, we workedwith the bank’s new partner to train uptheir staff and bring them up to ‘best inclass’ standards.

Today, the developer is renowned for beingthe best in the region. And the investmentbank is reporting IRR returns of morethan 20%, all of which is real proof that although there is still life after Lehmans for JVs, their success rests on diligence atevery step.

75%of the real estate investor JV partnerships did notdeliver the promised returns

An investment bank is reporting IRR returns of more than 20%. Matthew Cutts

Page 10: Positive Outcomes 2

Positive Outcomes: Could your supply chain be your secret weapon?

COULD YOUR SUPPLY CHAIN BE YOUR SECRET WEAPON?

Retailers and manufacturers have already discovered how a leaner and meaner supply chain can give them the critical edge over their competitors, whether it’s by cutting costs, improving time-to-market or speeding up response times. The same advantage exists for all kinds of organisations, from developers to energy companies, but it is missed by many.

Reaping the rewardsFor retailers, smarter packaging helps tocut handling, storage and shipping costs(and keeps their increasingly eco-consciouscustomers and shareholders happy).

For manufacturers, integrated planning canmake production smoother, which in turnmeans there’s no need to keep stock asa safety net.

There are other kinds of businesses that canalso benefit from a more proactive approachto managing their supply chain. Developersfor example, can challenge their suppliers to do things like improve delivery time or cut out defects and waste. Financial institutions can team up with service providers to deliver more services with fewer in-house costs, and some aviation companies have saved up to 50% on the cost of materials by cutting out the middleman.

The practicalities may be different for everysector, but the overall message is clear. Taking control of your supply chain can help your business perform better by making it more agile and competitive.

08

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Getting the right blendMost companies focus on certain parts of their supply chain over others. Asset-rich businesses (like oil and gas or utilities) tend to focus on cutting procurement costs - while neglecting the opportunity to understand the Total Cost of Operation (the Capex and Opex lifecycle). Or they focus on the optimisation of asset performance including maintenance, with longer-term or less obvious consequences. They also focus on the top tier of suppliers, turning a blind eye to the lower levels of the supply chain which could account for up to 70% of total procurement costs. This ‘tunnel vision’ is one of the reasons we see so many of these businesses outsource their operations, only to bring them back in-house within a few years.

First stepsA Forensic Cost Analysis (FCA) is a good starting point. It’s an easy way to pick up on any overlooked costs in your supply chain, so you can find ways to fix them.

It is also worth remembering that a responsive supply chain is built oncollaboration, transparency andcost-efficiency.

There are four key ways to make your supply chain more responsive:

1 Strategic Alignment: Making sure your supply chain and overall business strategy match up

2 Integrated Planning: Using consistent planning processes across every part of your business

3 Improved Processes: Regular reviews and ongoing improvement

4 Managed Complexity: Delivering more for your customers without complicating things behind-the-scenes.

To find out how to make the most ofa supply chain, please contact:

Adam SuttonGroup Head of Service - Strategy & Transformation

e [email protected]

Or visit our website:

echarris.com

09

Putting theory into practiceAfter casting a critical eye over their supplychain, a UK steel company decided tofocus on their coated steel building products.

They realised that their processes were geared towards clients with continual demand, rather than ‘spot’ customers with less predictable needs. In response they came up with a new short lead-timeproduction process, so now the spotcustomers can still get the range of colours and coatings they want at short notice - and track the whole order in real-time.Simpler production and better service.

Or there’s the example of a major developer in the Middle East that was using three different contractors for concrete delivery. All three contractors were getting their concrete from the same supplier - but there was up to 50% difference in their delivery times, unlike their biggest rival, who’d stolen a march on their competitors by putting well-defined supplier management and metrics in place.

We can helpIn our experience, most businesses come up with initiatives to try and improve their supply chain. But, all too often, they’re centred too heavily on procurement, at the expense of other essential areas. We can help you strike the right balance to suit your own business plans, sector and markets.

A responsive supply chain is built oncollaboration, transparency andcost-efficiency. Adam Sutton

Page 12: Positive Outcomes 2

THE BIG UTILITIES CHALLENGE. The UK utility regulators have set out the industry’s challenges for the next five years. As well as improving efficiency - something the regulators always demand - utility companies must now focus on three key areas.

Positive Outcomes: The big utilities challenge

These areas are;

1 Capital investment levels

2 Operation costs

3 Prescribed WACC (Weighted Average Cost of Capital).

It’s a huge ask for any utility company - even the frontier performers. Is it possibleto live up to the standards the regulatorsset, while still achieving the efficiencysavings demanded?

In recent years the industry has seen new and innovative business arrangements which have helped improve efficiency by between 5 and 15%. But if it’s to catch up with other industries, individual utility companies need to adopt new business models and smarter ways of working.

The view from other industriesTo see what exceptional performance looks like, many companies are now turning to national benchmarks. Whilst those benchmarks show that some world-class utility companies are working at high levels of efficiency, what’s surprising is the huge variation between the upper and lower quartiles.

In fact, based on our estimations, the difference between the capital delivery performance of companies in the upper and lower quartiles could be as much as 30%. This suggests that many companies still have a long way to go and even companies with a good track record need to work harder to catch up with the industry leaders.

When you compare the utilities industry with other sectors like oil and gas and retail, the opportunity to improve performance levels becomes even clearer. Companies in these industries consistently perform much higher than their equivalents in the utilities industry.

The Middle East; an even bigger opportunity to improveLooming water shortages, coupled with high levels of water consumption, mean governments in the Middle East have needed to commit huge amounts of money to water projects.

In the United Arab Emirates - which has one of the highest demands for water per capita - governments are poised to invest over $60 billion in water projects over the next five years in everything from desalination to wastewater treatment. In Abu Dhabi, where population growth is expected to bring water shortages as soon as 2012, the government investment in utility projects is unprecedented.

With such huge projects comes huge responsibility. How can those governments make sure each project runs on time and on budget in the most efficient way possible? Although each country faces its own challenges, most are now realising that they can’t afford to let efficiency slip at such an important time.

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The ingredients for successWherever utility companies are based, and whatever their specific challenges, they are all working towards one goal: to give people safe and available utilities at a fair price. To do this, in a sustainable and consistent way, companies must use a successful delivery model.

In other sectors, organisations have achieved this by adopting a commercial approach to programme management.

30%is the difference between the capital delivery performance of

companies in the upper

and lower quartiles

In brief, this means:

1 Creating robust programme delivery vehicles that are able to connect up multiple projects whilst being fully aligned to strategic objectives

2 Optimising the blend of different delivery partners to ensure they are working towards the same goal

3 Securing the right balance between client control and collaboration in the delivery model

4 Successfully balancing resource capacity and capability between the client and delivery providers so that ‘man marking’ and ‘cost to serve’ are reduced

5 Committing time to properly transition clients and delivery providers to new programme models

6 Making sure effective programme management is in place, from the start, to afford the visibility and appropriate control of performance from the outset.

Page 14: Positive Outcomes 2

Positive Outcomes: The big utilities challenge

Achieve the performance differenceBy adopting a portfolio mindset, utilitycompanies will optimally manage pan-organisational risks and interdependencies through an environment of strongercorporate governance. This is achievedby clearly defined accountability, consistent delivery and stakeholder confidence and maximum efficiency in the supply chain.

Delivery of complex programmes of work, in a highly multi-faceted industry, is challenging at the best of times. A high-performing commercially focused programme management team can be a catalyst for developing improved business performance. Therefore, getting the strategic programme management approach right - before the start of the investment - is key. Not only will this ensure improved efficiency, certainty, speed and control of the overall programme but there is also potential to generate significant savings.

Achieving these efficiency gains will enable utility organisations to become world-classand aid the delivery of multi-billion dollarexpenditure programmes acrossinternational boundaries.

At EC Harris we enable ‘best in class’ delivery of expenditure programmes through performance transformation.

For more information on our work in the Utilities sector, please contact

Terry PovallHead of Utilities

e [email protected]

Or visit our website:

echarris.com/utilities

12

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£0.81

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10 UK UTILITY COMPANIES

What is the £ in the ground worth in the Utility sector?

When you compare the utilities industrywith other sectors, the opportunity toimprove performance levels becomeseven clearer. Terry Povall

Page 15: Positive Outcomes 2

From world wars to booms and busts, business has always had to reinvent itself to respond to major shifts in the wider world. The latest global recession is no different.

Businesses of all shapes, sizes and sectors need toembrace new business models if they’re to survive the latest financial storm.Real estate is one area that’s under more pressurethan most.

In the new economy, it’s the ‘real estate -lite’ companies like Google and Amazonwho’ve rocketed to the top of the tree,with traditional offices and shopsbecoming increasingly obsolete. The rise of mobile or ‘cloud’ computing is afurther development helping occupiersto make the shift away from the traditionalbricks and mortar workplace.

The difference is clear. Those who adapt have the strongest chance of survival. As usual, the spoils will go to those who embrace these opportunities first.

Positive Outcomes: Silver Linings: Corporate property, I.T and the cloud

SILVER LININGS: CORPORATE PROPERTY, I.T AND THE CLOUD.

13

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14

Positive Outcomes: Silver Linings: Corporate property, I.T and the cloud

For more information on our approach to Corporate Real Estate please contact:

Oliver JonesHead of Corporate Real Estate

e [email protected]

Or visit our website:

echarris.com/cre

New challengesAfter two years of economic turmoil, businesses of all kinds are under mounting pressure to ‘trim the fat’. They need to findways to cut costs, improve efficiency androot out waste of any kind.

Most face the same four big challenges:

1 Agility: Being ready to react to changes in the market right away

2 Cost: Spending less and streamlining more

3 Risk: Spotting, mitigating and managing threats to profits, business models or reputation

4 Liquidity: Freeing up cash for core business activities or contingency.

Today, businesses need the freedom andflexibility to enter and exit new markets atshort notice. They’re less keen to put theirmoney into illiquid fixed assets whenalternative solutions that do not consumecash are available.

True valueThe value of property for business can no longer be measured in relation to square metres alone. All corporate real estate professionals - advisors, project and property managers - need to make a paradigm shift. They need to consider their clients’ business needs, not just the market value or apparent real estate-related costsor returns. In the short term, for example, a business might be keen to shed excess property from its portfolio but needs to have future expansion options retained tocope with quick growth. Similarly, on a commercial level, outsourcing can often be an appealing short term fix, but the wider impact on the business has to be addressed in structuring any long term deals.

The good news is that there are now plenty of tried and tested options that support achieving the balance between occupancy costs and productivity. From serviced offices, to ‘property operator’

partnerships, to total property outsourcing. There is no one right answer, the skill lies in blending these solutions to create what’s right for a particular business.

Fresh focusIt’s time for a step change. Not long ago,it was the norm to have long term, fixedlocations in static markets with a standardworking model. Today, businesses need a blend of short and long term locations, in fast and slow-moving markets, with people working dynamically and itinerantly - beyond the four walls of the traditional office.

For corporate real estate professionals, it’s a ‘do or die’ moment. It’s time to embrace the new world order, or be left behind.

In the new economy, it’s the ‘real estate-lite’ companies like Google and Amazon who’ve rocketed to the top.Oliver Jones

Page 17: Positive Outcomes 2

MEDICAL MAKEOVER: 10 STEPS TO A NEW KIND OF HEALTHCARE. Governments the world over are pouring money into healthcare,with many already spending more than 10% of their GDP onits delivery. In the USA, it’s moving towards 20% and thedemand will only grow, as people live longer and expectationsof the quality of care increase.

Healthcare is not just one of the world’s largest industries, it’s also one of the biggest employers and a sector that touches everyone at some point in their lives. So the pressure to squeeze maximum value from minimal resources - whilst improving patient outcomes - is tremendous. There isa universal need to unlock value andenable opportunity within the healthcarearena. Before we look at how this can be done, let’s look at some of the reasons this is such a major and pressing challenge:

1 Longer lives, more healthcare

With new drugs and technology giving critically ill people longer to live, the average life expectancy is nearly double what it was 150 years ago. This means the healthcare industry is having to provide care for people for many more years.

2 Higher expectations

The internet has made people more awareof what technology and treatment is

available - putting greater pressure on health systems to provide up-to-the-minute products.

3 Unsustainable spending

Given current trends and the way moneyis being spent in the sector, healthcare schemes will need 35% more funding inreal terms by 2050. That would mean some economies having to deliver growthat somewhere between 3.5 and 6% of theirGDP, which is clearly unrealistic. Historytells us that straightforward investmentisn’t enough, with too many examples ofincreased expenditure failing to deliverbetter outcomes.

What is needed is a new model forhealthcare that makes better use of all the available technology, talent and space to create entirely new, more efficient ways of working. Only then, will the money being spent make a difference.

Ten steps to efficient healthcareFrom our research, we’ve come up with tensteps for healthcare organisations to follow to become more efficient. We realise thatsome of these are not easy to introduce, but all are necessary if healthcare systemsare to change.

Step one: streamline clinicalcare pathways

This means thinking about which services are being offered, then making sure patients are moving through those services quickly and efficiently. If patients are getting caught up in lengthy processes, or going through the same process in each department they visit, then something needs to change.

Positive Outcomes: Medical makeover: 10 steps to a new kind of healthcare

15

To avoid requiring 35% more investment into developed health systems, productivity improvements are paramount.

Future health leaders will ensure value fortheir organisations by undertaking strategicasset reviews across staff, FM, estates and all processes to enable opportunity andmaximise returns. Conor Ellis

Page 18: Positive Outcomes 2

For the final six steps and EC Harris’track record of delivering betterhealthcare outcomes more efficiently,contact:

Conor EllisHead of Health

e [email protected]

Or visit our website:

echarris.com/health

Simulation models can help identify waysof streamlining pathways and I.T systems,and can help build up a strong businesscase for change.

Step two: become more patient-focused

Just like retailers, healthcare organisations need to start thinking more about whatpatients need and want, so they can besure they’re spending their money in theright places.

For example, hospitals in USA, Germany and Sweden, have responded to growing expectations from patients with systems like e-booking. They’ve also redesigned patient and staff areas, and made sure working environments are low-risk.

Step three: good governance

Health is a high-risk industry. Poorly designed care pathways, unproven clinical techniques, lack of training and supervision, poor FM performance, negligence and bad sanitation, cost tens of thousands of lives every year.

All healthcare providers and commissioners need to understand how they measure up to national and international benchmarks. For example, our research shows that by adopting commercial management techniques the NHS could raise the efficiency of its properties by 7% plus.

Positive Outcomes: Medical makeover: 10 steps to a new kind of healthcare

16

Governments are pouring money into healthcare.Are they doing it efficiently?

There is a 30% difference in performance levels between upper and lower quartiles

10.8%10.1% 9.8% 8.9%

11%10.4%

10.1% 8.9%

9.8%

9.2%

9.1%9.3%

16% 9.4%

10.4%

9.4The USA is the #1 in Health Spend - at 16% of GDP

11%10.1% 8.9%

9.1%9.3%

16% 9.4%

Healthcare spend in 2009 as % of GDP

Step four: operational performance

Every healthcare provider needs to squeeze the most out of their assets to deliver against the efficiency agenda, but let’s not lose sight of the carbon footprint too. Many health organisations could unlock millions by making better use of their property, leading to dramatic operating cost reductions over the long term.

For example, the Karolinksa Clinic in Sweden has a new sustainable building that they can easily adjust over the next 30 to 40 years to cope with changes in healthcare. With standardisation of rooms, extra service risers and deep ceiling voids, there’s plenty of ready space to change and install new equipment as it comes onto the market. Building this flexibility into the fabric of the place will save millions of pounds in the future.

The other steps to consider are;

5 I.T and equipment strategies

6 Service and estate strategy review

7 Review FM services and supply chain

8 Change of land and estate options

9 Multi-use of space

10 Sustainability implementation.

Source: OECD

Page 19: Positive Outcomes 2

Consumer - centric experienceHealthcare needs to become much more consumer centric. It could benefit from following the lead of the retail industry; using I.T as one of the enablers and reconsidering clinical processes to be more sensitive to clients’ needs.

SustainabilityA sustainability audit. Overall, hospitals have to reduce their carbon footprint and improve energy efficiency. Not only are there a number of valuable tool kits, but external benchmarking should drive sustainable services and lower estates and operating costs.

Good governance and minimising riskOrganisational and Statutory Governance - An essential part of any review is to use data and an external review, to drive theprovision of high quality and riskfree environments for both patientsand staff.

17

Capacity reviewDemand and capacity review, underpinned by benchmarking against peer group best practice which can be evidenced by simulations and ‘what if ’ scenario modelling. The review will also cover benchmarking productivity of all staffing groups.

Page 20: Positive Outcomes 2

Positive Outcomes | 2010 | Volume #02

SECTOR OVERVIEW

For more information contact: [email protected]

Energy & Manufacturing

Manufacturing

Nuclear

Power Distribution

Power Generation

Renewable Energy

Property

Corporate Real Estate

Commercial Development

Hotels, Leisure & Entertainment

Lenders & Investors

Residential Private

Retail

Oil, Gas & Chemicals

Chemicals

Oil & Gas

Transportation

Aviation

Highways

Rail

Public

Central Government

Education & Children’s Services

Health

Local Government & Communities

Regeneration & Growth

Residential Affordable

Utilities

Waste Management

Water

WORLDWIDE FEE TURNOVERAll amounts shown in GBP(£).

245m2010

306m2009

250m2008

197m2007

174m2006

161m2005

Page 21: Positive Outcomes 2

DELIVERING THE BEST POSSIBLE OUTCOME FROM MONEY SPENT ON BUILT ASSETS

Asset Performance and Facilities Management

- Asset Management- Asset and Facilities Management Consultancy- Asset Portfolio Management- Building Surveying and Technical Due Diligence- Energy, Sustainability and Environment - Facilities Engineering- Health, Safety and Statutory Compliance- Property and Estates Management- Shutdown and Turnaround Management Operation- Total FM Delivery.

Asset Investment and Finance

- Development Management- Financial Modelling - Investment Management- Structured Finance including PPP- Technical Investment Risk Management.

Strategy and Transformation

- Asset Strategy- Forensic Cost Assurance- Healthcare Planning- I.T Solutions - Organisation, People and Capability Development- Performance and Change Management- Strategic Asset Maintenance- Supply Chain Organisation and Management- Workplace Solutions.

Programme and Project Management

- Design Management and Assurance- Employer’s Agent and Contract Administration- Forensic Programme Analysis - Logistics Management- Operational Readiness- Planning and Scheduling- Programme / Project Controls- Programme Strategy- Project and Portfolio Management- Project Management Construction- Technical Site Supervision.

Cost, Commercial and Risk Management

- Commercial Management and Quantity Surveying - Cost and Value Management- Dispute Avoidance, Resolution and Expert Witness- Strategic Procurement and Contract Strategy- Risk and Opportunity Management- Taxation and Capital Allowances- Whole Life Costing.

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Owned Entities

Areas covered through Affiliates and Client Project Locations

Owned Entities

Europe

CroatiaCzech RepublicEnglandFranceGermanyHungary

IrelandItalyLatviaNorthern IrelandPolandPortugalRomania RussiaScotland

SerbiaSlovak RepublicSpainThe NetherlandsTurkeyWales

Asia

ChinaHong KongIndia IndonesiaMacauSingaporeTaiwan Thailand

Map View

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Asia

ChinaHong KongIndia IndonesiaMacauSingaporeTaiwan Thailand

Middle East

Abu DhabiDubaiKingdom of Saudi ArabiaQatar

North Africa

Egypt

USA

AtlantaHoustonNew York

Affiliates

South Africa South Korea

Current Project Locations

AustraliaAustriaAzerbaijanBahrainBelgiumBrazilBulgaria

CanadaDenmarkFinlandGibraltarGreeceJapanLibyaMoroccoOman

PhilippinesSwedenSyriaTrinidad and TobagoTunisiaUkraine

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