Patients in West Bromwich and Sandwell could be among the first to benefit from the new wave of ambulatory care and diagnostic centres.

David Roberts, acting chief executive of City Hospitals trust in Birmingham, says its£25m development, due to open in 2004, promises faster access to state-of-the-art equipment and includes an intermediate care facility.

'We are a large teaching hospital and we suffer just as everybody else does with emergency pressures which prevent us from routinely getting elective patients into and through the system, ' he says.

But he denies the new unit will lead to a reduction in beds in other parts of the trust. 'It will require us to think carefully about how we manage emergency demand while coping with the elective agenda. We do this already in our outpatients and day-surgery unit in a disjointed way but we will have to do it more efficiently. We have to look at how to get medical staff in the right place at the right time and how we get nurses with the right skills from the ward to the ambulatory environment. '

Fears the project's size would put off the major consortia proved unfounded. The trust has short-listed six bidders from an original list of 64. Mr Roberts believes this is good news for other projects. 'I met with every consortium on the NHS consortia list to explain what we were doing, but it paid dividends in the fact that we got so many people expressing interest in the project. I have no reason to doubt there will not be the same interest in the remaining diagnostic and treatment projects. '

He says the trust resisted requests from bidders to extend its specification to cover management of the new unit. 'We said: 'do not even think about clinical services and we do not see why you need to manage non-clinical services'' The trust has invited proposals for administration, such as the scheduling of outpatients. 'But we are not considering them as part of our proposal. ' Applications will be looked at as 'variations', but he does not think any will be put forward.