College of Health Sciences (Nelson R Mandela School

COLLEGE OF HEALTH SCIENCES
(NELSON R MANDELA SCHOOL OF MEDICINE &
ASSOCIATED HEALTH SCIENCES)
AND THE
NEW CENTRAL HOSPITAL FACILITY
(KING EDWARD VIII AND INKOSI ALBERT LUTHULI CENTRAL
HOSPITALS)
KWAZULU-NATAL
PENULTIMATE DOCUMENT
5 th September 2012

Acknowledgements
The following staff and departments contributed to this document:
- The National Department of Health
- The KwaZulu Natal Department of Health
- CSIR
- King Edward VIII Hospital
- Inkosi Albert Luthuli Central Hospital
- UKZN- College of Heath Sciences
- Nelson R Mandela School of Medicine
- Transaction Advisor - Technical and Clinical
Reference Documents
- The KwaZulu Department of Health Provincial Strategic Transformation Plan 2010-2020
- The King Edward VIII Business Case (2009)
- Modernization of Tertiary Services
- Government Gazette of the second of March 2012, section 90 of the National Health Act of
2003
2

CONTENTS
1. INTRODUCTION ............................................................................................................................. 6
2. STRATEGIC OBJECTIVES ............................................................................................................ 7
3. INSTITUTIONAL ANALYSIS : EXISTING FACILITIES ............................................................... 10
4. PROPOSAL FOR THE NEW KING EDWARD VIII CENTRAL HOSPITAL AND COLLEGE OF
HEALTH SCIENCES CAMPUS (NELSON R MANDELA SCHOOL OF MEDICINE AND
ASSOCIATED HEALTH SCIENCES): .......................................................................................... 17
5. BED CALCULATION FOR TERTIARY AND CENTRAL BEDS (KZN DOH STP 2010-2020) ...... 20
6. BED DISTRIBUTION ..................................................................................................................... 22
7. NEW ACADEMIC COMPLEX: KING EDWARD VIII CENTRAL HOSPITAL AND THE COLLEGE
OF HEALTH SCIENCES ............................................................................................................... 25
7.1. THE NEW KING EDWARD VIII CENTRAL HOSPITAL................................................ 26
8. THE COLLEGE OF HEALTH SCIENCES CAMPUS .................................................................... 35
9. ACADEMIC COMPLEX: FINANCIAL IMPLICATIONS ................................................................ 41
9.1. NEW KING EDWARD VIII CENTRAL HOSPITAL ........................................................ 41
9.2. INKOSI ALBERT LUTHULI CENTRAL HOSPITAL ...................................................... 42
9.3. COLLEGE OF HEALTH SCIENCES CAMPUS ............................................................ 43
10. CONCLUSION............................................................................................................................... 44
ANNEXURE A: EXECUTIVE SUMMARY
1. INTRODUCTION ............................................................................................................................. 3
2. PROPOSAL FOR THE NEW ACADEMIC COMPLEX: NEW KING EDWARD VIII CENTRAL
HOSPITAL AND COLLEGE OF HEALTH SCIENCES CAMPUS (NELSON R MANDELA
SCHOOL OF MEDICINE AND ASSOCIATED HEALTH SCIENCES) ............................................ 3
3. THE NEW KING EDWARD VIII CENTRAL HOSPITAL .................................................................. 4
3.1. CALCULATION OF TERTIARY BEDS ........................................................................... 5
3.2. ALLOCATION OF BEDS ................................................................................................. 6
4. SERVICE PACKAGES: NKECH AND IALCH ................................................................................. 7
5. NEW ACADEMIC COMPLEX: THE COLLEGE OF HEALTH SCIENCES (NELSON R MANDELA
MEDICAL SCHOOL WITH ASSOCIATED HEALTH SCIENCES) .................................................. 8
5.1. PROPOSED STUDENT INTAKE .................................................................................... 8
5.2. HEALTH CAMPUS : AREA ALLOCATION AND COSTS ............................................... 9
6. COMPLETE ACADEMIC COMPLEX: FINANCIAL IMPLICATIONS ........................................... 10
6.1. NEW KING EDWARD VIII CENTRAL HOSPITAL ........................................................ 10
6.2. TOTAL PROJECT COST .............................................................................................. 10
ANNEXURE B: ACCOMODATION SCHEDULE AND HIGH LEVEL COSTING
ANNEXURE C: DISTRIBUTION OF BEDS
3

LIST OF TABLES
Table 1: Top 25 causes of death in KZN, 2009, Stats SA 8
Table 2: KEH Current clinical services and beds in use 12
Table 3: The Business Case bed numbers to be reconfigured as follows 12
Table 4: Business Case bed allocation for the revitalisation of the existing KEH 12
Table 5: Enabling projects at King Edward VIII Hospital 13
Table 6: Current King Edward VIII Hospital beds at St Aidans Hospital 13
Table 7: Current bed allocation at IALCH 16
Table 8: Proposed Division of Services between IALCH and the NKECH 19
Table 9: Tertiary Hospitals in KZN 20
Table 10: Population Projections 21
Table 11: Bed Ratios per service 21
Table 12: The new proposed bed distribution between NKECH and IALCH 22
Table 13: Detailed Bed Allocation per hospital by subspecialties 23
Table 14: Student intake 40
Table 15: Preliminary High Level Cost Estimate for NKECH 41
Table 16: Preliminary High Level Cost Estimate for IALCH 42
Table 17: Preliminary High Level Areas and Cost for the College of Health Sciences 43
Table 18: Preliminary High Level Total Cost of Propose 44
LIST OF DIAGRAMS
Diagram 1: Aerial View of the existing King Edward VIII Hospital 10
Diagram 2: Aerial view of Proposed Site 14
Diagram 3: Proposed New Site for the New King Edward VIII Central Hospital
and Health Sciences Campus 15
Diagram 4: Relationship Drawing: NKECH and the Health Science Campus 17
Diagram 5: Relationship Drawing of the Hospitals and the Health Science Campus 20
Diagram 6: Relationship Drawing: NKECH and the Health Science Campus 25
Diagram 7: New King Edward VIII Central Hospital: Departmental Relationships 34
Diagram 8: College of Health Sciences: Teaching Disciplines 37
4

MAP 1: Indicating the Provinces in South Africa
5
eThekweni in the
province of
KwaZulu-Natal

1. INTRODUCTION
Accessible and appropriate healthcare has been established as a basic right in terms of the South
African Constitution. However there are challenges to the successful delivery of health care services
which the Medium Term Strategic Framework (MTSF) 2009-2014 identifies. The medium term
base to ensure universal access to basic
service packages throughout the country for all levels of care in order to reduce mortality, increase life
expectancy, reduce the incidence of HIV, decrease the TB case load and generally improve the
health care systems effectiveness. The key elements to achieve an effective delivery of health care
services include human resources, infrastructure and finance.
A National Health initiative was proposed which aims to address the current problems facing health
service delivery and significantly increase the number of health professionals by investing in the future
training of health professionals and scientists as well as in relevant health research. To effectively
achieve this, adequate infrastructure will have to be constructed (or existing upgraded) to
accommodate the necessary health services and teaching platform. The Minister of Health, as part of
this initiative, identified 6 flagship projects with the objective to provide central services while
improving teaching platforms throughout the country.
The new King Edward VIII Central Hospital (NKECH) is one of these ministerial flagship hospitals
identified to be built to provide central/tertiary services with an academic component for clinical health
science education and training. In KwaZulu Natal (KZN) alone, it is planned to increase the training
output of doctors from 220 to 880.
Investigations have commenced to ascertain the feasibility of the project as well as affordability of the
different procurement options, including the option of a public private partnership (PPP), to provide
the best technical, clinical, financial and legal solutions to deliver the NKECH.
Parallel to this process, a competition for the design of the NKECH was launched at the Design &
Health Conference in July 2012 at Kuala Lumpur. The design competition includes NKECH and the
College of Health Sciences which includes the Nelson R Mandela School of Medicine and associated
Health Sciences, on a site identified on the University of KwaZulu-Natal (UKZN) campus.
The purpose of this document is therefore to outline the strategic objectives, define the service needs,
the teaching requirements and recommend an option for the new service delivery and teaching
platform.
6

2. STRATEGIC OBJECTIVES
Though the NKECH project will be managed by National Department of Health, the Service
Transformation Plan (STP) 2010 -2020 for the KZN province had to be consulted too as it outlines the
plan for
Health System 10 point plan, the Medium Term Strategic Framework (MTSF) (specific to outcome 2 -
A long and healthy life for all South AfricansService Delivery Agreement (specific
to the four identified strategic health outcomes); the Millennium Development Goals (MDG)(goals 4,5
and 6); the 5 year Strategic Plan (SP) of the KwaZulu-Natal Department of Health (KZNDoH) and
current and future health care needs and services in KwaZulu-Natal.
A number of the strategic goals and objectives of the KZN SP include:
Expand and sustain the Registrar training programme and retain 75% of qualified Registrars
by 2014/15;
Rationalise hospital services in line with service delivery needs and STP imperatives
A number of the guiding principles of the KZN STP include:
Health care services delivered by well trained, skilled, competent and caring staff;
The configuration of Tertiary and Central Hospital services in line with the long term vision of
the Department;
Implementing cost effective service delivery models including Public Private Partnerships.
The aim being to transform the KZN health care system to provide sustainable, equitable, and high
quality health care services to all citizens in the Province.
Population
KZN is the second most populous Province in South Africa with an estimated total population of
10,467,466 in 2010. 54% of the population lives in the rural areas accordoing to Stats SA, 10.7% of
the population is under 5 years; 34% under the age of 14 years; 62.4% between 16-64 years
(economically active) and 5% is 65 years or older.
Epidemiology & Health Profile
The National decline in life expectancy is considered to be largely due to HIV & AIDS and TB.
According to mid-year estimates (Stats SA) the life expectancy of males in KZN is estimated at 49.1
years and females 50.2 years. Fertility rates declined to an average of 2.87 children per woman.
The quadruple burden of disease including traditional diseases of poverty (malnutrition and diarrhoeal
disease in children): injuries caused by road traffic accidents and violence; non communicable
diseases including heart disease, strokes and diabetes; and the explosive rise of infectious diseases
with the advent of the HIV epidemic and TB have a significant impact on health outcomes in the
province. (STP 2010-2020)
The National Burden of Disease study identifies TB, gastroenteritis, pneumonia, hypertension and
cancer as the most common causes of mortality in public hospital.A significant proportion of the
burden of disease is attributable to communicable diseases and nutritional, maternal and peri-natal
conditions
Diarrhoeal and respiratory conditions are the common causes of mortality and morbidity. Pneumonia
and diarrhoea are the two leading caused of mortality and morbidity in children under 5 years of age.
7

Table 1: Top 25 causes of death in KZN, 2009, Stats SA
Cause N Total
Ill defined natural 83,208 13.8%
Respiratory tuberculosis 66,500 11.1%
Lower respiratory infections 58,375 9.7%
Intestinal infectious diseases 40,850 6.8%
HIV/AIDS 38,751 6.4%
Cerebrovascular disease 2 5,321 4.2%
Diabetes mellitus 20,139 3.4%
Injuries with undetermined intent 20,128 3.3%
Heart failure 16,465 2.7%
Hypertensive heart disease 13,381 2.2%
Ischaemic heart disease 12,506 2.1%
Other infectious diseases 8,981 1.5%
Exposure to unspecified factor 8,930 1.5%
COPD 8,867 1.5%
Meningitis 8,427 1.4%
Endocrine nutritional, blood and 6,305 1.0%
immune disorders
Asthma 6,228 1.0%
Road injuries 6,038 1.0%
Extrapulmonary tuberculosis 5,749 1.0%
Septicaemia 5,186 0.9%
Miliary tuberculosis 5,008 0.8%
Mechanical forces; firearm 4,903 0.8%
Interpersonal violence without 0.8%
firearm 4,813
Trachea/bronchi/lung cancer 4,689 0.8%
Other respiratory disease 4,386 0.7%
Top 25 causes 484,134 80.5%
All causes 601,133 100.0%
Organisational Environment
There were 64,924 employees in the Department of Health at the end of March 2010 compared with
67,594 in 2008/09. Vacancy rates are high ie. 41.6% for Medical Officers;65.9% for Medical
Specialists; 25.7% for Professional Nurses; and 76.4% for Pharmacists. The significant increase in
the vacancy rates is a challenge to service delivery
Hospital Categories:
Hospitals are categorized into district hospitals, regional hospitals, tertiary hospitals, central hospitals
and specialized hospitals (tuberculosis hospitals, mental health hospitals and rehabilitation centres).
The categories and level of services for each hospital type are listed in the Government Gazette of
the 2nd of March 2012, section 90 of the National Health Act of 2003.
8

Tertiary Hospitals
Tertiary services:
- Specialist level services provided by regional hospitals
- Subspecialities of above
- Intensive care services under the supervision of a specialist intensivist
- Receives referrals from regional hospitals not limited to provincial boundaries
- Has between 100 and 800 beds
Central Hospitals
- Provide tertiary hospital services and central referral services and may provide national
referral services
- Must provide training of health care providers;
- Must conduct research
- Receive patients referred to it from more than one province
- Must be attached to a medical school as the main teaching platform and
- Could have a maximum of 1200 beds
Central referral services are provided in highly specialised units, require unique , highly skilled scarce
personnel and at a small number of sites nationwide.
Review of the STP and SP for the province has revaealed that there are two major issues that affect
the planning of the New King Edward Central Hospital (NKECH):
Population growth which is driving the need for more bed numbers in all categories
throughout the province and
Human resources which cannot keep up with the current service provision let alone future
needs. Post vacancies are high especially those of medical doctors, specialists (in some
instances as high as 46%) and nurses (26%)
Provision of improved academic facilities to enable the training of more health care personel in all
categories is essential. The NKECH and College of Health Sciences will substantially contribute to
alleviating these issues.
9

3. INSTITUTIONAL ANALYSIS : EXISTING FACILITIES
In order to fully understand the scope of services required for this project, it had been necessary to
conduct a needs assessment, investigating the existing services at King Edward VIII Hospital (KEH)
and Inkosi Albert Luthuli Central Hospital (IALCH) in relation to the Strategic Plan (SP) for the
Province. Services at St Aidans Hospital need to be considered too as they have tertiary services
temporarily located there from King Edward VIII Hospital.
EXISTING KING EDWARD VIII HOSPITAL (KEH)
provision prior to 1994.This legacy is reflected in the poor infrastructure and deteriorating buildings
that now exist, which has been further compounded by the lack of adequate maintenance since that
date.
For many years it has been the only academic hospital for the training of black doctors in the country.
The hospital has been expanded over the years to a 1 900 bed facility with makeshift temporary
structures (huts), which became a permanent feature for decades. No proper upgrading facilities
were undertaken for many years, as a New Durban Academic Hospital was planned by the then Natal
Provincial Administration. These plans, however, were put on hold by the then Central Government,
favouring the redevelopment of the hospitals serving certain medical schools in the other provinces
. Diagram 1: Aerial View of the existing King Edward VIII Hospital
Prior to 1994, KEH had a bed occupancy rate of well over 100% with many floor beds in certain
disciplines. A daily patient load in excess of 3 000 patient per day was not uncommon. Despite this
heavy workload, the hospital has a proud record of excellent service to the disadvantaged. In
health.
Since 1993, the health services in South Africa opened to all races. Consequently, the pressure on
the services at KEH abated. The demolition of the temporary huts on site led to a reduction of the
bed state of the hospital to 1 300 beds. With the commissioning of the Inkosi Albert Luthuli Central
Hospital (IALCH), the bed state was further reduced to 981 beds. The bed occupancy rate also
10

stabilized to a more manageable level of around 70%. With the refurbishment presently occurring on
the N & I ward blocks, the bed numbers have further reduced to the current number of 799 beds. This
is expected to go up to 922 once the renovations are complete.
KEH is one of the larger hospitals in the country catering for 1,2 million people. Lack of capacity in
other regional hospitals in the Durban Functional Region and the inability of IALCH to provide enough
tertiary care for the province has resulted in KEH still having to care for a large portion of the province
regarding tertiary services.
Existing Services:
922 bed Hospital (789 beds currently with 157 temporarily situated at St Aidans Hosptal)
providing Regional and Tertiary services. Wards at KEH are currently being upgraded
which has necessitated services being located to St Aidans Hospital temporarily. These
are planned to be re located back to KEH on completion of the upgrade.
.
A Teaching Hospital associated with the Nelson R Mandela School of
Medicine, UKZN, providing undergraduate and postgraduate training.
In 1996, resulting from evidence provided by the Health Facilities Audit and various other reports, the
Department of Health decided that, due to the general level of dilapidation and the ad hoc planning of
the existing hospital, renovation of the existing buildings at KEH would not be cost effective.
A proposal was submitted suggesting that the existing hospital be replaced by an entirely new
hospital designed to occupy the same site and interact with those buildings identified to be of good
condition and location to be retained. Architects were commissioned to provide sketch plans for this
purpose. Plans for a 1 000 bed hospital were completed and presented to the Department in 1997.
the view to reduce the Hospital to 800 beds and to rationalise some of the outpatient content.
Resulting from this, a new set of master plans was prepared. Unfortunately the request for funding of
KEH, as the first revitalization project, was turned down. The project could not be funded from the
KZN Health budget without adversely affecting service delivery, therefore the project was placed on
hold.
The project was identified as an urgent project in July 2005 after a visit by the Minister of Health, who
then requested that a Business Case for project selection, under the Revitalisation Grant, be
submitted.
11

Table 2: KEH Current clinical services and beds in use
CURRENT DEPARTMENTS KEH BEDS IN USE
Paediatrics 128
Gynaecology 35
Obstetrics including high care beds 152
Medical 146
Surgical 204
Acute wards 24
Orthopaedics 80
Psychiatric 20
TOTAL 789
St Aidans Hospital 157 (Tertiary)
A Business Case for the revitalisation of KEH was prepared and submitted to National Department of
Health in 2006 and was approved in 2009.
Table 3: The Business Case bed numbers to be reconfigured as follows:
HOSPITAL
ORIGINAL BED
ALLOCATION
CURRENT BED
ALLOCATION
PROPOSED BED
ALLOCATION
King Edward VIII Hospital 981 799 850
TOTAL 981 799 850
Transit beds were allowed for patients referred from Port Shepstone and Stanger, based on the
assumption that these patients would stay 2 days in transit per admission.
Lodger mother beds were provided for at Neonatology. These beds were allowed for mothers of
Neonates referred from rural areas.
Table 4: Business Case bed allocation for the revitalisation of the existing KEH
KING EDWARD VIII HOSPITAL: PROPOSED BED ALLOCATION (BUSINESS CASE)
PUBLIC ALLOCATED
NETT
REQUIRED
Regional discharge 45 45
Tertiary discharge 21 21
Sub-acute oncology - 36
Regional 452 452
Central and Tertiary 212 212
TB, recurrent - -
TB.MDR - -
Long term care - -
Hospice step down - -
Psychiatric beds - -
20 Non TB spinal and 20 Burns 40
Transit 30
Transit/Hostel lodger mother 14
Transit/Hostel social welfare -
TOTAL 730 850
(The above includes the services currently at St Aidans Hospital)
12

Enabling Work To The Existing Hospital
In the absence of progress on the NKECH and, due to the critically poor state of the existing hospital,
it became necessary to upgrade the facilities at KEH to enable service delivery to continue
adequately. This necessitated the initiation of a number of projects to ensure continued health service
and to provide conditions suitable for both patients and staff at the existing hospital.
Table 5: Enabling projects at King Edward VIII Hospital
1
2
3
KING EDWARD HOSPITAL
Project
Improve Ventilation To ARV (Philani) Clinic and upgrade. Renovation to 20
ward kitchens in all blocks. Partitioning and upgrade of male and female
psychiatric ward and completion of 2nd seclusion. Upgrade ARV Clinic,
Accident and Emergency Canopy and Convert old N theatre block into
allied services
Final phase of upgrades to existing staff residence: fire escape, ventilation,
improve sanitary conditions and recreational facilities
Demolition of old paediatric outpatient department (awaiting MOPD
contract completion)
4 Refurbishment of lifts to S, N & I Blocks.
5 Storm water repair and unblocking
6 Upgrade of MOPD
7 Upgrade of theatre block, ICU & high care
Tertiary services tempoarily located at St Aidans Hospital
Table 6: Current King Edward VIII Hospital beds at St Aidans Hospital
CURRENT BEDS
ST. AIDANS HOSPITAL
BEDS IN USE
Adult & Paediatric High Care
Surgery
8
Urology 36
Plastic Reconstructive 52
Ophthalmology Adults 37
Ophthalmology Paediatrics 3
General Paediatrics 21
TOTAL 157
13
Status
Tender
documentation
Tender award
pending appeal
Design
Tender awarded.
Awaiting delivery
of equipment.
Design report
received with
estimates.
Design concept
complete.
Design
investigations
complete,
awaiting concept
proposal

Revitalisation of the existing King Edward VIII Hospital
The proposed KEH project identified in the business case, submitted in 2006, comprised the
redevelopment of KEH as a Regional Hospital service with Tertiary services that would provide a
comprehensive level of care.
There were three options identified at business case stage, are as follows:
1. Phased Construction
2. Single Phased Construction on existing site
3. Building on alternative site
All three options were carefully analysed, advantages and disadvantages were identified for all three.
The resolution was to build on an alternative site. Negotiations began with UKZN, who offered a
site adjacent to the proposed new Health sciences campus. The site is on the same road (Francois
road) as the existing hospital, approximately 1 km inland.
PROPOSED NEW SITE FOR A NEW KING EDWARD VIII HOSPITAL
Diagram 2 : Aerial view of Proposed Site
14

IALCH
New Site
Diagram 3 :Proposed New Site for the New King Edward VIII Central Hospital
and Health Sciences Campus
15
UKZN

INKOSI ALBERT LUTHULI HOSPITAL
Table 7: Current bed allocation at IALCH
CURRENT BEDS
INKOSI ALBERT LUTHULI HOSPITAL
TOTAL BEDS IN
CRITICAL CARE
BEDS USE
Coronary/Cardio-thor care 14 14
Adult ICU/HC 46 43
Paeds ICU/HC 40 32
Neonatal ICU/HC 20 20
Trauma ICU/HC 16 16
Adults Burns 16 16
Paeds Burns 16 16
SURGICAL DISCIPLINES
Neurosurgery 64 64
Orthopaedics 32 32
Urology 20 20
Cardio-Thoracic 64 64
Plastic-Reconstructive 32 32
Vascular 32 32
Ophtalmology 8 8
Paediatric surgery 96 96
Specialised surgical units 26 26
MEDICAL DISCIPLINES
Cardiology 32 32
Pulmonology 10 10
Gastro-enterology 10 10
Endocrinology 10 10
Nephrology 25 25
Neurology 25 25
Haematology 18 18
Oncology 25 25
Rheumatology 24 24
Dermatology 4 4
PAEDIATRIC DISCIPLINES
Subspecialties 32 32
Haematology-oncology 25 25
OBSTETS & GYNAECOLOGY
Obstetrics 32 32
Gynaecology 32 32
TOTALS 846 835
16

4. PROPOSAL FOR THE NEW KING EDWARD VIII CENTRAL HOSPITAL
AND COLLEGE OF HEALTH SCIENCES CAMPUS (NELSON R MANDELA
SCHOOL OF MEDICINE AND ASSOCIATED HEALTH SCIENCES):
In 2010, National Health took over the planning of the NKECH and it was registered as a PPP. The
Transactional Advisor (TA) was appointed in 2011 and clinical task team meetings commenced.
Clinical task teams have met to establish the requirements for the new Central Hospital in line with
services currently provided at IALCH. The proposals for the bed allocations have been reviewed
against the KZN 2010-2020 STP. Special care has been taken to incorporate the optimal utilisation of
IALCH into the planning of the new hospital.
To comply with the national imperative to increase the number of health professionals significantly the
planning for the new Academic Health Sciences Complex has taken into account the fact that an
essential component in this strategy is an increase and improvement in the teaching platform, and the
unification and consolidation of the health sciences campus.
The following configuration is therefore proposed:
An academic health complex that will comprise of two major precincts
An academic hospital
A health sciences campus for the College of Health Sciences
Diagram 4: Relationship Drawing: NKECH and the Health Science Campus
Residences
Teaching and Learning
Centre College Administration
and Support
School of Clinical
Medicine
Maternal and Child
Health
Adult Acute Care
Emergency
Entrance
UNIVERSITY
School of Health
Sciences
CENTRAL FACILITY
Highly Specialisd
Services
17
School of
Laboratory
Medicine
Adult Comprehensive
Care
Research Centre
School of
Nursing & Public
Health
Ambulatory Care Facilities Ambulatory Care Facilities
HOSPITAL
Ambulatory Care Facilities

The main purpose is to provide Tertiary and Central Hospital services and to create a platform for the
training of all cadres of health care workers. The objective would be to render Central and Quaternary
Hospital services as well as Tertiary Hospital services.
A new College of Health Sciences Campus is being planned, incorporating all 4 schools of Health
Sciences (School of Clinical Medicine, School of Health Sciences, School of Laboratory Medicine
and School of Nursing and Public Health) and will be adjacent to the NKECH.
The NKECH will have central hospital status, but will incorporate the case mix of a tertiary hospital,
which include a regional component.
IALCH and the NKECH will complement each other and not compete,
The NKECH will constitute the flagship hospital for the training of undergraduate students and the
training of registrars at the more generalist level.
The purpose of the NKECH is to provide a comprehensive set of specialized services that will include
specialties not included in regional or district hospitals including but not limited to Cardiology,
Pulmonology, Nephrology, ENT, Infectious Diseases and Paediatric surgery.
With emphasis on reducing the infant and maternal mortality rate, a recommendation for the creation
of a mother and child pavilion has been made and will concentrate much needed specialized services
in one facility.
Integration with Inkosi Albert Luthuli Central Hospital
The following recommendations were made:
1. IALCH and NKECH should be viewed and administered as one complex with a common
Academic/Professional staff.
2. Functionally IALCH is divided into a number of units offering high-level, integrated and
multidisciplinary services for the province.
3. These units are multidisciplinary and cut across traditional disciplines.
4. Professional staff may therefore work in both hospitals.
These units are:
- IALCH Heart Centre
Elective cardiology, cardiac intervention and cardiac surgical services. (Coronary care unit
and acute cardiac intervention are provided at NKEH.);
- IALCH Renal & Transplant Centre
Investigation, workup and initiation of chronic dialysis and CPD, renal transplantation, liver,
heart and bone marrow transplantation;
- IALCH Neurosciences Centre
Elective neurology and neurosurgery services, neuropsychiatric and
neurogeriatric services, and geriatrics;
- IALCH Cancer Centre
Medical, surgical and radiation treatment for cancer;
- IALCH Burns Centre
- IALCH Assisted Reproduction Service
IVF facilities.
18

Table 8: Proposed Division of Services between IALCH and the NKECH
IALCH
Central and Tertiary services
Critical care
Oncology centre
Cardiology
Cardiothoracic surgery
Burns centre
Ophthalmology centre
Plastic surgery centre
Renal centre
Transplant centre
Neurosciences
Geriatrics
Psychiatry
Neurosurgery
Stroke unit
Internal Medicine
Infectious Diseases
Rheumatology
Surgery
Orthopaedics
Vascular surgery
Urology
ENT
Maxillo facial
In Vitro Fertilisation
Dermatology
Radiology
Nuclear medicine
NKECH
Central and Tertiary services
Mother and Child
Hospital
Adult Hospital
Critical care Critical care
Obstetrics Acute Cardiology
Paediatrics Acute Cardiothoracic
Paediatric
surgery
surgery Acute Stroke unit
Paediatric Pulmonology
Oncology Endocrinology
Paediatric Rheumatology
Radiology Dermatology
Neonatology Infectious Diseases
Isolation unit
Trauma centre
Victims of violence
Orthopaedics
General surgery
Urology
Vascular surgery
ENT
Maxillo Facial
Gynaecology
Radiology
Nuclear medicine
19

MOTHER & CHILD
HOSPITAL
New King Edward Viii
Central Hospital
Central/Tertiary/Regional
Shared
Support
services
Diagram 5 : Relationship Drawing of the Hospitals and the Health Science Campus
5. BED CALCULATION FOR TERTIARY AND CENTRAL BEDS
SITUATIONAL ANALYSIS : (Source: KZNDoH STP 2010-2020)
The designated Tertiary and Central Hospitals provide highly specialized care to a total population of
9,426,003 in KZN
Table 9: Tertiary Hospitals in KZN
COLLEGE OF HEALTH SCIENCES
Nelson R Mandela School of Medicine
& Associated Health Sciences
ADULT
HOSPITAL
Interconnected
Hospital Total
Beds
20
Inkosi Albert Luthuli
Central Hospital
Central Services
Existing
Tertiary
Beds
Future
Tertiary
Beds
Inkosi Albert Luthuli Central Hospital provides 100%
Tertiary package of services
846 846 846
Greys Hospital provides 80% Tertiary and 20% Regional 530 424
package of services
640
Ngwelezane Hospital provides 33% Tertiary, 42%
Regional and 25% District package of services
859 286 429
Lower Umfolozi War Memorial - Mother & Child Hospital 283 140 140
Addington Hospital - Oncology 500 32 32
King Edward (St Aidans ) 157 157
TOTAL TERTIARY BEDS AVAILABLE IN KZN 1885 2244

Table 10: Population Projections
The projected population, to 2022 was calculated by KZNDoH Strategic Planning and bed allocations
were derived from that figure.
2001 census 2005 2006 2007 2008 2009 2010 2011 2012
9,426,017 9,706,711 9,778,180 9,850,176 9,922,703 9,995,763 10,069,361 10,143,501 10,218,187
2013 2014 2015 2016 2017 2018 2019 2022
10,293,423 10,369,212 10,445,560
(Source: Stats SA midyear estimates)
Table 11: Bed Ratios per service
10,522,470
Breakdown of ratios per type
of bed type
Beds
per
1000
pop
12,232,026
(population
2022)
Stepdown / Sub Acute 0.35 4281
Level 1 GP 0.75 9174
Level 2 Specialist 0.25 3058
Level 3 Tertiary (SS)
Psychiatry (includes long term
0.22
2,691
patients)
0.05 611
TB 0.26 2,859
TB MDR 0.03 330
TOTAL 1.91 23 004
The total tertiary beds for the service platform including NKECH and IALCH were compiled:
1. Shortfall tertiary beds plus 447 beds
2. IALCH Central beds 846 beds
3. Oncology beds from Addington 32 beds
4. St Aidans Tertiary beds 157 beds
TOTAL SERVICE PLATFORM: TERTIARY BEDS 1482 beds
beds, the oncology beds from Addington were
included and so were the 157 tertiary beds from St Aidans Hospital to total 1482 beds before the
beds were divided up between the two facilities, NKECH and IALCH, according to the clinical
disciplines. Emphasis was placed on the best service delivery package whereby, in some instances, a
whole service would be provided at a facility.
21
10,599,946
10,677,993
10,756,614
12,232,026
Available Tertiary beds - 2,244 beds existing
Calculations indicate - 2,691 beds allowed
Shortfall of - 447 beds

6. BED DISTRIBUTION
The following table was compiled with reference to:
the STP 2010-2020 Allocation of services
Allocation of services between NKECH and IALCH,
the above calculation of Tertiary beds,
various Clinical task team meetings whereby clinical personnel and KZNDoH professional
staff informed the process by virtue of their knowledge of the existing and envisaged burden
of disease, Teaching needs as well as future clinical development envisaged for the KZN
province.
Table 12: The new proposed bed distribution between NKECH and IALCH
Notes:
CLINICAL DISCIPLINE
HOSPITAL BEDS
PROPOSED NEW
NKECH
CENTRAL/TERTIARY
The Teaching platform will consist of 1482 Tertiary beds and 109 regional beds, which
will provide the tertiary case mix as requested for training of Primary health care
professionals. Total bed numbers for NKECH was increased during an optimising
exercise of the Clinical task team to 850, after adding 68 Transit beds and 109 Regional
beds to the allocated 673 Tertiary beds.
This allowed for two balanced hospitals with sufficient Tertiary and Regional beds to
provide for effective central and tertiary service delivery as well as the training of
Primary health care professionals, Specialist training and Subspecialist training.
It was not possible during the abovementioned optimising exercise to allocate the balance
of 37 beds at IALCH to a specific discipline. By increasing the Radiation oncology
capacity at IALCH however, with subsequent new equipment space requirements, it was
recommended by the Clinical task team that the reduction of bed numbers at IALCH be
accepted and the space utilised to help accommodate the radiation equipment.
Lodger mother beds and Short stay beds were not included in total bed numbers
22
PROPOSED
IALCH
CENTRAL
Paediatrics
inc. neonates
300 20
Gynaecology 30 40
Obstetrics including high care
beds
98 0
Medical 101 205
Surgical 126 251
Acute wards 77 63
Orthopaedics 50 32
Psychiatric 60
Oncology 70
Transplants 10
Burns 30
Transit 68 28
TOTAL 850 809

Table 13 : Detailed Bed Allocation per hospital by subspecialties
BED ALLOCATION:
NKECH IALCH BEDS IN
PLATFOR
M
DISCIPLINE
Mother
& Child
Adult
Care
Sub
Total
Sub
Total
Total
All
MATERNITY 110 110
Obstetrics 90 90
Obstetric High Care 8 8
Transit Beds 12 12
NEONATOLOGY 50 50
Neonatal General 6 6
Neonatal HC 27 27
Neonatal ICU 17 17
*Mother Lodger Beds 15 15
PAEDIATRICS 138 138
Admission ward 16 16
Acute tertiary 39 39
Adolescent unit 6 6
Regional beds 16 16
Infectious diseases 3 3
Metabolic unit 3 3
Nephrology 6 6
Neurolgy 4 4
Cardiology 12 12
Haematology/Oncology 0 0
Onco reverse isolation 3 3
Endocrinology 4 4
Pulmonology 4 4
Rheumatology 4 4
Gastroenterology 4 4
Transit Beds 14 14
*Mother Lodger Beds 15 15
PAEDIATRIC SURGERY 110 110
Surgery 36 36
Neurosurgery 9 9
Plastic & Recon. Surgery 9 9
Orthopaedics 18 18
Cardiothoracic 12 12
Ophthalmology 3 3
ENT surgery 9 9
Transit Beds 14 14
PAEDIATRIC
It was recommended to place these beds at King
PSYCHIATRY
George V Psychiatric Hospital
Psychiatry 0 0
PAEDIATRIC CRITICAL
CARE
30 20 50
ICU 10 10
ICU isolation 7 7
High Care 13 13
Burns 0 20 20
GYNAECOLOGY 30 40 70
Gynaecology 30 40 70
Reproductive medicine 0 0
TRANSPLANTATION 10 10
Organ transplant centre 10 10
ONCOLOGY
Radiation
70 70
Medical 70 70
23

BED ALLOCATION:
NKECH
IALCH
BEDS ON
PLATFORM
Moth Adult Sub Sub Total
er & Care Total Total All
DISCIPLINE
Child
ADULT ACUTE CARE
Critical Care Incl Acute Cor
77 93 170
Care & Acute Stroke Unit 27 63 90
*Medical Admission Ward
16
16
*Surgical Admission Ward 16 16
*Medical Short Stay 16 16
*Surgical Short Stay 16 16
Adult burns unit 24 24
Adult burns HC unit 6 6
Trauma ICU 6 0 6
Trauma HC 12 0 12
ADULT COMPREHENSIVE
CARE - MEDICAL
115 219 334
Internal Medicine 335 58 88
Pulmonology 12 11 22
Endocrinology 12 11 22
Rheumatology 12 11 22
Infectious diseases 12 6 12
Infectious diseases isolation 12 6 12
Dermatology 6 6 6
Haematology 12 6 12
Elective cardiology 30 30
Geriatric medicine 10 10
Nephrology 30 30
Neurology 20 20
Transit 14 14 28
ADULT COMPREHENSIVE
CARE - SURGICAL
190 297 487
General surgery 33 26 59
Orthopaedics 50 32 82
Trauma general 30 30
Urology general 28 10 38
Vascular surgery 18 18
ENT general 10 15 25
Plastic/recon surgery 30 30
Maxillofacial surgery 7 5 12
Cardiothoracic surgery 176 60 60
Neurosurgery 65 65
Ophthalmology 40 40
Transit 14 14 28
PSYCHIATRY 60 60
Psychiatric 48hour
Observation ward
10 10
Psychogeriatric unit 20 20
Neuropsychiatric unit 20 20
Adolescent unit 10 10
TOTAL 438 412 850 809 1659
24

7. NEW ACADEMIC COMPLEX: KING EDWARD VIII CENTRAL HOSPITAL
AND THE COLLEGE OF HEALTH SCIENCES
The University and Province of KwaZulu-Natal share a common purpose: to improve the well-being of
our citizens by providing quality health-care, and by investing in the future with the training of
excellent health professionals and scientists as well as the performance of relevant research.
To comply with the national imperative to increase the number of health professionals significantly the
planning for the new Academic Health Sciences Complex has taken into account the fact that an
essential component in this strategy is an increase and improvement in the teaching platform, and the
unification and consolidation of the health sciences campus.
The following configuration is therefore proposed:
An academic health complex that will compromise of two major precincts
An academic hospital
A health sciences campus for the College of Health Sciences
The following schematic illustrates the envisaged interrelationship of the various components of the
complex. It is not to scale and does not necessarily reflect the actual geographic relationships of the
various components.
Residences
Teaching and Learning
Centre College Administration
and Support
School of Clinical
Medicine
Maternal and Child
Health
Adult Acute Care
Emergency
Entrance
UNIVERSITY
School of Health
Sciences
Adult Comprehensive
Care
CENTRAL FACILITY
Highly Specialisd
Services
Diagram 6: Relationship Drawing: NKECH and the Health Science Campus
25
School of
Laboratory
Medicine
Research Centre
School of
Nursing & Public
Health
Ambulatory Care Facilities Ambulatory Care Facilities
HOSPITAL
Ambulatory Care Facilities

7.1. THE NEW KING EDWARD VIII CENTRAL HOSPITAL
The hospital will provide state of the art facilities across the health continuum for the promotion of
health, prevention of disease, diagnosis and treatment of disease and rehabilitation of patients.
The hospital will be designed on the following principles:
Efficient, logical patient flow with the entry and exit to specific facilities at the closest point and
minimal mixing of patients en route to specific areas
Promotion of integrated inter-, multi- and trans-disciplinary care
Promotion of ambulatory on-going care and day-stay treatment in facilities with an identity
distinct from that of the in-patient facilities
Integration of Hospital and CHS campus into a single academic complex.
Integration with Inkosi Albert Luthuli Central Hospital
Since IALCH is an existing central hospital situated in close proximity to the new Academic Hospital,
special care has been taken to incorporate IALCH into the planning of the new hospital to maximise
synergies, avoid duplication and wherever possible, prevent splitting of services across the two
hospitals.
The following recommendations are made:
5. IALCH and NKECH should be viewed and administered as one complex with a common
Academic/Professional staff.
6. Functionally IALCH is divided into a number of units offering high-level, integrated and
multidisciplinary services for the province.
7. These units are multidisciplinary and cut across traditional disciplines.
8. Professional staff may therefore work in both hospitals.
These units are:
- IALCH Heart Centre
Elective cardiology, cardiac intervention and cardiac surgical services. (Coronary care unit
and acute cardiac intervention are provided at NKEH.);
- IALCH Renal & Transplant Centre
Investigation, workup and initiation of chronic dialysis and CPD, renal transplantation, liver,
heart and bone marrow transplantation;
- IALCH Neurosciences Centre
Elective neurology and neurosurgery services, neuropsychiatric and
neurogeriatric services, and geriatrics;
- IALCH Cancer Centre
Medical, surgical and radiation treatment for cancer;
- IALCH Burns Centre
- IALCH Assisted Reproduction Service
IVF facilities.
26

Affiliated Units and Standard Facilities:
Audiology, Dietetics, Occupational Therapy, Pharmacy, Physiotherapy, Speech & Language Therapy
The New King Edward Hospital will comprise two functional precincts:
A mother and child facility
An adult facility
7.1.1. MOTHER AND CHILD PAVILION
This will include obstetric and paediatric services. Patients will access these services via one or more
dedicated entrances. Both will have facilities for clinical training.
MATERNAL HEALTH
The obstetric unit should have easy access to the Gynaecology area of the main hospital to facilitate
intradepartmental cohesion.
Inpatient facilities
Antenatal and postnatal wards,
Facilities for the delivery of infants
Obstetric operating theatre suite. Each theatre to have paediatric ressuscitation facilities
situated such that ressuscitation is screened from the mother.
Obstetric high care unit
Obstetric radiology
Neonatal nursery, neonatal high care unit and neonatal intensive care unit.
Outpatient facilities
Antenatal clinic, including specialised antenatal clinics such as cardiac, diabetic and high-risk
pregnancy clinics.
Dedicated fetal unit for the investigation of the high-risk fetus, including sophisticated
sonography
CHILD HEALTH
The child health facility will be designed to incorporate two principal considerations:
Specifically designed to accommodate the physical and psychosocial needs of children
A focus on interdisciplinary integration.
27

Inpatient facilities
Paediatric Medical Wards (incorporating subspecialist medical disciplines)
Paediatric Surgical Wards (incorporating subspecialist surgical disciplines such as
neurosurgery, general surgery, ENT, ophthalmology, orthopaedics, plastic and reconstructive
surgery, cardiothoracic surgery)
Paediatric isolation facilities
Adolescent medical ward (age 10-16)
Paediatric operating theatre suite catering for both general surgery and the specific needs of
orthopaedic, neurosurgical, urological, cardiothoracic, ENT and ophthalmic surgery)
Paediatric emergency and trauma unit with an entrance and identity separate from but
preferably adjacent to the adult facility
Sexual violence assessment unit
Paediatric radiology facilities with the proviso that certain more complex modalities of
investigation may be provided in a central hospital radiology department.
Paediatric burns unit
Paediatric high care unit and intensive care unit
Paediatric renal dialysis facility.
Since inpatient services will be integrated at ward level, specific disciplines may require specialised
equipment (e.g. apparatus for ENT examination) in proximity to the wards.
Outpatient facilities
Outpatient facilities should reflect an emphasis on integrated ambulatory and day care rather than
hospital-based care,should have an identity distinct from the inpatient facility and preferably be sited
adjacent to but distinct from the inpatient complex:
Shared interdisciplinary clinic facilities in a number of mini-pavilions
Paediatric medical and surgical day-care wards
Developmental disabilities and early childhood screening and intervention facilities
Additional facilities
Hospital school
Paediatric physiotherapy, occupational therapy, audiology, speech and language therapy
Paediatric clinical psychology service
Social services
Dedicated pharmacy, preferably in continuity with main pharmacy facilities
Dedicated dietetics and child nutrition services
Parent's Lodge for the accommodation of the parents of hospitalised children
28

7.1.2. THE ADULT PAVILION
The Adult Hospital is divided functionally into further precincts: an Adult acute care facility and an
Adult comprehensive care facility. There will be facilities for clinical training.
Adult Acute Care Facility
This is a multidisciplinary facility which will focus on the reception and management of acutely ill
patients.
Integrated trauma and emergency reception centre
An extensive trauma and emergency reception centre serving a role as a regional referral
centre, containing facilities for triage, assessment, ressuscitation, radiological investigation
and treatment, including assessment of burns
Helipad and emergency ambulance reception facilities
Trauma operating theatres adjacent to Trauma Area but contiguous with main theatre
complex
Admission and observation wards
Multidisciplinary medical short-stay and observation ward
Multidisciplinary surgical short-stay and observation ward (including gynaecology)
Multidisciplinary trauma short-stay and observation ward
Medical admission ward
Surgical/gynaecological admission ward
Critical care facilities
Medical semi-open high care ward
Surgical semi-open high care ward
Multidisciplinary closed high care ward
Multidisciplinary intensive care unit
Coronary Care Unit
Cardiac catheterisation / Hybrid theatre
Support facilities
Dedicated emergency radiology facility, with the proviso that certain more complex modalities
of investigation may be provided in a central radiology department.
Facilities for emergency gastroscopy
29

7.1.3. ADULT COMPREHENSIVE CARE PAVILION
This will provide medical, surgical and gynaecological services. Patients will be referred from the adult
acute care facility following initial assessment and stabilisation, admitted electively or from outpatient
facilities.
This facility will have a strong focus on inter-, multi- and trans-disciplinary integration. There will be
facilities for clinical training.
Inpatient facilities
Medical wards (incorporating subspecialist medical disciplines)
Surgical wards (incorporating subspecialist surgical disciplines such as general surgery, ENT,
ophthalmology, orthopaedics, plastic and reconstructive surgery, cardiothoracic surgery)
Orthopaedic wards
Gynaecology Wards
Isolation unit for infectious diseases including a secure unit for the reception of highly
contagious diseases e.g. viral haemorrhagic fever
Maxillofacial unit equipped with dental chairs.
Given the intention that services will be integrated but that specific disciplines may require specific
facilities (for example apparatus for ENT examination), these specific facilities be situated in close
proximity to wards.
All wards to have procedure rooms, family rooms and counselling rooms
Special facilities
Bronchoscopy suite
Pulmonary function laboratories
Endoscopy suite
Dedicated pharmacy (part of the Main Pharmacy block but dedicated to service all wards and
departments)
Inpatient acute dialysis unit
Dietetics and nutrition services e.g. total parenteral nutrition, naso-gastric feeds etc.
Maxillofacial surgery department with dental chairs and associated services
Outpatient facilities
Outpatient facilities should reflect an emphasis on integrated ambulatory and day care rather than
hospital-based care,should have an identity distinct from the inpatient facility and preferably be sited
adjacent to but distinct from the inpatient complex:
Shared interdisciplinary clinic facilities in a number of mini-pavilions with an identity distinct
from the inpatient facility, situated adjacent to the inpatient complex.
Medical, surgical and gynaecological day-care wards.
Rehabilitation facilities in the form of inter alia relevant physiotherapy, occupational therapy,
audiology and speech therapy (shared with highly specialized services pavilion)
Clinical psychology service
Each mini-pavilion will be fully self-contained with the reception area, waiting areas, procedure areas
and provision for medical practitioners, advanced nursing practitioners, social workers and other
health professional staff in addition to standard nursing and reception staff.
Each clinic will contain one or more consulting rooms suitable for demonstration or discussion of
patients to student groups of up to 20 individuals.
30

Other facilities
Multidisciplinary Care Center comprising the following:
An integrated facility for physiotherapy, occupational therapy, audiology, speech therapy,
orthotics and prosthetics and rehabilitation medicine providing, designed for easy access for
both inpatient and outpatient clients
Facilities for clinical training of students in pharmacology, physiotherapy, occupational
therapy, optometry (in concert with ophthalmology), audiology, speech and language
pathology with envisaged expansion to include comprehensive oral and dental care.
Shared reception and staff facilities.
Special facilities
Cardiac catheterisation theatre / Hybrid theatre
Bronchoscopy suite
Pulmonary function laboratories
Endoscopy suite
Outpatient facilities
Clinic facilities in one or more mini-pavilions to the same specifications described above,
catering for medical and surgical gastroenterology, cardiology, haematology and transplant
patients
General-purpose day-care ward
Rehabilitation facilities in the form of inter alia relevant physiotherapy, occupational therapy,
audiology and speech therapy (shared with adult comprehensive care pavilion)
Each clinic will be fully self-contained with provision for medical practitioners, advanced nursing
practitioners, social workers and other health professional staff in addition to standard nursing and
reception staff.
SHARED FACILITIES
Surgery
Operating theatre suite catering for both general surgery and the specific needs of orthopaedic,
neurosurgical, urological, cardiothoracic, ENT and ophthalmic surgery)
Radiology
Comprehensive radiology facilities including angiography, PET, CT and MRI
Radiation Therapy
This should be designed as a freestanding facility which may be placed off site at the nearby Inkosi
Albert Luthuli Central Hospital.
Pharmacy
This central service to the maternal and child facility, the adult acute care facility, adult comprehensive
care facility , the facility for highly specialized services as well as associated out-patients.
This should be easily accessible to all areas of the hospital and for the recipt of goods. The
department should encompass all aspects of the pharmacy including but not limited to manufacturing,
pre-packing, cytotoxic and radio=pharmaceutical preparation areas.
31

Clinical Research Centre
A clinical research centre catering for approximately 30-50 overnight-stay patients and 30-50 walk-in
patients:
Overnight stay facilities for approximately 30-50 patients
Procedure room
Recreational facilities for patients
Offices
General-purpose laboratory
Data capture
Storage Facilities
Dispensary
Additional Support Services
Social services
Central pharmacy
Records Department
Blood bank
Security control room
Management
Hospital management suite
Staff facilities
On-call accommodation in close proximity to the hospital
Residential staff accommodation
Staff recreational facilities
Staff cafeterias
Limited office accommodation for professional staff: it is intended that academic professional
staff will be accommodated in a facility on the adjacent College of Health Sciences campus.
Radiology and Anaesthetics however require offices for professional staff proximate to their
clinical areas.
On-call facilities
On-call accommodation for staff
On-call accommodation for students
Meeting rooms
500-seater lecture theatres (2)
Rooms for clinical meetings and seminars in proximity to the wards
Clinical demonstration rooms in proximity to wards are large enough to accommodate two
patients in beds and up to 20 students per bed.
Centrally situated meeting and seminar rooms
Facilities for telehealth and teleconferencing.
Patient facilities
Cafeteria, shops etc.
Transit lounge/overnight accommodation for discharged patients awaiting transport
32

Industrial and service area
Steam and gas generation
Transport and logistics, maintenance, engineering services, standby generators, electrical
substation, chiller plant rooms etc.
Laundry
Kitchen
Information technology area with training facility
Stores with offices
Workshops
Registry and archives
Condemned equipment
CSSD Garden services
Cleaning services
HT and electronic repair workshops
Laboratory services
Plant rooms
Electrical sub stations
Mortuary and forensic pathology
Waste consolidation
External environmentally friendly and well landscaped areas designed to integrate with the
natural environment of the site. Those areas adjacent to the mother and child when to include
children's play areas.
Dedicated covered goods receipt area attached to the Pharmacy ar ground level
Parking facilities
33

Diagram 7: New King Edward VIII Central Hospital: Departmental Relationships
Car
Park
Adult
Out
patients
WARDS
ENTRANCE
to
ADULT
HOSPIT
AL
Radiology
PHARMACY
Emergency
Parking
Trauma
ICU and
High
Care
Wards
SPECIALIST
ENTRANCE to
Trauma Unit
EMERGENCY THEATRE
THEATRES
& CSSD
34
Trauma
Unit
Code
red
Orange
PAEDIATRIC
ADMINISTRATION
HOSPITAL
SUPPORT
SERVICES
Shared Services
EMERGENCY
OBSTETRICS
THEATRE
Delivery suite
Obstetrics
Out Patients
OBSTETRIC
WARDS
ENTRANCE
to Mother &
Child
Hospital
MOTHER &
CHILD
HOSPITAL
Car
Park
Paediatric
Out
patients
PAEDIATRIC
WARDS

8. THE COLLEGE OF HEALTH SCIENCES CAMPUS
The College of Health Sciences campus will be fully integrated into the larger academic health
complex. Functionally it will comprise six areas.
The requirement is for a facility which promotes excellent health science training and research in an
integrated and multidisciplinary fashion. It is required to cater for the training of students in the
professions of medicine, nursing, pharmacy, physiotherapy, oral and dental therapy, speech therapy,
as well as the education of science-track students in related sciences such as anatomy, physiology,
sports science, neurophysiology, etc as well as research in all these disciplines.
Six functional areas are envisaged.
The following four areas should be in close proximity, preferably housed in separate pavilions. The
teaching and learning and research pavilions should be designed to facilitate expansion (possibly
vertically) to cater for future need.
Administration and shared services
Accommodation for the four Schools
Teaching and Learning Centre
Research Centre
The fifth area comprises student residences and amenities.
The sixth area is reserved for an envisaged future dental school.
AREA 1: ADMINISTRATION CENTRE
Management Suite
Management suite housing the DVC and Head of College, Dean of Teaching and Learning,
Dean of Research and Director of Professional Services
Boardroom
Committee rooms
College Office
Accommodation for approximately 60 College support staff in a combination of singleoccupant
offices for managers and open-plan offices for the majority of staff
Associated facilities such as registry, facilities for copying and printing, reception of monies
etc.
Central Facilities
Health Sciences Library
Information and Communication Services
Security Control Room
Facilities for Staff and Students
Cafeteria, bookshop etc
35

Student Services
Student counselling
Campus clinic
Conference facility
500 seater lecture Theatre separate from the teaching and learning centre
reception area
offices
catering facilities
AREA 2: SCHOOL ACCOMMODATION
Four school office blocks for the Schools of Clinical Medicine, Laboratory Medicine and Medical
Sciences, Health Sciences and Nursing and Public Health, each to the following specifications:
School Office with accommodation for approximately 40 support staffing a combination of
single occupant offices for managers and open plan offices for the majority of staff
Boardroom, committee room and associated services.
Office accommodation for approximately 150 academic staff
Rest areas, meeting, seminar and committee rooms
This area is to be designed with the intention of maximising interaction between academics and
integration between disciplines.
36

AREA 3: TEACHING AND LEARNING CENTRE
School of
Clinical Medicine
Prof R Hift (Dean &
HOS)
Mrs AS Botha (Manager)
Anaesthetics
Cardiology
Cardiothoracic Surgery
Dermatology
Endocrinology
Gastroenterology
General Medicine
General Surgery
Geriatrics
Infectious Diseases
Nephrology
Neurology
Neurosurgery
Obstetrics & Gynaecology
Ophthalmology
Orthopaedic Surgery
Otorhinolaryngology
Paediatrics & Child Health
Paediatric Surgery
Plastic & Reconstructive
Surgery
Psychiatry
Pulmonology
Radiology
Radiotherapy & Oncology
Rheumatology
Urology
COLLEGE OF HEALTH
SCIENCES
Acting-DVC: Prof R Slotow
Director: Prof SJ Botha
School of Laboratory
Medicine & Medical Sciences
Prof W Daniels
(Dean & HOS)
Mr M Tufts
(Manager)
Anatomical Pathology
Chemical Pathology
Forensic
Medicine/Pathology
Haematology
Microbiology & Infection
Control
Virology & HIV Medicine
Anatomy
Medical Biochemistry
Physiology
Biomedical Resource Unit
Diagram 8: College of Health Sciences: Teaching Disciplines
37
School of Health
Sciences
Prof S Essack (Dean &
HOS)
Mr V Govender
(Manager)
Audiology
Dentistry
Occupational Therapy
Optometry
Pharmacy & Pharmacology
(including
Therapeutics & Medicines
Management)
Speech Language Pathology
School of Nursing &
Public Health
Prof B Ncama (Dean &
HOS)
Ms C Newman
(Manager)
Behavioural Medicine
Family Medicine
Occupational &
Environmental Health
Public Health
Rural Health
Telehealth
Nursing

Lecture Venues
500 seater large lecture venues (6)
250 seater teaching venue (2)
100 seater teaching venue (4)
25 seater small-group teaching menus (60)
Laboratories
400 seater multipurpose laboratory
400 seater skills laboratory
200 seater multipurpose laboratory
200 seater skills laboratory
100 seater skills laboratories (4)
100 seater biochemistry laboratories
100 seater physiology laboratory
Radiopharmacy& aseptic pharmacy training suite
Examination hall
500 seater flat-space examination hall which may double as a flat-space meeting venue
Practical demonstration areas
Appropriately equipped teaching facilities for each of the following professional disciplines:
Optometry
Audiology
Speech and language pathology
Physiotherapy
Occupational therapy
Pharmacy
Biokinetics
Dietetics and Nutrition
Oral and Dental Care
Clinics
Dedicated clinics and clinical training areas suitably equipped for consultation and therapy in:
o dietetics and nutrition,
o pharmacy,
o oral and dental care,
o optometry,
o audiology,
o speech and language pathology,
o physiotherapy,
o occupational therapy (including the Centre for Occupational Performance
Assessment and Rehabilitation),
o biokinetics and sports medicine,
with appropriate reception area, records, support facilities etc. A shared clinic and clinical
training area suitably equipped for consultation and therapy in dietetics and nutrition,
pharmacology, oral and dental care, optometry, audiology, speech and language pathology,
physiotherapy, occupational therapy, biokinetics and sports medicine, with appropriate
reception area, records, support facilities etc.
38

Other
500 seater computer centre
Anatomy Dissection Hall and associated facilities including plastination
Audiovisual Laboratory
AREA 4
A fully equipped research centre with facilities for biochemical, physiological, microbiological
and genetics research
A research commons with study and social facilities for postgraduate students
AREA 5
Student accommodation for approximately 2000 students
Recreational and support services for approximately 1500 students
AREA 6: RESEARCH CENTRE
Multipurpose laboratories with facilities for microbiological, biochemical and physiological
research
Specialised laboratories for e.g drug development and design, cell culture etc.
Postgraduate study area including 200 seater lecture theatre, seminar rooms, open plan
computer access facility etc.
Office accommodation for technical staff
Workshop
Stores, gas stores etc
AREA 7: STUDENT RESIDENCES AND AMENITIES
Residential facilities for approximately 1200 students
Associated amenities
AREA 8: ENVISAGED DENTAL SCHOOL
Space to be set aside for a proposed dental school to be undertaken as a future project.
SERVICE FACILITIES
Technical Workshops
Plant Rooms
Garden storage
Security
Parking
39

PROPOSED STUDENT INTAKE
Table 14: Student intake
Programme/Discipline First Intake of UG Students Total Number to be
Accommodated
Medicine 500 3000
Audiology 40 160
Biokinetics, Exercise & Leisure
Sciences
100 400
Dentistry 60
(40 Dentistry+ 40 Dental
Therapy + 20 Oral Hygiene)
380
Occupational Therapy 60 240
Optometry 50 200
Pharmacy 200 800
Physiotherapy 100 400
Speech Language Pathology 40 160
TOTAL 1150 5740
40

9. ACADEMIC COMPLEX: FINANCIAL IMPLICATIONS
9.1. NEW KING EDWARD VIII CENTRAL HOSPITAL
Cost estimate calculation:
No. of Tertiary beds = 673
No of Regional beds = 109
No of Transit beds = 68
Total beds = 850
Area per bed = 110m²
850 x 110m² = 93754m²
Total Gross Area: Net usable area + Balance area = gross
Table 15: Preliminary High Level Cost Estimate for NKECH
NKECH Total cost Cost per bed Cost per m²
Estimated building cost R 2 103 942 635 R 2 475 226 R 22 441.10
Estimated professional fees 18% R 378 709 674
Total building cost (if complete in Aug 2012) R 2 482 652 309
Health Technology Costs(if complete in Aug 2012) R 1 077 120 000 R 1 267 200 R 11 488.79
Commissioning cost(if complete in Aug 2012) R 17 872 966 R 21 027 R 182.02
Total current project cost(if complete in Aug 2012) R 3 577 645 275 R 4 208 994 R 38 159.92
VAT @ 14% R 500 870 338
TOTAL COST R 4 078 515 614 R 4 798 253 R 43 502.31
Note: Space Allocation and Costing calculated according to SAHNORM and correlated
with the Infrastructure Unit Support Systems Project
41

9.2. INKOSI ALBERT LUTHULI CENTRAL HOSPITAL
IALCH will require upgrading and alterations to create the different proposed new structures
and departments. The Oncology Centre will require sophisticated radiation equipment which
includes 6 linear accelerators and an allowance for 2 future bunkers, 2 brachytherapy rooms,
2 after loader, 2 ultra sound rooms and 2 hyperbaric chambers which is included in the
costing below.
Table 16: Preliminary High Level Cost Estimate for IALCH
IALCH Total cost Cost per
bed
Estimated building cost R 137 719 298
Estimated professional fees 18% R 24 789 473
Total building cost (if complete in Aug 2012) R 162 508 772
Health Technology Cost(if complete in Aug 2012) R 197,000,000
Commissioning cost(if complete in Aug 2012) R 264,000
Total current project cost(if complete in Aug 2012) R 359 772 772
VAT @14% R 50 368 188
TOTAL COST R 410 140 960
42
Cost per m²

9.3. COLLEGE OF HEALTH SCIENCES CAMPUS
Table 17: Preliminary High Level Areas and Cost for the College of Health Sciences
COLLEGE OF HEALTH SCIENCES
TOTAL STUDENTS TO BE ACCOMODATED = 5740
A TEACHING AREAS
AREA RATE COST
1 STAFF OFFICES AND RESEARCH SPACES 33575m² R 15 000.00 R 503 625 000.00
2
ADMINISTRATIVE, TECHNICAL, SECRETARIAL,
ETC 4517m² R 10 000.00 R 45 170 000.00
3 CLASSROOM, SEMINAR ROOMS, ETC 2613m² R 10 000.00 R 26 130 000.00
4 PRECLINICAL MEDICINE LABORATORIES 41054m² R 15 000.00 R 615 810 000.00
5
6
7
CLINICAL RESEARCH SPACE INCLUDING
ANCILLARIES 416m² R 18 000.00 R 7 488 000.00
ADDED SPACE FOR AUDIOVISUAL TO LECTURE
HALLS 585m² R 10 000.00 R 5 850 000.00
MAIN AND SATELITE LIBRARIES @
1.25m²/STUDENT 9327m² R 8 000.00 R 74 620 000.00
B ADMINISTRATION
1
CENTRAL ADMINISTRATION AND
MAINTANANCE 5270m² R 10 000.00 R 57 200 000.00
C AMENITY AREAS 7215m² R 10 000.00 R 72 150 000.00
D RESIDENTIAL ACCOMODATION 27600m² R 8 500.00 R 234 600 000.00
SPORTS FACILITIES
INDOOR 600m² R 10 000.00 R 6 000 000.00
OUT DOOR 2400m² R 4 000.00 R 9 600 000.00
PARKING 9000m² R 480.00 R 4 320 000.00
TOTAL excluding VAT R 1 662 563 000.00
Add Professional fees @ 18% R 299 261 340
SUBTOTAL R 1 961 824 340
VAT @14% R 274 655 407
TOTAL (Baseline September 2012) 144 172m² R 2 236 479 748
43

Table 18: Preliminary High Level Total Cost of Proposed Project
Total cost
NEW KING EDWARDS CENTRAL HOSPITAL R 4 078 515 614
INKOSI ALBERT LUTHULI CENTRAL HOSPITAL R 410 140 960
ACADEMIC CAMPUS R 2 236 479 742
TOTAL COST R 6 725 136 316
The above total costs are high level estimations. These figures will be influenced by any number of
unknowns on the site and a more accurate cost estimate will be possible after some physical planning
has been carried out.
10. CONCLUSION
The intensive needs analysis conducted to establish the services and teaching platform that will be
required for KZN, has shown clearly that by 2022 there will be a shortfall of 447 Tertiary service beds
in KZN and that the existing KEH, which has a planned 212 Tertiary beds provided for in the Business
case, will not be suitable to provide those beds as the condition of the hospital buildings is extremely
poor and the site too small for expansion of services. In spite of the fact that the hospital is
undergoing an upgrade to several departments, the classification of the existing KEH still has to be
finally resolved to determine the services the hospital will eventually provide.
It follows that the 212 Tertiary beds be removed from KEH and be incorporated in the NKECH.
combining the 447 shortfall tertiary beds with those of IALCH and then distributing the services
between IALCH and NKECH, will avoid duplication of services and create a comprehensive tertiary
and central teaching and service delivery platform to KZN and UKZN.
As the Academic Campus, incorporating the Nelson R Mandela School of Medicine and associated
Health sciences, will be linked to the NKECH and IALCH, this will improve the platform for the
training of professional medical staff in keeping with the initiative by the Department of Health to
produce more skilled professionals in the health field.
This document is a penultimate draft as a further Sensitivity test will still be done on the bed numbers
to determine the appropriateness with respect to the Teaching requirements, Service delivery as well
as the provision of sufficient tertiary and regional beds for KZN.
Based on the outcome of this test, a further optimization of the Bed numbers could be undertaken.
44

ANNEXURE A

COLLEGE OF HEALTH SCIENCES
AND THE
NEW CENTRAL HOSPITAL PLATFORM
KWAZULU-NATAL
3rd September 2012
Executive Summary
PENULTIMATE DOCUMENT

CONTENT
1. INTRODUCTION ............................................................................................................................. 3
2. PROPOSAL FOR THE NEW ACADEMIC COMPLEX: NEW KING EDWARD VIII CENTRAL
HOSPITAL AND COLLEGE OF HEALTH SCIENCES CAMPUS (NELSON R MANDELA
SCHOOL OF MEDICINE AND ASSOCIATED HEALTH SCIENCES) ............................................ 3
3. THE NEW KING EDWARD VIII CENTRAL HOSPITAL .................................................................. 4
3.1. CALCULATION OF TERTIARY BEDS ........................................................................... 5
3.2. ALLOCATION OF BEDS ................................................................................................. 6
4. SERVICE PACKAGES: NKECH AND IALCH ................................................................................. 7
5. NEW ACADEMIC COMPLEX: THE COLLEGE OF HEALTH SCIENCES (NELSON R MANDELA
MEDICAL SCHOOL WITH ASSOCIATED HEALTH SCIENCES) .................................................. 8
5.1. PROPOSED STUDENT INTAKE .................................................................................... 8
5.2. HEALTH CAMPUS : AREA ALLOCATION AND COSTS ............................................... 9
6. COMPLETE ACADEMIC COMPLEX: FINANCIAL IMPLICATIONS ........................................... 10
6.1. NEW KING EDWARD VIII CENTRAL HOSPITAL ........................................................ 10
6.2. TOTAL PROJECT COST10
2

1. INTRODUCTION
The new King Edward VIII Central Hospital (NKECH) is one of the ministerial flagship hospitals
identified to be built to provide central / tertiary services with an academic component for clinical
health science education and training. In KwaZulu Natal (KZN) alone, it is planned to increase the
training output of doctors from 220 to 880.
Investigations have commenced to ascertain the feasibility of the project as well as affordability of the
different procurement options, including the option of a public private partnership (PPP), to provide
the best technical, clinical, financial and legal solutions to deliver the NKECH.
The purpose of this document is therefore to define the service needs and teaching requirements,
recommend an option for the new service delivery and teaching platform and finally present high level
costing for the project.
2. PROPOSAL FOR THE NEW ACADEMIC COMPLEX: NEW KING EDWARD
VIII CENTRAL HOSPITAL AND COLLEGE OF HEALTH SCIENCES
CAMPUS (NELSON R MANDELA SCHOOL OF MEDICINE AND
ASSOCIATED HEALTH SCIENCES)
To comply with the national imperative to increase the number of health professionals significantly the
planning for the new Academic Health Sciences Complex has taken into account the fact that an
essential component in this strategy is an increase and improvement in the teaching platform, and the
unification and consolidation of the health sciences campus.
The following configuration is therefore proposed:
An academic health complex that will comprise of two major precincts
An academic hospital
A health sciences campus for the College of Health Sciences
The following schematic illustrates the envisaged interrelationship of the various components of the
complex. It is not to scale and does not necessarily reflect the actual geographic relationships of the
various components.
3

Diagram 1: Relationship Drawing: New Central Hospital and the Health Science Campus
Residences
Teaching and Learning
Centre College Administration
and Support
School of Clinical
Medicine
Maternal and Child
Health
Adult Acute Care
Emergency
Entrance
UNIVERSITY
School of Health
Sciences
Adult Comprehensive
Care
CENTRAL FACILITY
Highly Specialisd
Services
3. THE NEW KING EDWARD VIII CENTRAL HOSPITAL
In 2010, Department of National Health took over the planning of the NKECH and it was registered as
a PPP project. The Transactional Advisor (TA) was appointed in 2011 and clinical task team meetings
commenced.
Clinical task teams have met to establish the requirements for the new Central Hospital in line with
services currently provided at IALCH. The proposals for the bed allocations have been reviewed
against the KZN 2010-2020 STP and calculation of Tertiary beds for KZN according to the IHPF. This
was achieved in close co-operation with the KZNDoH.
Special care was also taken to align the planning of services with the needs of the KZN province with
valuable input from Strategic planning and Hospital services from KZNDoH.
4
School of
Laboratory
Medicine
Research Centre
School of
Nursing & Public
Health
Ambulatory Care Facilities Ambulatory Care Facilities
HOSPITAL
Ambulatory Care Facilities

3.1. Calculation of Tertiary Beds
Table 4: Tertiary Hospital Beds in KZN existing and Future
Hospital Total
Beds
5
Existing
Tertiary
Beds
Future
Tertiary
Beds
Inkosi Albert Luthuli Central Hospital provides 100%
Tertiary package of services
846 846 846 809
Greys Hospital provides 80% Tertiary and 20%
Regional package of services
530 424 640 640
Ngwelezane Hospital provides 33% Tertiary, 42%
Regional and 25% District package of services
859 286 429 429
Lower Umfolozi War Memorial - Mother & Child
Hospital
283 140 140 140
Addington Hospital - Oncology 500 32 32
King Edward (St Aidans ) 157 157
Allocated
Tertiary
Beds
TOTAL TERTIARY BEDS AVAILABLE IN KZN 1885 2244 2018
Table 5: Population Projection
The projected population, to 2022 was calculated by KZNDoH Strategic Planning and bed numbers
were derived from that figure.
10,218,187
2012 2022
12,232,026
The total Tertiary beds for the service platform including NKECH and IALCH were compiled:
(i) Shortfall tertiary beds 447 beds
(ii) IALCH Central beds 846 beds
(iii) Oncology beds from Addington 32 beds
(iv) St Aidans Tertiary beds 157 beds
TOTAL SERVICE PLATFORM: TERTIARY BEDS 1482 beds

3.2. Allocation of Beds
The following table was compiled with reference to:
the STP,
Allocation of services between NKECH and IALCH,
the above calculation of Tertiary beds,
various Clinical task team meetings whereby clinical personnel and KZNDoH professional
staff informed the process by virtue of their knowledge of the existing and envisaged burden
of disease, Teaching needs as well as future clinical development envisaged for the KZN
province.
TABLE 14: THE NEW PROPOSED BED DISTRIBUTION BETWEEN NKECH AND IALCH
Notes:
CLINICAL DISCIPLINE
HOSPITAL BEDS
PROPOSED NEW
NKECH
CENTRAL/TERTIARY
The Teaching platform will consist of 1482 Tertiary beds and 109 regional beds, which will
provide the tertiary case mix as requested for training of Primary health care professionals.
Total bed numbers for NKECH was increased during an optimising exercise of the Clinical task
team to 850, after adding 68 Transit beds and 109 Regional beds to the allocated 673 Tertiary
beds.
This allowed for two balanced hospitals with sufficient Tertiary and Regional beds to provide
for effective central and tertiary service delivery as well as the training of Primary health care
professionals, Specialist training and Subspecialist training.
It was not possible during the abovementioned optimising exercise to allocate the balance of 37
beds at IALCH to a specific discipline. By increasing the Radiation oncology capacity at IALCH
however, with subsequent new equipment space requirements, it was recommended by the
6
PROPOSED
IALCH
CENTRAL
Paediatrics
inc. neonates
300 20
Gynaecology 30 40
Obstetrics including high care
beds
98 0
Medical 101 205
Surgical 126 251
Acute wards 77 63
Orthopaedics 50 32
Psychiatric 60
Oncology 70
Transplants 10
Burns
St.Aidans Temporary
30
Transit 68 28
TOTAL 850 809

Clinical task team that the reduction of bed numbers at IALCH be accepted and the space
utilised to help accommodate the radiation equipment.
Lodger mother beds and Short stay beds were not included in total bed numbers
4. Service packages: NKECH and IALCH
Table 8: Proposed Division of Services between IALCH and NKECH
IALCH
Central and Tertiary services
Critical care
Oncology centre
Cardiology
Cardiothoracic surgery
Burns centre
Ophthalmology centre
Plastic surgery centre
Renal centre
Transplant centre
Neurosciences
Geriatrics
Psychiatry
Neurosurgery
Stroke unit
Internal Medicine
Infectious Diseases
Rheumatology
Surgery
Orthopaedics
Vascular surgery
Urology
ENT
Maxillo facial
In Vitro Fertilisation
Dermatology
Radiology
Nuclear medicine
NKECH
Central and Tertiary services
Mother and Child
Hospital
Adult Hospital
Critical care Critical care
Obstetrics Acute Cardiology
Paediatrics Acute Cardiothoracic
Paediatric
surgery
surgery Acute Stroke unit
Paediatric Pulmonology
Oncology Endocrinology
Paediatric Rheumatology
Radiology Dermatology
Neonatology Infectious Diseases
Isolation unit
Trauma centre
Victims of violence
Orthopaedics
General surgery
Urology
Vascular surgery
ENT
Maxillo Facial
Gynaecology
Radiology
Nuclear medicine
This document is a penultimate draft as a further Sensitivity test will still be done on the bed numbers
to determine the appropriateness with respect to the Teaching requirements, Service delivery as well
as the provision of sufficient tertiary and regional beds for KZN.
Based on the outcome of this test, a further optimization of the Bed numbers could be undertaken.
7

5. NEW ACADEMIC COMPLEX: THE COLLEGE OF HEALTH SCIENCES
(NELSON R MANDELA MEDICAL SCHOOL WITH ASSOCIATED HEALTH
SCIENCES)
5.1. Proposed Student Intake
Table 9: Student intake
Programme/Discipline First Intake of UG Students Total Number to be
Accommodated
Medicine 500 3000
Audiology 40 160
Biokinetics, Exercise & Leisure
Sciences
100 400
Dentistry 60
(40 Dentistry+ 40 Dental
Therapy + 20 Oral Hygiene)
8
380
Occupational Therapy 60 240
Optometry 50 200
Pharmacy 200 800
Physiotherapy 100 400
Speech Language Pathology 40 160
TOTAL 1150 5740

5.2. HEALTH CAMPUS : Area Allocation and Costs
Table 10: Academic Campus: Areas and Cost
ACADEMIC CAMPUS :
NELSON R MANDELA SCHOOL OF MEDICINE AND ASSOCIATED HEALTH SCIENCES
TOTAL STUDENTS TO BE ACCOMODATED = 5740
AREA RATE COST
A TEACHING AREAS
92087m² R 1 278 693 000.00
B ADMINISTRATION 5270m² R 57 200 000.00
C AMENITY AREAS 7215m² R 72 150 000.00
D RESIDENTIAL ACCOMODATION 39600m² R 254 520 000.00
TOTAL excluding VAT R 1 662 563 000.00
Add Professional fees @ 18% R 299 261 340
SUBTOTAL R 1 961 824 340
VAT @14% R 274 655 407
TOTAL (Baseline September 2012) 144 172m² R 2 236 479 748
9

6. COMPLETE ACADEMIC COMPLEX: FINANCIAL IMPLICATIONS
6.1. NEW KING EDWARD VIII CENTRAL HOSPITAL
Cost estimate calculation:
No. of Tertiary beds = 673
No of Regional beds = 109
No of Transit beds = 68
Total beds = 850
Area per bed = 110m²
850 x 110m² = 93754m²
6.2. TOTAL PROJECT COST
Table 13: Total Cost of Proposed Project
Area m² Total cost
NEW KING EDWARD CENTRAL HOSPITAL 93754m² R 4 078 515 614
INKOSI ALBERT LUTHULI CENTRAL HOSPITAL R 410 140 960
ACADEMIC CAMPUS 144172m² R 2 236 479 742
TOTAL 237926m² R 6 725 136 316
10

ANNEXURE B

ANNEXURE C